• In women, having had a prior sexually transmitted infection and ≥2 recent sex partners were risk factors for seropositivity as well. (bmj.com)
  • Behavioral health professionals will continue to play a major and significant role in preventing the spread of HIV infection and in caring for those who are infected or affected by HIV. (netce.com)
  • As the demographics of HIV infection evolve, both in the United States and around the world, it is clear that all healthcare professionals in all practice settings will be involved to some extent with HIV infection. (netce.com)
  • Whilst risk factors for HCC including Hepatitis C virus infection can influence T-cell phenotype, it is unknown whether HIV can influence functional characteristics of the T-cell infiltrate.MethodsFrom the Liver Cancer in HIV biorepository, we derived 129 samples of transplanted (76%) or resected (20%) HCC in 8 European and North American centres. (imperial.ac.uk)
  • We correlated immuno-pathologic features with patients' characteristics including markers of HIV infection.ResultsOf the 66 HIV+ patients, 83% were Hepatitis C virus co-infected with an undetectable HIV viral load (51%) and a median blood CD4+ cell count of 430 cells/mm3 (range 15-908). (imperial.ac.uk)
  • In this study, we investigate within-racial group patterns of HIV/STI infection between Black MSM and Black men who only have sex with women (MSW). (biomedcentral.com)
  • Logistic regression models were constructed to assess whether or not history of STIs were associated with current HIV infection. (biomedcentral.com)
  • Men with a history of syphilis (OR = 6.48, 95% CI: 2.68,15.71), genital warts (OR = 4.32, 95% CI: 1.79,10.43) or genital ulcers (OR = 21.3, 95% CI: 1.89,239.51) had an increased odds of HIV infection. (biomedcentral.com)
  • The associations between STIs and current HIV infection highlight the need for integrated of HIV/STI screening and treatment programs for Black men. (biomedcentral.com)
  • Over the past several decades, effective ways to prevent human immunodeficiency virus (HIV) infection and other sexually transmitted infections (STIs), as well as improved medical management for people living with HIV (PLHIV), have become widely available in high-income countries. (biomedcentral.com)
  • In patients with HIV infection, CMV involves the entire GI tract. (medscape.com)
  • Effect of tenofovir-based HIV pre-exposure prophylaxis against HBV infection in men who have sex with men. (stanford.edu)
  • Higher rates of infection with HIV are exhibited among injection drug users mainly because of unsafe injecting behavior. (benthamscience.com)
  • HIV-related, classic endemic, and iatrogenic) and with two rare neoplastic conditions usually associated with HIV infection: body cavity-based lymphoma, also known as primary effusion lymphoma (a B-cell lymphoma that typically arises in body cavities such as the pleural space), and multicentric Castleman disease (non-cancerous tumors that may develop in lymph nodes in a single site or in multiple sites throughout the body). (hiv.gov)
  • We conducted a systematic review and a meta-analysis to (1) strengthen the evidence on the association between HPV antibodies acquired through past infection and subsequent type-specific HPV detection, (2) investigate the potential influence of type-specific HPV antibody levels, and (3) assess differential effects by HIV status. (biomedcentral.com)
  • However, the extent to which naturally acquired, or infection-induced, antibodies can help prevent HPV reinfection remains poorly understood, especially with respect to the level and the duration of protection. (biomedcentral.com)
  • BACKGROUND: Brazil remains endemic for infection by the human immunodeficiency virus (HIV) and leprosy, having a major impact on public health and the life quality of affected patients. (bvsalud.org)
  • The objective of this study was to investigate the expression of FOXP3+ Treg cells in leprosy skin lesions and to correlate their clinical forms, laboratory characteristics (CD4, CD8, and CV), and the immune reconstitution syndrome in HIV-leprosy co-infection. (bvsalud.org)
  • METHODOLOGY/PRINCIPAL FINDINGS: An observational, cross-sectional, and analytical study was carried out comparing four groups of patients: those with concomitant diagnosis of leprosy and HIV infection without a leprosy reaction, those with leprosy and HIV co-infection patients with a reverse reaction (RR), those with leprosy without HIV and without reaction, and those with leprosywithout HIV and with RR. (bvsalud.org)
  • CONCLUSIONS/SIGNIFICANCE: These findings support that higher activity of the HIV may stimulate or result in a higher expression of FOXP3-Tregs and that they may be involved in active immunosuppression observed at the infection site at the tissue level. (bvsalud.org)
  • Serologic monitoring is recommended following acute Q fever infection to assess possible progression to chronic infection. (medscape.com)
  • through cellular receptors is responsible for death among uninfected CD4+/CCR5+ T cells and what are the effects of Env on CD4 +/CCR5-negative cells that might impact this website HIV infection. (egfr-signaling.com)
  • These high figures of HBV and levels (primary, preparatory and high priority efforts for prevention, control HCV infection among different pa- schools). (who.int)
  • The risk and progression of chronic infection are age-dependent and occur mainly in immunocompromised individuals. (sciendo.com)
  • METHODS: Within 6 cohorts of PWH and PWoH in the United States, we compared the 90-day risk of any hospitalization, COVID-19 hospitalization, and mechanical ventilation or death by HIV status and by prior exposure to tenofovir, among those with severe acute respiratory syndrome coronavirus 2 infection between 1 March and 30 November 2020. (bvsalud.org)
  • Adjusted risk ratios (aRRs) were estimated by targeted maximum likelihood estimation, with adjustment for demographics, cohort, smoking, body mass index, Charlson comorbidity index, calendar period of first infection, and CD4 cell counts and HIV RNA levels (in PWH only). (bvsalud.org)
  • We found that EBV, which transforms B cells, renders them susceptible to HIV-1 infection in a CXCR4 and CD4-dependent manner in vitro and that CXCR4-tropic HIV-1 integrates into the genome of these B cells with the same molecular profile as in autologous CD4+ T cells. (hku.hk)
  • The majority of research on HIV/AIDS and mental health has been carried out among clinical populations: the time of onset of comorbid depression and the mechanisms for this are therefore unclear. (biomedcentral.com)
  • Although there is evidence to suggest that asymptomatic people living with HIV/AIDS exhibit some cognitive deficits, the prevalence of poor cognitive functioning among people in low income settings at an early, pre-clinical stage has not yet been investigated. (biomedcentral.com)
  • We used a cross-sectional survey design to test the hypotheses that symptoms of Common Mental Disorder (CMD) and low scores on cognitive tests would be associated with seropositivity among participants coming for testing for HIV/AIDS. (biomedcentral.com)
  • If replicated, this may have implications for the way in which we measure and treat CMD and cognitive functioning among people living with HIV/AIDS. (biomedcentral.com)
  • Cancer is a leading cause of death among people living with HIV/AIDS (PLWHA). (nature.com)
  • This course is designed for all behavioral health professionals, including social workers, counselors, and marriage and family therapists, who may be involved with the care of persons with HIV or AIDS. (netce.com)
  • Thirty years after the first description of AIDS, an estimated 35.0 million [33.2 million-37.2 million] people were living with HIV at the end of 2013. (benthamscience.com)
  • This guideline on screening for anal cancer and dysplasia in individuals with HIV was developed by the Medical Care Criteria Committee (MCCC) of the New York State (NYS) Department of Health (DOH) AIDS Institute (AI) Clinical Guidelines Program. (hivguidelines.org)
  • The Council for International Organizations of Medical Sciences (CIOMS) acknowledges the substantial financial contribution of the Joint United Nations Programme on HIV/AIDS (UNAIDS) to the preparation of the 2002 International Ethical Guidelines for Biomedical Research Involving Human Subjects . (unibuc.ro)
  • The World Health Organization in Geneva contributed generously also through the departments of Reproductive Health and Research, Essential Drugs and Medicines Policy, Vaccines and Biologicals, and HIV/AIDS/Sexually Transmitted Infections, as well as the Special Programme for Research and Training in Tropical Diseases. (unibuc.ro)
  • METHODS: From September 2020 to March 2021, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium surveyed 238 HIV care sites across seven geographic regions to document constraints in HIV service delivery during the first year of the pandemic and strategies for ensuring care continuity for PWH. (bvsalud.org)
  • In untreated, seropositive, Caucasian, college-educated men, with a mean age of 55, the prevalence of frailty, 3.4%, was similar to that of HIV seronegative males older than 65 from the same cohort [73]. (natap.org)
  • 11 ] Similarly, the seropositivity of Anti-MOG+ cases was 20% for AQP4 seronegative cases in the study. (lww.com)
  • Median progression-free survival was 5.9 months. (bmj.com)
  • Background & AimsHIV-seropositivity shortens survival in patients with hepatocellular carcinoma (HCC). (imperial.ac.uk)
  • We assessed the correlation of LMR, RDW and NLR with patients' characteristics and the impact on survival by the Kaplan-Meier method, the log-rank test, and Cox regression models for multivariate analysis. (bvsalud.org)
  • The complete remission rate was 61.7%, with a 5- year overall survival (OS) and progression-free survival (PFS) of 59.5% and 60%, respectively. (bvsalud.org)
  • Treatment with ART is associated with increased survival among HIV-infected children with active Kaposi sarcoma. (hiv.gov)
  • Objectives: The objective was to assess the clinical and epidemiological correlates of HPV- seroreactivity in a cohort of HIV-negative and HIV-positive women. (sagepub.com)
  • HIV status data was extracted from clinical records. (biomedcentral.com)
  • Because the presence and progression of clinical signs can be useful in infectious disease research, uncertainty in how analgesics alter research outcomes or compromise characteristics of disease progression have outweighed the concern regarding animal discomfort from these symptoms. (cdc.gov)
  • Antiaquaporin4 antibodies and antimyelin oligodendrocytes antibodies are now considered as distinct entities of optic neuritis with their specific clinical presentation, neuroimaging characteristics, treatment options, and course of the disease. (lww.com)
  • Is there an indication for serologic testing for human herpesvirus 8 (HHV-8) in asymptomatic HIV-infected children (compared with not testing) to guide clinical management? (hiv.gov)
  • Results demonstrate that, compared with placebo, filgotinib consistently improved clinical outcomes in bDMARD-IR patients and that treatment efficacy was not impacted by any of these demographic and clinical baseline characteristics. (gilead.com)
  • BACKGROUND: People with human immunodeficiency virus (HIV) (PWH) may be at increased risk for severe coronavirus disease 2019 (COVID-19) outcomes. (bvsalud.org)
  • However, the risk varies widely depending on differences in factors such as co-occurrence with other sexually transmitted infections (STIs), level of viral load, stage of disease, and circumcision. (benthamscience.com)
  • Among 104 patients with an IgG test result, 90 patients were seropositive to date, with mean upper bound of time to seropositivity from initial diagnosis being 37.8 days (95% CI: 34.3-41.3). (nature.com)
  • Until now, serological [27,28], including immune-suppression due to HIV infec- studies have had little to offer in diagnosis of HPV infec- tion [25,29]. (sagepub.com)
  • 1.HIV infections - diagnosis. (bvsalud.org)
  • After controlling for the effects of confounders, the association between CMD and seropositivity was no longer statistically significant (AOR = 1.56, 0.86-2.85). (biomedcentral.com)
  • The density of cells expressing FOXP3 was higher in the BL/LL forms in patients without HIV, although the difference was not statistically significant. (bvsalud.org)
  • These biological factors are believed to impact the two key determinants of HIV transmission risk: the HIV viral load in the PLHIV's blood and genital secretions, and the number and density of HIV-susceptible cells in the sex partner (generally within their penile, vaginal, or anal mucosa) who is a person not living with HIV (non-PLHIV) [ 13 , 14 ]. (biomedcentral.com)
  • Plasma viral load is considered as the strongest determinant of sexual transmission of HIV. (benthamscience.com)
  • Evidence of a dose-response relationship of the association between levels of baseline HPV antibodies and type-specific HPV detection was assessed. (biomedcentral.com)
  • Finally, we pooled estimates from publications reporting associations between HPV serostatus and type-specific HPV detection by baseline HIV status. (biomedcentral.com)
  • We found evidence of protective effects of baseline HPV seropositivity and subsequent detection of HPV DNA (0.70, 95% CI 0.61-0.80, N E = 11) and persistent HPV positivity (0.65, 95% CI 0.42-1.01, N E = 5) mainly for HPV-16 among females, but not among males, nor for HPV-18. (biomedcentral.com)
  • Finally, we did not observe any differential effect by baseline HIV status due to the limited number of studies available. (biomedcentral.com)
  • HHV-6 (and HHV-7) levels in the brain are also elevated in people with Alzheimer's disease. (wikipedia.org)
  • Such an analysis has the potential to help inform the immunological basis for rapid viral control and disease progression. (nature.com)
  • Analysis of dynamic blood samples confirmed the utility of ctDNA for the real-time assessment of treatment response and revealed that the increases in ctDNA levels and changes in KMT2D mutation status could be useful predictors of disease progression. (bvsalud.org)
  • Retinitis is the most common manifestation of CMV disease in patients who are HIV positive. (medscape.com)
  • Its purpose is to inform clinicians in NYS who provide primary care to individuals with HIV about human papillomavirus (HPV)-related anal disease and assist them in identifying opportunities for prevention, screening, and treatment. (hivguidelines.org)
  • Reduce the morbidity and mortality associated with HPV-related anal and perianal disease in individuals with HIV through early identification and treatment of potentially precancerous and cancerous lesions, when treatment is most likely to be effective. (hivguidelines.org)
  • A separate analysis of the FINCH 2 trial assessed the efficacy of once-daily filgotinib 200 mg or 100 mg versus placebo for 24 weeks across prespecified subgroup characteristics such as disease duration/activity, seropositivity and concurrent medication use. (gilead.com)
  • The replication error (RER+) phenotype is characteristic of cancers arising in HNPCC kindreds (a familial cancer syndrome with a high incidence of colon, endometrial, gastric, and a lower incidence of ovarian and pancreatic cancers), and is also found in approximately 20% of sporadic endometrial cancers. (medmuv.com)
  • Frailty, regardless of HIV status, occurred without concurrent co-morbidities. (natap.org)
  • These findings highlight the need to offer FSW-targeted HCV interventions and ensure their access to HIV prevention and treatment. (who.int)
  • To be effective and provide compassionate care, adequate and up-to-date information about transmission, prevention, and care of HIV-infected individuals must be obtained by all behavioral health professionals. (netce.com)
  • Support the NYSDOH Prevention Agenda 2019-2024 by educating care providers on the importance of HPV vaccination and increasing the rate of 3-dose HPV immunization among individuals with HIV. (hivguidelines.org)
  • We examined HIV status and COVID-19 severity, and whether tenofovir, used by PWH for HIV treatment and people without HIV (PWoH) for HIV prevention, was associated with protection. (bvsalud.org)
  • The incidence of CMV seropositivity rises with age and in a US-based study was reported to increase from 36% in children aged 6-11 years to 91% in individuals older than 80 years. (medscape.com)
  • However, the protective effect of naturally acquired antibodies in terms of the level of protection, duration, and differential effect by sex remains incompletely understood. (biomedcentral.com)
  • The ability to detect antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently under investigation with various performance characteristics and indications for use. (researchgate.net)
  • Generally, the risk of HIV transmission for receptive anal intercourse, receptive vaginal intercourse and receptive oral intercourse is 0.5%, 0.1% and 0.01% per act, respectively. (benthamscience.com)
  • Increase the numbers of NYS residents with HIV who are screened and effectively treated for HPV-related anal and perianal dysplasia. (hivguidelines.org)
  • Münz, C Abstract: HIV and EBV are human pathogens that cause a considerable burden to worldwide health. (hku.hk)
  • Ultra-long-acting delivery platforms for HIV pre-exposure prophylaxis (PrEP) may increase adherence and maximize public health benefit. (cdc.gov)
  • Acute pancreatitis (AP) is characterized by abdominal pain, nausea, vomiting, and elevated levels of pancreatic enzymes in the blood. (health.mil)
  • 1] Thus, circulating levels of cytokines, prothrombotic factors, or acute phase reactants may play a role in precipitating acute stroke in the setting of diseased vessels, even when not stenotic. (medscape.com)
  • Effective suppression of HIV replication with ART is recommended to reduce the risk of HHV-8-associated Kaposi sarcoma (strong, low) . (hiv.gov)
  • Effective suppression of HIV replication with ART is recommended for all patients with evidence of active Kaposi sarcoma and other HHV-8-associated malignant lymphoproliferative disorders (strong, very low) . (hiv.gov)
  • Effective suppression of HIV replication with ART in HIV-infected patients with Kaposi sarcoma may prevent Kaposi sarcoma progression or occurrence of new lesions and may decrease risk of recurrence after remission. (hiv.gov)
  • HIV-positive women showed significantly less (66.7%) antibody response as compared with HIV-negative women (89.3%), with particularly impaired response to L antigens. (sagepub.com)
  • Estimates from 8 studies suggested a negative dose-response relationship between HPV antibody level and subsequent detection among females. (biomedcentral.com)
  • Many of these factors stem from the location of the epitope that can affect accessibility of the antibody to the epitope at a cellular or molecular level, direct inhibition of target antigen activity, conservation of function despite escape mutations, and even non-competitive inhibition sites. (preprints.org)
  • Since the discovery of HIV, scientists have made major inroads in understanding modes of transmission, infectivity, and pathogenicity. (netce.com)
  • Naturally acquired blocking Abs to DBPII from individuals with high levels residing in different P. vivax-endemic areas worldwide competed with mAbs, suggesting broadly shared recognition sites. (tropmedres.ac)
  • voluntary informed consent was sought for participation in research interviews and data linkage with HIV test results. (biomedcentral.com)
  • Our findings provide tentative evidence to suggest that low cognitive test scores (and possibly depressive symptoms) may be associated with HIV status among people who have yet to receive their HIV test results. (biomedcentral.com)
  • Implant removal via a small incision in 2 macaques at week 12 results in a 7- to 48-fold decrease in plasma CAB levels within 72hours. (cdc.gov)
  • In fact, when new combinations between different HIV-1 subtypes occurs, it results in different Unique Recombinant Forms (URFs), some developed into Circulating Recombinant Forms (CRFs) as propagated in three or more epidemiologically unlinked individuals. (benthamscience.com)
  • However, the cell mean was higher in the TT/BT forms in patients co-infected with leprosy and HIV, showing contradictory results. (bvsalud.org)
  • Data from earlier studies in Tanzania suggested either lack of exposure or low levels of HEV among women ( 7 , 8 ). (cdc.gov)
  • The risk of HIV transmission varies widely by the type of exposure. (benthamscience.com)
  • African, Caribbean, and Black (Black) men account for 16.5% of new HIV diagnoses among men in Ontario. (biomedcentral.com)
  • 2.HIV infections - therapy. (bvsalud.org)
  • RÉSUMÉ Une forte prévalence des infections par les virus de l'hépatite B et C a été signalée dans des groupes de patients spécifiques en Libye et une enquête a par conséquent été préparée pour évaluer l'étendue du problème à l'échelle nationale. (who.int)
  • Serum IL-6 levels were associated with frailty status (p=0.018) but not with low MoCA score (p=0.89 by JT). (natap.org)
  • No clear trends over time were observed in the seroprevalence of HEV, and HIV status was not associated with hepatitis seroprevalence. (cdc.gov)
  • We performed targeted transcriptomics and T-cell receptor sequencing in a restricted subset of samples evaluated in relationship with HIV status. (imperial.ac.uk)
  • Tumour infiltrating lymphocyte clonality was not influenced by HIV status.ConclusionsHIV-associated HCC harbours a profoundly immune-exhausted tumour microenvironment, warranting prospective testing of immunotherapy in this treatment-deprived patient population. (imperial.ac.uk)
  • The finding that the increase of tPLA 2 activity and the severity of the global cognitive status impairment are significantly linked suggests a possible role of tPLA 2 in MCI progression. (pharmaceuticalintelligence.com)
  • Some P. vivax-exposed individuals acquired Abs to DBPII that block DBPII-DARC interaction and inhibit P. vivax reticulocyte invasion, and Ab levels correlate with protection against P. vivax malaria. (tropmedres.ac)
  • To better understand the functional characteristics and fine specificity of protective human Abs to DBPII, we sorted single DBPII-specific IgG+ memory B cells from three individuals with high blocking activity to DBPII. (tropmedres.ac)
  • Biological specimens were collected to screen for HIV and other STIs. (biomedcentral.com)
  • Patterns of overall rates of CP by demographic and military characteristics were generally similar to those for AP. (health.mil)
  • Public health strategies are also needed to reduce disproportionate HIV/STI burden among Black MSM-including improving HPV vaccine coverage. (biomedcentral.com)
  • These outbreaks emphasize the need for maintaining high levels of vaccine coverage and continued surveillance for circulating virus. (basicmedicalkey.com)
  • We tested blood samples from HIV-uninfected and -infected populations of women and men enrolled in research studies in Malawi during 1989-2008 to determine the seroprevalence of HEV, hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV). (cdc.gov)
  • In both men and women, having a non-Western migration background was a risk factor for seropositivity. (bmj.com)
  • Among women positive for DNA of an individual HPV type, seropositivity for the related HPV type ranged from 13C33? (abt-888.net)
  • Mitochondrial DNA (mtDNA), released from dying cells, is a biomarker of inflammation, a mediator of immune activation and has been detected at elevated levels in the plasma of PLWH. (natap.org)
  • In 2011, 208 people per 100,000 (0.2%) were infected with HIV in Canada [ 1 ]. (biomedcentral.com)
  • However, Ontario's Black population (3.9% of the total population) comprises approximately 22.5% of people living with HIV in the province. (biomedcentral.com)
  • During maturation of HHV-6 virions, human cell membranes are used to form viral lipid envelopes (as is characteristic of all enveloped viruses). (wikipedia.org)
  • HIV has probably originated from multiple zoonotic transmissions of Simian Immunodeficiency Virus (SIV) from non-human primates to humans in West and Central Africa. (benthamscience.com)
  • The respective mice that reconstitute human immune system components upon transplantation with CD34+ human hematopoietic progenitor cells could recapitulate aspects of EBV and HIV immunobiology observed in dual-infected patients. (hku.hk)
  • We hypothesized that in older PLWH, plasma mtDNA would be associated with lower cognitive performance, frailty, and higher serum IL-6 level. (natap.org)
  • BACKGROUND: To analyze the relationship between the peripheral blood absolute lymphocyte count (ALC)/absolute monocyte count (AMC) ratio, soluble interleukin 2 receptor (sIL-2R) level, serum programmed cell death 1 (PD-1) level, and the prognosis of patients with diffuse large B-cell lymphoma (DLBCL). (bvsalud.org)
  • For example, serum biomarkers, such as high sensitivity C-reactive protein (hsCRP) and cytokine levels, predict progression of atherosclerosis and risk of stroke. (medscape.com)
  • We also know that Env binds to CCR5 present at high levels on CD4-negative.d T cells where it signals through p38 MAP kinase to activate caspases and Fas-independent cell death. (egfr-signaling.com)
  • There were no significant differences in the 5-year OS or PFS in patients with different levels of RDW, LMR, and NLR. (bvsalud.org)
  • LMR, RDW and NLR were correlated with many of patients' characteristics. (bvsalud.org)
  • Therefore, routine testing to identify HHV-8-seropositive, HIV-infected patients is not recommended (strong, very low) . (hiv.gov)
  • For HIV-infected patients initiating ART, are any specific ART regimens associated with lower rates of Kaposi sarcoma? (hiv.gov)
  • Similarly, a reduction in tacrolimus dose and dosing rate of recurrence from 2?mg twice daily to 0.5?mg every 7 days is expected to maintain Ctrough levels within the range observed before initiation of 3D treatment at 12 months after transplantation. (informationalwebs.com)
  • EFFECTS OF HIV, AGE, AND SEX ON SKELETAL MUSCLE MASS AND DENSITY (04/01/20) "Older age and being a woman was associated with smaller and fattier muscle, while obesity was associated with larger and fattier muscle. (natap.org)
  • To inform preventive and therapeutic strategies, continued research is needed to understand the factors that increase risk of progression from AP to CP and the importance of the interaction between genetic and environmental factors in this transition. (health.mil)
  • one or more supplemental doses of IPV can increase the rate of seropositivity for these serotypes. (basicmedicalkey.com)
  • After adjusting for the effects of confounders, the association between low scores on the test of verbal fluency and seropositivity was retained (AOR = 1.77, 1.27-2.48). (biomedcentral.com)
  • Outbreaks are thought to have been facilitated by suboptimal rates of vaccination, isolated pockets of unvaccinated children, poor sanitation and crowding, improper vaccine-storage conditions, and a reduced level of response to one of the serotypes in the vaccine. (basicmedicalkey.com)
  • a survey was thus designed to determine the extent of the problem at the national level. (who.int)
  • The pandemic of SARS-CoV-2 is unprecedented at many levels. (asm.org)