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  1. Fulltext Cellular immune responses to recurring influenza strains have limited boosting ability and limited cross-reactivity to other strains
    Keynan Y, Card CM, Ball BT, Li Y, Plummer FA, Fowke KR
    Clin Microbiol Infect, 2010 Aug;16(8):1179-86.
    PMID: 20670292 DOI: 10.1111/j.1469-0691.2010.03142.x
    Influenza vaccine provides protection against infection with matched strains, and this protection correlates with serum antibody titres. In addition to antibodies, influenza-specific CD8+ T-lymphocyte responses are important in decreasing disease severity and facilitating viral clearance. Because this response is directed at internal, relatively conserved antigens, it affords some cross-protection within a given subtype of influenza virus. With the possibility of a broader A(H1N1) Mexico outbreak in the fall of 2009, it appeared worthwhile studying the degree of cellular immune response-mediated cross-reactivity among influenza virus isolates. The composition of the 2006-2007 influenza vaccine included the A/New Caledonia/20/1999 strain (comprising a virus that has been circulating, and was included in vaccine preparations, for 6-7 years) and two strains not previously included (Wisconsin and Malaysia). This combination afforded us the opportunity to determine the degree of cross-reactive cellular immunity after exposure to new viral strains. We analysed the antibody responses and the phenotype and function of the T cell response to vaccine components. The results obtained show that antibody responses to A/New-Caledonia were already high and vaccination did not increase antibody or cytotoxic T lymphocyte responses. These data suggest that repeated exposure to the same influenza stain results in limited boosting of humoral and cellular immune responses.
  2. Fulltext Tuberculosis among people living with HIV/AIDS in Jazan Region, Southwestern Saudi Arabia
    Darraj MA, Abdulhaq AA, Yassin A, Mubarki S, Shalaby HM, Keynan Y, et al.
    J Infect Public Health, 2021 Nov;14(11):1571-1577.
    PMID: 34656963 DOI: 10.1016/j.jiph.2021.09.009
    BACKGROUND: Tuberculosis (TB) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) infections are leading causes of morbidity and mortality worldwide. People living with HIV/AIDS (PLWHA) are highly susceptible to TB infection and progression to active TB disease. This study aims to determine the proportion and risk factors of TB among PLWHA in Jazan Region, southwestern Saudi Arabia.

    METHODS: A cross-sectional study was conducted among HIV-infected individuals attending the main referral hospital in Jazan Region during the period 2017-2019. The participants' TB status, CD4+ lymphocyte count, and viral load were assessed. In addition, their demographic and clinical information was collected using a structured questionnaire.

    RESULTS: A total of 316 HIV-positive individuals aged between 13 and 81 years (75% male and 25% female) were enrolled in this study. Of them, 30 (9.5%; 95% confidence interval [CI]: 5.2, 10.6%) were diagnosed with TB: 46.7% (14/30) had pulmonary TB and 53.3% (16/30) had extrapulmonary TB. The highest proportion of TB-positive PLWHA was found among participants aged 18-30 years (11.6%) and among non-Saudis (14.0%) when compared to other age groups and Saudi participants (7.4%). Multivariate analysis showed that male gender (adjusted odds ratio [AOR] = 4.79; 95% CI = 1.22, 18.74), past medical history (PMH) of TB (AOR = 29.67; 95% CI = 5.31, 164.32), PMH of other RTIs (AOR = 5.86; 95 % CI = 2.14, 16.06), CD4+ lymphocyte count of <200 cells/mm³ (AOR = 4.33; 95% CI = 1.65, 11.36), and viral load of ≥1 × 103 copies/mL (AOR = 5.46; 95% CI = 2.02, 14.77) were the significant risk factors of TB among the studied PLWHA.

    CONCLUSION: The prevalence of TB/HIV co-infection among the studied population was 9.5%. Therefore, all PLWHA should be screened for TB at every visit to a health facility. The findings highlight that integration of health services for both TB and HIV/AIDS in Saudi Arabia is recommended.

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