Suchergebnisse

BACKGROUND: In-depth analysis of the HIV pandemic at its epicenter in the Congo basin has been hampered by 40 years of political unrest and lack of functional public health infrastructure. In recent surveillance studies (2017-18), we found that the prevalence of HIV in Kinshasa, Democratic Republic of Congo (11%) far exceeded previous estimates. METHODS: 10,457 participants were screened in Kinshasa with rapid tests from 2017-2019. Individuals confirmed as reactive by the Abbott ARCHITECT HIV Ag/Ab Combo assay (n=1968) were measured by the Abbott RealTime HIV-1 viral load assay. Follow up characterization of samples was performed with alternate manufacturer viral load assays, qPCR for additional blood borne viruses, unbiased next generation sequencing, and HIV Western blotting. FINDINGS: Our data suggested the existence of a significant cohort (n=429) of HIV antibody positive/viral load negative individuals. We systematically eliminated collection site bias, sample integrity, and viral genetic diversity as alternative explanations for undetectable viral loads. Mass spectroscopy unexpectedly detected the presence of 3TC antiviral medication in approximately 60% of those tested (209/354), and negative Western blot results indicated false positive serology in 12% (49/404). From the remaining Western blot positives (n=53) and indeterminates (n=31) with reactive Combo and rapid test results, we estimate 2.7-4.3% of infections in DRC to be potential elite controllers. We also analyzed samples from the DRC collected in 1987 and 2001-03, when antiretroviral drugs were not available, and found similarly elevated trends. INTERPRETATION: Viral suppression to undetectable viral loads without therapy occurs infrequently in HIV-1 infected patients around the world. Mining of global data suggests a unique ability to control HIV infection arose early in central Africa and occurs in <1% of founder populations. Identification of this group of elite controllers presents a unique opportunity to study potentially novel genetic ...

Frontmatter -- Contents -- Illustrations -- Introduction -- Part 1 -- Women's History and Social History: Are Structures Necessary? -- The Querelle des Femmes as a Cultural Studies Paradigm -- Grammar in Arcadia -- The Girl and the Hourglass: Periodization of Women's Lives in Western Preindustrial Societies -- Part 2 -- Getting Back the Dowry: Venice, c. 1360–1530 -- Daughters, Mothers, Wives, and Widows: Women as Legal Persons -- Women Married Elsewhere: Gender and Citizenship in Italy -- Part 3 -- "Saints" and "Witches": in Early Modern Italy: Stepsisters or Strangers? -- The Dimensions of the Cloister: Enclosure, Constraint, and Protection in Seventeenth-Century Italy -- The Third Status -- Part 4 -- "Non lo volevo per marito: in modo alcuno": Forced Marriages, Generational Conflicts, and the Limits of Patriarchal Power in Early Modern Venice, c. 1580–1680 -- Becoming a Mother in the: Seventeenth Century: The Experience of a Roman Noblewoman -- Space, Time, and the Power of Aristocratic Wives in Yorkist and Early Tudor England, 1450–1550 -- Eighteenth-Century Marriage Contracts: Linking Legal and Gender History -- Part 5 -- En-Gendering Selfhood: Defining Differences and Forging Identities in Early Modern Europe -- Construction of Masculinity and Male Identity in Personal Testimonies: Hans Von Schweinichen (1552–1616) in His Memorial -- About the Contributors -- Index