IntroductionThe most severe form of dengue virus (DENV) illness, dengue haemorrhagic fever, is characterised by plasma leakage and increased vascular permeability.ObjectivesGiven the critical role that endothelial cells play in the pathogenesis of DENV, we wanted to determine whether infection with DENV altered the expression of MHC class I related genes including HLA‐E.ResultsIn this study, we provide evidence that HLA‐E but not MICA/B or HLA‐G is upregulated by all four serotypes of DENV in an endothelial cell line human microvascular endothelial cells (HMEC)‐1. In contrast, Zika virus (ZIKV), a related flavivirus, where plasma leakage is not a major manifestation of disease, did not upregulate HLA‐E. We found modest levels of soluble HLA‐E in supernatants from DENV but not ZIKV‐infected cells. Coculture experiments found minimal activation of natural killer (NK) cells in the presence of both uninfected and infected HMEC‐1 cells. HLA‐E induced by DENV infection could not dampen the degranulation of activated NK cells by interacting with its ligand NKG2a.ConclusionsOur results suggest that while DENV infection induces HLA‐E, the high MHC class I expression on uninfected and infected HMEC‐1 cells may dominate the diverse signals generated between inhibitory and activating receptors on NK cells and ligands on target cells.

A 43-year-old woman presented with postpartum haemorrhage necessitating uterine artery embolisation. Prior to embolisation, angiography demonstrated the presence of a persistent sciatic artery (PSA). Due to the possibility of embolic particles inadvertently traveling to the lower extremity via this variant arterial pathway, care was taken to only embolise the uterine artery. PSAs are uncommon but important vascular pathways to screen for during pelvic intervention and are associated with other genitourinary anomalies.

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Study Objectives: Emergency department (ED) HIV screening programs are important sites for diagnosing HIV-infected individuals. Our EMR-assisted, triagebased, routine, opt-out program is based at an urban, safety-net ED where patient volume is approximately 148,000 annually and all patients presenting to the ED are offered HIV screening if eligible (18 years or older, not known to be HIV positive, not tested in prior 6 months). Georgia's COVID-19 peak occurred April 20, 2020, right behind our hospital peak COVID-19 diagnoses on April 19, 2020. During this time our ED volumes dropped significantly. We sought to characterize the impact on our HIV screening program. Methods: Data were analyzed to compare total ED visits and patients eligible for screening between January-April 2019 and 2020, and tabulated the percent who were offered testing through opt out screening language, had blood drawn for testing, and resulted in a confirmed positive test result. A simple comparison was used to analyze differences between 2019 and 2020, as well as between months in the same year. Results: Comparisons of ED visits between January-April 2019 versus 2020 showed a modest reduction in overall patients eligible to be screened in January-March 2020, and a 43% reduction in patients eligible in April 2020 (5540) compared with April 2019 (9781). In April 2020, only 26% of those eligible were screened, compared with 80% in 2019. On average 2020, 16% of patients screened were tested compared with 19% in 2019. The largest drop off in testing acceptance occurred in March 2020, with only 13% of patients who were screened being tested. Overall percent confirmed seropositivity was similar, 1.9% (2019) vs 2.3% (2020), p¼0.12, but absolute number of confirmed HIV positive patients identified (108 in 2019 vs. 74 in 2020) was reduced. Conclusion: Our ED-based HIV screening program was impacted by the COVID-19 pandemic in Georgia. In April 2020, the month most heavily impacted by COVID