Piloting a surveillance system for HIV drug resistance in the European Union

Background

A steady increase in HIV drug resistance (HIVDR) has been demonstrated globally in individuals initiating first-line antiretroviral therapy (ART). To support effective use of ART and prevent spread of HIVDR, monitoring is essential.

Aim

We piloted a surveillance system for transmitted HIVDR to assess the feasibility of implementation at the European level.

Method

All 31 countries in the European Union and European Economic Area were invited to retrospectively submit data on individuals newly diagnosed with HIV in 2015 who were tested for antiviral susceptibility before ART, either as case-based or as aggregate data. We used the Stanford HIV database algorithm to translate genetic sequences into levels of drug resistance.

Results

Nine countries participated, with six reporting case-based data on 1,680 individuals and four reporting aggregated data on 1,402 cases. Sequence data were available for 1,417 cases: 14.5% of individuals (n = 244) showed resistance to at least one antiretroviral drug. In case-based surveillance, the highest levels of transmitted HIVDR were observed for non-nucleoside reverse-transcriptase inhibitors (NNRTIs) with resistance detected in 8.6% (n = 145), followed by resistance to nucleoside reverse-transcriptase inhibitors (NRTI) (5.1%; n = 85) and protease inhibitors (2.0%; n = 34).

Conclusion

We conclude that standard reporting of HIVDR data was feasible in the participating countries. Legal barriers for data sharing, consensus on definitions and standardisation of interpretation algorithms should be clarified in the process of enhancing European-wide HIV surveillance with drug resistance information.

Evaluation of oral streptococci in saliva of children with severe Early Childhood Caries and caries-free

AIM

Oral streptococci were found to be associated with Early Childhood Caries. The aim of this study was to evaluate the 6 different bacteria in the streptococcus group in the saliva of children with severe early childhood caries (S-ECC) by polymerase chain reaction (PCR).

MATERIALS AND METHODS

A total of 60 children between 3 and 6 years of age were divided into two groups: children with S-ECC (Group S-ECC; n=30) and children who were caries-free (Group CF; n=30), according to the dmft and dmfs indices. Unstimulated saliva was collected from all participants for the detection of streptococcal group bacteria, including: Streptococcus mutans, Streptococcus oralis, Streptococcus sanguinis, Streptococcus gordonii, Streptococcus salivarius, and Streptococcus sobrinus, using PCR-restriction fragment length polymorphism (RFLP) of amplified 16S rRNA gene. The data were analysed using SPSS software.

RESULTS

The prevalence of S. oralis was significantly higher in the S-ECC group compared to the CF group (p<0.05). However, the frequencies of S. mutans, S. sanguinis, S. gordonii, S. salivarius, and S. sobrinus were similar between the two groups (p>0.05). The amount of streptococci colonies was higher in the S-ECC group compared to the CF group (p<0.05).

CONCLUSION

S. mutans or S. sobrinus alone may not be the only indicators for high risk of caries, but the prevalence of S. oralis in saliva may be a risk factor for increased caries activity in S-ECC.

Effect of EGF on Bax, Bcl-2 and Fas expression in ulcerous disease and N87 cell line

BACKGROUND

To evaluate the effect of epithelial growth factor (EGF) in primary culture of ulcer patients and N87 cell line on expressions of apoptotic genes.

METHODS

Ulcer patients who attended Gastroenterology Clinic of Mersin University Medical Faculty were included in this study. Three different doses of EGF were applied to the primary culture of biopsy samples from ulcer patients and gastric cancer cell-line (ATCC-NCI-N87) . The expression levels of Bax, Bcl-2 and Fas genes were measured with quantitative real-time PCR (qRT-PCR).

RESULTS

ΔΔCT analysis with qRT-PCR revealed no significant change in gene expression of Bax, Bcl-2 or Fas within the ulcer, normal tissue and gastric cancer. No significant change was determined between Bax and Bcl-2 gene expression levels and applied EGF doses when groups were compared for each EGF dose. On the other hand, when 50 ng/µl of EGF was administered, Fas mRNA expression level was significantly lower in the gastric cancer cell line compared to patients with ulcer and normal gastroduodenal tissue (p<0.05).

CONCLUSION

In this study which was done with a restricted patient group, our results revealed that apoptosis induced by Fas expression in gastroduodenal suppressing carcinogenesis process plays an active role in gaining anti-apoptotic properties of cells (Tab. 4, Fig. 2, Ref. 27).

Wild type HBx and truncated HBx: Pleiotropic regulators driving sequential genetic and epigenetic steps of hepatocarcinogenesis and progression of HBV-associated neoplasms

Hepatitis B virus (HBV) is one of the causative agents of hepatocellular carcinoma. The molecular mechanisms of tumorigenesis are complex. One of the host factors involved is apparently the long-lasting inflammatory reaction which accompanies chronic HBV infection. Although HBV lacks a typical viral oncogene, the HBx gene encoding a pleiotropic regulatory protein emerged as a major player in liver carcinogenesis. Here we review the tumorigenic functions of HBx with an emphasis on wild type and truncated HBx variants, and their role in the transcriptional dysregulation and epigenetic reprogramming of the host cell genome. We suggest that HBx acquired by the HBV genome during evolution acts like a cellular proto-onc gene that is activated by deletion during hepatocarcinogenesis. The resulting viral oncogene (v-onc gene) codes for a truncated HBx protein that facilitates tumor progression. Copyright © 2015 John Wiley & Sons, Ltd.

Synthesis and evaluation of phosphorus containing, specific CDK9/CycT1 inhibitors

Although there is a significant effort in the design of a selective CDK9/CycT1 inhibitor, no compound has been proven to be a specific inhibitor of this kinase so far. The aim of this research was to develop novel and selective phosphorus containing CDK9/CycT1 inhibitors. Molecules bearing phosphonamidate, phosphonate, and phosphinate moieties were synthesized. Prepared compounds were evaluated in an enzymatic CDK9/CycT1 assay. The most potent molecules were tested in cell-based toxicity and HIV proliferation assays. Selectivity of shortlisted compounds against CDKs and other kinases was tested. The best compound was shown to be a highly specific, ATP-competitive inhibitor of CDK9/CycT1 with antiviral activity.

Epigenetics of HIV infection: promising research areas and implications for therapy

We surveyed current trends in epigenetics in general and epigenetics of HIV infection and AIDS in particular to pinpoint promising areas for translational research. Epigenetic mechanisms mark and affect the structure of chromatin, thereby controlling the activity of promoters. Because epigenetic changes are reversible, epigenetic drugs can be used to modulate gene activity. At present, silenced HIV genomes, the latent HIV reservoir, is a major obstacle for a curative treatment of AIDS patients. Epigenetic therapy aims at the purging of the latent reservoir by switching on transcription of silent HIV genomes. The basic idea is that the cytopathic effect of the replicating virus and the immune system may eliminate the reactivated cells, whereas HAART may block the infection of new target cells. Although current efforts concentrate on long-lived resting memory CD4+ T-cells, dormant HIV proviruses also reside in other cell types. Thus, epigenetic characterization of the various HIV-infected host cells and host cell-dependent HIV latency mechanisms is a promising research area and may facilitate the development of cell type-specific epigenetic drugs. HAART itself affects the epigenotype of host cells. This may contribute to the development of drug resistance and unwanted side effects. A pharmacoepigenetic approach may help to elucidate and revert such phenomena. In addition to latent reservoir purging, epigenetic research offers alternative therapeutic tools as well; although not aimed at the elimination of the virus, targeted silencing of HIV transcription by epigenetic regulators may help HAART to minimize virus replication.

Epigenetic dysregulation of epstein-barr virus latency and development of autoimmune disease

Epstein-Barr virus (EBV) is ahumanherpesvirus thatpersists in the memory B-cells of the majority of the world population in a latent form. Primary EBV infection is asymptomatic or causes a self-limiting disease, infectious mononucleosis. Virus latency is associated with a wide variety of neoplasms whereof some occur in immune suppressed individuals. Virus production does not occur in strict latency. The expression of latent viral oncoproteins and nontranslated RNAs is under epigenetic control via DNA methylation and histone modifications that results either in a complete silencing of the EBV genome in memory B cells, or in a cell-type dependent usage of a couple of latency promoters in tumor cells, germinal center B cells and lymphoblastoid cells (LCL, transformed by EBV in vitro). Both, latent and lytic EBV proteins elicit a strong immune response. In immune suppressed and infectious mononucleosis patients, an increased viral load can be detected in the blood. Enhanced lytic replication may result in new infection- and transformation-events and thus is a risk factor both for malignant transformation and the development of autoimmune diseases. An increased viral load or a changed presentation of a subset of lytic or latent EBV proteins that cross-react with cellular antigens may trigger pathogenic processes through molecular mimicry that result in multiple sclerosis (MS), systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).