Sensitivity and specificity of human immunodeficiency virus rapid serologic assays and testing algorithms in an antenatal clinic in Abidjan, Ivory Coast

To evaluate serologic testing algorithms for human immunodeficiency virus (HIV) based on a combination of rapid assays among persons with HIV-1 (non-B subtypes) infection, HIV-2 infection, and HIV-1-HIV-2 dual infections in Abidjan, Ivory Coast, a total of 1,216 sera with known HIV serologic status were used to evaluate the sensitivity and specificity of four rapid assays: Determine HIV-1/2, Capillus HIV-1/HIV-2, HIV-SPOT, and Genie II HIV-1/HIV-2. Two serum panels obtained from patients recently infected with HIV-1 subtypes B and non-B were also included. Based on sensitivity and specificity, three of the four rapid assays were evaluated prospectively in parallel (serum samples tested by two simultaneous rapid assays) and serial (serum samples tested by two consecutive rapid assays) testing algorithms. All assays were 100% sensitive, and specificities ranged from 99.4 to 100%. In the prospective evaluation, both the parallel and serial algorithms were 100% sensitive and specific. Our results suggest that rapid assays have high sensitivity and specificity and, when used in parallel or serial testing algorithms, yield results similar to those of enzyme-linked immunosorbent assay-based testing strategies. HIV serodiagnosis based on rapid assays may be a valuable alternative in implementing HIV prevention and surveillance programs in areas where sophisticated laboratories are difficult to establish.     

The significance of isolated Y chromosome loss in bone marrow metaphase cells from males over age 50 years

To further investigate the potential clinical significance of Y chromosome loss as the sole bone marrow karyotype change, we studied 161 Mayo Clinic male patients with 75% or more metaphase cells with Y loss, and correlated the percent Y loss with age and hematopathologic review. In patients with a lymphoproliferative or plasma cell disorder, the negligible proportion of bone marrow involvement cannot account for the observed high proportion of -Y cells. In males with myeloid disease, Y loss appears to often represent the abnormal myeloid clone, which may also harbor acquired genetic changes that are not observed by conventional cytogenetic analysis.     

Successful combined use of Impella Recover 2.5 device and intra-aortic balloon pump support in cardiogenic shock from acute myocardial infarction

Ventricular assist devices (VADs) and intra-aortic balloon pumps (IABPs) are important tools that provide hemodynamic support to patients in cardiogenic shock. The Impella Recover 2.5 is a percutaneous VAD that provides temporary circulatory support. We report the case of a patient who required the combined support of both an IABP and the Impella device.     

Potential market size and impact of hepatitis C treatment in low‐ and middle‐income countries

The introduction of direct‐acting antiviral agents (DAAs) has made hepatitis C infection curable in the vast majority of cases and the elimination of the infection possible. Although initially too costly for large‐scale use, recent reductions in DAA prices in some low‐ and middle‐income countries (LaMICs) has improved the prospect of many people having access to these drugs/medications in the future. This article assesses the pricing and financing conditions under which the uptake of DAAs can increase to the point where the elimination of the disease in LaMICs is feasible. A Markov simulation model is used to study the dynamics of the infection with the introduction of treatment over a 10‐year period. The impact on HCV‐related mortality and HCV incidence is assessed under different financing scenarios assuming that the cost of the drugs is completely paid for out‐of‐pocket or reduced through either subsidy or drug price decreases. It is also assessed under different diagnostic and service delivery capacity scenarios separately for low‐income (LIC), lower‐middle‐income (LMIC) and upper‐middle‐income countries (UMIC). Monte Carlo simulations are used for sensitivity analyses. At a price of US$ 1680 per 12‐week treatment duration (based on negotiated Egyptian prices for an all oral two‐DAA regimen), most of the people infected in LICs and LMICs would have limited access to treatment without subsidy or significant drug price decreases. However, people in UMICs would be able to access it even in the absence of a subsidy. For HCV treatment to have a significant impact on mortality and incidence, a significant scaling‐up of diagnostic and service delivery capacity for HCV infection is needed.     

Association of human papillomavirus with HIV and CD4 cell count in women with high or low numbers of sex partners

OBJECTIVE: To explore whether HIV serostatus (HIV-1, HIV-2, and dual (HIV-D) reactivity) and CD4 cell count affect human papillomavirus (HPV) in two groups of women from Cote d''Ivoire. METHODS: We conducted a cross sectional study of two groups of women. One group had low numbers of lifetime sex partners (maternal women, n = 258) and were enrolled based on HIV serostatus. The other group had high numbers of sex partners (female sex workers, n = 278) and all consenting self identified sex workers were admitted to this study. We collected epidemiological and clinical data, and cervicovaginal lavage for HPV testing. RESULTS: The groups had different distributions of HIV seroreactivity, but the rates of HPV DNA detection were similar. Most of the HPV DNAs detected in both groups were high risk types. A strong association of high risk HPV DNA and HIV-1 seropositivity was found in both maternal women (adjusted odds ratio (OR) 7.5 (95% CI 3.2-17.4)) and in sex workers (OR 5.0 (2.1-12.0)). The maternal group also showed an association of high risk HPV DNA detection with HIV-2 (OR 3.7 (1.6-8.5)) and HIV-D (OR 12.7 (4.3-37.5)) that was not observed in the sex workers. In addition, the association of high risk HPV DNA with HIV-1 in the maternal group was independent of low CD4 cell count, while in the sex workers the association depended on CD4 cell counts < or = 500 x 10(6)/l. CONCLUSIONS: We found that an association between HPV and HIV varied depending on the sexual behaviour and CD4 cell count of the population examined.


     

Antigenic variants of rabies virus in isolates from eastern, central and northern Canada

Street rabies virus isolated from 51 specimens from Ontario, Quebec, Manitoba and the Northwest Territories have been typed by a panel of 36 antinucleocapsid monoclonal antibodies. Three main groups were found. The first group comprised those terrestrial mammals originating in Ontario, Quebec and the Northwest Territories. The second group was found in terrestrial mammals from Manitoba. The third heterogenous group was made up of bats from Ontario.     

肌松药物巴氯芬类似物的合成及其构效关系的研究

为研究解痉肌松药巴氯芬类似物的构效关系,合成了巴氯芬类似物15个,其中8个化合物是首次报道。采用小白鼠热板法及对抗吗啡竖尾反应实验评价目标化合物的镇痛和肌松作用。筛选结果表明:部分化合物有肌松和镇痛作用,其中Ⅰb,Ⅱb,Ⅲa和Ⅲc的镇痛作用较好,Ⅰd,Ⅱb,Ⅲa和Ⅲb的肌松作用较好,但均未超过巴氯芬。根据本研究及前人的研究结果,提出巴氯芬与GABA_B受体结合取决于巴氯芬分子中氨基、羧基和苯环三种基团。     

脱氧胆酸钠对麦角菌 Claviceps purpurea 94002 (EKP_N94002)产生 α-麦角隐亭的刺激作用

脱氧胆酸钠对麦角菌Ｃｌａｖｉｃｅｐｓｐｕｒｐｕｒｅａ９４００２（ＥＫＰＮ９４００２）产生α麦角隐亭的刺激作用朱平何惠霞陈世智（中国医学科学院、中国协和医科大学药物研究所，卫生部天然药物生物合成重点实验室，北京１０００５０）麦角菌属（Ｃｌａｖｉｃｅｐ...