Predictors of Attrition and Immunological Failure in HIV-1 Patients on Highly Active Antiretroviral Therapy from Different Healthcare Settings in Mozambique

In Mozambique, the evaluation of retention in HIV care and ART programmes is limited. To assess rate and predictors of attrition (no retention in care) and HAART effectiveness in HIV-1 infected patients who pay for medication and laboratory testing in Mozambique, we conducted a multicenter survey of HIV-1-infected patients who started HAART during 2002–2006. Cox proportional hazard models were used to assess risk of attrition and of therapy failure. Overall, 142 patients from 16 healthcare centers located in the capital city Maputo were followed-up for 22.2 months (12.1–46.7). The retention rate was 75%, 48% and 37% after one, two and three years, respectively. Risk of attrition was lower in patients with higher baseline CD4 count (P = 0.022) and attending healthcare center 1 (HCC1) (P = 0.013). The proportion of individuals with CD4 count ≤200 cells/µL was 55% (78/142) at baseline and decreased to 6% (3/52) at 36 months. Among the patients with available VL, 86% (64/74) achieved undetectable VL levels. The rate of immunologic failure was 17.2% (95% CI: 12.6–22.9) per 100 person-years. Risk of failure was associated to higher baseline CD4 count (P = 0.002), likely reflecting low adherence levels, and decreased with baseline VL ≥10,000 copies/mL (P = 0.033). These results suggest that HAART can be effective in HIV-1 infected patients from Mozambique that pay for their medication and laboratory testing. Further studies are required to identify the causes for low retention rates in patients with low CD4 counts and to better understand the association between healthcare setting and attrition rate.     

The Schistosome Oesophageal Gland: Initiator of Blood Processing

Background

Although the ultrastructure of the schistosome esophageal gland was described >35 years ago, its role in the processing of ingested blood has never been established. The current study was prompted by our identification of MEG-4.1 expression in the gland and the observation of erythrocyte uncoating in the posterior esophagus.

Methodology/Principal Findings

The salient feature of the posterior esophagus, characterized by confocal and electron microscopy, is the enormous increase in membrane surface area provided by the plate-like extensions and basal invaginations of the lining syncytium, with unique crystalloid vesicles releasing their contents between the plates. The feeding process was shown by video microscopy to be divided into two phases, blood first accumulating in the anterior lumen before passing as a bolus to the posterior. There it streamed around a plug of material revealed by confocal microscopy as tethered leucocytes. These were present in far larger numbers than predicted from the volume of the lumen, and in varying states of damage and destruction. Intact erythrocytes were detected in the anterior esophagus but not observed thereafter, implying that their lysis occurred rapidly as they enter the posterior. Two further genes, MEGs 4.2 and 14, were shown to be expressed exclusively in the esophageal gland. Bioinformatics predicted that MEGs 4.1 and 4.2 possessed a common hydrophobic region with a shared motif, while antibodies to SjMEG-4.1 showed it was bound to leucocytes in the esophageal lumen. It was also predicted that MEGs 4.1 and 14 were heavily O-glycosylated and this was confirmed for the former by 2D-electrophoresis and Western blotting.

Conclusions/Significance

The esophageal gland and its products play a central role in the processing of ingested blood. The binding of host antibodies in the esophageal lumen shows that some constituents are antibody targets and could provide a new source of vaccine candidates.     

How I Treat Histoplasmosis

Histoplasmosis is an endemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. Some important manifestations of infection include acute or chronic pulmonary disease, histoplasmomas, progressive disseminated histoplasmosis, and central nervous system infection. Depending on the clinical presentation, site of infection and severity of disease, either amphotericin B preparations followed by itraconazole, or itraconazole alone have become the preferred treatments. Because prolonged therapy (6 weeks to 24 months) may be required, careful monitoring for nephrotoxicity in patients on amphotericin B preparations is necessary. In addition, in patients receiving itraconazole, vigilance for drug interactions and pharmacokinetic properties is warranted. Histoplasma antigen testing has improved rapidity of diagnosis and the ability of long-term monitoring for clinical response in patients with histoplasmosis.     

Transition energy and potential energy curves for ionized inner-shell states of CO, O2 and N2 calculated by several inner-shell multiconfigurational approaches

Potential energy curves and inner-shell ionization energies of carbon monoxide, oxygen and nitrogen molecules were calculated using several forms of the inner-shell multiconfigurational self-consistent field (IS-MCSCF) method—a recently proposed protocol to obtain specifically converged inner-shell states at this level. The particular forms of the IS-MCSCF method designated IS-GVB-PP, IS-FVBL and IS-CASSCF stand for perfect pairing generalized valence bond, full valence bond-like MCSCF and complete active space self consistent field, respectively. A comparison of these different versions of the IS-MCSCF method was carried out for the first time. The results indicate that inner-shell states are described accurately even for the simplest version of the method (IS-GVB-PP). Dynamic correlation was recovered by multireference configuration interaction or multireference perturbation theory. For molecules not having equivalent atoms, all methods led to comparable and accurate transition energies. For molecules with equivalent atoms, the most accurate results were obtained by multireference perturbation theory. Scalar relativistic effects were accounted for using the Douglas-Kroll-Hess Hamiltonian.     

Modelling potential impacts of climate change on the bioclimatic envelope and conservation of the Maned Wolf (Chrysocyon brachyurus)

Forecasting the influence of climatic changes on the distribution of the Maned Wolf (Chrysocyon brachyurus) is important for the conservation of the species. We explored the environmental characteristics than best explain the current distribution of the species, modelled the past and present distribution, projected the niche model into the future, and identified suitable areas for conservation. Niche modelling was performed using Maxent and 21 environmental variables. For past conditions, we considered the Last Glacial Maximum (LGM) and the mid-Holocene (MH) climates. For future conditions, we used the A2a greenhouse gas emission scenario for 2050. Four General Circulation Models (FGOALS 1.0, HADCM3, IPSL-CM4 and MIROC 3.2) were used. The resulting niche model (AUC = 0.89 ± 0.02) predicts maximum probability of presence at precipitation of 106 mm during the coldest quarter, of 396 mm during the warmest quarter, and in totally flat areas. The suitable area for the Maned Wolf currently covers 4,320,364 km². For the LGM, there were inter-model differences in predicted areas (from 819,324 km² to 6,395,886 km²) and in geographic location. The MH models showed drastic changes with respect to the present and considerable inter-model variation. Predictions for 2050 show significant (at least 33%) reductions in distribution. Only a minor fraction (39%) of the current distribution can be considered stable for the period LGM-2050. The FGOALS model was the best option for projecting species occurrence into the future because it included the three localities known for the Maned Wolf from the late Pleistocene and predicts stable areas that coincide with spatial patterns of genetic diversity. The FGOALS projection for 2050 predicts a 33% reduction in suitable habitats, indicating some stable areas (central South America) that will probably be key sites for the conservation of the species.     

Trophic ecology of a top predator colonizing the southern extreme of South America: Feeding habits of invasive American mink (Neovison vison) in Tierra del Fuego

The American mink (Neovison vison) is a semi-aquatic, generalist carnivore released onto Tierra del Fuego (TDF) Island in the 1940s, subsequently spreading to adjacent islands in the archipelago with potential effects on native prey populations. Knowledge of this new predator's trophic ecology is essential to identify threats, plan control strategies and conserve native fauna. We studied seasonal mink diet in TDF in different habitats. We identified undigested remains from 493 scats collected between May 2005 and March 2009 along marine coasts and freshwater shores (rivers and lakes). Small mammals and fish were the main mink prey in TDF (over 65% of diet items). Seasonal variations were not detected, but diet did vary significantly between marine and freshwater habitats, where more terrestrial items were consumed. Among mammals, mink consumed more small native rodents than exotic species. Native fish consumption was also important with greater representation of species from the families Nototheniidae and Galaxiidae in marine and freshwater habitats respectively. Birds were the third item in importance, but did not constitute a particularly large part of the mink's diet on TDF. Overall, differences found in mink diet between habitats reflected their generalist/opportunistic feeding behaviour and did not differ greatly from observations in its native range or in other areas where it has been introduced. Our results establish the interactions between this novel predator and its prey and also illustrate the need to continue research on native prey populations to quantify mink impact on them and understand the ecological context of this biotic assemblage.     

The Genetic Basis of Escherichia coli Pathoadaptation to Macrophages

Antagonistic interactions are likely important driving forces of the evolutionary process underlying bacterial genome complexity and diversity. We hypothesized that the ability of evolved bacteria to escape specific components of host innate immunity, such as phagocytosis and killing by macrophages (MΦ), is a critical trait relevant in the acquisition of bacterial virulence. Here, we used a combination of experimental evolution, phenotypic characterization, genome sequencing and mathematical modeling to address how fast, and through how many adaptive steps, a commensal Escherichia coli (E. coli) acquire this virulence trait. We show that when maintained in vitro under the selective pressure of host MΦ commensal E. coli can evolve, in less than 500 generations, virulent clones that escape phagocytosis and MΦ killing in vitro, while increasing their pathogenicity in vivo, as assessed in mice. This pathoadaptive process is driven by a mechanism involving the insertion of a single transposable element into the promoter region of the E. coli yrfF gene. Moreover, transposition of the IS186 element into the promoter of Lon gene, encoding an ATP-dependent serine protease, is likely to accelerate this pathoadaptive process. Competition between clones carrying distinct beneficial mutations dominates the dynamics of the pathoadaptive process, as suggested from a mathematical model, which reproduces the observed experimental dynamics of E. coli evolution towards virulence. In conclusion, we reveal a molecular mechanism explaining how a specific component of host innate immunity can modulate microbial evolution towards pathogenicity.     

Reconstructing the Population Genetic History of the Caribbean

The Caribbean basin is home to some of the most complex interactions in recent history among previously diverged human populations. Here, we investigate the population genetic history of this region by characterizing patterns of genome-wide variation among 330 individuals from three of the Greater Antilles (Cuba, Puerto Rico, Hispaniola), two mainland (Honduras, Colombia), and three Native South American (Yukpa, Bari, and Warao) populations. We combine these data with a unique database of genomic variation in over 3,000 individuals from diverse European, African, and Native American populations. We use local ancestry inference and tract length distributions to test different demographic scenarios for the pre- and post-colonial history of the region. We develop a novel ancestry-specific PCA (ASPCA) method to reconstruct the sub-continental origin of Native American, European, and African haplotypes from admixed genomes. We find that the most likely source of the indigenous ancestry in Caribbean islanders is a Native South American component shared among inland Amazonian tribes, Central America, and the Yucatan peninsula, suggesting extensive gene flow across the Caribbean in pre-Columbian times. We find evidence of two pulses of African migration. The first pulse—which today is reflected by shorter, older ancestry tracts—consists of a genetic component more similar to coastal West African regions involved in early stages of the trans-Atlantic slave trade. The second pulse—reflected by longer, younger tracts—is more similar to present-day West-Central African populations, supporting historical records of later transatlantic deportation. Surprisingly, we also identify a Latino-specific European component that has significantly diverged from its parental Iberian source populations, presumably as a result of small European founder population size. We demonstrate that the ancestral components in admixed genomes can be traced back to distinct sub-continental source populations with far greater resolution than previously thought, even when limited pre-Columbian Caribbean haplotypes have survived.     

Saponins from the roots of Chiococca alba and their in vitro anti-inflammatory activity

Five triterpenoidal saponins were isolated from the roots of Chiococca alba (L.) Hitchc. (Rubiaceae). Two of the saponins, chiococcasaponin III (3-O-β-d-glucopyranurosyl-3β-hydroxyolean-12,15-dien-28-oic acid 28-O-β-d-xylopyranosyl (1 → 4)-α-l-rhamnopyranosyl (1 → 2)-α-l-arabinopyranosyl ester) and chiococcasaponin IV (3-O-β-d-glucopyranurosyl-3β-hydroxyolean-12,15-dien-28-oic acid 28-O-α-l-rhamnopyranosyl (1 → 2)-α-l-arabinopyranosyl ester) were new and their structures were elucidated on the basis of extensive application of NMR techniques and high resolution electrospray mass spectrometry together with acid hydrolysis product analysis. As part of our investigations on the chemical profile and pharmacological activity of the roots of C. alba, we report the results of the evaluation of the activity of the saponin fractions against in vitro lipopolysaccharide-induced inflammation. The results found, strongly support the fractions I, III and IV as having anti-inflammatory properties.