Experience with an ultrasound donation program in a low-income country

Increasing radiology capacity in low-income countries (LIC) can improve clinicians’ access to diagnostic imaging tools and improve patient care. Ultrasound (US) is important in LIC due to its lower cost compared to that of CT or MRI scans and its excellent diagnostic ability. The relative portability of the equipment makes it ideal for donation by charitable organizations. We describe our experience as a radiology-capacity-focused charity working with the Haitian healthcare system and propose strategies to increase ultrasound capacity in other poor countries

A highly virulent variant of HIV-1 circulating in the Netherlands

We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence