Sexual risk behaviour of Canadian participants in the first efficacy trial of a preventive HIV-1 vaccine

Background

Phase I and phase II HIV-1 vaccine trials have revealed increases in risky sexual activity among study subjects during the trials, perhaps because the subjects believe that the vaccine being tested is efficacious; subjects may thus suffer harm from their participation. We evaluated the sexual behaviour of Canadian men who have sex with men (MSM) who participated in the phase III Vax004 trial of an HIV-1 vaccine.

Methods

Using self-reports of sexual behaviours during the 6 months before trial entry as a baseline, we determined changes in reported sexual behaviour after 6, 12 and 18 months of participation in the trial.

Results

Of 291 HIV-seronegative MSM enrolled from July to October 1999, 260 (89%) completed 18 months of follow-up, 19 (7%) experienced seroconversion, and 12 (4%) did not complete follow-up. Unprotected receptive anal intercourse during the previous 6 months with partners whose HIV-1 serostatus was positive or unknown was reported by 21% of men at enrolment and by 27% at any point during 18 months of follow-up. No increase in this behaviour from baseline was reported by participants, including among men who were motivated to enrol because of expected protection from HIV-1 infection, men who believed they had received the vaccine, men who believed that the vaccine had greater than 50% efficacy, or men who believed that they had received the vaccine and that vaccine efficacy was greater than 50%.

Interpretation

MSM can be successfully enrolled in HIV-1 vaccine efficacy trials without evident increases in those sexual behaviours most associated with HIV-1 risk.Development of preventive HIV-1 vaccines requires clinical trials that effectively recruit, enrol and retain high-risk subjects, including men who have sex with men (MSM). Since candidate vaccines may prove to have little or no efficacy, these trials must also strive to minimize harms associated with participation. A major concern has been that trial participants might believe vaccination affords some protection and therefore increase their sexual risk-taking.^1,2 This concern derives in part from increases in unprotected anal intercourse observed during phase I and phase II vaccine trials. For example, self-reports of unprotected insertive anal intercourse during the previous 6 months increased among 44 gay men enrolled in San Francisco trials, from 9% at enrolment to 20% at the 12-month assessment; however, the HIV status of sexual partners was not assessed.¹ The world''s first phase III trial to evaluate a candidate preventive HIV-1 vaccine was recently completed in North America and Europe.² A consortium sponsored by the Canadian Network for Vaccines and Immunotherapeutics of Cancer and Chronic Viral Diseases (CANVAC) was formed to assess participation, retention and change in sexual risk behaviour at trial sites in this country. We report here the Canadian experience in this trial through 18 months of follow-up and assess trends in high-risk sexual behaviour reported by participants.     

Excipient selection can significantly affect solid-state phase transformation in formulation during wet granulation

Phase transformations in formulations can lead to instability in physicochemical, biopharmaceutical, and processing properties of products. The influences of formulation design on the optimal dosage forms should be specified. The aim here was to investigate whether excipients with different water sorption behavior affect hydrate formation of nitrofurantoin in wet masses. Nitrofurantoin anhydrate was used as a hydrate-forming model drug, and 4 excipients with different water-absorbing potential (amorphous low-substituted hydroxypropylcellulose, modified maize starch, partially amorphous silicified microcrystalline cellulose, and crystalline α-lactose monohydrate) were granulated with varying amounts of purified water. Off-line evaluation of wet masses containing nitrofurantoin anhydrate and excipient (1∶1) was performed using an X-ray powder diffractometer (XRPD) and near-infrared spectroscopy, and drying phase was evaluated by variable temperature XRPD. Only amorphous excipient in the formulation retarded hydrate formation of an active pharmaceutical ingredient (API) at high water contents. Hygroscopic partially crystalline excipient hindered hydrate formation of API at low water contents. Crystalline excipient was unable to control hydrate formation of API. The character of excipient affects the stability of formulation. Thus, correct selection of excipients for the formulation can control processing-induced phase transitions and improve the storage stability of the final dosage form. Published: October 6, 2005     

Discovery of rare and highly toxic microcystins from lichen-associated cyanobacterium Nostoc sp. strain IO-102-I

The production of hepatotoxic cyclic heptapeptides, microcystins, is almost exclusively reported from planktonic cyanobacteria. Here we show that a terrestrial cyanobacterium Nostoc sp. strain IO-102-I isolated from a lichen association produces six different microcystins. Microcystins were identified with liquid chromatography-UV mass spectrometry by their retention times, UV spectra, mass fragmentation, and comparison to microcystins from the aquatic Nostoc sp. strain 152. The dominant microcystin produced by Nostoc sp. strain IO-102-I was the highly toxic [ADMAdda(5)]microcystin-LR, which accounted for ca. 80% of the total microcystins. We assigned a structure of [DMAdda(5)]microcystin-LR and [d-Asp(3),ADMAdda(5)]microcystin-LR and a partial structure of three new [ADMAdda(5)]-XR type of microcystin variants. Interestingly, Nostoc spp. strains IO-102-I and 152 synthesized only the rare ADMAdda and DMAdda subfamilies of microcystin variants. Phylogenetic analyses demonstrated congruence between genes involved directly in microcystin biosynthesis and the 16S rRNA and rpoC1 genes of Nostoc sp. strain IO-102-I. Nostoc sp. strain 152 and the Nostoc sp. strain IO-102-I are distantly related, revealing a sporadic distribution of toxin production in the genus Nostoc. Nostoc sp. strain IO-102-I is closely related to Nostoc punctiforme PCC 73102 and other symbiotic Nostoc strains and most likely belongs to this species. Together, this suggests that other terrestrial and aquatic strains of the genus Nostoc may have retained the genes necessary for microcystin biosynthesis.     

Reconstruction of the carbon balance for microsites in a boreal oligotrophic pine fen, Finland

 Carbon dioxide (CO₂) exchange was studied at flark (minerotrophic hollow), lawn and hummock microsites in an oligotrophic boreal pine fen. Statistical response functions were constructed for the microsites in order to reconstruct the annual CO₂ exchange balance from climate data. Carbon accumulation was estimated from the annual net CO₂ exchange, methane (CH₄) emissions and leaching of carbon. Due to high water tables in the year 1993, the average carbon accumulation at the flark, Eriophorum lawn, Carex lawn and hummock microsites was high, 2.91, 6.08, 2.83 and 2.66 mol C m^–2, respectively, and for the whole peatland it was 5.66 mol m^–2 year^–1. During the maximum primary production period in midsummer, hummocks with low water tables emitted less methane than predicted from the average net ecosystem exchange (NEE), while the Carex lawns emitted slightly more. CH₄ release during that period corresponded to 16% of the contemporary NEE. Annual C accumulation rate did not correlate with annual CH₄ release in the microsites studied, but the total community CO₂ release seemed to be related to CH₄ emissions in the wet microsites, again excluding the hummocks. The dependence of CO₂ exchange dynamics on weather events suggests that daily balances in C accumulation are labile and can change from net carbon uptake to net release, primarily in high hummocks on fens under warmer, drier climatic conditions. Received: 16 August 1996 / Accepted: 30 November 1996     

A moderate increase in the annual CH4 efflux by raised CO2 or NH4NO3 supply in a boreal oligotrophic mire

Natural wetlands release about 20% of global emissions of CH₄, an effective greenhouse gas contributing to the total radiative forcing. Thus, changes in the carbon cycle in wetlands could have significant impacts on climate. The effect of raised supply of CO₂ or NH₄NO₃ on the annual CH₄ efflux from the lawn of a boreal oligotrophic mire was investigated over two years. Ten study plots were enclosed with mini‐FACE rings, five vented with CO₂‐enriched air and the other five with ambient air. In addition, five plots were sprayed with NH₄NO₃ so that the cumulative addition of N was 3 g m^?2 y^?1; and five plots were controls. The CO₂ enrichment (target concentration 560 ppm_v) increased CH₄ efflux about 30–40%, but half of this increase seemed to be caused by the air‐blowing system. The increasing atmospheric concentration of CO₂ would promote CH₄ release in boreal mires, but the increase in CH₄ efflux would be clearly smaller than that reported in studies made in temperate or subtropical temperature conditions. Addition of N enhanced the annual release of CH₄ only slightly. At least over the short‐term, the increase in N deposition would have little effect on CH₄ effluxes. The increase in CH₄ release would probably increase radiative forcing and thus accelerate climate change. However, CH₄ effluxes are only a small part in the whole matter balance in mires and thus further studies are needed to define the net effects of raised supply of CO₂ or N for carbon accumulation, trace gas fluxes and radiative forcing.     

Population regulation of vendace (Coregonus albula) in Lake Pyhäjärvi, southwest Finland

Previous time series analysis on vendace population dynamics in Lake Pyhäjärvi, 1971–1990, revealed a 2-year cycle in year-class strength, implying powerful density-dependent regulation. Here we have extended this analysis by using multiple regression models to test whether the recruitment series is influenced by density-independent factors. We chose population size with a lag of 1 year as the density-dependent factor; the density-independent factors were the summer water temperature with a lag of 2 years (temperature sum for June, July and August, indicating the year-class strength of predators) and the temperature-derived length of the larval period of vendace. For the years 1972–1990 the coefficient of determination ( r ²) of this regression model was 0·77. We suggest that the basic mechanism producing a persistent 2-year cycle of vendace in Lake Pyhäjärvi is the asymmetrical food competition between age groups. The abundance of predators in the lake and the warming of the water after the hatching of larvae in spring together determine the final year-class strength of vendace.     

Calicioid lichens and fungi in amber – Tracing extant lineages back to the Paleogene

Calicioid lichens and fungi are a polyphyletic grouping of tiny ascomycetes that accumulate a persistent spore mass (mazaedium) on top of their usually well-stalked ascomata (‘mazaediate fungi’). In addition to extant forms, six fossils of the group were previously known from European Paleogene amber. Here we report nine new fossils and analyze the preserved features of all fossils to assess their applicability for dating molecular phylogenies. Many fossils are extremely well preserved, allowing detailed comparisons with modern taxa. SEM investigation reveals that even fine details of ascospore wall ultrastructure correspond to those seen in extant specimens. All fossils can confidently be assigned to modern genera: three to Calicium (Caliciaceae, Lecanoromycetes), five to Chaenotheca (Coniocybaceae, Coniocybomycetes), six to Chaenothecopsis (Mycocaliciaceae, Eurotiales), and one to Phaeocalicium (Mycocaliciaceae, Eurotiales). Several Calicium and Chaenotheca fossils are assignable to specific lineages within their genera, while the Chaenothecopsis fossils demonstrate the extent of intraspecific variation within one such lineage. Some features in the morphology of Chaenotheca succina nov. sp. seem to be ancestral as they have not been reported from modern species of the genus.     

Geographic mosaic of symbiont selectivity in a genus of epiphytic cyanolichens

In symbiotic systems, patterns of symbiont diversity and selectivity are crucial for the understanding of fundamental ecological processes such as dispersal and establishment. The lichen genus Nephroma (Peltigerales, Ascomycota) has a nearly cosmopolitan distribution and is thus an attractive model for the study of symbiotic interactions over a wide range of spatial scales. In this study, we analyze the genetic diversity of Nephroma mycobionts and their associated Nostoc photobionts within a global framework. The study is based on Internal Transcribed Spacer (ITS) sequences of fungal symbionts and tRNA^Leu (UAA) intron sequences of cyanobacterial symbionts. The full data set includes 271 Nephroma and 358 Nostoc sequences, with over 150 sequence pairs known to originate from the same lichen thalli. Our results show that all bipartite Nephroma species associate with one group of Nostoc different from Nostoc typically found in tripartite Nephroma species. This conserved association appears to have been inherited from the common ancestor of all extant species. While specific associations between some symbiont genotypes can be observed over vast distances, both symbionts tend to show genetic differentiation over wide geographic scales. Most bipartite Nephroma species share their Nostoc symbionts with one or more other fungal taxa, and no fungal species associates solely with a single Nostoc genotype, supporting the concept of functional lichen guilds. Symbiont selectivity patterns within these lichens are best described as a geographic mosaic, with higher selectivity locally than globally. This may reflect specific habitat preferences of particular symbiont combinations, but also the influence of founder effects.     

Importance of the Collagen Adhesin Ace in Pathogenesis and Protection against Enterococcus faecalis Experimental Endocarditis

Ace is an adhesin to collagen from Enterococcus faecalis expressed conditionally after growth in serum or in the presence of collagen. Here, we generated an ace deletion mutant and showed that it was significantly attenuated versus wild-type OG1RF in a mixed infection rat endocarditis model (P<0.0001), while no differences were observed in a peritonitis model. Complemented OG1RFΔace (pAT392::ace) enhanced early (4 h) heart valve colonization versus OG1RFΔace (pAT392) (P = 0.0418), suggesting that Ace expression is important for early attachment. By flow cytometry using specific anti-recombinant Ace (rAce) immunoglobulins (Igs), we showed in vivo expression of Ace by OG1RF cells obtained directly from infected vegetations, consistent with our previous finding of anti-Ace antibodies in E. faecalis endocarditis patient sera. Finally, rats actively immunized against rAce were less susceptible to infection by OG1RF than non-immunized (P = 0.0004) or sham-immunized (P = 0.0475) by CFU counts. Similarly, animals given specific anti-rAce Igs were less likely to develop E. faecalis endocarditis (P = 0.0001) and showed fewer CFU in vegetations (P = 0.0146). In conclusion, we have shown for the first time that Ace is involved in pathogenesis of, and is useful for protection against, E. faecalis experimental endocarditis.