Suchergebnisse

Despite more than 300,000 rVSVΔG-ZEBOV-glycoprotein (GP) vaccine doses having been administered during Ebola virus disease (EVD) outbreaks in the Democratic Republic of the Congo (DRC) between 2018 and 2020, seroepidemiologic studies of vaccinated Congolese populations are lacking. This study examines the antibody response at 21 d and 6 mo postvaccination after single-dose rVSVΔG-ZEBOV-GP vaccination among EVD-exposed and potentially exposed populations in the DRC. We conducted a longitudinal cohort study of 608 rVSVΔG-ZEBOV-GP–vaccinated individuals during an EVD outbreak in North Kivu Province, DRC. Participants provided questionnaires and blood samples at three study visits (day 0, visit 1; day 21, visit 2; and month 6, visit 3). Anti-GP immunoglobulin G (IgG) antibody titers were measured in serum by the Filovirus Animal Nonclinical Group anti-Ebola virus GP IgG enzyme-linked immunosorbent assay. Antibody response was defined as an antibody titer that had increased fourfold from visit 1 to visit 2 and was above four times the lower limit of quantification at visit 2; antibody persistence was defined as a similar increase from visit 1 to visit 3. We then examined demographics for associations with follow-up antibody titers using generalized linear mixed models. A majority of the sample, 87.2%, had an antibody response at visit 2, and 95.6% demonstrated antibody persistence at visit 3. Being female and of young age was predictive of a higher antibody titer postvaccination. Antibody response and persistence after Ebola vaccination was robust in this cohort, confirming findings from outside of the DRC.

Background: There are few studies on HIV subtypes and primary and secondary antiretroviral drug resistance (ADR) in community-recruited samples in Brazil. We analyzed HIV clade diversity and prevalence of mutations associated with ADR in men who have sex with men in all five regions of Brazil.Methods: Using respondent-driven sampling, we recruited 3515 men who have sex with men in nine cities: 299 (9.5%) were HIV-positive; 143 subjects had adequate genotyping and epidemiologic data. Forty-four (30.8%) subjects were antiretroviral therapy-experienced (AE) and 99 (69.2%) antiretroviral therapy-naive (AN). We sequenced the reverse transcriptase and protease regions of the virus and analyzed them for drug resistant mutations using World Health Organization guidelines.Results: the most common subtypes were B (81.8%), C (7.7%), and recombinant forms (6.9%). the overall prevalence of primary ADR resistance was 21.4% (i.e. among the AN) and secondary ADR was 35.8% (i.e. among the AE). the prevalence of resistance to protease inhibitors was 3.9% (AN) and 4.4% (AE); to nucleoside reverse transcriptase inhibitors 15.0% (AN) and 31.0% (AE) and to nonnucleoside reverse transcriptase inhibitors 5.5% (AN) and 13.2% (AE). the most common resistance mutation for nucleoside reverse transcriptase inhibitors was 184V (17 cases) and for nonnucleoside reverse transcriptase inhibitors 103N (16 cases).Conclusions: Our data suggest a high level of both primary and secondary ADR in men who have sex with men in Brazil. Additional studies are needed to identify the correlates and causes of antiretroviral therapy resistance to limit the development of resistance among those in care and the transmission of resistant strains in the wider epidemic. ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through Brazilian Government ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through United Nations Office on Drugs and Crime-UNODC ; Department of STD, AIDS and Viral Hepatitis of the Ministry of Health ; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) ; Univ Fed Ceara, Dept Saude Comunitaria, BR-60430971 Fortaleza, Ceara, Brazil ; Universidade Federal de São Paulo, São Paulo, Brazil ; Tulane Univ, Sch Publ Hlth & Trop Med, New Orleans, LA USA ; Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil ; Univ Fed Bahia, Inst Saude Colet, BR-41170290 Salvador, BA, Brazil ; Univ Fed Rio de Janeiro, Rio de Janeiro, Brazil ; Univ Brasilia, BR-70910900 Brasilia, DF, Brazil ; Univ Calif San Francisco, San Francisco, CA 94143 USA ; Univ São Paulo, LIM 03, São Paulo, Brazil ; Universidade Federal de São Paulo, São Paulo, Brazil ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through Brazilian Government: AD/BRA/03/H34 ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through United Nations Office on Drugs and Crime-UNODC: AD/BRA/03/H34 ; Department of STD, AIDS and Viral Hepatitis of the Ministry of Health: CSV 234/07 ; FAPESP: 2004/15856-9 ; CAPES: BEX 3495/06-0 ; Web of Science

Advanced Breast Cancer (ABC) is a treatable but still generally incurable disease. The goals of care are to optimize both length and quality of life. Due to continuous research, several advances have been made, particularly for the HER-2-positive and for Luminal-like subtypes. Notwithstanding these advances, median overall survival of patients with ABC is still only 2e3 years, although the range is wide, and survival may be longer for patients treated in specialized institutions. Implementation of current knowledge is highly variable among countries and within each country. The use of treatment guidelines has been associated with a significant improvement in survival. This has been achieved mainly in early breast cancer. For ABC, and particularly metastatic breast cancer (MBC), less level 1 evidence exists and only recently have international consensus guidelines been developed (ABC1 e). The ABC Consensus Conference was created by the European School of Oncology (ESO) with the ambitious goal of improving outcomes for all patients with advanced breast cancer. Backed by strong political advocacy, ABC guidelines are seeking to improve standards of care, to raise awareness about how to best meet to the needs of this underserved group of patients, and to identify research priorities so that clinical research is focused on the most important areas of unmet need. Following the work of the ESO-ABC Task Force, created in 2005, and the successful undertaking of the 1st International Consensus Guidelines Conference on ABC (ABC1), held in November 2011, the 2nd International Consensus Conference for Advanced Breast Cancer (ABC2) took place in Lisbon, Portugal, on ; peer-reviewed

Two leaders engaged in international co-operation must each build trust by credibly signalling that they will not exploit the other by defecting at the implementation stage. Previous research does not reveal the difficulty and cost of such international reassurance. The role that costly adjustments by markets play in international reassurance is analysed, showing that fully efficient information revelation can be achieved when market actors under intense competitive pressures undergo sufficiently costly adjustments in expectation of international co-operation. 'Nice' leaders can reveal their true preferences simply by saying they intend to co-operate, because 'mean' leaders are unwilling to mislead market actors into undergoing futile costly adjustments. However, market imperfections prevent full information revelation unless market actors prefer international co-operation to the status quo. (British Journal of Political Science / FUB)