Retroviral Disease Research Articles

Tuberculosis in chronic renal failure stage V patients at a tertiary care nephology unit in India

Purpose: There is a high incidence of TB in India. The immune dysfunction in patients with chronic renal failure Stage V (CRF-V) predisposed them to infections. Co-existing TB adds to morbidity and the treatment with anti-tubercular drugs requires knowledge of the proportion of drug excreted by kidneys and its clearance, the toxicity and the availability of alternate effective agents to cure the patient of TB. Analysis was aimed to know the incidence of TB in CKF-V patients. Methods & Materials: CRF-V patients between 1st April 2015 and 1st March 2018 were retrospectively analyzed for TB. Data were collected on the demographics, clinical presentation, laboratory methods of TB diagnosis, disease site, comorbidities and outcome of tuberculosis. Results: Out of a total 312 patients with CKD-V a total of 51 were screened for tuberculosis on basis of clinical suspicion by Microbiological / histopathological findings. Fever, weight loss and decrease appetite were the predominant clinical presentations. 7 patients were positive for Tuberculosis; the incidence being (13.7%) for tuberculosis. 57.2% were males & 42.8% were females. The co-morbid conditions were retroviral disease, diabetes and Systemic lupus erythematosus in one patient each. Extra pulmonary tuberculosis was diagnosed in 3 and pulmonary in 4. One patient was MDR and was managed on 2nd line drugs successfully. Only one patient died due to septic shock with CMV and PCP pneumoniae Conclusion: The incidence of tuberculosis was (13.7%) in CKD-V patients. Thus a high index of clinical suspicion & early diagnosis can promote a favorable patient outcome.

Frequency of feline leukemia virus (FeLV) in southern aburrá valley, Colombia (2013-2018)

The feline leukemia virus (FeLV), causes a fatal disease for the Felidae family and is one of the main retroviral diseases in felines, and therefore has a diagnostic and preventive interest in animal health. Objective: of the study was to determine the frequency of FeLV by being diagnosed in four municipalities in the south of the Aburrá Valley, Colombia, using the records of the area diagnostic centers.

Pola Penggunaan Omeprazole pada Pasien HIV & AIDS di UPIPI RSUD DR. Soetomo Surabaya

Human Immunodeficiency Virus (HIV) is a virus that spreads through body fluids and attacks the immune system, especially CD4 + lymphocyte-T cells (CD4). AIDS is a retroviral disease characterized by severe immune suppression that causes opportunistic diseases, secondary neoplasms, and neurological disorders. Patients suffering from chronic diseases, such as HIV & AIDS patients may experience severe shocks or trauma. This condition can trigger the release of excessive stomach acid to experience erosion or acute gastric ulcers with bleeding. This injury is classified as a gastric ulcer. Treatment of ulcers is needed, because a continuous ulcer can cause bleeding. Gastrointestinal bleeding can manifest in the direction of melena and hematemesis. The therapy that can be used is omeprazole which is a class of proton pump inhibitors. Omeprazole can prevent mucosal damage from gastric acid and can inhibit excess acid production from gastric parietal cells. This study aims to present omeprazole therapy data which includes dosage, route of drug administration, duration of use and qualitative analysis of interactions related to medical record data at UPIPI Hospital Dr. Soetomo Surabaya. The research method used was observational retrospective on the medical record of patients with HIV & AIDS. Sampling was carried out from January 1 to December 31, 2015. The results showed that omeprazole was the most widely used gastric ulcer drug in HIV & AIDS patients, as many as 56 patients (91.80%). The most frequent doses, frequencies, and routes were omeprazole 40 mg 2x1 IV in 55 patients (90.16%). Omeprazole therapy was given to patients with HIV & AIDS at UPIPI Hospital Dr. Surabaya Soetomo, regarding the dosage, frequency, route, and duration of administration are in accordance with existing guidelines.

Atypical presentation of genital herpes in a retroviral disease patient on highly active anti-retroviral therapy

Herpes Simplex Virus type 2 (HSV-2) is the leading cause of Genital Ulcer Disease (GUD) worldwide. In HIV infected persons, it typically presents with increased number of recurrent genital lesions which often have severe and prolonged presentations. There are reports that patients receiving highly active antiretroviral therapy (HAART) may be more prone to chronic genital ulcers and a higher risk of acyclovir-resistant herpes infection than is seen in immune competent patients. We present a case of recurrent genital herpes infection in a sexually active 15 year old known HIV patient.Keywords: Recurrent genital ulcer, HSV-2, HIV, HAART

Role of Exosomes in Human Retroviral Mediated Disorders.

Retroviruses comprise an ancient and varied group of viruses with the unique ability to integrate DNA from an RNA transcript into the genome, a subset of which are able to integrate in humans. The timing of these integrations during human history has dictated whether these viruses have remained exogenous and given rise to various human diseases or have become inseparable from the host genome (endogenous retroviruses). Given the ability of retroviruses to integrate into the host and subsequently co-opt host cellular process for viral propagation, retroviruses have been shown to be closely associated with several cellular processes including exosome formation. Exosomes are 30-150nm unilamellar extracellular vesicles that originate from intraluminal vesicles (ILVs) that form in the endosomal compartment. Exosomes have been shown to be important in intercellular communication and immune cell function. Almost every cell type studied has been shown to produce these types of vesicles, with the cell type dictating the contents, which include proteins, mRNA, and miRNAs. Importantly, recent evidence has shown that infection by viruses, including retroviruses, alter the contents and subsequent function of produced exosomes. In this review, we will discuss the important retroviruses associated with human health and disease. Furthermore, we will delve into the impact of exosome formation and manipulation by integrated retroviruses on human health, survival, and human retroviral disease pathogenesis.

Clinicopathological Diversity of Pancytopenia: A Series of 400 Cases

Introduction: Pancytopenia is characterised by decreased haemoglobin, Packed Cell Volume (PCV), Total Leukocyte Count (TLC) and Platelet Count (PC). Variety of haematological disorders can present with pancytopenia and hence, it has an extensive differential diagnosis. The clinical presentation is based on the severity of pancytopenia as well as its aetiology that warrants a systematic approach to identify the cause of pancytopenia. Aim: To evaluate the clinicopathological characteristics of various causes of pancytopenia. Materials and Methods: A total of 400 cases presenting with pancytopenia were clinically assessed, and the haematological investigations were collected from the haematology unit of Department of Pathology, from January 2010 to December 2016. The clinical data of the patients was obtained and the haematological findings were analysed. Bone marrow aspiration (200/400 cases) and biopsy (77/400 cases) were evaluated. Data was analysed using SPSS 22.0 version. The test of significance was performed by Chi-square test. A p-value <0.05 was considered of statistical significant. Results: Among the 400 cases, malaria was the most common cause for pancytopenia (n=108,27%), followed by megaloblastic anaemia (n=93,23.25%). Other causes included hypersplenism, liver disease, retroviral disease, acute leukaemia, hypoplastic marrow, sepsis, myelodysplastic syndrome, lymphoma, myelofibrosis, and certain infections. Rare causes such as Fanconi anaemia, tuberculosis and mucolipidosis were also encountered. The most common symptom with which the patients presented was weakness and easy fatigability (n=337,84.3%) and pallor was the most common physical sign (n=400,100%). Conclusion: Pancytopenia is a commonly encountered entity in outpatient clinics which has got a wide variety of differential diagnosis. In certain diseases, pancytopenia is transient and uncomplicated; however, it can be a presenting feature of a life threatening disease as well. Therefore, a systematic approach in evaluating the underlying cause of pancytopenia is essential to plan and implement the timely intervention.

The Eminence of Neutrophil-lymphocyte Count Ratio in Predicting Bacteremia for Community-acquired Infections at an Emergency Medicine Department in a Tertiary Care Setting.

Introduction:The changes in the white blood cells counts and other blood parameters are well-recognized feature in sepsis. A ratio between neutrophils and lymphocytes can be used as a screening marker in sepsis. Even though new markers such as Procalcitonin and adrenomedullin have been rolled out in the field, implementation of these markers has been hindered by cost, accessibility, and proper validation. We looked for the ability of simple neutrophil-lymphocyte count ratio (NLCR) when compared to the gold standard blood culture method in predicting bacteremia, on patients presented to emergency department (ED) with features of suspected community-acquired infections.Materials and Methods:A comparative study done on 258 adult patients, admitted with suspected features of community-acquired infections. The study group included all patients who had positive blood culture results on index presentation at ED. Patients with hematological, chronic liver and retroviral diseases, patients receiving chemotherapy, and steroid medications were excluded from the study. The study group was compared with gender- and age-matched control group who were also admitted with a suspicion of the same, but in whom the blood culture results were negative.Results:There was no statistically significant difference for predicting bacteremia by NLCR (>4.63) and culture positivity methods (P = 1.00). NLCR of > 4.63 predicts bacteremia with an accuracy of 84.9%.Conclusion:In our setting, NLCR performs equally well with culture positivity, in detecting severe infection at the early phase of disease. The NLCR may, therefore, be used as a suitable screening marker at ED for suspected community-acquired infections.

Orbital kaposi sarcoma in a female retroviral disease negative nigerian and a review of literature

An orbital location of Kaposi sarcoma (KS) is rare, and none has been reported in Nigeria to the best of our knowledge. We report the multidisciplinary management of a case; a 50-year-old human immune-deficiency virus, seronegative female who presented with a painless, progressive swelling of the left eye of two years duration that was histologically confirmed as orbital KS. Occurrence of KS in the orbit is rare; we highlight the need for a very high index of suspicion for this tumor as well as the challenges of managing this unsightly indolent tumor in Nigeria.

A CASE REPORT OF SECONDARY CUTANEOUS CRYPTOCOCCOSIS IN A RETROVIRUS POSITIVE PATIENT

Cryptococcosis is a systemic mycosis caused by the capsulated yeast Cryptococcus neoformans. Cryptococcus remains an important opportunistic pathogen in HIV positive patients. It is usually acquired through inhalation of spores and by invasion of the respiratory system, and then, the organisms may spread hematogenously to other viscera mainly central nervous system. Although there are some reports of primary cutaneous cryptococcosis, cryptococcal skin disease is a rare feature of disseminated cryptococcosis and has poor outcome if undiagnosed and untreated. We present a case of secondary cutaneous cryptococcosis in a 50-year-old male, who was diagnosed as a case of retroviral disease 3 years back but not on anti-retroviral therapy.

Abstract 34: Bleomycin pulmonary toxicity in Hodgkin's lymphoma treated with ABVD regimen not followed by radiation

Abstract Introduction: One of the finest five accomplishments of medical oncology in the last fifty years is undeniably the evolution and advancement of curative systemic treatment of Hodgkin's disease. There are eight main chemotherapy regimens which are currently in use. Common regimens are BEACOPP (bleomycine, etoposide, adriyamycin, cyclophosphamide, vincristine, oncovin procarbazine, prednisone) and ABVD (ariyamycin, bleomycin, vinblastine, dacarbazine). In 1975 a report on the initial randomized control trial of ABVD pointed out its advantages and supported the combination along with the then-popular MOPP regimen. ABVD therapy alone unaccompanied by radiation therapy has a greater rate of overall survival. ABVD regimen, which was used as an alternative to first-line regimen, has now evolved as a highly preferred one and has become the mainstay. Bleomycin is a very effective antineoplastic drug and is a component of the ABVD regimen, which is a composite of water-soluble peptides. In 1992, there were studies conducted on mice which suggested the consistent and expeditious development of pulmonary fibrosis in them. Bleomycin pulmonary or lung toxicity can have a serious impact on treatment outcomes. Although there are no guidelines for screening pulmonary toxicity, various publications report pulmonary toxicity in patients receiving ABVD regimen. Bleomycin has been the pillar of many responsive cancers. Bleomycin is cytotoxic. In the presence of iron and oxygen it forms free radicals, and these free radicals binds to the DNA and produce single- or double-stranded DNA breaks. Although bleomycin-induced pulmonary toxicity has influence on the treatment outcome, there are currently no specific guidelines either for diagnosing or monitoring. Pulmonary fibrosis has been reported in various patients due to bleomycin administration in literature as early as the 1970s. A retrospective study from 1986 to 2003 including 141 cases of HL receiving bleomycin-containing treatment was reported in 2005 which observed that there is a marked reduction in five-year overall survival rate among the patients treated with the same. They add that the age of the patient increases the risk, especially above 40 years. Age, cumulative drug dose, renal function, stage of disease at presentation, radiation therapy, concomitant oxygen use, other chemotherapeutic agents, and G-CSF use may all influence the risk of developing BIP. Procedures: This is a retrospective study of patients who are treated with ABVD regimen without radiation therapy for newly diagnosed Hodgkin's lymphoma at a tertiary oncology care center in Mangalore, South India. Demographic details, histopathologic subtype, date of diagnosis, bone marrow involvement, B symptoms, biochemistry, and pulmonary toxicity will be analyzed and discussed. Results: 74 patients were diagnosed with Hodgkin's lymphoma from 2000 to now. Six to eight cycles of ABVD chemotherapy has been administered to all of the patients diagnosed as HL, not followed by radiation. Of these 74 patients, seven had bleomycin toxicity. The majority were males (5 of 7; 71%). Out of the two female patients one is in premenstrual stage, aged 38 years, and the other patient is in her post-menstrual stage, aged 68 years. None of the patients under the study were diagnosed with comorbidities or retroviral disease. There is wide distribution of ages. The majority of patients presented with lymph node enlargement as the chief complaint. Few patients had B symptoms. On clinical examination two patients had hepatosplenomegaly. Out of seven patients four had excision biopsy and three had an incision or Tru-cut biopsy. Twenty-nine percent were bulky and 71% were non-bulky. CD 15 and CD 30 were positive for majority of patients. The patients are reassessed on each follow-up visit using PETCT or CT scan since early treatment helps in better prognosis. Six to eight cycles of ABVD chemotherapy have been administered to all of the patients diagnosed as HL, not followed by radiation. Whenever a patient reports any respiratory system complaints such as cough or breathlessness, we start management for pulmonary toxicity. Oxygen saturation is monitored continuously. We stop administering bleomycin from the chemotherapy regimen. The patients are reassessed on each follow-up visit using PETCT or CT scan. Conclusion: Understanding of bleomycin toxicity continues to evolve. Bleomycin is an inevitable chemotherapeutic constituent which has the side effect of pulmonary toxicity. There are no specific guidelines to estimate the toxicity. The outcome of HL treatment with bleomycin-induced pulmonary toxicity will depend on how early treatment of pulmonary toxicity is started. The outcome is that all our patients are alive either without disease or ongoing treatment. Our center presents good outcome because of the immediate management of pulmonary toxicity. The literature shows that certain poor outcomes are due to lack of immediate reporting of respiratory complaints. Citation Format: Tara Rajendran, Krishna Prasad. Bleomycin pulmonary toxicity in Hodgkin's lymphoma treated with ABVD regimen not followed by radiation [abstract]. In: Proceedings of the Second AACR Conference on Hematologic Malignancies: Translating Discoveries to Novel Therapies; May 6-9, 2017; Boston, MA. Philadelphia (PA): AACR; Clin Cancer Res 2017;23(24_Suppl):Abstract nr 34.

Hematological findings and factors associated with feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) positivity in cats from southern Brazil

ABSTRACT: Using a retrospective study, 493 cats tested for FeLV and FIV were selected for analysis of the association between hematologic findings and positivity at immunoassay test. Individual and hematologic variables were assessed considering the influence of results using univariate and multivariate logistic regression analysis. Out 153 of the 493 cats were positive for FeLV (31%), 50 were positive for FIV (10.1%) and 22 were positive for both FIV and FeLV (4.4%). Multivariate analysis detected significant associations between FeLV infection and age below 1 year (p=0.01), age from 1 to 10 years (p=0.03), and crossbreed (p=0.04). Male cats were more likely to be FIV-positive (p=0.002). Regarding hematological changes, FeLV-positive cats have higher odds to anemia, leukopenia and lymphopenia than FeLV-negative cats. FIV-positive cats are more likely to have anemia than negative. Identification of associated factors related to animal status and correlation of hematological disorders with infection by retroviruses in cats could be useful for detecting these retroviral diseases in cats.

Tetherin Inhibits Cell-Free Virus Dissemination and Retards Murine Leukemia Virus Pathogenesis.

ABSTRACTThe relative contributions of cell-free virion circulation and direct cell-to-cell transmission to retroviral dissemination and pathogenesis are unknown. Tetherin/Bst2 is an antiviral protein that blocks enveloped virion release into the extracellular milieu but may not inhibit cell-to-cell virus transmission. We developed live-cell imaging assays which show that tetherin does not affect Moloney murine leukemia virus (MoMLV) spread, and only minimally affects vesicular stomatitis virus (VSV) spread, to adjacent cells in a monolayer. Conversely, cell-free MLV and VSV virion yields and VSV spread to distal cells were dramatically reduced by tetherin. To elucidate the roles of tetherin and cell-free virions during in vivo viral dissemination and pathogenesis, we developed mice carrying an inducible human tetherin (hTetherin) transgene. While ubiquitous hTetherin expression was detrimental to the growth and survival of mice, restriction of hTetherin expression to hematopoietic cells gave apparently healthy mice. The expression of hTetherin in hematopoietic cells had little or no effect on the number of MoMLV-infected splenocytes and thymocytes. However, hTetherin expression significantly reduced cell-free plasma viremia and also delayed MoMLV-induced disease. Overall, these results suggest that MoMLV spread within hematopoietic tissues and cell monolayers involves cell-to-cell transmission that is resistant to tetherin but that virion dissemination via plasma is inhibited by tetherin and is required for full MoMLV pathogenesis.IMPORTANCE Retroviruses are thought to spread primarily via direct cell-to-cell transmission, yet many have evolved to counteract an antiviral protein called tetherin, which may selectively inhibit cell-free virus release. We generated a mouse model with an inducible tetherin transgene in order to study how tetherin affects retroviral dissemination and on which cell types its expression is required to do so. We first developed a novel in vitro live-cell imaging assay to demonstrate that while tetherin does indeed dramatically reduce cell-free virus spreading, it has little to no effect on direct cell-to-cell transmission of either vesicular stomatitis virus (VSV) or the retrovirus MoMLV. Using our transgenic mouse model, we found that tetherin expression on hematopoietic cells resulted in the specific reduction of MoMLV cell-free plasma viremia but not the number of infected hematopoietic cells. The delay in disease associated with this scenario suggests a role for cell-free virus in retroviral disease progression.

Solid (Type 3) pleuropulmonary blastoma

Introduction: Pleuropulmonary blastoma is a rare solid and/or cystic progressive and aggressive malignant intra-thoracic tumor of childhood which belongs to a group of dysontogenetic neoplasms such as Wilms tumor, neuroblastoma and hepatoblastoma. The incidence of pleuropulmonary blastoma ranges between 0.25 and 0.5% of primary lung tumors making this entity a rare primary malignant lung tumor. Case Report: A two-month-old male neonate was referred from a regional hospital with a three-day history of cough, fever and shortness of breath. No previous medical history reported. The patient was delivered at term through a normal vaginal delivery which was uneventful. Birth weight 3 kg, length 48 cm, Apgar score 10/10 and the head circumference was 35 cm. The patient's retro-viral disease status was negative. On percussion there was dullness and bilateral crepitations. There was bilateral decreased air-entry. No signs of cardiac failure. The rest of the systems were within normal limits. The arterial blood gases showed respiratory acidosis with hypoxia. Chest X-ray showed a white out of the right hemithorax and CT scan of the chest showed a large soft tissue mass in the right hemithorax associated with free fluid in the right hemithorax and the biopsy was performed which confirmed the diagnosis of a pleuropulmonary blastoma. The pleuropulmonary blastoma was a solid type (Type 3). Conclusion: Pleuropulmonary blastoma poses a diagnostic challenge because it does not have specific clinical or radiological features. The late diagnosis and delayed treatment of pleuropulmonary blastoma are associated with a deadly prognosis.

The challenges of ESRD care in developing economies: sub-Saharan African opportunities for significant improvement.

Chronic kidney disease (CKD) is a significant cause of morbidity and mortality in sub-Saharan Africa. This, along with other noncommunicable diseases like hypertension, diabetes, and heart diseases, poses a double burden on a region that is still struggling to cope with the scourge of communicable diseases like malaria, tuberculosis, HIV, and more recently Ebola. Causes of CKD in the region are predominantly glomerulonephritis and hypertension, although type 2 diabetes is also becoming a significant cause as is the retroviral disease. Patients are generally younger than in the developed world, and there is a significant male preponderance. Most patients are managed by hemodialysis, with peritoneal dialysis and kidney transplantation being available in only few countries in the region. Government funding and support for dialysis is often unavailable, and when available, often with restrictions. There is a dearth of trained manpower to treat the disease, and many countries have a limited number of units, which are often ill-equipped to deal adequately with the number of patients who require end-stage renal disease (ESRD) care in the region. Although there has been a significant improvement when compared with the situation, even as recently as 10 years ago, there is also the potential for further improvement, which would significantly improve the outcomes in patients with ESRD in the region. The information in this review was obtained from a combination of renal registry reports (published and unpublished), published articles, responses to a questionnaire sent to nephrologists prior to the World Congress of Nephrology (WCN) in Cape Town, and from nephrologists attending the WCN in Cape Town (March 13-17, 2015).

ROLE OF PANCHAKARMA AND RASAYANA THERAPY IN HIV DEBILITATED PATIENT: A CASE REPORT

HIV is a retrovirus which weighed down the immunity of a hale and hearty person and causes of a syndrome called AIDS that means acquired immune deficiency syndrome. AIDS is a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections. HIV infects vital cells in the human immune system such as T Helper cells (CD4+ T cells mainly), macrophages and dendritic cells. HIV infection leads to low levels of CD4+ T cells through a number of mechanisms. A 43 years, male patient, sale’s man by occupation, known case of retroviral disease admitted in I.P.D. of I.P.G.T. & R.A. Jamnagar, Gujarat, with the complains of loss of movement in left half of body, weight loss of 22kg., chronic cough, loss of appetite and deep pressure soars over right Gluteus medius, Constipation & diarrhoea (intermittent) since 4 years. Patient was a treated case of pulmonary Koch’s with tubercular meningitis 4 years back. The patient was treated with 3 courses of Basti therapy and rejuvenating drugs. After the treatment patient’s appetite improved, 12 kg weight gain, improved power grade of limbs, motor function of limbs restored partially, pressure soar absolutely healed, and improvement in total leucocytes count. As absolute cure in the AIDS patients is still an awaited destiny, but with the Panchakarma along with rejuvenating therapy, quality of life of patient improved significantly. Though there is slight improvement in CD4 count and no change in viral overload but with the given remedy, complaints and associated disability treated successfully.

Audiological findings in a group of neurologically compromised children: A retrospective study

Background . Hearing loss is more prevalent in developing countries. Later diagnosis of hearing loss will result in delayed access to rehabilitation. It is typically more difficult to obtain subjective information required in a hearing test from neurocompromised children, causing audiologists to frequently turn to objective measures such as the auditory brainstem response (ABR) measure to obtain this information. Objective . To describe the ABR results in a group of neurologically compromised children and to establish a relationship between ABR findings and behavioural audiometry results, where these existed. Methods . A retrospective review was conducted on 40 ABR patient records of neurologically compromised participants aged 5 months to 10 years. Behavioural audiometry results were sought where these existed. Hearing status was described per ear for objective and behavioural results, and descriptive statistics were conducted. Results . Behavioural audiometry results were obtained in 72.5% of ears. Results correlated between ABR and behavioural audiometry for only 7.5% of ears, which were all diagnosed with normal hearing. About 12.5% of ears were misdiagnosed with behavioural audiometry. Premature infants were most likely to cope with behavioural audiometry. Hearing loss was highest in participants with cerebral palsy, Down syndrome, prematurity and retroviral disease. Conclusions . Behavioural audiometry appears to be a largely unreliable method of testing the hearing of children diagnosed with neurological disorders, as results were obtained in only 27.5% of the study sample; however, it remains the gold standard in paediatric hearing testing to evaluate the entire auditory system and provides information on how a child processes sound. Hearing thresholds should be established via objective testing. Conditioning should continue for a behavioural audiological test battery, with adaptations for the child’s developmental ability.

Short communication: Genetic correlation of bovine leukosis incidence with somatic cell score and milk yield in a US Holstein population

Bovine leukosis (BL) is a retroviral disease caused by the bovine leukosis virus (BLV), which affects only cattle. Dairy cows positive for BL produce less milk and have more days open than cows negative for BL. In addition, the virus also affects the immune system and causes weaker response to vaccines. Heritability estimates of BL incidence have been reported for Jersey and Holstein populations at about 0.08, indicating an important genetic component that can potentially be exploited to reduce the prevalence of the disease. However, before BL is used in selection programs, it is important to study its genetic associations with other economically important traits such that correlated responses to selection can be predicted. Hence, this study aimed to estimate the genetic correlations of BL with milk yield (MY) and with somatic cell score (SCS). Data of a commercial assay (ELISA) used to detect BLV antibodies in milk samples were obtained from Antel BioSystems (Lansing, MI). The data included continuous milk ELISA scores and binary milk ELISA results for 11,554 cows from 112 dairy herds across 16 US states. Continuous and binary milk ELISA were analyzed with linear and threshold models, respectively, together with MY and SCS using multitrait animal models. Genetic correlations (posterior means ± standard deviations) between BL incidence and MY were 0.17±0.077 and 0.14±0.076 using ELISA scores and results, respectively; with SCS, such estimates were 0.20±0.081 and 0.17±0.079, respectively. In summary, the results indicate that selection for higher MY may lead to increased BLV prevalence in dairy herds, but that the inclusion of BL (or SCS as an indicator trait) in selection indexes may help attenuate this problem.

Incidence of tuberculosis is high in chronic kidney disease patients in South East England and drug resistance common

The risk of tuberculosis (TB) is significantly increased in chronic kidney disease (CKD). Data on TB in CKD in the UK are sparse; most information stems from countries with high background prevalence. The aim of this study was to estimate the incidence of TB in CKD patients in South East London and to describe the epidemiology, treatment, and outcome. CKD patients with TB between 1994 and 2010 were identified retrospectively. Data were collected on type of renal replacement therapy, the method of TB diagnosis, disease site, treatment regimens, and risk factors. Forty patients were identified of whom 67.5% had CKD stages IV–V. Sixty-five percent were from non-UK born ethnic minorities. Median time from diagnosis of CKD to TB development was 12 months (range 0–192 months). Cumulative incidence of TB was 1267/100,000 [95% confidence interval (CI): 630–1904; 85 × background UK rate] in hemodialysis patients; 398/100,000 (95% CI: 80–1160; 26 × background UK rate) in peritoneal dialysis; and 522/100,000 (CI: 137–909; 35 × background UK rate) in transplant recipients. Sixty-three percent of patients had pulmonary TB and 25% of patients with culture-positive TB had resistant isolates. Fifty percent of patients were immunosuppressed due to drugs, diabetes, and/or retroviral disease. Treatment regimens were according to recent national guidance in 73% of cases. Seventy-six percent of patients experienced side effects. Greater awareness of risk factors, drug resistance, treatment regimens, and potential side effects is needed.

The Role of Human Endogenous Retroviruses (HERV-K) in the Pathogenesis of Human Cancers

Transmission of oncogenic retroviruses demonstrated in 1908. Much work was done around that period since by other researchers who demonstrated transfer of Sarcoma in chickens through filtrates. Although the name ‘retroviruses’ was coined as late as 1974, retroviral diseases were distinguished much earlier. Human endogenous retroviruses (HERVs) are natural components of the human genome and are considered remnants of ancient germ line infections by exogenous retroviruses. The human genome sequencing project revealed that 8 to 9% of the human genome is of retroviral origin. About 800 of these elements (class II HERVs) are beta-retrovirus-like and therefore distantly related to exogenous MMTV (an accepted aetiological agent for mammary tumour in mice). The majority of HERVs are noninfectious and replication-defective retroviral fossils. Some members of each HERV family however have been found to still be transcriptionally active. Furthermore, tissue-specific HERV expression profiles could be established for all human tissues investigated so far, confirming that HERVs are permanent components of the human transcriptome. A prevalence of HERV transcripts, in particular class II elements, such as members of the HML-2 family have been reported for various cancer tissues. In this review we focus our attention therefore on the association of class II HERVs with cancers. We also discuss the importance of this group of HERVs to humans, their relationship with other triggering factors (e.g. other viruses); and if there is to date a definitive causal role in cancer. We outlined the future perspectives with respect to HERVs and its contribution to human cancers, the methods of diagnosing and prognosticating; and plans to forestall attendant disease linked to these viruses by vaccine route, for example. The active sub-species purported to cause diseases in humans are the HERV-K and HERV-W.

Incidence and risk factors of abdominal surgical site infection in a Nigerian Tertiary Health care centre

This study aims to determine the incidence of and identify the risk factors responsible for surgical site infection (SSI) following laparotomies in adult patients in a Nigerian tertiary care facility. This is a prospective study carried out between January and December 2012. Wound assessment was done using standardized criteria stipulated by the Centres for Disease Control and Prevention. There were 291 patients during the study period, out of which 223 met the inclusion criteria: 157 (70.4%) males and 66 (29.6%) females. Surgical site infection was diagnosed in 85 patients giving an incidence rate of 38.1%. Identified risk factors for SSI include anaemia, contaminated and dirty wounds, retroviral disease status, physiological status (ASA scores IV and V), prolonged surgery time, cadre of surgeon, emergency surgeries and use of drains. The high incidence of SSI observed in this study was found more in patients that presented with septic abdomen and those that had large bowel procedures. Paying close attention to identified risk factors will reduce the burden of SSI.