Molecular investigation of two possible cases of accidental HIV-1 transmission in South Africa.

HIV-1 sequences from two possible transmission cases in South Africa were examined for evidence of genetic linkage. HIV-1-seropositive blood samples were obtained from a donor and recipient within 8 months following a blood transfusion and from a healthcare worker and her patient within 10 months following a needle-stick injury. A 700-bp region in env and 550-bp region in gag were analyzed. All sequences were phylogenetically associated with HIV-1 subtype C, the predominant HIV-1 subtype in South Africa. The nucleotide sequences from the blood transfusion case grouped together significantly with a bootstrap value of 100%. These samples were 98% and 100% identical in the predicted amino acid sequences of env and gag, respectively. In contrast, sequences from the needle-stick case showed only 67% and 80% amino acid identity in env and gag, respectively, and were separated on a phylogenetic tree. Molecular analysis suggested that HIV transmission occurred in the blood transfusion case but not in the case of the needle-stick injury. These data emphasize the need for molecular investigation of epidemiologically linked cases of HIV transmission.

Transfusion-transmissible virus and hepatocellular carcinoma: a case-control study.

Although transfusion-transmissible virus (TTV) is often present in the serum of patients with acute and chronic non-A-C liver diseases, its hepatotropism, pathogenicity to the liver and hepatocarcinogenicity have not been proven. We used a case-control format to compare the prevalence of TTV infection among 148 southern African Blacks with hepatocellular carcinoma and 148 matched hospital-based controls, and to test for possible interactive effects between this virus and hepatitis B virus (HBV) and hepatitis C virus (HCV) in the development of the tumour. We also determined the prevalence of TTV in 988 blood donors in Gauteng province of South Africa. The presence of TTV DNA in serum samples was detected by using the polymerase chain reaction, Southern hybridization and nucleotide sequencing. Individuals infected with TTV did not have an increased risk of developing hepatocellular carcinoma (relative risk 1.1; 95% confidence limits 0.5-2.4). Moreover, co-infection with TTV did not further increase the risk of tumour development in patients chronically infected with HBV and/or HCV. TTV was present in the serum of 2.2% of blood donors: 4.0% in Black and 1.5% in White donors. We conclude that TTV is unrelated to the development of hepatocellular carcinoma in Black Africans.

Hemolytic disease of the newborn as an unusual consequence of drug abuse. A case report.

Severe Rhesus isoimmunization occurred in a primigravida following self-injection of her partner's blood as a consequence of drug abuse. This case demonstrated the value of the true sinusoidal fetal heart rate pattern as an indicator of severe fetal compromise.

Screening antenatal blood samples for anti-human immunodeficiency virus antibodies by a large-pool enzyme-linked immunosorbent assay system. Results of an 18-month investigation.

Blood samples submitted for routine antenatal testing from 104,683 pregnant women resident in the southern Transvaal were screened for antibodies to the human immunodeficiency virus (HIV) during an 18-month period--1 May 1987 - 31 October 1988. All blood samples were initially screened by a modified enzyme-linked immunosorbent assay whereby 48 samples are tested simultaneously in one microtitre well. Each positive 48-pool was subdivided and retested in a 12-pool system. The individual positively reacting sample, having been identified, was submitted to a reference laboratory for confirmatory testing which included Western blotting. In the cohort of 84,527 black women tested, the incidence of confirmed anti-HIV positivity was 1:2753 (0.036%) in the first 3 months of the study and increased to 1:461 (0.217%) in the last 3-month period.

Purification of undegraded ceruloplasmin from outdated human plasma.

A method for the rapid isolation of homogeneous undegraded ceruloplasmin from outdated human plasma is reported. The procedure consists of a precipitation step with polyethylene glycol 4000, batchwise adsorption and elution from QAE-Sephadex, and gradient elution from DEAE-Sepharose CL-6B. Ceruloplasmin was purified 1740-fold and the yield from outdated plasma was 67%. The purified ceruloplasmin was found to be homogeneous on anionic polyacrylamide gel electrophoresis (PAGE), sodium dodecyl sulfate-PAGE, isoelectric focusing, and low-speed equilibrium centrifugation. The isoelectric point as determined by isoelectric focusing was 4.4. The purified enzyme was sensitive to storage; when a sample was resubmitted to PAGE after 4 months of storage at 4 degrees C, two bands were obtained and the fast-moving band showed no oxidase activity. The molecular weight estimated by gel electrophoresis and sedimentation equilibrium centrifugation was 130,000.