Reverse-phase Evaporation Method Research Articles

Characterization, stabilization and activity of uricase loaded in lipid vesicles

Uricase-containing lipid vesicles (UOXLVs) were prepared by reverse-phase evaporation method with high efficiency and the characteristics of UOXLVs were described. The average size and zeta potential of UOXLVs obtained by the optimized formulation were 205.47 nm and −37.33 mV, respectively. Uricase was encapsulated in the alkaline aqueous phase of the lipid vesicle and the stability of its tetrameric structure was thus improved and its activity preserved. The storage stability of uricase in lipid vesicles was significantly increased compared to that of free uricase at 4 °C in borate buffer of pH 8.5. At 55 °C, free uricase was deactivated much more quickly especially at lower concentration predominantly due to enhanced dissociation of uricase into subunits. An intrinsic tryptophan of uricase recovered from the lipid vesicle thermally treated at 55 °C revealed that a partially denatured uricase molecule was stabilized through its hydrophobic interaction with lipid vesicle membrane. This interaction was depressed mainly by dissociation of uricase into subunits. At the physiological pH, significant increase of enzyme activity was found for the uricase entrapped in the lipid vesicles (1.8 times that of free uricase) at their respective optimum pH. The shift of optimum pH and increased uricolytic activity suggested the conformation change of the uricase during the entrapment process. The stability to proteolytic digestion was increased obviously by entrapping the uricase in the lipid vesicles. UOXLVs also showed relatively slower loss in activity compared with free uricase when treated with some chemical reagents. Lastly, in vitro study explicitly indicated that the uricase entrapped by UOXLVs possessed higher uricolytic activity than that of native uricase solution.

Development and characterization of novel carrier gel core liposomes based transmission blocking malaria vaccine

The aim of present work was to investigate the potential utility of novel carrier gel core liposomes for intramuscular delivery of transmission blocking malaria antigen Pfs25 and to evaluate the effect of co-administration of vaccine adjuvant CpGODN on immune enhancement of recombinant protein antigen Pfs25. In the present work we have prepared gel core liposomes containing core of biocompatible polymer poly acrylic acid in phospholipid bilayer by reverse phase evaporation method and characterized for various in vitro parameters. In process stability of the encapsulated antigen was evaluated by SDS-PAGE followed by western blotting. The immune stimulating ability was studied by measuring anti-Pfs25 antibody titer in serum of Balb/c mice following intramuscular administration of various formulations. A Significant and perdurable immune responses was obtained after intramuscular administration of gel core liposomes encapsulated Pfs25 as compared to Pfs25 loaded conventional liposomes. Moreover co-administration of CpGODN in liposomes (conventional and gel core) was found to further increase the immunogenicity of vaccine. The result indicates high potential of gel core liposomes for their use as a carrier adjuvant for intramuscular delivery of recombinant antigen Pfs25 based transmission blocking malaria vaccine.

Preparation and characterization of Tegafur magnetic thermosensitive liposomes

The purpose was to study the preparation and properties of tegafur magnetic thermosensitive liposomes. The method was to employ an improved chemical coprecipitation method for preparing nano-magnetic particles and a reverse-phase evaporation and ultrasonic method for preparing tegafur magnetic thermosensitive liposomes. The results showed that tegafur magnetic thermosensitive liposomes were prepared successfully. They had comparatively strong magnetism and superparamagnetism, and their temperature showed a linear positive correlation with dosages and the field strength under a current value. The conclusion was that tegafur magnetic thermosensitive liposomes with comparatively small particle size, superparamagnetism and comparatively strong magnetism were prepared successfully.

Suppression of hepatitis B virus-derived human hepatocellular carcinoma by NF-κB-inducing kinase-specific siRNA using liver-targeting liposomes

Hepatitis B virus triggers an increase of NF-kappaB inducing kinase (NIK)-dependent NF-kappaB activation, followed by the promotion of hepatocellular carcinoma (HCC). Here, we examined the inhibitory effect of NIK-specific siRNA on NF-kappaB signaling and HCC. The results of this study indicated that these siRNAs suppressed HBV-derived HCC by regulating NIK activation. To exert a protective effect from degradation enzyme, cationic liposomes were contrived and modified to contain beta-sitosterol glucoside to target the asialoglycoprotein receptors in liver cancer cells. The cationic dimyristoyl diacyltrimethylammonium propane liposomes were prepared by a reverse-phase evaporation method with slight modification. beta-Sitosterol glucoside was added to the lipid mixture at the beginning of the liposome preparation for the purpose of liver targeting. These liposomes assisted the delivery of the siRNA to specific cells and protected it from various lyases, followed by the ultimate suppression of HCC.

Lipid-assisted formation and dispersion of aqueous and bilayer-embedded nano-C60.

Lipid assemblies provide a biocompatible approach for preparing aqueous nanoparticles. In this work, dipalmitoylphosphatidylcholine (DPPC) was used to assist in the formation and dispersion of C(60) and nano-C(60) aggregates using a modified reverse phase evaporation (REV) method. This method led to the rapid formation of aqueous nano-C(60) at DPPC/C(60) molar ratios from 500:1 to 100:1 (12-38 nm; verified by cryogenic transmission electron microscopy), which were present in the bulk phase and encapsulated within vesicles. In addition to forming nanoparticles, C(60) was trapped within the vesicle bilayer and led to a reduction in the lipid melting temperature. Solvent extraction was used to isolate nano-C(60) from the lipids and bilayer-embedded C(60). Our results suggest that bilayer-embedded C(60) was present as molecular C(60) and as small amorphous nano-C(60) (2.3 +/- 0.4 nm), which clustered in the aqueous phase after the lipids were extracted. In addition to developing a new technique for nano-C(60) formation, our results suggest that the lipid bilayer may be used as a hydrophobic region for dispersing and assembling small nano-C(60).

Improved photodynamic inactivation of gram‐positive bacteria using hematoporphyrin encapsulated in liposomes and micelles

Antimicrobial photodynamic inactivation (PDI) is a promising treatment modality for local infections. To increase the efficacy of photosensitizer, hematoporphyrin (Hp) was used as a model drug and encapsulated in liposomes and micelles. The bactericidal efficacy of the carrier-entrapped Hp was assessed against gram-positive bacteria. Hp was encapsulated in liposomes by a modified reversed-phase evaporation and extrusion method. Micelle-Hp was prepared by the reversed-phase evaporation method. Spectroscopic analysis was used to characterize the properties of Hp in PBS, liposome or micelle. The PDI efficacy was examined by using gram-positive pathogens including methicillin-susceptible, methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes. The absorption and fluorescence emission spectra indicated that Hp encapsulated in liposomes and micelles is less likely to exist in aggregated form compared to that generally seen in an aqueous medium. Liposome- or micelle-Hp can induce complete eradication of the bacteria above a critical Hp dose, which is significantly lower than the dose required when using the non-encapsulated Hp. Furthermore, the PDI effect of the Hp encapsulated in micelles was superior to the Hp encapsulated in liposomes at lower Hp doses. Similar PDI results were also found in S. epidermidis and S. pyogenes. Our results indicate that photosensitizer entrapped in micelle exert similar or better PDI efficacy than that of liposome, which indicates this formulation may be useful for the treatment of local infections in the future.

Preparation and pH Stability of Ferrous Glycinate Liposomes

Ferrous glycinate liposomes were prepared by reverse phase evaporation method. The effects of cholesterol, Tween 80, ferrous glycinate concentration, hydrating medium, pH of hydrating medium, and sonication strength on the encapsulation efficiency of liposomes were investigated. Encapsulation efficiency was significantly influenced by the different technique parameters. Ferrous glycinate liposomes might be obtained with high encapsulation efficiency of 84.80% under the conditions of optimized technique parameters. The zeta potential and average particle size of liposomes in the hydrating medium of pH 7.0 were 9.6 mV and 559.2 nm, respectively. The release property of ferrous glycinate liposomes in vitro was investigated in simulated gastrointestinal juice. A small amount of ferrous glycinate was released from liposomes in the first 4 h in simulated gastrointestinal juice. The mean diameters of liposomes increased from 559.2 to 692.9, 677.8, and 599.3 nm after incubation in simulated gastrointestinal juice of pH 1.3, 7.5, and 7.5 in the presence of bile salts, respectively. Results showed that the stability of ferrous glycinate in strong acid environment was greatly improved by encapsulation in liposomes, which protected ferrous glycinate from disrupting the extracapsular environment by lipid bilayer. The bioavailability of ferrous glycinate, as the iron source for biological activity including hemoglobin formation, may be increased. The ferrous glycinate liposomes may be a kind of promising iron fortifier.

Preparation and Characterization of Tea Polyphenols and Vitamin E Loaded Nanoscale Complex Liposome

The purpose of the present work was to prepare nanoscale complex liposome loaded both aqueous soluble drug tea polyphenols (TP) and insoluble drug vitamin E (VE) by reverse-phase evaporation method. The preparation formulation of TP-VE complex liposome was optimized by the orthogonal experiment. The entrapment efficiency of TP was (50.81 +/- 1.91)% while that of VE was (94.05 +/- 3.45)% for the optimal formulation. The results of penetration experiments of TP-VE liposome demonstrated a slight influence of the concentration of TP and the content of cholesterol on the penetration quantity of TP. These results indicate that the complex liposome offers a new approach to entrap aqueous soluble drug and poorly soluble drug, an inner liposome protection, a relatively high drug encapsulation efficiency and a sustained transdermal penetration.

Determination and pharmacokinetic profile of liposomal foscarnet in rabbit ocular tissues after intravitreal administration

The treatment of ocular diseases affecting the posterior segment of the eye, such as cytomegalovirus (CMV) retinitis, requires the access of the drugs to the vitreous humor. Foscarnet inhibits replication of herpesviruses, including CMV. The drug's encapsulation in liposomes is meant not only to increase activity and to prolong the effect of the drug, but also to reduce its toxicity. The aims of the present study were to evaluate foscarnet levels and its pharmacokinetic parameters in vitreous humor and retinal tissue of rabbits after the administration of an intravitreal injection of both liposomal foscarnet and foscarnet commercial solution. Liposomes were prepared by the reverse-phase evaporation method. The amount of encapsulated foscarnet (F) was 63% wt. The in vitro diffusion assays showed that F was released more slowly when formulated in liposomes than in the commercial solution. The in vivo studies showed that, as opposed to commercial solution F, liposomal F achieves stable and durable therapeutic levels in retina, going beyond 72h, reaching the vitreous humor with adequate levels to accomplish the aims of intravitreal therapy. Lyophilization also increased stability and dispersion of liposomes in aqueous medium, although not improving the pharmacokinetic results over those from non-lyophilized liposomes.

Effect of ampicillin and chloroquine on humoral immune response elicited by bovine albumin encapsulated in liposomes

Immune suppression resulting from chemoprophylaxis and potential drug interaction were investigated in experimental animals pre-medicated with ampicillin and chloroquine followed by immunization with bovine serum albumin bearing liposomes prepared by the reverse phase evaporation method. The prepared liposomes were evaluated for particle size, entrapment efficiency and in vitro release. Humoral immune response was measured in terms of systemic IgG antibody titre by the ELISA method. The present study showed that 7:3 molar ratio of soya phosphatidylcholine and cholesterol produced liposomes of mean diameter of 235.4 +/- 10.3 nm and entrapment efficiency of 41.3 +/- 3.2%. Ampicillin significantly (p < 0.05) decreased the antibody titre whereas chloroquine did not reduce the antibody titre significantly. The study will help in programming a new drug management and in characterization of vaccine-drug interaction.

Preparation of Alendronate Liposomes for Enhanced Stability and Bioactivity: In Vitro and In Vivo Characterization

Liposomes containing bisphosphonates have been shown to deplete circulating monocytes and reduce experimental restenosis. However, acceptable shelf life was not achieved, and the disruption extent and rate of the vesicles in the circulation has not been examined. Designing an optimal liposomal formulation in general, and for an anti-inflammatory effect in particular, requires careful consideration of the factors that contribute to their in vitro stability and integrity in the blood after injection. An improved liposomal alendronate formulation was prepared by a modified thin lipid film hydration technique followed by extrusion, resulting in relatively smaller size vesicles, narrow size distribution, and low drug to lipid ratio in comparison to the reverse phase evaporation method. In order to rule out premature leakage of the drug, the integrity of the vesicles was examined by means of size-exclusion chromatography in vitro and in vivo, with subsequent analysis of size, drug (fractions of encapsulated and free) and lipid concentrations. Vesicles were found to be stable in serum, with 15 +/- 3% leakage of the drug after 10 min in rabbit's circulation, and intact liposomes were detected in the circulation 24 h following administration. It is concluded that the new formulation results in increased stability (2.5 years) as determined by the insignificant changes in vesicle size, drug leakage, lipid and drug stability, in vitro bioactivity (macrophages inhibition), as well as in vivo in depleting circulating monocytes and inhibition of restenosis in rabbits. Our in vitro stability results regarding dilution in serum paralleled in vivo data. Thus, in vitro assessment may provide a valuable tool in assessing in vivo integrity of liposomal formulations.

Gel core liposomes: An advanced carrier for improved vaccine delivery

Many sub-unit vaccines are successful in preventing the occurrence of disease, but their use is largely restrained due to low immunogenicity. Novel carrier-based vaccine could serve as a vaccine adjuvant to overcome low immunogenicity of sub-unit vaccines. The use of liposomes as a delivery system for antigen is well recognized but they are unstable and release of antigen from them cannot be controlled over a prolonged period of time. To overcome the limitation of liposomes, this study has developed gel core liposomes in which a core of polymer was incorporated inside the liposomal vesicles, which serve the function of skeleton and provide mechanical strength to vesicles. In the present investigation BSA-loaded gel core liposomes were prepared by reverse phase evaporation method and characterized for vesicles size, shape, entrapment efficiency, in vitro release and stability studies. The in vivo studies to evaluate antigen presenting potential of the gel-core liposomes was performed in Balb/c mice by measuring the immune response elicited by intramuscular administration of BSA-loaded gel core liposomes and compared with intramuscularly administered BSA-loaded conventional liposomes, alum adsorbed BSA and plain antigen. Results indicate that intramuscular immunization with gel core liposomes induces efficient systemic antibody responses against BSA as compared to other formulations. The gel core liposomal formulation provides good entrapment efficiency, enhanced in vitro stability, prolonged antigen release and effective immunoadjuvant property, justifying its potential for improved vaccine delivery.

Calorimetric and EPR studies of the thermotropic phase behavior of phospholipid membranes

Transmission electron micrographs (TEM) showed that liposome vesicles prepared from DL-α-phosphatidylcholine dimyristoyl (1,2-ditetradecanoyl-rac-glycerol-3-phosphocholine) (DMPC) by the modified reverse-phase evaporation method (mREV) were spherical in shape and in majority of them were less than 100 nm in diameter. Differential scanning calorimetry (DSC) method was used to determine the influence of cholesterol content and pH of Tris-HCl buffer used for the preparation of liposomes on the temperature of phase transition T C of phospholipids which form the investigated liposome vesicles. The use of DSC method made it possible to determine not only the temperature of the main phase transition of phospholipids but also the temperature of the phospholipid phase transition from the tilted gel phase(L β′) to the ripple gel phase(P β′). The results were compared with those obtained with EPR study. EPR study was carried out in the temperature range from 284 to 310 K i.e. below and above the phase transition temperature T C of DMPC. On the basis of EPR spectra of spin marker 2,2,6,6-tetramethyl-1-piperidinyloxy (TEMPO) incorporated into the liposome, the values of parameters f were determined. Hence TEMPO can be used to observe the change in partition between aqueous and fluid lipid regions. The change in the relative values of f determined for DMPC as a function of temperature shows that this phospholipid undergoes a transition from a ‘gel phase’ to a lamellar smectic liquid crystalline phase in the presence of excess water. The EPR study of TEMPO allowed us to determine the transition temperature T C. The results were compared with those obtained with DSC method.

Development of chitosan‐coated liposomes for sustained delivery of tamarind fruit pulp’s extract to the skin

In this study, chitosan-coated liposomes were developed. To entrap lyophilized tamarind extract containing alpha-hydroxy acids (AHAs) together with tartaric acid, the reverse phase evaporation method was used to obtain well-formed liposomes loaded with the extract. The highest entrapment efficiency of 68.3 +/- 3.0% into the liposomes was obtained with liposomes consisting of phosphatidylcholine and cholesterol in a molar ratio of 2 : 1 after the extrusion process. The average particle size of the prepared liposomes was 158 +/- 26 nm showing a negative zeta potential of -6 mV. For the preparation of the chitosan-coated liposomes, two selected independent parameters were varied: chitosan concentrations of 0.1, 0.5 and 1.0% w/v and volumes of the chitosan solutions of 1, 2 and 3 mL, to study the effects of such parameters on the entrapment efficiency of the extract-loaded liposomes. Variation in the volumes of the chitosan solution did not affect the entrapment efficiency of the liposomes. However, the entrapment efficiency of the AHAs in the chitosan-coated liposomes significantly increased with increasing chitosan concentrations. The size of the chitosan-coated liposomes was in the range of 200-300 nm with a positive zeta potential in the range of 6-29 mV. An in vitro release study using dialysis technique was performed to evaluate the release profile of the tartaric acid from the chitosan-coated liposomes. The obtained results showed the effect of the chitosan-coated liposomes on the lower release rate and on the amount of tartaric acid in comparison with that of the uncoated liposomes. The study in an in vitro skin cell model indicated that the developed system could enhance the potential of tamarind's AHAs on the stimulation of human keratinocyte proliferation being two-fold higher than the solution of the tamarind extract.

Conventional and Dense Gas Techniques for the Production of Liposomes: A Review

The aim of this review paper is to compare the potential of various techniques developed for production of homogenous, stable liposomes. Traditional techniques, such as Bangham, detergent depletion, ether/ethanol injection, reverse-phase evaporation and emulsion methods, were compared with the recent advanced techniques developed for liposome formation. The major hurdles for scaling up the traditional methods are the consumption of large quantities of volatile organic solvent, the stability and homogeneity of the liposomal product, as well as the lengthy multiple steps involved. The new methods have been designed to alleviate the current issues for liposome formulation. Dense gas liposome techniques are still in their infancy, however they have remarkable advantages in reducing the use of organic solvents, providing fast, single-stage production and producing stable, uniform liposomes. Techniques such as the membrane contactor and heating methods are also promising as they eliminate the use of organic solvent, however high temperature is still required for processing.

Poly(propyleneimine) dendrimer and dendrosome mediated genetic immunization against hepatitis B

The purpose of the present research work is to explore the potential of dendrosomes in genetic immunization against hepatitis B. Plasmid DNA encoding pRc/CMV-HBs[S] (5.6 kb), encoding the small region of the hepatitis B surface antigen, was complexed with 5th generation poly(propyleneimine) dendrimer (PPI) in different ratios. Transfection of CHO cells revealed that a ratio of 1:50 for pDNA:PPI was optimum for transfection. Results of cytotoxicity studies showed that the toxicity of PPI–DNA complex was significantly ( p < 0.05) higher for PPI 75 and PPI 100 as compared to the other PPI–DNA complexes. PPI 50 was employed for preparation of dendrosomes by reverse phase evaporation method. The dendrosomal formulation DF3 was found to possess optimum vesicle size, zeta potential and entrapment efficiency. In vitro production of HBsAg in CHO cells showed that DF3 possess maximum transfection efficiency. In vivo immunization studies were carried out by giving a single intramuscular injection of 10 μg of plasmid DNA (pDNA) or its dendrimeric or dendrosomal formulation to female Balb/c mice, followed by estimation of total IgG, IgG 1, IgG 2a, IgG 2b, biweekly. DF3 was found to elicit maximum immune response in terms of total IgG and its subclasses under study as compared to PPI 50 and pDNA at all time points. Animals immunized with DF3 developed very high cytokine level. Higher level of IFN-γ suggests that the immune response was strictly Th1 mediated. Our observations clearly prove the superiority of dendrosomes over PPI–DNA complex and pDNA for genetic immunization against hepatitis B.

Application of NMR and UV spectroscopy in the study of interactions between anticancer drugs and their phospholipid carriers

The aim of this work was to encapsulate two drugs: 1-β- d-arabinofuranosylcytosine (Ara-C) with the amphiphilic properties and 5-fluorouracil (5-FU) with the hydrophobic properties into liposomes prepared by the modified reverse-phase evaporation method (mREV) from l-α-phosphatidylcholine dipalmitoyl (DPPC). Both drugs are used together in the anticancer multidrug therapy. We studied the competition for their encapsulation in liposomes by the use of two spectroscopies: 1H NMR and UV on the basis of the analysis of the signals of each drug in the liposome–drug system. We concluded that the mREV method allows us to obtain liposomes which may transport more than one drug simultaneously. The NMR and UV studies of the drug competitive encapsulation and transport in liposomes formed from DPPC by the mREV method should be the basis for the analysis of the changes which may occur in vivo.

A liposome immune lysis assay for enrofloxacin in carp and chicken muscle

A homogenous complement-mediated liposome immune lysis assay (LILA) was developed for the determination of enrofloxacin (ENRO) in carp and chicken muscle. ENRO was covalently coupled to DPPE, and then immobilized onto the surface of liposomes by reverse-phase evaporation method. The performed liposome would be specifically lysed by the sequential additions of anti-ENRO monoclonal antibody (MAb) and guinea pig complement. Through a competitive assay format, the performed liposome can be used to detect ENRO in a range of 5.0–20 ng mL −1 in assay buffer. The limit of detection of ENRO in carp and chicken muscle was 1 ng g −1 and the limit of quantification was 2 ng g −1. Recoveries ranged from 58.3% to 65.2% for carp and 55.6–63.8% for chicken muscle at spiked levels of 2–8 ng g −1, with intra-assay and inter-assay variations 5.6–12.3% and 7.1–19.2%, respectively.

Sucrose stearate-based proniosome-derived niosomes for the nebulisable delivery of cromolyn sodium

A Novel approach was developed for the preparation of controlled release proniosome-derived niosomes, using sucrose stearates as non-ionic biocompatible surfactants for the nebulisable delivery of cromolyn sodium. Conventional niosomes were prepared by a reverse phase evaporation method followed by the preparation of proniosomes by spraying the optimized surfactant–lipid mixture of sucrose stearate, cholesterol and stearylamine in 7:3:0.3 molar ratio onto the surface of spray dried lactose powder. Proniosome-derived niosomes were obtained by hydrating proniosomes with 0.9% saline at 50 °C and mixing for approximately 2 min. All vesicles were evaluated for their particle size, morphological characteristics, entrapment efficiency, in vitro drug release, nebulisation efficiency and physical stability at 2–8 °C. In addition, coating carrier surface with the surfactant–lipid mixture, during preparation of proniosomes, resulted in smaller, free flowing, homogenous and smooth vesicles with high drug entrapment efficiency. Compared to a standard drug solution, a successful retardation of the drug release rate was achieved with the proniosome-derived niosomes, where the t 50% value of the release profile was 18.1 h compared to 1.8 h. Moreover, high nebulisation efficiency percentage and good physical stability were also achieved. The results are very encouraging and offer an alternative approach to minimize the problems associated with conventional niosomes like degradation, sedimentation, aggregation and fusion.

Radiolabeling, pharmacoscintigraphic evaluation and antiretroviral efficacy of stavudine loaded 99mTc labeled galactosylated liposomes

The study was aimed to optimize radiolabeling with 99mTc, to determine the antiretroviral activity and to study the biodistribution of 99mTc labeled galactosylated liposomes loaded with stavudine. Liposomes were prepared using reverse-phase evaporation method followed by extrusion through 200 nm polycarbonate membranes. The galactosylated liposomes were assessed for in vitro ligand-specific activity and the aggregation of galactosylated liposomes was found to increase as lectin concentration was increased from 5 μg/ml to 30 μg/ml. Free stavudine and stavudine loaded plain and galactosylated liposomes were radiolabeled with 99mTc by direct labeling method using stannous chloride as a reducing agent. Labeling method was optimized for stannous chloride quantity to achieve maximum labeling efficiency >95%. Antiretroviral activity was determined using human immunodeficiency virus-1 (HIV) infected MT2 cell line. A dose-dependent inhibition of p24 production was observed upon treatment of HIV-1 infected MT2 cells with stavudine loaded liposomes and galactosylated liposomes. Scintigraphic imaging and quantitative biodistribution of 99mTc labeled drug and liposomes showed that liposomal formulations were better taken up by the liver and spleen. Free drug solution was cleared from the blood. Further, a significantly higher ( P < 0.05) liver and spleen retention was observed over a period of 24 h in case of galactosylated liposomes as compared to free drug and plain liposomes. Reduced uptake of the galactosylated liposomes in bone and higher and prolonged accumulation in mononuclear phagocyte system (MPS)-rich organs indicates the excellent potential of this formulation in the treatment of HIV infection.