Vitamin D Status among Pulmonary TB Patients and Non-TB Controls: A Cross-Sectional Study from Mwanza, Tanzania.

Little is known about vitamin D status in low-income populations burdened with infectious diseases. Hence, there is a need for data on correlates of serum 25-hydroxy vitamin D (S-25(OH)D) and its validity during infections. To assess the role of pulmonary TB (PTB) and HIV as correlates of S-25(OH)D. Age-sex-matched cross-sectional study among PTB patients and non-TB controls. PTB patients were categorized as sputum negative (PTB-) and positive (PTB+) by culture. Non-TB controls were randomly selected among age-sex-matched neighbours to PTB+ patients. Height, weight, arm circumference and triceps skinfold were measured, and body mass index (BMI), arm fat (AFA) and muscle area (AMA) computed. HIV status, and S-25(OH)D, C-reactive protein (S-CRP) and α1-acid glycoprotein (S-AGP) were determined. Linear regression analysis with controls and PTB patients combined was used to identify correlates of S-25(OH)D. S-25(OH)D data were available on 97.8% (1570) of 1605 participants. Mean (SD) S-25(OH)D was 84.4 (25.6) nmol/L with 39.6% <75 nmol/L among 347 non-TB controls. Time of recruitment, sex, PTB and HIV, and elevated S-AGP were correlates of S-25(OH)D. S-25(OH)D was 24.8 (95% CI 18.6;30.9) nmol/L higher in PTB compared to controls among females, but only 9.8 (95% CI:4.5;15.2) nmol/L among males (interaction p<0.0001). Females had 13.8 (95% CI:8.2;21.9) nmol/L lower S-25(OH)D than males, and HIV infected individuals had 8.5 (95% CI:4.9;12.1) higher S-25(OH)D compared to uninfected. Elevated S-AGP was a positive correlate of S-25(OH)D. Low BMI was associated with S-25(OH)D, but not with infections or S-AGP in the model. While S-25(OH)D may decline transiently during a mild acute phase response, it may increase if the acute phase response leads to loss of fat. The validity of S-25(OH)D as a marker of vitamin D status may be affected by infections

Mortality in Greenlanders with chronic hepatitis B virus infection

In‐depth reviewing of all medical records and clinical databases concluded a 7‐year shorter lifespan among Greenlanders infected with hepatitis B virus (HBV) compared with non‐infected. Mortality did not associate with liver disease or any other specific disease entity. A possible mechanism for the reduced lifespan is subclinical inflammation that may be augmented by chronic viral infection. We hypothesized that chronic HBV infection contributes to this process causing a reduced life span. We added measurement of two markers of inflammation to the 10‐year follow‐up on our study of HBV among 50‐ through 69‐years‐old subjects in Greenland. The markers were YKL40 related to liver disease and hsCRP as a global marker of inflammation. Survival was evaluated using Cox regression with time until death entered as dependent variable and age, sex, smoking, alcohol intake, BMI, the presence of HBsAg and one marker of inflammation as explanatory variables. Forty‐eight percent of participants with chronic HBV infection were alive after 10 years compared with 65% of participants without infection (p = 0.003). Survival associated with age (p < 0.001), BMI (p = 0.003) and both YKL40 and hsCRP (both, p < 0.001). Harbouring HBV influenced 10‐year survival in the Cox regression after adjusting for age, sex, BMI, smoking, alcohol intake and inflammation. In conclusion, chronic low‐grade inflammation and being infected with HBV were independent markers of mortality in otherwise healthy subjects. Thus, the 7‐year shorter lifespan among Greenlanders with chronic HBV infection seems related to the long‐lasting infection. Our findings call for caution in perceiving a chronic infection as benign

Log canonical pairs over varieties with maximal Albanese dimension

Let $(X,B)$ be a log canonical pair over a normal variety $Z$ with maximal Albanese dimension. If $K_X+B$ is relatively abundant over $Z$ (for example, $K_X+B$ is relatively big over $Z$), then we prove that $K_X+B$ is abundant. In particular, the subadditvity of Kodaira dimensions $\kappa(K_X+B) \geq \kappa(K_F+B_F)+ \kappa(Z)$ holds, where $F$ is a general fiber, $K_F+B_F= (K_X+B)|_F$, and $\kappa(Z)$ means the Kodaira dimension of a smooth model of $Z$. We discuss several variants of this result in Section 4. We also give a remark on the log Iitaka conjecture for log canonical pairs in Section 5.Comment: 24 pages. Some typos fixe