[Show abstract][Hide abstract] ABSTRACT: Introduction: The prevalence of drug resistance is approximately 10% in Europe and North America among newly infected patients. We aim to investigate the temporal patterns of resistance among drug naive HIV-infected individuals in Greece and also to determine transmission networking among those with resistant strains. Materials and Methods: Protease (PR) and partial reverse transcriptase (RT) sequences were determined from 2499 newly diagnosed HIV-1 patients, in Greece, during 2003-2013. Genotypic drug resistance was estimated using the HIVdb: Genotypic Resistance Interpretation Algorithm. We identified transmission clusters of resistant strains on the basis of a large collection of HIV-1 sequences from 4024 seropositives in Greece. Phylodynamic analysis was performed using a Bayesian method. Results: We estimated drug resistance levels among naïve patients on the basis of all resistance mutations in PR and partial RT. The overall prevalence of resistance was 19.6% (490/2499). Resistance to NNRTIs was the most common (397/2499, 15.9%) followed by PIs (116/2499, 4.6%) and NRTIs (79/2499, 3.2%). We found a significant trend for decreasing resistance to NRTIs over time (6.7%-1.6%). There was no time trend for the overall PI and NNRTI resistance. The most frequently observed major resistant sites in PR were V82 (2.0%) and L90 (1.8%). In RT, we found E138 (58.6%), K103 (13.1%), V179 (8.4%) and T215 (7.1%), M41 (4.7%) associated with resistance to NNRTIs and NRTIs, respectively. The prevalence of K103N and E138Q were significantly increased during 2003-2013. Crucially, we found that both K103N, E138Q are associated with transmission networking within men having sex with men (MSM) and intravenous drug user (IDU) local networks. The K103N network included seropositives across Greece, while the latter only from the recent IDU outbreak in Athens metropolitan area (1). Phylodynamic analyses revealed that the exponential growth for K103N network started in 2009 (Figure 1) and for the E138Q in 2010. Conclusions: The overall resistance has been stable in Greece over time; however, specific NNRTI resistance patterns are increasing. Notably, they are associated with local transmission networking, thus suggesting that this is the cause for the increased patterns of NNRTI resistance and not multiple transmissions of resistant strains from different sources among treated individuals. Our study highlights the advance of molecular epidemiology for understanding the dynamics of resistance.
Journal of the International AIDS Society 01/2014; 17(4(Suppl 3)):19742. · 3.94 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this questionnaire-based study is to investigate antibiotic prescription practices among primary health care physicians in Greece using the 2007 Hellenic Center for Diseases Control and Prevention guidelines as the gold standard. Seven case scenarios were used. A total of 527 physicians participated. The mean compliance rate with the first recommended antibiotic by the guidelines was 51%, ranging from 22.9% to 71.5% by scenario. Younger physicians and female physicians had higher scores of compliance.
American journal of infection control 05/2013; · 3.01 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: During 2011, a dramatic increase (1600%) of reported HIV-1 infections among injecting drug users (IDUs) was noted in Athens, Greece. We herein assess the potential causal pathways associated with this outbreak.
Our study employed high resolution HIV-1 phylogenetic and phylogeographic analyses. We examined also longitudinal data of ecological variables such as the annual growth of gross domestic product (GDP) of Greece in association with HIV-1 and HCV sentinel prevalence in IDUs, unemployment and homelessness rates and HIV transmission networks in Athens IDUs before and during economic recession (2008-2012).
IDU isolates sampled in 2011 and 2012 suggested transmission networks in 94.6% and 92.7% of the cases in striking contrast with the sporadic networking (5%) during 1998-2009. The geographic origin of most HIV-1 isolates was consistent with the recently documented migratory waves in Greece. The decline in GDP was inversely correlated with annual prevalence rates of HIV and HCV and with unemployment and homelessness rates in IDUs (all p<0.001). The slope of anti-HCV prevalence in the sentinel populations of IDUs and in "new" drug injectors was found 120 and 1.9-fold (p = 0.007, p = 0.08 respectively) higher in 2008-2012 (economic recession) compared with 2002-2006. The median (25th, 75th) size of transmission networks were 34 (12, 58) and 2 (2, 2) (p = 0.057) in 2008-2012 and 1998-2007, respectively. The coverage of harm reduction services was low throughout the study period.
Scaling-up harm reduction services and addressing social and structural factors related to the current economic crisis should be urgently considered in environments where HIV-1 outbreaks may occur.
PLoS ONE 01/2013; 8(11):e78941. · 3.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Whether response to combination antiretroviral therapy (cART) differs between those infected with HIV-1 subtype A or B, remains unclear. We compared virologic and immunologic response to cART in individuals infected with subtype A or B in an ethnically homogenous population. Data derived from the Athens Multicenter AIDS Cohort Study (AMACS) and analysis was restricted to those of Greek origin. Time to virologic response (confirmed HIV-RNA<500 copies/ml) and failure (>500 copies/ml at any time or no response by month 6) were analysed using survival models and CD4 changes after cART initiation using piece-wise linear mixed effects models. Of the 571 subjects included in the analysis, 412 (72.2%) were infected with subtype B and 159 (27.8%) with A. After adjusting for various prognostic factors, rate of virologic response was higher for those infected with subtype A versus B (adjusted HR: 1.35; 95% CI: 1.08 - 1.68; P=0.009). Subtype A was also marginally associated with lower hazard of virologic failure compared to subtype B (HR=0.73; 95% CI: 0.53 - 1.02; P=0.062). Further adjustment for treatment adherence did not substantially changed main results. No significant differences were observed in the rates of CD4 increases by subtype. The overall median (95% CI) CD4 increase at 2 years of cART was 193 (175, 212) cells/µl. Our study, based on one of the largest homogenous group of subtype A and B infections in Europe, showed that individuals infected with subtype A had improved virologic but similar immunologic response to cART compared to those infected with subtype B.
AIDS research and human retroviruses 10/2012; · 2.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess the attitudes about mandatory vaccination and vaccination coverage against vaccine-preventable diseases among health-care workers (HCWs) working in tertiary-care hospitals in Greece.
A questionnaire was distributed to HCWs working in four tertiary-care hospitals.
In total, 505 HCWs participated in the survey. Self-reported completed vaccination rates were 18.8% against measles, 18.8% against mumps, 22.2% against rubella, 1.9% against varicella, 3.6% against hepatitis A, 56.5% against hepatitis B, and 35.7% against tetanus-diphtheria. Younger age groups had higher completed vaccination rates against measles, mumps, rubella, varicella, and hepatitis B compared with older HCWs (p-value < 0.001). Self-reported susceptibility rates were 12.7% for measles, 18.9% for mumps, 15.8% for rubella, 15.2% for varicella, 89.9% for hepatitis A, 34.2% for hepatitis B, and 64.3% for tetanus-diphtheria. Sixty three percent of 451 HCWs who answered this question supported mandatory vaccinations for HCWs, with significant differences per target disease. Physicians more frequently supported a mandatory vaccination policy compared to nurses and other professions (72.1% versus 61.9% and 54.2%, respectively; p-value = 0.028).
Approximately two thirds of HCWs working in tertiary-care hospitals in Greece support mandatory vaccinations for HCWs, however suboptimal vaccination rates against vaccine-preventable diseases were recorded.
The Journal of infection 12/2011; 64(3):319-24. · 4.13 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Platelet-activating factor (PAF) is implicated in human immunodeficiency virus (HIV)-related manifestations. Increased PAF synthesis has been recently detected in HIV-infected patients. In this study, we examined in naive HIV-infected patients the in vivo effects of a highly active antiretroviral therapy (HAART) regimen, containing tenofovir-DF/emtricitabine/efavirenz, on PAF metabolism. The specific activities of PAF basic biosynthetic enzymes, PAF-cholinephosphotransferase (PAF-CPT) and lyso-PAF-acetyltransferase (lyso-PAF-AT), but also the ones of PAF-basic catabolic enzymes, PAF acetylhydrolase (PAF-AH) in leukocytes and platelets, and lipoprotein-associated-phospholipase-A(2) (LpPLA(2)) in plasma, were measured in blood samples of eight asymptomatic naive male HIV-infected patients just before and after 1, 3, and 6 months of treatment. CD4 cell counts, viral load, and several biochemical markers were also measured in the same blood samples of these patients. The repeated measures ANOVA and the Pearson r criterion were used to study statistical differences and correlations-partial correlations, while linear mixed models were conducted in order to estimate association(s) between time-dependent changes in these factors. Before treatment, the activities of PAF-CPT in leukocytes and LpPLA(2) in plasma were found to be inversely correlated with CD4 cell counts and positively correlated with the viral load. After 6 months of treatment, the activities of basic PAF-biosynthetic enzymes, PAF-CPT and lyso-PAF-AT, were both reduced in leukocytes. At 6 months, PAF-AH activity was also reduced in these cells, while LpPLA(2) remained stable. The reduction of PAF-CPT occurred even from the first month, while there is a time-dependent correlation between the increase of CD4 and the decrease of both viral load and PAF-CPT of leukocytes during treatment. Apart from its classical antiretroviral activities the tenofovir-DF/emtricitabine/efavirenz regimen also exhibited favorable effects on PAF metabolism and therefore may also display beneficial effects in some HIV-related conditions, such as cardiovascular disease (CVD), in which PAF is implicated.
AIDS research and human retroviruses 11/2011; 28(8):766-75. · 2.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Platelet-activating factor (PAF), a mediator of proatherosclerotic inflammatory processes, is also implicated in endothelial dysfunction during human immunodeficiency virus (HIV) infection. We examined PAF metabolism in blood of naive male patients, 8 with early HIV infection (group A) and 17 just before treatment initiation (group B), versus 18 healthy age-matched males (group C). Statistical analysis was performed with 1-way analysis of variance (ANOVA) criterion and Pearson r test. Higher PAF biosynthesis in patients' leukocytes versus group C was accompanied by an increase in lipoprotein-associated phospholipase A2 (Lp-PLA2) activity that degrades PAF. Moreover, PAF synthesis was higher and Lp-PLA2 activity was lower in group B compared to group A. Lipoprotein-associated phospholipase A2 was positively correlated with viral load and negatively correlated with CD4 cell counts in group B. The activities of PAF-basic biosynthetic enzymes in patients' leukocytes were also negatively correlated with CD4 cell counts. The observed continuous increase in PAF biosynthesis during HIV infection progress seems to amplify the risk of AIDS manifestations and/or cardiovascular complications in HIV-infected patients, while a subsequent increase in Lp-PLA2 activity seems to be a host response.
[Show abstract][Hide abstract] ABSTRACT: Sepsis is characterized as a systemic inflammatory response that results from the inability of the immune system to limit bacterial spread during an ongoing infection. In this condition the significant mediator of inflammation Platelet Activating Factor (PAF) and the coagulant factor thrombin are implicated. In animal models, treatment with PAF-antagonists or co-administration of antibiotics with recombinant-PAF-Acetylhydrolase (rPAF-AH) have exhibited promising results. In order to examine the putative anti-inflammatory and/or antithrombotic interactions between antibiotic treatment used in sepsis with PAF and/or thrombin, we studied the in vitro effects of these compounds towards PAF or/and thrombin related activities and towards PAF basic metabolic enzymes.
We assessed the inhibitory effect of these drugs against PAF or thrombin induced aggregation on washed rabbit platelets (WRPs) or rabbit Platelet Reach Plasma (rPRP) by evaluating their IC50 values. We also studied their effect on Cholinephosphotransferase of PAF (PAF-CPT)/Lyso-PAF-Acetyltransferase (Lyso-PAF-AT) of rabbit leukocytes (RLs), as well as on rabbit plasma-PAF-AH, the key enzymes of both de novo/remodelling PAF biosynthesis and PAF degradation, respectively.
Several antibiotics inhibited PAF-induced platelet aggregation of both WRPs and rPRP in a concentration-depended manner, with clarithromycin, azithromycin and amikacin exhibiting the higher inhibitory effect, while when combined they synergistically inhibited PAF. Higher concentrations of all antibiotics tested were needed in order to inhibit PAF induced aggregation of rPRP, but also to inhibit thrombin induced aggregation of WRPs. Concentrations of these drugs similar to their IC50 values against PAF activity in WRPs, inhibited also in vitro PAF-CPT and Lyso-PAF-AT activities of rabbit leukocytes, while only clarithromycin and azithromycin increased rabbit plasma-PAF-AH activity.
These newly found properties of antibiotics used in sepsis suggest that apart from their general actions, these drugs may present additional beneficial anti-inflammatory and anti-coagulant effects against the onset and establishment of sepsis by inhibiting the PAF/PAF-receptor and/or the thrombin/protease-activated-receptor-1 systems, and/or by reducing PAF-levels through both PAF-biosynthesis inhibition and PAF-catabolism induction. These promising in vitro results need to be further studied and confirmed by in vivo tests, in order to optimize the efficacy of antibiotic treatment in sepsis.
Journal of Inflammation 07/2011; 8:17. · 2.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Calcific myonecrosis is a rare late complication of trauma, affecting almost exclusively the lower limb. Its radiologic appearance is characteristic. Superimposed infection usually is a sequela of biopsy.
We present three patients, one with bilateral involvement, who presented with calcific myonecrosis and spontaneous infection. Three infections were attributable to a single microorganism: Enterobacter cloacae, Staphylococcus hominis, and S. haemolyticus were recovered. Multiple microorganisms were responsible in the other case. Treatment consisted of radical surgical debridement and antibiotics. The incision was closed over a suction drain, where possible, or left open to close by secondary intention.
Calcific myonecrosis may present as infection without any obvious precipitating factor, and it should be included in the differential diagnosis in cases of soft tissue infection of the leg.
[Show abstract][Hide abstract] ABSTRACT: HIV drug resistance is a multifactorial phenomenon and constitutes a major concern as it results in therapy failure. The aim of this study was to assess the impact of an amino acid insertion identified at position 33 of the protease gene, derived from samples from three patients under lopinavir therapy, on viral fitness and protease inhibitor (PI) resistance. Successive samples were available from one of the patients for genotypic and phenotypic testing in order to investigate the role of this insertion. The patient had been pretreated with various antiretroviral drugs and showed poor virological response from the point of the acquisition of the mutation onward. The insertion was acquired in the context of a number of other PI mutations and was stable following acquisition. Phenotypic testing revealed reduced susceptibility to various PIs and a reduction of the replicative capacity (RC) of the virus. In the presence of the insertion alone, a decrease of the RC was observed, which seemed to be compensated by the presence of other mutations. The L33ins might have a potential role in PI resistance pathways but further investigation in a larger number of clinical samples is required in order to elucidate this resistance mechanism.
AIDS research and human retroviruses 03/2011; 27(11):1223-9. · 2.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Information about patterns of HIV-1 drug resistance among treatment-exposed patients is crucial for the development of novel effective drugs. Currently no system exists that monitors patterns of resistance in patients failing therapy.
The study included 1,988 HIV-1 sequences from patients experiencing therapy failure collected between 2000 and 2004 in 15 European countries. Genotypic resistance was interpreted using the ANRS algorithm. Phenotypic resistance was predicted using the Virco geno- to phenotype system.
80.7% of the sequences included at least one drug-resistance mutation. Mutations were found for NRTIs (73.5%), NNRTIs (48.5%), and protease inhibitors (35.8%). Ninety percent of sequences with genotypic resistance harbored M184V, M41L, K103N, D67N, and/or T215Y. Among NRTIs, resistance was most frequently predicted for lamivudine. About half of all sequences had reduced susceptibility for NNRTIs. Resistance to most boosted protease inhibitors was found in < 25%. No sequence had resistance to all currently available drugs.
Levels of resistance among patients with therapy failure were high. The patterns of resistance reflect resistance to drugs available for a longer time. Fully suppressive regimens can be designed even for the most mutated HIV because boosted protease inhibitors have remained active against most circulating viruses and new drug classes have become available.
Acta dermatovenerologica Alpina, Panonica, et Adriatica 12/2010; 19(4):3-9.
[Show abstract][Hide abstract] ABSTRACT: A nationwide survey was conducted in October-November 2009 to investigate determinants of intention to get vaccinated against novel (pandemic) influenza A H1N1 among health-care workers (HCWs) in Greece. Out of 12,879 participating HCWs (response rate: 12.1%) working in 152 (40%) of 380 health-care facilities in Greece, 2814 (21.8%) reported that they intend to get vaccinated against novel influenza A N1H1. Intention rates to get vaccinated increased with age, male sex, being a physician, history of vaccination against seasonal influenza, training in use of personal protective equipment and hand hygiene, and training and involvement in the management of novel influenza cases. Main reasons for refusing vaccination were concerns about vaccine safety (43.1%), inadequate information about the vaccine (27.8%), and perception that they were not at risk for contracting novel influenza (10.7%). Given the low rates of acceptance of pandemic vaccination among HCWs, as found in this study, public health bodies should consider the implementation of a mandatory vaccination policy for HCWs for future pandemics, in order to prevent nosocomial transmission and to protect patients at high-risk for influenza-related complications and death, and to assure the continuity of the essential health-care infrastructure. New strategies should be explored to built safety perception towards influenza vaccines and enhance vaccination rates among HCWs.
The Journal of infection 09/2010; 61(3):252-8. · 4.13 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background: Peripheral arterial disease (PAD) has not been adequately evaluated in HIV+ persons. We studied the prevalence of lower limb PAD in our HIV+ population.
Methods: PAD was assessed by measuring the systolic ankle-brachial blood pressure index (ABI) at rest. ABI was obtained by the standard technique from the left and right side of the patient utilizing the smaller of the two numbers. Patients were placed in 3 groups: group A (ABI<0.9) , group B (ABI 0.91-1.100) and group C (ABI>1.101). Statistical analysis involved ANOVA and Pearson’s r, with statistical significance set at p<0.05.
Results: 317 consecutive HIV+ patients were evaluated (mean age 43.1 yrs). Group A 14/317 (4.42%), group B 172/317 (54.26%) and group C 131/317 (41.32%). Groups’ mean age was 48.6, 41.7 and 44.3 yrs respectively (F 3.56, p=0.03). No difference has been observed regarding gender between the three groups. ABI was correlated negatively with systolic blood pressure (r -0.120, p=0.032), cardiac frequency (r -0.149, p=0.000), metabolic syndrome (r -0.150, p=0.010) and positively with HDLc (r 0.129, p=0.022).
Conclusion: Prevalence of PAD is significant despite the young age of our population. PAD correlates with age, blood pressure, cardiac frequency, metabolic syndrome and HDLc. Larger epidemiological studies are needed to better define risk factors and to evaluate whether PAD is associated with increased mortality in HIV+ populations.
Infectious Diseases Society of America 2009 Annual Meeting; 10/2009
[Show abstract][Hide abstract] ABSTRACT: Platelet-activating factor (PAF) is a potent inflammatory mediator, which seems to play a role in the pathogenesis of several AIDS manifestations such as AIDS dementia complex, Kaposi's sarcoma, and HIV-related nephropathy. PAF antagonists have been studied in these conditions with promising results. In order to examine the possible interactions between PAF and antiretroviral therapy, we studied the effect of nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors against PAF biological activities and its basic biosynthetic enzymes dithiothreitol-insensitive PAF-cholinephosphotransferase (PAF-CPT) and lyso-PAF-acetyltransferase (Lyso-PAF-AT), as well as its main degradative enzyme PAF-acetylhydrolase, of human mesangial cell line (HMC). We also studied the effect of several backbones and highly active antiretroviral therapy (HAART) regimens against PAF activity. Among the drugs tested, several inhibited PAF-induced platelet aggregation in a concentration-depended manner, with tenofovir, efavirenz, and ritonavir exhibiting the higher inhibitory effect. In addition, when these drugs were combined in backbones and HAART regimens based on American antiretroviral therapy proposals, they also synergistically exhibited an inhibitory effect against PAF-induced platelet aggregation. Several of these drugs have also inhibited in vitro microsomal PAF-CPT activity, and concentrations of lopinavir-r or tenofovir-DF (similar to their IC(50) against PAF-induced platelet aggregation) exhibited the same effect against PAF-CPT and Lyso-PAF-AT when added in the cell medium of cultured HMC. In addition, in naïve patients treated with one of the most potent anti-PAF HAART regimens (efavirenz/emtricitabine/tenofovir-DF) for a period of 1 month, a significant reduction of the specific activity of PAF-CPT of washed human leukocytes of these patients was also observed, compared with its levels before the HAART treatment. These promising results need to be further studied and confirmed by additional in vivo tests in order to optimize HAART efficacy.
AIDS research and human retroviruses 08/2008; 24(8):1079-86. · 2.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In North America and Europe, human immunodeficiency virus (HIV)-1 infection has typically been dominated by subtype B transmission. More recently, however, non-B subtypes have been increasingly reported in Europe.
We analyzed 1158 HIV-1-infected individuals in Greece by DNA sequencing and phylogenetic analyses of protease and partial reverse-transcriptase regions.
We found that the prevalence of non-B subtypes has increased over time and that this significant trend can be mainly attributed to subtype A, which eventually surpassed subtype B in prevalence in 2004 (42% and 33%, respectively). Multivariate analysis revealed that the year of HIV diagnosis was independently associated with subtype A infection (odds ratio for being infected with subtype A for a 10-year increase in the time period of diagnosis, 2.09 [95% confidence interval, 1.36-3.24]; P<.001). Phylogenetic analysis revealed that the subtype A epidemic in Greece is the result of a single founder event. The date of the most recent common ancestor of the subtype A in Greece was estimated to be 1977.9 (95% highest posterior density interval, 1973.7-1981.9).
Subtype A circulates among the long-term residents of Greece. This is in contrast to the situation in most European countries, in which infection with non-B genetic forms is associated either with being an immigrant or heterosexual or with intravenous drug use.
The Journal of Infectious Diseases 10/2007; 196(8):1167-76. · 5.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We present the rare case of a 64-year-old man who developed knee pyarthrosis due to Nocardia asteroides following intraarticular injections. The patient was suffering from chronic lymphocytic leukaemia; however, there were no
signs of disseminated Nocardia infection. The patient was treated with antibiotics, arthroscopic lavage of the joint and paracentesis of a cyst that was
formed in the popliteal fossa and calf.
Nous présentons l’observation rare d’un patient de 64 ans qui a développé une arthrite septique à Nocardia asteroides à la suite d’une injection intra articulaire. Le patient souffrait d’une leucémie lymphoïde chronique; cependant il n’y avait
pas de signes de septicémie à Nocardia. Le patient a été traité par antibiothérapie, lavage arthroscopique du genou et ponction du kyste qui s’était formé au niveau
du creux poplité et du mollet.
European Journal of Orthopaedic Surgery & Traumatology 01/2007; 17(5):503-505. · 0.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The COBAS TaqMan HIV-1 test (Roche Diagnostics) was compared with the LCx HIV RNA quantitative assay (Abbott Laboratories), the Versant HIV-1 RNA 3.0 (bDNA) assay (Bayer) and the COBAS Amplicor HIV-1 Monitor v1.5 test (Roche Diagnostics), using plasma samples of various viral load levels from HIV-1-infected individuals. In the comparison of TaqMan with LCx, TaqMan identified as positive 77.5% of the 240 samples versus 72.1% identified by LCx assay, while their overall agreement was 94.6% and the quantitative results of samples that were positive by both methods were strongly correlated (r=0.91). Similarly, in the comparison of TaqMan with bDNA 3.0, both methods identified 76.3% of the 177 samples as positive, while their overall agreement was 95.5% and the quantitative results of samples that were positive by both methods were strongly correlated (r=0.95). Finally, in the comparison of TaqMan with Monitor v1.5, TaqMan identified 79.5% of the 156 samples as positive versus 80.1% identified by Monitor v1.5, while their overall agreement was 95.5% and the quantitative results of samples that were positive by both methods were strongly correlated (r=0.96). In conclusion, the new COBAS TaqMan HIV-1 test showed excellent agreement with other widely used commercially available tests for the quantitation of HIV-1 viral load.
Journal of Virological Methods 03/2006; 131(2):168-74. · 1.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The LCx HIV RNA quantitative assay (Abbott Laboratories, Delkenheim, Germany) was compared with the Versant HIV-1 RNA 3.0 (bDNA) assay (Bayer, Tarrytown, NY) and the COBAS Amplicor HIV-1 Monitor v1.5 test (Roche Diagnostics, Branchburg, NJ), using plasma samples of various viral load levels from HIV-1-infected patients. Considering the lower limit of the linear range of 50 copies/ml of both assays, the detection range of the LCx was 127/151 (84.1%) versus the 131/151 (86.8%) of the bDNA 3.0 assay, while overall agreement between the two assays was 93.4% (141/151). LCx and bDNA 3.0 results were found to be strongly correlated (r = 0.96). The fitted regression line was described by the equation log10(LCx copies/ml) = 0.05 + 1.06 x log10(bDNA 3.0 copies/ml) with 95% CI for the estimated slope and intercept at 1.01, 1.12 and -0.16, 0.26, respectively. Similarly, the detection range of the LCx was 115/148 (77.7%) versus the 128/148 (86.5%) of the Monitor v1.5 test. A 91.2% concordance (135/148) was observed between these two assays at a cut-off of 50 copies/ml. LCx and Monitor v1.5 results were highly correlated (r = 0.96). The fitted regression line was described by the equation log10(LCx copies/ml) = 0.06 + 1.03 x log(10)(Monitor v1.5 copies/ml) with 95% CI for the estimated slope and intercept at 0.97, 1.09 and -0.16, 0.28, respectively.
Journal of Virological Methods 11/2004; 121(1):93-9. · 1.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction: Interfacility transmission of R pathogens has been well documented. Considering the increasing frequency of isolation of EB-R in hospitals, a survey was performed to determine the prevalence of EB-R colonization among elderly residents in Greek LTCF. Methods: A total of 22 LTCF were randomly selected from the public sanitation list of Attica province. Urine, nasopharyngeal and wound samples were collected from 668 residents. We chose randomly 30% of the existing population from each LTCF (minimum sum 25 residents, age > 65 years). EB species were identified by API strips and underwent antimicrobial disk susceptibility testing, following the NCCLS guidelines. Confirmation of ESBL production was done by MIC broth microdilution and double disk diffusion, as per NCCLS. Results: The mean age of the residents was 86 years. 386 EB were isolated from 1418 samples (27,2%). Resistance to ampicillin (AMP), ampicillin-sulbactam (AM/SB), aminoglycosides (AMS), fluoroquinolones (FQ) and third-generation cephalosporines (Chep3) was analyzed. AMP and AM/SB resistant rates were 64% (leading bacteria: Proteus spp. 63% and Escherichia coli 51%) and 37% (leading isolates: Klebsiella spp. 57% and Proteus spp. 48%) respectively. 8,8% of the isolated EB were Chep3-R (Proteus spp. 16,7%, Klebsiella spp. 8,4% and E. coli 5,8% respectively). From Chep3-R EB, 52% were producing ESBL (leading isolates: E. coli 48% and Klebsiella spp. 39%). 66,5 % of the ESBL strains were also FQ- resistant. R to AMS was 24% (leading isolates: Providencia stuartii 70% and Proteus spp 28%) and R to FQ was 19% (leading isolates: Morganella morganii 45% and E. coli 22%). Conclusions: I. Resistance among EB to Chep3, FQ and AMS in Greek LTCF is worrisome. II. The close relationship between FQ-R and ESBL production is remarkable III. The high resistance of E. coli to FQ must be taken into consideration before the administration of empirical therapy.
Infectious Diseases Society of America 2004 Annual Meeting; 10/2004
[Show abstract][Hide abstract] ABSTRACT: One HIV-1 and HCV assay simultaneously detects HIV-1 and HCV RNA (Procleix, Chiron Corp.). The main intended use of the assay is the testing of blood and blood products in blood banking.
To evaluate the clinical sensitivity of the assay, 164 anti-HIV-1+ and 160 anti-HCV+ patients of different viral load were tested. The assay specificity was determined in 1000 HIV-1- and HCV-seronegative blood donors. The ability of the assay to detect different HCV genotypes was investigated in a total of 40 patients of different genotypes (1-4). Furthermore, to investigate the reduction of the HCV window phase before seroconversion, serial samples of 25 hemodialysis patients who seroconverted to anti-HCV were also tested.
The assay detected all 60 HIV-1-infected patients with a viral load of greater than 50 copies per mL and 48 of 104 patients with a viral load of less than 50 copies per mL. Moreover, all 60 patients with an HCV RNA load of greater than 521 IU per mL and 7 of 100 patients with a viral load of less than 50 IU per mL tested positive. The assay specificity was found to be 100 percent. In addition, all 40 patients of different HCV genotypes were successfully detected. Finally, the median time that the assay detected HCV infection before second- and third-generation anti-HCV assay was found to be 183 and 91 days, respectively.
The assay sensitivity and specificity, its ability to detect different HCV genotypes, and the significant reduction of window period of HCV infection further support its use for improving the safety of blood and blood products.