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Cross-reactive immune responses to SARS-CoV-2 have been observed in pre-pandemic cohorts and proposed to contribute to host protection. Here we assess 52 COVID-19 household contacts to capture immune responses at the earliest timepoints after SARS-CoV-2 exposure. Using a dual cytokine FLISpot assay on peripheral blood mononuclear cells, we enumerate the frequency of T cells specific for spike, nucleocapsid, membrane, envelope and ORF1 SARS-CoV-2 epitopes that cross-react with human endemic coronaviruses. We observe higher frequencies of cross-reactive (p = 0.0139), and nucleocapsid-specific (p = 0.0355) IL-2-secreting memory T cells in contacts who remained PCR-negative despite exposure (n = 26), when compared with those who convert to PCR-positive (n = 26); no significant difference in the frequency of responses to spike is observed, hinting at a limited protective function of spike-cross-reactive T cells. Our results are thus consistent with pre-existing non-spike cross-reactive memory T cells protecting SARS-CoV-2-naïve contacts from infection, thereby supporting the inclusion of non-spike antigens in second-generation vaccines.

Background Whilst migration and urbanization have been linked with higher obesity rates, especially in low-resource settings, prospective information about the magnitude of these effects is lacking. We estimated the risk of obesity and central obesity among rural subjects, rural-to-urban migrants, and urban subjects. Methods Prospective data from the PERU MIGRANT Study were analysed. Baseline data were collected in 2007-08 and participants re-contacted in 2012-13. At follow-up, outcomes were obesity and central obesity measured by body mass index (BMI) and waist circumference. At baseline, the primary exposure was demographic group: rural, rural-to-urban migrant, and urban. Other exposures included an assets index and educational attainment. Cumulative incidence, incidence ratio (IR), and 95% confidence intervals (95% CI) for obesity and central obesity were estimated with Poisson regression models. Results At baseline, mean age (±SD) was 47.9 (±12.0) years, and 53.0% were females. Rural subjects comprised 20.2% of the total sample, while 59.7% were rural-to-urban migrants and 20.1% were urban dwellers. A total of 3,598 and 2,174 person-years were analysed for obesity and central obesity outcomes, respectively. At baseline, the prevalence of obesity and central obesity was 20.0% and 52.5%. In multivariable models, migrant and urban groups had an 8- to 9.5-fold higher IR of obesity compared to the rural group (IR migrants 8.19, 95% CI 2.72-24.67; IR urban 9.51, 95% CI 2.74-33.01). For central obesity, there was a higher IR only among the migrant group (IR 1.95; 95% CI 1.22-3.13). Assets index was associated with a higher IR of central obesity (IR top vs. bottom tertile 1.45, 95% CI 1.03-2.06). Conclusion Peruvian urban individuals and rural-to-urban migrants show a higher incidence of obesity compared to their rural counterparts. Given the ongoing urbanization occurring in middle-income countries, the rapid development of increased obesity risk by rural-to-urban migrants suggests that measures to reduce obesity should be a priority for this group.

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Supplemental Digital Content is available in the text.

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BackgroundThis longitudinal study aimed to evaluate the impact of a multifaceted educational intervention (Sexual Health in Practice, SHIP) on general practice HIV testing rates in a high prevalence London area.InterventionSHIP offered training in sexual health clinical skills to general practitioners (GPs) and practice nurses (PNs) in Haringey. SHIP training aims to break down stigma in sexual health and provide sexual history and communication tools (e.g. differential diagnosis), and provides resources to practices (including condoms).DesignNumbers of GP HIV tests were collected from laboratories for 24 months prior, 19 months during and 5 months after training. Attendance data and practice list sizes were obtained.Results39 of 51 practices had at least one trained individual. These `trained' practices conducted an average 526 HIV tests p.a. before training began which rose to a projected 1556 p.a. (on the basis of the last 6 months of data). Testing rates of trained and untrained practices increased from 2.29 to 6.66 and 1.54 to 1.90 tests/1000 registered patients/year (p=0.0016 and p=0.5195) respectively. The rate of positive diagnosis was high in the trained group (18.0 and 16.7 positives/1000 tests before and after training began; p=0.7908). This equates to a rise from 9.5 to 22 new diagnoses p.a.ConclusionsThe training intervention has been found to significantly increase general practice HIV testing rates in the absence of financial incentives. Positivity rates are substantially higher than that found in pilots of screening in London, suggesting that the training nurtured and supplemented complex clinical skills.