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HIV-infected men who have low CD4 T-cell counts, advanced disease or white blood cells in their semen are more likely to have the virus in their semen and would be more likely to transmit the virus through sexual intercourse. Semen samples taken from 95 HIV-positive men were tested for the presence of HIV. The virus was found in nine samples. Men who had CD4 counts less than 200, who were in an advanced stage of the infection or who were not taking zidovudine (AZT) were more likely to have the virus in their semen. Those who had white blood cells in their semen (seminal leukocytosis) were also more likely to have the virus in their semen. However, a separate study of 14 of the men whose CD4 counts were above 200 found that six had one semen sample that was positive for HIV at some time over a period of several months. All HIV-infected men should consider themselves potentially infective.

Abstract Background Genetic variations in MBL2 that reduce circulating levels and alter functional properties of the mannose binding lectin (MBL) have been associated with many autoimmune and infectious diseases. We examined whether MBL2 variants influence the outcome of hepatitis C virus (HCV) infection. Methods Participants were enrolled in the Urban Health Study of San Francisco Bay area injection drug users (IDU) during 1998 through 2000. Study subjects who had a positive test for HCV antibody were eligible for the current study. Participants who were positive for HCV RNA were frequency matched to those who were negative for HCV RNA on the basis of ethnicity and duration of IDU. Genotyping was performed for 15 single nucleotide polymorphisms in MBL2. Statistical analyses of European American and African American participants were conducted separately. Results The analysis included 198 study subjects who were positive for HCV antibody, but negative for HCV RNA, and 654 IDUs who were positive for both antibody and virus. There was no significant association between any of the genetic variants that cause MBL deficiency and the presence of HCV RNA. Unexpectedly, the MBL2 -289X promoter genotype, which causes MBL deficiency, was over-represented among European Americans who were HCV RNA negative (OR = 1.65, 95% CI 1.05–2.58), although not among the African Americans. Conclusion This study found no association between genetic variants that cause MBL deficiency and the presence of HCV RNA. The observation that MBL2 -289X was associated with the absence of HCV RNA in European Americans requires validation.

Abstract Background Chronic hepatitis C virus infection is prevalent and often causes hepatic fibrosis, which can progress to cirrhosis and cause liver cancer or liver failure. Study of fibrosis progression often relies on imputing the time of infection, often as the reported age of first injection drug use. We sought to examine the accuracy of such imputation and implications for modeling factors that influence progression rates. Methods We analyzed cross-sectional data on hepatitis C antibody status and reported risk factor histories from two large studies, the Women's Interagency HIV Study and the Urban Health Study, using modern survival analysis methods for current status data to model past infection risk year by year. We compared fitted distributions of past infection risk to reported age of first injection drug use. Results Although injection drug use appeared to be a very strong risk factor, models for both studies showed that many subjects had considerable probability of having been infected substantially before or after their reported age of first injection drug use. Persons reporting younger age of first injection drug use were more likely to have been infected after, and persons reporting older age of first injection drug use were more likely to have been infected before. Conclusion In cross-sectional studies of fibrosis progression where date of HCV infection is estimated from risk factor histories, modern methods such as multiple imputation should be used to account for the substantial uncertainty about when infection occurred. The models presented here can provide the inputs needed by such methods. Using reported age of first injection drug use as the time of infection in studies of fibrosis progression is likely to produce a spuriously strong association of younger age of infection with slower rate of progression.

Background: Clearance of hepatitis C virus (HCV) results in rapid changes in metabolic parameters early in direct-acting antiviral (DAA) therapy. Long-term changes after sustained virologic response (SVR) remain unknown.Methods: We investigated longitudinal changes in metabolic and inflammatory outcomes in chronic hepatitis C (CHC) patients: low-density lipoprotein (LDL), high-density lipoprotein, triglycerides, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) using a general linear model for repeated measurements at 5 clinical time points and by human immunodeficiency virus (HIV) coinfection and IFNL4 genotype.Results: The mean LDL increased markedly during DAA therapy (pre-DAA, 86.6 to DAA, 107.4 mg/dL; P < .0001), but then it decreased to 97.7 mg/dL by post-SVR year 1 (P < .001 compared with DAA; P = .0013 compared with SVR). In patients who carry the IFNL4-ΔG allele, mean LDL increased during treatment, then decreased at post-SVR year 1; however, in patients with TT/TT, genotype did not change during and after DAA treatment. The mean ALT and AST normalized rapidly between pre-DAA and DAA, whereas only mean ALT continued to decrease until post-SVR. Metabolic and inflammatory outcomes were similar by HIV-coinfection status.Conclusions: Changes in LDL among CHC patients who achieved SVR differed by IFNL4 genotype, which implicates the interferon-λ4 protein in metabolic changes observed in HCV-infected patients. [ABSTRACT FROM AUTHOR]

Non-hodgkin's lymphoma (NHL) are cancers of the lymph tissue, other than Hodgkin's disease. Recent studies have shown that exposure to phenoxy herbicides, chemicals used to kill plants, may increase the risk for NHL. 'Agent Orange' is a herbicide that was widely used during the Vietnam war. The question of whether Vietnam veterans are at greater risk for NHL has been raised. This study compared NHL rates in Vietnam veterans with rates in veterans from the same time period, but were not in Vietnam. The study randomly selected 18,313 veterans who served between January 1965 and December 1971, of which 9,324 were Vietnam veterans and 8,989 were non-Vietnam veterans. Phone interviews were conducted and 15,288 veterans were interviewed. Results showed that seven Vietnam veterans and one non-Vietnam veteran had been diagnosed with NHL. The expected number of cases were 3.9 for the Vietnam veterans and 3.5 for the non-Vietnam veterans. Therefore, these results suggest that Vietnam veterans may have an increased risk for developing NHL. However, the small number of cases in this study, and the inability to directly measure exposure to Agent Orange, make it difficult reach any definitive conclusions as to why these veterans have increased rates of NHL. (Consumer Summary produced by Reliance Medical Information, Inc.)

IL10 is a powerful TH-2 cell cytokine produced by lymphoid cells that limits HIV-1 replication in vivo, ostensibly by inhibiting macrophage/monocyte and T-cell lymphocyte replication and secretion of inflammatory cytokines (IL1, TNF[Alpha], IL6, IL8, and IL12). A genetic epidemiological scan of patients enrolled in AIDS cohorts for candidate gene-linked short tandem repeat polymorphisms revealed significant genotype associations for HIV-1 infection and progression to AIDS with markers adjacent to and tracking (by linkage disequilibrium) common single nucleotide polymorphic variants in the IL10 promoter region. Individuals carrying the IL10-5'-592A (IL10-5'A) promoter allele possibly were at increased risk for HIV-1 infection, and once infected they progressed to AIDS more rapidly than homozygotes for the alternative IL10-5'-592 C/C (IL10-+/+) genotype, particularly in the later stages of HIV-1 infection. An estimated 25-30% of long-term nonprogressors (who avoid clinical AIDS for 10 or more years after HIV-1 infection) can be attributed to their IL10-+/+ promoter genotype. Alternative IL10 promoter alleles are functionally distinct in relative IL10 production, in retention of an avian erythroblastosis virus transcription factor recognition sequence and in binding to specific putative nuclear transcription factors, suggesting a potential mechanism whereby IL10-5'A down-regulation of inhibitory IL10 facilitates HIV-1 replication in vivo, accelerating the onset of AIDS.

Despite important recent insights into the short-term dynamics of HIV-1 infection, our understanding of the long-term pathogenesis of AIDS remains unclear. Using an approach that places rapid progressors, typical progressors, and nonprogressors on a single clinical spectrum of disease progression, we quantitate the previously reported relationship between viral load and survival time. We introduce the concept of viral constant, present evidence that this quantity is conserved across patients, and explore the immunopathological implications of this finding. We conclude with a quantitative approach for assessing the benefits of a given regime of antiviral therapy.

An editorial is presented on the COVID-19 a respiratory illness caused by a novel coronavirus has first identified in the Hubei province of China in December 2019 and has spread worldwide. Topics icnlude the investigators found that although these 2 coronaviruses have similar cell tropism, and the viral replication being much more efficient for SARS-CoV-2 than SARSCoV.

Diabetes mellitus is a serious disease rated as the seventh most common cause of death in the US. Diabetes can cause complications including blindness, heart disease, kidney failure, and limb amputation. Black Americans have a higher incidence of diabetes mellitus and approximately twice the mortality rate from diabetes compared to whites. The basis of these racial differences has not been determined. One important research question is whether higher rates of obesity among blacks lead to their greater incidence of diabetes. This survey evaluated 12,558 white and 1,677 black Vietnam veterans, age 30-47 years. Information collected included medical history as reported by the veterans, and for a sub-group, additional clinical examinations and laboratory tests. Blacks had a higher prevalence of diabetes than whites (3.0 versus 1.4 percent respectively) and this racial difference was not explained by adiposity (degree of fatness), age or socioeconomic status. Some participants had their fasting blood sugar tested, and more blacks had fasting hyperglycemia (high blood sugar) than whites. The data presented suggest that obesity does not account for the higher incidence of diabetes in blacks compared to whites., ABSTRACT: To determine whether the higher prevalence of diabetes found among blacks in the United States is explained by racial differences in obesity, we examined the prevalence of diabetes adjusted for adiposity, education, and income in a cohort of US Army veterans from the Vietnam era. Among 12 558 white men and 1677 black men, aged 30 to 47 years, blacks were more likely than whites to have diagnosed diabetes (adjusted prevalence ratio, 1.9; 95% confidence interval, 1.3 to 2.7). Within every age, adiposity, and socioeconomic stratum, blacks had a higher prevalence of diagnosed diabetes than whites. In a subgroup of veterans for whom fasting serum glucose values were measured, blacks were more likely than whites to have fasting hyperglycemia (fasting serum glucose value >/= 7.8 mmol/L)(adjusted prevalence ratio, 5.7; 95% confidence interval, 2.7 to 12.0). These data provide evidence that the higher prevalence of diabetes found among blacks is not explained by differences in obesity.

The contamination of drinking water by cryptosporidium is probably not detected by the current methods of treating public water supplies. An outbreak of gastroenteritis effected an estimated 13,000 people in a county in western Georgia. A parasite, cryptosporidium oocyst, was found in the stools of 39 percent of the patients with gastroenteritis. Studies eliminated the presence of other parasitic pathogens. Inefficient flocculation and filteration may have allowed the parasite to pass into the water supply.