Performance of a Limiting-Antigen Avidity Enzyme Immunoassay for Cross-Sectional Estimation of HIV Incidence in the United States

Background

A limiting antigen avidity enzyme immunoassay (HIV-1 LAg-Avidity assay) was recently developed for cross-sectional HIV incidence estimation. We evaluated the performance of the LAg-Avidity assay alone and in multi-assay algorithms (MAAs) that included other biomarkers.

Methods and Findings

Performance of testing algorithms was evaluated using 2,282 samples from individuals in the United States collected 1 month to >8 years after HIV seroconversion. The capacity of selected testing algorithms to accurately estimate incidence was evaluated in three longitudinal cohorts. When used in a single-assay format, the LAg-Avidity assay classified some individuals infected >5 years as assay positive and failed to provide reliable incidence estimates in cohorts that included individuals with long-term infections. We evaluated >500,000 testing algorithms, that included the LAg-Avidity assay alone and MAAs with other biomarkers (BED capture immunoassay [BED-CEIA], BioRad-Avidity assay, HIV viral load, CD4 cell count), varying the assays and assay cutoffs. We identified an optimized 2-assay MAA that included the LAg-Avidity and BioRad-Avidity assays, and an optimized 4-assay MAA that included those assays, as well as HIV viral load and CD4 cell count. The two optimized MAAs classified all 845 samples from individuals infected >5 years as MAA negative and estimated incidence within a year of sample collection. These two MAAs produced incidence estimates that were consistent with those from longitudinal follow-up of cohorts. A comparison of the laboratory assay costs of the MAAs was also performed, and we found that the costs associated with the optimal two assay MAA were substantially less than with the four assay MAA.

Conclusions

The LAg-Avidity assay did not perform well in a single-assay format, regardless of the assay cutoff. MAAs that include the LAg-Avidity and BioRad-Avidity assays, with or without viral load and CD4 cell count, provide accurate incidence estimates.     

A new Sphagesaurus (Mesoeucrocodylia: Notosuchia) from the Upper Cretaceous of Monte Alto City (Bauru Group,Brazil), and a revision of the Sphagesauridae

Oxygen consumption and ammonia excretion rates were assessed for Terebratulina retusa (L.) held under 3 different regimes of temperature and food availability. These were: 5.6?C, no food (cold, starved); 5.8?C, food present (cold, fed) and 10.7?C food present (warm, fed), which simulated winter conditions, summer conditions and an intermediate treatment. Regressions of oxygen consumption on ash‐free dry weight (AFDW) had slopes which were not significantly different from each other and ranged from 0.953 to 0.999. A common slope of 0.976 was calculated and intercepts based on the common slope used to compare oxygen consumption in each treatment. The rise from cold, starved conditions to warm, fed was 24.5 per cent and this was significant (P < 0.05). Other differences were not significant (P > 0.05) but the cold, fed result was 12.6 per cent higher than cold, starved. Therefore feeding and temperature probably account for equivalent proportions of the rise in metabolism from winter to summer. Ammonia production data were much more variable. Excretion rates of a 50 mg AFDW individual (in ng‐at NH₃‐N.h^‐1) were as follows: cold, starved: 30.2 cold, fed: 7.1; and warm, fed: 22.9. Oxygen to nitrogen (O:N) ratios reflected these results. Mean O:N ratios were: cold, starved: 8.0; cold, fed: 42.4; warm, fed: 16.3. This shows that the simulated winter group relied heavily on protein to fuel their metabolism, the simulated summer group were less dependent on protein and the intermediate group probably used lipids and carbohydrates to fuel metabolic demands. This possibly reflected a trade off between food supply and increased metabolism from treatment to treatment, demonstrating a flexibility which could have been a contributing factor in the ecological tolerance and geological longevity of some brachiopods.     

Concomitant Socioeconomic,Behavioral, and Biological Factors Associated with the Disproportionate HIV Infection Burden among Black Men Who Have Sex with Men in 6 U.S. Cities

Background

American Black men who have sex with men (MSM) are disproportionately affected by HIV, but the factors associated with this concentrated epidemic are not fully understood.

Methods

Black MSM were enrolled in 6 US cities to evaluate a multi-component prevention intervention, with the current analysis focusing on the correlates of being newly diagnosed with HIV compared to being HIV-uninfected or previously diagnosed with HIV.

Results

HPTN 061 enrolled 1553 Black MSM whose median age was 40; 30% self-identified exclusively as gay or homosexual, 29% exclusively as bisexual, and 3% as transgender. About 1/6^th (16.2%) were previously diagnosed with HIV (PD); of 1263 participants without a prior HIV diagnosis 7.6% were newly diagnosed (ND). Compared to PD, ND Black MSM were younger (p<0.001); less likely to be living with a primary partner (p<0.001); more likely to be diagnosed with syphilis (p<0.001), rectal gonorrhea (p = 0.011) or chlamydia (p = 0.020). Compared to HIV-uninfected Black MSM, ND were more likely to report unprotected receptive anal intercourse (URAI) with a male partner in the last 6 months (p<0.001); and to be diagnosed with syphilis (p<0.001), rectal gonorrhea (p = 0.004), and urethral (p = 0.025) or rectal chlamydia (p<0.001). They were less likely to report female (p = 0.002) or transgender partners (p = 0.018). Multivariate logistic regression analyses found that ND Black MSM were significantly more likely than HIV-uninfected peers to be unemployed; have STIs, and engage in URAI. Almost half the men in each group were poor, had depressive symptoms, and expressed internalized homophobia.

Conclusions

ND HIV-infected Black MSM were more likely to be unemployed, have bacterial STIs and engage in URAI than other Black MSM. Culturally-tailored programs that address economic disenfranchisement, increase engagement in care, screen for STIs, in conjunction with safer sex prevention interventions, may help to decrease further transmission in this heavily affected community.     

A validity-driven approach to the understanding of the personal and societal burden of low back pain: development of a conceptual and measurement model

Introduction  

While the importance and magnitude of the burden of low back pain upon the individual is well recognized, a systematic understanding of the impact of the condition on individuals is currently hampered by the lack of an organized understanding of what aspects of a person's life are affected and the lack of comprehensive measures for these effects. The aim of the present study was to develop a conceptual and measurement model of the overall burden of low back pain from the individual's perspective using a validity-driven approach.     

A novel missense mutation T101N in the melanocortin-4 receptor gene associated with obesity

Mutations in the melanocortin-4 receptor (MC4R) are associated with severe obesity, independent of their effect on cortisol or thyroid-stimulating hormone levels. We examined a morbidly obese male (BMI = 62 kg/m2) with a binge-eating disorder and eight family members for mutations in the MC4R gene and potential differences in leptin levels. Fifty healthy individuals served as controls. Sequence analysis revealed a novel heterozygous missense mutation (c.302 C>A, p.T101N) located in the second transmembrane domain of the receptor, which was not detected in controls. The Fisher exact test revealed an association between the T101N mutation and history of obesity (P < 0.05) in the family. The Kruskal-Wallis test showed an association between the mutation and the leptin/BMI ratio (P < 0.05), while there was no association between the T101N mutation and diabetes or arterial hypertension in the family. Although the available family was small, we could show a significant association between the heterozygous T101N mutation and obesity.     

The Diversity of Flower Flies (Diptera: Syrphidae) in Colombia and Their Neotropical Distribution

In Colombia, like most Neotropical countries, faunistic studies on flower flies have been occasional and most of them have been primarily focused on taxonomy. Colombia is the second-most species-rich country in flower fly diversity in the Neotropics after Brazil, and has one of the highest numbers of species per unit area (2.49 per 10,000?km²), based on a review of literature and national collections. Including new data presented here, a total of 47 genera and 300 species are recorded in Colombia. The genera Scaeva Fabricius and Lycastrirhyncha Bigot, as well as 101 species are recorded here for the first time. The altitudinal range and the distribution of the flower fly genera in Colombia are presented. A preliminary comparison of the fauna of Colombia with that of other Neotropical countries is given. A historical perspective is also provided in order to illustrate how Colombian Syrphidae knowledge has progressed over the last 168?years. Information presented here will be useful for ongoing and future biodiversity research as well as conservation projects on Syrphidae in the Neotropical region.     

Impact of transgenic Bt-cotton on the diversity of pink-pigmented facultative methylotrophs

Pink-pigmented facultative methylotrophs (PPFMs) are one of the beneficial proteobacteria commonly found in phyllosphere, rhizosphere and as endophytes in cotton. To assess the impact of transgenic Bt-cotton on changes in the diversity and community profile of PPFMs by comparing with its non-transgenic cotton, a polyphasic approach including differential carbon-substrate utilization profiling and DNA fingerprinting techniques like ARDRA, RISA, BOX-PCR and ERIC-PCR were studied. PPFMs from phyllosphere, rhizoplane and internal tissues of the stem of both Bt-cotton and non-Bt-cotton were isolated and analysed in this study. All the results suggested that the diversity richness of PPFMs present in the phyllosphere, rhizoplane and internal tissues did not differ between Bt- and non-Bt-cotton. In this study, there was no evidence to indicate any adverse effects of Bt-cotton on the diversity of plant-associated methylobacteria.     

Tolerability and efficacy of single dose albendazole,diethylcarbamazine citrate (DEC) or co-administration of albendazole with DEC in the clearance of <Emphasis Type="Italic">Wuchereria bancrofti</Emphasis>in asymptomatic microfilaraemic volunteers in Pondicherry,South India: a hospital-based study

Background  

The tolerability and efficacy of single dose albendazole (400 mg), diethylcarbamazine citrate (DEC) (6 mg/kg bodyweight) or co-administration of albendazole (400 mg) + DEC (6 mg/kg bodyweight) was studied in 54 asymptomatic Wuchereria bancrofti microfilaraemic volunteers in a double blind hospital-based clinical study.