bluuebunny/crossref_metadata_2025_split huggingface dataset:
O3-S6.04 Multi-site screening for lymphogranuloma venereum (LGV) in the USA
Authors: Hardick J , Quinn N , Eshelman S , Piwowar-Manning E , Cummings V , Marsiglia V C , Gaydos C A ,   The HPTN 061 Study Team
Published: July 2011

BackgroundLymphogranuloma venereum is a clinical condition caused by infection with one of theChlamydia trachomatis(CT) L serovars. Proper diagnosis of LGV is critical as the treatment varies significantly from antibiotic therapy utilised for other CT infections. LGV has re-emerged in Europe as an important sexually transmitted infection (STI), particularly in men who have sex with men (MSM), due to an outbreak in the Netherlands. LGV surveillance data for the USA is lacking as LGV screening is not routinely performed, even in high risk populations. This study presents LGV surveillance data from multiple sites in the USA.Methods1671 rectal samples from African-American MSM participating in a study of the HIV Prevention Trials Network (HPTN 061) BROTHERS Project, were collected from six different cities: Los Angeles and San Francisco CA, Atlanta, GA, Boston MA, Washington D.C., New York, NY; and tested for CT by Aptima Combo 2 (Gen-Probe). Additionally, 127 samples from men from Baltimore, MD who reported anal sex or were symptomatic for CT, and had rectal swabs positive for CT by Combo 2 were also included. All samples were screened for LGV utilising a previously verified LGV specific real-time PCR to determine if the samples were positive for any one of the CT L serovars.ResultsOf the 1671 HPTN 061 samples, 112 (6.75%) were positive for CT and 102 of these have been screened thus far for LGV; none were LGV+. Of 127 CT+ samples from Baltimore, two were LGV+. Thus, of 229 CT+ rectal samples, only 2 (0.87%), tested positive for LGV by real-time PCR.ConclusionsLess than 1% of the CT positive samples obtained from rectal swabs from MSM in the US tested positive for LGV. The samples utilised for this study were from a population presumably at high risk for acquisition of LGV, as all samples tested were from men who had either tested positive for CT, reported anal sex, or were symptomatic for CT infection. The prevalence for LGV in this study was quite low, while the non LGV CT prevalence was high in African American MSM from the six cities. Concomitant STDs are thought to drive the disproportionate HIV epidemic among African American MSM and the low prevalence of LGV in this study is of interest. LGV has re-emerged as an important STI in Europe, however this data suggests that it has either not re-emerged in the U.S. or has re-emerged in a population that is not being screened.
O3-S6.05 Perceptions on point-of-care tests for sexually transmitted infections‑disconnect between frontline clinicians and professionals in industry
Authors: Hsieh Yu-Hsiang , Gaydos C , Hogan T , Uy O , Jackman J , Jett-Goheen Mary , Rompalo A 
Published: July 2011

BackgroundSome recently developed or available sexually transmitted infection (STI) point-of-care tests (POCTs) are not very accurate and are not feasible for use in clinical settings. We conducted a study to determine if a gap exists between STI clinicians/academic experts and industry professionals regarding perceptions of the ideal types and characteristics of STI POCTs.MethodsOur online survey design informed by a large-scale focus group study among STI professionals contained sections on demographics; barriers of use for available STI POCTs; characteristics of an ideal POCT, including prioritising pathogens for targets; and building your own POCT". Practicing clinicians and academic experts from two venues, STI-related international conference attendees and U.S. STD clinic clinicians, were invited to participate in the clinician survey. Professionals from industry in the STI diagnostic field were invited to participate in the industry survey. χ2test and conditional logistical regression were used for data analysis.ResultsClinician survey participants (n=218) identified “the time frame required” (39.9%), “complexity” (31.2%), and “interruption of work flow” (30.3%) as the top three barriers making it difficult to use STI POCTs, while the industry survey participants (n=107) identified "complexity" (65.4%), “unreliability” (53.3%), and “difficulty in reading results” (34.6%) as the top three barriers. Significant differences in barriers named in the two surveys included “complexity”, “the time frame required”, “laboratory driven”, “difficulty in reading results”, and “unreliability”. Participants from both surveys rankedC trachomatisas the top priority organism chosen for a new POCT (clinician: 62%, industry: 39%, p<0.05), followed by a test that would diagnose early seroconversion for HIV (clinician: 14%, industry: 32%, p<0.05). Sensitivity was always the most important attribute to be considered for a new STI POCT by both participant groups. Participants of the clinician group chose cost as the second priority attribute, while those of the industry group chose specificity as the second priority.ConclusionsWe identified differences in the perceptions regarding barriers and ideal attributes for STI POCTs between frontline clinical providers and industry personnel. Tailored training is warranted to inform scientists, biomedical engineers, and other industry experts about characteristics that clinicians desire for STI POCTs.
O4-S1.01 Rapid array-based multilocus genotyping ofChlamydia trachomatis: the easy and economical alternative
Authors: Herrmann B , Christerson L , Ruettger A , Gravningen K , Ehricht R , Sachse K 
Published: July 2011

BackgroundGenotyping ofChlamydia trachomatis(C.) is an important technique to understand its epidemiology. Methods such as DNA sequencing of the ompA gene or multilocus sequence typing (MLST), either offer limited epidemiological resolution, or are laborious and expensive, or both. Here we present a microarray-based method for genotyping ofC trachomatis.MethodsThe database for our high-resolution MLST system (http://mlstdb.bmc.uu.se/) was used to design a multilocus typing (MLT) DNA microarray based on the ArrayStrip format (Alere Technologies, Jena, Germany). In total, the present MLT array version includes 210 different oligonucleotide probes covering the discriminatory variation in the highly variable, but stable, MLST target regions (hctB, CT058, CT144, CT172 and pbpB), as well as 61 probes for ompA. Validation of the array was done by examining 80 clinical C. trachomtis specimens from unselected adolescents and compare with results from MLST and ompA-based serotyping.ResultsSuccessful typing was achieved for 78 (97%) of the specimens. Processing of the obtained hybridisation patterns resulted in 17 different MLT array groups, whereas sequence-based examination led to 19 MLST genotypes and seven ompA genotypes. Thus, the MLT microarray assay provided 2.4 times higher resolution than ompA and separated the commonly predominating ompA E/Bour genotype into seven genotypes. The MLT array showed 100% specificity. Compared to MLST analysis, the equipment needed for the MLT array is about 75% cheaper, consumables are 50% cheaper, analysis can be completed within one working day, instead of 3–4 days, and data analysis is easily conducted in high troughput conditions using up to 96 wells, while the practical operations are easy-to-handle and do not require specially trained personnel.ConclusionThis novel MLT array is a promising alternative for high resolution and high throughput typing of C. trachomatis and will facilitate molecular epidemiology studies of chlamydia infections.
O4-S1.05 RNA helicases, p72 and p68 and HDAC1 interact with HIV-1 integrase and affect viral replication
Authors: Larguet F , Rassart É , Edouard E 
Published: July 2011

BackgroundHuman immunodeficiency virus type-1 (HIV-1) infection is one of the leading causes of death worldwide. Current anti-HIV-1 therapy, referred as highly active antiretroviral therapy (HAART), is based on the use of combination of drugs directed against viral enzymes mainly reverse transcriptase and protease and more recently integrase. Indeed, HAART has dramatically improved the clinical course of the disease. However, the emergence of multi-drug resistant virus strains during treatment highlights the urgent need to develop novel antiretroviral drugs against new HIV-1 targets. HIV-1 is able to hijack cellular machinery for its replication through protein-protein interactions between viral and host cell factors and a rising strategy against HIV-1 infection is to inhibit key virus-cell interactions. Integrase that catalyses HIV-1 viral DNA integration into the host cell genome is currently a focus for the development of new drugs. Several cellular partners of integrase have been identified using different methods. Based on a different strategy, our study aimed to identify new integrase cellular partners.MethodsWe used a biotinylated oligonucleotide derived from the viral U3 LTR end as bait to isolate integrase in a streptavidin beads magnetic separation. Proteins co-purified with integrase were analysed by mass spectrometry.ResultsInterestingly, our method allowed the identification of new cellular proteins notably p72 and p68 RNA helicases and histone deacetylase 1 (HDAC1) as integrase partners in addition to proteins already reported in literature. The interaction of p72, p68 and HDAC1 proteins with integrase was confirmed by co-immunoprecipitation. In addition, specific knockdown of p72 and p68 RNA helicases and HDAC1 were shown to affect HIV-1 replication.ConclusionsOur data suggest that cellular proteins, p72 and p68 RNA helicases and HDAC1 facilitate HIV-1 replication through interaction with integrase.
O4-S2.01 The host response to chlamydial infection results in increased gonococcal colonisation in a novel coinfection model
Authors: Jerse A , Vonck R , Darville T 
Published: July 2011

ObjectiveNeisseria gonorrhoeaeandChlamydia trachomatiscause similar urogenital diseases and up to 70% of individuals with gonorrhoea also have chlamydia. Using a newly developed female mouse model of coinfection, we recently reported that higher numbers ofN gonorrhoeaewere recovered from mice with a pre-existingChlamydia muridaruminfection, the mouse strain of Chlamydia, compared to mice infected withN gonorrhoeaealone. Recent studies on the host response toN gonorrhoeaeimplicate toll-like receptor 4 (TLR4) and IL17 responses as being protective againstN gonorrhoeae. Here we tested the hypothesis that the immune response to chlamydial infection makes the genital tract more permissive toN gonorrhoeae.MethodsUsing an immune-targeted RT-PCR array we screened for alterations in host gene expression during chlamydial infection of BALB/c mice that may account for the observed increase in gonococcal colonisation. Mouse genital cells were collected by vaginal swab and analysed for TLR4 expression by flow cytometry. Coinfection studies were performed in BALB/cJ (TLR4 wild type) and C.C3-TLR4LPS-d/J (TLR4 mutant) mice and the number of viable chlamydiae and gonococci recovered from each group was determined by immunofluorescence using L929 cells and quantitative culture on GC agar, respectively.ResultsPrior toN gonorrhoeaeinoculation, mice with a pre-existing chlamydial infection had decreased expression of TLR4 and antimicrobial peptide (CRAMP, SLPI) genes. Consistent with the finding of decreased TLR4expression in coinfected mice, markers of inflammation (TLR2, TNFα, IL-1ß, platelet activating factor receptor [Pafr], and IL-23α) were up-regulated only in mice infected withN gonorrhoeaealone. A significantly lower percentage of TLR4-expressing epithelial cells was detected in vaginal swabs from chlamydia-infected wild-type mice prior to gonococcal challenge, and importantly, chlamydial infection did not enhanceN gonorrhoeaeinfection of TLR4 mutant mice.ConclusionsThese data suggest the host response to chlamydial infection creates an environment that is less protective against gonococcal infection by down-regulating the expression of TLR4 and antimicrobial peptides. This work therefore further illuminates the basis of this interesting consequence of coinfection and may also help direct the development of immunomodulatory therapies against this common coinfection and its consequences on reproductive health.
O4-S2.06 A primate model ofMycoplasma genitaliumcervical infection
Authors: Totten P , Wood G , Iverson-Cabral S , Cummings P , Sweeney Y Cosgrove , Patton D 
Published: July 2011

BackgroundMycoplasma genitalium(MG) is a newly recognised pathogen associated with acute and persistent reproductive tract infection in men and women. Understanding of the disease mechanisms, persistence and immune avoidance of this organism is hampered by the lack of a suitable animal model.MethodsFemale pigtail macaques (Macaca nemestrina) were inoculated cervically with ∼109 genome equivalents (∼108 ccu's) of MG strain G37, then assessed at intervals over 8 weeks for the persistence of MG in lower tract specimens. Fallopian tube biopsies were collected via laparotomy at Weeks 4 and 8. Specimens were assessed for the presence of MG DNA by qPCR and for viable MG by growth in H broth and Vero cell co-cultures. Serum collected at intervals was evaluated by immunoblot and ELISA for reactivity to MG antigens. Finally the variable regions of the immunodominant surface antigens, MgpB and MgpC, were analysed by PCR cloning and sequencing to evaluate sequence variation during infection.ResultsOf the five primates inoculated cervically with MG, three were infected throughout the 8 weeks of the study, one maintained infection for 4 weeks and one resisted infection. Recovery of viable MG from lower reproductive tract sites was improved by co-culture in Vero cells followed by qPCR to measure an increase in MG genomes during culture. Growth in H broth, as determined by colour change proved an unreliable indicator of the presence of viable MG in the specimen possibly due to the presence of primate microorganisms that inhibit the growth of MG. No viable MG or MG DNA was detected in upper tract tissues in any of the primates perhaps suggesting that longer infection times or repeated inoculations are needed to achieve ascension in this model. Analysis of mgpB variable regions B and G indicated that after 8 weeks of infection the predominant expressed sequence changed from that of the G37C inoculum to 1 to 5 novel sequences consistent with recombination between the expression site and the MgPars. In contrast, no sequence variation was observed in the inoculum grown in vitro for a similar duration. Antibodies reactive with MG antigens, including the variable regions of MgpB and MgpC, were detected by immunoblot and ELISA in serum and cervical exudates.ConclusionsThe cervical inoculation model of pigtail macaques results in long-term infection and can be used to study the persistence of MG, development of antibodies and antigenic variation.
O5-S1.02 Acceptability of in SPOT and patient-delivered partner therapy among men who have sex with men seeking medical care
Authors: Kerani R , Mark F , Golden M 
Published: July 2011

BackgroundPatient-delivered partner therapy (PDPT) and internet partner notification (PN) sites (eg, inSPOT) are being adopted in some areas to improve PN outcomes. Neither intervention has been well-studied in men who have sex with men (MSM). We evaluated the acceptability and potential efficacy of these PN strategies among MSM.MethodsWe anonymously surveyed MSM seen in an STD clinic and a private medical practice in Seattle, WA, USA. The survey presented respondents with three scenarios in which they had oral or anal sex with a new partner and were then notified and offered PDPT. A fourth scenario described PN via an inSPOT ecard.ResultsMSM completed 198 surveys. A total of 115 (58%) men reported ever being diagnosed with a bacterial STD, 100 (50%) had previously been notified by a partner of an STD exposure, and 27 (14%) reported being HIV positive. The percentage of men who indicated that they would seek medical care was higher when scenarios indicated that the respondent had symptoms of proctitis (97%–98%) than when they were asymptomatic (83%–89%) or had symptoms of pharyngitis (84%). Only 123 (62%) men said they would seek medical care if notified via an anonymous inSPOT ecard and were asymptomatic, though this rose to 98% when the question indicated that the respondent had rectal symptoms. Men were somewhat more likely to report that they would take medication given to them as PDPT if they had symptoms than if they were asymptomatic (52%–57% vs 48%–49%). The proportion of MSM who would seek medical care if asymptomatic was lower among men who said they would take PDPT (74%–84%) than among men who indicated that they would not (92%–94%, p<0.06); this pattern was not observed when questions described rectal symptoms. When asked directly if they would use inSPOT to notify partners if they had an STD, 56% said they would. However, when given multiple options and asked how they would prefer to notify partners, only 38% chose an ecard. MSM were less likely to report that they would seek a medical evaluation if notified via an anonymous ecard than via email or a signed ecard (75% vs 94%–95%).ConclusionsThese results suggest that substantial numbers of MSM are interested in using PDPT and internet partner notification sites. However, they also support concerns that PDPT may decrease recipient's likelihood of testing for HIV and syphilis, and that anonymous ecards may be less effective in prompting partners to seek medical care than other forms of PN.
O5-S1.05 Computer assisted self interviewing in a sexual health clinic as part of routine clinical care: impact on service and patient and clinician views
Authors: Vodstrcil L , Hocking J , Cummings R , Chen M , Bradshaw C , Read T , Sze J , Fairley C 
Published: July 2011

BackgroundComputer assisted self interviewing (CASI) has been used at the Melbourne Sexual Health Centre (MSHC) in Victoria, Australia since June 2008, to obtain a pre-consultation sexual risk history. We aimed to evaluate the impact of CASI on consultation times, STI testing rates, patient response rates to CASI questions, and obtain patient and clinician views on CASI.MethodsThe proportion of patients who declined to answer questions using CASI since 2008 was calculated. We then used the same 12 week period (Feb to May) over three years (2008 pre-CASI), (2009 CASI period), and (2010 non-CASI period-due to a computer theft) to assess consultation times and STI-testing rates. We carried out surveys of clinicians and patients to determine their experience and the acceptability of CASI as part of routine clinical practice.Results14 190 patients completed CASI during the audit period. Men were more likely than women to decline questions about the number of partners they had of the opposite sex (4.4% v 3.6%, p=0.05) and same sex (8.9% v 0%, p<0.01). One third (34%) of HIV-positive men did not answer questions on number of partners and 18% declined questions about condom use with insertive anal sex. There was no difference in the mean consultation times during CASI and non-CASI operating periods (p?0.17). Only the proportion of women tested for chlamydia differed between CASI and non-CASI periods (p<0.01, 84% v 88% respectively). 267 patients completed the survey about CASI. Most (72% men and 69% women) were comfortable using the computer and reported that all their answers were accurate (76% men and 71% women). Half preferred CASI but 18% would have preferred a clinician to have asked the questions. 39 clinicians completed the staff survey, but a varying proportion (11%–44%) felt that face-to-face interviewing was more accurate, depending on the risk factor. Only 5% were unsatisfied with CASI.ConclusionsThis is the first evaluation of CASI operating routinely in a sexual health clinic. We have demonstrated that CASI is acceptable to most patients and clinicians in a sexual health setting and does not adversely affect various measures of clinical output. The true value of CASI is most likely to be realised when it is integrated with further innovations in clinical care such as the development of express clinical services, decision support software and detailed behavioural surveillance system.
O5-S2.01 A National Program with a National impact: quadrivalent HPV vaccination and genital warts in Australia, 2004–2010
Authors: Donovan B , Guy R , Ali H , Grulich A , Regan D , Wand H , Fairley C 
Published: July 2011

BackgroundFrom mid-2007 Australia funded a universal free vaccination program for all females between 12 and 26 years, but not for men or for women who were older than 26 years in 2007. Vaccine coverage rates of >80% were achieved for school-girls, though coverage was probably lower for young women in the community. To determine the population effect of the vaccine program we established a national surveillance network to measure trends in clinical presentations for genital warts.MethodsEight sexual health services dispersed around Australia provided data on all new patients between 2004 and 2010, including new diagnoses of genital warts, demographics, sexual behaviour, and HPV vaccination status.ResultsAmong more than 130 000 new patients we identified over 10 000 new cases of genital warts. Before the vaccination program there was no change in the proportion of women or heterosexual men diagnosed with genital warts. In the first 30 months of the vaccination program we detected a 59% decline in the proportion of young resident women diagnosed with genital warts (p-trend <0.0001) and preliminary analysis indicates that this trend was ongoing in 2010. In contrast, we could not detect any significant decline in genital warts among non-resident young women, older women, or men who have sex with men. Interestingly, the proportion of younger men (<26 years in mid-2007) diagnosed with genital warts declined by 39% (p-trend <0.0001) while there was no significant decline among older heterosexual men. By 2009, 65% of resident women of free vaccine-eligible age, 15% of non-resident women of the same age, and 11% of older women reported having had a quadrivalent or an unknown HPV vaccine.ConclusionThe vaccination program has had a large population-level impact on the incidence of genital warts in young Australian women, with some flow-on benefit for young heterosexual men as a result of herd immunity.