Unsafe Sex and Increased Incidence of Hepatitis C Virus Infection among HIV-Infected Men Who Have Sex with Men: The Swiss HIV Cohort Study

Background. Data on the incidence of hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-infected persons are sparse. It is controversial whether and how frequently HCV is transmitted by unprotected sexual intercourse. Methods. We assessed the HCV seroprevalence and incidence of HCV infection in the Swiss HIV Cohort Study between 1988 and 2004. We investigated the association of HCV seroconversion with mode of HIV acquisition, sex, injection drug use (IDU), and constancy of condom use. Data on condom use or unsafe sexual behavior were prospectively collected between 2000 and 2004. Results. The overall seroprevalence of HCV infection was 33% among a total of 7899 eligible participants and 90% among persons reporting IDU. We observed 104 HCV seroconversions among 3327 participants during a total follow-up time of 16,305 person-years, corresponding to an incidence of 0.64 cases per 100 person-years. The incidence among participants with a history of IDU was 7.4 cases per 100 person-years, compared with 0.23 cases per 100 person-years in patients without such a history (P < .001). In men who had sex with men (MSM) without a history of IDU who reported unsafe sex, the incidence was 0.7 cases per 100 person-years, compared with 0.2 cases per 100 person-years in those not reporting unsafe sex (P = .02), corresponding to an incidence rate ratio of 3.5 (95% confidence interval, 1.2-10.0). The hazard of acquiring HCV infection was elevated among younger participants who were MSM. Conclusions. HCV infection incidence in the Swiss HIV Cohort Study was mainly associated with IDU. In HIV-infected MSM, HCV infection was associated with unsafe se

Modeling the Halpha line emission around classical T Tauri stars using magnetospheric accretion and disk wind models

Spectral observations of classical T Tauri stars show a wide range of line profiles, many of which reveal signs of matter inflow and outflow. Halpha is the most commonly observed line profile due to its intensity, and it is highly dependent on the characteristics of the surrounding environment of these stars. Our aim is to analyze how the Halpha line profile is affected by the various parameters of our model which contains both the magnetospheric and disk wind contributions to the Halpha flux. We used a dipolar axisymmetric stellar magnetic field to model the stellar magnetosphere and a modified Blandford & Payne model was used in our disk wind region. A three-level atom with continuum was used to calculate the required Hydrogen level populations. We use the Sobolev approximation and a ray-by-ray method to calculate the integrated line profile. Through an extensive study of the model parameter space, we have investigated the contribution of many of the model parameters on the calculated line profiles. Our results show that the Halpha line is strongly dependent on the densities and temperatures inside the magnetosphere and the disk wind region. The bulk of the flux comes, most of the time, from the magnetospheric component for standard classical T Tauri stars parameters, but the disk wind contribution becomes more important as the mass accretion rate, the temperatures and densities inside the disk wind increase. We have also found that most of the disk wind contribution to the Halpha line is emitted at the innermost region of the disk wind. Models that take into consideration both inflow and outflow of matter are a necessity to fully understand and describe classical T Tauri stars.Comment: 15 pages, 9 figures, accepted for publication in Astronomy & Astrophysics. Revised version with English correction

On the observability of T Tauri accretion shocks in the X-ray band

Context. High resolution X-ray observations of classical T Tauri stars (CTTSs) show a soft X-ray excess due to high density plasma (n_e=10^11-10^13 cm^-3). This emission has been attributed to shock-heated accreting material impacting onto the stellar surface. Aims. We investigate the observability of the shock-heated accreting material in the X-ray band as a function of the accretion stream properties (velocity, density, and metal abundance) in the case of plasma-beta<<1 in the post-shock zone. Methods. We use a 1-D hydrodynamic model describing the impact of an accretion stream onto the chromosphere, including the effects of radiative cooling, gravity and thermal conduction. We explore the space of relevant parameters and synthesize from the model results the X-ray emission in the [0.5-8.0] keV band and in the resonance lines of O VII (21.60 Ang) and Ne IX (13.45 Ang), taking into account the absorption from the chromosphere. Results. The accretion stream properties influence the temperature and the stand-off height of the shocked slab and its sinking in the chromosphere, determining the observability of the shocked plasma. Our model predicts that X-ray observations preferentially detect emission from low density and high velocity shocked accretion streams due to the large absorption of dense post-shock plasma. In all the cases examined, the post-shock zone exhibits quasi-periodic oscillations due to thermal instabilities, but in the case of inhomogeneous streams and beta<<1, the shock oscillations are hardly detectable. Conclusions. We suggest that, if accretion streams are inhomogeneous, the selection effect introduced by the absorption on observable plasma components may explain the discrepancy between the accretion rate measured by optical and X-ray data as well as the different densities measured using different He-like triplets in the X-ray band.Comment: 12 pages, 7 figures. Accepted for publication on A&

High Levels of Human Immunodeficiency Virus Type 1 in Blood and Semen of Seropositive Men in Sub-Saharan Africa

High levels of human immunodeficiency virus type 1 (HIV-1) replication, as reflected in HIV-1 RNA concentrations in blood and semen, probably contribute to both rapid disease progression and enhanced sexual transmission. Semen and blood were collected from 49 Malawian and 61 US and Swiss (US/Swiss) HIV-1.seropositive men with similar CD4 cell counts and no urethritis or exposure to antiretroviral drugs. Median seminal plasma and blood plasma HIV-1 RNA concentrations were > 3-fold (P = .034) and 5-fold (P = .0003) higher, respectively, in the Malawian men. Similar differences were observed in subsets of the Malawian and US/Swiss study groups matched individually for CD4 cell count (P = .035 and P <.002, respectively). These observations may help explain the high rates of HIV-1 sexual transmission and accelerated HIV-1 disease progression in sub-Saharan Afric

THERMAP: a mid-infrared spectro-imager for space missions to small bodies in the inner solar system

We present THERMAP, a mid-infrared (8-16 μm) spectro-imager for space missions to small bodies in the inner solar system, developed in the framework of the MarcoPolo-R asteroid sample return mission. THERMAP is very well suited to characterize the surface thermal environment of a NEO and to map its surface composition. The instrument has two channels, one for imaging and one for spectroscopy: it is both a thermal camera with full 2D imaging capabilities and a slit spectrometer. THERMAP takes advantage of the recent technological developments of uncooled microbolometers detectors, sensitive in the mid-infrared spectral range. THERMAP can acquire thermal images (8-18 μm) of the surface and perform absolute temperature measurements with a precision better than 3.5 K above 200 K. THERMAP can acquire mid-infrared spectra (8-16 μm) of the surface with a spectral resolution Δλ of 0.3 μm. For surface temperatures above 350 K, spectra have a signal-to-noise ratio >60 in the spectral range 9-13 μm where most emission features occur

Low pH immobilizes and kills human leukocytes and prevents transmission of cell-associated HIV in a mouse model

BACKGROUND: Both cell-associated and cell-free HIV virions are present in semen and cervical secretions of HIV-infected individuals. Thus, topical microbicides may need to inactivate both cell-associated and cell-free HIV to prevent sexual transmission of HIV/AIDS. To determine if the mild acidity of the healthy vagina and acid buffering microbicides would prevent transmission by HIV-infected leukocytes, we measured the effect of pH on leukocyte motility, viability and intracellular pH and tested the ability of an acidic buffering microbicide (BufferGel(®)) to prevent the transmission of cell-associated HIV in a HuPBL-SCID mouse model. METHODS: Human lymphocyte, monocyte, and macrophage motilities were measured as a function of time and pH using various acidifying agents. Lymphocyte and macrophage motilities were measured using video microscopy. Monocyte motility was measured using video microscopy and chemotactic chambers. Peripheral blood mononuclear cell (PBMC) viability and intracellular pH were determined as a function of time and pH using fluorescent dyes. HuPBL-SCID mice were pretreated with BufferGel, saline, or a control gel and challenged with HIV-1-infected human PBMCs. RESULTS: Progressive motility was completely abolished in all cell types between pH 5.5 and 6.0. Concomitantly, at and below pH 5.5, the intracellular pH of PBMCs dropped precipitously to match the extracellular medium and did not recover. After acidification with hydrochloric acid to pH 4.5 for 60 min, although completely immotile, 58% of PBMCs excluded ethidium homodimer-1 (dead-cell dye). In contrast, when acidified to this pH with BufferGel, a microbicide designed to maintain vaginal acidity in the presence of semen, only 4% excluded dye at 10 min and none excluded dye after 30 min. BufferGel significantly reduced transmission of HIV-1 in HuPBL-SCID mice (1 of 12 infected) compared to saline (12 of 12 infected) and a control gel (5 of 7 infected). CONCLUSION: These results suggest that physiologic or microbicide-induced acid immobilization and killing of infected white blood cells may be effective in preventing sexual transmission of cell-associated HIV

Horizontal supergranule-scale motions inferred from TRACE ultraviolet observations of the chromosphere

We study horizontal supergranule-scale motions revealed by TRACE observation of the chromospheric emission, and investigate the coupling between the chromosphere and the underlying photosphere. A highly efficient feature-tracking technique called balltracking has been applied for the first time to the image sequences obtained by TRACE (Transition Region and Coronal Explorer) in the passband of white light and the three ultraviolet passbands centered at 1700 {\AA}, 1600 {\AA}, and 1550 {\AA}. The resulting velocity fields have been spatially smoothed and temporally averaged in order to reveal horizontal supergranule-scale motions that may exist at the emission heights of these passbands. We find indeed a high correlation between the horizontal velocities derived in the white-light and ultraviolet passbands. The horizontal velocities derived from the chromospheric and photospheric emission are comparable in magnitude. The horizontal motions derived in the UV passbands might indicate the existence of a supergranule-scale magnetoconvection in the chromosphere, which may shed new light on the study of mass and energy supply to the corona and solar wind at the height of the chromosphere. However, it is also possible that the apparent motions reflect the chromospheric brightness evolution as produced by acoustic shocks which might be modulated by the photospheric granular motions in their excitation process, or advected partly by the supergranule-scale flow towards the network while propagating upward from the photosphere. To reach a firm conclusion, it is necessary to investigate the role of granular motions in the excitation of shocks through numerical modeling, and future high-cadence chromospheric magnetograms must be scrutinized.Comment: 5 figures, accepted by Astronomy & Astrophysic

Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya

Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18–25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrolment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.Vestergaard Frandse

Case Series of Fertility Treatment in HIV-Discordant Couples (Male Positive, Female Negative): The Ontario Experience

The success of combination antiretroviral therapies for the treatment of human immunodeficiency virus (HIV) has resulted in prolonged life expectancy (over 40 years from diagnosis) and an improved quality of life for people living with HIV. The risk of vertical HIV transmission during pregnancy has been reduced to less than 1%. As a result of these breakthroughs and as many of these individuals are of reproductive age, fertility issues are becoming increasingly important for this population. One population in which conception planning and reduction of horizontal HIV transmission warrants further research is HIV-discordant couples where the male partner is HIV-positive and the female partner is HIV-negative. Sperm washing is a technique carried out in a fertility clinic that separates HIV from the seminal fluid. Although sperm washing followed by intrauterine insemination significantly reduces the risk of horizontal HIV transmission, there has been limited access to the procedure in North America. Furthermore, little is known about the conception decision-making experiences of HIV-discordant couples who might benefit from sperm washing. Chart reviews and semi-structured interviews were completed with 12 HIV-discordant couples in Ontario, Canada. Couples were recruited through HIV clinics and one fertility clinic that offered sperm washing. Participants identified a number of factors that affected their decision-making around pregnancy planning. Access to sperm washing and other fertility services was an issue (cost, travel and few clinics). Participants identified a lack of information on the procedure (availability, safety). Sources of support (social networks, healthcare providers) were unevenly distributed, especially among those who did not disclose their HIV status to friends and family. Finally, the stigmatisation of HIV continues to have a negative affect on HIV-discordant couples and their intentions to conceive. Access to sperm washing and fertility service is significantly limited for this population and is accompanied with a number of challenges