Confined vulnerability of HIV infection among pregnant women attending antenatal care clinics in Karnataka, India: Analysis of data from the HIV sentinel surveillance 2017
CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH
Authors: Santhakumar, Aridoss; Ganesh, Balasubramanian; Malathi, Mathiyazhakan; Nagaraj, Jaganathasamy; Manikandan, Natesan; Padmapriya, V. M.; Kirubakaran, B. K.; Govindasamy, Chinnasamy; Ramachandran, V; Sridhar, Rajendran; Kumar, Pradeep; Rajan, Shobini; Elangovan, Arumugam
Background: HIV Sentinel Surveillance among pregnant women attending antenatal care clinics, ANC-HSS, is used to estimate HIV prevalence among the general population. Despite the declining trend, HIV prevalence among the general population in Karnataka is still higher than the national average (0.22%), with a recent, noticeable stabilization. Demographic analysis on concentrated HIV infection among pregnant women could be potential indicators for targeted HIV interventions among general population as well as and prevention of parent to child transmission (PPTCT). Objectives: To analyse the demographics of HIV-positive pregnant mothers in Karnataka, thereby identifying the most-at-risk populations (MARP) within the general population. Methods: In total, 24800 eligible pregnant women aged 15-49 attending the ANC clinic for the first time during the surveillance period (Jan-Mar, 2017) were enrolled. Demographic data and blood samples were collected, recorded and tested for HIV. Age-specific factors associated with HIV prevalence, besides the demographics of the HIV positive pregnant women, were analysed to identify the MARP for targeted HIV interventions. Results: Comprehensively, none of the demographic factors was significantly associated with HIV prevalence. Nevertheless, analysis of demographics, HIV test history and ART status of HIV-positive pregnant women reveals prominent prevalence patterns. The epidemic was majorly confined within young, less educated, primigravida and rural mothers of low economic status. Conclusion: ANC-HSS is designed to estimate the HIV prevalence among general population at national, state and district levels and is not reflective of the concentrated epidemic confined to MARP. Identifying the disease pattern specific to MARP is essential for effective targeted interventions and disease management.
Measuring immunity to SARS-CoV-2 infection: comparing assays and animal models
NATURE REVIEWS IMMUNOLOGY
Authors: Khoury, David S.; Wheatley, Adam K.; Ramuta, Mitchell D.; Reynaldi, Arnold; Cromer, Deborah; Subbarao, Kanta; O'Connor, David H.; Kent, Stephen J.; Davenport, Miles P.
The rapid scale-up of research on coronavirus disease 2019 (COVID-19) has spawned a large number of potential vaccines and immunotherapies, accompanied by a commensurately large number of in vitro assays and in vivo models to measure their effectiveness. These assays broadly have the same end-goal - to predict the clinical efficacy of prophylactic and therapeutic interventions in humans. However, the apparent potency of different interventions can vary considerably between assays and animal models, leading to very different predictions of clinical efficacy. Complete harmonization of experimental methods may be intractable at the current pace of research. However, here we analyse a selection of existing assays for measuring antibody-mediated virus neutralization and animal models of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and provide a framework for comparing results between studies and reconciling observed differences in the effects of interventions. Finally, we propose how we might optimize these assays for better comparison of results from in vitro and animal studies to accelerate progress. Are you new to virus research and trying to interpret the ever-expanding literature on immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)? Here, the authors compare the different assays and animal models used to measure immunity to SARS-CoV-2 infection and reconcile differences in apparent potency of antibodies assessed in different assays.