Viral Counts Research Articles

Distribution and antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with HIV in the era of universal test and treat policy in Uganda.

Despite the increased frequency of oropharyngeal candidiasis among people living with human immunodeficiency virus (HIV), its management is no longer effective due to empirical treatment and emergence of antifungal resistance (AFR). This study sought to investigate the prevalence of oropharyngeal candidiasis and assess the antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with human immunodeficiency virus. Additionally, we evaluated the correlation between oropharyngeal candidiasis and CD4 T cell as well as viral load counts. A descriptive cross-sectional study was carried out from April to October 2023 in which 384 people living with HIV underwent clinical examination for oral lesions. Oropharyngeal swabs were collected and cultured on Sabouraud Dextrose agar to isolate Candida species which were identified using the matrix assisted laser desorption ionization time of flight mass spectrometry. Additionally, the antifungal susceptibility profile of Candida isolates to six antifungal drugs was determined using VITEK® (Marcy-l'Étoile, France) compact system. Data on viral load were retrieved from records, and CD4 T cell count test was performed using Becton Dickinson Biosciences fluorescent antibody cell sorter presto. The prevalence of oropharyngeal candidiasis was 7.6%. Oropharyngeal candidiasis was significantly associated with low CD4 T cell count and high viral load. A total of 35 isolates were obtained out of which Candida albicans comprised of 20 (57.1%) while C. tropicalis and C. glabrata comprised 4 (11.4%) each. C. parapsilosis, C. dubliniensis and C. krusei accounted for 2 (5.7%) each. Additionally, 7 (20%) isolates were resistant to fluconazole, 1 (2.9%) to flucytocine and 0.2 (5.7%) isolates were intermediate to caspofungin. However, specific specie isolates like C. albicans showed 20% (4/20), C. glabrata 50% (2/4) and C. krusei 50% (1/2) resistance to fluconazole. Additionally, C. krusei showed 50% resistance to flucytosine. The prevalence of oropharyngeal candidiasis (OPC) among people living with HIV was low, and there was a significant association between OPC and CD4 T cell count as well as viral load. C. albicans was the most frequently isolated oropharyngeal Candida species. C. glabrata and C. krusei exhibited the highest AFR among the non-albicans Candida species. The highest resistance was demonstrated to fluconazole.

Human Immunodeficiency Virus-1 Drug Resistance Mutations in Iranian Treatment-experienced Individuals.

Human immunodeficiency virus-1 infection still remains a global health threat. While antiretroviral therapy is the primary treatment option, concerns about the emergence of drug-resistance mutations and treatment failure in HIV-infected patients persist. In this study, we investigated the development of drug resistance in HIV-1-infected individuals receiving antiretroviral therapy for 6-10 years. In this cross-sectional study, we evaluated 144 people living with HIV-1 who had received antiretroviral therapy for at least 6 years. Plasma specimens were collected, and the HIV-1 viral load and drug-resistance mutations were assessed using molecular techniques. The demographic and epidemiological characteristics of the participants were also analyzed: Twelve [8.3%) of the studied patients showed a viral load over 1000 copies per/mL, which indicates the suboptimal response to antiretroviral therapy. Significant correlations were found between viral load and CD4 count, as well as epidemiological factors, such as vertical transmission, history of imprisonment, and needle stick injuries. Drug resistance mutations were detected in 10 (83.3%) of patients who failed on antiretroviral therapy, with the most common mutations observed against nucleoside reverse transcriptase inhibitors (5 (41.7%)) and non-nucleoside reverse transcriptase inhibitors (9 (75%)). Phylogenetic analysis revealed that 12 patients who failed treatment were infected with CRF35_AD. Our study provides important insights into the characteristics and development of drug resistance in HIV-1-infected individuals receiving long-term antiretroviral therapy in Iran. The findings underline the need for regular viral load monitoring, individualized treatment selection, and targeted interventions to optimize treatment outcomes and prevent the further spread of drug-resistant strains.

ЭФФЕКТИВНОСТЬ МОДЕЛИ ДЕЦЕНТРАЛИЗАЦИИ МЕДИЦИНСКОЙ ПОМОЩИ ЛЮДЯМ, ЖИВУЩИМ С ВИЧ, С ИНТЕГРАЦИЕЙ ВИЧ УСЛУГ В ПМСП ДУШАНБЕ

Objective: To evaluate the model of decentralization of medical care for people living with HIV (PLHIV), with the integration of HIV services into primary health care (PHC) by comparing the virologic efficacy of antiretroviral therapy (ART) between Dushanbe urban health centers (UHCs) and the Republican Center for AIDS Prevention and Control (RCAPC). Methods: The research was conducted using a cross-sectional design, with information gathered from the electronic HIV monitoring system and outpatient records of individuals living with HIV who were over 18 years old. The research examined clinical data on 220 patients (female-to-male sex ratio of 48:52) who were over 18 years old, had been on ART for more than two years, and was seen at 15 UHCs in Dushanbe, as well as 190 patients (female-to-male sex ratio of 48:52) from the RCAPC. The patients were categorized by age into three groups: 18-39, 40-49, and 50+ years. The study's objective was to assess these patients' viral load (VL) and CD4 counts in 2022. Descriptive statistics, computation of variable values, and correlation analysis were conducted, and a 95% confidence level interval was established for the variable considering VL suppression. The statistical significance of differences between data in groups was assessed using the Chi-square test (χ2 ) and Fisher's exact test (p). Results: Suppressed VL in patients was observed in 95.3% (p>0.05; 95% CI: 92.5-98.1) and 90.6% (p>0.05; 95% CI: 86.5-94.7) of cases in Dushanbe UHCs and at the RCAPC, respectively. In the meantime, unsuppressed VL was observed in 4.7% and 9.4% of cases in UHCs and at the RCAPC, respectively. In patients aged 18-39, 40-49, and 50+, suppressed VL was seen in 90%, 96%, and 99% at the UHCs, and the RCAPC – 93%, 90%, and 90% (p>0.05; p>0.05; p<0.05 respectively). CD4 counts of less than 350 cells/mm3 were found in 20.1% and 25.7% of patients in UHCs and at the RCAPC, respectively. In patients with viral hepatitis C (HCV), CD4 counts of less than 350 cells/mm3 were found in 37.7% and 23.2% of patients in UHCs and at the RCAPC, respectively. Spearman's rank correlation coefficient, denoted as rs , indicated a strong relationship between the proportions of HCV and CD4 counts of <350 cells/mm3 in different age subgroups within the UHCs and the RCAPC, with a correlation coefficient of 1.00 and a p-value of 0.01 in both groups. Conclusion: In Dushanbe's UHCs, the treatment of HIV patients with ART is more effective than at the RCAPC due to high patient adherence, resulting in VL suppression similar to 95-95-95 targets in the new UNAIDS Global AIDS Strategy (2021-2026). The proximity of HIV services to patients' homes likely contributes to treatment adherence, demonstrating the success of decentralized HIV care through integrated services in PHC in Dushanbe, Tajikistan. Keywords: HIV infection, people living with HIV, antiretroviral therapy, suppressed viral load, integration of HIV services, primary health care.

Do respiratory virus infections modify associations of asthma exacerbation with aeroallergens or fine particulate matter? A time series study in Philadelphia PA

ABSTRACT Respiratory virus infections are related to over 80% of childhood asthma exacerbations. They enhance pro-inflammatory mediator release, especially for sensitized individuals exposed to pollens/molds. Using a time-series study design, we investigated possible effect modification by respiratory virus infections of the associations between aeroallergens/PM2.5 and asthma exacerbation rates. Outpatient, emergency department (ED), and inpatient visits for asthma exacerbation among children with asthma (28,540/24,444 [warm/cold season]), as well as viral infection counts were obtained from electronic health records of the Children’s Hospital of Philadelphia from 2011 to 2016. Rate ratios (RRs, 90th percentile vs. 0) for late-season grass pollen were 1.00 (0.85–1.17), 1.04 (0.95–1.15), and 1.12 (0.96–1.32), respectively, for respiratory syncytial virus (RSV) counts within each tertile. However, similar trends were not observed for weed pollens/molds or PM2.5. Overall, our study provides little evidence supporting effect modification by respiratory viral infections.

COVID-19 Testing Among People with HIV: A Population Level Analysis Based on Statewide Data in South Carolina.

People with HIV (PWH) are at an elevated risk of developing severe COVID-19 outcomes because of compromised immunity and more comorbidities. However, existing literature suggests a lower rate of COVID-testing among PWH. This study aimed to explore the temporal trend of county-level COVID-19 testing rate and multi-level predictors of COVID-19 ever-testing among PWH in South Carolina (SC). Leveraging linked statewide HIV and COVID-19 datasets, we defined the study population as all adult (18 + years) PWH who were alive on March 2020 and living in SC. PWH with a COVID-19 testing record between March 2020 and October 2021 were defined as COVID-19 ever-testers. Logistic regression and generalized mixed models were used to investigate the association of PWH's demographic profile, HIV clinical characteristics (e.g., CD4 count, viral load), comorbidities, and social factors with COVID-19 testing among PWH. Among 15,660 adult PWH, 8,005 (51.12%) had ever tested for COVID-19 during the study period (March 2020-October 2021). PWH with older age, being male, and Hispanics were less likely to take COVID-19 testing, while men who have sex with men or injection drug users were more likely to take COVID-19 testing. PWH with higher recent viral load (10,000-100,000 copies/ml vs. <200 copies/ml: adjusted odds ratio [AOR]: 0.64, 95%CI: 0.55-0.75) and lower CD4 counts (> 350 cells/mm3 vs. <200 cells/mm3: AOR: 1.25, 95%CI: 1.09-1.45) had lower odds for COVID-19 testing. Additionally, PWH with lower comorbidity burden and those living in rural areas were less likely to be tested for COVID-19. Differences in COVID-19 test-seeking behaviors were observed among PWH in the current study, which could help provide empirical evidence to inform the prioritization of further disease monitoring and targeted intervention. More efforts on building effective surveillance and screening systems are needed to allow early case detection and curbing disease transmission among older, male, Hispanic, and immune-suppressed PWH, especially in rural areas.

Demographics of Youth With Newly Diagnosed Acute/Recent HIV Infection in Adolescent Trials Network 147: Early Treatment of Acute HIV Infection

PurposeGay, bisexual, and other cisgender men who have sex with men, and racial minority youth are at elevated risk of acquiring HIV infection. The Adolescent Trials Network 147 recruited youth with acute/recent HIV-infection for early antiretroviral treatment. The cohort make-up is described here. MethodsTreatment-naïve, recently identified HIV + youth, aged 12–24 years, from Los Angeles and New Orleans were recruited from community centers, clinics, social media, and a high-risk seronegative cohort (n = 1,727, the Adolescent Trials Network 149) using point-of-care assays. Acute HIV infection was determined by Fiebig staging. HIV RNA viral load (VL) and CD4 cell counts, along with demographic and behavioral data were assessed at enrollment. ResultsBetween July 2017 and July 2021, 103 newly diagnosed youth were enrolled, initiating antiretroviral treatment within a week. Mean age was 20.8 years (standard deviation: 2.4); 90.3% identified as cis male, 83.5% were single or in casual relationships, 71.8% were gay, bisexual, and other cisgender men who have sex with men; 60.2% were Black. One-fourth (24.3%) reported homelessness ever; 10.7% within last 4 months. At enrollment, median plasma VL was 37,313 HIV RNA copies/ml (interquartile range: 5,849–126,162) and median CD4 count 445.5 cells/mm3 (interquartile range: 357–613). 40% of youth reported acute retroviral symptoms before or at enrollment. Acutely infected, seroconverting youth had the highest VL. Sexually transmitted coinfections were present at enrollment in 56% of the cohort, with syphilis being most frequent (39%). DiscussionEarly identification and treatment of HIV can increase positive HIV outcomes. A high sexually transmitted infection burden was present in recently HIV-infected youth. Acute retroviral symptoms were not reported by most participants, demonstrating that broad universal HIV screening is needed for identification of recent infection in youth.

Treatment-naïve people living with HIV aged 50 years or older in Beijing, China, 2010-2020: joinpoint regression model analysis of surveillance data.

As they age, people living with HIV (PLWH) must face new challenges, such as accelerated ageing and higher rates of comorbidities. This study described the characteristics of HIV acquisition among treatment-naïve PLWH aged ≥50 years and <50 years in Beijing from 2010 to 2020, exploring associated risk factors for comorbidities. In this cross-sectional study, differences in HIV-related and non-HIV-related characteristics were compared using the t-test, Mann-Whitney U test and chi-square test. Temporal trend data were analysed via joinpoint regression. A multivariate logistic regression model was conducted to analyse the associated factors with PLWH having one or more comorbidities. The proportion of PLWH aged ≥50 years has significantly increased since 2013, with a corresponding increase in homosexual transmission in this age group over the past decade. The proportion of individuals with CD4 counts <200 cells/μl significantly decreased from 2010 to 2013 among PLWH aged ≥50 years and from 2010 to 2014 among those aged <50 years. Delayed initiation of antiretroviral therapy (ART) improved for both age groups over the course of the decade, especially from 2014 to 2020. Compared to PLWH aged <50 years, those aged ≥50 years had a higher proportion of CD4 counts <200 cells/μl, higher levels of plasma HIV RNA load and a higher prevalence of non-HIV-related risk factors. Multivariate analysis revealed that PLWH aged ≥50,male, not single, transmission through heterosexual contact or drug injection, WHO Stage IV, coinfection with hepatitis B virus/hepatitis C virus and CD4 counts <200 cells/μl at the initiation of ART were associated with higher risk of the presence of an HIV comorbidity. Due to the persistent burden of HIV-related characteristics or symptoms and the increasing prevalence of coexisting comorbidities among treatment-naïve PLWH aged ≥50 years, physicians should provide the highest-quality screening, prevention, treatment and management of coexisting comorbidities, adopting a multidisciplinary approach.

HIV Type-1 Genotyping in the Context of the COVID-19 Pandemic: A Critical Tool for Identifying Antiretroviral Drug Resistance and Optimizing Treatment Strategies

Abstract Introduction/Objective The COVID-19 pandemic strained the healthcare system and the WHO recently reported increased rates of antibiotic resistance. Meanwhile, antiretroviral resistance can also lead to treatment failure and disease progression, especially in HIV patients. Here, we investigated the rates of HIV drug resistance (HIVDR) in our HIV population between pre and post-COVID-19 eras. Methods/Case Report The post-COVID-19 era began on 03/11/2020. Patients positive for HIV-1 between 01/2019- 08/2021 were included (total: 94 patients, 46 pre-COVID-19; 48 post-COVID-19). Patients’ charts were reviewed for demographics, laboratory results (including HIV-1 sequencing/genotyping (e.g., Genosure)), clinical presentation and management. Student t-test and Fisher exact test were calculated. Results (if a Case Study enter NA) Most patients were male (70%) and had a mean age of 49 years. 70% of patients had sufficient viral loads in samples reflexed to HIV genotyping. Post-COVID-19 patients harbored lower viral loads (1.8x105 vs. 3.4x105 copies/mL, p=0.05), CD4 counts (174 vs. 196 cells/mcL, p=0.7), CD8 counts (555 vs. 800 cells/mcL, p=0.04), and higher CD4/CD8 ratio (0.312 vs. 0.266, p=0.57). Overall, 20% of patients had HIVDR. Following COVID-19 pandemic, there was a 9% increase in HIVDR, predominantly seen in non-nucleotide reverse transcriptase inhibitors (NNRTI), although insignificant. Specifically, high resistance was documented for drugs Efavirenz (16%), Nevirapine (16%), and Rilpivirine (13%). We observed an increased prevalence of G190A, K101, K103, and E138 mutations conferring resistance to NNRTIs. Changes to therapy were observed in 47.8% (42/88) of total cases, with an increase of 12.5% in patients from post-COVID-19 era. Additionally, changes to therapy were observed more in patients with infectious diseases consultation (16% increase). Conclusion Increasing HIVDR was seen in our patient population post-COVID-19. Continued surveillance is critical to managing HIVDR and improving patient outcomes. The clinical utility of sequencing tests can outweigh the cost if results are appropriately acted upon which may involve the participation of other clinical teams and the antimicrobial stewardship committee.

Screening of hepatitis B and C viral infection, recognition of risk factors, and immunization of patients against hepatitis B virus: a module developed for effective hepatitis control.

The continually increasing incidence of hepatitis, a worldwide health issue, in Pakistan, has highlighted the need to investigate the epidemiology factors and implement preventive measures accordingly. The purpose of this study was to scrutinize the prevalent and significantly associated risk factors of hepatitis in students and employees, screening them for hepatitis B and C virus and vaccinating them against HBV to make IUB hepatitis free. A total of 12,912 participants including students (n = 10,948) and employees (n = 1964) were screened for HBV and HCV via immunochromatographic test. Hepatitis- positive participants' blood samples were further tested and viral load was estimated by quantitative PCR. All the hepatitis-negative participants were vaccinated against HBV. The demographic and risk factors-related data were collected using the questionnaire. Statistical analysis (Chi-square test and bivariate regression analysis) was performed using SPSS software to explore any association between risk factors and hepatitis. Results indicated that 662/12912 participants (students = 478/10,948, employees = 184/1,964) tested positive for hepatitis. Among them, HCV was observed to be more prevalent than HBV among the study participants, employees, and students, and viral count was low in both HBV and HCV-infected participants. However, men were more affected than women. The studied risk factors represented higher frequency among hepatitis-positive participants relative to the hepatitis-negative participants. The Chi-square test revealed that students' gender, history of hepatitis in the family and relatives, dental treatment, sharing cosmetics and shaving blades were significant (p > 0.005) risk factors of hepatitis while in the employees group surgery and age were significant. Moreover, the reused of syringes was found to be associated with hepatitis in both groups. The bivariate analysis helped to identify various new risk factors which were independently, either positively or negatively, associated with hepatitis. Our study enabled us to recognize different risk factors of hepatitis among the target population. The information thus generated can be usefully applied in planning hepatitis awareness, targeted screening, and effective control programs for other target populations. In general, this module can be further utilized for any other disease.

Bipolar ionization rapidly inactivates real-world, airborne concentrations of infective respiratory viruses.

The SARS-CoV-2 (COVID-19) pandemic has highlighted the urgent need for strategies that rapidly inactivate airborne respiratory viruses and break the transmission cycle of indoor spaces. Air ions can reduce viable bacteria, mold, and virus counts, however, most studies use small test enclosures with target microbes and ion sources in close vicinity. To evaluate ion performance in real-world spaces, experiments were conducted in a large, room-size BSL-3 Chamber. Negative and positive ions were delivered simultaneously using a commercially available bipolar air ion device. The device housed Needle Point Bipolar ionization (NPBI) technology. Large chamber studies often use unrealistically high virus concentrations to ensure measurable virus is present at the trial end. However, excessively high viral concentrations bias air cleaning devices towards underperformance. Hence, devices that provide a substantial impact for protecting occupants in real-world spaces with real-world virus concentrations are often dismissed as poor performers. Herein, both real-world and excessive virus concentrations were studied using Influenza A and B, Human Respiratory Syncytial Virus (RSV), and the SARS-CoV-2 Alpha and Delta strains. The average ion concentrations ranged from 4,100 to 24,000 per polarity over 60-minute and 30-minute time trials. The reduction rate was considerably greater for trials that used real-world virus concentrations, reducing infectivity for Influenza A and B, RSV, and SARS-CoV-2 Delta by 88.3-99.98% in 30 minutes, whereas trials using in-excess concentrations showed 49.5-61.2% in 30 minutes. These findings strongly support the addition of NPBI ion technology to building management strategies aimed to protect occupants from contracting and spreading infective respiratory viruses indoors.

Flow Virometry: A Fluorescence-Based Approach to Enumerate Bacteriophages in Liquid Samples.

Correctly designed flow cytometry (virometry) assays allow accurate detection and enumeration of viruses in water. However, rigorous controls and calibrators are needed to obtain quality data. In the absence of proper controls, the use of fluorescent dyes for virus enumeration can produce false positive signals and lead to the wrong estimation of total virus counts by misreporting colloid particles as virions. Here we describe a protocol that addresses the problems that might potentially confound virometry data accuracy.

Honduras HIV cohort: HLA class I and CCR5-Δ32 profiles and their associations with HIV disease outcome.

We identify both canonical and novel human leukocyte antigen (HLA)-HIV associations, providing a first step toward improved understanding of HIV immune control among the understudied Honduras Mestizo population. Our results are relevant to understanding the protective or detrimental effects of HLA subtypes in Latin America because their unique HLA diversity poses challenges for designing vaccines against HIV and interpreting results from such vaccine trials. Likewise, the description of the HLA profile in an understudied population that shows a unique HLA immunogenetic background is not only relevant for HIV immunology but also relevant in population genetics, molecular anthropology, susceptibility to other infections, autoimmune diseases, and allograft transplantation.

Prevalence of apical periodontitis in people living with HIV in southern Brazil

This cross-sectional study aimed to describe the prevalence of apical periodontitis (AP) in people living with HIV (PLHIV) over 50 years old and explore its association with sociodemographic, medical, and oral characteristics. Data from 59 PLHIV were collected, and the periapical area of 1018 teeth was evaluated through periapical radiographs (Rx) using Periapical Index (PAI). Presence and quality of root fillings and restorations (coronal fillings and crowns) were also assessed in the Rx; presence of caries was based on Rx and clinical data. Viral load (VL) and T-CD4 count were also evaluated. The prevalence of AP in individuals was 71%, and 8% of the teeth presented AP. Family income &gt;5 Brazilian minimum wage (OR=0.06, 95% CI=0.005-0.62) and having at least one root-filled tooth (OR=14.55, 95% CI=1.45-145.72) were associated with the prevalence of AP, whereas VL and T-CD4 were not. The presence of caries, root filling, and restorations were associated with the presence of AP in a tooth. PLHIV presented a high prevalence of AP, but intrinsic factors related to HIV infection were not associated with AP in the studied subjects. PLHIV would benefit from oral health policies to prevent AP, as the results indicates that the endodontic disease in the present sub-population could be related to social problems.

Atmospheric PM2.5 before and After Lockdown in Relation to COVID-19 Evolution and Daily Viral Counts: Could Viral Natural Selection Have Occurred due to Changes in the Airborne Pollutant PM2.5?

Background: Genes coding for SARS-CoV-2 have been detected on the microscopic airborne pollutant particulate matter, which has been suggested as a vector and co-factor for COVID-19 transmission. Lockdown in China has been shown to be associated with significant reduction in pollution including the particulate matter component which coincided with the appearance of a viral mutant (Clade G) which steadily displaced the original Clade D after lockdown. The reason why Clade G developed a fitness advantage is as yet unknown. This paper examines the possible role of airborne particulate matter PM2.5 as selective pressure determining viral Clade predominance and further shedding light on the mode of SARS-CoV-2 transmission. Methods: The average levels of PM2.5 of a number of cities were obtained from the Air Quality Index (AQI), a real-time assessment of atmospheric pollution. The daily average PM2.5 levels were assessed between January 23rd and April 29th 2020 determined by the timeline when viral counts in Beijing and other cities were available. Daily viral counts of Clades D and G were available starting from the 12th February as determined by the scientific literature published in August 2020. The cities chosen were Beijing, Sheffield, Nottingham, Sydney and Cambridge because of their substantially elevated viral counts compared to other cities. Cities as opposed to vaster areas/nations were chosen as PM2.5 levels vary across regions and countries. Results: For the time period assessed, the Beijing PM2.5 pattern initiated with highly elevated mean PM2.5 levels of 147.5µg/ m3 (SD+/-70.5) during high viral counts, followed by 98.5µg/m3 (SD+/-50.7) (p&lt;0.007) when the viral counts decreased. In all the other cities assessed, the pattern differed whereby the PM2.5 levels increased significantly over the preceding baseline contemporaneously with the viral count rise. The changes in these cities’ PM2.5 levels were on average 34.4µg/m3 before viral counts rose and 46.0µg/m3 contemporaneous with viral count rise. As regards the viral counts from data retrieved from Beijing, the latter part of the bell-shaped curve and a subsequent smaller curve of the viral count was available for evaluation. The average viral count for Clade D in Beijing was 11.1(SD+/-13.5) followed by a mean viral count for Clade G was 13.8(SD+/- 9.2). Conversely in all the other cities besides Beijing, the viral counts averaged 45.8 for Clade D and 161 for Clade G. The variation in viral counts between cities suggests the strong possibility of variation in the availability of sampling between cities. The newer variant, Clade G demonstrated viral counts initially appearing in mid-February in Beijing to later displace Clade D as the dominant viral Clade. The appearance of Clade G coincided with the decreasing gradient of PM2.5 levels. A number of significant correlations were obtained between PM2.5 levels and the viral count in all the cities reviewed. Conclusion: COVID-19 viral counts appear to increase concomitant with increasing PM2.5 levels. Viral counts of both Clades correlated differentially with PM2.5 levels in all the cities assessed. The significantly highly elevated PM2.5 levels in Beijing resulted in correlating mainly with Clade D, however Clade G began to appear with decreasing PM2.5 levels, suggesting the beginnings for the initial SARS-CoV-2 Clade evolution. Clade G, the newer variant was able to flourish at lower levels of PM2.5 than Clade D. Clade G may possibly have utilized other sources of particulate matter as a viral vector, and co-factor such as that derived from tobacco smoking, whereby 66% of Chinese males are smokers and 70% of the Chinese non-smoking population are exposed to 2nd hand smoking.

Prevalence of polypharmacy and pharmacotherapy complexity in elderly people living with HIV in Spain. POINT study

ObjectiveTo determine the prevalence of polypharmacy in persons living with HIV of at least 65 years of age receiving antiretroviral treatment. A characterization of antiretroviral treatment, as well as a determination of the prevalence of comorbidities; of the most common types of concomitant medication; of adherence rates; of the pharmacotherapeutic complexity; and of drug-drug interactions were also among the goals of the study. MethodTh is was a multi-center, cross-sectional observational study that included persons living with HIV aged 65 years or more who were on active antiretroviral treatment. Demographic, clinical (viral load, CD4 count and comorbidities) and pharmacotherapeutic (type of antiretroviral treatment: single tablet regimen, polypharmacy [six active ingredients or more] and major polypharmacy [11 active ingredients or more] variables were considered). Adherence to antiretroviral treatment was measured by dispensation records and the Simplified Medication Adherence Questionnaire, while adherence to concomitant medication was measured using dispensation records and the Morisky-Green questionnaire. The Medication Regimen Complexity Index was calculated. Drug-drug interactions were analyzed using the Liverpool and Lexicomp databases. ResultsSeventy-four patients (86.5% male) were included, with a median age of 69 years (66.7-72.0). The sexual route was the most common route of transmission of the disease (67.6%). The virus was undetectable in 89.2% of patients; the CD4 count was over 200/mL in 94.6% of the sample. The median number of comorbidities was 3.5 (2.0-5.0), 52.7% of them being cardiovascular; 50.0% related to the central nervous system; 176% hepatic; and 8.1% consisting in chronic pulmonary disease. A total of 81.1% of patients received triple therapy and 48.6% single tablet regimen. The median number of concomitant drugs administered was 5.0 (2.0-70), polypharmacy was observed in 71.6% of cases and major polypharmacy in 25.7%. Antihypertensive and cardiovascular drugs were prescribed to 56.8% of patients, lipid-lowering drugs to 50.0%, antiulcer agents to 33.8% and psychoactive drugs to 32.4%. According to dispensation records, adherence to antiretroviral treatment was 85.1% and to concomitant medication 62.8%. The median Medication Regimen Complexity Index for the whole treatment was 13.0 (8.0-176). Potential drug-drug interactions were observed in 55.4% of patients and contraindicated interactions in 12.2%. ConclusionsElderly persons living with HIV exhibit a high prevalence of polypharmacy, pharmacotherapeutic complexity, poor adherence and drug-drug interactions. For that reason, pharmacotherapeutic optimization must be a priority in these patients.

Exploring Tomato Fruit Viromes through Transcriptome Data Analysis.

This study delves into the complex landscape of viral infections in tomatoes (Solanum lycopersicum) using available transcriptome data. We conducted a virome analysis, revealing 219 viral contigs linked to four distinct viruses: tomato chlorosis virus (ToCV), southern tomato virus (STV), tomato yellow leaf curl virus (TYLCV), and cucumber mosaic virus (CMV). Among these, ToCV predominated in contig count, followed by STV, TYLCV, and CMV. A notable finding was the prevalence of coinfections, emphasizing the concurrent presence of multiple viruses in tomato plants. Despite generally low viral levels in fruit transcriptomes, STV emerged as the primary virus based on viral read count. We delved deeper into viral abundance and the contributions of RNA segments to replication. While initially focused on studying the impact of sound treatment on tomato fruit transcriptomes, the unexpected viral presence underscores the importance of considering viruses in plant research. Geographical variations in virome communities hint at potential forensic applications. Phylogenetic analysis provided insights into viral origins and genetic diversity, enhancing our understanding of the Korean tomato virome. In conclusion, this study advances our knowledge of the tomato virome, stressing the need for robust pest control in greenhouse-grown tomatoes and offering insights into virus management and crop protection.

COVID-19 hospitalizations and deaths predicted by SARS-CoV-2 levels in Boise, Idaho wastewater

The viral load of COVID-19 in untreated wastewater from Idaho's capital city Boise, ID (Ada County) has been used to predict changes in hospital admissions (statewide in Idaho) and deaths (Ada County) using distributed fixed lag modeling and artificial neural networks (ANN). The wastewater viral counts were used to determine the lag time between peaks in wastewater viral counts and COVID-19 hospitalizations as well as deaths (14 and 23 days, respectively). Quantitative measurement of SARS-CoV-2 viral RNA counts in the untreated wastewater was determined three times a week using RT-qPCR over a span of 13 months. To mitigate the effects of PCR inhibitors in wastewater, a series of dilution tests were conducted, and the 1/4 dilution was used to generate the most successful model. Wastewater SARS-CoV-2 viral RNA counts and hospitalization from June 7, 2021 to December 29, 2021 were used as training data to predict hospitalizations; and wastewater SARS-CoV-2 viral RNA counts and deaths from June 7, 2021 to December 20, 2021 were used as training data to predict deaths. These training data were used to make predictive ANN models for future hospitalizations and deaths. To the best of our knowledge, this is the first report of prediction of deaths from COVID-19 based on wastewater SARS-CoV-2 viral RNA counts using machine learning-based multilayered ANN. The applied modeling demonstrates that wastewater surveillance data can be combined with hospitalizations and death data to generate machine learning-based ANN models that predict future COVID-19 hospital admissions and deaths, providing an early warning for medical response teams and healthcare policymakers.

Pulmonary Function in HIV-Infected Children at a Tertiary Care Hospital in North India: A Prospective Cross-Sectional Study.

Background The global burden of HIV remains significant, particularly in India. Antiretroviral therapy (ART) has improved outcomes for children with HIV, yet understanding the virus's impact on respiratory health is essential. Pulmonary complications, common in HIV-infected adults, are poorly understood in children. Despite India's high HIV prevalence, data on pediatric lung function are lacking. This study aims to evaluate spirometry-based pulmonary function in perinatally HIV-infected children, exploring associations with disease severity, immune status, and other factors. Methods This prospective cross-sectional study conducted in a North Indian tertiary care hospital aimed to assess pulmonary function using spirometry in children (6-18 years) with HIV infection. Ethical approval and informed consent were secured. Data on demographics, clinical history, CD4+ T-cell counts, and viral load were collected. Certified respiratory therapists performed spirometry using standardized protocols. Descriptive statistics were computed, and differences in pulmonary function based on CD4+ T-cell counts, viral load, and opportunistic infection were analyzed. The study adhered to ethical guidelines and maintained participants' confidentiality. Results This cross-sectional study enrolled 57 children (mean age 13.6±3.2 years) with HIV infection. Age distribution was <9 years (24.6%), 9-11 years (28.1%), and >11 years (47.4%). Males constituted 56.1%. The mean BMI was 15.92±2.78 kg/m². HIV viral load (87.23±56.28 copies/μL) and CD4 count (1146.32±103.98 cells/mm³) were recorded. ART duration averaged 6.21±1.36 years. Viral load groups were <1 (52.6%), 1-1000 (26.3%), and >1000 copies/μL (21.1%). CD4 categories were >500 cells/mm³ (47.4%), 200-499 (42.1%), and <200 cells/mm³ (10.5%). Spirometry showed 71.9% normal and 28.1% abnormal (mild/moderate obstruction: 18.8%, mild/moderate restriction: 81.3%). No significant spirometric differences were observed among CD4 or viral load groups (p>0.05), nor with opportunistic infections (p>0.05). Conclusion This study reveals complex associations between spirometric parameters and CD4 count, viral load, and opportunistic infections in children with HIV. Further research, including longitudinal studies, is needed to unravel the intricate interplay and improve management strategies for this population.

Development and Validation of a Three-Parameter Scoring System for Monitoring HIV/AIDS Patients in Low-Resource Settings Using Hematological Parameters.

This study aimed to test the validity of a composite score using complete blood count (CBC) for monitoring HIV patients receiving antiretroviral therapy (ART) in the absence of viral load and CD4 count. This retrospective cohort study analyzed the laboratory data of 82 HIV patients who had pre- and post-treatment viral load, CD4 count, and CBC data. Pre- and post-treatment data were pooled to analyze the correlation of CBC parameters with Polymerase Chain Reaction (PCR) ranks and their performance in indicating a CD4 count<200 cells/mm3 using the Operating Characteristics Curve (ROC), with the determination of cutoffs. A score combining the significant parameters was tested to predict a CD4 count of <200. Total lymphocyte count (TLC), percentage (TLP), and hemoglobin concentration (Hb) were the most significant parameters, showing negative correlations with PCR (Spearman's Rho = -0.357 to -0.242). The risk of acquired immunodeficiency syndrome (AIDS) was independently associated with TLC<1345 cells/mm3 (OR=2.92), TLP<29.07% (OR=3.53), and Hb<10.55 mg/dL (OR=3.60). A combined score of 2-3 indicated a CD4 count<200 with an odds ratio of 8.3-86.7. The proposed 3-parameter score combining the use of TLC, TLP, and Hb, is an affordable and practical approach that may have clinical utility in monitoring HIV patients receiving ART in low-resource settings.

Assessments of viral load and haematological parameters in HIV patients on HAART in Ilorin, Kwara state

Human immune deficiency virus (HIV) infection represents the most common cause of acquired immune deficiency and leads to clinical disease referred to as Acquired Immune Deficiency Syndrome (AIDS). Highly active antiretroviral therapies (HAART) are the gold standard for the management of HIV disease. Viral load indicates that treatment is effective. A high viral load in a person on treatment indicates either that the medication is not being taken properly or that the virus is becoming resistant to the medication. This is a comparative study aimed at assessing the Viral load count and haematological parameters. 120 HIV positive individual and 40 HIV negative subjects were recruited for this study,while haematological parameters were carried out using Sysmex KX-21 analyser. Results was analyzed using SPSS version 20. .Our result shows the following mean absolute counts of haematological parameters; lymphocyte count of HIV positive persons to be 1.42±1.82, Neutrophil 1.64±2.80, Monocyte 0.07±0.08, Basophil 0.05±0.06 Eosinophil 1.71±3.42 while the mean value of TWBC 5.130±1.43, RBC 3.97±0.48, HB 11.41±1.65, MCV 87.054±15.59 and MCHC MCHCf/l, compared to 0.78±0.08, 1.10±0.32, 0.06±0.02, 0.01±0.01 and 1.14±3.42 respectively among the HIV negative individual. In conclusion, we found that the use of antiretroviral drugs could positively or negatively affect haematological parameters, depending on the choice of combination used.