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Iordan I, Vlădăreanu AM, Mambet C, Onisâi M, Cîșleanu D, Bumbea H. Clinical Features and Survival Outcome in Aggressive-Type Adult T-Cell Leukemia/Lymphoma Patients: Real-Life Experience of a Single Center from an HTLV-1 Endemic Country. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:872. [PMID: 38929489 PMCID: PMC11205487 DOI: 10.3390/medicina60060872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Adult T-cell leukemia/lymphoma (ATLL) is a highly aggressive T-cell lymphoproliferative disease associated with the human T-cell lymphotropic virus type I (HTLV-1). ATLL is a rare disease, found more frequently in HTLV-1-endemic areas, Romania being one of them. Despite treatment advances, the prognosis remains dismal. We aimed to describe the clinical, biological, and survival outcome features of Romanian patients with aggressive-type ATLL. Materials and Methods: We report the data of a prospective, observational, and unicentric study of all 20 patients diagnosed with lymphoma and acute types of ATLL at our center over the past 12 years. Data were collected from the patients' medical records. Results: Lymphoma-type ATLL (60%) was more common than acute-type ATLL (40%). Median age at diagnosis was 40.5 years, and most patients were female. Laboratory data revealed significant differences between acute and lymphoma-type ATLL, namely, higher leukocyte (p = 0.02) and lymphocyte counts (p = 0.02) and higher levels of corrected calcium (p = 0.001) in acute-type ATLL. All patients received chemotherapy, and only two underwent allogeneic stem cell transplantation. Only six patients obtained a complete or partial response to chemotherapy, mostly the lymphoma-type ones. The median survival for all patients was 6.37 months, with higher survival in the lymphoma-type ATLL (8.16 months) than in the acute-type (3.60 months). Normal calcium levels (p = 0.011), uric acid (p = 0.005), BUN score (p = 0.000), JCOG-PI moderate risk (p = 0.038), and obtaining complete or partial response (p = 0.037) were associated with higher survival. Conclusion: Aggressive-type ATLL among Romanian patients presents distinct characteristics, including younger age at diagnosis, female predominance, and higher incidence of lymphoma-type ATLL compared to currently reported data. Survival remains very low, with all subtypes experiencing a median survival of less than one year.
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Affiliation(s)
- Iuliana Iordan
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
- Department of Medical Semiology and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ana-Maria Vlădăreanu
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
| | - Cristina Mambet
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
- Department of Virology, “Stefan S. Nicolau” Institute, 030304 Bucharest, Romania
| | - Minodora Onisâi
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
| | - Diana Cîșleanu
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
| | - Horia Bumbea
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
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Rouet F, Nouhin J, Zheng DP, Roche B, Black A, Prak S, Leoz M, Gaudy-Graffin C, Ferradini L, Mom C, Mam S, Gautier C, Lesage G, Ken S, Phon K, Kerleguer A, Yang C, Killam W, Fujita M, Mean C, Fontenille D, Barin F, Plantier JC, Bedford T, Ramos A, Saphonn V. Massive Iatrogenic Outbreak of Human Immunodeficiency Virus Type 1 in Rural Cambodia, 2014-2015. Clin Infect Dis 2019; 66:1733-1741. [PMID: 29211835 DOI: 10.1093/cid/cix1071] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/01/2017] [Indexed: 12/12/2022] Open
Abstract
Background In 2014-2015, 242 individuals aged 2-89 years were newly diagnosed with human immunodeficiency virus type 1 (HIV-1) in Roka, a rural commune in Cambodia. A case-control study attributed the outbreak to unsafe injections. We aimed to reconstruct the likely transmission history of the outbreak. Methods We assessed in 209 (86.4%) HIV-infected cases the presence of hepatitis C virus (HCV) and hepatitis B virus (HBV). We identified recent infections using antibody (Ab) avidity testing for HIV and HCV. We performed amplification, sequencing, and evolutionary phylogenetic analyses of viral strains. Geographical coordinates and parenteral exposure through medical services provided by an unlicensed healthcare practitioner were obtained from 193 cases and 1499 controls during interviews. Results Cases were coinfected with HCV (78.5%) and HBV (12.9%). We identified 79 (37.8%) recent (<130 days) HIV infections. Phylogeny of 202 HIV env C2V3 sequences showed a 198-sample CRF01_AE strains cluster, with time to most recent common ancestor (tMRCA) in September 2013 (95% highest posterior density, August 2012-July 2014), and a peak of 15 infections/day in September 2014. Three geospatial HIV hotspots were discernible in Roka and correlated with high exposure to the practitioner (P = .04). Fifty-nine of 153 (38.6%) tested cases showed recent (<180 days) HCV infections. Ninety HCV NS5B sequences formed 3 main clades, 1 containing 34 subtypes 1b with tMRCA in 2012, and 2 with 51 subtypes 6e and tMRCAs in 2002-2003. Conclusions Unsafe injections in Cambodia most likely led to an explosive iatrogenic spreading of HIV, associated with a long-standing and more genetically diverse HCV propagation.
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Affiliation(s)
- François Rouet
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Janin Nouhin
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Du-Ping Zheng
- International Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Benjamin Roche
- Unité Mixte de Recherche Institut de Recherche pour le Développement 224, Centre National de la Recherche Scientifique 5290, Université de Montpellier, Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle, Montpellier, France
| | - Allison Black
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Sophearot Prak
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Marie Leoz
- Centre National de Référence sur le VIH, Laboratoire Associé, EA2656, Rouen University Hospital, Tours, France
| | - Catherine Gaudy-Graffin
- Centre National de Référence sur le VIH and Institut national de la santé et de la recherche médicale, Unité 966, Tours, France
| | | | - Chandara Mom
- National Center for HIV/AIDS, Dermatology and Sexually Transmitted Diseases, Phnom Penh, Cambodia
| | - Sovatha Mam
- National Center for HIV/AIDS, Dermatology and Sexually Transmitted Diseases, Phnom Penh, Cambodia
| | - Charlotte Gautier
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Gérard Lesage
- Centre National de Référence sur le VIH and Institut national de la santé et de la recherche médicale, Unité 966, Tours, France
| | - Sreymom Ken
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Kerya Phon
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Alexandra Kerleguer
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Chunfu Yang
- International Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William Killam
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Phnom Penh, Cambodia
| | | | - Chhivun Mean
- National Center for HIV/AIDS, Dermatology and Sexually Transmitted Diseases, Phnom Penh, Cambodia
| | - Didier Fontenille
- Unité Virus de l'Immunodéficience Humaine (VIH)/Hépatites, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Francis Barin
- Centre National de Référence sur le VIH and Institut national de la santé et de la recherche médicale, Unité 966, Tours, France
| | - Jean-Christophe Plantier
- Centre National de Référence sur le VIH, Laboratoire Associé, EA2656, Rouen University Hospital, Tours, France
| | - Trevor Bedford
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Artur Ramos
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Phnom Penh, Cambodia
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Burlacu R, Umlauf A, Marcotte TD, Soontornniyomkij B, Diaconu CC, Bulacu-Talnariu A, Temereanca A, Ruta SM, Letendre S, Ene L, Achim CL. Plasma CXCL10 correlates with HAND in HIV-infected women. J Neurovirol 2019; 26:23-31. [PMID: 31414350 DOI: 10.1007/s13365-019-00785-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/22/2019] [Accepted: 07/10/2019] [Indexed: 12/21/2022]
Abstract
HIV-associated neurocognitive disorder (HAND) is characterized by chronic immune activation. We aimed to identify biomarkers associated with HAND and to investigate their association with cognitive function and sex, in a homogenous cohort of HIV-infected (HIV+) young adults, parenterally infected during early childhood. One hundred forty-four HIV+ Romanian participants (51% women) without major confounders underwent standardized neurocognitive and medical evaluation in a cross-sectional study. IFN-γ, IL-1β, IL-6, CCL2, CXCL8, CXCL10, and TNF-α were measured in plasma in all participants and in cerebrospinal fluid (CSF) in a subgroup of 56 study participants. Biomarkers were compared with neurocognitive outcomes, and the influence of sex and HIV disease biomarkers was assessed. In this cohort of young adults (median age of 24 years), the rate of neurocognitive impairment (NCI) was 36.1%. Median current CD4+ count was 479 cells/mm3 and 36.8% had detectable plasma viral load. Women had better HIV-associated overall status. In plasma, controlling for sex, higher levels of IL-6 and TNF-α were associated with NCI (p < 0.05). Plasma CXCL10 showed a significant interaction with sex (p = 0.02); higher values were associated with NCI in women only (p = 0.02). Individuals with undetectable viral load had significantly lower plasma CXCL10 (p < 0.001) and CCL2 (p = 0.02) levels, and CSF CXCL10 (p = 0.01), IL-6 (p = 0.04), and TNF-α (p = 0.04) levels. NCI in young men and women living with HIV was associated with higher IL-6 and TNF-α in plasma, but not in the CSF. CXCL10 was identified as a biomarker of NCI specifically in women with chronic HIV infection.
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Affiliation(s)
- R Burlacu
- HIV Department, 'Dr. Victor Babes' Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
| | - A Umlauf
- HIV Neurobehavioral Research Program, University of California at San Diego, La Jolla, San Diego, CA, USA
| | - T D Marcotte
- HIV Neurobehavioral Research Program, University of California at San Diego, La Jolla, San Diego, CA, USA
| | - B Soontornniyomkij
- HIV Neurobehavioral Research Program, University of California at San Diego, La Jolla, San Diego, CA, USA
| | - C C Diaconu
- Cellular and Molecular Pathology Department, Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - A Bulacu-Talnariu
- HIV Department, 'Dr. Victor Babes' Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - A Temereanca
- Department of Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Emerging Viral Diseases Department, Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - S M Ruta
- Department of Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Emerging Viral Diseases Department, Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - S Letendre
- HIV Neurobehavioral Research Program, University of California at San Diego, La Jolla, San Diego, CA, USA
| | - L Ene
- HIV Department, 'Dr. Victor Babes' Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - C L Achim
- HIV Neurobehavioral Research Program, University of California at San Diego, La Jolla, San Diego, CA, USA
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Kostaki EG, Karamitros T, Bobkova M, Oikonomopoulou M, Magiorkinis G, Garcia F, Hatzakis A, Paraskevis D. Spatiotemporal Characteristics of the HIV-1 CRF02_AG/CRF63_02A1 Epidemic in Russia and Central Asia. AIDS Res Hum Retroviruses 2018; 34:415-420. [PMID: 29455562 DOI: 10.1089/aid.2017.0233] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Eastern European countries, including Russia, Ukraine, and other former Soviet Union (FSU) countries, have experienced a human immunodeficiency virus (HIV) epidemic spreading mostly among people who inject drugs (PWID). We aimed to investigate the origin and the dispersal patterns of HIV-1 CRF02_AG in Russia and other FSU countries. We studied 136 CRF02_AG sequences originating from Russia, and FSU countries along with a globally sampled dataset of 3,580 CRF02_AG sequences. Maximum-likelihood phylogeny reconstruction with bootstrap evaluation was conducted in RAxML. Bayesian phylogeographic analysis was performed in BEAST v1.8 using the discrete trait model. We found that all CRF02_AG sequences from Russia and other FSU countries formed a single monophyletic cluster within CRF02_AG radiation. The Russian/FSU clade was classified as CRF63_02A1. Sequences from the FSU countries clustered further within distinct subclades (two from Russia, three from Uzbekistan, and one Kazakhstan) according to the geographic origin of sampling. Molecular clock analysis revealed that the time to the most recent common ancestor (tMRCA) of the CRF63_02A1 epidemic was in 1996 [95% higher posterior density (95% HPD): 1992-1999], while for the two Russian subclades, tMRCA was estimated in 2003 (95% HPD: 2001-2004) and in 2007 (95% HPD: 2005-2008). Phylogeographic analysis suggested that the potential origin of the epidemic was in Uzbekistan. Early dispersal of CRF63_02A1 occurred in Kazakhstan and Uzbekistan and thereafter the epidemic spread to Russia. Notably, spillover transmissions to Russia kept occurring from both countries. Previous studies have shown that Russia and Ukraine have provided the source for the PWID-driven, HIV-1 subtype-A epidemic, spreading across the FSU countries (AFSU). In great contrast, CRF63_02A1 established an epidemic in central Asia (Uzbekistan and Kazakhstan), from where it subsequently disseminated to Russia. Our study suggests that cross-border transmissions among PWID occur bidirectionally between Russian and other FSU populations. These results are of public health importance and suggest that prevention actions have to be reinforced in this area to assist the management of high-risk practices.
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Affiliation(s)
- Evangelia-Georgia Kostaki
- 1 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens, Greece
| | | | - Marina Bobkova
- 3 Ivanovsky Institute of Virology , FSBI "N.F. Gamaleya FRCEM" of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Martha Oikonomopoulou
- 1 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens, Greece
| | - Gkikas Magiorkinis
- 1 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens, Greece
- 2 Department of Zoology, University of Oxford , Oxford, United Kingdom
| | - Federico Garcia
- 4 Servicio de Microbiología, Hospital Universitario San Cecilio, Complejo Hospitalario Universitario Granada, Cohorte de Adultos de la Red de Investigación en SIDA-CoRIS, Instituto de Investigación Ibs , Granada, Granada (Andalucía), Spain
| | - Angelos Hatzakis
- 1 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens, Greece
| | - Dimitrios Paraskevis
- 1 Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens, Greece
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Cluster of HIV Infections Associated With Unsafe Injection Practices in a Rural Village in Cambodia. J Acquir Immune Defic Syndr 2018; 75:e82-e86. [PMID: 28129255 DOI: 10.1097/qai.0000000000001295] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
INTRODUCTION Sex differences in cognition of HIV positive (HIV) patients are controversial. We aimed to investigate the relationship between cognition, HIV status, and sex, in a highly homogenous cohort of young Romanians parenterally infected during early childhood. METHODS In total, 250 HIV participants were compared with age-matched HIV negative (HIV) controls (n = 72) in a cross-sectional study. After standardized neurocognitive, psychological testing and medical evaluation, linear regression was used to assess the effect of sex and HIV on neurocognitive outcomes. RESULTS Study participants were on average 23 years old with balanced sex distribution (% women = 52% vs. 43%). HIV were more educated (12.7 vs. 11.6 years, P = 0.002).HIV status was associated with a lower global performance (β = -0.22, P < 0.001), after controlling for age and education. HIV women had better previous and current HIV-associated markers. The effect of HIV on global cognition did not differ between sexes in most cognitive domains (β = 0.07, P = 0.14). An interaction between sex, HIV status, and cognitive functioning was found in the psychomotor domain. HIV women had worse motor skills than HIV women (β = -0.32, P < 0.001) suggesting a specific effect of HIV on motor functioning in women only. Moreover, current CD4 less than 200 cells/μl (P = 0.013) and longer time lived with CD4 less than 200 cells/μl (P = 0.023) were negatively correlated with the motor scaled score in women (β = -0.22, P = 0.034). CONCLUSION Despite less advanced disease in women, long-term HIV infection has an equally detrimental effect on cognitive performances of both sexes, in all cognitive domains, except the psychomotor domain where women are preferentially affected.
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Ene L, Marcotte TD, Umlauf A, Grancea C, Temereanca A, Bharti A, Achim CL, Letendre S, Ruta SM. Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection. J Neuroimmunol 2016; 299:1-7. [PMID: 27725106 DOI: 10.1016/j.jneuroim.2016.08.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 07/30/2016] [Accepted: 08/02/2016] [Indexed: 12/11/2022]
Abstract
We evaluated the impact of latent toxoplasmosis (LT) on neurocognitive (NC) and neurobehavioural functioning in young adults with and without chronic HIV infection, using a standardised NC test battery, self-reported Beck Depression Inventory, Frontal System Behavior Scale, MINI-International Neuropsychiatric Interview and risk-assessment battery. 194 young adults (median age 24years, 48.2% males) with chronic HIV infection (HIV+) since childhood and 51 HIV seronegative (HIV-) participants were included. HIV+ individuals had good current immunological status (median CD4: 479 cells/μl) despite a low CD4 nadir (median: 93 cells/μl). LT (positive anti-Toxoplasma IgG antibodies) was present in one third of participants. The impairment rates in the HIV- with and without Toxo were not significantly different (p=0.17). However, we observed an increasing trend (p<0.001) in impairment rates with HIV and LT status: HIV-/LT- (6.1%); HIV-/LT+ (22%), HIV+/LT- (31%), HIV+/LT+ (49%). In a multivariable analysis using the entire study group there were main effects on cognition for HIV and also for LT. Within the HIV+ group LT was associated with worse performance globally (p=0.006), in memory (p=0.009), speed of information processing (p=0.01), verbal (p=0.02) and learning (p=0.02) domains. LT was not associated with depressive symptoms, frontal systems dysfunction or risk behaviors in any of the groups. HIV participants with lower Toxoplasma antibody concentration had worse NC performance, with higher GDS values (p=0.03) and worse learning (p=0.002), memory (p=0.006), speed of information processing (p=0.01) T scores. Latent Toxoplasmosis may contribute to NC impairment in young adults, including those with and without chronic HIV infection.
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Affiliation(s)
- L Ene
- "Dr. Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
| | - T D Marcotte
- University of California San Diego, La Jolla, CA, USA
| | - A Umlauf
- University of California San Diego, La Jolla, CA, USA
| | - C Grancea
- "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania
| | - A Temereanca
- "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania
| | - A Bharti
- University of California San Diego, La Jolla, CA, USA
| | - C L Achim
- University of California San Diego, La Jolla, CA, USA
| | - S Letendre
- University of California San Diego, La Jolla, CA, USA
| | - S M Ruta
- "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania
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Ene L, Voinea C, Stefanescu C, Sima D, Duiculescu D, Mehta SR. Cervical HPV infection in Romanian women infected with HIV during early childhood. Int J STD AIDS 2015; 27:1079-1085. [PMID: 26404111 DOI: 10.1177/0956462415608333] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 09/03/2015] [Indexed: 11/16/2022]
Abstract
Human papillomavirus (HPV) is the most common cause of cervical cancer worldwide, and Romania has the highest rate of cervical cancer in Europe. Sixty-five young Romanian women infected with HIV during early childhood and 25 control subjects were evaluated for the presence of cervical HPV infection and for cytologic abnormalities. HPV infection was evaluated longitudinally in 42 HIV-infected individuals. Overall 28/65 (43.1%) of HIV-infected and 8/25 (32.0%) of uninfected subjects were infected with HPV, and 21/65 (32.3%) and 6/25 (24%) had high-risk subtypes, respectively. In HIV-infected women, those maintaining or acquiring a new subtype in follow-up were more likely to have a lower nadir (p = 0.04) and current (p = 0.01) CD4 cell counts. The incidence rate for HPV acquisition events was 0.69 per subject per year, and 0.52 for high-risk subtypes. In the HIV-infected group, 9/13 (69.2%) individuals with abnormal cytology progressed at follow-up. Although HPV prevalence was similar to controls, the rate of Pap smear abnormalities was much higher, possibly due to the decreased ability to mount new immune responses. Given the high rate of incident detection of vaccine preventable strains and cytologic progression in this cohort, HPV vaccination may be beneficial at any age in co-infected women.
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Affiliation(s)
- Luminita Ene
- Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - Cristina Voinea
- Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - Claudia Stefanescu
- Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - Diana Sima
- Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - Dan Duiculescu
- Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania School of Medicine, "Titu Maiorescu" University, Bucharest, Romania
| | - Sanjay R Mehta
- Department of Medicine, San Diego Veterans Affairs Medical Center, CA, USA Department of Medicine, University of California San Diego, CA, USA
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Parczewski M, Urbanska A, Grzeszczuk A, Maciejewska K, Witak-Jedra M, Leszczyszyn-Pynka M. Phylogeographic analysis on the travel-related introduction of HIV-1 non-B subtypes to Northern Poland. INFECTION GENETICS AND EVOLUTION 2014; 27:121-30. [PMID: 25038296 DOI: 10.1016/j.meegid.2014.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 06/27/2014] [Accepted: 07/05/2014] [Indexed: 11/16/2022]
Abstract
Phylodynamic, sequence data based reconstructions for the surveillance of the geographic spatial spread are a powerful tool in molecular epidemiology. In this study region of origin for the set of 57 partial pol sequences derived from the patients the history of travel-related HIV transmission was analyzed using phylogeographic approach. Maximum likelihood trees based on the sets of country-annotated reference sequences were inferred for identified non-B variants. Region of sequence import was assigned using on the highest approximate likelihood ratios. Import of the A1 clades was traced to the Eastern Europe and associated with immigration from this region. Subtype C infections clustered most frequently with sequences of the South African origin while majority of subtype Ds were similar to the European clades. Subtype G sequences clustered with Portuguese lineage, CRF01_AE with Eastern or South-Eastern Asian. Eastern European, Middle African or Western African lineage was assigned for the CFR02_AG. Rare circulating recombinants originated either from Central Africa (CRF11_cpx - Democratic Republic of Congo, CRF13_cpx - Central African Republic, CRF37_cpx - Cameroon) or South America (CRF28_BF and CRF46_BF - Brazil). Import of the HIV-1 non-B variants, including recombinant forms previously rarely found in Poland and Europe is frequent among travelers. Observed founder events result in the heterosexually-driven introduction of the novel HIV-1 variants into the population.
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Affiliation(s)
- Milosz Parczewski
- Department of Infectious Diseases and Hepatology, Pomeranian Medical University, Szczecin, Poland.
| | - Anna Urbanska
- Department of Infectious Diseases and Hepatology, Pomeranian Medical University, Szczecin, Poland
| | - Anna Grzeszczuk
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
| | - Katarzyna Maciejewska
- Department of Infectious Diseases and Hepatology, Pomeranian Medical University, Szczecin, Poland
| | - Magdalena Witak-Jedra
- Department of Infectious Diseases and Hepatology, Pomeranian Medical University, Szczecin, Poland
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Goldwater PN. Iatrogenic blood-borne viral infections in refugee children from war and transition zones. Emerg Infect Dis 2013; 19. [PMID: 23739597 PMCID: PMC3713815 DOI: 10.3201/eid1906.120806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Pediatric infectious disease clinicians in industrialized countries may encounter iatrogenically transmitted HIV, hepatitis B virus, and hepatitis C virus infections in refugee children from Central Asia, Southeast Asia, and sub-Saharan Africa. The consequences of political collapse and/or civil war—work migration, prostitution, intravenous drug use, defective public health resources, and poor access to good medical care—all contribute to the spread of blood-borne viruses. Inadequate infection control practices by medical establishments can lead to iatrogenic infection of children. Summaries of 4 cases in refugee children in Australia are a salient reminder of this problem.
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Affiliation(s)
- Paul N Goldwater
- Women’s and Children’s Hospital, Adelaide, South Australia, Australia
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11
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Parczewski M. Subtype variability and phylogenetic analyses in HIV. HIV & AIDS REVIEW 2013. [DOI: 10.1016/j.hivar.2013.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Mbisa JL, Hué S, Buckton AJ, Myers RE, Duiculescu D, Ene L, Oprea C, Tardei G, Rugina S, Mardarescu M, Floch C, Notheis G, Zöhrer B, Cane PA, Pillay D. Phylodynamic and phylogeographic patterns of the HIV type 1 subtype F1 parenteral epidemic in Romania. AIDS Res Hum Retroviruses 2012; 28:1161-6. [PMID: 22251065 DOI: 10.1089/aid.2011.0390] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the late 1980s an HIV-1 epidemic emerged in Romania that was dominated by subtype F1. The main route of infection is believed to be parenteral transmission in children. We sequenced partial pol coding regions of 70 subtype F1 samples from children and adolescents from the PENTA-EPPICC network of which 67 were from Romania. Phylogenetic reconstruction using the sequences and other publically available global subtype F sequences showed that 79% of Romanian F1 sequences formed a statistically robust monophyletic cluster. The monophyletic cluster was epidemiologically linked to parenteral transmission in children. Coalescent-based analysis dated the origins of the parenteral epidemic to 1983 [1981-1987; 95% HPD]. The analysis also shows that the epidemic's effective population size has remained fairly constant since the early 1990s suggesting limited onward spread of the virus within the population. Furthermore, phylogeographic analysis suggests that the root location of the parenteral epidemic was Bucharest.
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Affiliation(s)
- Jean L. Mbisa
- Virus Reference Department, Microbiology Services, Health Protection Agency, London, United Kingdom
| | - Stéphane Hué
- MRC Centre for Medical Molecular Virology, Division of Infection and Immunity, University College London, London, United Kingdom
| | - Andrew J. Buckton
- Virus Reference Department, Microbiology Services, Health Protection Agency, London, United Kingdom
| | - Richard E. Myers
- Virus Reference Department, Microbiology Services, Health Protection Agency, London, United Kingdom
| | - Dan Duiculescu
- AIDS Department, Victor Babes Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Luminita Ene
- AIDS Department, Victor Babes Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Cristiana Oprea
- AIDS Department, Victor Babes Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Gratiela Tardei
- Immunology, Virology, and Molecular Biology Department, Victor Babes Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Sorin Rugina
- Hospital for Infectious Diseases, Constanta, Romania
| | - Mariana Mardarescu
- Matei Bals National Institute of Infectious Diseases, Bucharest, Romania
| | - Corinne Floch
- AP-HP, Hôpital Louis Mourier, Service de Pédiatrie, Colombes, France
| | - Gundula Notheis
- Childrens Hospital of the Ludwig Maximilians University, Munich, Germany
| | | | - Patricia A. Cane
- Virus Reference Department, Microbiology Services, Health Protection Agency, London, United Kingdom
| | - Deenan Pillay
- MRC Centre for Medical Molecular Virology, Division of Infection and Immunity, University College London, London, United Kingdom
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Parczewski M, Leszczyszyn-Pynka M, Bander D, Urbanska A, Boroń-Kaczmarska A. HIV-1 subtype D infections among Caucasians from Northwestern Poland--phylogenetic and clinical analysis. PLoS One 2012; 7:e31674. [PMID: 22359615 PMCID: PMC3280981 DOI: 10.1371/journal.pone.0031674] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 01/11/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND HIV-1 subtype D infections, which are associated with a faster rate of progression and lymphocyte CD4 decline, cognitive deficit and higher mortality, have rarely been found in native Europeans. In Northwestern Poland, however, infections with this subtype had been identified. This study aimed to analyze the sequence and clinical data for patients with subtype D using molecular phylogeography and identify transmission clusters and ancestry, as well as drug resistance, baseline HIV tropism and antiretroviral treatment efficacy. METHODS Phylogenetic analyses of local HIV-1 subtype D sequences were performed, with time to the most recent common ancestor inferred using bayesian modeling. Sequence and drug resistance data were linked with the clinical and epidemiological information. RESULTS Subtype D was found in 24 non-immigrant Caucasian, heterosexually infected patients (75% of females, median age at diagnosis of 49.5 years; IQR: 29-56 years). Partial pol sequences clustered monophyletically with the clades of Ugandan origin and no evidence of transmission from other European countries was found. Time to the most common recent ancestor was 1989.24 (95% HPD: 1968.83-1994.46). Baseline drug resistance to nucleoside reverse transcriptase inhibitors was observed in 54.5% of cases (mutations: M41L, K103N, T215S/D) with evidence of clustering, no baseline integrase or protease resistance and infrequent non-R5 tropism (13.6%). Virologic failure was observed in 60% of cases and was associated with poor adherence (p<0.001) and subsequent development of drug resistance (p = 0.008, OR: 20 (95%CI: 1.7-290). CONCLUSIONS Local subtype D represented an independently transmitted network with probably single index case, high frequency of primary drug resistance and evidence of transmission clusters.
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Affiliation(s)
- Miłosz Parczewski
- Department of Infectious Diseases and Hepatology, Pomeranian Medical University, Szczecin, Poland.
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Mehta SR, Wertheim JO, Delport W, Ene L, Tardei G, Duiculescu D, Pond SLK, Smith DM. Using phylogeography to characterize the origins of the HIV-1 subtype F epidemic in Romania. INFECTION GENETICS AND EVOLUTION 2011; 11:975-9. [PMID: 21439403 DOI: 10.1016/j.meegid.2011.03.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 03/11/2011] [Accepted: 03/15/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND During the late 1980s and early 1990s, an estimated 10,000 Romanian children were infected with HIV-1 subtype F nosocomially through contaminated needles and blood transfusions. However, the geographic source and origins of this epidemic remain unclear. METHODS Here we used phylogenetic inference and "relaxed" molecular clock dating analysis to further characterize the Romanian HIV-1 subtype F epidemic. RESULTS These analyses revealed a major lineage of Romanian HIV sequences consisting nearly entirely of virus sampled from adolescents and children and a distinct cluster that included a much higher ratio of adult sequences. Divergence time estimates inferred the time of most recent common ancestor of subtype F1 sequences to be 1973 (1966-1980) and for all Angolan sequences to 1975 (1968-1980). The most common ancestor of the Romanian sequences was dated to 1978 (1972-1983) with pediatric and adolescent sequences interspersed throughout the lineage. The phylogenetic structure of the entire subtype F epidemic suggests that multiple introductions of subtype F into Romania occurred either from the Angolan epidemic or from more distant ancestors. Since the historical records note that the Romanian pediatric epidemic did not begin until the late 1980s, the inferred time of most recent common ancestor of the Romanian lineage of 1978 suggests that there were multiple introductions of subtype F occurred into the pediatric population from HIV already circulating in Romania. CONCLUSIONS Analysis of the subtype F HIV-1 epidemic in an historical context allows for a deeper appreciation of how the HIV pandemic has been influenced by socio-political events.
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Affiliation(s)
- Sanjay R Mehta
- Department of Medicine, University of California, San Diego, CA 92103, USA.
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Gisselquist D, Potterat JJ, St Lawrence JS, Hogan M, Arora NK, Correa M, Dinsmore WW, Mehta G, Millogo J, Muth SQ, Okinyi M, Ounga T. How to contain generalized HIV epidemics? A plea for better evidence to displace speculation. Int J STD AIDS 2009; 20:443-6. [PMID: 19541883 DOI: 10.1258/ijsa.2009.009003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the worst generalized HIV epidemics in East and Southern Africa, from one-quarter to three-quarters of women aged 15 years can expect to be living with HIV or to have died with AIDS by age 40 years. This disaster continues in the face of massive HIV prevention programmes based on current inexact knowledge of HIV transmission pathways and risks. To stop this disaster, both the public and public health experts need better information about the specific factors that allow HIV to propagate so extensively in countries with generalized epidemics. This knowledge could be acquired by tracing HIV infections to their source - especially tracing HIV infections in women of all ages, and tracing unexplained HIV infections in children with HIV-negative mothers.
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GISSELQUIST DAVID. HIV Infections as Unanticipated Problems During Medical Research in Africa. Account Res 2009; 16:199-217. [DOI: 10.1080/08989620903065277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Gisselquist D, Upham G, Potterat JJ. Efficiency of human immunodeficiency virus transmission through injections and other medical procedures: evidence, estimates, and unfinished business. Infect Control Hosp Epidemiol 2006; 27:944-52. [PMID: 16941321 DOI: 10.1086/506408] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Accepted: 03/21/2005] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To estimate the transmission efficiency of human immunodeficiency virus (HIV) through medical injections and other invasive procedures. DESIGN We searched our own files and Medline (from 1966-2004, using the keywords ["iatrogenic" or "nosocomial" or "injections"] and "HIV") for reports of iatrogenic outbreaks worldwide, except outbreaks traced to receipt of contaminated blood or blood products. We also analyzed information from a case-control study of percutaneous exposures to healthcare workers. SETTING Worldwide healthcare settings. EVENTS: We identified 8 iatrogenic outbreaks that met our study criteria; published information from 4 outbreaks was sufficient to estimate transmission efficiency. RESULTS From the 4 documented iatrogenic outbreaks, we estimated that 1 iatrogenic infection occurred after 8-52 procedures involving HIV-infected persons. Although only 0.3% of healthcare workers seroconvert after percutaneous exposure, a case-control study reported that deep injuries and other risk factors collectively increased seroconversion risk by as much as 50 times. Laboratory investigations demonstrate HIV survival through time and various rinsing regimens. We estimate that the transmission efficiency in medical settings with no or grossly insufficient efforts to clean equipment ranges from 0.5% to 3% for lower risk procedures (eg, intramuscular injections) and from 10% to 20% or more for high-risk procedures. Efforts to clean equipment, short of sterilization, may cut the transmission efficiency by 0%-100%. Procedures that contaminate multidose vials may accelerate transmission efficiency. CONCLUSION To achieve better estimates of the transmission efficiency for a range of medical procedures and settings, investigations of iatrogenic outbreaks should be accorded high priority.
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Leibovitz E, Dragomir C, Sfartz S, Porat N, Yagupsky P, Jica S, Florescu L, Dagan R. Nasopharyngeal carriage of multidrug-resistant Streptococcus pneumoniae in institutionalized HIV-infected and HIV-negative children in northeastern Romania. Int J Infect Dis 1999; 3:211-5. [PMID: 10575151 DOI: 10.1016/s1201-9712(99)90027-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES The study compared nasopharyngeal carriage of resistant pneumoniae in human immunodeficiency virus (HIV)-seropositive and -seronegative children. METHODS Nasopharyngeal colonization with Streptococcus pneumoniae was investigated during May 1996 in 162 HIV-negative infants and children (age range, 1-38 mo) and 40 HIV-infected children (age range, 39-106 mo) living in an orphanage in Iasi, northeastern Romania. The HIV-infected children lived separated from the other children and were cared for by a different staff. Streptococcus pneumoniae was isolated from 12 of 40 (30%) HIV-infected and from 81 of 160 (50%) HIV-negative children. Antimicrobial susceptibility to penicillin and ceftriaxone was determined by E-test, and to another five antibiotics by disk diffusion. Serotyping was performed by the Quellung method on 81 of 93 (87%) isolates. RESULTS Serotypes 6A, 6B, 19A, and 23F together represented 98% of all isolates. Ninety-nine percent of S. pneumoniae isolates were resistant to penicillin, and 74% were highly resistant to penicillin (minimum inhibitory concentration [MIC] > 1 mg/mL); MIC50 and MIC90 to penicillin of the isolates were 2 mg/mL and 8 mg/mL, respectively. Eighty-nine of ninety-one isolates were susceptible to ceftriaxone; 99%, 87%, 87%, 48%, and 21% of the isolates were resistant to trimethoprim-sulphamethoxazole, erythromycin, clindamycin, tetracycline, and chloramphenicol, respectively. Eighty-two (89%) isolates were multidrug resistant (resistant to =/>3 antibiotic classes); 37 of 92 (40%) isolates were resistant to 5 or more antibiotic classes, and 16 of these 37 (43%) belonged to serotype 19A. All serotype 19 isolates were highly resistant to penicillin. CONCLUSIONS No significant differences were observed in the resistance rates of S. pneumoniae in HIV-infected children compared to HIV-negative children. Multidrug-resistant pneumococci were highly prevalent in this Romanian orphanage in both HIV-negative and older HIV-infected children. The observed high prevalence of multidrug-resistant pneumococci (coupled with high penicillin resistance) with a limited number of circulating serotypes emphasizes the need to further evaluate the conjugate vaccines in children at risk for invasive pneumococcal infection.
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Affiliation(s)
- E Leibovitz
- Pediatric Infectious Disease Unit, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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D'Ubaldo C, Pezzotti P, Rezza G, Branca M, Ippolito G. Association between HIV-1 infection and miscarriage: a retrospective study. DIANAIDS Collaborative Study Group. Diagnosi Iniziale Anomalie Neoplastiche AIDS. AIDS 1998; 12:1087-93. [PMID: 9662206 DOI: 10.1097/00002030-199809000-00016] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the role of HIV-1 infection on miscarriage, we compared the obstetric histories of a cohort of HIV-1-infected and uninfected Italian women. DESIGN Retrospective study. METHODS The study participants were women (with at least one reproductive event) with HIV-1 infection or HIV-1-negative sharing the same exposure modalities; all women were attending a network of 16 infectious disease units in 12 Italian cities. Trained interviewers used a standard questionnaire to collect information on obstetric history [i.e., number of pregnancies, pregnancy outcome (live birth, spontaneous or induced abortion) and time of occurrence of these events (i.e., year of birth)]. The association between spontaneous abortion and HIV-1 status at the time of pregnancy was evaluated. RESULTS The analysis included 272 women and accounted for 480 pregnancies (217 in HIV-infected women, 132 in uninfected women and 131 in women with undefined HIV status) and 60 miscarriages (23 in HIV-infected women, 22 in uninfected women and 15 in women with undefined HIV status). We estimated an adjusted odds ratio of 1.67 between spontaneous abortion and HIV-1 infection. CONCLUSIONS We observed a 67% increase in risk of spontaneous abortion among HIV-1-infected women compared with HIV-1-negative women. This result should be considered in the counselling and management of women with HIV-1 infection who are of reproductive age.
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Affiliation(s)
- C D'Ubaldo
- Centro di Riferimento AIDS--Servizio di Epidemiologia delle Malattie Infettive, Istituto di Ricoveroe Cura a Carrattere Scientifico Lazzaro Spallanzani Hospital, Rome, Italy
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Franceschi S, Dal Maso L, La Vecchia C. Trends in incidence of AIDS associated with transfusion of blood and blood products in Europe and the United States, 1985-93. BMJ (CLINICAL RESEARCH ED.) 1995; 311:1534-6. [PMID: 8520395 PMCID: PMC2548206 DOI: 10.1136/bmj.311.7019.1534] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To quantify patterns and trends in incidence of AIDS associated with transfusion of blood and its products in 14 European countries and the United States. DESIGN Data were derived from the World Health Organisation's European non-aggregate AIDS dataset and, for the United States, from the Centers for Disease Control AIDS public information dataset. Rates were standardised by using the world standard populations and adjusted for reporting delays in each country. SUBJECTS Cases of AIDS in patients with haemophilia and recipients of transfusions. RESULTS Overall, between 1985 and 1993 almost 6000 cases of AIDS associated with transfusions were registered in the 14 European countries considered and over 8000 in the United States between 1985 and 1992. Most European countries had annual age adjusted rates lower than 0.5 per million children aged 12 or less and between 1 and 2 per million adults. The United States had rates around 1 per million children and 5 per million adults in the most recent period. For children, the highest rates were generally reached in 1985-7, whereas in adults the highest rates were in the late 1980s. France had the highest overall incidence of AIDS related to transfusion in Europe (3.3 per million). Romania had a major epidemic in children (over 30 cases per million children in 1988-90). Incidence rates of AIDS associated with transfusion were still increasing in some southern European countries in the early 1990s. CONCLUSIONS Apart from in France and Romania it is clear that rates of bloodborne AIDS in European countries are lower than those registered in the United States.
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Affiliation(s)
- S Franceschi
- Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano, Italy
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Holm-Hansen C, Grothues D, Rustad S, Røsok B, Pascu FR, Asjö B. Characterization of HIV type 1 from Romanian children: lack of correlation between V3 loop amino acid sequence and syncytium formation in MT-2 cells. AIDS Res Hum Retroviruses 1995; 11:597-603. [PMID: 7576916 DOI: 10.1089/aid.1995.11.597] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The biological properties and amino acid sequences of the third variable domain (V3 loop and flanking regions) of the env region of 34 HIV-1 isolates obtained from Romanian children were analyzed. Unambiguous nucleic acid sequences were obtained from 31 isolates. The derived V3 amino acid sequences were highly homologous (93-100%) and clustered with the HIV-1 subtype F Romanian consensus. Five of the 31 isolates presented a syncytium-inducing phenotype in MT-2 cells and established continuous viral replication in various CD4+ cell lines (rapid/high phenotype). The V3 sequence from one of these isolates showed a slightly lesser degree of homology with the consensus sequence. The presence of positively charged amino acids at positions 306 and 320 has been strongly associated with the ability to induce syncytia in MT-2 cells, whereas negatively or uncharged amino acids at these positions are present in non-syncytium-inducing isolates (slow/low phenotype). There was, however, no correlation between phenotype and amino acid sequence in the five syncytium-inducing isolates; negatively or uncharged amino acids were conserved at positions 306 and 320 for all 31 isolates in sequences obtained from PBMCs. A tendency toward a more positive net charge in the V3 loop of syncytium-inducing isolates was noted. These data confirm the recent observations that HIV-1 isolates from Romania not only cluster in subtype F, but also show a high degree of interpatient homogeneity in the V3 region.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C Holm-Hansen
- Centre for International Health, University of Bergen, Norway
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Mortimer PP. Arsphenamine jaundice and the recognition of instrument-borne virus infection. Genitourin Med 1995; 71:109-19. [PMID: 7744400 PMCID: PMC1195466 DOI: 10.1136/sti.71.2.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Soon after its introduction in 1910, intravenous arsphenamine treatment for syphilis was found to be complicated by jaundice. The underlying cause, unsterile syringes and needles, was eventually recognised in the early 1940s, mainly through the efforts of British Army investigators. The infection most often transmitted was probably hepatitis B virus (HBV), but the high mortality in a few of the outbreaks of arsphenamine jaundice suggests that variants of HBV, or other hepatitis viruses, were sometimes involved. Fifty years later, at a time when there are estimated to be over three hundred million carriers of HBV in the world and probably at least as many hepatitis C virus carriers, and when the World Health Organisation estimates that there have been 17 million infections with human immunodeficiency virus, the lessons learnt around 1945 about the need to use sterile instruments and needles for all injections and venepunctures remain highly pertinent.
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Affiliation(s)
- P P Mortimer
- Hepatitis and Retrovirus Laboratory, Virus Reference Division, London, UK
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