No seroconversion among healthcare workers exposed to SARS-CoV-2 during the early phase of the pandemic / Ausencia de seroconversión en trabajadores de la salud expuestos a SARS-CoV-2 durante la primera fase de la pandemia

BACKGROUND: The SARS-CoV-2 pandemic is associated with morbidity, hospitalizations, absenteeism, and mortality among healthcare workers (HCW). AIM: To evaluate the seroconversion rate in HCW exposed to SARS-CoV-2 in the early pandemic phase in 2020 at a regional reference hospital. MATERIAL AND METHODS: One hundred seventy-nine HCW working at a regional hospital were invited to a longitudinal study performed between April-July 2020. A serological analysis by ELISA IgG for viral nucleoprotein and protein S with a secondary analysis by ELISA IgG protein S1/S2 for samples with positive or doubtful result was carried out together with a complementary online survey to inquire about occupational or community exposures to SARS-CoV-2. RESULTS: Two cases with baseline infection were detected (1.1%, one symptomatic and one asymptomatic) and no cases of seroconversion were detected. During the study period, there were 136 patients hospitalized with COVID-19, and regional weekly COVID-19 incidence ranged from 2.7 to 24.4 per 100,000 inhabitants. No SARS-CoV-2 cases were detected by PCR among 27 HCW who consulted for respiratory symptoms in the period. Online surveys confirmed direct care of COVID-19 patients and also detected a high degree of unprotected social interaction at work. CONCLUSIONS: There was no evidence of seroconversion in this group of HCW exposed to the risk of infection by SARS-CoV-2 during the onset of the COVID-19 pandemic. Personal protective equipment and other measures used by the HCW were extremely useful for their protection in the initial phase of the pandemic.

ANTECEDENTES: La pandemia de SARS-CoV-2 está asociada a morbilidad, hospitalizaciones, ausentismo y mortalidad entre el personal de salud (PS). OBJETIVO: Evaluar la tasa de seroconversión en el PS expuesto al SARS-CoV-2 en la fase pandémica inicial el 2020 en un hospital regional de referencia. MATERIAL Y MÉTODOS: Ciento setenta y nueve trabajadores de la salud fueron invitados a un estudio longitudinal realizado entre abril-julio de 2020. Se efectuó un análisis serológico por ELISA IgG para nucleoproteína viral y proteína S con un análisis secundario por ELISA IgG proteína S1 / S2 para muestras con resultado positivo o dudoso junto a encuestas complementarias en línea para preguntar sobre exposiciones ocupacionales o comunitarias al SARS-CoV-2. RESULTADOS: Se detectaron dos casos con infección basal (1,1%, uno sintomático y uno asintomático) sin casos de seroconversión. Durante el período de estudio, hubo 136 pacientes hospitalizados con COVID-19, y la incidencia semanal regional de COVID-19 osciló entre 2,7 y 24,4 por 100.000 habitantes. No se detectaron casos de SARS-CoV-2 por PCR entre los 27 funcionarios que consultaron por síntomas respiratorios en este período. Las encuestas en línea confirmaron la atención directa de los pacientes con COVID-19 y también detectaron un alto grado de interacción social desprotegida en el trabajo. CONCLUSIONES: No hubo evidencia de seroconversión en un grupo de funcionarios expuestos al riesgo de infección por SARS-CoV-2 durante el inicio de la pandemia de COVID-19. Los equipos de protección personal y otras medidas utilizadas por el PS fueron de suma utilidad para su protección en la fase inicial de la pandemia.

Immune Status of Cohort of Children Vaccinated against Hepatitis B Virus in Ekiti State over Ten Years after Incorporation into National Program on Immunization

Background:Hepatitis B vaccine has been introduced in Nigeria for over a decade now, yet, data on sero-conversion status of the immunized cohort in the population are scarce. Such data are important for objective evaluation of the impact and effectiveness of the HBV vaccination program This study therefore aims at determining the sero-conversion status and the prevalence of HBV infection among immunized cohort of children in Ekiti state, Nigeria.Methodology:This cross-sectional study was conducted across the three senatorial districts of Ekiti state, between October and December, 2017. A total of 441 children consisting of 226 males and 215 females (Male to female ratio= 1.1:1).Immunization was confirmed by immunization cards. Multistage sampling technique was used. Questionaire were administered after caregiver’s consentand assent from subjects, 2 to 5mls of blood samples were then collected and tested for the various hepatitis B viral markers (HBeAg, HBeAb, HBcAb, HBsAb and HBsAg) using Hepatitis B combo kit manufactured by Innovita Biological Technology. Very low levels antibody titres which may not be detectable by qualitative detection method used is a limitation to this study.Results:Subjects were between 5 to 10 years. All subjects had 3 full doses of hepatitis B vaccination before the age of 1 year and all subjects were negative for HBsAg, HBeAg, HBeAB and HBcAb. However, only 47 (10.7%) had detectable HBsAb. Among HBsAb positive patients 22 were males while 25 were females. Our findings showed zero prevalence of hepatitis B but minimal seroconversion rate among vaccinated children in Ekiti state, Nigeria.Conclusion:Hepatitis B vaccination protects children against HBV in the study population. However, seroconversion rate showed that majority of the children may be at risk of HBV infection at a later age. We recommend a booster dose of HBV vaccination

Meta analysis on HIV-negative partners' or lovers' sero-conversion among HIV sero-discordant couples in China / 中国感染控制杂志

Objective To investigate HIV sero-conversion in HIV-negative partners or lovers among HIV serodiscordant couples.Methods China National Knowledge Infrastructure(CNKI),Wangfang data,and PubMed were retrieved,literatures about HIV sero-conversion in HIV-negative partners or lovers among HIV sero-discordant couples were included in the study,Meta analysis was performed by R software.Results There were 11 literatures were included in the study,Meta analysis showed that HIV-negative partners' or lovers' overall sero-conversion rates among HIV sero-discordant couples in China was 1.0/100 person-year;in different economic levels and epidemic areas,HIV-negative partners' or lovers' sero-conversion rates were both 1.0/100 person-year.Conclusion The HIV-negative partners' or lovers' sero-conversion rates among HIV sero-discordant couples in China are not high.

Primary HIV Infection as an Unusual Cause of Neutropenia in Crohn’s Disease: A Case Report.

Although primary human immune deficiency virus (HIV) infection is a well described entity, it is frequently misdiagnosed or underdiagnosed. This has been attributed to the non-specific clinical features at presentation, inadequate history taking and a low index of suspicion by practicing clinicians. Haematological abnormalities are a recognised feature of HIV infection and may present in the form of pancytopenia or isolated cytopenias. One of the cardinal features of HIV seroconversion is leucopenia, however primary HIV infection as a cause of neutropenia and lymphopaenia in Crohn’s disease, has to our knowledge, not been described in the medical literature. We present a case of profound neutropenia in Crohn’s disease secondary to acute HIV sero-conversion illness.

Analysis on sero-conversion status of human immunodeficiency virus-discordant spouse during 5-year follow-up period / 中华传染病杂志

Objective To investigate the influence of safe sex education and antiretroviral therapy (ART) on human immunodeficiency virus (HIV) antibody sero-conversion status among HIV-discordant spouses.Methods Totally 1 258 HIV/acquired immunodeficiency syndrome (AIDS) cases and their spouses were enrolled and the related information was collected during 2005 to 2007.The HIV negative spouses were tested for HIV antibody once every 6 months.The effects of safe sex education and ART on sero-conversion status of HIV-discordant spouses were analyzed.The date were analyzed by x2 test.Results Without any intervention,505 out of 1 258 HIV/AIDS spouses were positive for HIV test,with the HIV natural spousal transmission rate of 40.1％.Among 442 blood source and 816 sexual source index HIV cases,HIV was positive in 103 and 402 of their spouses,respectively,with the HIV transmission rates between couples of 23.3％ and 49.3 ％,respectively.HIV transmission rate in sexual source group was higher than that in blood source group (x2 =80.421,P＜0.01).Among 608 male and 650 female index HIV cases,HIV was positive in 333 and 172 of their spouses,respectively,with the HIV transmission rates between couples of 54.8％ and 26.5％,respectively.Rate of HIV transmission from men to women was higher than that from women to men (x2 =104.770,P＜0.01).Among 753 HIV discordant couples,only 5 spouses had HIV sero-conversion (0.7％) after comprehensive intervention measures during 5 years of follow-up period.Among 31 HIV/AIDS patients who were only accepted safe sex education,3 of their spouses were HIV positive (9.7％).The transmission rate was lower than that in patients without any intervention (40.1％) (x2 =11.760,P＜0.01).Among 722 HIV/AIDS patients received ART,2 of their spouses were HIV positive (0.3 ％),which was lower than the transmission rate (9.7％) in ART-na(i)ve group (x2=39.821,P＜0.01).Conclusion Safe sex education should be implemented throughout the health management of HIV/AIDS patients and their spouses.If possible,early ART should be carried out to reduce the risk of HIV transmission between married couples.

The Role of the Family Doctor in HIV Medicine

The outlook of people living with HIV (PLHIV) has changed for the better. With the discovery of effective drugs HIV is more like a chronic disease. The family doctor has several roles in HIV medicine: find, test, treat, and retain. Find - at risk individuals, and reduce their HIV risks. Test – to diagnosis those with acute HIV infection, to identify the asymptomatic patients, and to identify those with AIDS defining illnesses. Treat - participate in shared care management with HIV specialists. Retain – retain wellbeing of PLHIV - monitor for complications, provide patient education to help them minimise complications. Routine testing for HIV infection is now the practice. For treatment, A combination ART regimen consisting of two NRTIs + one active drug from one of the classes: NNRT, PI, INSTI, or a CCRS antagonist. Retaining the wellbeing of PLHIV requires monitoring for complications, and providing patient education to help them minimise complications.

Analysis on sero-conversion status of HIV-discordant spouse from 2006-2010 in Henan province / 中华流行病学杂志

Objective To study the management status of HIV-discordant family in Henan province from 2006 to 2010.Methods Data on AIDS infected family from “AIDS Infected Family Follow-up Management and Analysis System” was collected and analized to uderstand the management status of HIV-discordant situation.Results The sero-conversion rates of HIV-discordant spouse were 1.94/100 person-years in 2006,1.79/100 person-years in 2007,0.59/100 person- years in 2008 and 0.41/100 person-years in 2009,showing the yearly decrease.Regarding the number of sero-conversion in the same year,male was significantly higher than female in 2007,but not in the other years.The ratio on the course of sero-conversion which was ＞2.5 years was increasing.Frequency of most HIV-discordant couples' sexual activities was 1-4 times/month with consistent use of condoms.Conclusion The population of HIV-discordant spouse in Henan province was stable.Regarding management of those HIV-discordant spouse,the acceptance on the rate of test rate was increasing.The course of sero-conversion was also increasing,with most HIV-discordant couples insist on condom use while the sero-conversion rate of HIV-discordant spouse appeared to be low.