Environmental fate and ecotoxicological effects of antiretrovirals: A current global status and future perspectives

Mechanistic exploration of COVlD-19 antiviral drug ritonavir on anaerobic digestion through experimental validation coupled with metagenomics analysis

Aggregation of antiviral drugs (ATVs) in waste activated sludge (WAS) poses considerable environmental risk, so it is crucial to understand the behavior of these agents during WAS treatment. This study investigated the effects of ritonavir (RIT), an ATV used to treat human immunodeficiency virus infection and coronavirus disease 2019, on anaerobic digestion (AD) of WAS to reveal the mechanisms by which it interferes with anaerobic flora. The dosage influence results showed that methane production in AD of WAS decreased by 46.56 % when RIT concentration was increased to 1000 μg/kg total suspended solids (TSS). The AD staging test revealed that RIT mainly stimulated microbial synthesis of the extracellular polymeric substance (EPS), limiting organic matter solubilization. At 500 μg/kg TSS, RIT decreased CHO and CHON levels in dissolved organic matter by 23.12 % and 56.68 %, respectively, significantly reducing substrate availability to microorganisms. Metagenomic analysis of microbial functional gene sets revealed that RIT had greater inhibitory effects on protein and amino acid metabolism than on carbohydrate metabolism. Under RIT stress, methanogens switched from hydrogenotrophic and acetotrophic methanogenesis to methylotrophic and acetotrophic methanogenesis.

Transport and retention of COVID-19-related antiviral drugs in saturated porous media under various hydrochemical conditions

Antiviral drugs have garnered considerable attention, particularly in the global battle against the COVID-19 pandemic, amid heightened concerns regarding environmentally acquired antiviral resistance. A comprehensive understanding of their transport in subsurface environments is imperative for accurately predicting their environmental fate and risks. This study investigated the mobility and retention characteristics of six COVID-19 antiviral drugs in saturated quartz sand columns. Results showed that the mobility of the drugs was primarily contingent on their hydrophobicity, with ribavirin and favipiravir exhibiting the highest transportability, while arbidol displaying the greatest retention. The transport characteristics of ribavirin and favipiravir remained largely unaffected by pH, whereas the retention of the other four antivirals remained consistently minimal under alkaline conditions. Elevating ionic strength marginally facilitated the transport of these antivirals, while the presence of Ca2+ notably enhanced their retention in quartz sand compared to Na+. Ribavirin and remdesivir warrant particular attention due to their relatively high transportability and propensity for environmentally acquired antiviral resistance. These findings contribute to an enhanced understanding of the leachate potential and transport of COVID-19-related antivirals in sandy porous media, furnishing fundamental data for predicting their environmental fate and associated risks.

Toxic mechanisms of the antiviral drug arbidol on microalgae in algal bloom water at transcriptomic level

Increasing antivirals in surface water caused by their excessive consumption pose serious threats to aquatic organisms. Our recent research found that the input of antiviral drug arbidol to algal bloom water can induce acute toxicity to the growth and metabolism of Microcystis aeruginosa, resulting in growth inhibition, as well as decrease in chlorophyll and ATP contents. However, the toxic mechanisms involved remained obscure, which were further investigated through transcriptomic analysis in this study. The results indicated that 885-1248 genes in algae were differentially expressed after exposure to 0.01-10.0 mg/L of arbidol, with the majority being down-regulated. Analysis of commonly down-regulated genes found that the cellular response to oxidative stress and damaged DNA bonding were affected, implying that the stress defense system and DNA repair function of algae might be damaged. The down-regulation of genes in porphyrin metabolism, photosynthesis, carbon fixation, glycolysis, tricarboxylic acid cycle, and oxidative phosphorylation might inhibit chlorophyll synthesis, photosynthesis, and ATP supply, thereby hindering the growth and metabolism of algae. Moreover, the down-regulation of genes related to nucleotide metabolism and DNA replication might influence the reproduction of algae. These findings provided effective strategies to elucidate toxic mechanisms of contaminants on algae in algal bloom water.

Adsorption of antiretroviral drugs, abacavir, nevirapine, and efavirenz from river water and wastewater using exfoliated graphite: Isotherm and kinetic studies

In this work, exfoliated graphite was used to adsorb antiretroviral drugs from river water and wastewater. The exfoliated graphite was prepared from natural graphite by intercalating it with the acids and exfoliating it at 800 °C. It was characterized using Fourier Transform Infrared Spectroscopy which showed phenolic, alcoholic, and carboxylic functional groups between 1000 cm-1 and 1700 cm-1. Energy-dispersive X-ray spectroscopy results showed carbon as the main element with splashes of oxygen. The Scanning Electron Microscopy images showed increased c-axis distance between graphene layers after intercalation, which further increased after the exfoliation. The exfoliation resulted in elongated distorted cylinders, which were confirmed by the lower density (0.0068 g/mL) of exfoliated graphite material compared to the natural graphite (0.54 g/mL). The X-ray diffraction pattern showed the characteristics of hexagonal phase graphitic structure by the diffraction plane (002) at 26.74°. Raman spectroscopy results showed the natural graphite, graphite intercalated, and exfoliated graphite contained the D, G, D', and G' peaks at about 1350 cm-1, 1570 cm-1, 2440 cm-1, and 2720 cm-1, respectively indicating that the material's crystallinity was not affected by the modification. The highest antiretroviral drugs removal (95-99%), from the water was achieved with a solution pH of 7, an adsorbent mass of 30 mg, and an adsorption time of 30 min. The kinetic model and adsorption isotherm studies showed that the experimental data fit well in pseudo-second-order kinetics and is well explained by Freundlich's adsorption isotherm. The maximum adsorption capacity of the exfoliated graphite for antiretroviral drugs ranges between 1.660 and 197.0, 1.660-232.5, and 1.650-237.7 mg/g for abacavir, nevirapine, and efavirenz, respectively. The obtained removal percentages were 100% in river water, 63-100% in influent and 70-100% in effluent wastewater unspiked samples.

Integrated study of antiretroviral drug adsorption onto calcined layered double hydroxide clay: experimental and computational analysis

This study focused on the efficacy of a calcined layered double hydroxide (CLDH) clay in adsorbing two antiretroviral drugs (ARVDs), namely efavirenz (EFV) and nevirapine (NVP), from wastewater. The clay was synthesized using the co-precipitation method, followed by subsequent calcination in a muffle furnace at 500 °C for 4 h. The neat and calcined clay samples were subjected to various characterization techniques to elucidate their physical and chemical properties. Response surface modelling (RSM) was used to evaluate the interactions between the solution's initial pH, adsorbent loading, reaction temperature, and initial pollutant concentration. Additionally, the adsorption kinetics, thermodynamics, and reusability of the adsorbent were evaluated. The results demonstrated that NVP exhibited a faster adsorption rate than EFV, with both reaching equilibrium within 20-24 h. The pseudo-second order (PSO) model provided a good fit for the kinetics data. Thermodynamics analysis revealed that the adsorption process was spontaneous and exothermic, predominantly governed by physisorption interactions. The adsorption isotherms followed the Freundlich model, and the maximum adsorption capacities for EFV and NVP were established to be 2.73 mg/g and 2.93 mg/g, respectively. Evaluation of the adsorption mechanism through computational analysis demonstrated that both NVP and EFV formed stable complexes with CLDH, with NVP exhibiting a higher affinity. The associated adsorption energies were established to be -731.78 kcal/mol for NVP and -512.6 kcal/mol for EFV. Visualized non-covalent interaction (NCI) graphs indicated that hydrogen bonding played a significant role in ARVDs-CLDH interactions, further emphasizing physisorption as the dominant adsorption mechanism.

Effects of solution chemistry on dielectric barrier atmospheric non-thermal plasma for operative degradation of antiretroviral drug nevirapine

The global prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been an environmental menace. Tons of drug wastes from antiretroviral therapy are released into the environment annually. We, for the first time, employed the novel dielectric barrier atmospheric non-thermal plasma (DBANP) discharge, to mitigate the inadvertent pollution arising from the antiretroviral therapy. A 40-min treatment of nevirapine achieved >94 % (0.075 min-1) removal efficiency at discharge power of 63.5 W and plasma working gas of atmospheric air. Chemical probes confirmed •OH, ONOO- and eaq- as the dominant reactive species whilst further revealing the reaction acceleration role of NaNO3 and CCl4 which are known reaction terminators. The commonly coexisting inorganic anions potentiated nevirapine removal with over 98 % efficiency, achieving the highest rate constant of 0.148 min-1 in this study. Moreover, the initial solution pH (1.5-11.1) was no limiting factor either. The insensitivity of the DBANP discharge to actual water matrices was an eminent inference of its potential applicability in practical conditions. With reference to data obtained from the liquid chromatography-mass spectrometer analysis, nevirapine degradation pathway was proposed. A nucleophilic attack by ONOO- at the cyclopropyl group and •OH attack at the carbonyl carbon of the amide group, respectively, initiated nevirapine degradation process. It is anticipated that the findings herein, will provide new insights into antiretroviral drug waste management in environmental waters using the innovative and green non-thermal plasma process.

Occurrence and environmental risks of contaminants of emerging concern across the River Athi Basin, Kenya, in dry and wet seasons

Globally, the environmental occurrence of Contaminants of Emerging Concern (CECs) including pharmaceuticals (PhACs), personal care products (PCPs) and modern polar pesticides has raised ecological and human health awareness. However, as the developed world races against time to establish regulatory measures to mitigate their effects, developing nations including Kenya are lagging behind, partly due to unavailability of adequate data. In this work, a multi-residue analysis of 86 CECs was carried out on 198 surface water and 18 effluent samples collected at 24 sites across the River Athi basin area, Kenya, in both dry and rainy seasons. Overall, 57 CECs comprising 31 PhACs (0.4 ng L-1-142 μg L-1), 6 PCPs (0.7-570 ng L-1) and 20 pesticides (0.3 ng L-1-8.3 μg L-1) were detected. The maximum loads varied from 217 g day-1 (PCPs) to 46 kg day-1 (PhACs). Individually, carbamazepine, nevirapine, sulfamethoxazole and DEET were the most ubiquitous CECs, with detection frequencies (DF) higher than 80 %. The highest concentrations were observed at river sites that are heavily impacted by informal settlements, highlighting the critical role of slums in urban rivers pollution. At least 8 CECs including acetamiprid, alachlor, atrazine, diuron, nevirapine and paracetamol show potential risk to algae, Daphnia magna and fish, as exemplified by Risk Quotients (RQ) up to 174. Similarly, potential risk of antibiotic resistant bacteria development is evident (RQ up to 64), being driven by metronidazole, sulfamethoxazole and trimethoprim. Ultimately, further studies on the occurrence and distribution of antibiotic resistant bacteria within the basin and among the communities consuming untreated river water for drinking is merited.

Neurotoxic effects of chloroquine and its main transformation product formed after chlorination

Pharmaceutical transformation products (TPs) generated during wastewater treatment have become an environmental concern. However, there is limited understanding regarding the TPs produced from pharmaceuticals during wastewater treatment. In this study, chloroquine (CQ), which was extensively used for treating coronavirus disease-19 (COVID-19) infections during the pandemic, was selected for research. We identified and fractionated the main TP produced from CQ during chlorine disinfection and investigated the neurotoxic effects of CQ and its main TP on zebrafish (Danio rerio) embryos. Halogenated TP353 was observed as one of the main TPs produced from CQ during chlorine disinfection. Zebrafish embryos test revealed that TP353 caused higher neurotoxicity in zebrafish larvae, as compared to the CQ, and that was accompanied by significantly decreased expression levels of the genes related to central nervous system development (e.g., gfap, syn2a, and elavl3), inhibited activity of acetylcholinesterase (AChE), reduced GFP fluorescence intensity of motor neuron axons in transgenic larvae (hb9-GFP), and reduced total swimming distance and swimming velocity of larvae during light-dark transition stimulation. The results of this study can potentially be utilized as a theoretical reference for future evaluations of environmental risks associated with CQ and its related TPs. This work presents a methodology for assessing the environmental hazards linked to the discharge of pharmaceutical TPs after wastewater treatment.

In vitro antibacterial activity of antiretroviral drugs on key commensal bacteria from the human microbiota

Introduction

Antiretroviral therapy has improved life expectancy in HIV-infected patients. However, people living with HIV under antiretroviral therapy are at higher risks of developing chronic complications and acquiring multidrug resistant bacteria than healthy population. These factors have been associated with shifts in gut microbiome composition and immune activation. It is unclear how antiretroviral drugs affect gut microbiota composition, but it has been observed that antiretroviral treatment is not able to fully restore gut health after HIV infection. Additionally, some antiretroviral drugs have shown antibacterial activity suggesting that these drugs could have a direct impact on the human microbiome composition.

Methods

We determined the in vitro antibacterial activity of 16 antiretroviral drugs against a set of key clinically relevant and human commensal bacterial strains.

Results

Our results demonstrate that 5 antiretroviral drugs have in vitro antibacterial activity against gut and vaginal human commensal bacteria. Zidovudine has antibacterial activity against Escherichia coli, Klebsiella pneumoniae and Prevotella bivia, abacavir against Gardnerella vaginalis, efavirenz against G. vaginalis and P. bivia and bictegravir against Enterococcus spp. and G. vaginalis. Moreover, we describe for the first time that elvitegravir has antibacterial activity against G. vaginalis and P. bivia and, most importantly, against vancomycin-resistant Enterococcus spp. and methicillin-resistant Staphylococcus aureus strains with MIC values of 4-16 and 4 µg/mL, respectively showing high level of effectiveness against the tested multidrug-resistant bacteria.

Discussion

Our results underscore that some antiretroviral drugs may influence the human microbiota composition. In addition, we report the potential use of elvitegravir to treat multidrug-resistant Gram-positive bacteria warranting the need of clinical studies to repurpose this antiretroviral drug.

The Hepatoprotective Effects of Moringa oleifera against Antiretroviral-Induced Cytotoxicity in HepG2 Cells: A Review

The untreated human immunodeficiency virus (HIV), a lentivirus species that attacks immune cells (CD4+ T cells), causes acquired immunodeficiency syndrome (AIDS). HIV-positive people manage HIV/AIDS by using antiretroviral therapy (ART). The ART treatment regimen contains two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor/integrase strand transfer inhibitor. Tenofovir, an NRTI approved for managing HIV infection, is associated with hepatic steatosis and lactic acidosis, which are linked to mitochondrial toxicity and oxidative stress. Due to side-effects associated with ART, people living with HIV often use medicinal plants or a combination of medicinal plants with ART to promote adherence and diminish the side-effects and cytotoxicity. The Moringa oleifera (MO) tree from the family of Moringaceae is among the medicinal trees studied in managing HIV/AIDS in sub-Saharan Africa. The MO tree extracts have been reported to have inhibitory activity primarily against HIV due to their bioactive compounds. However, there is a scarcity of knowledge about the use of the MO tree amongst HIV/AIDS patients receiving ART in South Africa and its effect on patient compliance and outcomes. Thus, this review aims to outline the impact of MO aqueous leaf extract on oxidative stress and antioxidant responses in human HepG2 liver cells after exposure to antiretrovirals such as tenofovir. The review will contribute to a comprehensive understanding of the potential protective effect of MO aqueous leaf extract on tenofovir-induced cytotoxicity.

Bacteria exposed to antiviral drugs develop antibiotic cross-resistance and unique resistance profiles

Antiviral drugs are used globally as treatment and prophylaxis for long-term and acute viral infections. Even though antivirals also have been shown to have off-target effects on bacterial growth, the potential contributions of antivirals to antimicrobial resistance remains unknown. Herein we explored the ability of different classes of antiviral drugs to induce antimicrobial resistance. Our results establish the previously unrecognized capacity of antivirals to broadly alter the phenotypic antimicrobial resistance profiles of both gram-negative and gram-positive bacteria Escherichia coli and Bacillus cereus. Bacteria exposed to antivirals including zidovudine, dolutegravir and raltegravir developed cross-resistance to commonly used antibiotics including trimethoprim, tetracycline, clarithromycin, erythromycin, and amoxicillin. Whole genome sequencing of antiviral-resistant E. coli isolates revealed numerous unique single base pair mutations, as well as multi-base pair insertions and deletions, in genes with known and suspected roles in antimicrobial resistance including those coding for multidrug efflux pumps, carbohydrate transport, and cellular metabolism. The observed phenotypic changes coupled with genotypic results indicate that bacteria exposed to antiviral drugs with antibacterial properties in vitro can develop multiple resistance mutations that confer cross-resistance to antibiotics. Our findings underscore the potential contribution of wide scale usage of antiviral drugs to the development and spread of antimicrobial resistance in humans and the environment.

Recent Developments in Semiconductor-Based Photocatalytic Degradation of Antiviral Drug Pollutants

The prevalence of antiviral drugs (ATVs) has seen a substantial increase in response to the COVID-19 pandemic, leading to heightened concentrations of these pharmaceuticals in wastewater systems. The hydrophilic nature of ATVs has been identified as a significant factor contributing to the low degradation efficiency observed in wastewater treatment plants. This characteristic often necessitates the implementation of additional treatment steps to achieve the complete degradation of ATVs. Semiconductor-based photocatalysis has garnered considerable attention due to its promising potential in achieving efficient degradation rates and subsequent mineralization of pollutants, leveraging the inexhaustible energy of sunlight. However, in recent years, there have been few comprehensive reports that have thoroughly summarized and analyzed the application of photocatalysis for the removal of ATVs. This review commences by summarizing the types and occurrence of ATVs. Furthermore, it places a significant emphasis on delivering a comprehensive summary and analysis of the characteristics pertaining to the photocatalytic elimination of ATVs, utilizing semiconductor photocatalysts such as metal oxides, doped metal oxides, and heterojunctions. Ultimately, the review sheds light on the identified research gaps and key concerns, offering invaluable insights to steer future investigations in this field.

Stability and WBE biomarkers possibility of 17 antiviral drugs in sewage and gravity sewers

Wastewater-based epidemiology (WBE) is a promising technique for monitoring the rapidly increasing use of antiviral drugs during the COVID-19 pandemic. It is essential to evaluate the in-sewer stability of antiviral drugs in order to determine appropriate biomarkers. This study developed an analytical method for quantification of 17 typical antiviral drugs, and investigated the stability of target compounds in sewer through 4 laboratory-scale gravity sewer reactors. Nine antiviral drugs (lamivudine, acyclovir, amantadine, favipiravir, nevirapine, oseltamivir, ganciclovir, emtricitabine and telbivudine) were observed to be stable and recommended as appropriate biomarkers for WBE. As for the other 8 unstable drugs (abacavir, arbidol, ribavirin, zidovudine, ritonavir, lopinavir, remdesivir and efavirenz), their attenuation was driven by adsorption, biodegradation and diffusion. Moreover, reaction kinetics revealed that the effects of sediments and biofilms were regarded to be independent in gravity sewers, and the rate constants of removal by biofilms was directly proportional to the ratio of surface area against wastewater volume. The study highlighted the potential importance of flow velocity for compound stability, since an increased flow velocity significantly accelerated the removal of unstable biomarkers. In addition, a framework for graded evaluation of biomarker stability was proposed to provide reference for researchers to select suitable WBE biomarkers. Compared with current classification method, this framework considered the influences of residence time and different removal mechanisms, which additionally screened four antiviral drugs as viable WBE biomarkers. This is the first study to report the stability of antiviral drugs in gravity sewers.

Antiviral drugs in wastewater are on the rise as emerging contaminants: A comprehensive review of spatiotemporal characteristics, removal technologies and environmental risks

Antiviral drugs (ATVs) are widely used to treat illnesses caused by viruses. Particularly, ATVs were consumed in such large quantities during the pandemic that high concentrations were detected in wastewater and aquatic environment. Since ATVs are not fully absorbed by the human or animal body, this results in large amounts of them being discharged into the sewage through urine or feces. Most ATVs can be degraded by microbes at wastewater treatment plants (WWTPs), while some ATVs either require deep treatment to reduce concentration and toxicity. Parent and metabolites residing in effluent posed a varying degree of risk when entering the aquatic environment, while increasing the potential of natural reservoirs for environmentally acquired antiviral drug resistance potential. There is a rising research on the behavior of ATVs in the environment has surged since the pandemic. In the context of multiple viral diseases worldwide, especially during the current COVID-19 pandemic, a comprehensive assessment of the occurrence, removal, and risk of ATVs is urgently needed. This review aims to discuss the fate of ATVs in WWTPs from various regions in the world with wastewater as the main analyzing object. The ultimate goal is to focus on ATVs with high ecological impact and regulate their use or develop advanced treatment technologies to mitigate the risk to the environment.

Toxicity Evaluation and Effect-Based Identification of Chlorine Disinfection Products of the Anti-COVID-19 Drug Chloroquine Phosphate

Antiviral transformation products (TPs) generated during wastewater treatment are an environmental concern, as their discharge, in considerable amounts, into natural waters during a pandemic can pose possible risks to the aquatic environment. Identification of the hazardous TPs generated from antivirals during wastewater treatment is important. Herein, chloroquine phosphate (CQP), which was widely used during the coronavirus disease-19 (COVID-19) pandemic, was selected for research. We investigated the TPs generated from CQP during water chlorination. Zebrafish (Danio rerio) embryos were used to assess the developmental toxicity of CQP after water chlorination, and hazardous TPs were estimated using effect-directed analysis (EDA). Principal component analysis revealed that the developmental toxicity induced by chlorinated samples could be relevant to the formation of some halogenated TPs. Fractionation of the hazardous chlorinated sample, along with the bioassay and chemical analysis, identified halogenated TP387 as the main hazardous TP contributing to the developmental toxicity induced by chlorinated samples. TP387 could also be formed in real wastewater during chlorination in environmentally relevant conditions. This study provides a scientific basis for the further assessment of environmental risks of CQP after water chlorination and describes a method for identifying unknown hazardous TPs generated from pharmaceuticals during wastewater treatment.

The phytoremediation capacity of Lemna minor prevents deleterious effects of anti-HIV drugs to nontarget organisms

We investigated physiological responses of Lemna minor plants and their capacity to remove tenofovir (TNF; 412 ng l^-1), lamivudine (LMV; 5428 ng l^-1) and/or efavirenz (EFV; 4000 ng l^-1) from water through phytoremediation. In addition, the toxicological safety of water contaminated with these drugs after treatment with L. minor plants to photosynthetic microorganisms (Synechococcus elongatus and Chlorococcum infusionum) was evaluated. The tested environmental representative concentrations of drugs did not have a toxic effect on L. minor, and their tolerance mechanisms involved an increase in the activity of P450 and antioxidant enzymes (catalase and ascorbate peroxidase). L. minor accumulated significant quantities of TNF, LMV and EFV from the media (>70%), and the interactive effect of LMV and EFV increased EFV uptake by plants submitted to binary or tertiary mixture of drugs. Photosynthetic microorganisms exposed to TNF + LMV + EFV showed toxicological symptoms which were not observed when exposed to contaminated water previously treated with L. minor. An increased H₂O₂ concentrations but no oxidative damage in S. elongatus cells exposed to non-contaminated water treated with L. minor was observed. Due to its capacity to tolerate and reclaim anti-HIV drugs, L. minor plants must be considered in phytoremediation programs. They constitute a natural-based solution to decrease environmental contamination by anti-HIV drugs and toxicological effects of these pharmaceuticals to nontarget organisms.

Predicted Environmental Risk Assessment of Antimicrobials with Increased Consumption in Portugal during the COVID-19 Pandemic; The Groundwork for the Forthcoming Water Quality Survey

The environmental release of antimicrobial pharmaceuticals is an imminent threat due to ecological impacts and microbial resistance phenomena. The recent COVID-19 outbreak will likely lead to greater loads of antimicrobials in the environment. Thus, identifying the most used antimicrobials likely to pose environmental risks would be valuable. For that, the ambulatory and hospital consumption patterns of antimicrobials in Portugal during the COVID-19 pandemic (2020–2021) were compared with those of 2019. A predicted risk assessment screening approach based on exposure and hazard in the surface water was conducted, combining consumption, excretion rates, and ecotoxicological/microbiological endpoints in five different regions of Portugal. Among the 22 selected substances, only rifaximin and atovaquone demonstrated predicted potential ecotoxicological risks for aquatic organisms. Flucloxacillin, piperacillin, tazobactam, meropenem, ceftriaxone, fosfomycin, and metronidazole showed the most significant potential for antibiotic resistance in all analysed regions. Regarding the current screening approach and the lack of environmental data, it is advisable to consider rifaximin and atovaquone in subsequent water quality surveys. These results might support the forthcoming monitorisation of surface water quality in a post-pandemic survey.

Methods optimization and application: Solid phase extraction, Ultrasonic extraction and Soxhlet extraction for the determination of antiretroviral drugs in river water, wastewater, sludge, soil and sediment

The continuous release of antiretroviral drugs into the environmental has resulted in the interest to assess their occurrence in various environmental matrices. Their presence has led to antiretroviral drugs being considered the pollutants of concern due to their possible alterations of the ecosystem as well as the antiviral resistance that may develop upon their unintentional consumption. Therefore, in this work, solid phase extraction (SPE), ultrasonic extraction (UE), Soxhlet extration (SE) and liquid chromatography coupled to photodiode array detector (LC-PDA) methods have been optimized and validated. They were then applied for the simultaneous determination of abacavir, nevirapine and efavirenz antiretroviral drugs in wastewater, river water, sludge, soil and sediments. The percentage recoveries ranged from 71% to 112% for SPE, 88 - 108% for SE and 61 - 104% for UE. Good precision with a relative standard deviation less than 20% in all compounds for all methods was obtained. The LODs and LOQs ranged between 0.68 and 0.77 µg/L and 2.1-2.4 µg/L for SPE; 0.8-0.9 µg/kg and 2.3-2.8 µg/kg for SE and 1.6-2.8 µg/kg and 4.9 - 7.0 µg/kg for UE, respectively. The concentrations ranged from <lod - 102 µg/L, <lod - 814 µg/L, and <lod - 6759 µg/L, <lod - 138 µg/g, <lod - 98.9 µg/g, in river water, wastewater, sludge, soil and sediment samples, respectively. Abacavir was dominant in water while efavirenz was dominant in soil/sediments. The results showed that SE is more sensitive and more accurate than UE, hence it can be recommended for routine analysis despite its longer extraction times. The percentage removal efficiency ranged from 44% to 87% for nevirapine, 6-53% for efavirenz, and 75-91% for abacavir which indicates that these compounds were not completely removed during the WWTP processes, hence they ended up in river waters.

Assessing the potential for nevirapine removal and its ecotoxicological effects on Coelastrella tenuitheca and Tetradesmus obliquus in aqueous environment

Remediation of the antiretroviral (ARV) drug, nevirapine (NVP) has attracted considerable scientific attention in recent years due to its frequent detection and persistence in aquatic environments and potential hazards to living organisms. Algae-based technologies have been emerging as an environmentally friendly option for the removal of pharmaceutical compounds, but their ARV drug removal potential has not been fully explored yet. This study aimed to explore the ecotoxicity and removal potential of NVP by two microalgal species, Coelastrella tenuitheca and Tetradesmus obliquus. Lower environmental concentrations (up to 200 ng L^-1) of NVP enhanced the microalgal growth, and the highest dry cell weight of 941.27 mg L^-1 was obtained in T. obliquus at 50 ng L^-1 NVP concentration. Both microalgae showed varying removal efficiencies (19.53-74.56%) when exposed to NVP concentration levels of up to 4000 ng L^-1. At the late log phase (day 8), T. obliquus removed the highest percentage of NVP (74.56%), while C. tenuitheca removed 48% at an initial NVP concentration of 50 ng L^-1. Photosynthetic efficiency (Fv/Fm and rETR) of the two microalgal species, however, was not affected by environmental concentrations of NVP (up to 4000 ng L^-1) at the mid log phase of growth. SEM analysis demonstrated that both algal species produced distinct ridges on their cell surfaces after NVP uptake. In the ecotoxicity study, the calculated IC₅₀ values of NVP (0-100 mg L^-1) after 96 h of exposure were 23.45 mg L^-1 (C. tenuitheca) and 18.20 mg L^-1 (T. obliquus). The findings of the present study may contribute to a better understanding of the environmental hazards associated with NVP and the efficacy of microalgae in removing this pharmaceutical from aquatic environments.

Occurrence, distribution, and environmental risk of pharmaceutical residues in Mombasa peri-urban creeks, Kenya

The information on pharmaceutical compounds' distribution and their possible risks in marine ecosystems along the Kenya coast is limited especially in the peri-urban creeks. Hence, this study aimed to determine pharmaceutical residue levels and distribution in selected peri-urban creeks in Mombasa and Gazi bay. The target compounds were analgesic (acetaminophen), antibiotics (trimethoprim and sulfamethoxazole), antiepileptic (carbamazepine), and antiretroviral (nevirapine). Pharmaceutical residues in grab surface seawater in wet and dry seasons ranged from below detection limit (BDL)-1065.6 μg L-1 and BDL-71.3 μg L-1, respectively. The concentration of the pharmaceutical residues was high in Tudor creek in the dry and wet seasons with a mean concentration of 63.3 μg L-1 and 233.1 μg L-1 respectively compared to Makupa creek (dry season, 54.2 μg L-1; wet season 16.2 μg L), and Mtwapa creek (dry season, 43.1 μg L-1; wet season, 15.0 μg L-1). Gazi Bay being used as a control site had a mean concentration of 21.3 μg L-1 and 3.1 μg L-1 during the dry season and wet season respectively. Acetaminophen and nevirapine were the most ubiquitous compounds in seawater since they were found in all seawater samples collected. Risk quotients (RQ) for invertebrates and algae based on the mean concentrations of the analytes were estimated to provide a preliminary environmental risk assessment. The results suggest that the studied acetaminophen, trimethoprim, sulfamethoxazole, and carbamazepine in seawater pose low (0.01 ≤ RQ < 0.1) to medium (0.1 ≤ RQ < 1) ecological risk whereas nevirapine poses medium to high (RQ ≥ 1) ecological risk to the ecosystems of Mombasa periurban creeks and Gazi bay. Further research, however, is encouraged on the distribution of pharmaceuticals in the marine environment and the long-term synergistic effects of mixtures of these compounds on marine biota.

The screening of emerging micropollutants in wastewater in Sol Plaatje Municipality, Northern Cape, South Africa

Although pollutants pose environmental and human health risks, the majority are not routinely monitored and regulated. Organic pollutants emanate from a variety of sources, and can be classified depending on their chemistry and environmental fate. Classification of pollutants is important because it informs fate processes and apposite removal technologies. The occurrence of emerging contaminants (ECs) in water bodies is a source of environmental and human health concern globally. Despite being widely reported, data on the occurrence of ECs in South Africa are scarce. Specifically, ECS in wastewater in the Northern Cape in South Africa are understudied. In this study, various ECs were screened in water samples collected from three wastewater treatment plants (WWTPs) in the province. The ECs were detected using liquid chromatography coupled to high resolution Orbitrap mass spectrometry following Oasis HLB solid-phase extraction. The main findings were: (1) there is a wide variety of ECs in the WWTPs, (2) physico-chemical properties such as pH, total dissolved solids, conductivity, and dissolved organic content showed reduced values in the outlet compared to the inlet which confirms the presence of less contaminants in the treated wastewater, (3) specific ultraviolet absorbance of less than 2 was observed in the WWTPs samples, suggesting the presence of natural organic matter (NOM) that is predominantly non-humic in nature, (4) most of the ECs were recalcitrant to the treatment processes, (5) pesticides, recreational drugs, and analgesics constitute a significant proportion of pollutants in wastewater, and (6) NOM removal ranged between 35 and 90%. Consequently, a comprehensive database of ECs in wastewater in Sol Plaatje Municipality was created. Since the detected ECs pose ecotoxicological risks, there is a need to monitor and quantify ECs in WWTPs. These data are useful in selecting suitable monitoring and control strategies at WWTPs.

Do anti-HIV drugs pose a threat to photosynthetic microorganisms?

We investigated the occurrence and risk assessment of three anti-HIV drugs [(tenofovir (TNF), lamivudine (LMV) and efavirenz (EFV)] in urban rivers from Curitiba (Brazil), as well as the individual and combined effects of their environmental representative concentrations on the freshwater periphytic species Synechococcus elongatus (Cyanobacteria) and Chlorococcum infusionum (Chlorophyta). The three studied drugs, except TNF, were found in 100% of the samples, and concentrations in samples ranged from 165 to 412 ng TNF L^-1, 173-874 ng LMV L^-1 and 13-1250 ng EFV L^-1. Bioassays using artificial contaminated water showed that at environmental concentrations, TNF and LMV did not represent environmental risks to the studied photosynthetic organisms. However, EFV was shown to be toxic, affecting photosynthesis, respiration, and oxidative metabolism. The studied drugs demonstrated interactive effects. Indeed, when submitted to the combination of TNF and LMV, decreased photosynthesis was observed in C. infusionum cells. Moreover, the toxic effects of EFV were amplified in both species when TNF and/or LMV were added to the media. The simultaneous presence of TNF, LMV and EFV in environmental matrices associated with their interactive effects, lead to increased toxicological effects of water contaminated by anti-HIV drugs and thus to an ecological threat to photosynthetic microorganisms.

A sustainable approach for the removal methods and analytical determination methods of antiviral drugs from water/wastewater: A review

In the last years, antiviral drugs especially used for the treatment of COVID-19 have been considered emerging contaminants because of their continuous occurrence and persistence in water/wastewater even at low concentrations. Furthermore, as compared to antiviral drugs, their metabolites and transformation products of these pharmaceuticals are more persistent in the environment. They have been found in environmental matrices all over the world, demonstrating that conventional treatment technologies are unsuccessful for removing them from water/wastewater. Several approaches for degrading/removing antiviral drugs have been studied to avoid this contamination. In this study, the present level of knowledge on the input sources, occurrence, determination methods and, especially, the degradation and removal methods of antiviral drugs are discussed in water/wastewater. Different removal methods, such as conventional treatment methods (i.e. activated sludge), advanced oxidation processes (AOPs), adsorption, membrane processes, and combined processes, were evaluated. In addition, the antiviral drugs and these metabolites, as well as the transformation products created as a result of treatment, were examined. Future perspectives for removing antiviral drugs, their metabolites, and transformation products were also considered.

Antiviral drugs against influenza: Treatment methods, environmental risk assessment and analytical determination

Over the past few years, antiviral drugs against influenza are considered emerging contaminants since they cause environmental toxicity even at low concentrations. They have been found in environmental matrices all around the world, showing that conventional treatment methods fail to remove them from water and wastewater. In addition, the metabolites and transformation products of these drugs can be more persistent than original in the environment. Several techniques to degrade/remove antiviral drugs against influenza have been investigated to prevent this contamination. In this study, the characteristics of antiviral drugs against influenza, their measurement by analytical methods, and their removal in both water and wastewater treatment plants (WWTPs) were presented. Different treatment methods, such as traditional procedures (biological processes, filtration, coagulation, flocculation, and sedimentation), advanced oxidation processes (AOPs), adsorption and combined methods, were assessed. Ecotoxicological effects of both the antiviral drug and its metabolites as well as the transformation products formed as a result of treatment were evaluated. In addition, future perspectives for improving the removal of antiviral drugs against influenza, their metabolites and transformation products were further discussed. The research indicated that the main tested techniques in this study were ozonation, photolysis and photocatalysis. Combined methods, particularly those that use renewable energy and waste materials, appear to be the optimum approach for the treatment of effluents containing antiviral drugs against influenza. In light of high concentrations or probable antiviral resistance, this comprehensive assessment suggests that antiviral drug monitoring is required, and some of those substances may cause toxicological effects.

Health effects and risks associated with the occurrence of pharmaceuticals and their metabolites in marine organisms and seafood

Pharmaceuticals and their metabolites are continuously invading the marine environment due to their input from the land such as their disposal into the drains and sewers which is mostly followed by their transfer into wastewater treatment plants (WWTPs). Their incomplete removal in WWTPs introduces pharmaceuticals into oceans and surface water. To date, various pharmaceuticals and their metabolites have been detected in marine environment. Their occurrence in marine organisms raises concerns regarding toxic effects and development of drug resistant genes. Therefore, it is crucial to review the health effects and risks associated with the presence of pharmaceuticals and their metabolites in marine organisms and seafood. This is an important study area which is related to the availability of seafood and its quality. Hence, this study provides a critical review of the information available in literature which relates to the occurrence and toxic effects of pharmaceuticals in marine organisms and seafood. This was initiated through conducting a literature search focussing on articles investigating the occurrence and effects of pharmaceuticals and their metabolites in marine organisms and seafood. In general, most studies on the monitoring of pharmaceuticals and their metabolites in marine environment are conducted in well developed countries such as Europe while research in developing countries is still limited. Pharmaceuticals present in freshwater are mostly found in seawater and marine organisms. Furthermore, the toxicity caused by different pharmaceutical mixtures was observed to be more severe than that of individual compounds.

SARS-CoV-2 pharmaceutical drugs: a critical review on the environmental impacts, chemical characteristics, and behavior of advanced oxidation processes in water

This review summarizes research data on the pharmaceutical drugs used to treat the novel SARS-CoV-2 virus, their characteristics, environmental impacts, and the advanced oxidation processes (AOP) applied to remove them. A literature survey was conducted using the electronic databases Science Direct, Scopus, Taylor & Francis, Google Scholar, PubMed, and Springer. This complete research includes and discusses relevant studies that involve the introduction, pharmaceutical drugs used in the SARS-CoV-2 pandemic: chemical characteristics and environmental impact, advanced oxidation process (AOP), future trends and discussion, and conclusions. The results show a full approach in the versatility of AOPs as a promising solution to minimize the environmental impact associated with these compounds by the fact that they offer different ways for hydroxyl radical production. Moreover, this article focuses on introducing the fundamentals of each AOP, the main parameters involved, and the concomitance with other sources and modifications over the years. Photocatalysis, sonochemical technologies, electro-oxidation, photolysis, Fenton reaction, ozone, and sulfate radical AOP have been used to mineralize SARS-CoV-2 pharmaceutical compounds, and the efficiencies are greater than 65%. According to the results, photocatalysis is the main technology currently applied to remove these pharmaceuticals. This process has garnered attention because solar energy can be directly utilized; however, low photocatalytic efficiencies and high costs in large-scale practical applications limit its use. Furthermore, pharmaceuticals in the environment are diverse and complex. Finally, the review also provides ideas for further research needs and major concerns.

Ultraviolet-coupled advanced oxidation processes for anti-COVID-19 drugs treatment: Degradation mechanisms, transformation products and toxicity evolution

Remdesivir (RDV), dexamethasone (DEX) and hydroxychloroquine (HCQ) were widely used in the treatment of COVID-19 pneumonia, possibly causing environmental risks and drug-resistance viruses. This study elucidated the degradation mechanisms and potential toxicity risks of the three anti-COVID-19 drugs by UV and ultraviolet-coupled advanced oxidation processes (UV/AOPs). All the drugs could be degraded by more than 98% within 3 min under the following optimal conditions: pH of 5.0 and drug-to-oxidant (H₂O₂) molar ratio of 1:200. Combined with density functional theory (DFT) analysis and high-performance liquid chromatography quadrupole time-of-flight mass spectrometry (HPLC-QTOF-MS), twenty-four transformation products (TPs) were detected and the main degradation pathways were investigated. Based on bacterial luminescence inhibition test and the peak-area evolution of TPs, RDV and HCQ showed an obvious toxicity-increase region when TPs were generated in large quantities, while the toxicity of DEX continued to decline during degradation processes. By QSAR predictions, the main contributors to the toxicity evolution during the UV/AOPs were predicted. Halogen-containing TPs showed significantly higher toxicity than other TPs, and thus the chlorine-containing structure in HCQ presented the potential toxicity. Appropriate reaction parameters and adequate reaction time for the UV/AOPs could eliminate the toxicity of TPs and ensure environmental safety. This study could play a positive role in the treatment of anti-COVID-19 drugs and their environmental hazard assessment.

Bioaccumulation of abacavir and efavirenz in Rhinella arenarum tadpoles after exposure to environmentally relevant concentrations

Antiretrovirals are pharmaceuticals used in the treatment of the human immunodeficiency virus; they are contaminants of emerging concern that have received considerable attention in recent decades due to their potential negative environmental effects. Data on the bioaccumulation and possible environmental risks posed by these drugs to aquatic organisms are very scarce. Therefore, the aim of this study was to evaluate the bioaccumulation of abacavir and efavirenz in Rhinella arenarum tadpoles subjected to acute static toxicity tests (96 h) at environmentally relevant concentrations. The analytical procedure consisted of the development and optimization of a method involving ultra-high performance liquid chromatography with tandem mass spectrometry detection. The instrumental conditions, optimized by design of experiments using the response surface methodology, yielded limits of detection of 0.3 μg L^-1 for abacavir and 0.9 μg L^-1 for efavirenz; and limits of quantification of 1.9 μg L^-1 for abacavir and 5.6 μg L^-1 for efavirenz. Subsequently, the bioaccumulation of the pharmaceutical drugs in tadpoles was evaluated at three exposure concentrations. Efavirenz displayed the highest bioaccumulation levels. This study shows the bioaccumulation potential of abacavir and efavirenz in amphibian tadpoles at exposure concentrations similar to those already detected in the environment, indicating an ecological risk for R. arenarum and probably other aquatic organisms exposed to these drugs in water bodies.

Effects of Two Antiretroviral Drugs on the Crustacean Daphnia magna in River Water

Antiretroviral (ARVs) drugs are used to manage the human immunodeficiency virus (HIV) disease and are increasingly being detected in the aquatic environment. However, little is known about their effects on non-target aquatic organisms. Here, Daphnia magna neonates were exposed to Efavirenz (EFV) and Tenofovir (TFV) ARVs at 62.5–1000 µg/L for 48 h in river water. The endpoints assessed were mortality, immobilization, and biochemical biomarkers (catalase (CAT), glutathione S-transferase (GST), and malondialdehyde (MDA)). No mortality was observed over 48 h. Concentration- and time-dependent immobilization was observed for both ARVs only at 250–1000 µg/L after 48 h, with significant immobilization observed for EFV compared to TFV. Results for biochemical responses demonstrated that both ARVs induced significant changes in CAT and GST activities, and MDA levels, with effects higher for EFV compared to TFV. Biochemical responses were indicative of oxidative stress alterations. Hence, both ARVs could potentially be toxic to D. magna.

Pharmaceutical Pollution in Aquatic Environments: A Concise Review of Environmental Impacts and Bioremediation Systems

The presence of emerging contaminants in the environment, such as pharmaceuticals, is a growing global concern. The excessive use of medication globally, together with the recalcitrance of pharmaceuticals in traditional wastewater treatment systems, has caused these compounds to present a severe environmental problem. In recent years, the increase in their availability, access and use of drugs has caused concentrations in water bodies to rise substantially. Considered as emerging contaminants, pharmaceuticals represent a challenge in the field of environmental remediation; therefore, alternative add-on systems for traditional wastewater treatment plants are continuously being developed to mitigate their impact and reduce their effects on the environment and human health. In this review, we describe the current status and impact of pharmaceutical compounds as emerging contaminants, focusing on their presence in water bodies, and analyzing the development of bioremediation systems, especially mycoremediation, for the removal of these pharmaceutical compounds with a special focus on fungal technologies.

Occurrence and point-of-use treatment of contaminants of emerging concern in groundwater of the Nzoia River basin, Kenya

Groundwater constitutes a major source of fresh water globally. However, it faces serious quality challenges from both conventional pollutants and contaminants of emerging concern (CECs) such as pharmaceutically active compounds (PhACs), personal care products (PCPs) and pesticides. There exists a significant knowledge gap regarding the occurrence of CECs in groundwater, especially in Africa. This study presents unique data on the concentration of fourteen PhACs, five PCPs and nine pesticides in groundwater wells in Nzoia River basin, Kenya. Generally, PCPs were the most dominant class with concentrations up to 10 μg/L (methylparaben). Anti(retro)virals, being important in the treatment of HIV/AIDS, were more prevalent among the PhACs as compared to the developed world, with concentrations up to 700 ng/L (nevirapine). In contrast, pesticides were measured at lower concentrations, the maximum being 42 ng/L (metolachlor). A basic risk assessment shows that - among the detected CECs - carbamazepine may pose medium human health risk and requires further investigation among infants and children. Point-of-use (POU) technologies are being increasingly promoted especially in the developing nations to provide drinking water solutions at the household level, but very little data is available on their performance towards CECs removal. Therefore, besides measuring CECs in groundwater, we investigated ceramic filters and solar disinfection (SODIS) as possible POU treatment options. Both techniques show potential to treat CECs in groundwater, with removal efficiencies higher than 90% obtained for 41 and 22 compounds in ceramic filters and SODIS, respectively. Moreover, for the more recalcitrant compounds (e.g. sulfadoxin), the performance is improved by up to three orders of magnitude when using TiO₂ as a photocatalyst in SODIS.

Adsorption and desorption of antiviral drugs (ritonavir and lopinavir) on sewage sludges as a potential environmental risk

The aim of this work was to evaluate the adsorption capacity and mechanism of two antiviral drugs AVDs (lopinavir (LOP) and ritonavir (RIT)) on three various sewage sludges (SSLs). The results showed that SSLs differed in the structure and chemical composition and LOP and RIT had a high affinity to the studied SSLs (K_d in ranges 2076-3449 L/kg). The adsorption capacities differed between SSLs and ranged 7.55-8.71 mg/g (RIT) and 8.10-8.64 mg/g (LOP). The Freundlich model provided a best fitting of adsorption isotherms of all AVDs-SSLs. The adsorption kinetics were best described by pseudo-second order kinetic model. The adsorption of LOP and RIT on SSLs was exothermic, spontaneous, and thermodynamically feasible. The sorption of LOP and RIT to SSLs was complex due to the diverse chemical composition of SSLs and the differences in the chemical structure of AVDs. Analysis of binary solution of both AVDs showed the competition effect between AVDs and a decrease in adsorption efficiency (3-17%) compared to single solutions. The amount of desorbed AVDs from all SSLs was low (less than 15%). The findings of the present work are significant in the prediction of fate and persistence of AVDs on SSLs in the context of their further transmission and possible environmental contamination.

Target and Suspect Screening of Pharmaceuticals and their Transformation Products in the Klip River, South Africa, using Ultra-High-Performance Liquid Chromatography-Mass Spectrometry

In spite of recent reports about the presence of pharmaceuticals in African water bodies, their prevalence has still not been sufficiently quantified. The few available studies have mostly focused on a limited number of pharmaceuticals. In the present study, a suspect screening of 92 compounds (mainly pharmaceuticals and their transformation products) along the Klip River, South Africa was conducted, followed by target monitoring of 21 of the detected pharmaceuticals. The experimental approach was based on solid-phase extraction followed by analysis with ultra-high-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry (UHPLC-QTOF-MS). The results revealed 47 pharmaceuticals, 31 of which were detected for the first time in South African waters. Seven detected pharmaceuticals (propyphenazole, sulfamerazine, levamisole, tryptophan, dibucaine, albuterol, and fenpropimorph) are not approved medications in South Africa. Six pharmaceutical metabolites were detected for the first time in South Africa. Pharmaceuticals with the highest concentrations in river water were flumequine (0.257 µg L^-1 ), oxolinic acid (0.355 µg L^-1 ), and acetaminophen (0.432 µg L^-1 ). Oxolinic acid presented the highest hazard quotient, 48.6, indicating a risk of toxicity to aquatic organisms. Hazard quotients for other pharmaceuticals were below 1, except that of flumequine, which reached 1.285. These results suggest a need for further research into the fate of pharmaceuticals in surface waters, and a quantification of the risks associated with the identified drugs because they are likely to accumulate in the tissues of fish/aquatic organisms, thus affecting humans. Environ Toxicol Chem 2022;41:437-447. © 2021 SETAC.

HIV-antiretrovirals in river water from Gauteng, South Africa: Mixed messages of wastewater inflows as source

South Africa has the highest number of people living with the human immunodeficiency virus (HIV). High usage of HIV-antiretroviral drugs (ARVs) for the treatment of the acquired immunodeficiency syndrome (AIDS) leads to the presence of ARVs in the environment. Wastewater is a major contributor of pharmaceuticals in surface and drinking water as wastewater treatment plants (WWTPs) are not designed to remove these compounds. Pharmaceuticals in the environment pose risks and the effects of ARVs on non-target organisms are largely unknown. The concentrations of ARVs in surface water upstream and downstream from WWTPs in rivers were determined. The samples were extracted by solid-phase extraction and analysed by using liquid chromatography coupled with a quadrupole time-of-flight mass spectrometer. Five ARVs were quantified, mostly in downstream samples of the WWTPs, indicating wastewater as a source of ARVs, but this was not apparent in all cases. Nevirapine, lopinavir, and efavirenz were frequently detected; the highest concentrations being lopinavir and efavirenz at 38 μg/L and 24 μg/L, respectively. Aquatic ecosystems are at risk due to the constant input of pharmaceuticals that include large amounts of everyday use and the release of ARVs. This study highlights the potential of increased water pollution worldwide should more people consume increased quantities of pharmaceuticals.

Antiretroviral Drugs in African Surface Waters: Prevalence, Analysis, and Potential Remediation

The sources, ecotoxicological impact, and potential remediation strategies of antiretroviral drugs (ARVDs) as emerging contaminants in surface waters are reviewed based on recent literature. The occurrence of ARVDs in water bodies raises concern because many communities in Africa depend on rivers for water resources. Southern Africa is a potential hotspot regarding ARVD contamination due to relatively high therapeutic application and detection thereof in water bodies. Efavirenz and nevirapine are the most persistent in effluents and are prevalent in surface water based on environmental concentrations. Whereas the highest concentration of efavirenz reported in Kenya was 12.4 µg L^-1 , concentrations as high as 119 and 140 µg L^-1 have been reported in Zambia and South Africa, respectively. Concentrations of ARVDs ranging from 670 to 34 000 ng L^-1 (influents) and 540 to 34 000 ng L^-1 (effluents) were determined in wastewater treatment plants in South Africa, compared with Europe, where reported concentrations range from less than limit of detection (LOD) to 32 ng L^-1 (influents) and less than LOD to 22 ng L^-1 (effluents). The present African-based review suggests the need for comprehensive toxicological and risk assessment of these emerging pollutants in Africa, with the intent of averting environmental hazards and the development of sustainable remediation strategies. Environ Toxicol Chem 2022;41:247-262. © 2021 SETAC.

A comprehensive review on preparation, functionalization and recent applications of nanofiber membranes in wastewater treatment

The direct discharge of significant amounts of polluted water into water bodies causes adverse ecological and human health effects. This severe deterioration in water quality creates significant challenges to meet the growing demand for clean water. Therefore, the world urgently needs environmentally friendly advanced technology to overcome this global crisis. In this regard, nanofiber-based membrane filtration is a promising technique in wastewater remediation because of their huge surface area, extremely porous structure, amenable pore size/pore size distribution, variety of material choices, and flexibility to modification with other functional materials. However, despite their unique properties, fouling, poor mechanical properties, shrinkage, and deformation are major drawbacks of nanofiber membranes for treating wastewater. This review presents a comprehensive overview of nanofiber membranes' fabrication and function in water purification applications as well as providing novel approaches to overcoming/alleviating the mentioned disadvantages. The review first presents nanofiber membrane preparation methods, focusing on electrospinning as a versatile and viable technique alongside discussing the parameters controlling nanofiber morphology. Afterward, the functionalization of nanofiber membranes by combining them with other nanomaterials, such as metal and metal-oxide nanoparticles, carbon nanotubes, metal-organic frameworks, and biomolecules, were demonstrated and discussed. In addition, nanofiber membranes functionalized with microorganisms were highlighted. Finally, we introduced and discussed in detail the most relevant and recent advances in nanofiber applications in wastewater treatment in the context of removing different pollutants (e.g., heavy metals, nutrients, radioactive elements, pharmaceuticals, and personal care products, dyes, and pesticides). Moreover, the promising antimicrobial ability of nanofiber membranes in removing microorganisms from wastewater has been fully underscored. We believe this comprehensive review could provide researchers with preliminary data and guide both researchers and producers engaged in the nanofiber membrane industry, letting them focus on the research gaps in wastewater treatment.

COVID-19 drugs in aquatic systems: a review

The outbreak of the human coronavirus disease 2019 (COVID-19) has induced an unprecedented increase in the use of several old and repurposed therapeutic drugs such as veterinary medicines, e.g. ivermectin, nonsteroidal anti-inflammatory drugs, protein and peptide therapeutics, disease-modifying anti-rheumatic drugs and antimalarial drugs, antiretrovirals, analgesics, and supporting agents, e.g. azithromycin and corticosteroids. Excretion of drugs and their metabolites in stools and urine release these drugs into wastewater, and ultimately into surface waters and groundwater systems. Here, we review the sources, behaviour, environmental fate, risks, and remediation of those drugs. We discuss drug transformation in aquatic environments and in wastewater treatment systems. Degradation mechanisms and metabolite toxicity are poorly known. Potential risks include endocrine disruption, acute and chronic toxicity, disruption of ecosystem functions and trophic interactions in aquatic organisms, and the emergence of antimicrobial resistance.

Ultra-high pressure liquid chromatography coupled to travelling wave ion mobility-time of flight mass spectrometry for the screening of pharmaceutical metabolites in wastewater samples: Application to antiretrovirals

The presence of pharmaceutical compounds in the aquatic environment is a significant environmental health concern, which is exacerbated by recent evidence of the contribution of drug metabolites to the overall pharmaceutical load. In light of a recent report of the occurrence of metabolites of antiretroviral drugs (ARVDs) in wastewater, we investigate in the present work the occurrence of further ARVD metabolites in samples obtained from a domestic wastewater treatment plant in the Western Cape, South Africa. Pharmacokinetic data indicate that ARVDs are biotransformed into several positional isomeric metabolites, only two of which have been reported wastewater samples. Given the challenges associated with the separation and identification of isomeric species in complex wastewater samples, a method based on liquid chromatography hyphenated to ion mobility spectrometry-high resolution mass spectrometry (LC-IMS-HR-MS) was implemented. Gradient LC separation was achieved on a sub-2 µm reversed phase column, while the quadrupole-time-of-flight MS was operated in data independent acquisition (DIA) mode to increase spectral coverage of detected features. A mass defect filter (MDF) template was implemented to detect ARVD metabolites with known phase I and phase II mass shifts and fractional mass differences and to filter out potential interferents. IMS proved particularly useful in filtering the MS data for co-eluting species according to arrival time to provide cleaner mass spectra. This approach allowed us to confirm the presence of two known hydroxylated efavirenz and nevirapine metabolites using authentic standards, and to tentatively identify a carboxylate metabolite of abacavir previously reported in literature. Furthermore, three hydroxylated-, two sulphated and one glucuronidated metabolite of efavirenz, two hydroxylated metabolites of nevirapine and one hydroxylated metabolite of ritonavir were tentatively or putatively identified in wastewater samples for the first time. Assignment of the metabolites is discussed in terms of high resolution fragmentation data, while collisional cross section (CCS) values measured for the detected analytes are reported to facilitate further work in this area.

Occurrence, removal and mass loads of antiviral drugs in seven wastewater treatment plants with various treatment processes

Antiviral drugs are among the most common and important classes of pharmaceuticals to treat viral infections, however their continuous emission and persistence in the receiving environment has attracted increasing attention about their potential ecological risks. Here we investigated the occurrence, fate and mass load of 9 antiviral drugs for acquired immunodeficiency syndrome and hepatitis B, in 7 wastewater treatment plants (WWTPs) with different treatment processes in Guangdong, China. Totally, 8 target antiviral drugs were detected in the WWTPs influent wastewater, effluent wastewater and sludge, with maximal concentrations up to 7624 ng/L (telbivudine), 568 ng/L (telbivudine), and 2013 ng/g wet weight (telbivudine), respectively. The removal efficiency varied widely between different antiviral drugs, with the mean aqueous removal efficiency and total removal efficiency ranging from -6.2% (nevirapine) to 100% (lamivudine) and -1.2% (nevirapine) to 100% (lamivudine), respectively. Mass balance analysis showed that their elimination was mostly attributed to the biodegradation/biotransformation. The total back-estimated usage and emission of 9 target antiviral drugs were 77.8 t/y and 13.2 t/y in Guangdong province, China, respectively. Based on the sewage epidemiology approach, the consumption and emission of antiviral drugs in seven studied WWTPs were ranged at 2.31 mg/d/1000 people (nevirapine) to 4970 mg/d/1000 people (telbivudine), and 0 (lamivudine) to 900 mg/d/1000 people (telbivudine), respectively. Preliminary risk assessment showed that the antiviral drugs of zidovudine, ritonavir, lopinavir, and telbivudine in the receiving rivers could pose high ecological risks for aquatic environment. The findings from the present study illustrate the persistence of nevirapine in WWTPs, and provide essential evidence for further study into the development of wastewater treatment technologies.

Development and validation of sensitive methods for simultaneous determination of 9 antiviral drugs in different various environmental matrices by UPLC-MS/MS

Trace antiviral drug contamination in aquatic ecosystems is becoming a significant environmental concern that requires an urgent efficient determination method. Here we developed sensitive and robust multi-residue determination methods to simultaneously extract and analyze 9 commonly used antiviral drugs (abacavir, zidovudine, efavirenz, nevirapine, ritonavir, lopinavir, lamivudine, telbivudine and entecavir) in surface water, wastewater, sediment, and sludge. Water samples were extracted with solid-phase extraction (SPE) technique using tandem hydrophilic-lipophilic balance and graphitized carbon black cartridges, while sediment and sludge samples were extracted using QuEChERS (quick, easy, cheap, effective, rugged, and safe) method. The extraction conditions of SPE (pH and cartridge type) and QuEChERS (acetic acid content, salts reagent, and purification sorbent) methods were carefully optimized. We observed that under optimum conditions, the method quantification limits of the 9 antiviral drugs in water and solid samples ranged from 0.05 to 19.23 ng L^-1 and from 0.02 to 7.38 ng g^-1, respectively. For environmental samples spiking 3 different concentrations, the recovery values for the most targeted antiviral drugs ranged from 70 to 130%, except for efavirenz. All targeted antiviral drugs were detected in wastewater samples except for entecavir. We also found abacavir, efavirenz, ritonavir, lopinavir, and telbivudine in sediment and sludge samples. Notably, telbivudine was identified in all environmental matrices, with a high concentration of 127 ng L^-1 and 222 ng g^-1 in water and sediment samples, respectively.

Algae-mediated processes for the treatment of antiretroviral drugs in wastewater: Prospects and challenges

The prevalence of pharmaceuticals (PCs), especially antiretroviral (ARV) drugs in various aquatic ecosystems has been expansively reported, wherein wastewater treatment plants (WWTPs) are identified as the primary point source. Consequently, the occurrence, ecotoxicity and treatment of ARV drugs in WWTPs have drawn much attention in recent years. Numerous studies have shown that the widely employed activated sludge-based WWTPs are incapable of removing ARV drugs efficiently from wastewater. Recently, algae-based wastewater treatment processes have shown promising results in PCs removal from wastewater, either completely or partially, through different processes such as biosorption, bioaccumulation, and intra-/inter-cellular degradation. Algal species have also shown to tolerate high concentrations of ARV drugs than the reported concentrations in the environmental matrices. In this review, emphasis has been given on discussing the current status of the occurrence of ARV drugs in the aquatic environment and WWTPs. Besides, the current trends and future perspectives of PCs removal by algae are critically reviewed and discussed. The potential pathways and mechanisms of ARV drugs removal by algae have also been discussed.

Adsorptive removal of noxious atrazine using graphene oxide nanosheets: Insights to process optimization, equilibrium, kinetics, and density functional theory calculations

Atrazine is a toxic herbicide whose alarming rate of contamination in the drinking water and wastewater poses a severe threat to the environment and human health. Here in this study, the graphene oxide (GO) nanosheets were prepared using Hummers' method with minor modification and studied as a potential adsorbent for atrazine removal from simulated wastewater. The spectroscopy and microscopic analysis confirmed the successful formation of GO with a multilayer structure resembling the crumpled sheets with random stacking. The Response Surface Methodology (RSM) employing Box Behnken design (BBD) was successfully developed to predict the optimal conditions for maximal atrazine removal as adsorbent dosage 121.45 mg/L; initial feed concentration 27.03 mg/L; temperature 27.69 °C, pH 5.37, and time 180 min. The atrazine adsorption onto GO was found to be higher in acidic pH and lower temperature. Density functional theory (DFT) calculation of adsorbent-adsorbate complex in the implicit solvent medium suggests adsorption affinity energy of -24.4 kcal/mol for atrazine. A careful observation of the molecules configuration and binding energy showed that the π-π interactions and hydrogen bonds played a significant role in the adsorption phenomena. Langmuir isotherm suited well to the adsorption process with a maximum adsorption capacity of 138.19 mg/g, at 318 K. The fitness of kinetic models for atrazine adsorption onto GO nanosheets were in following order Ho < Sobkowsk-Czerwi < Avrami model based on their correlation coefficient (R²) values. Reusability analysis showed that GO nanosheets could be effectively recycled using 0.01 N NaOH up to six cycles of atrazine removal. Thus, this study provided a theoretical and experimental basis for the potential application of GO nanosheets as a novel adsorbent for the removal of hazardous atrazine.

Environmental Risk Characterization of an Antiretroviral (ARV) Lamivudine in Ecosystems

Antiretroviral drugs for the treatment of human immunodeficiency virus (HIV) and other viral infections are among the emerging contaminants considered for ecological risk assessment. These compounds have been reported to be widely distributed in water bodies and other aquatic environments, while data concerning the risk they may pose to unintended non-target species in a different ecosystem (environment) is scanty. In South Africa and other developing countries, lamivudine is one of the common antiretrovirals applied. Despite this, little is known about its environmental impacts as an emerging contaminant. The present study employed a battery of ecotoxicity bioassays to assess the environmental threat lamivudine poses to aquatic fauna and flora. Daphnia magna (filter feeders), the Ames bacterial mutagenicity test, Lactuca sativa (lettuce) germination test, and the Allium cepa root tip assay were conducted, testing lamivudine at two concentrations (10 and 100 µg/L), with environmental relevance. The Daphnia magna toxicity test revealed a statistically significant response (p << 0.05) with a mortality rate of 85% on exposure to 100 µg/L lamivudine in freshwater, which increased to 100% at 48-h exposure. At lower concentrations of 10 µg/L lamivudine, 90% and 55% survival rates were observed at 24 h and 48 h, respectively. No potential mutagenic effects were observed from the Ames test at both concentrations of lamivudine. Allium cepa bioassays revealed a noticeable adverse impact on the root lengths on exposure to 100 µg/L lamivudine. This impact was further investigated through microscopic examination, revealing some chromosomal aberration in the exposed Allium cepa root tips. The Lactuca sativa bioassay showed a slight adverse impact on both the germination rate of the seeds and their respective hypocotyl lengths compared to the control. Overall, this indicates that lamivudine poses an ecological health risk at different trophic levels, to both flora and fauna, at concentrations previously found in the environment.

Identification of Antibiotics in Surface-Groundwater. A Tool towards the Ecopharmacovigilance Approach: A Portuguese Case-Study

Environmental monitoring, particularly of water, is crucial to screen and preselect potential hazardous substances for policy guidance and risk minimisation strategies. In Portugal, extensive data are missing. This work aimed to perform a qualitative survey of antibiotics in surface- groundwater, reflecting demographic, spatial, consumption and drug profiles during an observational period of three years. A passive sampling technique (POCIS) and high-resolution chromatographic system were used to monitor and analyse the antibiotics. The most frequently detected antibiotics were enrofloxacin/ciprofloxacin and tetracycline in surface-groundwater, while clarithromycin/erythromycin and sulfamethoxazole were identified only in surface water. The detection of enzyme inhibitors (e.g., tazobactam/cilastatin) used exclusively in hospitals and abacavir, a specific human medicine was also noteworthy. North (Guimarães, Santo Tirso and Porto) and South (Faro, Olhão and Portimão) Portugal were the regions with the most significant frequency of substances in surface water. The relatively higher detection downstream of the effluent discharge points compared with a low detection upstream could be attributed to a low efficiency in urban wastewater treatment plants and an increased agricultural pressure. This screening approach is essential to identify substances in order to perform future quantitative risk assessment and establishing water quality standards. The greatest challenge of this survey data is to promote an ecopharmacovigilance framework, implement measures to avoid misuse/overuse of antibiotics and slow down emission and antibiotic resistance.

Predicted occurrence, ecotoxicological risk and environmentally acquired resistance of antiviral drugs associated with COVID-19 in environmental waters

Antiviral drugs have been used to treat the ever-growing number of coronavirus disease, 2019 (COVID-19) patients. Consequently, unprecedented amounts of such drug residues discharging into ambient waters raise concerns on the potential ecotoxicological effects to aquatic lives, as well as development of antiviral drug-resistance in wildlife. Here, we estimated the occurrence, fate and ecotoxicological risk of 11 therapeutic agents suggested as drugs for COVID-19 treatment and their 13 metabolites in wastewater and environmental waters, based on drug consumption, physical-chemical property, and ecotoxicological and pharmacological data for the drugs, with the aid of quantitative structure-activity relationship (QSAR) modelling. Our results suggest that the removal efficiencies at conventional wastewater treatment plants will remain low (<20%) for half of the substances, and consequently, high drug residues (e.g. 7402 ng/L ribavirin, 4231 ng/L favipiravir, 730 ng/L lopinavir, 319 ng/L remdesivir; each combined for both unchanged forms and metabolites; and when each drug is administered to 100 patients out of 100,000 populations on a day) can be present in secondary effluents and persist in the environmental waters. Ecotoxicological risk in receiving river waters can be high (risk quotient >1) by a use of favipiravir, lopinavir, umifenovir and ritonavir, and medium (risk quotient >0.1) by a use of chloroquine, hydroxychloroquine, remdesivir, and ribavirin, while the risk will remain low (risk quotient <0.1) for dexamethasone and oseltamivir. The potential of wild animals acquiring antiviral drug resistance was estimated to be low. Our prediction suggests a pressing need for proper usage and waste management of antiviral drugs as well as for improving removal efficiencies of drug residues in wastewater.

Histopathological changes in Oreochromis mossambicus (Peters, 1852) ovaries after a chronic exposure to a mixture of the HIV drug nevirapine and the antibiotics sulfamethoxazole and trimethoprim

The burden of the human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) infection has transformed the African continent into a major consumer of antiretrovirals (ARVs) drugs. In addition to HIV burden, the African continent has also a high incidence of tuberculosis (TB) and has been experiencing recurring outbreaks of several other viral, bacterial, and parasitic epidemic diseases. The novel severe acute respiratory syndrome coronavirus 2 (SARS-COV-2 or Covid-19) pandemic outbreak is adding to the continent's infectious diseases burden as experts are predicting that it will be here for a long time. One of the consequences of these infectious diseases is that antiviral and antibiotic compounds have become some of the most consumed pharmaceuticals on the continent. Many of these drugs have been frequently detected in surface waters across Africa. There is limited information available on the adverse effects of the mixtures of different types of pharmaceuticals in African aquatic environments on fish reproduction. The present study investigated the effects of the ARV drug nevirapine (NVP - 1.48 and 3.74 μg/L) and its mixture with the antibiotic sulfamethoxazole (3.68 μg/L) and trimethoprim (0.87 μg/L) on O. mossambicus gonads using histopathological endpoints as biomarkers. The fish (n = 52) were exposed for 30 days in a static renewal system. Female O. mossambicus exposed to nevirapine (3.74 μg/L) and to NVP - antibiotic mixture recorded higher ovary indices. Statistically significant differences were found in female ovary indices between the fish exposed to NVP (3.74 μg/L) and the control fish (p = 0.002) as well as between the fish exposed to the NVP - antibiotic mixture and the control fish (p = 0.009). The main observed histopathological changes in the ovaries were increased vitellogenic oocyte atresia and vacuolation of the interstitial tissue in the fish exposed to NVP - antibiotic mixture. It is evident that the presence of NVP - antibiotics mixture in water triggered the observed histopathology in female fish ovaries. The detected abnormal high rate of atretic oocytes could result in impaired fish reproduction.

Ozonation products of zidovudine and thymidine in oxidative water treatment

Ozonation is an advanced treatment technology that is increasingly used for the removal of organic micropollutants from wastewater and drinking water. However, reaction of organic compounds with ozone can also result in the formation of toxic transformation products. In the present study, the degradation of the antiviral drug zidovudine during ozonation was investigated. To obtain further insights into the reaction mechanisms and pathways, results of zidovudine were compared with the transformation of the naturally occurring derivative thymidine. Kinetic experiments were accompanied by elucidation of formed transformation products using lab-scale batch experiments and subsequent liquid chromatography - high resolution mass spectrometry (LC-HRMS) analysis. Degradation rate constants for zidovudine with ozone in the presence of t-BuOH as radical scavenger varied between 2.8 ∙ 10⁴ M^-1 s^-1 (pH 7) and 3.2 ∙ 10⁴ M^-1 s^-1 (pH 3). The structural difference of zidovudine to thymidine is the exchange of the OH-moiety by the azide function at position 3'. In contrast to inorganic azide, no reaction with ozone was observed for the organic bound azide. In total, nine transformation products (TPs) were identified for both zidovudine and thymidine. Their formation can be attributed to the attack of ozone at the C-C-double bond of the pyrimidine-base. As a result of rearrangements, the primary ozonide decomposed in three pathways forming two different TPs, including hydroperoxide TPs. Rearrangement reactions followed by hydrolysis and subsequent release of H₂O₂ further revealed a cascade of TPs containing amide moieties. In addition, a formyl amide riboside and a urea riboside were identified as TPs indicating that oxidations of amide groups occur during ozonation processes.