ABSTRACT
With the spread of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is a need to assess the protection conferred by both previous infections and current vaccination. Here we tested the neutralizing activity of infected and/or vaccinated individuals against pseudoviruses expressing the spike of the original SARS-CoV-2 isolate Wuhan-Hu-1 (WH1), the D614G mutant and the B.1.1.7 variant. Our data show that parameters of natural infection (time from infection and nature of the infecting variant) determined cross-neutralization. Uninfected vaccinees showed a small reduction in neutralization against the B.1.1.7 variant compared to both the WH1 strain and the D614G mutant. Interestingly, upon vaccination, previously infected individuals developed more robust neutralizing responses against B.1.1.7, suggesting that vaccines can boost the neutralization breadth conferred by natural infection.
Subject(s)
Antibodies, Neutralizing/blood , COVID-19 Vaccines/immunology , COVID-19/immunology , Neutralization Tests/statistics & numerical data , SARS-CoV-2/immunology , Vaccination/statistics & numerical data , Adult , Aged , Aged, 80 and over , Antibodies, Viral/immunology , COVID-19/blood , COVID-19 Serological Testing/statistics & numerical data , COVID-19 Vaccines/administration & dosage , Cross Reactions/immunology , Female , Humans , Immunity, Humoral , Male , Middle Aged , Prospective Studies , SARS-CoV-2/geneticsABSTRACT
OBJETIVO: Prevalencia de diagnóstico tardío (DT) e identificar oportunidades perdidas. MÉTODOS: Estudio observacional retrospectivo de nuevos diagnósticos de VIH entre el 2013 y el 2018 en nuestra área de referencia. Se analizan variables sociodemográficas y clínico-analíticas en el momento del diagnóstico. Se revisa la atención sanitaria prestada en los 5 años previos para identificar oportunidades perdidas de diagnóstico precoz. RESULTADOS: Setenta y cuatro pacientes. Edad media 35,3 años, 83,8% hombres. Prevalencia de DT del 44,6% y de enfermedad avanzada del 23,0%. Tendencia aumentada de DT en los pacientes mayores de 40 años, en especial entre los españoles. Ser testado de VIH protege de presentar un DT. Todos los pacientes con contacto previo con el sistema sanitario presentaban indicadores o factores de riesgo asociados al VIH, pero tan solo el 50% había sido testado del VIH. CONCLUSIONES: A pesar del contacto repetido de nuestros pacientes con el sistema sanitario, casi la mitad de nuevos diagnósticos se realizan de forma tardía. Es importante implementar estrategias que permitan identificar mejor a aquellos pacientes con factores de riesgo o indicadores clínicos para una detección más precoz del VIH
BACKGROUND: Prevalence of late diagnosis (LD) and identifying missed opportunities. METHODS: Retrospective observational study of new HIV diagnoses between 2013 and 2018 in our referral area. Sociodemographic and clinical-analytical variables were analysed at the time of diagnosis. The patient's clinical history in the last 5 years before the HIV diagnoses was reviewed to identify missed opportunities for early diagnosis. RESULTS: Seventy-four patients were included. The prevalence of LD was 44.6%, and 23% as an advanced disease. A tendency for LD was observed in patients older than 40 years, especially among Spaniards. Being tested 11for HIV protected against LD. All patients who had previous contact with the health system had clinical indicators or risk factors associated with HIV, but only 50% had ever been tested in their lifetime of HIV. CONCLUSIONS: In spite of multiple contacts with our health system, almost half of the new cases of HIV infection are diagnosticated late. Different strategies should be implemented to improve the identification of the risk factors and clinical indicators of possible HIV infection
Subject(s)
Humans , Male , Female , Adult , HIV Infections/diagnosis , HIV Infections/epidemiology , Delayed Diagnosis , Retrospective Studies , Delivery of Health Care/statistics & numerical data , Risk Factors , Early Diagnosis , Longitudinal Studies , Sexual Partners , Electronic Health Records/statistics & numerical dataABSTRACT
BACKGROUND: Prevalence of late diagnosis (LD) and identifying missed opportunities. METHODS: Retrospective observational study of new HIV diagnoses between 2013 and 2018 in our referral area. Sociodemographic and clinical-analytical variables were analysed at the time of diagnosis. The patient's clinical history in the last 5 years before the HIV diagnoses was reviewed to identify missed opportunities for early diagnosis. RESULTS: Seventy-four patients were included. The prevalence of LD was 44.6%, and 23% as an advanced disease. A tendency for LD was observed in patients older than 40 years, especially among Spaniards. Being tested 11for HIV protected against LD. All patients who had previous contact with the health system had clinical indicators or risk factors associated with HIV, but only 50% had ever been tested in their lifetime of HIV. CONCLUSIONS: In spite of multiple contacts with our health system, almost half of the new cases of HIV infection are diagnosticated late. Different strategies should be implemented to improve the identification of the risk factors and clinical indicators of possible HIV infection.
