Viral tropism by geno2pheno as a tool for predicting CD4 decrease in HIV-1-infected naive patients with high CD4 counts

OBJECTIVES: To investigate the value of tropism (determined by genotypic testing) to predict CD4 depletion in HIV-infected antiretroviral-naive patients with high CD4 counts. METHODS: Viral tropism was determined by geno2pheno (false positive rate\u200a=\u200a10%) in 223 HIV-infected subjects naive to antiretrovirals with CD4 count 65350 cells/\u3bcL and HIV-RNA >500 copies/mL enrolled in the ICONA Foundation Study for whom a stored plasma sample (baseline) was retrospectively tested. We monitored CD4 cell count and identified predictors of decline before antiretroviral therapy initiation, applying a mixed linear model with covariates (age, gender, tropism, HIV risk factor, calendar year of HIV infection, months from HIV diagnosis to baseline, hepatitis C virus status, CD4 and HIV-RNA at sample collection and duration of follow-up). RESULTS: Two hundred and twenty-three subjects met the eligibility criteria; 137 (61%) were male and the median age was 35 (31-40) years. Median follow-up was 16.4 (3.2-37.2) months. Median CD4 decrease during follow-up was -157 (-278 to -13) cells/\u3bcL. At baseline, 192 (86%) subjects were defined as harbouring R5 virus and 31 (14%) non-R5. Median CD4 count was 571 (458-729) cells/\u3bcL and median HIV-RNA was 4.08 (3.57-4.55) log(10) copies/mL. At multivariable analysis, a greater mean CD4 decrease was associated with non-R5 viral tropism (-159.9 \ub1 12.22, P = 0.0002) at baseline. Other significant covariates were female gender, older age, intravenous drug use, longer duration of follow-up, and higher CD4 cell count and higher HIV-RNA at sample collection. CONCLUSIONS: In patients with CD4 counts 65350 cells/\u3bcL, non-R5 viral tropism by geno2pheno is predictive of CD4 decrease independent of their viral set point and CD4 counts

HuGoS: A Multi-user Virtual Environment for Studying Human–Human Swarm Intelligence

The research topic of human–human swam intelligence includes many mechanisms that need to be studied in controlled experiment conditions with multiple human subjects. Virtual environments are a useful tool to isolate specific human interactions for study, but current platforms support only a small scope of possible research areas. In this paper, we present HuGoS—‘Humans Go Swarming’—a multi-user virtual environment in Unity, as a comprehensive tool for experimentation in human–human swarm intelligence. We identify possible experiment classes for studying human collective behavior, and equip our virtual environment with sufficient features to support each of these experiment classes. We then demonstrate the functionality of the virtual environment in simple examples for three of the experiment classes: human collective decision making, human social learning strategies, and agent-level human interaction with artificial swarms, including robot swarms.info:eu-repo/semantics/publishedDorigo, M. Stützle, T. Blesa, M. J. Blum, C. Hamann, H. Heinrich, M. K. & Strobel, V. (2020). Swarm Intelligence: 12th International Conference, ANTS 2020, Barcelona, Spain, October 26-28, 2020, Proceedings. Cham: Springer International Publishing AG. 978303060375

Início da terapia anti-retroviral em estágio avançado de imunodeficiência entre indivíduos portadores de HIV/AIDS em Belo Horizonte, Minas Gerais, Brasil Initiation of antiretroviral therapy in HIV-infected patients with severe immunodeficiency in Belo Horizonte, Minas Gerais State, Brazil

O objetivo deste trabalho foi verificar a proporção de início tardio da terapia anti-retroviral (TARV) e seus fatores associados. Estudo de corte transversal com pacientes de dois serviços públicos de referência (n = 310) em Belo Horizonte, Minas Gerais, Brasil. Atraso no início da TARV foi definido como ter contagem de linfócitos T CD4+ < 200 células/mm³ ou manifestação clínica de imunodepressão grave. A maioria era do sexo masculino (63,9%) e não possuía plano de saúde (76,1%). A proporção de início tardio da TARV foi 68,4%. Grande parte (75,2%) iniciou TARV < 120 dias após a primeira consulta médica. Estar desempregado, realizar anti-HIV por indicação de profissional de saúde, < 2 consultas no serviço até seis meses antes do início da TARV e tempo entre primeira consulta para o HIV e início da TARV < 120 dias estiveram associados de forma independente com início tardio da TARV. São necessários estudos que avaliem o custo-efetividade da realização do anti-HIV como teste de rastreamento da população geral. Facilitar o acesso dos pacientes com resultado positivo aos serviços de referência pode contribuir para a redução do número de pacientes que iniciam tardiamente a TARV.<br>The main objective was to assess the proportion of delayed initiation of antiretroviral therapy (ART) and associated factors. This was a cross-sectional study of 310 patients enrolled in two public health centers in Belo Horizonte, Minas Gerais State, Brazil. Delayed ART initiation was defined as starting treatment with a CD4 count lower than 200 cells/mm³ or clinical symptoms of severe immunodepression at the time of first antiretroviral prescription. The majority of participants were males (63.9%), had no health insurance (76.1%), and started ART less than 120 days after the first medical visit (75.2%). The proportion of delayed ART initiation was 68.4%. Unemployment, referral by a health professional for HIV testing, fewer than two medical visits in the six months prior to ART initiation, and time between first medical visit and ART initiation less than 120 days were independently associated with the outcome. Our results suggest that every patient 13 to 64 years of age should be offered HIV testing, which could increase the rate of early HIV diagnosis, and thus patients that tested positive could benefit from timely follow-up and antiretroviral therapy

Larval development of Angiostrongylus vasorum in the land snail Helix aspersa

The metastrongyloid nematode Angiostrongylus vasorum affects the heart and pulmonary arteries of dogs and wild animals. Over the recent years, dog angiostrongylosis has gained great attention in the veterinary community for the expansion of its geographic range and for a rise in the number of clinical cases. Global warming, changes in phenology of mollusc intermediate hosts and movements of wild reservoirs have been evocated in the spreading of mollusc-borne parasites, including A. vasorum. The land snail Helix aspersa, a vector of other respiratory metastrongyloids, is endemic in most regions of the World, where it is a pest outside its native Mediterranean range. In the present study, the susceptibility and suitability of H. aspersa as an intermediate host of A. vasorum were investigated along with the characteristics of larval recovery and development following two different ways of inoculation, i.e. experimental (group A) vs natural infection (group B). After infections, the snails were kept at environmental conditions for 2 months. Five snails from groups A and B were randomly selected, digested and examined at 15-day intervals for 2 months. L1s, L2s and L3s were microscopically identified based on key morphological and morphometric characteristics and their identity was genetically confirmed. The results showed that A. vasorum may reach the infective stage in H. aspersa and that uptake of larvae and parasitic burden within the snails depend on the grazing capability of the molluscs. Biological and epidemiological implications are discussed