Impact of accelerated progression to AIDS on public health monitoring of late HIV diagnosis.

Some patients develop AIDS within a year of HIV infection ("accelerated progression"). Classifying such cases as late HIV diagnosis may lead to inaccurate evaluation of HIV testing efforts. We sought to determine this group's contribution to overall late diagnosis rates. To identify cases of accelerated progression (development of AIDS within 12 months of a negative HIV test), we reviewed published HIV seroconverter cohort studies and used New York City's (NYC) HIV/AIDS surveillance registry. From the literature review, three seroconverter cohort studies revealed that 1.0-3.6% of participants had accelerated progression to AIDS. Applying this frequency estimate to the number of new infections in NYC (4762) for 2006 calculated by the Centers for Diseases Control and Prevention's incidence formula, we estimated that 3.6-13.0% of 1317 NYC HIV cases who are diagnosed with AIDS within 12 months of HIV diagnosis are accelerated progressors, not persons HIV infected for many years who did not test and present with AIDS (i.e., delayed diagnosis). In addition, our analysis of the 2006 NYC surveillance registry confirmed the occurrence of accelerated progression in a population-based setting; 67 accelerated progressors were reported and 9 (13%) could be confirmed through follow-up medical record review. With increased HIV testing initiatives, the irreducible proportion of AIDS cases with accelerated progression must be considered when interpreting late diagnosis data.

Visual perception and mixed-initiative interaction for assisted visualization design.

This paper describes the integration of perceptual guidelines from human vision with an AI-based mixed-initiative search strategy. The result is a visualization assistant called ViA, a system that collaborates with its users to identify perceptually salient visualizations for large, multidimensional datasets. ViA applies knowledge of low-level human vision to: (1) evaluate the effectiveness of a particular visualization for a given dataset and analysis tasks; and (2) rapidly direct its search towards new visualizations that are most likely to offer improvements over those seen to date. Context, domain expertise, and a high-level understanding of a dataset are critical to identifying effective visualizations. We apply a mixed-initiative strategy that allows ViA and its users to share their different strengths and continually improve ViA's understanding of a user's preferences. We visualize historical weather conditions to compare ViA's search strategy to exhaustive analysis, simulated annealing, and reactive tabu search, and to measure the improvement provided by mixed-initiative interaction. We also visualize intelligent agents competing in a simulated online auction to evaluate ViA's perceptual guidelines. Results from each study are positive, suggesting that ViA can construct high-quality visualizations for a range of real-world datasets.

Latent infection as a source of disseminated disease caused by organisms of the Mycobacterium avium complex in simian immunodeficiency virus-infected rhesus macaques.

Whether infection with Mycobacterium avium complex (MAC) among patients with acquired immune deficiency syndrome results from recent exposure to virulent strains or reactivation of latent infection acquired years earlier is unknown. To address this question, tissue samples from 47 simian immunodeficiency virus (SIV)-infected and 63 SIV-uninfected rhesus macaques were cultured. MAC was cultured from 14 SIV-uninfected macaques (22.2%) and 32 SIV-infected macaques (68.1%); median bacterial burdens were 33.3 and 998.7 cfu/g, respectively. Genetically distinct strains of MAC were identified for 13 SIV-uninfected macaques (20.6%) and 15 SIV-infected macaques (31.9%). A genetically identical MAC strain (K128A) was identified for 25 SIV-infected macaques (53.2%) and 1 SIV-uninfected macaque (1.6%). Multivariate analysis identified infection with SIV/Delta(B670), diagnosis of an SIV-related tumor or opportunistic infection, and birth on site as risks for MAC infection. SIV-uninfected and SIV-infected macaques yielding unique strains of MAC were considered to have latent and reactivation infection, respectively, whereas animals infected with strain K128A were considered to have recent infection, demonstrating that both mechanisms occur among rhesus macaques.