Viral Escape in the Central Nervous System with Multidrug-Resistant Human Immunodeficiency Virus-1

In this study, we report the case of a patient infected with human immunodeficiency virus (HIV)-1 who developed ataxia and neurocognitive impairment due to viral escape within the central nervous system (CNS) with a multidrug-resistant HIV-1 despite long-term viral suppression in plasma. Antiretroviral therapy optimization with drugs with high CNS penetration led to viral suppression in the CSF, regression of ataxia, and improvement of neurocognitive symptoms.

Hepatitis B Infection, Viral Load and Resistance in HIV-Infected Patients in Mozambique and Zambia.

BACKGROUND Few data on the virological determinants of hepatitis B virus (HBV) infection are available from southern Africa. METHODS We enrolled consecutive HIV-infected adult patients initiating antiretroviral therapy (ART) at two urban clinics in Zambia and four rural clinics in Northern Mozambique between May 2013 and August 2014. HBsAg screening was performed using the Determine® rapid test. Quantitative real-time PCR and HBV sequencing were performed in HBsAg-positive patients. Risk factors for HBV infection were evaluated using Chi-square and Mann-Whitney tests and associations between baseline characteristics and high level HBV replication explored in multivariable logistic regression. RESULTS Seventy-eight of 1,032 participants in Mozambique (7.6%, 95% confidence interval [CI]: 6.1-9.3) and 90 of 797 in Zambia (11.3%, 95% CI: 9.3-13.4) were HBsAg-positive. HBsAg-positive individuals were less likely to be female compared to HBsAg-negative ones (52.3% vs. 66.1%, p<0.001). Among 156 (92.9%) HBsAg-positive patients with an available measurement, median HBV viral load was 13,645 IU/mL (interquartile range: 192-8,617,488 IU/mL) and 77 (49.4%) had high values (>20,000 UI/mL). HBsAg-positive individuals had higher levels of ALT and AST compared to HBsAg-negative ones (both p<0.001). In multivariable analyses, male sex (adjusted odds ratio: 2.59, 95% CI: 1.22-5.53) and CD4 cell count below 200/μl (2.58, 1.20-5.54) were associated with high HBV DNA. HBV genotypes A1 (58.8%) and E (38.2%) were most prevalent. Four patients had probable resistance to lamivudine and/or entecavir. CONCLUSION One half of HBsAg-positive patients demonstrated high HBV viremia, supporting the early initiation of tenofovir-containing ART in HIV/HBV-coinfected adults.

Standard genotyping overestimates transmission of Mycobacterium tuberculosis among immigrants in a low incidence country.

Immigrants from high tuberculosis (TB) incidence regions are a risk group for TB in low-incidence countries such as Switzerland. In a previous analysis of a nationwide collection of 520 Mycobacterium tuberculosis isolates from 2000-2008, we identified 35 clusters comprising 90 patients based on standard genotyping (24-loci MIRU-VNTR and spoligotyping). Here, we used whole genome sequencing (WGS) to revisit these transmission clusters. Genome-based transmission clusters were defined as isolate pairs separated by ≤12 single nucleotide polymorphisms (SNPs). WGS confirmed 17/35 (49%) MIRU-VNTR clusters; the other 18 clusters contained pairs separated by >12 SNPs. Most transmission clusters (3/4) of Swiss-born patients were confirmed by WGS, as opposed to 25% (4/16) of clusters involving only foreign-born patients. The overall clustering proportion using standard genotyping was 17% (90 patients, 95% confidence interval [CI]: 14-21%), but only 8% (43 patients, 95% CI: 6-11%) using WGS. The clustering proportion was 17% (67/401, 95% CI: 13-21%) using standard genotyping and 7% (26/401, 95% CI: 4-9%) using WGS among foreign-born patients, and 19% (23/119, 95% CI: 13-28%) and 14% (17/119, 95% CI: 9-22%), respectively, among Swiss-born patients. Using weighted logistic regression, we found weak evidence for an association between birth origin and transmission (aOR 2.2, 95% CI: 0.9-5.5, comparing Swiss-born patients to others). In conclusion, standard genotyping overestimated recent TB transmission in Switzerland when compared to WGS, particularly among immigrants from high TB incidence regions, where genetically closely related strains often predominate. We recommend the use of WGS to identify transmission clusters in low TB incidence settings.

Interferon-gamma and interleukin-4 mRNA expression by peripheral blood mononuclear cells from pregnant and non-pregnant cattle seropositive for bovine viral diarrhea virus

The acceptance of the fetal allograft by pregnant women and mice seems to be associated with a shift from a Th 1 dominated to a Th 2 dominated immune response to certain infectious agents. The goal of this study was to examine cytokine expression in peripheral blood mononuclear cells (PBMCs) from cattle immune to bovine viral diarrhea virus (BVDV) to determine whether pregnancy also has an influence on the type of immune response in this species. Forty-six heifers and cows between 14 months and 13 years of age were included in this study. Twenty-four were seropositive and 22 seronegative for BVDV. Eleven of the seropositive animals and 11 of the seronegative animals were in the eighth month of gestation, the remaining animals were virgin heifers. PBMC from these animals were analyzed for Interferon (IFN)-gamma and Interleukin (IL)-4 mRNA expression by real-time RT-PCR after stimulation with a non-cytopathic strain of BVDV. Additionally, an ELISA was performed to measure IFN-gamma in the supernatants of stimulated cell cultures. In BVDV seropositive animals, IFN-gamma mRNA levels were significantly higher than in BVDV seronegative animals and there was a significant positive correlation between the changes in IFN-gamma and IL-4 mRNA expression. There was, however, no significant difference in IFN-gamma and IL-4 mRNA levels between pregnant and non-pregnant animals. These results are inconsistent with BVDV inducing a Th1 or Th2 biased immune response. Furthermore, a shift in the cytokine pattern during bovine pregnancy was not evident.

Leónidas Lamborghini y la poesía viral

En el marco del estudio de los procedimientos e instrumentos retóricos de la obra poética de Leónidas Lamborghini -obra compleja y proteica como pocas-, el volumen Carroña última forma (2001), una summa de experimentación formal de escritura poética y de problemas críticos derivados, se muestra como un desafío para la tipología de los géneros y para los estudios de la poesía argentina y contemporánea en general. Los caminos creativos recorridos por Lamborghini en cinco décadas -reescritura, parodia y grotesco principalmente- desembocan en un novedoso método: el que hemos llamado de la "viralización" de la poesía. De acuerdo con el modelo de los virus biológicos, este procedimiento opera sobre la desestabilización del sistema literario y el "contagio" de distintos corpora poéticos y narrativos, manifestándose, entre otros modos, en la presión y ruptura sobre los modelos discursivos, la fractura del verso y de la sintaxis hasta su casi extinción, hasta la putrefacción de la propia obra. La poética de la carroña "cuerpo muerto en el que bulle la fauna cadavérica" y la técnica de la viralización son los procedimientos centrales de una poética formalmente extremada que pone en entredicho la categoría de verso y de estrofa, la métrica, la noción y dirección de lectura, la posibilidad de la cita y la práctica de la marginalia

Leónidas Lamborghini y la poesía viral

En el marco del estudio de los procedimientos e instrumentos retóricos de la obra poética de Leónidas Lamborghini -obra compleja y proteica como pocas-, el volumen Carroña última forma (2001), una summa de experimentación formal de escritura poética y de problemas críticos derivados, se muestra como un desafío para la tipología de los géneros y para los estudios de la poesía argentina y contemporánea en general. Los caminos creativos recorridos por Lamborghini en cinco décadas -reescritura, parodia y grotesco principalmente- desembocan en un novedoso método: el que hemos llamado de la "viralización" de la poesía. De acuerdo con el modelo de los virus biológicos, este procedimiento opera sobre la desestabilización del sistema literario y el "contagio" de distintos corpora poéticos y narrativos, manifestándose, entre otros modos, en la presión y ruptura sobre los modelos discursivos, la fractura del verso y de la sintaxis hasta su casi extinción, hasta la putrefacción de la propia obra. La poética de la carroña "cuerpo muerto en el que bulle la fauna cadavérica" y la técnica de la viralización son los procedimientos centrales de una poética formalmente extremada que pone en entredicho la categoría de verso y de estrofa, la métrica, la noción y dirección de lectura, la posibilidad de la cita y la práctica de la marginalia

Leónidas Lamborghini y la poesía viral

En el marco del estudio de los procedimientos e instrumentos retóricos de la obra poética de Leónidas Lamborghini -obra compleja y proteica como pocas-, el volumen Carroña última forma (2001), una summa de experimentación formal de escritura poética y de problemas críticos derivados, se muestra como un desafío para la tipología de los géneros y para los estudios de la poesía argentina y contemporánea en general. Los caminos creativos recorridos por Lamborghini en cinco décadas -reescritura, parodia y grotesco principalmente- desembocan en un novedoso método: el que hemos llamado de la "viralización" de la poesía. De acuerdo con el modelo de los virus biológicos, este procedimiento opera sobre la desestabilización del sistema literario y el "contagio" de distintos corpora poéticos y narrativos, manifestándose, entre otros modos, en la presión y ruptura sobre los modelos discursivos, la fractura del verso y de la sintaxis hasta su casi extinción, hasta la putrefacción de la propia obra. La poética de la carroña "cuerpo muerto en el que bulle la fauna cadavérica" y la técnica de la viralización son los procedimientos centrales de una poética formalmente extremada que pone en entredicho la categoría de verso y de estrofa, la métrica, la noción y dirección de lectura, la posibilidad de la cita y la práctica de la marginalia

Viral decay and production in sediments of the Mediterranean Sea

Here, for the first time, we have carried out synoptic measurements of viral production and decay rates in continental-shelf and deep-sea sediments of the Mediterranean Sea to explore the viral balance. The net viral production and decay rates were significantly correlated, and were also related to prokaryotic heterotrophic production. The addition of enzymes increased the decay rates in the surface sediments, but not in the subsurface sediments. Both the viral production and the decay rates decreased significantly in the deeper sediment layers, while the virus-to-prokaryote abundance ratio increased, suggesting a high preservation of viruses in the subsurface sediments. Viral decay did not balance viral production at any of the sites investigated, accounting on average for c. 32% of the gross viral production in the marine sediments. We estimate that the carbon (C) released by viral decay contributed 6-23% to the total C released by the viral shunt. Because only ca. 2% of the viruses produced can infect other prokaryotes, the majority is not subjected to direct lysis and potentially remains as a food source for benthic consumers. The results reported here suggest that viral decay can play an important role in biogeochemical cycles and benthic trophodynamics.

Fulminant hepatic and multiple organ failure following acute viral tonsillitis: a case report.

BACKGROUND Pyogenic tonsillitis may often be observed in the general Western population. In severe cases, it may require antibiotic treatment or even hospitalization and often a prompt clinical response will be noted. Here we present an unusual case of progressive multiple organ failure including fulminant liver failure following acute tonsillitis initially mistaken for "classic" pyogenic (that is bacterial) tonsillitis. CASE PRESENTATION A 68-year-old previously healthy white man was referred with suspicion of pyogenic angina. After tonsillectomy, he developed acute liver failure and consecutive multiple organ failure including acute hemodynamic, pulmonary and dialysis-dependent renal failure. Immunohistopathological analysis of his tonsils and liver as well as serum polymerase chain reaction analyses revealed herpes simplex virus-2 to be the causative pathogen. Treatment included high-dose acyclovir and multiorgan supportive intensive care therapy. His final outcome was favorable. CONCLUSIONS Fulminant herpes simplex virus-2-induced multiple organ failure is rarely observed in the Western hemisphere and should be considered a potential diagnosis in patients with tonsillitis and multiple organ failure including acute liver failure. From a clinical perspective, it seems important to note that fulminant herpes simplex virus-2 infection may masquerade as "routine" bacterial severe sepsis/septic shock. This persevering condition should be diagnosed early and treated goal-oriented in order to gain control of this life-threatening condition.