CD41 T cell recovery during suppression of HIV replication: an international comparison of the immunological efficacy of antiretroviral therapy in North America, Asia and Africa.

BACKGROUND Even among HIV-infected patients who fully suppress plasma HIV RNA replication on antiretroviral therapy, genetic (e.g. CCL3L1 copy number), viral (e.g. tropism) and environmental (e.g. chronic exposure to microbial antigens) factors influence CD4 recovery. These factors differ markedly around the world and therefore the expected CD4 recovery during HIV RNA suppression may differ globally. METHODS We evaluated HIV-infected adults from North America, West Africa, East Africa, Southern Africa and Asia starting non-nucleoside reverse transcriptase inhibitorbased regimens containing efavirenz or nevirapine, who achieved at least one HIV RNA level <500/ml in the first year of therapy and observed CD4 changes during HIV RNA suppression. We used a piecewise linear regression to estimate the influence of region of residence on CD4 recovery, adjusting for socio-demographic and clinical characteristics. We observed 28 217 patients from 105 cohorts over 37 825 person-years. RESULTS After adjustment, patients from East Africa showed diminished CD4 recovery as compared with other regions. Three years after antiretroviral therapy initiation, the mean CD4 count for a prototypical patient with a pre-therapy CD4 count of 150/ml was 529/ml [95% confidence interval (CI): 517–541] in North America, 494/ml (95% CI: 429–559) in West Africa, 515/ml (95% CI: 508–522) in Southern Africa, 503/ml (95% CI: 478–528) in Asia and 437/ml (95% CI: 425–449) in East Africa. CONCLUSIONS CD4 recovery during HIV RNA suppression is diminished in East Africa as compared with other regions of the world, and observed differences are large enough to potentially influence clinical outcomes. Epidemiological analyses on a global scale can identify macroscopic effects unobservable at the clinical, national or individual regional level.

Geochemical studies of surface sediment samples off North-West Africa

One hundred and twenty-eight surface-sediment samples collected off North-West Africa were studied geochemically to detect the expressions of different meridional climate regimes and zonal productivity gradients in the surface sediments. This geochemical multi-tracer approach, coupled with additional information on the bulk carbonate and TOC contents makes it possible to characterise the sedimentological regime in detail. Typical terrigenous elements like Al, K and Fe mirror the importance of the humid (fluvial) influence in the north of the study area and the dominance of aeolian input in the south. Furthermore, the distributions of Ti and Fe in the surface sediments serve as tracers for the supply of eolian volcanic material from the Canary Islands. The spatial variability of the TOC contents in the surface sediments closely follows the ocean surface productivity patterns, whereas the CaCO3 contents are mainly controlled by dilution with terrigenous matter. The potential productivity proxy Ba is not a reliable tracer for productivity in this region, since it is mainly supplied by terrigenous input (coupled with aluminosilicates).

Sedimentological and paleoclimatological investigation of two sediment cores off Cape Barbas, North-West Africa

Two box cores taken off Cape Barbas (North-West Africa) have been studied using three methods. The analyses of the coarse fraction, of biogenic opal and of planktonic foraminifera revealed : 1. Core GIK12310-4 penetrates Z, Y, X and upper part of W zone, whereas core GIK12379-1 penetrates Z and upper part of Y zone. 2. Holocene sedimentation rates are 2.5 cm/1000 y for core GIK12310-4 and 6.0 cm/1000 y for core GIK12379-1. During the Y zone 5 cm/l000 y were sedimented incore GIK12310-4 and > 10-20 cm/1000 y in core GIK12379-1. 3. Paleoclimatohgical results are: arid climate and relatively warm water temperatures during the Holocene (Z zone) and during X zone; humid climate and relatively cool water temperatures within the Wuerm (Y zone) (with a non-dated more arid interval found in the middle part of the Y zone) and in the upper part of the W zone. 4. Increased contents of benthos and radiolaria in the Y zone indicate upwelling. Upwelling, characterized by high content of biogenic opal and low water temperatures, was found in core GIK12310-4 at 250 to 350 cm in the lower part of the Y zone. The plankton/benthos ratio of foraminifera, the benthos/radiolaria ratio and water temperatures derived from planktonic foraminifera, differ in both cores in the Holocene, and are nearly identical during the Wuerm.

Composition of recent carbonate bottom sediments from the Guiana shelf an off the West Africa

This work was based on a study of the upper layer of recent carbonate bottom sediments of the Atlantic Ocean. Biogenic carbonate of recent sediments is represented by metastable and stable minerals. In the ocean metastable phases can exist indefinitely long, but the structure of polymorphism determines inevitability of transformation of metastable phases into stable ones. This transformation occurs in the solid phase. In the absence of a critical point between the two phases of the transition process is not available for study by microscopic methods. It is estimated indirectly by studying the nature and extent of changes in mineral and chemical compositions. With aging of sediments their mineral composition alters in direction of increasing contents of resistant minerals. Fine grained sediments and fractions are subject to more intensive effects of early diagenesis processes, rather than coarse ones; this is reflected in their mineral composition. Regularities of distribution of carbonate minerals in size fractions consistent with the direction of polymorphic transformations in calcium carbonate. Such transformations can occur in a particular dimension of grains. Concrete grain size depends on environmental conditions. This situation explains presence of metastable biogenic carbonates at different depths of the ocean and suggests presence of diagenetic calcite in sediments occurring below expected for each case depth of the transition.

(Table 1) Composition of bottom sediments and pore waters from the West Africa shelf

Organic and mineral phosphorus (P_org and P_min) have been determined in pore waters of terrigenous, biogenous, as well as weakly phosphatic and phosphatic sediments from the shelf of the West Africa (in 30 samples). Concentrations of P_min in the pore waters have been examined in close relation to grain size and chemical composition (amounts of P and N_org) of solid phase of the sediments. It has been demonstrated that among sands and coarse silts, maximum concentrations of P_min (up to 1.7 mg/l) in the pore waters have been observed in weakly phosphatic and phosphatic sediments rich in organic matter of the highly productive shelf of the Southwest Africa. Concentrations of P_min in the pore waters are most clearly associated with contents of N_org in the solid phase of the sediments (correlation coefficient R = 0.71) and P_org in the pore waters (R = 0.78).

Age determination of sediment cores from the continental shelf and slope off North-West Africa

Three sediment cores from the continental shelf and slope off NW Africa (Banc d'Arguin; 52 m, 665 m and 973 m water depth) have been investigated by means of a coarse fraction analysis. The two shallower cores have been deposited during less than 10,000 years, the deeper one during the last 36,000 years. The Holocene sedimentation ( 4000 years) in the deeper part of core 79 the edge of the Banc d'Arguin is strongly influenced by reworking of Late Glacial dune sands and biogenic particles from shallower ware (<40 m), as well as eroding current influence. A decrease in grain size of silicate material and a decrease in lateral supply, correlated to a doubling of accumulation rates in the upper part of the core, indicates a more autochthonous sedimentation with less sorting influence in the youngest Holocene. The depth of provenance of the allochttonous material can be assumed in 100-300 m water depth as indicated by various biogenous particles. Small amounts of shallow water particles in the autochthonous layers indicate a supplay from shallow water, which probably occured b ythe mechanism of "particle by particle supply". None of the three cores indicates upwelling influence, although occanographers found intense upwelling in the area of the Banc d'Arguin. The Holocene climate in that area probably has been arid, small variations in terrigenous matter composition and grain size in the Early Holocene might be due to decreased wind strength or to an increase in rain fall. The Peak Glacial section (14,000-22,000 y. B.P.) of the deepest core 88 indicates a very much intensified eolian silt supply and an additional bottom supply of quartz sand In the interval 22,000-36,000 y. B.P. wind strength decreased, but probably no increase in humidity occurred. So this area in about 19° 40' N had an arid climate in the Late Holocene and in the Peak Glacial. The fragmentation of planktonic foraminifers and the abundance of aragonitic tests of pteropods in core 88 indicate an Early Holocene (8330 y. B.P.) preservation spike. Two minima in fragmentation correlated to maxima in pteropod content at about 15,700 and 21,000 y. B.P. are correlated to maxima in shallow water supply and thus do not reflect preservation conditions, but only lateral supply from the carbonate dissolution minimum zone in about 300 m water depth.

Benthic foraminifera of surface sediments from the continental slope off Sierra Leone, North-West Africa

On "Meteor" cruise 30 (1973) 22 piston-cores were collected off Sierra Leone from water-depths between about 5000 m (Sierra Leone Basin) and 500 m (upper continental slope) with the objective to study the sediment composition and age as well as processes of sedimentation on the continental slope in a tropical humid region. Granulometric analysis and determinations of the carbonate contents of the sediment samples were carried out, as well as qualitative and quantitative analysis of the components of the grain size fractions > 63 µm and of the planktonic and benthonic foraminifera > 160 µm. Presently, the cold Canary Current influences the composition of the planktonic foraminifera within the northwestern area of investigation (profile A), whereas the planktonic fauna of the eastern area (profile C) seems to be truly tropical. In all Quaternary sediments from the continental slope off Sierra Leone, species of Globorotalia are less abundant than in truly pelagic sediments. For that reason, the zonation of the Pleistocene sediments based on the presence or absence of Globorotalia cultrata does not always agree with the climatic changes reflected in the sediments. Concerning past climates better results can be obtained by using the changes in percentage abundances of Globigerina sp. sp. and Globigerinoides sp. sp. as indicators for cool and warm temperatures. The Tertiary sediments contain a pelagic foraminiferal assemblage. In the Holocene sediments the benthonic foraminifera do not only serve as good paleodepth indicators, but their communities are also restricted to defined water masses, which change their positions in accordance with climatic changes. Thus, Cassidulina carinata in the area of investigation is an excellent indicator for sediments deposited during times, which were cooler than today; this is true for all cores from the continental slope off Sierra Leone independent of water-depth although this species presently abounds at water-depths around 600 m. The cores from the continental rise and from the Sierra Leone Basin (M30-261, M30-146, M30-147) were deposited below the calcium carbonate compensation depth. Only small sections of the cores consist of the original carbonate-free sediments, whereas the main part of the sediment column is redeposited material, rich in foraminifera, which normally live on the upper continental slope, or even on the shelf. From these cores only M30-261 can be subdivided into biostratigraphic zones ranging from zone V to zone Y. In all cores from the middle and upper continental slope of the eastern area of investigation (profile C; KL 230, 209-204) and in cores KL 183 and KL 184 from the northwestern area (profile A) we observed an undisturbed succession of sediments from the biostratigraphic zones X (partly), Y and Z. All cores from the central area (M30-181, M30-182, M30-262 to 264) and M30-187 from the upper slope of profile A show variable hiatuses in the sedimentary record. Locally, high velocity bottom currents were probably responsible for erosion, nondeposition or minimal sedimentation rates. These currents might have been initiated partly by the somewhat exposed position of this part of the continental slope, where the shelf edge bends from a northwest towards an eastern direction, and partly by very young tectonic movements. Fracture zones with vertically displaced fault blocs are frequent at Sierra Leone continental margin. According to seismic measurements by McMaster et al. (1975) the sites of the central area are located on an uplifted fault bloc explaining the reduced sediment rates or erosion. Unlike the central area, the eastern area (profile C) is situated on a downfaulted bloc with high sediment rates. The sediments from the cores of profile B as well as the turbiditic deep-sea sediments were deposited under a higher flow regime; therefore they are coarser than the extremely fine-grained sediments of the cores from profile C. Since the sand fraction (> 63 µm) is mainly composed of foraminifera, besides pteropods and light-colored fecal pellets, the carbonate content increases with the increasing percentage of the coarse grain fraction. Higher concentrations of quartz were only observed in core sections with considerable carbonate dissolution (mainly in the X-Zone), and, in general, in all sediments from the eastern area with higher terrigenous input including larger concentration of mica. Especially during times transitional between glacials and interglacials (or interstadials) the bottom currents were intensified. The percentages of coarse fraction and carbonate increase with increasing current velocities. Calcium carbonate dissolution becomes important in water depths > 3500 m. During cooler times the lysokline is depressed. Light-colored fecal pellets were redeposited from Late Neogene sediments (M30-187, M30-181). In the area of investigation they occur in the Holocene and mainly the Pleistocene sediments of the cores from the northwestern and central area because only here Tertiary sediments have been eroded at the uppermost continental slope. In the central area there are at least two periods of non-sedimentation and/or erosion which can be confined as being (1) not older than middle Pliocene and not younger than zone V and (2) younger than zone W. The local character of the erosion is documented by the fact that a complete Late Quaternary section is present in the cores of the northwestern and eastern area, each within less than 100 km from incomplete cores from the central area.

Dinoflagellate cysts and pollen distribution of marine surface sediments off West Africa

An organic-walled dinoflagellate cyst analysis was carried out on 53 surface sediment samples from West Africa (17-6°N) to obtain insight in the relationship between their spatial distribution and hydrological conditions in the upper water column as well as marine productivity in the study area. Multivariate analysis of the dinoflagellate cyst relative abundances and environmental parameters of the water column shows that sea-surface temperature, salinity, marine productivity and bottom water oxygen are the factors that relate significantly to the distribution patterns of individual species in the region. The composition of cyst assemblages and dinoflagellate cyst concentrations allows the identification of four hydrographic regimes; 1) the northern regime between 17 and 14°N characterized by high productivity associated with seasonal coastal upwelling, 2) the southern regime between 12 and 6°N associated with high-nutrient waters influenced by river discharge 3) the intermediate regime between 14 and 12°N influenced mainly by seasonal coastal upwelling additionally associated with fluvial input of terrestrial nutrients and 4) the offshore regime characterized by low chlorophyll-a concentrations in upper waters and high bottom water oxygen concentrations. Our data show that cysts of Polykrikos kofoidii, Selenopemphix quanta, Dubridinium spp., Echinidinium species, cysts of Protoperidinium monospinum and Spiniferites pachydermus are the best proxies to reconstruct the boundary between the NE trade winds and the monsoon winds in the subtropical eastern Atlantic Ocean. The association of Bitectatodinium spongium, Lejeunecysta oliva, Quinquecuspis concreta, Selenopemphix nephroides, Trinovantedinium applanatum can be used to reconstruct past river outflow variations within this region.