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Trends in incidences and risk factors for hepatocellular carcinoma and other liver events in HIV and hepatitis C virus co-infected individuals from 2001 to 2014: a multi-cohort study.

BACKGROUND  While liver-related deaths in HIV and hepatitis C virus (HCV) co-infected individuals have declined over the last decade, hepatocellular carcinoma (HCC) may have increased. We described the epidemiology of HCC and other liver events in a multi-cohort collaboration of HIV/HCV co-infected individuals. METHODS  We studied all HCV antibody-positive adults with HIV in the EuroSIDA Study, the Southern Alberta Clinic Cohort, the Canadian Co-infection Cohort, and the Swiss HIV Cohort Study from 2001 to 2014. We calculated the incidence of HCC and other liver events (defined as liver-related deaths or decompensations, excluding HCC) and used Poisson regression to estimate incidence rate ratios. RESULTS  Our study comprised 7,229 HIV/HCV co-infected individuals (68% male, 90% white). During follow-up, 72 cases of HCC and 375 other liver events occurred, yielding incidence rates of 1.6 (95% confidence interval (CI): 1.3, 2.0) and 8.6 (95% CI: 7.8, 9.5) cases per 1,000 person-years of follow-up, respectively. The rate of HCC increased 11% per calendar year (95% CI: 4%, 19%) and decreased 4% for other liver events (95% CI: 2%, 7%), but only the latter remained statistically significant after adjustment for potential confounders. High age, cirrhosis, and low current CD4 cell count were associated with a higher incidence of both HCC and other liver events. CONCLUSIONS  In HIV/HCV co-infected individuals, the crude incidence of HCC increased from 2001 to 2014, while other liver events declined. Individuals with cirrhosis or low current CD4 cell count are at highest risk of developing HCC or other liver events.

Sources and seasonality of polycyclic aromatic hydrocarbons transported to Alert, Canadian Arctic

A probabilistic function (integrated source contribution function, ISCF) based on backward air mass trajectory calculation was developed to track sources and atmospheric pathways of polycyclic aromatic hydrocarbons (PAHs) to the Canadian High Arctic station of Alert. In addition to the movement of air masses, the emission intensities at the sources and the major processes of partition, indirect photolysis, and deposition occurring on the way to the Arctic were incorporated into the ISCF. The predicted temporal trend of PAHs at Alert was validated by measured PAH concentrations throughout 2004. The PAH levels in the summer are orders of magnitude lower than those in the winter and spring when long-range atmospheric transport events occur more frequently. PAHs observed at Alert are mostly from East Asia (including Russia Far East), North Europe (including European Russia), and North America. These sources account for 25, 45, and 27% of PAHs atmospheric level at Alert, respectively. Source regions and transport pathways contributing to the PAHs contamination in the Canadian High Arctic vary seasonally. In the winter, Russia and Europe are the major sources. PAHs from these sources travel eastward and turn to the north at approximately 120°E before reaching Alert, in conjunction with the well- known Arctic haze events. In the spring, PAHs from Russia and Europe first migrate to the west and then turn to the north at 60°W toward Alert. The majority of PAHs in the summer are from northern Canada where they are carried to Alert via low- level transport pathways. In the fall, 70% of PAHs arriving at Alert are delivered from North American sources.

(Table 1) Age determination of sediment cores of the Labrador Sea

A close look at the sedimentology of Heinrich event 4 from the northwest Labrador Sea indicates that an extended ice margin, perhaps greater than before Heinrich events 1 or 2 (H-1 and H-2), existed in the Hudson Strait region pre-Heinrich event 4 (H-4) and, that on the basis of characteristics of the sediment unit, Heinrich event-4 was different than Heinrich events 1 or 2 (i.e., larger ice sheet collapse(?), longer duration(?), "dirtier" icebergs(?)). Other data from across the southern and eastern margin of the Laurentide Ice Sheet, as well as Greenland and the North Atlantic, support this interpretation, possibly indicating a relative mid-Wisconsin glacial maximum pre-Heinrich event 4. Many of these data also indicate that Heinrich event 4 (35 ka) resulted in serious climatic and oceanographic reorganizations. We suggest that Heinrich event 4 gutted the Hudson Strait, leaving it devoid of ice for Heinrich event 3. We further hypothesize that Heinrich event 3 did not originate from axial ice transport along the Hudson Strait; thus Heinrich event 3 may be more analogous to the proposed northward advancing ice from Ungava Bay during Heinrich event 0 than to the more typical down-the-strait flow during H-1, H-2, and H-4. Consequently, the climatic and oceanographic impacts resulting from Heinrich events are highly susceptible to the type, origin, and magnitude of ice sheet collapse, something which varied per Heinrich event during the last glacial period.

Oak and maple : English and Canadian verses /

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Canadian stories /

Mode of access: Internet.