No abstract

Background Data on SARS-CoV-2 vaccine immunogenicity in PLWH are currently limited. Aim of the study was to investigate immunogenicity according to current CD4 T-cell count. Methods PLWH on ART attending a SARS-CoV-2 vaccination program, were included in a prospective immunogenicity evaluation after receiving BNT162b2 or mRNA-1273. Participants were stratified by current CD4 T-cell count (poor CD4 recovery, PCDR: <200/mm 3; intermediate CD4 recovery, ICDR: 200-500/mm 3 high CD4 recovery, HCDR: >500/mm 3). RBD-binding IgG, SARS-CoV-2 neutralizing antibodies (nAbs) and IFN-γ release were measured. As control group, HIV-negative healthcare workers (HCWs) were used. Findings Among 166 PLWH after 1 month from the second dose, detectable RBD-binding IgG were elicited in 86.7% of PCDR, 100% of ICDR, 98.7% of HCDR, and a neutralizing titre ≥1:10 elicited in 70.0%, 88.2% and 93.1%, respectively. Compared to HCDR, all immune response parameters were significantly lower in PCDR. After adjusting for confounders, current CD4 T-cell <200/mm 3 significantly predicted a poor magnitude of anti-RDB, nAbs and IFN-γ response. As compared with HCWs, PCDR elicited a consistently reduced immunogenicity for all parameters, ICDR only a reduced RBD-binding antibody response, whereas HCDR elicited a comparable immune response for all parameters. Conclusion Humoral and cell-mediated immune response against SARS-CoV-2 were elicited in most of PLWH, albeit significantly poorer in those with CD4 T-cell <200/mm 3 versus those with >500 cell/mm 3 and HIV-negative controls. A decreased RBD-binding antibody response than HCWs was also observed in PLWH with CD4 T-cell 200-500/mm 3, whereas immune response elicited in PLWH with a CD4 T-cell >500/mm 3 was comparable to HIV-negative population.

No abstract

No abstract

outbreak of the monkeypox (MPX) virus and Siddiqui et al. 2 highlighted the current challenges of the ongoing epidemic, which include a lack of available treatment options for severe cases. Currently, little evidence supports antiviral therapy with cidofovir or tecovirimat for the treatment of severe MPX cases. 3,4 In this letter, we present the use of cidofovir for the treatment of hospitalized severe MPX cases.Overall, four men who have sex with men diagnosed with MPX infection between June and August 2022 at the Infectious Diseases Unit of San Raffaele Scientific Institute, Milan, Italy, were treated with cidofovir following hospitalization. Individual characteristics are presented in Table 1. Two individuals were living with human immunodeficiency virus (HIV), with an optimal immune-virologic status (CD4 + lymphocytes 676 and 1013 cells/µl and undetectable HIV-RNA within 6 months before MPX diagnoses), and one was taking HIV preexposure prophylaxis (PrEP). All reported high-risk sexual behaviors, >10 partners in the 3 months before their MPX diagnosis, and had a past medical history of sexually transmitted infections (STIs). Real-time polymerase chain reaction (RT-PCR) (RealStar ® Orthopoxvirus PCR Kit 1.0; Altona Diagnostics) targeting the variola virus and the nonvariola Orthopoxvirus species (cowpox, MPX, raccoonpox, camelpox, vaccinia virus) was used to detect nonvariola DNA on swabs and serum, plasma, seminal fluids, and urine samples and a specific RT-PCR targeting MPX virus DNA (Liferiver; Shanghai ZJ Bio-Rech Co., Ltd) subsequently confirmed MPX infections. No concurrent STIs were detected in all cases. Individuals were hospitalized for severe MPX involvement at different sites: (Case 1) pharyngeal and laryngeal MPX associated with dyspnea, dysphonia, and dysphagia; (Case 2) cutaneous and genital MPX with >50 lesions and suspected bacterial superinfection; (Case 3) rectal MPX with >30 perianal and intrarectal lesions with uncontrolled severe pain; (Case 4) ocular MPX with >10

No abstract

No abstract

No abstract