bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-2318. Practices Surrounding Peri-Transplant Prevention of Coccidioidomycosis: Preliminary Report from a Survey of California Transplant Centers
Authors: DeVoe Catherine , Fung Monica , Nam Hannah H , Koff Alan , Logan Cathy , Chandran Sindhu , Chang Sandy , Sakoulas George , Schaenman Joanna M , Schwartz Brian S 
Published: January 2025

Abstract

Background
Coccidioidomycosis is a significant cause of morbidity and mortality in solid organ transplant (SOT) recipients. Although existing guidelines address some aspects of pre- and post-transplant testing, prophylaxis, and monitoring, in many cases best practices are unknown, particularly for regions with variable Coccidioides endemicity such as California. This study aims to understand existing coccidioidomycosis prevention strategies at California transplant centers.

Methods
We designed a web-based survey that inquired about California transplant centers’ protocols for pre-transplant coccidioidomycosis testing, post-transplant prophylaxis, and post-transplant monitoring. The Organ Procurement and Transplantation Network website was used to identify adult transplant centers in California that performed at least one SOT in 2023. Primarily pediatric centers were excluded. A transplant infectious disease or transplant physician from each center was invited to complete the survey on behalf of their institution.

Results
Eight out of 15 California transplant centers, representing 68.9% of the total SOT volume for 2023, completed the survey by the time of this report. Types of SOTs performed by the centers are shown in Table 1. All centers had at least one coccidioidomycosis protocol. Many centers had protocols that applied to multiple SOT types; no center had different protocols for the different abdominal transplant types. Details of the seven prophylaxis protocols for abdominal transplants are provided in Table 2. No center recommended Coccidioides-directed prophylaxis for all recipients.

Conclusion
All transplant centers that responded to the survey had at least one coccidioidomycosis protocol, but not all had protocols that applied to all transplant types, and the amount of detail provided by the protocols varied widely. All centers provided some guidance about prophylaxis for recipients from endemic areas, and the majority recommended indefinite prophylaxis for those who were seropositive pre-transplant. Fewer centers provided guidance addressing recipients’ personal history of coccidioidomycosis or donor status. Further research is needed to clarify best practices for reducing coccidioidomycosis after SOT so that approaches can be better standardized.

Disclosures
Catherine DeVoe, MD, AN2 Therapeutics: Grant/Research Support Alan Koff, MBBS, Astra Zeneca: Clinical trial support to institution Joanna M. Schaenman, MD, PhD, FAST, Eurofins Viracor: Honoraria|F2G: Grant/Research Support|MedCure: Advisor/Consultant|Moderna: Clinical trial support to institution|OneLegacy: Advisor/Consultant
P-2321. Role of the Transplant Infectious Disease Physician in Potential Donor Evaluation for Successful and Safe Abdominal Transplantation
Authors: DiStefano Nicholas , Shah Nikita , Natori Yoichiro , Anjan Shweta , Guerra Giselle , Simkins Jacques , Viotti Julia Bini , Morsi Mahmoud , Martin Eric , Venkatatsamy Vighnesh 
Published: January 2025

Abstract

Background
Preventing donor derived infections is critical in solid organ transplant medicine. However, to expand the donor pool, utilizing organs from donors with known infections or at risk of disease transmission with proper prophylaxis and/or treatments is necessary. The purpose of this study is to determine the efficacy and impact of robust transplant Infectious disease (TxID) evaluation for high-risk donors in solid organ transplant centers.

Methods
This is a retrospective study conducted at one of the largest solid organ transplant centers in the US. All electrical medical records regarding donor information and obtained interventions were retrospectively reviewed between June 2023, and March 2024.

Results
During study period, we performed 358 (250, 15, and 93 kidney, kidney-pancreas, and liver) transplants. At the time of organ offer, out of 4,579 total organ offers, 93(2.03%) TxID consultations occurred. The majority of TxID consults were to review positive culture (50/93, 53.8%) and abnormal imaging. TxID declined 19/93 (20.4%) cases due to high risk of infectious disease transmission such as active staphylococcal bacteremia or candidemia. Additional 44 cases were either declined due to other reasons or accepted in other centers. Finally, 30 cases were transplanted and out of those, 22 (73.3%) received prophylaxis. No donor derived infections were noted in those 30 cases. Of note, graft loss or death due to infection within 90 days post-transplant was seen in 10/250, 7/93, and 2/15 for kidney, kidney pancreas, and liver transplants respectively, and none of those cases developed donor derived disease.

Conclusion
Solid organ transplantation helps prolong and improve recipients’ quality of life. Risk assessment, prophylaxis, and monitoring makes it possible to safely accept donors who are considered high risk for infection transmission, while preventing donor derived infections. Early TxID consultation for those cases is crucial.

Disclosures
Yoichiro Natori, MD, Eurofin/Viracor: Honoraria|Nobel Pharma: Advisor/Consultant
P-44. Immunogenicity and Safety of High-dose versus Standard-dose Quadrivalent Inactivated Influenza Vaccine in Patients Living with HIV: A Randomized Controlled Trial
Authors: Laoharattanahirun Nutchaya , Kiertiburanakul Sasisopin , Boonnak Kobporn , Bruminhent Jackrapong 
Published: January 2025

Abstract

Background
Influenza can lead to severe complications in patients living with HIV (PLWH). Annual standard-dose (SD) quadrivalent inactivated influenza vaccine (QIIV) is recommended for PLWH, although it is associated with poor vaccine response. We aimed to investigate the immunogenicity and safety of high-dose (HD) versus SD QIIV in PLWH, as well as safety.

Methods
We conducted a randomized, open-label, controlled trial to compare the immunogenicity of the 2023 southern hemisphere HD QIIV at 60 μg (Efluelda, Sanofi) versus SD QIIV at 15 μg (Fluarix tetra, Sanofi) in patients living with HIV (PLWH) during August and November 2023. Seroprotection (SP), defined as serum hemagglutination-inhibition antibody titers ≥1:40 at 1 month post-vaccination, was assessed. Adverse events (AEs) following vaccination were also evaluated.

Results
We enrolled 110 patients who received the study vaccine, and 103 (52 HD; 51 SD) were eligible for analysis. Among them, 65 (62.1%) were male, with a mean age (SD) of 49.6 (11.2) years and a median CD4 count (IQR) of 555 (418-680) cells/mm3. The integrase strand transfer-based regimen was the most common antiretroviral regimen (57.3%), and the majority had an undetectable HIV viral load (93.2%). Fifty-two (50.5%) achieved SP to all strains (A/H1N1, A/H3N2, B/Victoria and B/Yamagata) after vaccination. Those who received HD QIIV reached SP significantly more compared to SD QIIV (61.5% vs. 39.2%, p = 0.02). In particular, SP to the A/H3N2 strain was significantly greater in the HD QIIV group compared to the SD QIIV group (76.9% vs. 52.9%, p = 0.011). Use of HD QIIV were independent factors for SP to all strains (OR 2.7, 95%CI 1.9-6.1, p = 0.02) and SP to the A/H3N2 strain (OR 3.2, 95%CI 1.4-7.8, p = 0.01). Twenty-nine (57.3%) participants in the HD group reported AEs, including muscle ache (36.5%), pain at the injection site (21.2%), and fever (13.5%). Those were all non-severe and comparable to those receiving SD QIIV.

Conclusion
HD QIIV could offer significantly better immunogenicity across all strains, especially the A(H3N2) strain, compared to SD QIIV in PLWH and should be considered as the preferred influenza vaccine for this population, without safety concerns. TCTR20230501002.

Disclosures
All Authors: No reported disclosures
P-2363. Efficacy Of SARS–CoV-2 Specific Antiviral Therapy for Enteroviral Myalgic Encephalomyelitis/ChronicFatigue Syndrome
Authors: Chia John K , Wang David 
Published: January 2025

Abstract

Background
Etiology remains elusive for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and no treatment exists. Antivirals had no efficacy in randomized clinical trials (RCT) for Epstein-Barr Virus and HHV-6. Enteroviruses (EV) have been implicated, but no antivirals are available. Many patients who received SARS–CoV-2-specific antiviral drugs for acute Covid-19 (COV19) infection experienced significant improvement of prior ME/CFS symptoms. This study summarizes their responses to antivirals for SARS-Cov-2.

Methods
Neutralizing Antibody (NA) for Coxsackievirus B (CVB)1-6 and Echovirus 6, 7, 9, 11, 30 were done by ARUP lab. Enterovirus Protein (EVP) of Peripheral Blood Leukocytes (PBL) was determined by Western Blot. ME/CFS patients fulfilled Canadian consensus criteria, and had either elevated NA for enteroviruses and/or positive EVP in PBL. ME/CFS patients hospitalized for acute COV19 infection and patients without COV19, were given 5-10 days of IV Remdesivir (Rem) +/- immune modulators. Controls: 20 ME/CFS patients seen concurrently without Remdesivir treatment. Other ME/CFS patients (non-COV19) were given Nirmaltrelvir/Ritonavir (PAX) daily for 10 days +/- one repeat.
The energy index (EI) was monitored by the patients before, during and after treatment. Significant improvement was defined as &gt; 30%.

Results
15/20 (75%) ME/CFS patients – 10/12 hospitalized, 5/8 non-COV19 patients – responded to IV Rem 2-6 weeks after infusions; remission lasted 6-8 weeks to 6-9 months before relapse. Of Controls: 2/20 had mild improvement (&lt; 0.001, X 2 ).
104/200 (52%) of PAX-treated ME/CFS patients improved, often within 2-3 days; all relapsed within days to weeks after treatment. 66%, 33% and 44% of CVB4+, CVB3+, non-CVB3,4+ patients responded to treatment, respectively. EVP decreased and increased with clinical response and relapse.

Conclusion
Rem and PAX demonstrated clinical efficacy in ME/CFS patients with chronic enterovirus infections. Placebo-controlled RCT will be needed to clarify the role of antivirals in ME/CFS.

Disclosures
All Authors: No reported disclosures
P-2364. Estimated Additional Burden Averted for the 2022-2023 influenza season from Use of Cell-Based Influenza Vaccines Compared to Egg-Based Influenza Vaccines Among People 0-64 Years of Age in the United States
Authors: McGovern Ian , Stein Alicia N , Haag Mendel 
Published: January 2025

Abstract

Background
Estimation of burden averted is useful to contextualize the impact of differentiated vaccines. Traditional influenza vaccine production in eggs can introduce egg-adaptive mutations. Cell-based influenza vaccines avoid egg-adaptation, potentially improving match to circulating influenza viruses and thereby vaccine effectiveness (VE). This study modeled the public health impact if all people aged 0-64 years vaccinated in the United States during the 2022-2023 influenza season had received either cell-based inactivated quadrivalent influenza vaccine (ccIIV4) or egg-based inactivated quadrivalent influenza vaccine (IIV4).Table 1:Number of outcomes prevented from use of IIV4 and ccIIV4, individuals 0—64 Years

Methods
The modeling method used by the US Centers for Disease Control and Prevention (CDC) to estimate overall burden averted due to influenza vaccination was extended to a relative VE (rVE) context. The model utilized 2022-2023 CDC data on influenza vaccine uptake, influenza incidence, influenza-related healthcare resource (HRU) use and deaths. CDC estimates of absolute VE (aVE) (any vaccine) were used as the aVE of IIV4. We applied an rVE of 7.7% (0.9 to 13.9%), estimated in a 2022-2023 retrospective test-negative design study. Base-case results were validated with deterministic (DSA) and probabilistic (PSA) sensitivity analyses.Table 2:Number of additional outcomes prevented from use of ccIIV4 compared to IIV4, by age group

Results
Table 1 shows the anticipated number of symptomatic influenza cases and associated HRU and deaths that would have been averted if all vaccinated people 0-64 years of age received either ccIIV4 or IIV4 and Table 2 shows the additional burden averted by age. Use of ccIIV4 would result in prevention of an additional 622,826 symptomatic illnesses, 307,682 outpatient visits, 3,680 hospitalizations, 559 intensive care unit (ICU) admissions, and 127 deaths compared to IIV4. DSA results showed that the rVE estimate was associated with the most variability, followed by influenza-related HRU and deaths. Mean PSA results were all within a 0.1% difference of base-case results.

Conclusion
Use of ccIIV4 instead of IIV4 during the 2022-2023 influenza seasons in the US would have had a substantial public health impact on the population 0-64 years of age due to prevention of an additional 622,826 symptomatic illnesses as well as proportionate reductions in associated HRU and deaths.

Disclosures
Ian McGovern, MPH, CSL Seqirus: Employee|CSL Seqirus: Stocks/Bonds (Public Company) Alicia N. Stein, MBiostats, PhD, CSL Seqirus: Employee|CSL Seqirus: Stocks/Bonds (Public Company) Mendel Haag, PhD, PharmD, CSL Seqirus: Employment|CSL Seqirus: Stocks/Bonds (Public Company)
P-46. A Comparative Analysis of Vaccine Uptake in Face-to-Face vs. Virtual Care for Active Duty Air Force Members Living with HIV
Authors: Wurtz Paul J , Finney Laquonda , Yabes Joseph 
Published: January 2025

Abstract

Background
Military regulation requires US Air Force (USAF) members living with HIV receive Infectious Disease evaluation at the Medical Evaluation Unit (MEU). With a worldwide distribution of the USAF, telehealth utilization began in 2020 with improvements in clinical outcomes and decreased costs. However, not all facets of care are easily amenable to telehealth. We aimed to review differences in vaccination rates since transition from face to face (F) to virtual (V) visits.

Methods
All USAF active-duty members with incident HIV diagnosis between 2018 and 2023 were included. Only airmen stationed local to the MEU were evaluated F after 2020. Demographic, and clinical information was compiled. Vaccines of interest were selected according to current guidelines: human papilloma virus (HPV), meningococcal ACWY, pneumococcal, recombinant zoster and Mpox vaccines. Vaccine completion rates and time from HIV diagnosis to first vaccine dose was compared between groups.

Results
All 108 patients were male. Forty-four percent of visits occurred F and 56% were V. Median age was similar, 27 years for F and 26 years for V (p=0.84). Overall, demographics were not significantly different between groups (Table 1). Initial CD4 count was lower among those who received V care (472 vs 567; p=0.01). It took longer for patients to receive their first vaccine dose with V visits compared to F visits (99 vs 3 days; p&lt; 0.01) (Table 2). Likewise, days from HIV diagnosis to first dose of vaccine administration was longer with V visits compared to F (134 vs 36; p&lt; 0.01). Vaccine completion rates varied by type. Pneumococcal and HPV completion rates were higher in the F group compared with V group (p=0.02). Completion rates of the meningococcal ACWY primary series were similarly higher in the V group 92% vs 55%; p=&lt; 0.001). Mpox completion rates were higher with F visits but not statistically significant (8% vs 3%; p=0.4). Recombinant zoster vaccine completion rates were nearly identical (22% vs 23%; p=0.96).

Conclusion
Vaccination rates were lower and took longer among USAF personnel who underwent V visits compared to F. As healthcare systems increasingly employ telehealth, future studies should investigate provider and patient attitudes on vaccine counseling during V visits to ensure the delivery of high-quality care in the virtual era.

Disclosures
All Authors: No reported disclosures
P-48. Uptake of pneumococcal vaccination after invasive pneumococcal diseases in two centers in northern Italy
Authors: Ponta Giacomo , Roberto Raccagni Angelo , Carletti Silvia , Mauri Carola , Morena Valentina , Gemignani Nicole , Pontiggia Silvia , Ripa Marco , Castagna Antonella , Piconi Stefania 
Published: January 2025

Abstract

Background
Aim of this study is to evaluate factors associated with uptake of pneumococcal vaccination after invasive pneumococcal disease (IPD). Since pneumococcal infection doesn’t protect from future ones, vaccination is recommended in patients who recover from IPD.
Table 1
Population's characteristics.

Methods
Retrospective, bicenter cohort study of patients hospitalized with invasive pneumococcal disease at IRCCS San Raffaele Hospital (Milan, Italy) and ASST Manzoni Hospital (Lecco, Italy) between January 1st 2015 and December 31st 2019. Patients older than 18 years with positive blood or cerebrospinal fluid cultures for Streptococcus pneumoniae were included. Patients who died before discharge and whose vaccinal record and discharge documentations were not available were excluded. All vaccination data were retrieved through Italian national vaccination portal (SIAVR). Follow-up data were updated until March 31st, 2024.
The characteristics of patients who were vaccinated (VAX) and were not vaccinated (UNVAX) after the event were compared using the chi-square test for categorical variables and the Mann-Whitney U-test for continuous variables.
Table 2
Characteristics of vaccination cycles.

Results
The characteristics of the 211 included patients are described in table 1, completed vaccination cycles in table 2. Only 26 patients (12.3%) received an indication at discharge to get vaccinated for S. pneumoniae, and 47 (22.2%) patients were vaccinated during the observation period, after a median of 6.6 (2.3-29.9) months after the event. There was no difference in age between the two groups (70.7 [60.1-78.4] vs 69.5 [58.8-78.5], p-value=0.82), while a greater proportion of VAX patients was male (33 [70.2%] vs 86 [52.4%], p-value=0.03). Charlson comorbidity index was similar between the two groups (5 [3-6] vs 5 [3-6], p-value=0.845), but a significant higher percentage of VAX patients had lymphoma (8 [17%] vs 8 [4.9%], p-value=0.006). Patients who received an indication to vaccinate were significantly more likely to receive pneumococcal vaccination (16 [34%] vs 10 [6.1%], p-value&lt; 0.001).

Conclusion
Our cohort revealed low pneumococcal vaccination uptake, with inadequate frequency of vaccination indication at discharge. Reinforcing prevention culture among patients and physicians is imperative.

Disclosures
Antonella Castagna, MD, Bristol-Myers Squibb: Advisor/Consultant|Gilead Sciences, Inc.: Advisor/Consultant|Gilead Sciences, Inc.: Grant/Research Support|Gilead Sciences, Inc.: Honoraria|Janssen: Advisor/Consultant|Janssen: Grant/Research Support|Janssen: Honoraria|Merck Sharp & Dohme: Advisor/Consultant|Merck Sharp & Dohme: Grant/Research Support|Merck Sharp & Dohme: Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Honoraria
P-61. Perceived Importance of Adult Immunizations among HIV Providers in New Orleans, Louisiana
Authors: Yau Tat , Edwards Blane , Richey Lauren 
Published: January 2025

Abstract

Background
Immunizations are key to primary care for people with HIV (PWH). Unfortunately, immunization rates among PWH are reportedly low. In addition to patients’ preferences, limited time and acute issues, knowledge gap and beliefs about vaccine among clinicians could negatively impact their recommendations, which would ultimately affect vaccine uptake for PWH.
Table 1
Survey results about perceived importance of vaccines of interest for people with HIV in different age groups prior to (pre-test) and after (post-test) education session

Methods
This was a clinical quality improvement project at HIV Outpatient Program (HOP) at University Medical Center, New Orleans in 2023. A pretest survey was conducted to evaluate providers’ perceived importance of the vaccines of interest for PWH in different age groups: aged 19 to 26, 27 to 45, and 65 or above. Participants were asked to rank the vaccines on a scale of 0 to 3: 0 means the vaccine is not indicated; 1 means the vaccine is optional; 2 means the vaccine is important; and 3 means the vaccine is very important. The pre-test was followed by an educational session to review updates of adult immunizations tailored to PWH. Following this a post-test survey was collected to assess changes in perceived importance among participants.
Image 1
Perceived importance of immunizations among PWH aged 19 to 26

Results
12 physicians participated in this study. Participants’ perceived importance of most immunizations improved after education (table 1 and figure 1-3). The perceived most important vaccines after education, defined by a score of 2.5 or above, were: meningococcus, hepatitis B, hepatitis A, HPV, and pneumococcus vaccines among PWH aged 19 to 26; hepatitis B, pneumococcus, hepatitis A, meningococcus, and COVID-19 vaccines among PWH aged 27 to 45; pneumococcus, COVID-19, herpes zoster, hepatitis B, and influenza vaccines among PWH aged 65 or above. There was a statistically significant increase in the perceived importance of HPV vaccines among PWH aged 19 to 26 after education. In addition, all participants thought pneumococcus vaccine is very important (score of 3 in both pre and posttests) for PWH aged 65 or above.
Image 2
Perceived importance of immunizations among PWH aged 27 to 45

Conclusion
Educational training among HIV providers raised awareness of the importance of immunization. After the training session, we noticed a 46% increase in total number of PWH aged 19 to 26 who completed HPV vaccine series. Similar approach could be implemented to general practitioners to improve vaccine uptake in primary care.
Image 3
Perceived importance of immunizations among PWH aged 65 or above

Disclosures
All Authors: No reported disclosures