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Rosadas C, Taylor GP. HTLV-1 and Co-infections. Front Med (Lausanne) 2022; 9:812016. [PMID: 35187000 PMCID: PMC8850362 DOI: 10.3389/fmed.2022.812016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/12/2022] [Indexed: 01/02/2023] Open
Abstract
Human T lymphotropic virus type 1 (HTLV-1) is a retrovirus that causes lifelong T-cell infection in humans, impacting the host immune response. This virus causes a range of clinical manifestations, from inflammatory conditions, including neuronal damage (HTLV-1 associated myelopathy, HAM) to life-threatening leukemia (adult T-cell leukemia, ATL). Human T lymphotropic virus type 1 is also associated with increased risk of all-cause mortality, but the mechanisms remain unclear. As a blood-borne and sexually transmitted infection (STI), HTLV-1 shares transmission routes to many other pathogens and although it has worldwide distribution, it affects mainly those in low- and middle-income tropical areas, where the prevalence of other infectious agents is high. These factors contribute to a high incidence of co-infections in people living with HTLV-1 (PLHTLV). This comprehensive review addresses the impact of HTLV-1 on several co-infections and vice-versa. There is evidence of higher rates of HTLV-1 infection in association with other blood borne (HCV, HBV) and sexually transmitted (Syphilis, Chlamydia, HPV, HSV) infections but whether this represents increased susceptibility or opportunity is unclear. Higher frequency of Mycobacterium tuberculosis (MTb) and Mycobacterium leprae (M. leprae) is observed in PLHTLV. Reports of opportunistic infections and high frequency of crusted scabies in patients with HTLV-1 points to immune impairment in those individuals. Human T lymphotropic virus type 1 may influence the persistence of pathogens, exemplified by the higher rates of Schistosoma mansoni and Strongyloides stercoralis (St. stercoralis) treatment failure observed in PLHTLV. This retrovirus is also associated with increased tuberculosis (TB) severity with some evidence pointing to a deleterious impact on leprosy outcome as well. These findings are supported by immune alterations observed in those co-infected individuals. Although the role of HTLV-1 in HCV outcome is debatable, most data indicate that HTLV may negatively impact the clinical course of hepatitis C. Co-infections may also influence the risk of developing HTLV-1 associated disease, but data are still limited. The impact of HTLV-1 on the response to more common infections, might contribute to the increased mortality rate of HTLV-1. Large scale prospective controlled studies on the prevalence and impact of HTLV-1 in co-infections and vice-versa are needed. Human T lymphotropic virus type 1 impact in public health is broad. Measures to increase awareness and to prevent new infections are needed.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, Division of Medicine and Integrated Care, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- *Correspondence: Graham P. Taylor
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Ismail MB, Omari SA, Rafei R, Dabboussi F, Hamze M. COVID-19 in children: Could pertussis vaccine play the protective role? Med Hypotheses 2020; 145:110305. [PMID: 33032174 PMCID: PMC7521348 DOI: 10.1016/j.mehy.2020.110305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/19/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022]
Abstract
While COVID-19 continues to spread across the globe, diligent efforts are made to understand its attributes and dynamics to help develop treatment and prevention measures. The paradox pertaining to children being the least affected by severe illness poses exciting opportunities to investigate potential protective factors. In this paper, we propose that childhood vaccination against pertussis (whooping cough) might play a non-specific protective role against COVID-19 through heterologous adaptive responses in this young population. Pertussis is a vaccine-preventable infectious disease of the respiratory tract and it shares many similarities with COVID-19 including transmission and clinical features. Although pertussis is caused by a bacterium (Bordetella pertussis) while COVID-19 is a viral infection (SARS-CoV-2), previous data showed that cross-reactivity and heterologous adaptive responses can be seen with unrelated agents of highly divergent groups, such as between bacteria and viruses. While we build the arguments of this hypothesis on theoretical and previous empirical evidence, we also outline suggested lines of research from different fields to test its credibility. Besides, we highlight some concerns that may arise when attempting to consider such an approach as a potential public health preventive intervention against COVID-19.
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Affiliation(s)
- Mohamad Bachar Ismail
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon; Faculty of Sciences, Lebanese University, Tripoli, Lebanon
| | - Sarah Al Omari
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Rayane Rafei
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.
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Madureira BP, de Carvalho FM, Pessolani MC, Collin SM, Deps PD. PGL-1 and LID-1 antibody levels in HIV-infected and HIV-uninfected individuals in a Hansen's disease (leprosy) endemic area of Brazil. Immunobiology 2019; 225:151866. [PMID: 31757558 DOI: 10.1016/j.imbio.2019.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/31/2019] [Accepted: 11/07/2019] [Indexed: 11/24/2022]
Abstract
Serological tests for subclinical Mycobacterium leprae infection based on antibodies to phenolic glycolipid-1 (PGL-1) and leprosy IDRI diagnostic-1 (LID-1) have not been compared in HIV-infected and uninfected individuals. PGL-1 seropositivity by ELISA was 6.0 % (21/350) in HIV-infected compared with 29.1 % (102/350) in HIV-uninfected individuals (p < 0.001); LID-1 seropositivity was 45.4 % (159/350) in HIV-infected compared with 50.3 % (153/304) in HIV-uninfected individuals (p = 0.21). In HIV-infected individuals, LID-1 but not PGL-1 antibody levels were inversely associated with CD4+ cell count (p = 0.02). These differential associations of HIV infection and CD4 count with PGL-1 and LID-1 have implications for M leprae immunodiagnostic tools and require replication.
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Affiliation(s)
- Brunela Pitanga Madureira
- Department of Social Medicine, Federal University of Espírito Santo, Vitória, ES, Brazil; Programme of Postgraduation of Infectious Diseases, Infectious Diseases Unit, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | | | | | - Patrícia Duarte Deps
- Department of Social Medicine, Federal University of Espírito Santo, Vitória, ES, Brazil; Programme of Postgraduation of Infectious Diseases, Infectious Diseases Unit, Federal University of Espírito Santo, Vitória, ES, Brazil.
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Abrahim SA, Girma M, Habteselassie A, Gezahegn N, Feleke A, Berheto TM, Demissie M, Belete W, Deressa T. Diagnostic accuracy of HIV test kits, Genscreen Ultra and Bioelisa. HIV AIDS (Auckl) 2019; 11:17-22. [PMID: 30804685 PMCID: PMC6375533 DOI: 10.2147/hiv.s184603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Genetic diversities in different countries affect the performance of HIV test kits. Therefore, WHO recommends evaluation of every HIV test kit in countries' context before its use. Therefore, this study aimed to evaluate the performance of Genscreen ULTRA HIV Ag-Ab and Bioelisa. MATERIALS AND METHODS The study had used 400 characterized plasma samples obtained from CDC Atlanta bio-bank derived from Africa, USA, and Thailand. RESULTS Diagnostic performance of both test kits under evaluation was assessed at 95% CI. Genscreen ULTRA HIV Ag-Ab had sensitivity and negative predictive value of 99.5% [95% CI, 97.2-99.9] and the specificity and positive predictive value of 98.5% [95% CI, 95.7-99.7]. Bioelisa HIV test kit had exhibited sensitivity and negative predictive value of 99% [95% CI, 96.4-99.7] and specificity and positive predictive value of 98.5% [95% CI, 95.7-99.7]. Both test kits were able to detect almost all samples with HIV-2, dual infections, and seroconversion. CONCLUSION Both the test kits were highly sensitive and specific in detecting HIV. However, there are still few samples containing HIV antibody which were not identified by both kits. Therefore, additional screening measures should be done in using these assays for blood transfusion and organ transplantation. In addition, the study can be used as a reference by other African countries.
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Affiliation(s)
- Saro Abdella Abrahim
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Mulu Girma
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Abebe Habteselassie
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Nigussie Gezahegn
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Altaye Feleke
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Tezera Moshago Berheto
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Minilik Demissie
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Wudnesh Belete
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
| | - Tekalign Deressa
- HIV/TB Research and Reference Laboratory Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,
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Kawamoto K, Miyoshi H, Suzuki T, Muto R, Yamada K, Yanagida E, Koshino M, Sasaki Y, Takizawa J, Sone H, Sugita Y, Seto M, Ohshima K. Clinicopathological features of cryptococcal lymphadenitis and a review of literature. J Clin Exp Hematop 2017; 57:26-30. [PMID: 28592745 DOI: 10.3960/jslrt.17011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Cryptococcosis is an invasive fungal infection in immunocompromised patients. The clinicopathological characteristics of cryptococcal lymphadenitis are not well known. We analyzed three cases of cryptococcal lymphadenitis and compared their characteristics with those in previous reports. Two patients were human immunodeficiency virus (HIV) carriers, and one patient was a human T-cell leukemia virus type-1 (HTLV-1) carrier. The age of the HTLV-1 carrier with cryptococcosis was much higher than that of the HIV-1 carriers. CD4-positive cell counts in peripheral blood were 5.8/μL (Case 1) and 79.9/μL (Case 2) in the HIV carriers and 3285/μL in the HTLV-1 carrier (Case 3). According to flow cytometric analysis of the lymph nodes of Cases 1, 2, and 3, 50.0%, 87.1%, and 85.9%, respectively, of the T-cells were CD3; 9.8%, 16.3%, and 75.8%, respectively, were CD4; and 35.5%, 77.3%, and 10.2%, respectively, were CD8. Cryptococcus neoformans was detected in tissue culture in all patients. Although gelatinous lesions and numerous fungal cocci were observed in the two HIV patients, the granuloma formation was small. Gelatinous formation and granuloma formation were observed in the HTLV-1 carrier. Necrosis was observed in all cases. In previous reports, granuloma formation, epithelioid cells, and necrotic lesions were observed in most cases. Most of the patients were also immunosuppressed. However, no HTLV-1 carrier was detected. In conclusion, lymphadenopathy in a HTLV-1 carrier may suggest the presence of cryptococcal lymphadenitis. The frequency of cryptococcosis in HTVL-1 carriers may increase with increase in the long-term survival rate of HTLV-1 carriers.
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Affiliation(s)
- Keisuke Kawamoto
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University.,Department of Pathology, School of Medicine, Kurume University
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University
| | - Takaharu Suzuki
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University
| | - Reiji Muto
- Department of Pathology, School of Medicine, Kurume University
| | - Kyohei Yamada
- Department of Pathology, School of Medicine, Kurume University
| | - Eriko Yanagida
- Department of Pathology, School of Medicine, Kurume University
| | - Mayuko Koshino
- Department of Pathology, School of Medicine, Kurume University
| | - Yuya Sasaki
- Department of Pathology, School of Medicine, Kurume University
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University
| | - Yasuo Sugita
- Department of Pathology, School of Medicine, Kurume University
| | - Masao Seto
- Department of Pathology, School of Medicine, Kurume University
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University
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Papadopulos-Eleopulos E, Turner VF, Papadimitriou JM, Bialy H. AIDS in Africa: distinguishing fact and fiction. World J Microbiol Biotechnol 2014; 11:135-43. [PMID: 24414488 DOI: 10.1007/bf00704634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/02/1994] [Accepted: 12/02/1994] [Indexed: 12/15/2022]
Abstract
The data widely purporting to show the existence and heterosexual transmission in Africa of a new syndrome caused by a retrovirus which induces immune deficiency are critically evaluated. It is concluded that both acquired immune deficiency (AID) and the symptoms and diseases which constitute the clinical syndrome (S) are of long standing in Africa, affect both sexes equally and are caused directly and indirectly by factors other than human immunodeficiency virus (HIV). Seropositivity to HIV in Africans usually represents no more than cross-reactivity caused by an abundance of antibodies induced by the numerous infectious and parasitic diseases which are endemic in Africa. The apparently high prevalence of 'AIDS' and 'HIV' seropositives is therefore not surprising and is not proof of heterosexual transmission of either HIV or AIDS.
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7
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Machado PRL, Johnson WD, Glesby MJ. The role of human T cell lymphotrophic virus type 1, hepatitis B virus and hepatitis C virus coinfections in leprosy. Mem Inst Oswaldo Cruz 2013; 107 Suppl 1:43-8. [PMID: 23283452 DOI: 10.1590/s0074-02762012000900008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 08/30/2012] [Indexed: 11/22/2022] Open
Abstract
Leprosy spectrum and outcome is associated with the host immune response against Mycobacterium leprae. The role of coinfections in leprosy patients may be related to a depression of cellular immunity or amplification of inflammatory responses. Leprosy remains endemic in several regions where human T cell lymphotrophic virus type 1 (HTLV-1), hepatitis B virus (HBV) or hepatitis C virus (HCV) are also endemic. We have evaluated the evidence for the possible role of these viruses in the clinical manifestations and outcomes of leprosy. HTLV-1, HBV and HCV are associated with leprosy in some regions and institutionalization is an important risk factor for these viral coinfections. Some studies show a higher prevalence of viral coinfection in lepromatous cases. Although HBV and HCV coinfection were associated with reversal reaction in one study, there is a lack of information about the consequences of viral coinfections in leprosy. It is not known whether clinical outcomes associated with leprosy, such as development of reactions or relapses could be attributed to a specific viral coinfection. Furthermore, whether the leprosy subtype may influence the progression of the viral coinfection is unknown. All of these important and intriguing questions await prospective studies to definitively establish the actual relationship between these entities.
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Watt G, Kantipong P, Burnouf T, Shikuma C, Philpott S. Natural Scrub Typhus Antibody Suppresses HIV CXCR4(X4) Viruses. Infect Dis Rep 2013; 5:e8. [PMID: 24470959 PMCID: PMC3892615 DOI: 10.4081/idr.2013.e8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 04/12/2013] [Accepted: 04/12/2013] [Indexed: 11/22/2022] Open
Abstract
Viral load generally rises in HIV-infected individuals with a concomitant infection, but falls markedly in some individuals with scrub typhus (ST), a common Asian rickettsial infection. ST infection appears to shift the viral population from CXCR4-using (X4) to CCR5-utilizing (R5) strains, and there is evidence of cross-reactivity between ST-specific antibodies and HIV-1. We examined the mechanism of ST suppression of HIV by measuring the effects of ST infection on X4 and R5 viruses in vivo and in vitro, and assessing the relative contributions of antibodies and chemokines to the inhibitory effect. In vivo, a single scrub typhus plasma infusion markedly reduced the subpopulation of HIV-1 viruses using the X4 co-receptor in all 8 recipients, and eliminated X4 viruses 6 patients. In vitro, the 14 ST sera tested all inhibited the replication of an X4 but not an R5 virus. This inhibitory effect was maintained if ST sera were depleted of chemokines but was lost upon removal of antibodies. Sera from STinfected mice recognized a target that co-localized with X4 HIV gp120 in immunofluorescent experiments. These in vivo and in vitro data suggest that acute ST infection generates cross-reactive antibodies that produce potent suppression of CXCR4- but not CCR5-using HIV-1 viruses. ST suppression of HIV replication could reveal novel mechanisms that could be exploited for vaccination strategies, as well as aid in the development of fusion inhibitors and other new therapeutic regimens. This also appears to be the first instance where one pathogen is neutralized by antibody produced in response to infection by a completely unrelated organism.
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Affiliation(s)
- George Watt
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa , Honolulu, HI, USA
| | - Pacharee Kantipong
- Department of Internal Medicine, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
| | - Thierry Burnouf
- Human Protein Process Sciences, Lille, France and Taipei Medical University , Taipei, Taiwan
| | - Cecilia Shikuma
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa , Honolulu, HI, USA
| | - Sean Philpott
- The Bioethics Program, Union Graduate College , Schenectady, NY, USA
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Tagny CT, Mbanya D, Leballais L, Murphy E, Lefrère JJ, Laperche S. Reduction of the risk of transfusion-transmitted human immunodeficiency virus (HIV) infection by using an HIV antigen/antibody combination assay in blood donation screening in Cameroon. Transfusion 2011; 51:184-90. [DOI: 10.1111/j.1537-2995.2010.02782.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Low prevalence rate of indeterminate serological human immunodeficiency virus results among pregnant women from Burkina Faso, West Africa. J Clin Microbiol 2010; 48:1333-6. [PMID: 20129958 DOI: 10.1128/jcm.01734-09] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rapid human immunodeficiency virus (HIV) antibody tests have been adopted into national guidelines for HIV testing in many countries in sub-Saharan Africa. One goal of HIV rapid testing is to minimize the occurrence of indeterminate results. From January 2005 to December 2007, plasma (or serum) samples from pregnant women in Bobo-Dioulasso (Burkina Faso, West Africa) were screened for HIV by using two rapid tests (the Determine HIV1/2 test [Abbott] and Genie II HIV-1/HIV-2 [Bio-Rad]) through a sequential algorithm prior to enrollment of HIV-1-infected women in a prevention of mother-to-child transmission (PMTCT) trial (WHO/ANRS 1289 Kesho Bora trial). Samples exhibiting indeterminate results (Determine positive and Genie II negative) were further tested with a fourth-generation HIV enzyme immunoassay (EIA) (Murex HIV Ag/Ab combination in 2005 and 2006 and Vironostika HIV Uni-Form II Ag/Ab in 2007). If positive, they were finally assessed for HIV-1 RNA (Generic HIV-1 RNA viral load assay; Biocentric). From a total of 44,653 samples tested, 597 (1.3%) showed indeterminate results. Of these, 367 could be analyzed by EIA. Only 15 (15/367, 4.1%) samples were found EIA reactive. Of these, 11 could be tested for HIV-1 RNA. All were HIV-1 RNA negative. In our clinical practice, pregnant women with such indeterminate results are now reassured during posttest counseling that they are very unlikely to be infected with HIV-1. As a consequence, such women with indeterminate results can reliably be considered negative when urgent clinical decisions (such as providing PMTCT prophylaxis) need to be taken.
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11
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AIDS: "it's the bacteria, stupid!". Med Hypotheses 2008; 71:741-8. [PMID: 18691828 DOI: 10.1016/j.mehy.2008.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 05/01/2008] [Accepted: 06/04/2008] [Indexed: 11/21/2022]
Abstract
Acid-fast tuberculous mycobacterial infections are common in AIDS and are regarded as secondary "opportunistic infections." According to the National Institute of Allergy and Infectious Diseases, TB is the major attributable cause of death in AIDS patients. Could such bacteria play a primary or causative role in AIDS? Certainly, In screening tests for HIV, there is frequent, up to 70%, cross-reactivity, between the gag and pol proteins of HIV and patients with mycobacterial infections such as tuberculosis. By 1972, five years before gays started dying in the U.S., Rolland wrote Genital Tuberculosis, a Forgotten Disease? And ironically, in 1979, on the eve of AIDS recognition, Gondzik and Jasiewicz showed that even in the laboratory, genitally infected tubercular male guinea pigs could infect healthy females through their semen by an HIV-compatible ratio of 1 in 6 or 17%, prompting him to warn his patients that not only was tuberculosis a sexually transmitted disease, but also the necessity of the application of suitable contraceptives, such as condoms, to avoid it. Gondzik's solution and date of publication are chilling; his findings significant. Since 1982 Cantwell et al found acid-fast bacteria closely related to tuberculosis (TB) and atypical tuberculosis in AIDS tissue. On the other hand molecular biologist and virologist Duesberg, who originally defined retroviral ultrastructure, has made it clear that HIV is not the cause of AIDS and that the so-called AIDS retrovirus has never been isolated in its pure state. Dr. Etienne de Harven, first to examine retroviruses under the electron, agrees. In 1993 HIV co-discoverer Luc Montagnier reported on cell-wall-deficient (CWD) bacteria which he called "mycoplasma" in AIDS tissue. He suspected these as a necessary "co-factor" for AIDS. Remarkably, Montagnier remained silent on Cantwell's reports of acid-fast bacteria which could simulate "mycoplasma" in AIDS tissue. Mattman makes clear that the differentiation between mycoplasma and CWD bacteria is difficult at best and cites Pachas's 1985 study wherein one mycoplasma was actually mistaken for a CWD form of a bacterium closely related to the mycobacteria. It is important to realize that the statement "HIV is the sole cause of AIDS" is just a hypothesis. There are unanswered questions and controversy concerning the role of HIV "as the sole cause of AIDS." And until they are resolved, a cure is not possible. This paper explores the possible role of acid-fast tuberculous mycobacteria as "primary agents" in AIDS.
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Swaminathan S, Hanna LE, Sundaramurthi JC, Leonard A, Angayarkanni B, Francis AC, Lakshmi S, Nayak K. Prevalence and pattern of cross-reacting antibodies to HIV in patients with tuberculosis. AIDS Res Hum Retroviruses 2008; 24:941-6. [PMID: 18593340 DOI: 10.1089/aid.2007.0211] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In many countries, HIV testing among tuberculosis (TB) patients is recommended so that both infections are appropriately treated. Cross-reacting antibodies to HIV antigens have been reported for several conditions, including TB, leprosy, malaria, and rheumatoid arthritis. To study the pattern and prevalence of cross-reacting antibodies to HIV antigens, we examined sera from 153 HIV-negative TB patients and 40 healthy individuals in Chennai, south India. We also studied the differences in cross-reactivity of various HIV antigens using two different Western blot kits. Of the 153 samples studied, 80 were tested using HIV Western blot and 73 were tested using INNOLIA. Most patients in the study had concordantly negative ELISA and rapid tests, and no subject had a positive Western blot. However, seven TB patients had antibodies that cross-reacted with HIV antigens, giving rise to an indeterminate result. While p51/55 was the most frequently recognized antigen in the Western blot assay, antibodies to sgp120 was most frequently identified in INNOLIA. Sequence similarities between the two organisms could be responsible for eliciting cross-reacting antibodies, since a few related epitopes were identified in HIV and Mycobacterium. These findings could have potential implications for the development of diagnostics and vaccines.
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Affiliation(s)
- Soumya Swaminathan
- Division of HIV/AIDS, Tuberculosis Research Center, Indian Council of Medical Research, Chetput, Chennai, India
| | - Luke Elizabeth Hanna
- Division of HIV/AIDS, Tuberculosis Research Center, Indian Council of Medical Research, Chetput, Chennai, India
| | | | - Antony Leonard
- Division of HIV/AIDS, Tuberculosis Research Center, Indian Council of Medical Research, Chetput, Chennai, India
| | - B. Angayarkanni
- Division of HIV/AIDS, Tuberculosis Research Center, Indian Council of Medical Research, Chetput, Chennai, India
| | | | - S. Lakshmi
- Division of HIV/AIDS, Tuberculosis Research Center, Indian Council of Medical Research, Chetput, Chennai, India
| | - Kaustuv Nayak
- Division of HIV/AIDS, Tuberculosis Research Center, Indian Council of Medical Research, Chetput, Chennai, India
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Guan M. Frequency, causes, and new challenges of indeterminate results in Western blot confirmatory testing for antibodies to human immunodeficiency virus. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2007; 14:649-59. [PMID: 17409223 PMCID: PMC1951092 DOI: 10.1128/cvi.00393-06] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ming Guan
- MP Biomedicals Asia Pacific Pte Ltd., 85 Science Park Drive No. 04-01, Singapore Science Park, Singapore 118259, Republic of Singapore.
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14
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Uneke CJ, Alo MN, Ogbu O, Ngwu BAF. Western blot-indeterminate results in Nigerian patients HIV serodiagnosis: the clinical and public health implication. AIDS Patient Care STDS 2007; 21:169-76. [PMID: 17428184 DOI: 10.1089/apc.2006.0089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The clinical and public health implication of HIV Western blot (WB) indeterminate results is yet to be appraised in sub-Saharan Africa, including Nigeria. Using HIV Tri Line Test enzyme-linked immunosorbent assay (ELISA), 1286 patients (600 males and 686 females; age range, 5-60 years) with symptoms suggestive of HIV infection were screened. A total of 1020 (79.3%, 95% confidence interval [CI] 76.8-81.5) of the patients comprising of 514 (85.7%) males and 506 (73.8%) females were HIV seropositive and the difference was statistical significantly (chi(2) = 5.72, df = 1, p < 0.05). Western blot analysis of sera from the 1020 HIV-seropositive individuals using the BIO-RAD NEW LAV-BLOT I specifying World Health Organization (WHO) interpretive criteria, confirmed the HIV serostatus of 815 (79.9%, 95% CI, 77.4-82.4) of them with 205 (20.1%, 95% CI, 17.6-22.6) individuals having indeterminate results consisting of either; 1 env +/- gag +/- pol, gag + pol, gag only or pol only. Of these, 102 (19.8%) were males and 103 (20.4%) were females. Patients aged 11-20 years old recorded the highest percentage of indeterminate results (31.7%, 95% CI, 20.2-43.2) while those aged 21-30 years recorded the least (14.2%, 95% CI, 10.6-17.8) and the difference was statistically significant (chi(2) = 15.73, df = 5, p < 0.05). Result confirmed the limitation of Western blot assays in HIV confirmatory serodiagnosis. After obtaining HIV indeterminate Western blot result, clinicians should consider the total profile for the patient, reassess risk factors for HIV infection, perform a HIV retesting at 3-month intervals for 6 months or use an alternate HIV antibody confirmatory assay and running antibody tests for other human retroviruses.
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Affiliation(s)
- Chigozie J Uneke
- Department of Medical Microbiology, Faculty of Clinical Medicine, Abakaliki, Nigeria.
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Mascarenhas RE, Brodskyn C, Barbosa G, Clarêncio J, Andrade-Filho AS, Figueiroa F, Galvão-Castro B, Grassi F. Peripheral blood mononuclear cells from individuals infected with human T-cell lymphotropic virus type 1 have a reduced capacity to respond to recall antigens. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2006; 13:547-52. [PMID: 16682474 PMCID: PMC1459653 DOI: 10.1128/cvi.13.5.547-552.2006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Evidence indicates that human T-cell lymphotropic virus type 1 (HTLV-1) infection leads to chronic immunosuppression and a greater susceptibility to infectious diseases. Spontaneous in vitro proliferation of peripheral blood mononuclear cells (PBMC) is an important immunological feature of HTLV-1-infected individuals. However, the association between spontaneous proliferation and immunosuppression is not clear. In this study, we evaluated the cellular immune responses of PBMC from 58 asymptomatic HTLV-1-infected individuals with PBMC showing or not showing spontaneous proliferation. Individuals with PBMC that spontaneously proliferated had increased proportions of CD4 T cells expressing CD45RO and dramatically reduced responses to recall antigens. In addition, frequencies of positive responses to recall antigens were also decreased in HTLV-infected individuals without spontaneous proliferation of PBMC. There was a polyclonal expansion of multiple T-cell receptor Vbeta families of CD4+ T lymphocytes in patients with spontaneous proliferation. We observed that HTLV-1 induced an immunosuppression characterized by a decrease in the stimulation index to a recall antigen, even in individuals who did not present spontaneous proliferation. On the other hand, only patients with PBMC presenting spontaneous proliferation showed polyclonal activation and increased proportion of CD4 T cells expressing CD45RO.
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Papadopulos-Eleopulos E, Turner VF, Page BAP, Papadimitriou J, Causer D. No proof HIV antibodies are caused by a retroviral infection. Emerg Med Australas 2006; 18:308-9; author reply309-10. [PMID: 16712545 DOI: 10.1111/j.1742-6723.2006.00859.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Ustianowski AP, Lawn SD, Lockwood DNJ. Interactions between HIV infection and leprosy: a paradox. THE LANCET. INFECTIOUS DISEASES 2006; 6:350-60. [PMID: 16728321 DOI: 10.1016/s1473-3099(06)70493-5] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Early in the HIV epidemic it was feared that the disease would undermine leprosy control, as has occurred with tuberculosis. It was predicted that patients with leprosy and HIV coinfection would have an increased risk of lepromatous disease and a faster clinical evolution, and that the leprosy would be more difficult to treat. None of these concerns have materialised and the interaction between HIV and Mycobacterium leprae seems to be far more subtle than that between HIV and tuberculosis. We review the epidemiological, clinical, and pathological data relating to leprosy/HIV coinfection. The published epidemiological data are limited in quality but show neither an increased HIV prevalence among leprosy cases nor an alteration in clinical spectrum of leprosy among coinfected patients. Some data suggest that immune-mediated reactions that complicate leprosy occur at a higher frequency in coinfected patients. Leprosy has now been reported presenting as immune reconstitution disease among patients commencing highly active antiretroviral treatment. Histopathological observations reveal a normal spectrum of appearances in biopsies of leprosy lesions from coinfected patients, even among those with advanced immunodeficiency. These observations suggest that cell-mediated immune responses to M leprae are preserved at the site of disease despite evidence that these responses are abrogated systemically, by contrast with tuberculosis, in which the host granulomatous response is impaired by HIV coinfection. We speculate that this paradox may relate to differences between the activation state and rates of cell turnover within leprosy and tuberculosis granulomas that differentially affect the susceptibility of the granulomas to HIV. The interactions between leprosy and HIV have been little studied and further research on the clinical, pathological, and management aspects of this coinfection is warranted.
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Scollard DM, Adams LB, Gillis TP, Krahenbuhl JL, Truman RW, Williams DL. The continuing challenges of leprosy. Clin Microbiol Rev 2006; 19:338-81. [PMID: 16614253 PMCID: PMC1471987 DOI: 10.1128/cmr.19.2.338-381.2006] [Citation(s) in RCA: 494] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Leprosy is best understood as two conjoined diseases. The first is a chronic mycobacterial infection that elicits an extraordinary range of cellular immune responses in humans. The second is a peripheral neuropathy that is initiated by the infection and the accompanying immunological events. The infection is curable but not preventable, and leprosy remains a major global health problem, especially in the developing world, publicity to the contrary notwithstanding. Mycobacterium leprae remains noncultivable, and for over a century leprosy has presented major challenges in the fields of microbiology, pathology, immunology, and genetics; it continues to do so today. This review focuses on recent advances in our understanding of M. leprae and the host response to it, especially concerning molecular identification of M. leprae, knowledge of its genome, transcriptome, and proteome, its mechanisms of microbial resistance, and recognition of strains by variable-number tandem repeat analysis. Advances in experimental models include studies in gene knockout mice and the development of molecular techniques to explore the armadillo model. In clinical studies, notable progress has been made concerning the immunology and immunopathology of leprosy, the genetics of human resistance, mechanisms of nerve injury, and chemotherapy. In nearly all of these areas, however, leprosy remains poorly understood compared to other major bacterial diseases.
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Affiliation(s)
- D M Scollard
- Laboratory Research Branch, National Hansen's Disease Programs, LSU-SVM, Skip Bertman Dr., Baton Rouge, LA 70803, USA.
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Concha R, Harrington W, Rogers AI. Intestinal strongyloidiasis: recognition, management, and determinants of outcome. J Clin Gastroenterol 2005; 39:203-11. [PMID: 15718861 DOI: 10.1097/01.mcg.0000152779.68900.33] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Significant advances have occurred in our understanding of the biology, immunology, and immunopathology of the usually asymptomatic human infection by the intestinal parasite, Strongyloides stercoralis. Factors that increase the risk for the occurrence of symptomatic intestinal hyperinfection and/or often-fatal disseminated strongyloidiasis have been better defined. The pathophysiology underlying these risk factors, whether disease-related or iatrogenically induced, is a compromised immune system leading to dysfunction of TH-2 helper cells. These specialized lymphocytes are central to maintaining the delicate balance that exists between the infected human host and the stabilized parasite. Recognition of risk factors that impair the function of TH-2 lymphocytes is essential to heightening the index of clinical suspicion enhancing earlier, accurate diagnosis, and the introduction of appropriate therapy. This review summarizes what is understood about infection by S. stercoralis; its focus will be on the epidemiology, diagnosis, clinical presentation patterns in the immunocompetent and immunocompromised human hosts, and recommended treatment regimens.
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Affiliation(s)
- Ronald Concha
- Division of Internal Medicine, University of Miami, 8501 SW 87th Court, Miami, FL 33173-4552, USA.
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Affiliation(s)
- P K C Goon
- Wright-Fleming Institute, Imperial College, London
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Craven BM, Fiala C, de Harven E, Stewart GT. Making AIDS a business imperative. Lancet 1999; 354:679-80. [PMID: 10466693 DOI: 10.1016/s0140-6736(05)77659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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HIV-(1/2) indeterminate western blot results: follow-up of asymptomatic blood donors in belo horizonte, minas gerais, brazil. Rev Inst Med Trop Sao Paulo 1999; 41:155-8. [PMID: 10529833 DOI: 10.1590/s0036-46651999000300004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The clinical and public health importance of indeterminate results in HIV-(1/2) testing is still difficult to evaluate in volunteer blood donors. At Fundacao Hemominas, HIV-(1/2) ELISA is used as the screening test and, if reactive, is followed by Western blot (WB). We have evaluated 84 blood donors who had repeatedly reactive ELISA tests for HIV-(1/2), but indeterminate WB results. Sixteen of the 84 donors (19.0%) had history of sexually transmitted diseases; 18/84 (21.4%) informed receiving or paying for sex; 3/84 (3.6%) had homosexual contact; 2/26 women (7.6%) had past history of multiple illegal abortions and 3/84 (3.6%) had been previously transfused. Four out of 62 donors (6.5%) had positive anti-nuclear factor (Hep2), with titles up to 1:640. Parasitological examination of the stool revealed eggs of S. mansoni in 4/62 (6.4%) donors and other parasites in 8/62 (12.9%). Five (5.9%) of the subjects presented overt seroconversion for HIV-(1/2), 43/84 (51.2%) had negative results on the last visit, while 36/84 (42.9%) remained WB indeterminate. Although some conditions could be found associated with the HIV-(1/2) indeterminate WB results and many donors had past of risky behavior, the significance of the majority of the results remains to be determined.
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Question and Answer. Trop Doct 1999. [DOI: 10.1177/004947559902900235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bergman JN, Dodd WA, Trotter MJ, Oger JJ, Dutz JP. Crusted scabies in association with human T-cell lymphotropic virus 1. J Cutan Med Surg 1999; 3:148-52. [PMID: 10223831 DOI: 10.1177/120347549900300310] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Human T-cell lymphotropic virus I (HTLV- 1) infection can lead to myelopathy/tropical spastic paresis and adult T-cell leukemia/lymphoma (ATLL). Infection with HTLV-1 has also been associated with clinically significant immunosuppression. Crusted scabies, also known as Norwegian scabies, is an uncommon presentation of scabies that may occur in conjunction with immunosuppression. Although crusted scabies has been reported in association with HTLV-1 infection, to our knowledge it has never been described in association with HTLV-1 associated myelopathy. OBJECTIVE The aim is to describe a case of HTLV-1 associated myelopathy and concomitant crusted scabies. METHODS This article includes a case report and a literature review. CONCLUSIONS Crusted scabies is reported in association with HTLV-1 infection with or without concomitant ATLL. Crusted scabies should be considered in the differential diagnosis of a generalized cutaneous eruption in an HTLV-1 positive patient. Patients with crusted scabies from an HTLV-1 endemic population should be rested for a possible HTLV-1 infection. These patients may be at increased risk of progressing to ATLL.
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Affiliation(s)
- J N Bergman
- Division of Dermatology, The University of British Columbia, Vancouver, Canada
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26
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Muneishi H, Taguchi H, Sawada T, Ikezoe T, Matsui S, Tanaka S, Taniguchi T, Onoue O, Miyoshi I. Prevalence of HTLV-I in leprosy patients in two sanatoriums in Japan. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL RETROVIROLOGY ASSOCIATION 1998; 17:380-3. [PMID: 9525441 DOI: 10.1097/00042560-199804010-00014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To determine the association between leprosy and HTLV-I, 450 and 394 leprosy patients in two sanatoriums in Japan (Sanatorium-A in Okayama prefecture and Sanatorium-B in Gunma prefecture) were investigated serologically for antibodies to HTLV-I. Serology was positive for HTLV-I in 38 (8.4%) of 450 leprosy patients in Sanatorium-A and in 34 (8.6%) of 394 patients in Sanatorium-B. Prevalence was much higher than that in the general population of these areas in Japan. A large proportion of HTLV-I-positive patients in both sanatoriums came from HTLV-I nonendemic areas in Japan, suggesting that HTLV-I infection occurred after the patients arrived at the sanatoriums. Infection through sexual contact or reuse of needles for frequent vaccination are possible routes of infection for HTLV-I in these cases.
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Affiliation(s)
- H Muneishi
- Department of Internal Medicine, Kochi Medical School, Japan
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Ramakrishnan S, Sukhaswami MB, Patil KM, Eswaran C. Sequence data analysis reveals a relationship between LSR2, the recombinant fusion protein mimicing M. Leprae and VIF of bovine immunodeficiency virus (BIV). J Biomol Struct Dyn 1997; 15:605-9. [PMID: 9440006 DOI: 10.1080/07391102.1997.10508970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the course of computer simulation study looking for active sites for the interaction between MHC II and T7--a 12 residue long peptide of LSR2--a recombinant fusion protein mimicing the native bacillus M.Leprae--an interesting relationship between the antigenicity of LSR2 and VIF of BIF has come to light. Computer analysis study has revealed this stretch of residue from 36 to 48 of LSR2 is highly antigenic. The experimental observation seems to confirm the role of this 12 residue peptide in antibody response. In an effort to determine whether a significant sequence level relationship exists between this and any other known protein, the sequence homology of both protein and nucleic acid was studied. It is found that this 12 residue long peptide (T7) of LSR2 is homologous with Viral Infectivity Factor (VIF) of the Bovine Immunodeficiency Virus (BIV). Homology with translated nucleic acid sequence also indicate the same fact. The VIF gene which codes for this protein is known to be essential for ability of cell-free virus preparation to infect cells. These results lead to the question--whether this 12 residue long peptide which is common to both proteins play a role in their infectivity. Whether mutations in the peptide or elimination of this peptide from the protein and studying the effect of this on the diseases themselves may help in controlling them is another important question relevant to medical researchers.
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Gama Sosa MA, De Gasperi R, Patarca R, Fletcher MA, Kolodny EH. Antisulfatide IgG antibodies recognize HIV proteins. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL RETROVIROLOGY ASSOCIATION 1997; 15:83-4. [PMID: 9215659 DOI: 10.1097/00042560-199705010-00013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Papadopulos-Eleopulos E, Turner VF, Papadimitriou JM, Stewart G, Causer D. HIV antibodies: further questions and a plea for clarification. Curr Med Res Opin 1997; 13:627-34. [PMID: 9327197 DOI: 10.1185/03007999709113336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The existence of specific antibody/protein reactions is the crucial assumption underlying proof of HIV isolation, proof of HIV infection and the causative role of HIV in AIDS. However, since 1. antibodies which react with the 'HIV' proteins arise following allogenic stimuli in non-HIV-infected animals and humans, as well as in mice and humans with autoimmune disorders; antibodies to antigens from both mycobacteria and yeasts cross-react with HIV env and gag proteins; 2. individuals belonging to the AIDS risk groups are subjected to allogenic stimuli and have high levels of autoimmune antibodies, while the vast majority of patients in the AIDS risk groups are infected with either or both mycobacteria or yeasts; the evidence for the existence of HIV and its putative role in AIDS must be reappraised.
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Nuwayhid NF. Laboratory tests for detection of human immunodeficiency virus type 1 infection. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 1995; 2:637-45. [PMID: 8574822 PMCID: PMC170213 DOI: 10.1128/cdli.2.6.637-645.1995] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- N F Nuwayhid
- Department of Veterans Affairs Medical Center, Department of Internal Medicine, Amarillo, USA
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Strickler H, Hoover DR, Dersimonian R. Problems in interpreting HIV sentinel seroprevalence studies. Ann Epidemiol 1995; 5:447-54. [PMID: 8680607 DOI: 10.1016/1047-2797(95)00070-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Estimating human immunodeficiency virus (HIV) prevalence from sentinel seroprevalence studies is difficult. We characterize these studies and show that most are investigations of incompletely defined (hypothetical) cohorts and are usually based on nonprobability samples. Prevalence in HIV sentinel serosurveys is also time-averaged and vulnerable to several time-dependent sources of bias (e.g., migration, deaths, and changes in incidence). Assumptions must be made that these time-dependent biases did not meaningfully affect the data, and this can be helped by reducing the period of investigation. Furthermore, we show that "reliability" can not be adequately measured by standard error, that "internal validity" is vulnerable to self-selection bias and laboratory problems, and that "generalizability" is limited. We propose that what is needed is a procedure (like formal metaanalysis methods) incorporating information from several separate HIV sentinel seroprevalence studies, in a manner that is reproducible and can take into consideration the differences between studies.
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Affiliation(s)
- H Strickler
- Viral Epidemiology Branch, Division of Cancer Etiology, National Cancer Institute, National Institutes of Health, Rockville, MD 20852, USA
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Slavik T, Wolfaardt M, van Zyl H, Simson IW. Retrospective determination of HIV-1 status by a PCR method on paraffin wax embedded sections. J Clin Pathol 1995; 48:733-6. [PMID: 7560200 PMCID: PMC502800 DOI: 10.1136/jcp.48.8.733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AIM To develop a simple but reliable polymerase chain reaction (PCR) method to determine the HIV-1 status of patients on formalin fixed, paraffin wax embedded lymph node tissue. METHODS Fifty lymph node specimens, 20 from HIV-1 seropositive and 30 from HIV-1 seronegative patients, were analysed. Lymph nodes with a variety of disease conditions were included in the study. Tissue sections were treated with a DNA extraction buffer containing proteinase K and the crude cell lysate was used in PCR analysis. Nested primers were used to amplify HIV-1 DNA sequences coding for gag, pol and env proteins. PCR products were demonstrated by polyacrylamide gel electrophoresis. Results were then compared with HIV-1 serology of the patients from whom the tissue was obtained. RESULTS The PCR method yielded a specificity of 100%, a sensitivity of 95%, a positive predictive value of 100%, and a negative predictive value of 97% when compared with HIV-1 serology. The kappa statistic (0.958) showed an excellent agreement between the PCR method and serology. Furthermore, HIV-1 DNA was demonstrated in lymph node tissue from a serologically unconfirmed acquired immunodeficiency syndrome case necropsied in 1982. CONCLUSION This PCR method is a simple and reliable means of retrospectively determining the HIV-1 status of patients using formalin fixed, paraffin wax embedded lymph node tissue.
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Affiliation(s)
- T Slavik
- Department of Anatomical Pathology, Faculty of Medicine, University of Pretoria, South Africa
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