NCT00455793.

Objectives To investigate the effects of aging and smoking on carotid intima-media thickness (cIMT) among patients with and without HIV. Methods Data from a community sample of HIV-infected and HIV-uninfected participants were analyzed. Carotid intima-media thickness was measured via carotid ultrasound and smoking history was obtained via patient interview. Results Data on 166male and female participants with stable HIV-infection and 152 healthy HIV-uninfected participants were analyzed. Among the HIV-infected and HIV-uninfected participants, a significant association was observed between age and cIMT [r=0.51, P<0.0001 (HIV), r=0.39, P<0.0001, (non-HIV)], and between smoking burden and cIMT [r=0.42, P<0.0001 (HIV), r=0.24, P=0.003 (non-HIV)]. In multivariate regression modeling among all participants (HIV and non-HIV), a significant three-way interaction was observed between age, smoking burden, and HIV status with respect to cIMT (P<0.010), controlling for gender, race and traditional cardiovascular disease (CVD) risk factors, such that increased cIMT was associated with increased smoking burden and age to a greater degree among HIV-infected vs. HIV-uninfected participants. Among HIV-infected participants a significant interaction between smoking burden and age with respect to cIMT was seen (P=0.027), controlling for race, gender, CVD risk factors, immunological function and antiretroviral therapy use. Conclusion A significant interaction between HIV, age and smoking on cIMT was observed, suggesting that HIV-infection modifies the relationship of age and smoking on cIMT in this population. These findings emphasize the need to encourage smoking cessation in this population, due to its deleterious effect on subclinical atherosclerosis in older HIV-infected patients.

Objective To test an intervention to increase screening for hepatitis B (HBV) in at-risk immigrants in the primary care setting. Patients and Methods From a Mayo Clinic primary care panel, we identified approximately 19,000 immigrant patients from 9 high-risk countries/ethnic groups with intermediate or high prevalences of chronic HBV. Eligible patients with no record of prior HBV testing scheduled for primary care visits within the study period spanning October 1, 2017, through October 31, 2018, were identified. During the intervention period, the primary health care professional was notified by email 1 week prior to each primary care visit and encouraged to discuss screening for HBV infection and order screening tests at the appointment. We assessed rates of HBV screening during control and intervention periods. Results We identified 597 patients in the control period and 212 patients in the intervention period who had not been screened previously for HBV. During the intervention period, 31.4% (58) of the 185 eligible patients were screened for HBV vs 7.2% (43) of the 597 eligible patients in the control period. Thus, the intervention resulted in a 4.3-fold increase in screening ( P <.00001). Of the 101 patients screened in the at-risk population, 22 (21.8%) screened positive for prior exposure to HBV (hepatitis B core antibody–positive) and 6 (5.9%) for chronic HBV infection (hepatitis B surface antigen–positive). Conclusion Notifying primary care physicians of the high-risk status of immigrant patients substantially increased screening for HBV. Identifying patients with HBV is important for monitoring disease prevalence, preventing transmission, and initiating treatment and cancer surveillance, allowing earlier recognition and prevention of chronic hepatitis, disease reactivation, cirrhosis, and hepatocellular carcinoma.

Fatty acid and retinol binding proteins are a family of proteins found in free living and parasitic nematodes. It is our hypothesis that parasitic nematodes secrete FAR into host tissues, resulting in localized immunosuppression, and hence chronic parsitic infection. Heligmosomoides polygyrus is a mouse model for hookworm that is commonly used in the laboratory for the investigation of the cellular responses to chronic helminth infections. Our laboratory is investigating a protein retrieved from the L4 larval stage of this parasite, a protein believed to be involved in assisting the parasite to form and maintain chronic infections. We have termed this protein Hp‐FAR‐1, for H. polygyrus Fatty Acid and Retinol Binding Protein 1. Creation of mutant FAR proteins that do not bind retinol are of interest for the development of potential vaccine candidates. The purpose of this study was to compare Ce‐FAR‐4, a non‐functional FAR protein from C. elegans, with parasitic FAR proteins. The primary amino acid structures of both parasitic and Ce‐FAR‐4 were analyzed for regions of conservation. Specifically, we target regions that were conserved among the parasitic proteins, including Hp‐FAR‐1, but not in Ce‐FAR‐4; hypothesizing that mutating the conserved regions of Hp‐FAR‐1to the amino acids found in Ce‐FAR‐4 would inhibit retinol binding.

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