Knowledge, attitudes, and testing preferences for Herpes Simplex Virus infections among undergraduate students at a large university in Los Angeles, California.

OBJECTIVE: Genital herpes is a common sexually transmitted disease among young adults in the United States. We conducted a cross-sectional survey to evaluate herpes simplex virus knowledge among university students. PARTICIPANTS: 612 full-time undergraduate students. METHODS: We gathered data on demographics, sexual activity, knowledge about the herpes simplex virus, attitudes toward it, and preferences for testing and treatment. RESULTS: Of 612 full-time undergraduate students, 71.4% (437/612) reported being sexually active. Of them, 54.2% (237/437) reported ever being tested for a sexually transmitted infection. On a standardized knowledge assessment of genital herpes, 22.7% (139/612) of participants scored ≥80% correct. Over half of participants, 57.2% (350/612), reported that they could not cope with a genital herpes outbreak. Being sexually active and tested for sexually transmitted infections was associated with higher scores on the genital herpes knowledge assessment. CONCLUSION: University students have low knowledge regarding genital herpes. Genital herpes education is needed to improve sexual health and wellness.

Duration of COVID-19 PCR positivity for Omicron vs earlier variants.

There have been reports that the Omicron variant of SARS-CoV-2 is milder and may resolve more quickly than earlier variants of SARS-CoV-2, like the Delta variant. Due to a dearth of studies on duration of PCR positivity for the Omicron variant, we studied this question in a cohort of routinely tested employees that work in a large laboratory. We found that there was no difference in duration of PCR positivity among those infected with the Omicron variant of SARS-CoV-2 versus earlier variants of SARS-CoV-2. That suggests in a clinical study that the increased infectiousness of Omicron might likely be due to factors related to viral and host cell interactions, rather than viral load or duration of infectivity, which has been suggested in immune escape studies.

Incidence of SARS-CoV-2 infection among previously infected or vaccinated employees.

INTRODUCTION: We aimed to determine the incidence of SARS-CoV-2 infection among individuals with a previous SARS-CoV-2 infection versus vaccinated individuals. METHODS: In March 2020, a SARS-CoV-2 testing company began routinely screening its workforce for SARS-CoV-2 with a PCR test. On December 15, 2020, vaccination with either the BNT162b2 or mRNA-1273 vaccines became available. Routine screening has continued through July 2021. We compared the incidence of SARS-CoV-2 infection between people who were SARS-CoV-2 naïve and unvaccinated, people with prior COVID-19 without vaccination, and people vaccinated without prior COVID-19. Incidence in 100 person-years with 95% confidence intervals (95% CIs) was calculated with the Poisson Exact equation. The incidence rate ratio (IRR), the ratio of confirmed COVID-19 cases per 100 person-years of follow-up with 95% CIs, was used as a measure of association between groups. Analyses were performed on StataSE. RESULTS: The median age of employees was 29.0 years (interquartile range: 23.6, 39.9). During the observation period, 258 SARS-CoV-2 incident infections were identified. The naïve, unvaccinated group had a SARS-CoV-2 incidence of 25.9 per 100 person-years (95% CI: 22.8-29.3). The previously infected, unvaccinated group had an incidence of 0 per 100 person-years (95% CI: 0-5.0). The vaccinated group had an incidence of 1.6 per 100 person-years (95% CI: 0.04-4.2). CONCLUSION: We found a strong association between prior SARS-CoV-2 infection and/or vaccination for SARS-CoV-2 with either the BNT162b2 or mRNA-1273 vaccines and the reduced incidence of SARS-CoV-2 infection when compared with those naïve and/or unvaccinated to SARS-CoV-2.

A Systematic Review of the Protective Effect of Prior SARS-CoV-2 Infection on Repeat Infection.

We systematically reviewed studies to estimate the risk of SARS-CoV-2 reinfection among those previously infected with SARS-CoV-2. For this systematic review, we searched scientific publications on PubMed and MedRxiv, a pre-print server, through August 18, 2021. Eligible studies were retrieved on August 18, 2021. The following search term was used on PubMed: ((("Cohort Studies"[Majr]) AND ("COVID-19"[Mesh] OR "SARS-CoV-2"[Mesh])) OR "Reinfection"[Majr]) OR "Reinfection"[Mesh]. The following search term was used on MedRxiv: "Cohort Studies" AND "COVID-19" OR "SARS-CoV-2" AND "Reinfection". The search terms were broad to encompass all applicable studies. There were no restrictions on the date of publication. Studies that did not describe cohorts with estimates of the risk of SARS-CoV-2 reinfection among those with previous infection were excluded. Studies that included vaccinated participants were either excluded or limited to sub-groups of non-vaccinated individuals. To identify relevant studies with appropriate control groups, we developed the following criteria for studies to be included in the systematic analysis: (1) baseline polymerase chain reaction (PCR) testing, (2) a uninfected comparison group, (3) longitudinal follow-up, (4) a cohort of human participants, i.e. not a case report or case series, and (5) outcome determined by PCR. The review was conducted following PRISMA guidelines. We assessed for selection, information, and analysis bias, per PRISMA guidelines. We identified 1,392 reports. Of those, 10 studies were eligible for our systematic review. The weighted average risk reduction against reinfection was 90.4% with a standard deviation of 7.7% (p-value: <0.01). Protection against SARS-CoV-2 reinfection was observed for up to 10 months. Studies had potential information, selection, and analysis biases. The protective effect of prior SARS-CoV-2 infection on re-infection is high and similar to the protective effect of vaccination. More research is needed to characterize the duration of protection and the impact of different SARS-CoV-2 variants.

Self-Collected Oral Fluid and Nasal Swabs Demonstrate Comparable Sensitivity to Clinician Collected Nasopharyngeal Swabs for Coronavirus Disease 2019 Detection.

We compared self-collected oral fluid swab specimens with and without clinician supervision, clinician-supervised self-collected anterior nasal swab specimens, and clinician-collected nasopharyngeal swab specimens for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Supervised oral fluid and nasal swab specimens performed similarly to clinician-collected nasopharyngeal swab specimens. No sample type could detect SARS-CoV-2 infections amongst all positive participants.

Aetiological testing compared with syndromic management for sexually transmitted infections in HIV-infected pregnant women in South Africa: a non-randomised prospective cohort study.

OBJECTIVE: To measure the frequencies of sexually transmitted infections (STIs) and adverse pregnancy outcomes among women receiving either aetiological testing or syndromic management for STIs. DESIGN: Non-randomised prospective cohort study. SETTING: Primary healthcare facilities in Tshwane, South Africa. POPULATION: HIV-infected pregnant women attending antenatal care services. METHODS: Participants were enrolled to receive aetiological testing using Xpert® CT/NG and Xpert® TV assays or standard syndromic management. Outcome data were collected at the postnatal care visit (≤30 days from delivery) and from maternity records. Enrolment gestational age-adjusted relative risk (aRR) was calculated. MAIN OUTCOME MEASURES: STI prevalence at postnatal visit, and frequency of adverse pregnancy outcomes (preterm birth, low birthweight). RESULTS: We enrolled 841 women. The prevalence of any STI at baseline was 40%; Chlamydia trachomatis 30%, Neisseria gonorrhoeae 5.6%, Trichomonas vaginalis 20%. The prevalence of STIs at postnatal care was lower among those receiving aetiological testing compared with those receiving syndromic management (14% versus 23%; aRR 0.61; 95% CI 0.35-1.05). No difference was observed between study groups for frequency of preterm birth (23% versus 23%; aRR 1.2, 95% CI 0.81-1.8) and low birth weight (15% versus 13%; aRR 1.1, 95% CI 0.66-1.7). CONCLUSIONS: Aetiological testing provides an effective intervention to reduce the high burden of STIs in pregnant women in South Africa; however, the optimal implementation strategy remains to be determined. TWEETABLE ABSTRACT: Aetiological testing effectively reduces the burden of sexually transmitted infections in pregnancy.

Genotyping Neisseria gonorrhoeae gyrA and penA antimicrobial genes from remnant Neisseria gonorrhoeae positive Cepheid Xpert® clinical specimens - A feasibility study.

Neisseria gonorrhoeae (NG) has developed resistance to most antibiotics, making it increasingly difficult to treat. Previous studies have predicted antimicrobial NG susceptibility based on the antimicrobial gene target DNA gyrase subunit A (gyrA) codon serine 91 and the penicillin-binding protein 2 (penA) using Roche Cobas® and Hologic APTIMA™ clinical specimens. We studied whether similar methods could be used on remnant NG-positive Cepheid Xpert® specimens.

Cytokine expression in Treponema pallidum infection.

BACKGROUND: Current syphilis tests cannot distinguish between active and past syphilis among patients with serofast rapid plasma reagin (RPR) titers. We investigated whether cytokine profiles might provide insight in the differentiation of active and treated syphilis. METHODS: We collected quarterly serum samples from participants at risk for incident syphilis in a prospective cohort study of men and male-to-female transgender women. We defined incident syphilis as a new RPR titer ≥ 1:8 or a fourfold increase from a prior RPR titer and a positive Treponema pallidum particle agglutination assay. We measured cytokine expression using a 63-multiplex bead-based Luminex assay (eBiosciences/Affymetrix, San Diego, California, USA). We used tertile bins and Chi square tests to identify differences in proportions of cytokines between samples from patients with active and treated syphilis. We constructed a network of cytokine profiles from those findings. We used R software (R version 3.4.1, R, Vienna, Austria) to fit models. RESULTS: We identified 20 pairs of cytokines (out of 1953 possible pairs) that differed between active and treated syphilis. From those, we identified three cytokine networks of interest: an Eotaxin-Rantes-Leptin network, a Mig-IL1ra-Trail-CD40L network, and an IL12p40-IL12p70 network. CONCLUSIONS: Differences in cytokine profiles are present among men and male-to-female transgender women with active and treated syphilis. Cytokine assays may be a potentially useful tool for identifying active syphilis among patients with serologic syphilis reactivity.