Survival of Hepatitis C Virus in Syringes Is Dependent on the Design of the Syringe-Needle and Dead Space Volume

Background

Many people who inject drugs (PWID) use syringes with detachable needles, which have high dead space (HDS). Contaminated HDS blood may substantially contribute to the transmission of HIV, hepatitis C (HCV), and other blood-borne viruses within this population. Newly designed low dead space (LDS) syringe-needle combinations seek to reduce blood-borne virus transmission among PWID. We evaluated the infectivity of HCV-contaminated residual volumes recovered from two LDS syringe-needle combinations.

Methods

We tested two different design approaches to reducing the dead space. One added a piston to the plunger; the other reduced the dead space within the needle. The two approaches cannot be combined. Recovery of genotype-2a reporter HCV from LDS syringe-needle combinations was compared to recovery from insulin syringes with fixed needles and standard HDS syringe-needle combinations. Recovery of HCV from syringes was determined immediately following their contamination with HCV-spiked plasma, after storage at 22°C for up to 1 week, or after rinsing with water.

Results

Insulin syringes with fixed needles had the lowest proportion of HCV-positive syringes before and after storage. HCV recovery after immediate use ranged from 47%±4% HCV-positive 1 mL insulin syringes with 27-gauge ½ inch needles to 98%±1% HCV-positive HDS 2 mL syringes with 23-gauge 1¼ inch detachable needles. LDS combinations yielded recoveries ranging from 65%±5% to 93%±3%. Recovery was lower in combinations containing LDS needles than LDS syringes. After 3 days of storage, as much as 6-fold differences in virus recovery was observed, with HCV recovery being lower in combinations containing LDS needles. Most combinations with detachable needles required multiple rinses to reduce HCV infectivity to undetectable levels whereas a single rinse of insulin syringes was sufficient.

Conclusions

Our study, the first to assess the infectivity of HCV in residual volumes of LDS syringes and needles available to PWID, demonstrates that LDS syringe-needle combination still has the greater potential for HCV transmission than insulin syringes with fixed needles. Improved LDS designs may be able to further reduce HCV recovery, but based on the designed tested, LDS needles and syringes remain intermediate between fixed-needle syringes and HDS combinations in reducing exposure to HCV.     

Comparison of HIV-1 nef and gag Variations and Host HLA Characteristics as Determinants of Disease Progression among HIV-1 Vertically Infected Kenyan Children

Objectives

Disease progression varies among HIV-1-infected individuals. The present study aimed to explore possible viral and host factors affecting disease progression in HIV-1-infected children.

Methods

Since 2000, 102 HIV-1 vertically-infected children have been followed-up in Kenya. Here we studied 29 children (15 male/14 female) who started antiretroviral treatment at <5 years of age (rapid progressors; RP), and 32 (17 male/15 female) who started at >10 years of age (slow progressors; SP). Sequence variations in the HIV-1 gag and nef genes and the HLA class I-related epitopes were compared between the two groups.

Results

Based on nef sequences, HIV-1 subtypes A1/D were detected in 62.5%/12.5% of RP and 66.7%/20% of SP, with no significant difference in subtype distribution between groups (p = 0.8). In the ten Nef functional domains, only the PxxP₃ region showed significantly greater variation in RP (33.3%) than SP (7.7%, p = 0.048). Gag sequences did not significantly differ between groups. The reportedly protective HLA-A alleles, A*74:01, A*32:01 and A*26, were more commonly observed in SP (50.0%) than RP (11.1%, p = 0.010), whereas the reportedly disease-susceptible HLA-B*45:01 was more common in RP (33.3%) than SP (7.4%, p = 0.045). Compared to RP, SP showed a significantly higher median number of predicted HLA-B-related 12-mer epitopes in Nef (3 vs. 2, p = 0.037), HLA-B-related 11-mer epitopes in Gag (2 vs. 1, p = 0.029), and HLA-A-related 9-mer epitopes in Gag (4 vs. 1, p = 0.051). SP also had fewer HLA-C-related epitopes in Nef (median 4 vs. 5, p = 0.046) and HLA-C-related 11-mer epitopes in Gag (median 1 vs. 1.5, p = 0.044) than RP.

Conclusions

Compared to rapid progressors, slow progressors had more protective HLA-A alleles and more HLA-B-related epitopes in both the Nef and Gag proteins. These results suggest that the host factor HLA plays a stronger role in disease progression than the Nef and Gag sequence variations in HIV-1-infected Kenyan children.     

Characteristics of Anopheles arabiensis larval habitats in Tubu village,Botswana

Documented information on the ecology of larval habitats in Botswana is lacking but is critical for larval control programs. Therefore, this study determined the characteristics of these habitats and the influences of biotic and abiotic factors in Tubu village, Botswana. Eight water bodies were sampled between January and December, 2013. The aquatic vegetation and invertebrate species present were characterized. Water parameters measured were turbidity (NTU), conductivity (μS/cm), oxygen (mg/l), and pH. Larval densities of Anopheles arabiensis mosquitoes and their correlation with abiotic factors were determined. Larval breeding was associated with ‘short’ aquatic vegetation, a variety of habitats fed by both rainfall and flood waters and sites with predators and competitors. The monthly mean (± SE_mean) larval density was 8.16±1.33. The monthly mean (±SE_mean) pH, conductivity, oxygen, and turbidity were 7.65±0.13, 1152.834±69.171, 5.59±1.33, and 323.421±33.801, respectively. There was a significant negative correlation between larval density and conductivity (r = ‐0.839; p < 0.01), while a significant positive correlation occurred between turbidity and larval density (r = 0.685; p < 0.05). Oxygen (r = 0.140; p > 0.05) and pH (r = 0.252; p > 0.05) were not correlated with larval density. Floods and diversified breeding sites contributed to prolonged and prolific larval breeding. ‘Short’ aquatic vegetation and predator‐infested waters offered suitable environments for larval breeding. Turbidity and conductivity were good indicators for potential breeding places and can be used as early warning indices for predicting larval production levels.     

Aqueous fullerene aggregates (nC60) generate minimal reactive oxygen species and are of low toxicity in fish: a revision of previous reports

This review aims to clarify inconsistencies in previous reports regarding the potential for aqueous aggregates of fullerenes (nC60) to generate reactive oxygen species (ROS) and cause toxicity in fish. Methods for evaluation of ROS production and toxicity of aqueous nC60 have evolved over time and limitations in initial studies have led to unintentional erroneous reports of nC60 ROS generation and toxicity. Some of these reports continue to lead to misconceptions of the environmental effects of C60. Critical review of the evidence (2007-2011) indicates that aqueous nC60 have minimal potential to produce ROS and that oxidative stress in fish is not induced by environmentally relevant exposure to nC60. Future studies should acknowledge that current evidence indicates low toxicity of nC60 and refrain from citing articles that attribute toxicity in fish to nC60 based on methods shown to be compromised by experimental artifacts. Despite low toxicity of nC60 in fish, an emerging environmental issue is that nC60 can affect environmental fate, transport, and bioavailability of co-contaminants in aquatic environments in a similar manner to that observed for other anthropogenic particulates (e.g., microplastics).     

Phenanthrene Emulsification and Biodegradation Using Rhamnolipid Biosurfactants and Acinetobacter calcoaceticus In Vitro

The ability of biosurfactants and Acinetobacter calcoaceticus to enhance the emulsification and biodegradation of phenanthrene was investigated. Phenanthrene is a polycyclic aromatic hydrocarbon that may be derived from various sources, for example incomplete combustion of petroleum fuel, and thus it occurs ubiquitously throughout the environment. In order to assess the efficacy of a biosurfactant microparticle system, emulsification assays and in vitro biodegradation studies were conducted. Emulsification assays were carried out to assess the stability of phenanthrene emulsions. Emulsion stability was determined by the height of the emulsion layer (Emulsification Index) and turbidity. In vitro biodegradation tests were done to estimate phenanthrene degradation from an aqueous system by A. calcoaceticus supplemented with encapsulated (ERhBS) and nonencapsulated biosurfactants (NERhBS). Results show that phenanthrene emulsifications were stabilized after 48 h with NERhBS and remained stable for 72 additional hours. Phenanthrene emulsifications were stabilized with ERhBS after 216 h and remained stable for an additional 96 h. A. calcoaceticus alone and supplemented with rhamnolipid biosurfactant were able to biodegrade 10 to 50 mg L^?1 of phenanthrene within 250 h. When supplemented with NERhBS, A. calcoaceticus degraded phenanthrene significantly faster than when nonsupplemented or supplemented with ERhBS. Addition of exogenous biosurfactants was considered to be a major factor driving the direct correlation between decreasing phenanthrene concentration in the system and increasing bacterial biomass.     

Sequential hypothesis testing with spatially correlated presence-absence data

A pest management decision to initiate a control treatment depends upon an accurate estimate of mean pest density. Presence-absence sampling plans significantly reduce sampling efforts to make treatment decisions by using the proportion of infested leaves to estimate mean pest density in lieu of counting individual pests. The use of sequential hypothesis testing procedures can significantly reduce the number of samples required to make a treatment decision. Here we construct a mean-proportion relationship for Oligonychus perseae Tuttle, Baker, and Abatiello, a mite pest of avocados, from empirical data, and develop a sequential presence-absence sampling plan using Bartlett's sequential test procedure. Bartlett's test can accommodate pest population models that contain nuisance parameters that are not of primary interest. However, it requires that population measurements be independent, which may not be realistic because of spatial correlation of pest densities across trees within an orchard. We propose to mitigate the effect of spatial correlation in a sequential sampling procedure by using a tree-selection rule (i.e., maximin) that sequentially selects each newly sampled tree to be maximally spaced from all other previously sampled trees. Our proposed presence-absence sampling methodology applies Bartlett's test to a hypothesis test developed using an empirical mean-proportion relationship coupled with a spatial, statistical model of pest populations, with spatial correlation mitigated via the aforementioned tree-selection rule. We demonstrate the effectiveness of our proposed methodology over a range of parameter estimates appropriate for densities of O. perseae that would be observed in avocado orchards in California.     

Mutations in Calmodulin Cause Ventricular Tachycardia and Sudden Cardiac Death

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating inherited disorder characterized by episodic syncope and/or sudden cardiac arrest during exercise or acute emotion in individuals without structural cardiac abnormalities. Although rare, CPVT is suspected to cause a substantial part of sudden cardiac deaths in young individuals. Mutations in RYR2, encoding the cardiac sarcoplasmic calcium channel, have been identified as causative in approximately half of all dominantly inherited CPVT cases. Applying a genome-wide linkage analysis in a large Swedish family with a severe dominantly inherited form of CPVT-like arrhythmias, we mapped the disease locus to chromosome 14q31-32. Sequencing CALM1 encoding calmodulin revealed a heterozygous missense mutation (c.161A>T [p.Asn53Ile]) segregating with the disease. A second, de novo, missense mutation (c.293A>G [p.Asn97Ser]) was subsequently identified in an individual of Iraqi origin; this individual was diagnosed with CPVT from a screening of 61 arrhythmia samples with no identified RYR2 mutations. Both CALM1 substitutions demonstrated compromised calcium binding, and p.Asn97Ser displayed an aberrant interaction with the RYR2 calmodulin-binding-domain peptide at low calcium concentrations. We conclude that calmodulin mutations can cause severe cardiac arrhythmia and that the calmodulin genes are candidates for genetic screening of individual cases and families with idiopathic ventricular tachycardia and unexplained sudden cardiac death.