Current assays for HIV-1 diagnostics and antiretroviral therapy monitoring: challenges and possibilities

In 2011, there were over 34 million people living with HIV infections, placing a heavy burden on public health sectors. HIV infection is a lifelong threat that cannot be prevented by vaccination or cured by antiretroviral drugs. The infected patients rely on daily antiretroviral therapy to suppress HIV viral replication. Hence, it is important to diagnose HIV infections as early as possible and to monitor the efficacy of antiretroviral therapy every 3–6 months. Different immunoassays detecting HIV antigens and antibodies have been modified to offer better sensitivity and more rapid diagnosis. Several clinical and virological parameters, including CD4+ cell counts, viral load and drug resistance mutations, are also used for treatment monitoring. Many molecular assay optimizations are now being utilized to improve patient care. This review will focus on the most updated HIV diagnostic assays, as well as discussing the upcoming possibilities of other advanced technologies.postprin

Genomic structure, alternative splicing and tissue expression of rFrp/sFRP-4, the rat frizzled related protein gene

Secreted frizzled related proteins (sFRP) are regulators of Wnt signaling pathways that play central roles in developmental processes and oncogenesis. Various sFRP genes have been cloned from different tissues and implicated in diverse biological activities. rFrp, the rat homologue of sFRP-4, was initially identified as being upregulated in mutant p53-induced cellular transformation. Here, we report on the isolation of five novel splice variants, rFrp/sFRP-4 II, II, III, IVa and IVb. The complete rFrp/sFRP-4 genomic structure spans over 31 kb covering 9 exons. Except for the variant IVb, which was derived from IVa by alternative polyadenylation signal, variants I to IVa were alternatively spliced to different exons in the 3'end of mRNA and resulted in transcripts with truncated open reading frame. The deduced proteins of the variants had truncated C-termini, however, the two key functional protein domains, the cysteine-rich domain and the netrin-like domain of the isoforms, were not altered. In addition, different transcriptional initiation sites were found with variants II and IV, implying that these variants may be regulated differently from the rFrp/sFRP-4. RT-PCR analysis showed that these splice variants displayed different patterns of tissue-specific expression. Northern blot analysis revealed that the rFrp/sFRP-4 is most abundant in the ovary. Taken together, our findings suggest that alternative splicing of rFrp/sFRP-4 plays a role in regulating tissue-specific expression. The truncated C terminals of rFrp/sFRP-4 variants may confer structural specificity and hence exert different biological functions in different tissues. Characterization of these novel splice variants should help to elucidate the function of the sFRP family gene. © 2005 Elsevier B.V. All rights reserved.postprin

Performance Evaluation of the Verigene Gram-Positive and Gram-Negative Blood Culture Test for Direct Identification of Bacteria and Their Resistance Determinants from Positive Blood Cultures in Hong Kong

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The prevalence and characterization of verotoxin-producing Eschericha coli isolated from cattle and pigs in an abattoir in Hong Kong

The aim of the study was to define the prevalence of verotoxin-producing Escherichia coli (VTEC) in cattle and pigs in a Hong Kong abattoir. Faecal and carcass samples collected from 986 cattle and 487 pigs from an abattoir were tested for verotoxin (VT) by PCR and cytotoxicity assays. VTEC was isolated from 41.5 and 1.8% of cattle faecal and carcass samples and from 2.1 and 0.2% of porcine faecal and carcass samples, respectively. Amongst 409 VTEC isolates from cattle, 9 were serotype O157:H7 and eaeA+. The most prevalent vt genotype among bovine VTEC was vt1+ vt2+ (73.8%) and in porcine VTEC was vt2e+ (30%). None of the porcine VTEC isolates and 9.3% of the bovine VTEC isolates was eaeA+. The non-O157 serogroup VTEC isolates carrying eaeA and EHEC-hlyA belonged to serogroups O172, O15, O84, O91, O110 and O121. The local dietary preference for pork or chicken (rather than beef), the low VTEC carriage in pigs, the rarity of additional virulence factors (eaeA) in VTEC isolated from cattle may explain the apparently low incidence of human diarrhoeal disease associated with VTEC in Hong Kong hitherto. However, the presence of non-O157 VTEC strains carrying the eaeA virulence marker in cattle highlights the fact that sole reliance on sorbitol-MacConkey agar for screening human VTEC isolates may underestimate the human disease burden. The changing dietary habits of the population in Hong Kong reinforce the need for continued vigilance.published_or_final_versio

Vibrio cholerae O139 synonym Bengal in Hong Kong [12]

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Risk Factors for Development of Paradoxical Response During Antituberculosis Therapy in HIV-Negative Patients

The risk factors for development of paradoxical response were studied in a cohort of 104 patients with culture-documented Mycobacterium tuberculosis infection. Paradoxical deterioration occurred in 16 (15.4%) patients (case group) during antituberculosis therapy, involving lungs and pleura (n=4), spine and paraspinal tissue (n=5), intracranium (n=3), peritoneum (n=2), bone and joint (n=1), and lymph node (n=1). The median time from commencement of treatment to paradoxical deterioration was 56 days (range, 20-109 days). Compared with 53 patients without clinical deterioration after antituberculosis therapy (control group), patients with paradoxical response were more likely to have extrapulmonary involvement (62.5% vs. 17.0%; P<0.05) at initial diagnosis, to have lower baseline lymphocyte counts (672±315 cells/μl vs. 1,328±467 cells/μl; P<0.001), and to exhibit a greater surge in lymphocyte counts (627±465 cells/μl vs. 225±216 cells/ μl; P<0.05) during paradoxical response. Further studies on lymphocyte subsets and cytokine levels would be useful in understanding the exact immunological mechanisms involved in immunorestitution.postprin

Stable and low prevalence of transmitted HIV type 1 drug resistance despite two decades of antiretroviral therapy in Hong Kong

Transmitted HIV resistance is of both clinical and public health importance. Baseline genotypic resistance testing was performed for HIV-1-infected treatment-naive patients who were newly diagnosed between 2003 and 2007 and attended the government HIV clinic in Hong Kong. International AIDS Society-USA mutation figures and the Stanford resistance interpretation algorithm were used to identify resistance mutations and drug susceptibility, respectively. The pattern and factors associated with resistance were examined. The presence of one or more IAS-USA resistance mutations was found in 26 (3.6%) of 731 patients over the 5-year study period. Overall, protease inhibitor (PI) resistance mutations were most common (16), followed by nucleoside reverse transcriptase inhibitors (NRTIs) (8) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) (3). Resistance to drugs in one, two, and three classes was present in 25 (3.4%), 1 (0.1%), and 0, respectively. Seventy-eight (10.7%) had strains of reduced susceptibility, as predicted by the Stanford algorithm to display at least low-level resistance to one or more drugs of the three classes. Intermediate or high-level resistance was found in 1.6% overall, and in descending order for NRTIs, PIs, and NNRTIs. There was no temporal trend of increase in resistance. Sex between men, Chinese ethnicity, and lower baseline CD4 were associated with harboring resistant strains as elucidated by either method. We conclude that transmitted HIV-1 drug resistance is uncommon in up to two decades of antiretroviral therapy in Hong Kong. The situation has to be continually monitored for any change in significance. Copyright 2010, Mary Ann Liebert, Inc.published_or_final_versio

A unique strain of Escherichia coli O157:H7 that produces low verocytotoxin levels not detected by use of a commercial enzyme immunoassay kit

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Molecular epidemiology and phylogenetic analysis of minor HIV-1 subtypes in Hong Kong: Emergence and spread of CRF07_BC and subtype C

Paper Poster Session 3 - HIV/AIDS: PO552OBJECTIVES: HIV-1 subtype B and CRF01_AE are the pre-dominant strains in Hong Kong. A noticeable increase in non-B and non-AE infections has been observed in recent years. This study aimed to conduct a molecular epidemiological and phylogenetic analysis on CRF07_BC and subtype C to illustrate their transmission and spread in our locality. METHODS: HIV-1 partial pol sequences were available from a routine antiretroviral ...postprin

Model order reduction for multiband quantum transport simulations and its application to p-type junctionless transistors

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