The feasibility of HIV vaccine efficacy trials among Russian injection drug users

Beyrer, Chris; Baral, Stefan; Шаболтас, Алла Вадимовна; Dukhovlinova, Elena; Masharsky, Alexey; Verevochkin, Sergei V.; Latkin, Carl A.; Heimer, Robert; Hoffman, Irving; Kozlov, Andrei P.

doi:10.1016/j.vaccine.2007.07.028

Cited by 10 publications

(5 citation statements)

References 13 publications

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“…Although we obtained our samples from one of the largest cohorts of injection drug users [ 58 ], there are still only a limited number of samples from individuals sampled prior to HIV-1 seroconversion. We did not seek samples from other cohort of injection drug users because of subject heterogeneity and viral subtype differences [ 59 , 60 ]. In context to the statistical analyses, it should be noted that we did not adjust for multiple comparisons.…”

Section: Discussionmentioning

confidence: 99%

Characterization of HIV-1 envelopes in acutely and chronically infected injection drug users

et al. 2014

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BackgroundMucosally acquired human immunodeficiency virus type 1 (HIV-1) infection results from a limited number of variants, and these infecting strains potentially have unique properties, such as increased susceptibility to entry blockers, relative interferon-alpha (IFN-α) resistance, and replication differences in some primary cells. There is no data about the phenotypic properties of HIV-1 envelope variants found early after acquisition among subjects infected through injection drug use (IDU). For the first time, we compared the characteristics of virus envelopes among injection drug users sampled prior to seroconversion (HIV RNA+/Ab-), within 1 year (early), and more than 2 years (chronic) after estimated acquisition.ResultsVirus envelopes from 7 HIV RNA+/Ab- subjects possessed lower genetic diversity and divergence compared to 7 unrelated individuals sampled during the chronic phase of disease. Replication competent recombinant viruses incorporating the HIV RNA+/Ab- as compared to the chronic phase envelopes were significantly more sensitive to a CCR5 receptor inhibitor and IFN-α and showed a statistical trend toward greater sensitivity to a fusion blocker. The early as compared to chronic infection envelopes also demonstrated a statistical trend or significantly greater sensitivity to CCR5 and fusion inhibitor and IFN- α. The HIV RNA+/Ab- as compared to chronic envelope viruses replicated to a lower extent in mature monocyte derived dendritic cells – CD4+ T cell co-cultures, but there were no significant replication differences in other primary cells among the viruses with envelopes from the 3 different stages of infection.ConclusionsSimilar to mucosal acquisition, HIV-1 envelope quasispecies present in injection drug users prior to seroconversion have unique phenotypic properties compared to those circulating during the chronic phase of disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12977-014-0106-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Characterization of HIV-1 envelopes in acutely and chronically infected injection drug users

et al. 2014

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“…Studies of new prevention technologies, including HIV vaccines, need to consistently include fully powered strata of people at risk via parenteral exposure; otherwise, the focus may fall on vaccines of uncertain effectiveness in the large populations where these risks predominate. 65 …”

Section: Making Changes Happenmentioning

confidence: 99%

Time to act: a call for comprehensive responses to HIV in people who use drugs

Beyrer

Malinowska-Sempruch²,

et al. 2010

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The published work on HIV in people who use drugs shows that the global burden of HIV infection in this group can be reduced. Concerted action by governments, multilateral organisations, health systems, and individuals could lead to enormous benefits for families, communities, and societies. We review the evidence and identify synergies between biomedical science, public health, and human rights. Cost-effective interventions, including needle and syringe exchange programmes, opioid substitution therapy, and expanded access to HIV treatment and care, are supported on public health and human rights grounds; however, only around 10% of people who use drugs worldwide are being reached, and far too many are imprisoned for minor offences or detained without trial. To change this situation will take commitment, advocacy, and political courage to advance the action agenda. Failure to do so will exacerbate the spread of HIV infection, undermine treatment programmes, and continue to expand prison populations with patients in need of care.

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“…3–5 Concerns about a generalised HIV epidemic 67 have led to an increased focus on efforts to reduce HIV sexual risks among drug injectors, whereas other important health risks have received less attention in this high-risk group. Unwanted pregnancy, for example, particularly among individuals who inject illicit drugs, may have marked consequences.…”

Section: Introductionmentioning

confidence: 99%

Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia: Table 1

Abdala

Kershaw

Krasnoselskikh

et al. 2011

J Fam Plann Reprod Health Care

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Background This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. Methodology A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Results Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11–2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36–0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33–0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49–0.97, p = 0.03). Conclusions Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.

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The feasibility of HIV vaccine efficacy trials among Russian injection drug users

Cited by 10 publications

References 13 publications

Characterization of HIV-1 envelopes in acutely and chronically infected injection drug users

Characterization of HIV-1 envelopes in acutely and chronically infected injection drug users

Time to act: a call for comprehensive responses to HIV in people who use drugs

Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia: Table 1

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