Evaluation of the Nitrite and Leukocyte Esterase Activity Tests for the Diagnosis of Acute Symptomatic Urinary Tract Infection in Men

For 422 male patients with symptoms indicative of a urinary tract infection, nitrite and leukocyte esterase activity dipstick test results were compared with results of culture of urine samples. The positive predictive value of a positive nitrite test result was 96%. Addition of results of the leukocyte esterase test did not improve the diagnostic accuracy of the nitrite test.

Evaluation of mechanical transmission of HIV by the African soft tick, Ornithodoros moubata

OBJECTIVES

To assess the ability of the African Hut Tampan, Ornithodoros moubata, to mechanically transmit HIV-1 and to re-appraise HIV-1 infectivity in an arthropod cell line at 28 and 35 degrees C.

DESIGN

To evaluate HIV-1 transmission by O. moubata, as determined by HIV-1 survival, 'blood-meal' size and interval between feeds, various tick developmental stages were allowed to feed on a heavily infected lymphoblast-rich blood-meal containing HIV-1BRU in an in vitro feeding chamber.

METHODS

Blood-meal regurgitation was evaluated using 51Cr-labelled human erythrocytes, and human lymphoblast survival in ticks using Trypan blue. HIV-1 survival in ticks was evaluated by reverse transcriptase activity in tick homogenates cocultured with CEM lymphoblasts. Polymerase chain reaction and Southern blot analysis were used to detect proviral HIV-1 in arthropod cells in vitro.

RESULTS

HIV-1BRU remained viable for up to 10 days with O. moubata adults. This is the longest recorded survival of HIV in an arthropod. In agreement with other studies. O. moubata regurgitated part of its previous blood-meal into the feeding lesion. Human CEM lymphoblasts partially survived for up to 7 days at 28 and 35 degrees C inside O. moubata's digestive tract. The blood-meal of adult female ticks was as high as 240 microliters (approximately 70 times more than a mosquito), while the most likely potential mechanical vectors (fourth- and fifth-stage nymphs) ingested an average of 39 microliters (maximum, 73 microliters), with some ticks re-feeding as early as 14 days postfeed in the absence of a moult. Shortcomings associated with the experimental protocol suggest that HIV survival within O. moubata may reach 14 days following natural infection, or that ticks might re-feed earlier. Although HIV-1BRU and HIV-1NDK were unable to replicate at 28 and 35 degrees C in CD4- Aedes albopictus C6/36 mosquito cells, HIV-1NDK was detected in its proviral form.

CONCLUSIONS

Our investigations showed that mechanical transmission of HIV-1 by O. moubata is unlikely to occur in the laboratory. This may not be the situation under field conditions.

Productive infection of CD4+ cells by selected HIV strains is not inhibited by anti-CD4 monoclonal antibodies

Differential susceptibility of four diverse HIV strains to inhibition of infection of CD4+ CEM cells by anti-CD4 monoclonal antibodies was studied. The highly cytopathic HIV-1 246 and NDK strains were able to infect CEM cells and undergo several cycles of replication at saturating doses of LEU3-A, OKT4-A, and 13B8-2 monoclonal antibodies, whereas propagation of reference HIV-1 BRU and weakly cytopathic strain HIV-1 PAS was inhibited. Postadsorption treatment by anti-CD4 antibodies had stronger inhibitory effect than did treatment during the virus adsorption period. In parallel experiments, the same monoclonal antibodies successfully blocked syncytium formation between uninfected MT4 cells and CEM cells infected by all four HIV-1 virus strains tested. To explain these seemingly contradictory data we have postulated that anti-CD4 antibodies efficiently inhibit cell-to-cell but not virus-to-cell infection.