No abstract

b After 1 year of follow-up, patients on HAART with a baseline viral load (VL) of <20 copies/ml showed significantly lower odds of virological rebound to two consecutive VLs of >50 copies/ml than those with baseline VLs of 20 to 39 and 40 to 49 (P < 0.001). The time to virological rebound was also significantly shorter (P < 0.001) for the groups with baseline VLs of 20 to 39 and 40 to 49. T he number of patients failing antiretroviral treatment with low-level viremia (e.g., a viral load [VL] ranging from 40 to 1,000 copies/ml) is increasing (1, 2), and special interest has been shown in the clinical significance of this finding. During the last years of the past decade, commercial assays for measuring viral loads reduced their detection limits (3-6), which shifted from 50 to 40 to 20 copies/ml, depending on the assay (7). Recently, a number of reports (8-12) have focused on the clinical significance of very low-level viremia (e.g., viral-load levels below 20 or between 20 and 50 copies/ml). The use of different assays or a different sample size, and even different baseline characteristics of the studies, may partially explain some of the contradictory findings of the studies. In addition, high variability of the Cobas Ampliprep/Cobas TaqMan v2.0 assay at levels of 20 and 40 HIV copies/ml has been described (13).Since the introduction in our institution of Cobas TaqMan v2.0 (Roche Diagnostics) in June 2009, the lower detection cutoff of 50 copies/ml was shifted to 20 copies/ml, and this new threshold was reported to physicians treating HIV and thus used for making clinical decisions.In this retrospective cohort study, we have investigated the clinical significance of having a viral load between 20 and 50 copies/ml in terms of the odds for a viral-load rebound to more than 50 copies/ml or 400 copies/ml 1 year after testing. When possible, the emergence of resistance was also investigated.All adult HIV patients (Ͼ18 years old) who were on highly active antiretroviral therapy (HAART) with an available follow-up 12 months (median, 12.42 months; interquartile range [IQR], 11.73 to 13.80 months) after a viral-load test result below 50 copies/ml (time zero [T 0 ]) using the Cobas TaqMan v2.0 assay were included. When needed, resistance testing of very low-level viral loads was performed using a concentration step (14) prior to following the standard procedure of the Trugene HIV genotyping kit (Siemens NAD). Two hundred ninety patients met the inclusion criteria, and the pre-T 0 CD4 count, time (in years) with a VL of Ͻ50 before T 0 , number of years on HAART, and type of HAART regimen were retrieved from their medical records. Virological rebound was considered when two consecutive viral loads were recorded. Two definitions of virological rebound were evaluated: (i) rebound to more than 50 copies/ml, confirmed in two consecutive samples, and (ii) rebound to more than 400 copies/ ml, also confirmed in two consecutive samples. The time to virological rebound in months was also recorded. The baseline characteristics were ...

BACKGROUNDThe gut microbiota plays a key role in the maintenance of intestinal homeostasis and the development and activation of the host immune system. It has been shown that commensal bacterial species can regulate the expression of host genes. 16S rRNA gene sequencing has shown that the microbiota in inflammatory bowel disease (IBD) is abnormal and characterized by reduced diversity. MicroRNAs (miRNAs) have been explored as biomarkers and therapeutic targets, since they are able to regulate specific genes associated with Crohn’s disease (CD). In this work, we aim to investigate the composition of gut microbiota of active treatment-naïve adult CD patients, with miRNA profile from gut microbiota.AIMTo investigate the composition of gut microbiota of active treatment-naïve adult CD patients, with miRNA profile from gut microbiota.METHODSPatients attending the outpatient clinics at Valme University Hospital without relevant co-morbidities were matched according to age and gender. Faecal samples of new-onset CD patients, free of treatment, and healthy controls were collected. Faecal samples were homogenized, and DNA was amplified by PCR using primers directed to the 16S bacterial rRNA gene. Pyrosequencing was performed using GS-Junior platform. For sequence analysis, MG-RAST server with the database Ribosomal Project was used. MiRNA profile and their relative abundance were analyzed by quantitative PCR.RESULTSMicrobial community was characterized using 16S rRNA gene sequencing in 29 samples (n = 13 CD patients, and n = 16 healthy controls). The mean Shannon diversity was higher in the healthy control population compared to CD group (5.5 vs 3.7). A reduction in Firmicutes and an increase in Bacteroidetes were found. Clostridia class was also significantly reduced in CD. Principal components analysis showed a grouping pattern, identified in most of the subjects in both groups, showing a marked difference between control and CD groups. A functional metabolic study showed that a lower metabolism of carbohydrates (P = 0.000) was found in CD group, while the metabolism of lipids was increased. In CD patients, three miRNAs were induced in affected mucosa: mir-144 (6.2 ± 1.3 fold), mir-519 (21.8 ± 3.1) and mir-211 (2.3 ± 0.4).CONCLUSIONChanges in microbial function in active non-treated CD subjects and three miRNAs in affected vs non-affected mucosa have been found. miRNAs profile may serve as a biomarker.

No abstract

linezolid, rifampicin, tetracycline and vancomycin, and resistant to ciprofloxacin, clindamycin, erythromycin, gentamicin, levofloxacin and penicillin. Subsequently, the patient was treated with doxycycline 100 mg for 7 days with successful results. No new post-treatment control sample was sent.Few reports have associated this microorganism to urinary tract infection [2,3]. However, the etiology of UTI's can be very wide ranging, from the most common pathogens such as Es-