Source

Editora Elsevier

Revista Científica ‘Parkinsonism and Related Disorders’

Authors

Jose Luiz Pedroso, Thiago Cardoso Vale, Maria Thereza Drumond Gama, Gustavo Ribas, Julio C.G. Kristochik, Francisco M.B. Germiniani, Maria Cristina Domingues da Silva Fink, Augusto Cesar Penalva de Oliveira, Helio A.G. Teive e Orlando G. Barsottini.

Abstract

Introduction
The spectrum of neurologic disorders associated with HIV infection is very broad, resulting from direct virus invasion, opportunistic infections, malignancies and toxic effects of drugs.

Methods
Among a large cohort of ataxia patients (N = 1050) evaluated between 2008 and 2017, we detected four patients with HIV-infection who developed a pure progressive cerebellar ataxia syndrome combined with cerebellar atrophy.

Results
Adverse drug effects, opportunistic infections and malignancies as well as immune-reconstitution syndrome were ruled out based on history and laboratory data. The exact pathophysiological mechanisms of ataxia in HIV patients is not very clear, but seems to be immune-mediated or a direct neurotoxic virus effect leading to apoptosis of Purkinje and granular cells.

Conclusion
HIV infection should be investigated in adult patients with undetermined sporadic progressive pure ataxia with cerebellar atrophy.

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Brazilian Journal of OTORHINOLARYNGOLOGY Otorhinolaryngology.

SciELO – Eletronic Library

Authors

Carla Gentile Matasa , Alessandra Giannella Samellia, Fernanda Cristina Leite Magliaroa e Aluisio Seguradob.

Abstract

Introduction:

The Human Immunodeficiency Virus (HIV) and infections related to it can affect multiple sites in the hearing system. The use of High Activity Anti-Retroviral Therapy (HAART) can cause side effects such as ototoxicity. Thus, no consistent patterns of hearing impairment in adults with Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome have been established, and the problems that affect the hearing system of this population warrant further research.

Objectives:

This study aimed to compare the audiological and electrophysiological data of Human Immunodeficiency Virus-positive patients with and without Acquired Immune Deficiency Syndrome, who were receiving High Activity Anti-Retroviral Therapy, to healthy individuals.

Methods:

It was a cross-sectional study conducted with 71 subjects (30-48 years old), divided into groups: Research Group I: 16 Human Immunodeficiency Virus-positive individuals without Acquired Immunodeficiency Syndrome (not receiving antiretroviral treatment); Research Group II: 25 Human Immunodeficiency Virus-positive individuals with Acquired Immunodeficiency Syndrome (receiving antiretroviral treatment); Control Group: 30 healthy subjects. All individuals were tested by pure-tone air conduction thresholds at 0.25-8 kHz, extended high frequencies at 9-20 kHz, electrophysiological tests (Auditory Brainstem Response, Middle Latency Responses, Cognitive Potential).

Results:

Research Group I and Research Group II had higher hearing thresholds in both conventional and high frequency audiometry when compared to the control group, prolonged latency of waves I, III, V and interpeak I-V in Auditory Brainstem Response and prolonged latency of P300 Cognitive Potential. Regarding Middle Latency Responses, there was a decrease in the amplitude of the Pa wave of Research Group II compared to the Research Group I.

Conclusions:

Both groups with Human Immunodeficiency Virus had higher hearing thresholds when compared to healthy individuals (group exposed to antiretroviral treatment showed the worst hearing threshold) and seemed to have lower neuroelectric transmission speed along the auditory pathway in the brainstem, subcortical and cortical regions.

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Source

Revista Científica – ‘BioMedical – Journal of Scientific & Technical Research’

Authors

Dennis Minoru Fujita, Luiz Henrique da Silva Nali, Paulo Roberto Palma Urbano e Expedito José de Albuquerque Luna

Abstract

The economic development in emerging countries promoted an increase of access for new medical technologies and services which improve the life expectancy of your population at last 10 years. In Brazil, the increase of senior group is accompanied by new demands for a better quality of life, based on the interaction and social integration of the elderly. However, this social renaissance may be followed by agents that did not represent a risk for this group. Either by lack of preventive knowledge or by the cultural conduct to not use condoms, in the past, of this generation. Our study assessed the number of HIV-infected from Brazilian Ministry of Health public database (DATASUS) during the last 10 years. We focused on analyzing the frequency in senior age group, which was divided in the following distribution by age: 60-64, 65-69, 70-74, 75-79 and 80<years old. We compared the price’s evolution from the two main drugs for erectile dysfunction (Drug 1 and Drug 2) at Agencia Nacional de VigilanciaSanitaria – ANVISA database in the last 10 years. Today, there are ~36.7 million people infected by HIV in the world, whereas in Brazil there was an increase in estimated number of people (all ages) living with HIV(n~700.000 in 2010/ n~830.000 in 2015) in Brazil, with an estimative of ~15.000 deaths/year.

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Journal ‘Clinical Microbiology and Infection’ – Editora Elsevier

Authors

Claudia Figueiredo-Mello, Pontus Naucler, Marinella Della Negra e Anna S. Levin

Abstract

Objectives:To evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome whencompared with monotherapy with ceftriaxone, in hospitalized patients with human immunodeficiencyvirus/acquired immunodeficient syndrome (HIV/AIDS) with community-acquired pneumonia (CAP).Methods:Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one oftwo regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 1:1 proportion (BrazilianClinical Trials Registry: RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondaryoutcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation,time to clinical stability and length of hospitalization.Results:A total of 227 patients were randomized, two were excluded after randomization; 225 patientswere analysed (112 receiving ceftriaxone plus placebo and 113 receiving ceftriaxone plus macrolide). Thefrequency of the primary outcome, in-hospital mortality, was not statistically different between theregimens: 12/112 (11%) patients who received ceftriaxone plus placebo and 17/113 (15%) who receivedceftriaxone plus macrolide died during hospitalization (hazard ratio 1.22, 95% CI 0.57e2.59). We did notfind differences between the regimens for any of the secondary outcomes, including mortality within14 days, which occurred in 5/112 (4%) patients with ceftriaxone plus placebo and in 12/113 (11%) patientswith ceftriaxone plus macrolide (relative risk 2.38, 95% CI 0.87e6.53).Conclusions:Among hospitalized patients with HIV/AIDS with CAP, treatment with ceftriaxone and amacrolide did not improve patient outcomes, when compared with ceftriaxone monotherapy.

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Editora Springer

Archives of Virology – Virology Division of the International Union of Microbiological Societies

Authors

A. C. Ferreira, Michele Soares Gomes-Gouvêa, G. Lisboa-Neto,  M. C. J. Mendes-Correa, C. M. Picone, N. A. Salles, A. Mendrone-Junior, F. J. Carrilho e J. R. R. Pinho

Abstract

In Brazil, the circulation of hepatitis E virus (HEV) has been demonstrated in distinct groups of individuals and some animals, but its prevalence among individuals with human immunodeficiency virus (HIV) infection is unknown. This study aimed to assess the frequency of serological and molecular HEV markers in individuals infected with HIV from São Paulo, Brazil. Serum and plasma samples of 354 HIV-infected patients collected between 2007 and 2013 were included. All samples were tested for anti-HEV IgG and IgM antibodies and HEV RNA. Anti-HEV IgG and IgM antibodies were detected in 10.7% (38/354) and 1.4% (5/354) of the samples, respectively. Both antibodies were detected simultaneously in only two samples. HEV RNA was not detected in any sample. There was no significant correlation of anti-HEV serological status (positivity to anti-HEV IgG and/or IgM) with sex, age, CD4⁺ T cell count, HIV viral load, antiretroviral therapy, liver enzyme levels, or coinfection with hepatitis B virus and/or hepatitis C virus. Our study provides serological evidence of past and recent HEV infections in HIV-infected patients from São Paulo, Brazil. However, the occurrence of ongoing HEV infection appears be a rare event in this population.

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Fonte

Revista  do Instituto medicina tropical de São Paulo

Scientific Electronic Library Online ( SciELO)

Autoria

Marilia Ladeira de Araújo, Wellington Duarte, Augusto César Penalva de Oliveira, Maria Rita Polo Gascón ,Luiz Augusto Marcondes Fonseca,Raquel de Melo Alves Paiva, Bárbara Santana,Rodrigo Tocantins Calado Jorge Casseb

Resumo

Objective: We evaluated the association between cognitive deficits and leukocyte telomere
length (LTL) in HIV-1-infected individuals. Design: 73 HIV-1-infected patients undergoing
neuropsychological evaluation and 91 healthy controls were included in this study. Fifteen
HIV-1 positive patients did not have cognitive disorders whereas 26 had asymptomatic
neurocognitive disorder (ANI), 13 presented mild to moderate neurocognitive disorder
(MND), and 10 had HIV-associated dementia (HAD). Methods: DNA from the peripheral
blood of HIV-1-infected patients was used for measurement of telomere length by real-time
PCR. HIV-1 viral load was determined in blood. Results: LTL decreased with age in healthy
controls (p=0.0001). Regardless of the HIV status, age-matched LTL from HIV patients,
including those with ANI and MND, were shortened in comparison to the healthy control
group (p=0.0073); however, no association was found among the HIV-1-infected individuals
with cognitive deficits (p=0.01). In addition, no gender-related association with LTL was
observed (p=0.80), smoking, physical exercise, and plasma viral load were not correlated to
telomere length (p=0.66). Conclusions: We concluded that leukocyte telomere length may
not be a marker of cellular senescence in individuals with HIV infection and neurocognitive
disorders.

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Source

BMC Public Health

Author

 André Pereira dos Santos, Navarro, Anderson Marliere, Schwingel, Andiara Alves, Thiago C. Abdalla, Pedro P. Venturini, Ana Claudia R. Santana, Rodrigo de Carvalho Machado e Dalmo Roberto Lopes.

Abstract

Background: Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA. Methods: A cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model. Results: Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2 PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women (r2 = 0.78, SEE = 0.11, r2 PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) (“Yes” for Asian race = 1; “No” = 0). Conclusions: The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA

81 s12889-018-5707-z

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Source

Biblioteca Digital de Teses e Dissertações – USP

Authors

Queiroz, Artur Acelino Francisco Luz Nunes

Abstract

Aim: Analyze the vulnerabilities of men who have sex with men, users of geossocial applications against HIV infection.

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Source

International Journal of Public Health volume 63, pages 123–136 (2018)

Springer Link

Authros

Mokdad, Ali H.

Abstract

Aim: Used the results of the Global Burden of Disease 2015 study to estimate trends of HIV/AIDS burden in Eastern Mediterranean Region (EMR) countries between 1990 and 2015

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Source

Biblioteca Digital de Teses e Dissertações – USP

Authors

Sadraeian, Mohammad

Abstract

Aim: Propose to use anti-HIV immunotoxins to eliminate infected cells that serve as the persistent virus reservoir.

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Journal of the Association of Nurses in AIDS Care, Volume 28, Issue 5, September–October 2017, Pages 807-818

ScienceDirect

Authors

Artur Acelino; Francisco Luz Nunes Queiroz; Álvaro Francisco Lopes de Sousa; Telma Maria Evangelista de Araújo; Francisco Braz Milanez de Oliveira; Maria Eliete Batista Moura; Renata Karina Reis.

Abstract

Aim: Analyze the relationship between the use of geosocial networking phone apps and risk behaviors for HIV infection in men who have sex with men (MSM).

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Source

DEDALUS USP

Authors

Renata Buccheri
Gil Benard

Abstract

Two distinct patterns of immune recovery inflammatory syndrome (IRIS) are recognized, paradoxical and unmasking IRIS. Here we raise some concerns regarding the first case of neuroPCM-IRIS published to date, as recently proposed by Almeida and Roza for a patient originally described by Silva-Vergara et al. taking in account the different case definitions for IRIS and the cases of neuroparacoccidioidomycosis already described in the literature.

Source

SAGE Journals.

Authors

Marcia T Couto; Alexandre Grangeiro; Gustavo Venturi; Renata B Levy.

Abstract

Aim: Analyses data from a national survey to distinguish groups of heterosexually active men in relation to their risk of infection

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Source

Frontiers.

Authors

Marcos V. S. Dias; Cristina S. Costa; Luis L. P. da Silva.

Abstract

Aim: A summary of the literature describing the intricate relationship between HIV and EVs biogenesis.

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Source

Scientific Electronic Library Online – SciELO.

Authors

Pérsio Yvon Adri Cezarino; Ricardo dos Santos Simões; Edmund Chadat Baracat; José Maria Soares Junior.

Abstract

Aim: To analyze studies that evaluated the loss of bone mass through DEXA in women living with HIV.

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Source

Scientific Electronic Library Online – SciELO

Authors

Sybelle de Souza Castro; Lúcia Marina Scatena; Alfredo Miranzi; Almir Miranzi Neto; Fernanda Carolina Camargo; Altacílio Aparecido Nunes.

Abstract

Aim: Verify the geographic distribution of human immunodeficiency virus/acquired immunodeficiency syndrome and analyze the association between case definition criteria, sociodemographic data, and clinical aspects of the disease in the State of Minas Gerais between 2007 and 2016.

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Source

Observatório da Produção Intelectual (OPI)

Authors

CASSENOTE, Alex Jones Flores; GRANGEIRO, Alexandre; ESCUDER, Maria Mercedes; ABE, Jair Minoro; SEGURADO, Aluisio Augusto Cotrim

Abstract

Aim: Present the validating design and results for the laboratory biomarkers viral load and CD4+ T-cell count from the HIV-Brazil Cohort Study

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Source:

Escola Anna Nery

Authors:

Gabriela Tavares Magnabosco, Lívia Maria Lopes, Rubia Laine de Paula Andrade, Maria Eugênia Firmino Brunello, Aline Aparecida Monroe Tereza Cristina Scatena Villa

Abstract:

Objective: To analyze the integration of actions and health services in care provided by Specialized Services (SS) in Ribeirão Preto/SP in people living with HIV/AIDS (PLWHA) perception.

Methods: Exploratory descriptive study, survey type in which 253 PLWHA were interviewed using a structured questionnaire. The data were analyzed by indicators (classified as unsatisfactory-average from 1 to 2.5; regular-between 2.6 and 3.5; satisfying-3.6 to 5) and multiple correspondence analysis.

Results: The integration of health care actions had an average 3.7 (SD = 1.7) classified as satisfactory. The horizontal integration was satisfactory regarding the use of medical records, and the vertical one regarding the referral to other health services. The low utilization of Basic Care and Emergency Care services was also identified.

Conclusion: Despite of the satisfactory rating on the integration of assistance to PLWHA, challenges still be done, highlighting the need for greater empowerment of individuals and strengthening reference mechanisms with support of SCS to other points of attention in HIV/AIDS specificities

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Source:

Caderno de saúde pública- SciElo

Authors:

Ana Paula Loch,Maria Ines Battistella Nemes, Maria Altenfelder Santos, Ana Maroso Alves, Regina Melchior, Cáritas Relva Basso, Joselita Maria de Magalhães Caraciolo, Maria Teresa Seabra Soares de Britto e Alves, Elen Rose Lodeiro Castanheira, Wania Maria do Espírito Santo Carvalho, Ruth Terezinha Kehrig, Aline Aparecida Monroe.

Abstract:

Health services play a crucial role in reaching the 90-90-90 target of controlling the HIV epidemic. This study evaluates the organization of Brazilian health services in improving, monitoring, and retention in HIV care and adherence support. Percentage variation (PV) was used to compare the responses by services to an evaluation questionnaire on organizational quality (Qualiaids) in 2007 and 2010. The study analyzed the 419 services that completed the questionnaire in 2007 (83.1% of respondents) and 2010 (63.6%). Management actions of retention and support although increased in the period, but remained at low rates, for example: systematic meetings for case discussion (32.7% in 2010; PV = 19.8%) and recording of missed medical appointments (35.3%; PV = 36.8%). Patient care actions related to adherence to ART remained largely exclusive to the attending physician. The supply of funds and resources from the Federal Government (medicines and specific HIV tests) remained high for the vast majority of the services (~90%). It will not be possible to achieve a significant decrease in HIV transmission as long as retention in treatment is not a priority in all the health services.

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Source:

Journal of Antimicrobial chemotherapy.

Authors:

Elidamar Nunes de Carvalho Lima, Jose  Roberto Castilho Piqueira, Michelle Camargo, Juliana Galinskas,  Maria Cecilia Sucupira and Ricardo Sobhie Diaz.

Abstract:

Objectives: The present study investigated the relationship between genomic variability and resistance of HIV-1sequences in protease (PR) and reverse transcriptase (RT) regions of thepolgene. In addition, we analysed the resistance among 651 individuals presenting antiretroviral virological failure, from 2009 to 2011, in the state ofS~ao Paulo, Brazil.

Methods: The genomic variability was quantified by using informational entropy methods and the relationship between resistance and replicative fitness, as inferred by the residual viral load and CD4!T cell count.

Results: The number of antiretroviral schemes is related to the number of resistance mutations in the HIV-1PR (a”0.2511,P”0.0003,R2″0.8672) and the RT (a”0.7892,P”0.0001,R2″0.9141). Increased informa-tional entropy rate is related to lower levels of HIV-1 viral loads (a”#0.0121,P”0.0471,R2″0.7923), lower levels of CD4!T cell counts (a”#0.0120,P”0.0335,R2″0.8221) and a higher number of antiretroviral resistance-related mutations.

Conclusions: Less organized HIV genomes as inferred by higher levels of informational entropy relate to lesscompetent host immune systems, lower levels of HIV replication and HIV genetic evolution as a consequence of antiretroviral resistance.

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Source:

DovePress

Authors:

Ana lucia l Munhoz lima,Priscila Rosalba Oliveira,Vladimir C Carvalho,Alexandre leme godoy-Santos,leandro ejnisman,Claudia R Oliveira1David e Uip,Maria Irma S Duarte.

Abstract:

Objective: To examine the presence of HIV in bone tissue of people living with HIV (PLWHIV) with osteonecrosis of femoral head and describe clinical and anatomopathological findings.Design: This is a case series which included 44 PLWHIV with osteonecrosis of femoral head who underwent total hip arthroplasty.Methods: Clinical data were obtained through analysis of the patients’ medical records. Bone tissue obtained during total hip arthroplasty was retrieved and sent for conventional and immuno-histochemical analysis. Monoclonal antibodies were used to mark the p24 (HIV), CD31 (vascular endothelial cells), CD68 (macrophages), and D240 (cells of the lymphatic endothelium) antigens.Results: Dyslipidemia was found in 48% of the patients and lipodystrophy in 31%. Histological analysis showed similar characteristics for the entire sample. Degeneration of joint cartilage was visualized with the presence of fissures and fibrillations, as well as subchondral sclerosis and necrosis of the subchondral cancellous bone tissue. Lymphoplasmocytic inflammatory reaction was observed, with the presence of macrophages containing a foamy, vacuolated cytoplasm, as well as the presence of ceroid pigment and occasional granulation tissue. The reaction with the monoclonal anti-p24 antibody was negative in the samples from all 44 PLWHIV undergoing hip arthroplasty. Reactions with the anti-CD31 and anti-D240 antibodies were negative. Stain-ing with CD68 antibody confirmed that the cells visualized with foamy, vacuolated cytoplasm were macrophages.Conclusion: p24 HIV antigen was not detected in the bone tissue of PLWHIV and osteone-crosis. The most frequent anatomopathological findings were extensive necrosis of bone tissue, large vacuoles filled with fat cells, inflammatory lymphoplasmocytic reaction with macrophages containing vacuolated cytoplasm, and the presence of ceroid pigment.

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Source:

ScienceDirect

Authors:

Beatriz Grinsztejn, Brenda Hoagland, Ronaldo I Moreira, Esper G Kallas, Jose V Madruga, Silvia Goulart, Iuri C Leite, Lucilene Freitas, Luana M S Martins, Thiago S Torres, Ricardo Vasconcelos, Raquel B De Boni, Peter L Anderson, Albert Liu, Paula M Luz, Valdiléa G Veloso,

Abstract:

PrEP Brasil was a demonstration study to assess feasibility of daily oral tenofovir diphosphate disoproxil fumarate plus emtricitabine provided at no cost to men who have sex with men (MSM) and transgender women at high risk for HIV within the Brazilian public health system. We report week 48 pre-exposure prophylaxis (PrEP) retention, engagement, and adherence, trends in sexual behaviour, and incidence of HIV and sexually transmitted infections in this study cohort.

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Source:

Iranian Journal of Parasitology

Authors:

Abstract:

Patients coinfected with Leishmania/HIV can develop atypical forms of visceral leishmaniasis (VL), making it indispensable to identify the etiological agent. We are presenting a post-mortem specie definition by ITS1-PCR-RFLP in a larynx tissue of a patient presented coinfection Leishmania/HIV. This patient was from a leishmaniasis endemic region in São Paulo (SP), Brazil, and was diagnosed clinically with mucocutaneous leishmaniasis. Before a rK39 immunochromatographic test positive, a tiny stored paraffin-embedded larynx tissue was obtained post-mortem and submitted to 3 conventional PCR assays: kDNA (K20/K22 and RV1/RV2), and ITS1 (LITSR/L5.8S). The last one was followed by RFLP (HaeIII) and analyzed by 4% Metaphor agarose gel electrophoresis. Leishmania genus and Leishmania (Leishmania) subgenus were defined by kDNA-PCR, with K20/K22 (120 bp) and RV1/RV2 (145 bp), respectively. ITS1-PCR-RFLP identified L. (L.) infantum chagasi species visualized by the restriction patterns of 180, 70 and 50 bp. This case draws attention to the necessity for a clear identification of the etiological agent causing infection, especially in endemic regions of cutaneous and visceral leishmaniasis, and particularly in patients with comorbidities who often present atypical forms of the disease. L. (L.) infantum chagasi, which is usually responsible for VL, had changed its clinical spectrum for mucocutaneous. Unequivocal identification was carried out by ITS-PCR-RFLP, therefore confirming rK39 result. These techniques, which complemented each other, have a convenient cost-benefit ratio that makes them suitable to be applied in developing countries.

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Source:

Frontiers in immunology

Authors:

Juliana de Souza Apostólico Victória Alves Santos Lunardelli ,Marcio Massao Yamamoto, Edecio Cunha-Neto, Silvia Beatriz Boscardin and Daniela Santoro Rosa.

Abstract:

Cellular immune responses are implicated in resistance to HIV and have been considered for the development of an effective vaccine. Despite their safety profile, subunit vaccines need to be delivered combined with an adjuvant. In the last years, in vivo antigen targeting to dendritic cells (DCs) using chimeric monoclonal antibodies (mAb) against the DC endocytic receptor DEC205/CD205 was shown to support long-term T cell immunity. Here, we evaluated the ability of different adjuvants to modulate specific cellular immune response when eight CD4⁺ HIV-derived epitopes (HIVBr8) were targeted to DEC205⁺ DCs in vivo. Immunization with two doses of αDECHIVBr8 mAb along with poly(I:C) induced Th1 cytokine production and higher frequency of HIV-specific polyfunctional and long-lived T cells than MPL or CpG ODN-assisted immunization. Although each adjuvant elicited responses against the 8 epitopes present in the vaccine, the magnitude of the T cell response was higher in the presence of poly(I:C). More over, poly(I:C) up regulated the expression of costimulatory molecules in both cDC1 and cDC2 DCs subsets. In summary, the use of poly(I:C) in a vaccine formulation that targets multiple epitopes to the DEC205 receptor improved the potency and the quality of HIV-specific responses when compared to other vaccine-adjuvant formulations. This study highlights the importance of the rational selection of antigen/adjuvant combination to potentiate the desired immune responses.

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