Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children

Background Combination antiretroviral therapy (cART) is associated with marked immune reconstitution. Although a long term viral suppression is achievable, not all children however, attain complete immunological recovery due to persistent immune activation. We use CD4/CD8 ratio like a marker of immune reconstitution. Methods Perinatal HIV-infected children who underwent a first-line cART, achieved viral suppression in the first year and maintained it for more than 5 years, with no viral rebound were included. Logistic models were applied to estimate the prognostic factors, clinical characteristics at cART start, of a lower CD4/CD8 ratio at the last visit. Results 146 HIV-infected children were included: 77% Caucasian, 45% male and 28% CDC C. Median age at cART initiation was 2.3 years (IQR: 0.5-6.2). 42 (30%) children received mono-dual therapy previously to cART. Time of undetectable viral load was 9.5 years (IQR: 7.8, 12.5). 33% of the children not achieved CD4/CD8 ratio >1. Univariate analysis showed an association between CD4/CD8 <1 with lower CD4 nadir and baseline CD4; older age at diagnosis and at cART initiation; and a previous exposure to mono-dual therapy. Multivariate analysis also revealed relationship between CD4/CD8 <1 and lower CD4 nadir (OR: 1.002, CI 95% 1.000-1.004) as well as previous exposure to mono-dual therapy (OR: 0.16, CI 95% 0.003-0.720). Conclusions CD4/CD8 > 1 was not achieved in 33% of the children. Lower CD4 nadir and previous exposure to suboptimal therapy, before initiating cART, are factors showing independently association with a worse immune recovery (CD4/CD8 < 1)

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time, and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space. While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes, vast areas of the tropics remain understudied. In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity, but it remains among the least known forests in America and is often underrepresented in biodiversity databases. To worsen this situation, human-induced modifications may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge, it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Riparian Deforestation Affects the Structural Dynamics of Headwater Streams in Southern Brazilian Amazonia

Comparative studies of streams with altered versus conserved riparian zones are important to evaluate the degree of alterations caused by inappropriate use of these streams’ vital buffer zones. The aim of this study was to determine the impact of riparian deforestation on the habitat structure of southern Brazilian Amazonian headwater streams, as well as to provide elements for impact assessment and the monitoring of these water bodies. We selected ten sites and two headwater streams at each site; one stream was located in an area with preserved riparian vegetation (pristine streams) and the other stream in a deforested riparian zone (altered streams). Stretches of these streams were analyzed across hydrological periods (dry period, beginning of the rainy period, and end of the rainy period) for hydro-morphological aspects, water physical-chemical variables, and habitat integrity (proportion of forestation in buffer zones and habitat integrity index). Compared to pristine streams in all the hydrological periods analyzed, altered streams presented lower oxygen concentration (~1.0 mg/L), an increase of 1 °C in water temperature, and less organic material availability. We found that riparian deforestation affects habitat structure variability among hydrological periods, making them more homogeneous. Therefore, beyond the necessary broadening of the spatial scale of studies in this region, monitoring these understudied headwater stream environments is also crucial for determining the magnitude of deforestation effects on these vulnerable aquatic ecosystems. © Monica Elisa Bleich, Amanda Frederico Mortati, Thiago André and Maria Teresa Fernandez Piedade