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The international index of erectile function: development of an adapted tool for use in HIV-positive men who have sex with men
No full textABSTRACT Introduction. Erectile dysfunction is common in HIV-positive men who have sex with men (MSM). A standardized scale is needed to assess erectile function in clinical practice and research studies. Aim. The International Index of Erectile Function (IIEF) is a widely accepted tool for assessing erectile function designed for heterosexual men. We modified the tool for MSM. We present an analysis of internal consistency of the questionnaire in an HIV-positive cohort. Methods. The adapted questionnaire included modified questions within each of the five domains of the IIEF: (i) erectile function, (ii) intercourse satisfaction, (iii) orgasmic function, (iv) sexual desire, and (v) overall satisfaction with sex. MSM at seven European HIV treatment centers completed the questionnaire. Main Outcome Measures. Responses were analyzed for internal consistency using standardized Cronbach's alpha values within each of the five domains. A factor analysis was performed to confirm the domain structure of the questionnaire. Results. Data from 486 MSM were analyzed. The factor analysis supported the domain structure described. Questions about erectile function, orgasmic function, and sexual desire performed well, with Cronbach's alpha values of 0.82, 0.83, and 0.89, respectively. Questions concerning intercourse satisfaction were less consistent (Cronbach's alpha 0.55) because frequency of attempts at sexual intercourse did not correlate with other responses. Responses about satisfaction with sex with a regular partner diverged from satisfaction with overall sex life. Frequency of morning erections diverged from other aspects of erectile function, whereas erections with masturbation correlated better. Conclusions. Internal consistency was high overall. This tool is suitable for HIV-positive MSM and can be used in screening, research, and monitoring treatment response
HIV RNA suppression rates after 24 weeks of treatment with etravirine, darunavir/ritonavir and raltegravir in the etravirine early access programme [letter]
No full textBlood soluble human leukocyte antigen G levels are associated with human immunodeficiency virus type 1 infection in Beninese commercial sex workers
No full textHuman leukocyte antigen (HLA)-G is a powerful modulator of the immune response. The aim of this study was to investigate whether soluble HLA-G (sHLA-G) expression is associated with human immunodeficiency virus type 1 (HIV-1) infection. HIV-1-infected female commercial sex workers (CSWs) had significantly lower levels of plasma sHLA-G compared with those in both the HIV-1-uninfected CSW and the non-CSW groups. The presence of HLA-G*010101, HLA-G*010404 alleles, and the 3'-untranslated region (3'UTR) genetic variant at position 3,952 were all significantly associated with lower plasma sHLA-G levels in the HIV-1-infected CSWs, whereas the HLA-G 3'UTR 14-bp sequence insertion was also associated with lower plasma sHLA-G levels in the overall population. When adjustment was made for all significant variables, the reduced expression of sHLA-G in the plasma remained significantly associated with HIV-1 infection and the HLA-G 3'UTR 14-bp insertion homozygote genotype. This study demonstrates that low levels of plasma sHLA-G are associated with HIV-1 infection. Copyright 2010 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved
Trichomonas vaginalis is highly prevalent in adolescent girls, pregnant women, and commercial sex workers in Ndola, Zambia
No full textOBJECTIVES: The aim of the study was to assess the prevalence of Trichomonas sp. infection among adolescent girls, pregnant women, and commercial sex workers in Ndola, Zambia. METHODS:: A cross-sectional study was conducted among 460 girls attending school, 307 pregnant women, and 197 commercial sex workers. Self-collected specimens from the vagina, rectum, and mouth were tested by polymerase chain amplification assays for the presence of Trichomonas vaginalis, Pentatrichomonas hominis, and Trichomonas tenax. Genotyping was performed on specimens that tested positive for T. vaginalis. RESULTS:: The prevalence of vaginal infection with T. vaginalis was 24.6% among the adolescents, 32.2% among the pregnant women, and 33.2% among the commercial sex workers. Trichomonads other than T. vaginalis were rarely found in the vagina, rectum, and mouth. The presence of T. vaginalis in the rectum was associated with T. vaginalis in the vagina. T. tenax was also detected in the vagina. A total of 9 actin genotypes of T. vaginalis were identified. The distribution of the actin genotypes of T. vaginalis was similar in the 3 study groups. CONCLUSION:: We detected high prevalence rates of trichomoniasis among women in Ndola, Zambia. Prevalence among adolescent girls was lower than among pregnant women and commercial sex workers but was still high. We were not able to detect differences in T. vaginalis actin genotypes among the 3 study groups
Evaluation of the Immunoquick+4 malaria rapid diagnostic test in a non-endemic setting
No full textThe aim of this retrospective study was to evaluate the Immunoquick+4 (BioSynex, Strasbourg, France), a three-band malaria rapid diagnostic test (MRDT) targeting histidine-rich protein-2 (HRP-2) and pan Plasmodium-specific parasite lactate dehydrogenase, in a non-endemic reference setting. Stored whole-blood samples (n = 613) from international travellers suspected of malaria were used, with microscopy corrected by polymerase chain reaction (PCR) as the reference method. Samples infected by P. falciparum (n = 323), P. vivax (n = 97), P. ovale (n = 73) and P. malariae (n = 25) were selected, as well as 95 malaria-negative samples. The overall sensitivities of the Immunoquick+4 for the diagnosis of P. falciparum, P. vivax, P. malariae and P. ovale were 88.9, 75.3, 56.0 and 19.2%, respectively. Sensitivity was significantly related to parasite density for P. falciparum (93.6% versus 71.4% at parasite densities >100/microl and 500/microl and <or=500/microl, respectively). The Immunoquick+4 showed good reproducibility and reliability for both test results and line intensities. The Immunoquick+4 performed well for the detection of P. falciparum and P. vivax
Folding properties of the hepatitis B core as a carrier protein for vaccination research
No full textThe hepatitis B core (HBc) protein has been used successfully in numerous experiments as a carrier for heterologous peptides. Folding and capsid formation of the chimeric proteins is not always achieved easily. In silico analyses were performed to provide further comprehension of the feasibility for predicting successful capsid formation. In contrast to previous work, we show that common in silico predictions do not ensure assembly into particles. We included new considerations regarding capsid formation of HBc fusion proteins. Not only the primary sequence and the length of the inserts seem important, also the rigidity, the distance between the N and the C-terminus and the presence of cysteines, which could form disulphide bonds, could influence proper capsid formation. Furthermore, new conformational insights were formulated when linkers were added to create extra flexibility of the chimeric particles. Different hypotheses were suggested to clarify the obtained results. To this extent, the addition of glycine-rich linkers could lower high rigidity of the insert, removal of the strain of the core protein or ease interaction between the HBc and the insert. Finally, we observed specific changes in capsid formation properties when longer linkers were used. These findings have not been reported before in this and other virus-like particle carriers. In this study, we also propose a new high-yield purification protocol for fusion proteins to be used in vaccination experiments with the carrier protein or in comparative studies of particulate or non-particulate HBc fusion proteins
Buffer substitution in malaria rapid diagnostic tests causes false-positive results
No full textBACKGROUND: Malaria rapid diagnostic tests (RDTs) are kits that generally include 20 to 25 test strips or cassettes, but only a single buffer vial. In field settings, laboratory staff occasionally uses saline, distilled water (liquids for parenteral drugs dilution) or tap water as substitutes for the RDT kit's buffer to compensate for the loss of a diluent bottle. The present study assessed the effect of buffer substitution on the RDT results. METHODS: Twenty-seven RDT brands were run with EDTA-blood samples of five malaria-free subjects, who were negative for rheumatoid factor and antinuclear antibodies. Saline, distilled water and tap water were used as substitute liquids. RDTs were also run with distilled water, without adding blood. Results were compared to those obtained with the RDT kit's buffer and Plasmodium positive samples. RESULTS: Only eight cassettes (in four RDT brands) showed no control line and were considered invalid. Visible test lines occurred for at least one malaria-free sample and one of the substitutes in 20/27 (74%) RDT brands (saline: n = 16; distilled water: n = 17; and tap water: n = 20), and in 15 RDTs which were run with distilled water only. They occurred for all Plasmodium antigens and RDT formats (two-, three- and four-band RDTs). Clearance of the background of the strip was excellent except for saline. The aspects (colour, intensity and crispness) of the control and the false-positive test lines were similar to those obtained with the RDT kits' buffer and Plasmodium positive samples. CONCLUSION: Replacement of the RDT kit's dedicated buffer by saline, distilled water and tap water can cause false-positive test result
Taking up Daniels' challenge: the case for global health justice
No full textIn Just Health, Norman Daniels makes a strong argument for obligations of mutual assistance to fulfill the right to health at the national level and challenges readers to develop arguments supporting obligations of mutual assistance at the global level. In this paper, we argue that there is global responsibility for global health and that there are obligations of justice (beyond charity) to help fulfill (not merely respect or even protect) the right to health in other countries; these we call obligations of global health justice. We show how international human rights law affirms obligations of global health justice - beyond national obligations and beyond obligations of charity - and assert that the human rights approach provides guidance on delineating the relationship between national and global responsibility for fulfilling the core obligations that arise from socioeconomic human rights and addressing global health inequities. We further argue that new ways of providing international assistance, originating from the global HIV/AIDS response, demonstrate the feasibility of improving health outcomes through exogenous efforts and that obligations of global health justice thus carry much weight: the weight of lives not saved. The global response to the HIV/AIDS pandemic has led to the emergence of a new international health assistance paradigm, and the Global Fund to fight AIDS, Tuberculosis and Malaria is, we suggest, an embryonic form of this new paradigm. We conclude that agreements on several common parameters delineating global and national responsibility for global health can advance the movement towards a global institution for the distribution of health-related goods