Human immunodeficiency virus 1 subtypes detected in Scottish blood donors

The aim of our study was to determine human immunodeficiency virus 1 subtypes in Scottish blood donors. We were able to document virus subtypes present in this population over a period of 19 years and examine associated risk factors where available. Subtype B was found to be the predominant cause of human immunodeficiency virus 1 infection in Scottish blood donors with subtype C increasing in this population after 2002. Non-B subtypes were found mainly in heterosexuals but also in all other risk categories with the exception of men having sex with men (MSM). Within Scotland there is an increase in transmission via heterosexual contact and the consequential introduction of non-B subtypes.     

Human immunodeficiency virus, hepatitis C and hepatitis B infections among blood donors in Germany 2000-2002: risk of virus transmission and the impact of nucleic acid amplification testing

Blood and plasma donations in Germany are collected by several institutions, namely the German Red Cross, community and hospital-based blood services, private blood centres, commercial plasma donation sites and transfusion services of the army. All blood donation centres are required to report quarterly data on infection markers to the Robert Koch Institute, thus providing current and accurate epidemiological data. The prevalence and incidence of relevant viral infections are low in the blood donor population in Germany, with a decreasing trend for hepatitis C infections in new and repeat donors since 1997. The implementation of mandatory nucleic acid amplification technique (NAT) testing for hepatitis C virus (HCV) in 1999 has markedly improved transfusion safety. HIV-NAT became mandatory in 2004 but was done voluntarily by the majority of the blood donation services before then. The potential benefit of hepatitis B virus (HBV) minipool NAT is not as clear because chronic HBV carriers with very low virus levels might donate unidentified. The residual risk of an infectious window period donation inadvertently entering the blood supply can be estimated using a mathematic model which multiplies the incidence rate by the number of days during which an infection may be present but not detectable, i.e. the length of the window period. The risk of an undetected infection without NAT testing was estimated to be 1 in 2,770,000 for HIV, 1 in 670,000 for HCV and 1 in 230,000 for HBV in 2001/2002. This contrasts with 1 in 5,540,000 for HIV, 1 in 4,400,000 for HCV and 1 in 620,000 for HBV with minipool NAT testing. This demonstrates that NAT testing can further reduce the already very small risk of infectious donations entering the blood supply.     

Human immunodeficiency virus/human parvovirus B19 co-infection in blood donors and AIDS patients in Sichuan, China

Background

Human parvovirus B19 (B19) is a common pathogen which causes a variety of diseases. Persistent B19 infection is related to the degree of host immunodeficiency in patients with human immunodeficiency virus (HIV) infection. However, the existence, loading, virus evolution and distribution of B19 in Chinese HIV-positive patients have not been determined.

Materials and methods.

We investigated 573 HIV-positive blood donors and AIDS patients in Sichuan, China in the last two decades. Bl9-specific serology and quantitative polymerase chain reaction were used to determine the prevalence of B19/HIV co-infection. Viral genome fragments were subjected to phylogeny and haplotype analysis.

Results

B19 genomic DNA was found in 26 of 573 (4.5%) HIV-positive individuals, a higher prevalence than in blood donors. DNA levels ranged from 5.3×10²–1.1×10⁵ copies/mL. The seroprevalence of IgG was significantly lower in HIV-positive samples than in HIV-negative blood donors, indicating deficient production of B19-specific IgG in the former. The B19 isolates were genotype-1 subtype B19-1A which formed a monophyletic group; seven distinct haplotypes were discovered with 60% of the B19/HIV co-infected variants sharing one central haplotype.

Discussion.

This study on the prevalence, phylogeny and distribution of human parvovirus B19 in Sichuan, China, demonstrates the persistence of B19 in the circulation of both immunocompetent and immunocompromised subjects, with implications for blood safety.     

Syphilis serology and human immunodeficiency virus positivity in Chandigarh

AIDS and other sexually transmitted diseases are interlinked. VDRL positivity may indicate that the individual has an increased risk of being HIV positive as the epidemiological risk factors for developing syphilis and AIDS are similar. We analysed 323 (5.8%) VDRL positive serum samples (out of 5592 screened) for HIV positivity. All were HIV negative. While syphilitic infection in India at present is not commonly associated with HIV infection, experience in other countries indicates caution.     

Human immunodeficiency virus infection and inter-arm blood pressure difference

Objective To analyze the association between cardiovascular risk factors and inter-arm blood pressure difference(IAD) in patients with human immunodeficiency virus(HIV) infection,and to confirm as to whether HIV infection promotes atherosclerosis. Methods 41 HAART-naive HIV infected-patients and 43 healthy people were     

人类免疫缺陷病毒感染与臂间血压差异相关性研究

目的分析人类免疫缺陷病毒(HIV)感染的患者心血管危险因素与臂间血压差异(IAD)的相关关系,明确HIV感染是否有促进动脉粥样硬化的作用。方法采用病例对照研究的方法,比较分析2007—2008年北京协和医院41例未经高效抗逆转录病毒联合疗法(HAART)治疗的HIV患者与43例普通对照人群的传统心血管危险因素和IAD,并进一步分析IAD与HIV感染指标的相关性。结果未经HAART治疗的HIV患者的总胆固醇、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇则均低于对照组(P<0.01)。HIV组患者的臂间收缩压差异(sIAD)和臂间舒张压差异(dIAD)均明显大于对照组[sIAD:(6.22±4.64)mmHg对(2.98±2.69)mmHg,P<0.01;dIAD:(4.20±2.93)mmHg对(2.23±3.17)mmHg,P<0.01](1 mmHg=0.133 kPa)。sIAD与病毒载量的对数成负相关(r=-0.370,P=0.02);而dIAD与HIV感染指标没有明显相关性(P>0.05)。结论即使是未经过HAART治疗的HIV患者,与普通人群相比,仍存在有早发动脉粥样硬化的趋势,因此HIV感染本身可能促进动脉粥样硬化。     

Seroprevalence of human immunodeficiency virus among blood donors in a rural Ethiopian hospital

We describe our experience of the HIV seroprevalence among blood donors in a rural general hospital in Ethiopia during an eight-year period (January 1998-December 2006). From 3305 blood donors screened, 51 (1.4%) were positive for HIV antibodies.     

Human immunodeficiency virus and pregnancy

The recent spread of HIV infection into the heterosexual population in the United States, Europe, and Australia, as well as its earlier heterosexual presence in the developing world, has led to increased scientific and clinical attention to the role of HIV infection in pregnancy. In managing a pregnant HIV-positive woman, it is most important to treat the patient as someone who is HIV-positive rather than someone who is pregnant. Withholding antiviral or prophylactic therapies from the mother for fear of harming the child is not justified, because failure to treat the mother increases the fetal risk. The most important parameter to follow is the maternal plasma HIV-RNA level, and the most important treatment issue is to reduce this level because it is directly related to the risk of vertical transmission.     

Molecular epidemiology of human immunodeficiency virus type 1 and hepatitis C virus in former blood donors in central China

The prevalence of hepatitis C virus (HCV) among human immunodeficiency virus (HIV-1)-positive former blood donors (FBDs) in Hubei province, central China, and the subtypes of these two viruses are identified. HIV-1-positive specimens were collected from FBDs, transfusion recipients, and their sexual partners in Hubei province, central China. The prevalence of HCV in HIV-1-positive FBDs was 78.6%. The dominant circulating HIV-1 subtype of FBDs was subtype B' (Thai-B); one belonged to U.S.-European subtype B. HCV genotypes 2a (78.6%) and 1b (21.4%) were detected. No recombinant form of HIV-1 was identified. Non-B' subtypes occurring among FBDs indicate the complexity of the HIV-1 prevalence in central China, where HIV is beginning to spread into the general population.     

Human immunodeficiency virus endocrinopathy

Human immunodeficiency virus (HIV) endocrinopathy encompasses a broad spectrum of disorders. Almost all the endocrine organs are virtually affected by HIV infection. HIV can directly alter glandular function. More commonly secondary endocrine dysfunction occurs due to opportunistic infections and neoplasms in immunocompromised state. The complex interaction between HIV infection and endocrine system may be manifested as subtle biochemical and hormonal perturbation to overt glandular failure. Antiretroviral therapy as well as other essential medications often result in adverse endocrinal consequences. Apart from adrenal insufficiency, hypogonadism, diabetes and bone loss, AIDS wasting syndrome and HIV lipodystrophy need special reference. Endocrinal evaluation should proceed as in other patients with suspected endocrine dysfunction. Available treatment options have been shown to improve quality of life and long-term mortality in AIDS patients.     

Seroprevalence of human immunodeficiency virus among blood donors in Northwest Ethiopia, 1995-2002

Data on age, sex, occupation, HIV serostatus and year of donation were collected from the blood donors log book of Gondar College of Medical Sciences Hospital, Northwest Ethiopia, for the period between January 1995 and December 2002 and analysed. The crude HIV seroprevalence was 9.9% (1109/11,204). A declining trend in the prevalence was observed from as high as 15.7% (207/1321) in 1995 to 9.3% (123/1327) in 1999 and down to 4.3% (68/1576) in 2002. The declining trend observed in recent years is encouraging and should further be strengthened by making use of the blood bank as an entry point for HIV testing and counselling services.     

Risk behaviour among blood donors who give blood in order to be tested for the human immunodeficiency virus

BACKGROUND AND OBJECTIVES: There has been concern that some individuals may donate blood primarily motivated by the easy access to human immunodeficiency virus (HIV) testing, and that such donors may represent a risk to the transfusion service. In this article we focus on the risk behaviour of donors who reported that they gave blood in order to be HIV tested. MATERIALS AND METHODS: Anonymous questionnaires were given to 5859 blood donors. The response rate was 70%. RESULTS: Of the responders, 2.8% reported to have donated blood in order to be HIV tested. However, 87% of the donation-for-test group did not have any identified risk behaviour. CONCLUSIONS: The proportion who donated blood in order to be HIV tested was higher than expected, but the majority of the group did not have any identifiable HIV risk.     

Human immunodeficiency virus type 1 modulates telomerase activity in peripheral blood lymphocytes

The effect of human immunodeficiency virus type 1 (HIV-1) on telomerase activity in peripheral blood lymphocytes (PBL) was examined. Telomerase is an enzyme that is involved in mechanisms that control cell life span and replicative potential. HIV-1 reduced telomerase activity in in vitro-infected PBL and impaired enzyme activation upon cell stimulation. Telomerase activity was significantly lower in PBL from 23 HIV-1-infected patients than in PBL from healthy donors and significantly increased during highly active antiretroviral therapy (HAART) in 10 patients who had both a virological and an immunological response and in 5 and 8 patients with a virological or an immunological response, respectively. Further analyses of fractionated cells revealed that telomerase activity increased mainly in CD4(+) lymphocytes. Overall, these findings demonstrate that HIV-1 infection down-modulates telomerase activity and suggest that both the HIV-1 decline and immunorestoration in response to HAART contribute to increased telomerase activity in CD4(+) lymphocytes.     

Enzymatic amplification of the human immunodeficiency virus in peripheral blood mononuclear cells from pediatric patients

The presence of the human immunodeficiency virus type 1 (HIV) provirus was assessed in peripheral blood mononuclear cells (PBMCs) from 27 offspring of HIV-infected mothers, 12 of these mothers, and 4 HIV-uninfected mother-infant control pairs. Enzymatic amplification of specific conserved regions of the gag and env genes was performed directly in PBMC lysates using the polymerase chain reaction (PCR) technique. The enzymatically amplified gene products were evaluated using the oligomer hybridization detection procedure. PBMCs from infected infants (as determined by Centers for Disease Control clinical criteria) and from HIV-infected mothers manifested a characteristic HIV oligomer hybridization product. Clinically uninfected seropositive infants with declining HIV antibody titers and infants who became seronegative lacked an enzymatically amplified HIV gene product. These preliminary data indicate that PCR is a valuable diagnostic technique to detect or exclude HIV infection in young infants and children.     

Specificity of polymerase chain amplification reactions for human immunodeficiency virus type 1 DNA sequences

The polymerase chain amplification reaction (PCR) is a sensitive, specific, and quantitative assay of human immunodeficiency virus type 1 (HIV-1). The assay was performed with polymerases from Escherichia coli or Thermus aquaticus (Taq). A single pair of oligonucleotide primers within the long terminal repeat (LTR) sequences were used to detect HIV-1 sequences in infected cell cultures and fresh tissues of the large majority of infected individuals. The amplified product was a faithful copy of this LTR sequence. Utilization of a subsaturating number of cycles of amplification allowed quantitation of HIV-1 DNA sequences.     

Nationwide nucleic acid amplification testing of hepatitis B virus, hepatitis C virus and human immunodeficiency virus type 1 for blood transfusion and follow-up study of nucleic acid amplification positive donors. Japanese Red Cross NAT Screening Research Group

This study described a program for and the results of a nationwide nucleic acid amplification testing (NAT) screening for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus type 1 (HIV-1) by multiplex reagent with a pooled system. After routine serological screening, this test was used in order to be in time for blood transfusions. The Japanese Red Cross currently supplies donated blood all over Japan for blood transfusion. As of January 2000, 2,140,207 units (5,093 pools) were tested by a pool size of 500 and 19 HBV DNA-positive cases and 8 HCV RNA-positive cases were found. Since February 2000, the pool size was switched to 50 and among 420,770 units (8,564 pools), 7 HBV DNA-positive cases and 1 HCV RNA-positive case were found. HIV RNA was not detected in any of the tested pools. Among the 26 HBV DNA positives, 22 were wild type; of these, 6 (23%) had hepatitis B surface antigen (HBsAg) that was undetectable by overnight enzyme immunoassay (EIA). Except for one case, in which coexisting antibody inhibited the immune reaction, all 17 cases that were followed later showed seroconversion. In 10 of these cases, HBV DNA disappeared below the level of detection and seroconversion of IgM anti-HBc and anti-HBc antibody occurred during the observation period. The remaining 4 cases were precore mutants and all had an undetectable level of HBsAg by EIA. Three cases did not show IgM anti-HBc seroconversion, which should be observed during the early stage of HBV infection. As for the HCV RNA, the following types were identified: 2 genotype II (1b), 3 genotype III (2a), and 4 genotype IV (2b). A weak anti-HCV positive reaction was observed in two cases and strong seroconversion in one case among 4 of the cases that were followed. Although it is not 100%, NAT narrows the window period in early-stage infection, resulting in an exponential reduction of the virus load that escapes serological screening tests for blood destined for blood transfusions. In the case of HBV, NAT screening detects HBV DNA in persistently infected individuals with extremely low levels of HBV antigen and antibody often observed in the case of HBV mutants.     

Epidemiology of blood donors in Japan, positive for hepatitis B virus and hepatitis C virus by nucleic acid amplification testing

BACKGROUND AND OBJECTIVES: The Japanese Red Cross screens seronegative blood donors by nucleic acid amplification testing (NAT) for hepatitis B, hepatitis C and human immunodeficiency virus-1 markers. NAT-positive donors thus identified seemed to have a different infectious background from serologically positive donors. The purpose of our study was to characterize this background in the hepatitis B virus (HBV) and hepatitis C virus (HCV) NAT-positive donors. MATERIALS AND METHODS: Some 328 HBV DNA-positive and 44 HCV RNA-positive donors were detected by NAT testing of seronegative blood donors. These were characterized regarding age, gender and genotype of HBV and HCV. RESULTS: Those who were HBV NAT-positive were mainly young, in particular teenage girls. In Japan, genotypes C and B have previously been dominant, but recently genotype A has increased, and genotype H was recently detected. In HBV NAT-positive donors, the rate of genotype A was high (12.2%) compared with patients in hospital (1.7-2%). Donors who were HCV NAT-positive were also young, but mostly men in their twenties. The ratio of genotype 1b to 2a or 1b to 2b in HCV NAT-positive donors differed from that of hospitalized patients in Japan. We did not find genotype 1a, which is dominant in the USA. CONCLUSIONS: The high-risk donors detected by NAT were mainly young, with a different distribution of genotypes from that of hospitalized patients, regarding both HBV and HCV. The rare HBV genotype H has been found for the first time in Japan. The findings reflect the present spread of hepatitis viruses B and C.