Rather than relying on molecular diagnosis based on RNA detection, the point-of-care test www.selleckchem.com/products/MDV3100.html for dengue NS1 antigen would be appropriate for travelers’ screen. NS1 sensitivity is highest between the 2nd and 4th
day of illness and would be useful early in acute phase in non-endemic countries.3 Extreme utility of NS1 antigen assay was witnessed in travelers at airports in Taiwan. By NS1 antigen detection, 19 RT-PCR negative travelers could be labeled dengue positive. Two such travelers turned out to be IgM positive on day 17 or 18 of illness.4 Subhash C. Arya 1 and Nirmala Agarwal 1 “
“Cardiovascular disease is an increasing concern among HIV-infected persons and their providers. We determined if fatty liver disease is a marker for underlying coronary atherosclerosis among HIV-infected persons. We performed a cross-sectional study in HIV-infected adults to evaluate the prevalence of and factors, including fatty liver disease, associated with subclinical coronary atherosclerosis. All participants underwent computed tomography for determination of coronary artery calcium (CAC; positive defined as a score >0) and fatty liver disease (defined Selleck Dasatinib as a liver-to-spleen ratio <1.0). Factors associated with CAC were determined using multivariate logistic regression
models. We included in the study 223 HIV-infected adults with a median age of 43 years [interquartile range (IQR) 36–50 years]; 96% were male and 49% were Caucasian. The median CD4 count was 586 cells/μL and 83% were receiving antiretroviral medications. Seventy-five (34%) had a positive CAC score and 29 (13%) subjects had fatty liver disease. Among those with CAC scores of 0, 1–100 and >100, the percentage with concurrent fatty liver disease was 8, 18 and 41%, respectively (P=0.001). In the multivariate model, CAC was associated with increasing age [odds ratio (OR) 4.3 per 10 years; P<0.01], hypertension (OR 2.6; P<0.01) and fatty liver disease (OR 3.8; P<0.01). Coronary atherosclerosis as detected using CAC is prevalent among young HIV-infected persons. The detection of fatty
liver disease among HIV-infected adults should prompt consideration of assessment for underlying cardiovascular disease and risk factor reduction. As HIV-infected persons are experiencing longer life expectancies, there is increasing concern regarding non-AIDS-defining conditions, including cardiovascular Low-density-lipoprotein receptor kinase disease [1,2]. HIV-infected persons appear to have a higher risk of coronary artery atherosclerosis compared with the general population, which may be a result of HIV-induced inflammation, antiretroviral medications, or concurrent medical conditions, such as insulin resistance, dyslipidaemia, hypertension, visceral fat deposition and tobacco abuse [1–10]. Elevated prevalence rates of subclinical cardiovascular disease among HIV-infected persons have recently been demonstrated using computed tomography (CT) coronary artery calcium (CAC) scores [9,11–18].
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