Comorbidities among HIV-infected injection drug users in Chennai, India.

BACKGROUND & OBJECTIVE: HIV-infected injection drugs users (IDUs) are known to have high rates of co-infections. A few reports exist on comorbidities among HIV-infected IDUs in India. We carried out a retrospective study to analyse data on comorbidities in India and treatment challenges faced when treating HIV-infected IDUs in India. METHODS: A retrospective chart review of 118 HIV-infected IDUs who accessed care at the YRG Centre for Substance Abuse-Related Research, Chennai, between August 2005 and February 2006 was done. Demographic, laboratory and clinical information was extracted from medical records. Descriptive demographic and clinical characteristics and distributions of comorbidities across CD4 cell count strata were analysed. RESULTS: All IDUs were male with a median age of 35.5 yr. The majority were married with average monthly income less than INR 3000 per month. The prevalence of hepatitis B and C infections were 11.9 and 94.1 per cent, respectively. Other common co-morbidities included oral candidiasis (43.2%), tuberculosis (33.9%), anaemia (22.9%), lower respiratory tract infections (16.1%), cellulitis (6.8%), herpes zoster (9.3%) and herpes simplex (9.3%). Among participants with CD4+ < 200 cells/microl, the prevalence of TB was 60 per cent. INTERPRETATION & CONCLUSION: IDUs in Chennai were commonly co-infected with HBV, HCV and tuberculosis, complicating use of antiretroviral and anti-tuberculous therapy. The current regimens available for the management of HIV and TB in India may need to be re-assessed for IDUs given the potential for increased rates of hepatotoxicity.

Production and recovery process of polyhydroxybutyrate (PHB) from waste activated sludge.

Polyhydroxybutyrate (PHB) is bacterial storage polyester, currently receiving much attention because of its biodegradable potential. Production of microbial polymers is expensive due to supplementary carbon source and downstream processing cost. The present study aimed at reducing the fermentation carbon source cost by using waste activated sludge and wastewater, and evaluating the use of proper solvent for the recovery of PHB from activated sludge to minimize the downstream cost. To improve the recovery process efficiency, different strategies for the extraction and recovery of the polymer from the waste activated sludge were applied. The maximum solubility of PHB (80%) was observed in chloroform, and precipitation with methanol (95%) was observed. Impurities interference in the PHB recovery process was also studied. By using these optimized recovery processes with optimized C:N ratio 10, the maximum product recovery was observed to be 62.3% (w/w). The results are presented and discussed in this paper.