Coherent Control of the Fine-Structure Qubit in a Single Alkaline-Earth Atom

We report on the first realization of a novel neutral atom qubit encoded in the spin-orbit coupled metastable states ^{3}P_{0} and ^{3}P_{2} of a single ^{88}Sr atom trapped in an optical tweezer. Raman coupling of the qubit states promises rapid single-qubit rotations on par with the fast Rydberg-mediated two-body gates. We demonstrate preparation, readout, and coherent control of the qubit. In addition to driving Rabi oscillations bridging an energy gap of more than 17 THz using a pair of phase-locked clock lasers, we also carry out Ramsey spectroscopy to extract the transverse qubit coherence time T_{2}. When the tweezer is tuned into magic trapping conditions, which is achieved in our setup by tuning the tensor polarizability of the ^{3}P_{2} state via an external control magnetic field, we measure T_{2}=1.2  ms. A microscopic quantum mechanical model is used to simulate our experiments including dominant noise sources. We identify the main constraints limiting the observed coherence time and project improvements to our system in the immediate future. Our Letter opens the door for a so-far-unexplored qubit encoding concept for neutral atom-based quantum computing.

Pancytopenia in celiac disease-A case series of 20 children

Pancytopenia in children with celiac disease (CeD) is postulated to be due to nutritional deficiency such as vitamin B12, folate and copper or an autoimmune process resulting in aplastic anemia with hypoplastic marrow. In the present case series, we report the profile and explore the etiology of pancytopenia among children with CeD. There are only a few case reports of pancytopenia in children with CeD. We enrolled newly diagnosed cases of CeD and pancytopenia presenting in the celiac disease clinic over three years. Detailed evaluation was carried out for the cause of pancytopenia. We followed up on the cases for compliance and response to gluten-free diet at three months, six months and 12 months. Twenty patients were eligible for inclusion. They were divided into two groups: one with aplastic anemia with hypoplastic marrow labeled as Gp CeD-AA and the other with megaloblastic/nutritional anemia labeled as Gp CeD-MA. Patients in Gp CeD-MA presented with classical symptoms of CeD as recurrent diarrhea, abdomen distension, pallor and poor weight gain. They had none or just one transfusion requirement and had an early and complete recovery from pancytopenia. Patients in Gp CeD-AA presented with atypical symptoms such as epistaxis, short stature, fever, pallor and weakness. They had a multiple blood transfusion requirement and had delayed and partial recovery from pancytopenia. Pancytopenia is not a disease in itself but is the presentation of an underlying disease. It can occur due to various coexisting disorders in children with CeD, which can be as simple as nutritional deficiencies to as complex as an autoimmune process or malignancy. CeD should be included in the differential diagnosis of aplastic anemia as CeD and aplastic anemia both have a similar pathological process involving T cell destruction of tissues.

Boron carbide thin film surface characterization after graphitic carbon removal using low-pressure oxygen gas RF plasma

B ₄ C-coated thin film mirrors are used in high brilliance synchrotron and x-ray free electron laser beamlines due to their low absorption coefficient and high thermal stability. As in the case of gold, platinum, and other thin film mirrors, B ₄ C-coated mirrors also are affected due to synchrotron radiation-induced carbon contaminations in beamlines. In the present study, a graphitic carbon (C) layer deposited on top of boron carbide (B _x C) thin film surface is removed by five successive oxygen radio frequency (RF) plasma exposures (RF power, 10 W; O ₂ flow, 30 sccm; exposure time, 10 min each). Before and after the carbon layer removal, structural and compositional properties of the B _x C/C bilayer are characterized by soft x-ray reflectivity, x-ray photoelectron spectroscopy, grazing angle x-ray diffraction, and Raman spectroscopy techniques. Characterization results reveal that in the first four exposures the carbon layer thickness decreases continuously without affecting the B _x C layer properties; however, in the fifth exposure, the carbon layer is completely removed along with a partial etching of the B _x C layer too.

Human Leukocyte Antigen-DQ Genotyping in Pediatric Celiac Disease

PURPOSE

The purpose of this study was to determine the pattern of human leukocyte antigen (HLA)-DQ genotype in children diagnosed with celiac disease (CD) (biopsy proven), and to compare this with a control group; and secondarily, to correlate HLA genotypes with clinical profiles of CD.

METHODS

This cross-sectional comparative observational study included 26 controls and 52 patients diagnosed with CD who presented at Sir Padampat Mother and Child Health Institute, Jaipur, from May, 2017 to October, 2018. HLA DQ genotype was assessed for each patients and correlated with clinical profiles.

RESULTS

HLA DQ2/DQ8 genotypes were significantly more common in CD (present in 100.0% cases) than in controls (23.1%) in Northern India (Rajasthan). When HLA DQ2.5 and DQ8 were present together, individuals had significantly more atypical presentations and severe findings on duodenal biopsy. Similarly, patients with the HLA DQ 2.5 genotype were also predisposed to more severe endoscopic findings, while HLA DQ2.2 predisposed them to less severe biopsy findings. HLA DQ8 was significantly associated with later age at diagnosis (>5 years) and shorter stature. The highest HLA DQ relative risk (RR) for CD development was associated with HLA DQ2.5 and DQ2.2 in combination, followed by HLA DQ2.5 and DQ8 in combination, while HLA DQx.5 and HLA DQ2.2 together had the lowest risk.

CONCLUSION

HLA DQ2/DQ8 genotypes are strongly associated with pediatric CD patients in northern India. These genotypes and their combinations may be associated with different clinical presentations of CD, and may help predict severity of CD.

Zinc Oleate Nanorod-Induced Vertical Alignment of Nematic Liquid Crystal

Nanocomposite zinc oxide nanorods capped with oleic acid (ZOR) with positive dielectric anisotropy liquid crystal (LC) 4'-octyl-4-biphenylcarbonitrile (8CB) filled in unaligned cells exhibit homeotropic alignment of host LC molecules. Further, systematic investigation of the textural, dielectric, and conductivity properties of nanocomposites filled in planar cells is performed with increasing concentration of nanorods. At a nanorod concentration ≤0.2 wt % in 8CB, the order parameter of nanocomposite samples is found to be increasing and ionic conductivity is found to be decreasing as compared to pure LC. Beyond 0.3 wt % concentration of nanorods in 8CB, vertical alignment (VA) of host LC is observed even in a planar aligned cell. The VA of LC molecules in ZOR nanocomposites is confirmed through attenuated total reflection-Fourier transform infrared absorption spectra studies.

The Evolution of Public Sentiments During the COVID-19 Pandemic: Case Comparisons of India, Singapore, South Korea, the United Kingdom, and the United States

BACKGROUND

Public sentiments are an important indicator of crisis response, with the need to balance exigency without adding to panic or projecting overconfidence. Given the rapid spread of the COVID-19 pandemic, governments have enacted various nationwide measures against the disease with social media platforms providing the previously unparalleled communication space for the global populations.

OBJECTIVE

This research aims to examine and provide a macro-level narrative of the evolution of public sentiments on social media at national levels, by comparing Twitter data from India, Singapore, South Korea, the United Kingdom, and the United States during the current pandemic.

METHODS

A total of 67,363,091 Twitter posts on COVID-19 from January 28, 2020, to April 28, 2021, were analyzed from the 5 countries with "wuhan," "corona," "nCov," and "covid" as search keywords. Change in sentiments ("very negative," "negative," "neutral or mixed," "positive," "very positive") were compared between countries in connection with disease milestones and public health directives.

RESULTS

Country-specific assessments show that negative sentiments were predominant across all 5 countries during the initial period of the global pandemic. However, positive sentiments encompassing hope, resilience, and support arose at differing intensities across the 5 countries, particularly in Asian countries. In the next stage of the pandemic, India, Singapore, and South Korea faced escalating waves of COVID-19 cases, resulting in negative sentiments, but positive sentiments appeared simultaneously. In contrast, although negative sentiments in the United Kingdom and the United States increased substantially after the declaration of a national public emergency, strong parallel positive sentiments were slow to surface.

CONCLUSIONS

Our findings on sentiments across countries facing similar outbreak concerns suggest potential associations between government response actions both in terms of policy and communications, and public sentiment trends. Overall, a more concerted approach to government crisis communication appears to be associated with more stable and less volatile public sentiments over the evolution of the COVID-19 pandemic.

Refractive index of graphene AA and AB stacked bilayers under the influence of relative planar twisting

The optical properties of graphene in monolayer and bilayer structure is essential for the development of optical devices viz surface plasmon resonance (SPR) based bio-sensors. The band structure of the twisted bilayer graphene (BLG) is remarkably different than the normal AA or AB stacking. This provides an opportunity to control the optical and electrical properties of BLG by applying an in-plane twist to one of the layer relative to other in a BLG system. Here, we calculated the refractive index (RI) of AA and AB stacking of BLG system using density functional theory. Though the spectrum for AA stacking shows some similarity with that of monolayer graphene, the spectrum for AB stacking was found to be remarkably different. The spectrum of AB stacked layer is red-shifted and the absorption peaks in low energy regime increases nearly by three-folds. A large dependency of the twist angle on RI of twisted BLG were found. Based on the calculation, a schematic of phase diagram showing material behavior of such twisted BLG systems as a function of twist angle and photon energy was constructed. The twisted AA stacked BLG shows largely dielectric behavior whereas the twisted AB stacked BLG shows predominately semimetallic and semiconducting behavior. This study presents a RI landscape of twisted BLG dependent on important parameters viz photon energy and inplane relative twist angle. Our studies will be very useful for the design and development of optical devices employing BLG systems particularly SPR based bio-sensors which essentially measures change in RI due to adsorption of analytes.

Impact of COVID-19 induced lockdown and unlock down phases on the ambient air quality of Delhi, capital city of India

The present study deals with the impact of the pandemic outbreak of COVID-19 on the ambient air quality in the capital city of India. Real-time data were collected from eight continuous ambient air quality monitoring stations measuring important air quality parameters (NO₂, PM₁₀ and PM_2.5). Results revealed that the city's air quality had improved significantly during the lockdown period due to COVID-19 outbreak. The concentration of gaseous and particulate matter during the lockdown period (March-May 2020) declined significantly compared with the preceding years' data from the same timeframe. However, the ambient air quality deteriorates with the onset of unlocking phases and post-monsoon season (October 2020). Higher concentration of NO₂, PM₁₀ and PM_2.5 were recorded at industrial (S1 and S2) and hotspot (S4 and S5) sites. The lowest concentrations of studied pollutants were observed during the first phase of lockdown (March 24 - May 14, 2020). The present study, once again, establishes the direct effect of anthropogenic activities and deteriorating ambient air quality of Delhi.

Comparison of Bone-Patellar Tendon-Bone Graft, Semitendinosus-Gracilis Graft and Semitendinosus-Gracilis with Preserved Tibial Insertion Graft in Anterior Cruciate Ligament Reconstruction in Sports Persons

Introduction

Bone-patellar tendon-bone (BPTB) and semitendinosus-gracilis (STG) are the commonest grafts used for ACL reconstruction. However even after having been debated for years, there is no consensus about the ideal graft. Moreover, the literature is deficient about STG graft with preserved tibial insertion (STGPI) which preserves the proprioception. Our aim is to compare the outcome of BPTB, free STG and STGPI grafts after ACL reconstruction in professional sports persons. We compared the outcome in terms of mechanical stability, functional outcome, return to sports activity and degenerative changes.

Material and Methods

Professional sports persons aged between 16-50 years operated for ACL tear using BPTB, free STG and STGPI grafts with minimum follow-up of two years were identified from hospital records. Patients with associated knee injuries were excluded. Patients, divided in three groups according to graft used, were compared in terms of mechanical stability (arthrometric examination KT-1000 score), functional outcome (Lysholm Score), return to sports activity (Tegner score and difference in thigh circumference) and degenerative changes (KL grading).

Results

BPTB graft group was found to be better than free STG and STGPI graft groups in terms of KT-1000 score. There was no statistically significant difference among the groups in terms of Lysholm score, Tegner score, difference in thigh circumference and KL grading.

Conclusion

BPTB graft is better than free STG and STGPI grafts in terms of knee stability. When compared for patient reported outcome, return to sports activity, osteoarthritic changes and graft failure there is no significant difference among the three types of grafts.

Residence time distribution studies on recycle reactor with recirculation

Residence time distribution (RTD) experiments provide very important information about the performance of reactors. In the present work, RTD experiments were performed with varying recycle and recirculation rates to see their effect on mean residence time (MRT), flow bypassing and stagnant volume in the reactor. A computer program was developed to solve the model equations using fourth-order Runge–Kutta method. A low bypass flow (<5%) was observed from the experimental RTD curves obtained at different operating conditions. A change in the MRT from 1.2 to 1.8 h was observed at different recycle and recirculation rates. At maximum recycle and maximum recirculation, in the study ranges, a 37% stagnant volume (with exchange) was predicted. In the absence of recycle and recirculation, a 53% stagnant volume (with exchange) was predicted corresponding to the best fit of the experimental RTD data.

Post Vaccination Epidemiology and Genotyping of Rotavirus Gastroenteritis at a Tertiary Care Centre of North-East Rajasthan

OBJECTIVES

To estimate the proportion of rotavirus diarrhea among hospitalized children aged under-five years, to determine the circulating rotavirus genotypes and to know impact rotavirus vaccine on prevalence and severity of rotavirus diarrhea.

METHODS

This study was a hospital based cross-sectional observational study conducted over a period of 29 mo (September 2017 through January 2020). Stool samples were collected from children who fall within the age range of 0-59 mo with acute diarrhea attending emergency or needing admission. Stool samples were tested for rotavirus by the enzyme linked immune-sorbent assay (ELISA) and genotyped using published methods.

RESULTS

Out of 1480 samples, 360 (24.32%) cases were positive for rotavirus by ELISA, majority of them were male (62.97%). Maximum rotavirus positivity was found in the age group of <11 mo (55.27%). Statistically significance difference was seen in episodes of diarrhea and experience of vomiting in rotavirus diarrhea cases. Highest prevalence has been seen during winter season. The most prevalent G and P type combinations were G3P [8] strains [122 (34.08%)], G2P [4] [83 (23.18%)], G1P [8] [27 (7.54%)] and G9P [4] [20 (5.59%)]. Mixed strains contribute a significant proportion of stool sample.

CONCLUSIONS

Rotavirus is an important cause of diarrhea in hospitalized children. There is continued circulation of G9 and G12 strains and the emergence of G3P [8] as most common strain.

Dual Microbial Inoculation, a Game Changer? - Bacterial Biostimulants With Multifunctional Growth Promoting Traits to Mitigate Salinity Stress in Spring Mungbean

Soil microbes play a vital role in improving plant growth, soil health, ameliorate biotic/abiotic stress and enhance crop productivity. The present study was aimed to investigate a coordinated effect of compatible consortium [salt tolerating Rhizobium and rhizobacterium with 1-aminocyclopropane-1-carboxylate (ACC) deaminase] in enhancing plant growth promoting (PGP) traits, symbiotic efficiency, nutrient acquisition, anti-oxidative enzymes, grain yield and associated profitability in spring mungbean. We identified a non-pathogenic compatible Rhizobium sp. LSMR-32 (MH644039.1) and Enterococcus mundtii LSMRS-3 (MH644178.1) from salt affected areas of Punjab, India and the same were assessed to develop consortium biofertilizer based on salt tolerance, multifarious PGP traits, antagonistic defense activities and presence of nifH, acds, pqq, and ipdc genes. Indole Acetic acid (IAA), P-solubilization, biofilm formation, exo-polysaccharides, siderophore, salt tolerance, ACC deaminase activities were all found highly significant in dual inoculant (LSMR-32 + LSMRS-3) treatment compared to LSMR-32 alone. Under saline soil conditions, dual inoculant showed a higher seed germination, plant height, biomass, chlorophyll content and macro and micro-nutrient uptake, than un-inoculated control. However, symbiotic (nodulation, nodule biomass and leghaemoglobin content) and soil quality parameters (phosphatase and soil dehydrogenase enzymes) increased numerically with LSMR-32 + LSMRS-3 over Rhizobium sp. LSMR-32 alone. Dual bacterial inoculation (LSMR-32 + LSMRS-3) increased the proline content (2.05 fold), anti-oxidative enzymes viz., superoxide dismutase (1.50 fold), catalase (1.43 fold) and peroxidase (3.88 folds) in contrast to control treatment. Decreased Na⁺ accumulation and increased K⁺ uptake resulted in favorable K⁺/Na⁺ ratio through ion homeostasis. Co-inoculation of Rhizobium sp. LSMR-32 and Enterococcus mundtii LSMRS-3 significantly improved the grain yield by 8.92% and led to superior B: C ratio over Rhizobium sp. alone under salt stress. To best of our knowledge this is perhaps the first field report from Indian soils that largely describes dual inoculation of Rhizobium sp. LSMR-32 and Enterococcus mundtii LSMRS-3 and the same can be considered as a game-changer approach to simultaneously induce salt tolerance and improve productivity in spring mungbean under saline stress conditions.

Duration of Viral Clearance in Children With SARS-CoV-2 Infection in Rajasthan, India

OBJECTIVE

To study the clinical and laboratory profile and to assess period for viral clearance in COVID 19 children.

METHODS

We reviewed hospital records of children (<18 years) admitted from 1 April to 31 May, 2020 at a tertiary-care public hospital and identified those positive for severe acute respiratory syndrome corona virus (SARS-CoV-2) by RT-PCR of respiratory secretions.

RESULTS

81.2% of the 85 children studied were asymptomatic and 3 (8.5%) died. Severe lymphopenia (43.8%), raised C-reactive protein (93.8%), raised erythrocyte sedimentation rate (75%) and high (>500ng/mL) levels of D-dimer (37.5%) were common. Median (IQR) duration of viral shedding was 7 (5-10) days, with range of 2 to 45 days; 96.3% had viral clearance within 14 days.

CONCLUSIONS

Majority of children aged <18 years with SARS-CoV-2 infection had viral clearance within 14 days.

Carbon removal from a mirror-like gold surface by UV light, RF plasma, and IR laser exposure: a comparative study

A decrease in photon intensity due to carbon contamination on optical elements is a serious issue in synchrotron radiation (SR) beamlines. Photon intensity can be regained by refurbishment of optical elements using suitable techniques. In the literature, three suitable techniques [radio frequency (RF) plasma, ultraviolet (UV) radiation (λ=172nm), and infrared (IR) laser (λ=1064nm) exposure] are reported to remove carbon contaminations from optical elements. These techniques are used independently to remove carbon, and, to the best of our knowledge, no systematic study is available on their relative efficiencies and effects on a mirror surface. We have applied these techniques independently for removal of carbon contamination from a gold surface, and detailed surface characterizations are carried out using soft x-ray reflectivity, x-ray photoelectron spectroscopy, Raman spectroscopy, and atomic force microscopy techniques. Characterization results suggest that all three techniques are capable of removing carbon contamination with certain limitations. Here, detailed relative effects on a gold surface after cleaning experiments with three techniques are discussed.

Neutralising antibodies in Spike mediated SARS-CoV-2 adaptation

SARS-CoV-2 Spike protein is critical for virus infection via engagement of ACE2, and amino acid variation in Spike is increasingly appreciated. Given both vaccines and therapeutics are designed around Wuhan-1 Spike, this raises the theoretical possibility of virus escape, particularly in immunocompromised individuals where prolonged viral replication occurs. Here we report chronic SARS-CoV-2 with reduced sensitivity to neutralising antibodies in an immune suppressed individual treated with convalescent plasma, generating whole genome ultradeep sequences by both short and long read technologies over 23 time points spanning 101 days. Although little change was observed in the overall viral population structure following two courses of remdesivir over the first 57 days, N501Y in Spike was transiently detected at day 55 and V157L in RdRp emerged. However, following convalescent plasma we observed large, dynamic virus population shifts, with the emergence of a dominant viral strain bearing D796H in S2 and ΔH69/ΔV70 in the S1 N-terminal domain NTD of the Spike protein. As passively transferred serum antibodies diminished, viruses with the escape genotype diminished in frequency, before returning during a final, unsuccessful course of convalescent plasma. In vitro, the Spike escape double mutant bearing ΔH69/ΔV70 and D796H conferred decreased sensitivity to convalescent plasma, whilst maintaining infectivity similar to wild type. D796H appeared to be the main contributor to decreased susceptibility, but incurred an infectivity defect. The ΔH69/ΔV70 single mutant had two-fold higher infectivity compared to wild type and appeared to compensate for the reduced infectivity of D796H. Consistent with the observed mutations being outside the RBD, monoclonal antibodies targeting the RBD were not impacted by either or both mutations, but a non RBD binding monoclonal antibody was less potent against ΔH69/ΔV70 and the double mutant. These data reveal strong selection on SARS-CoV-2 during convalescent plasma therapy associated with emergence of viral variants with reduced susceptibility to neutralising antibodies.

Duration of Viral Clearance in Children With SARS-CoV-2 Infection in Rajasthan, India

Objective

Methods

Results

Conclusions

Influence of spin orbit splitting and satellite transitions on nickel soft X-ray optical properties near its L2,3 absorption edge region

Transition elements exhibit strong correlations and configuration interactions between core and valence excited states, which give rise to different excitations inside materials. Nickel exhibits satellite features in its emission and absorption spectra. Effects of such transitions on the optical constants of nickel have not been reported earlier and the available database of Henke et al. does not represent such fine features. In this study, the optical behaviour of ion beam sputter deposited Ni thin film near the L_2,3-edge region is investigated using reflection spectroscopy techniques, and distinct signatures of various transitions are observed. The soft X-ray reflectivity measurements in the 500-1500 eV photon energy region are performed using the soft X-ray reflectivity beamline at the Indus-2 synchrotron radiation source. Kramers-Kronig analysis of the measured reflectivity data exhibit features corresponding to spin orbital splitting and satellite transitions in the real and imaginary part of the refractive index (refraction and absorption spectra). Details of fine features observed in the optical spectra are discussed. To the best of our knowledge, this is the first study reporting fine features in the measured optical spectra of Ni near its L_2,3-edge region.

Facile ultrathin film of silver nanoparticles for bacteria sensing

Silver nanoparticles (AgNPs) exhibit excellent anti-microbial and bactericidal properties. Due to bacterial abhorrence for AgNPs, it is difficult to develop a label-free, sensitive and low-cost bacteria sensor using them. In the present article, we report that an ultrathin and uniform Langmuir-Schaefer (LS) film of AgNPs can be employed for bacteria sensing effectively as compared to that of non-uniform and randomly distributed AgNPs in spin coated film. The uniformly distributed AgNPs in the LS film offer a relatively larger contact surface for bacteria as compared to that of spin coated film. Due to higher contact surface, adsorption of the bacteria on LS film is strongly preferable as compared to that of spin coated film leading to an enhanced sensing performance of the LS film than that of spin coated film. Soil bacteria was grown by the standard protocol and were utilized as model system for bacteria sensing application. The soil bacteria sensing was done by monitoring the piezoresponse and dissipation parameters using a quartz crystal microbalance, simultaneously. Our study indicates that the LS film of AgNPs not only facilitates the adsorption of the soil bacteria but also kills them.

Morphological transformation in the supramolecular assembly of discotic liquid crystal molecules using silver nanoparticles and its sensing application

Triphenylene based discotic liquid crystal (TP) molecules are rich in π-electrons which facilitate π-stacking interaction of the molcules leading to formation of one dimensional nanowires. These nanowires can assemble to form nanoribbons due to a lateral cohesive force among the nanowires. The flat nanoribons undergo a morphological transformation due to incorporation of silver nanoparticles (SNP) into the matrix of TP molecules. The presence of SNP induces a chiral twisting to the nanoribbons and therefore the flat nanoribbons transform into a helical nanoribbon structure. The global chiral structure exhibited by the composition of achiral constituents is due to the creation of topological defects like disclination and dislocation. These defects can lead to a geometrical frustration in the nanoribbons which relaxes with the formation of twisted helical nanoribbons. A minor change in morphology of the supramolecular assembly can have a remarkable effect on the physicochemical properties of the nanoribbons. In this article, we demonstrate that even a minor change in the geometry of aliphatic chains on the surface of nanoribbons can be employed for sensing organic solvents such as acetone and ethanol. The sensing was performed at room temperature. Relative humidity has no effect on the sensing response.

Human Immunodeficiency Virus-1 Viral Load Is Elevated in Individuals With Reverse-Transcriptase Mutation M184V/I During Virological Failure of First-Line Antiretroviral Therapy and Is Associated With Compensatory Mutation L74I

BACKGROUND

M184V/I cause high-level lamivudine (3TC) and emtricitabine (FTC) resistance and increased tenofovir disoproxil fumarate (TDF) susceptibility. Nonetheless, 3TC and FTC (collectively referred to as XTC) appear to retain modest activity against human immunodeficiency virus-1 with these mutations possibly as a result of reduced replication capacity. In this study, we determined how M184V/I impacts virus load (VL) in patients failing therapy on a TDF/XTC plus nonnucleoside reverse-transcriptase inhibitor (NNRTI)-containing regimen.

METHODS

We compared VL in the absence and presence of M184V/I across studies using random effects meta-analysis. The effect of mutations on virus reverse-transcriptase activity and infectiousness was analyzed in vitro.

RESULTS

M184I/V was present in 817 (56.5%) of 1445 individuals with virologic failure (VF). Virus load was similar in individuals with or without M184I/V (difference in log10 VL, 0.18; 95% confidence interval, .05-.31). CD4 count was lower both at initiation of antiretroviral therapy and at VF in participants who went on to develop M184V/I. L74I was present in 10.2% of persons with M184V/I but absent in persons without M184V/I (P < .0001). In vitro, L74I compensated for defective replication of M184V-mutated virus.

CONCLUSIONS

Virus loads were similar in persons with and without M184V/I during VF on a TDF/XTC/NNRTI-containing regimen. Therefore, we did not find evidence for a benefit of XTC in the context of first-line failure on this combination.

Baseline PI susceptibility by HIV-1 Gag-protease phenotyping and subsequent virological suppression with PI-based second-line ART in Nigeria

Objectives

Previous work showed that gag-protease-derived phenotypic susceptibility to PIs differed between HIV-1 subtype CRF02_AG/subtype G-infected patients who went on to successfully suppress viral replication versus those who experienced virological failure of lopinavir/ritonavir monotherapy as first-line treatment in a clinical trial. We analysed the relationship between PI susceptibility and outcome of second-line ART in Nigeria, where subtypes CRF02_AG/G dominate the epidemic.

Methods

Individuals who experienced second-line failure with ritonavir-boosted PI-based ART were matched (by subtype, sex, age, viral load, duration of treatment and baseline CD4 count) to those who achieved virological response (‘successes’). Successes were defined by viral load <400 copies of HIV-1 RNA/mL by week 48. Full-length Gag-protease was amplified from patient samples for in vitro phenotypic susceptibility testing, with PI susceptibility expressed as IC₅₀ fold change (FC) relative to a subtype B reference strain.

Results

The median (IQR) lopinavir IC₅₀ FC was 4.04 (2.49–7.89) for virological failures and 4.13 (3.14–8.17) for virological successes (P = 0.94). One patient had an FC >10 for lopinavir at baseline and experienced subsequent virological failure with ritonavir-boosted lopinavir as the PI. There was no statistically significant difference in single-round replication efficiency between the two groups (P = 0.93). There was a moderate correlation between single-round replication efficiency and FC for lopinavir (correlation coefficient 0.32).

Conclusions

We found no impact of baseline HIV-1 Gag-protease-derived phenotypic susceptibility on outcomes of PI-based second-line ART in Nigeria.