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1. Viegas, Edna Omar. Human immunodeficiency virus and human papillomavirus infections in Mozambique : from epidemiological reports to clinical trials and vaccine implementation .

Degree: 2017, Karolinska Institute

Human immunodeficiency virus (HIV) and human papillomavirus (HPV) are sexually transmitted microorganisms responsible for two major infectious diseases and public health concerns, particularly in developing countries and in sub-Saharan Africa. HIV is the causative agent of the acquired immunodeficiency syndrome (AIDS) that has so far claimed more than 35 million lives. HPV is responsible for virtually all cervical cancers (CC), the seventh most common cancer in the world and the fourth in women. Mozambique is highly affected by both HIV and HPV epidemics. The country has the fifth highest prevalence of HIV in the world and the second highest rates of CC in Africa. The national seroprevalence of HIV in 2015 was estimated to be 13.2% in populations aged 15-49 years. A previous report from Southern Mozambique has demonstrated a high prevalence of HPV in women aged 14-61 years (75.9%). This thesis aimed at describing the epidemiology of HIV and HPV infections in young adults in Maputo city, Mozambique and to evaluate preventive strategies for control of HIV and HPV. This thesis embraces a total of four studies (I-IV). Study I aimed at determining the HIV incidence in youths aged 18-24 years. In this study 1380 subjects were screened for HIV, hepatitis B virus and syphilis. HIV-uninfected individuals (n=1309) were prospectively followed for one year with quarterly study visits to determine the HIV status. The HIV, hepatitis B and syphilis prevalence found at baseline were 5.1%, 12.2% and 0.36%, respectively. The overall HIV incidence was 1.14/100 PY and was slightly higher in the female population (1.49/100 WY). The relatively low prevalence and incidence of HIV and the low prevalence of syphilis described in this study associated to the considerable stable visit retention rates, suggest that this cohort is suitable for recruitment into phase I/II HIV vaccine trials. Study II was a phase I HIV vaccine trial that recruited 24 healthy HIV-uninfected individuals from the cohort established in study I and aimed at exploring the safety and immunogenicity of an HIV-DNA/HIV-MVA prime-boost strategy using a low-dose (600 μg, 2 x 0.1 mL) and a high-dose (1200 μg, 2 x 0.2 mL) of HIV-DNA prime, delivered intradermally using a needle-free device, the ZetajetTM. This was the first HIV vaccine trial ever conducted in Mozambique and the first to assess the use of the ZetajetTM in a higher injection volume. The vaccines were safe and well tolerated. After the first HIV-MVA, Env responses were significantly higher in the high-dose group compared to the low-dose group (median 420 vs. 157.5 SFC/million PBMC, p = 0.014). Four weeks after the 2nd HIV-MVA, binding antibodies to recombinant CN54 subtype C gp140 and to native subtype B gp160 were induced in all vaccinees, with a median titer of 800 and 400, respectively. The findings suggest that the higher 1200 μg HIV-DNA dose should be considered in the future. Study III describes HPV genotypes in young women and men recruited from the cohort established…

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APA (6th Edition):

Viegas, E. O. (2017). Human immunodeficiency virus and human papillomavirus infections in Mozambique : from epidemiological reports to clinical trials and vaccine implementation . (Thesis). Karolinska Institute. Retrieved from http://hdl.handle.net/10616/45960

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Viegas, Edna Omar. “Human immunodeficiency virus and human papillomavirus infections in Mozambique : from epidemiological reports to clinical trials and vaccine implementation .” 2017. Thesis, Karolinska Institute. Accessed September 22, 2017. http://hdl.handle.net/10616/45960.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Viegas, Edna Omar. “Human immunodeficiency virus and human papillomavirus infections in Mozambique : from epidemiological reports to clinical trials and vaccine implementation .” 2017. Web. 22 Sep 2017.

Vancouver:

Viegas EO. Human immunodeficiency virus and human papillomavirus infections in Mozambique : from epidemiological reports to clinical trials and vaccine implementation . [Internet] [Thesis]. Karolinska Institute; 2017. [cited 2017 Sep 22]. Available from: http://hdl.handle.net/10616/45960.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Viegas EO. Human immunodeficiency virus and human papillomavirus infections in Mozambique : from epidemiological reports to clinical trials and vaccine implementation . [Thesis]. Karolinska Institute; 2017. Available from: http://hdl.handle.net/10616/45960

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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