Inflammation-modulating cytokine profile and lipid interaction in HIV-related risk factors for cardiovascular diseases

Elizabeth Gori,1,2 Takafira Mduluza,3,4 Mudavanhu Nyagura,2 Babill Stray-Pedersen,5 Zvenyika Alfred Gomo1 1Chemical Pathology Department, College of Health Sciences, 2Preclinical Veterinary Studies Department, Faculty of Veterinary Sciences, 3Biochemistry Department, University of Zimbabwe, Harare, Zimbabwe; 4School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; 5Institute of Clinical Medicine, University in Oslo, Oslo University Hospital, Oslo, Norway Abstract: HIV infection and antiretroviral therapy (ART) are associated with changes in plasma levels of lipoproteins, thus posing the risk of cardiovascular complications in infected individuals. The alteration in plasma lipoprotein levels results from dysregulation of inflammation-modulating cytokines that control lipid metabolism. Little is understood regarding the relationship between the cytokines and serum lipid levels, which have been reported to be altered in adults receiving ART. The objective of this study was to describe the profiles of inflammation-modulating cytokines and their relationship to lipids as cardiovascular disease (CVD) risk factors in HIV infection. This observational cross-sectional study measured plasma levels of interleukin (IL)-10, tumor necrosis factor-alpha (TNF)-α, IL-4, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-c) in HIV-infected and uninfected adults. A total of 219 HIV-infected participants were enrolled from an HIV treatment center; of them, 187 were receiving ART and 32 were ART naïve, while 65 were HIV-uninfected blood donors. HIV-infected individuals had higher levels of IL-10 (HIV-infected ART-naïve [P=0.0024] and ART-receiving [P=0.033]) than their uninfected counterparts. ART-naïve subjects had significantly higher plasma levels of IL-10 than ART-receiving subjects (P=0.0014). No significant difference was observed in plasma levels of IL-4 and TNF-α across the three groups. Regarding plasma lipoproteins, HDL-c levels were reduced in HIV ART-naïve (P=0.002) and ART-receiving (P=0.015) subjects compared to HIV-uninfected subjects. Similarly, TC levels were lower in the HIV-infected than in the HIV-uninfected group regardless of whether the patients were undergoing ART or not (P<0.001). IL-10 levels correlated with TC levels in the HIV-uninfected group but not in the HIV-infected groups. Levels of HDL-c were reduced, while IL-10 plasma concentrations were elevated in HIV-infected individuals. A correlation observed in HIV-uninfected individuals between anti-inflammatory cytokine IL-10 and TC was lost in HIV-infected individuals. Clinical significance of these differences needs to be ascertained with respect to HIV-related CVD risk. Keywords: HIV, inflammation, cytokines, antiretroviral therapy, cardiovascular disease ris

Adult Hematology and Clinical Chemistry Laboratory Reference Ranges in a Zimbabwean Population

Laboratory reference ranges used for clinical care and clinical trials in various laboratories in Zimbabwe were derived from textbooks and research studies conducted more than ten years ago. Periodic verification of these ranges is essential to track changes over time. The purpose of this study was to establish hematology and chemistry laboratory reference ranges using more rigorous methods.A community-based cross-sectional study was carried out in Harare, Chitungwiza, and Mutoko. A multistage sampling technique was used. Samples were transported from the field for analysis at the ISO15189 certified University of Zimbabwe-University of California San Francisco Central Research Laboratory. Hematology and clinical chemistry reference ranges lower and upper reference limits were estimated at the 2.5th and 97.5th percentiles respectively.A total of 769 adults (54% males) aged 18 to 55 years were included in the analysis. Median age was 28 [IQR: 23-35] years. Males had significantly higher red cell counts, hemoglobin, hematocrit, and mean corpuscular hemoglobin compared to females. Females had higher white cell counts, platelets, absolute neutrophil counts, and absolute lymphocyte counts compared to males. There were no gender differences in eosinophils, monocytes, and absolute basophil count. Males had significantly higher levels of urea, sodium, potassium, calcium, creatinine, amylase, total protein, albumin and liver enzymes levels compared to females. Females had higher cholesterol and lipase compared with males. There are notable differences in the white cell counts, neutrophils, cholesterol, and creatinine kinase when compared with the currently used reference ranges.Data from this study provides new country specific reference ranges which should be immediately adopted for routine clinical care and accurate monitoring of adverse events in research studies

Sefficiency of a water use system: the case of Kano River irrigation project, Nigeria

Northern Nigeria is part of the semi-arid region of Africa experiencing water scarcity. The ever increasing population and climate change have placed a considerable pressure on Kano River Irrigation Project (KRIP), a major water user on Kano River, the most upstream tributary of Yobe River flowing directly to Lake Chad which is an important transboundary basin in West Africa. Performance of KRIP was evaluated using meso-level of the new and innovative Sefficiency (sustainable efficiency) framework, which incorporates quantity, quality, and beneficial aspects of water use in a comprehensive and systemic manner. Two major stakeholders were contacted, namely, farmers and water managers, and their views on the value of water flows were registered through interviews. The results indicated that useful consumption relative to effective consumption of farmers is significantly lower than management, showing a higher relative consumptive impact on both KRIP and Kano River. In addition, the useful outflow per unit of useful inflow is lower according to the farmers relative to the managers. Water managers underscore the importance of pollution impacts, give relevance in allocating water to downstream users including environmental flows, and contributing to groundwater recharge, whereas farmers do not. Flawed classical efficiency in use globally gives much lower values than mesoefficiency. For proper policy analysis in KRIP, the paper recommends using meso-efficiency with technologies to derive better data and to educate farmers on the importance of pollution and return flow.This work is partially financed by the Portuguese Foundation for Science and Technology (FCT) under the contract UID/ECI/04047/2013 for the Centre of Territory, Environment and Construction (CTAC). The support provided by the management of Hadejia-Jama’are River Basin Development Authority (H-JRBDA) and farmers in Kano River Irrigation Project (KRIP) especially Abdulkadir Abdulmalik and those that participated in the survey are duly acknowledged. Moreover, the authors thank the anonymous reviewers for their helpful comments.info:eu-repo/semantics/publishedVersio