Pitfalls in measuring high-density lipoprotein cholesterol concentrations in HIV-infected patients.

OBJECTIVES: HIV infection and its treatment are associated with dyslipidaemia and increased risk of cardiovascular disease. Accurate high-density lipoprotein (HDL) cholesterol values are necessary for the management of these abnormalities, but current methods have not been properly assessed in these patients. The aim of this study was to assess in HIV-infected patients the consistency and accuracy of a synthetic polymer/detergent homogeneous assay used to measure HDL cholesterol concentrations and to evaluate the impact of storage. METHODS: HDL cholesterol was measured using a synthetic polymer/detergent homogeneous method in samples from HIV-infected patients and healthy subjects for each of the storage regimens: baseline, after 1 week at 4 degrees C, and after 12 months at -80 degrees C. The ultracentrifugation and precipitation assays were used for comparison. RESULTS: Three out of every 20 samples from HIV-infected patients had discrepant HDL cholesterol values with respect to the ultracentrifugation method. Overestimation was associated with high C-reactive protein concentrations and underestimation with plasma gamma-globulin concentrations, an effect that was amplified by any of the storage conditions tested. CONCLUSIONS: Caution is needed when using the synthetic polymer/detergent homogeneous method for direct measurement of HDL cholesterol concentrations in HIV-infected patients. This assay is of limited use in clinical trials in which frozen samples are analysed.

Treatment of acute hepatitis C virus infection with alpha interferon in patients on hemodialysis.

To evaluate the response to alpha-interferon (INF) in patients who develop acute hepatitis C virus (HCV) infection during hemodialysis, we studied 17 patients who had infection while on dialysis. We administered three million units of alpha interferon subcutaneously to nine adult patients three times per week for 12 weeks; the rest of the patients served as controls. The patients in both groups were followed for 24 months after the diagnosis of seroconversion to anti-HCV antibody. Serum alanine aminotransferase (ALT) levels, anti-HCV antibody levels and HCV- poly chain reaction (HCV-PCR) were performed at regular intervals during the follow-up. Two patients in the treatment group dropped out; one because of colitis and another because of non-compliance. Of the seven patients who completed the course of therapy, all the patients had normal serum ALT levels in 2-8 weeks of therapy, three (42%) patients converted back to anti-HCV antibodies negative and six (86%) had HCV-PCR negative at 12 weeks of therapy (primary virological response) and remained so till the end of follow-up (sustained virological response). The liver biopsy performed in all the responders to therapy at 4-24 months after completion of treatment showed mild hepatitis. In the control group, all the patients continued to have raised serum ALT levels throughout the study; 12% converted anti-HCV antibodies to negative and HCV-PCR (performed on five patients) remained positive during the whole study period. In conclusion our study suggests the efficacy and safety of alpha interferon in the therapy of acute HCV infection in hemodialysis patients.

Molecular analyses of Old World Leishmania RAPD markers and development of a PCR assay selective for parasites of the L. donovani species Complex.

Three amplicons, appearing in a species-specific manner on the electrophoregrams of RAPD reactions that were obtained with primer OPA1, OPA1-800, OPA1- 900, and OPA1-1200, are analyzed in this study. The study revealed that each of these products is composed of one Leishmania DNA band, taxonomically conserved among the different Old World species studied. Subsequently, only the electrophoretic position of the RAPD products can be considered species-specific. In addition, sequence data, genomic organization, and chromosomal location have proved that these fragments are different and physically independent. However, they possess common features related to the presence of different kinds of short DNA repeats, more particularly microsatellites and a CCCTTC motive, corresponding to the 3' half of the OPA1 primer. These results suggest that the OPA1 primer has initiated amplification from different priming sites, having a species-specific location. This corresponds to sequence micro-heterogeneity of DNA fragments present within the different species and leading eventually to a selective amplification of different RAPD products. This characteristic has been used to develop an original selective PCR test based on the sequence of the OPA1-800 product, in which only DNAs from the L. donovani species complex are amplified. Restriction site polymorphisms and sequence variations are identified within the PCR fragment amplified from these parasite DNAs. In fact, the OPA1-800 fragment proved to be a useful DNA marker either as a DNA probe or as a target for PCR-based assays. This tool can therefore be recommended for the control of Old World Leishmania parasites, such as species discrimination, molecular tracking of isolates, or study of polymorphisms within the L. donovani species complex. Moreover, the molecular bases underlying the amplification of the RAPD fragments studied correspond to mechanisms already described. Although they do not account for the amplification of all Leishmania RAPD products, such mechanisms stress some of the pitfalls of the technique, which need to be taken into consideration. We have identified at least misleading observations of DNA bands amplified in a species-specific manner, in spite of their presence in the genome of the other taxa, and relatedness between bands within the amplification profiles. Therefore, recommendations for careful interpretation of RAPD data in population genetics or phylogenetic analyses are reiterated. Molecular analyses are essential to validate conclusions.

Electrochemical and thermodynamic studies of the ion-pair formation of chloropentamminecobalt(III) ion in ethyl alcohol-water media containing different dicarboxylate ligands.

The ion-pair dissociation constants, K(D), of the ion-pair formed between chloropentamminecobalt(III) ion (CpX(2+)) and a variety of dicarboxylate ligands, have been determined from EMF measurements of a cell composed of glass and calomel electrodes. Measurements were made in water and in aqueous binary mixtures of ethyl alcohol, over a wide range of solvent composition (0-60 wt% ethyl alcohol), at six different temperatures (ranging from 30 to 55 degrees C at intervals of 5 degrees C). The thermodynamic parameters of association DeltaG(ass)(0), DeltaH(ass)(0) and DeltaS(ass)(0) have been calculated and discussed. DeltaH(ass)(0)-DeltaS(ass)(0), DeltaS(ass)(0)-DeltaS(1(or 2))(0), DeltaG(ass)(0)-G(1(or 2))(0) and DeltaH(ass)(0)-DeltaH(1(or 2))(0) correlations among different solvent media and different dicarboxylate ligands were examined (where 1 and 2 denote the first and the second dissociation reactions of the studied dicarboxylic acids). The pK(D) value has been correlated with the dielectric constant of the medium according to Born's equation.