Backgrounds:

Half of new sexual transmitted infections(STI) occur in adolescents, due to poor sexual education and less awareness of disease, leading to risk behaviours. Our aims were to describe the identified STI and estimate their incidence in patients younger than 18-years attended in our hospital over the last 7 years.

Methods

Retrospective descriptive study, including all STI diagnosed in our tertiary hospital in Madrid between 2015-2021. Two periods were compared: A(2015-2017) and B(2018-2021, excluding 2020 due to COVID-19-lockdown).

Epidemiological-clinical data were collected from medical history. Microbiological tests were performed according to symptoms or medical history and they included: PCR for N.gonorrhoeae(NG) and C.trachomatis(CT) in urethral/urine samples, PCR for herpes-simplex-2(HSV-2) or human papillomavirus(HPV) in scraped samples and serological tests for HIV and syphilis.

Results:

There were 58 STI diagnosed: 33 CT, 20 NG, 2 HSV-2, 2 syphilis(one HIV-infected) and 1 HPV, in 44 adolescents. Median age at diagnosis was 17.0years (IQR16.0-17.6); 25(56%) were female. There were 14 coinfections(CT-NG). CT was isolated more frequently in female(22 vs 11, p:0.02) while NG was in males(12 vs 8, p:0.03).

One third of patients were asymptomatic and diagnosed after reporting sexual risk behaviour. All HSV-2 and HPV were tested due to consistent skin lesions. All infections were treated at the emergency room. Three girls required hospitalization due to pelvic inflammatory disease.

The estimated incidence of STI in patients in period A was 0.51 per 1000-patients-years compared to 0.67 per 1000-patients-years in period B (p:0.36).

Conclusions/Learning Points:

C. trachomatis and N. gonorrhoeae are the main STI diagnosed in adolescents in our setting, but other preventable severe STI occurred. Asymptomatic infections were common as well as co-infections. Paediatricians should be familiar to these infections, which may increase in the following years.

Backgrounds:

There is a need to assess the immunogenicity and duration of immune response to SARS-CoV-2 mRNA vaccination in HIV-infected patients. Scarce data exist on HIV-infected adolescents.

Methods

A prospective ongoing observational study is being conducted in HIV-infected patients > 12 years of age after the introduction of mRNA vaccination in Spain. Blood samples were drawn 3-10weeks after the first or second dose (according to prior SARS-CoV2 infection) of BNT162b2 (Pfizer/BioNTech) and CoV-2-mRNA-1273 (Moderna) vaccines in 20 HIV-infected adolescents and compared to 20 matched healthy-control subjets. Humoral response was assesed by detection of SARS-CoV-2 antibodies by chemiluminescent-microparticle-immunoassay (CMIA) (Alinity® Quant assay-Abbott) to detect IgG against S1-region of the spike-protein of SARS-CoV-2 (≥50U/mL considered reactive). T-Cell response to SARS-CoV-2 was measured by an interferon-gamma-released-assay (IGRA,Euroimmun) of S1 peptide-stimulated T-cells in whole blood (≥200mlU/ml considered reactive).

Results:

Blood samples from 20 HIV-infected adolescents were drawn after vaccination (15 Pfizer/BioNTech, 5 Moderna), see figure one. Mean age was 16.7±3.9 and 14.3±3.9 years in patients and controls, respectively (p:0.06). Mean intervals since last vaccine dose in HIV-infected and controls were 44.0±15.1 and 38.5±12.6 days,(p>0.05). Two HIV-infected patients and 6 controls had documented past SARS-CoV-2 infection.

All patients and controls had reactive humoral and celular responses. HIV-infected subjects had lower anti-Spike antibodies titers (mean 14251±8270 U/mL) than controls (mean 27716±15768 U/mL)(p:0.013). Likewise, cellular immune responses were lower in HIV-infected adolescents (mean 1609±418 mlU/ml) than in controls (mean 1777±356 mlU/ml),(p:0.024).

Conclusions/Learning Points:

Perinatally HIV-infected adolescents with good immunologic and virological status elicit appropriate specific antispike-antibody levels and cellular immune responses against SARS-CoV-2 shortly after mRNA vaccination, but of lower amount than healthy control subjects. More prolonged studies are underway to determine the evolution of humoral and cellular immune responses after vaccination.

Backgrounds:

Half of new sexual transmitted infections(STI) occur in adolescents, due to poor sexual education and less awareness of disease, leading to risk behaviours. Our aims were to describe the identified STI and estimate their incidence in patients younger than 18-years attended in our hospital over the last 7 years.

Methods

Retrospective descriptive study, including all STI diagnosed in our tertiary hospital in Madrid between 2015-2021. Two periods were compared: A(2015-2017) and B(2018-2021, excluding 2020 due to COVID-19-lockdown).

Epidemiological-clinical data were collected from medical history. Microbiological tests were performed according to symptoms or medical history and they included: PCR for N.gonorrhoeae(NG) and C.trachomatis(CT) in urethral/urine samples, PCR for herpes-simplex-2(HSV-2) or human papillomavirus(HPV) in scraped samples and serological tests for HIV and syphilis.

Results:

There were 58 STI diagnosed: 33 CT, 20 NG, 2 HSV-2, 2 syphilis(one HIV-infected) and 1 HPV, in 44 adolescents. Median age at diagnosis was 17.0years (IQR16.0-17.6); 25(56%) were female. There were 14 coinfections(CT-NG). CT was isolated more frequently in female(22 vs 11, p:0.02) while NG was in males(12 vs 8, p:0.03).

One third of patients were asymptomatic and diagnosed after reporting sexual risk behaviour. All HSV-2 and HPV were tested due to consistent skin lesions. All infections were treated at the emergency room. Three girls required hospitalization due to pelvic inflammatory disease.

The estimated incidence of STI in patients in period A was 0.51 per 1000-patients-years compared to 0.67 per 1000-patients-years in period B (p:0.36).

Conclusions/Learning Points:

C. trachomatis and N. gonorrhoeae are the main STI diagnosed in adolescents in our setting, but other preventable severe STI occurred. Asymptomatic infections were common as well as co-infections. Paediatricians should be familiar to these infections, which may increase in the following years.

Backgrounds:

There is a need to assess the immunogenicity and duration of immune response to SARS-CoV-2 mRNA vaccination in HIV-infected patients. Scarce data exist on HIV-infected adolescents.

Methods

A prospective ongoing observational study is being conducted in HIV-infected patients > 12 years of age after the introduction of mRNA vaccination in Spain. Blood samples were drawn 3-10weeks after the first or second dose (according to prior SARS-CoV2 infection) of BNT162b2 (Pfizer/BioNTech) and CoV-2-mRNA-1273 (Moderna) vaccines in 20 HIV-infected adolescents and compared to 20 matched healthy-control subjets. Humoral response was assesed by detection of SARS-CoV-2 antibodies by chemiluminescent-microparticle-immunoassay (CMIA) (Alinity® Quant assay-Abbott) to detect IgG against S1-region of the spike-protein of SARS-CoV-2 (≥50U/mL considered reactive). T-Cell response to SARS-CoV-2 was measured by an interferon-gamma-released-assay (IGRA,Euroimmun) of S1 peptide-stimulated T-cells in whole blood (≥200mlU/ml considered reactive).

Results:

Blood samples from 20 HIV-infected adolescents were drawn after vaccination (15 Pfizer/BioNTech, 5 Moderna), see figure one. Mean age was 16.7±3.9 and 14.3±3.9 years in patients and controls, respectively (p:0.06). Mean intervals since last vaccine dose in HIV-infected and controls were 44.0±15.1 and 38.5±12.6 days,(p>0.05). Two HIV-infected patients and 6 controls had documented past SARS-CoV-2 infection.

All patients and controls had reactive humoral and celular responses. HIV-infected subjects had lower anti-Spike antibodies titers (mean 14251±8270 U/mL) than controls (mean 27716±15768 U/mL)(p:0.013). Likewise, cellular immune responses were lower in HIV-infected adolescents (mean 1609±418 mlU/ml) than in controls (mean 1777±356 mlU/ml),(p:0.024).

Conclusions/Learning Points:

Perinatally HIV-infected adolescents with good immunologic and virological status elicit appropriate specific antispike-antibody levels and cellular immune responses against SARS-CoV-2 shortly after mRNA vaccination, but of lower amount than healthy control subjects. More prolonged studies are underway to determine the evolution of humoral and cellular immune responses after vaccination.