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1.
Ecotoxicol Environ Saf ; 146: 104-110, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28526170

RESUMO

The Deepwater Horizon oil spill contaminated thousands of miles of habitat valuable to hundreds of species of migratory and resident birds of the Gulf of Mexico. Many birds died as a direct result of the oil spill; however, the indirect effects of oil exposure on the flight ability and body condition of birds are difficult to assess in situ. This study utilizes the homing pigeon as a surrogate species for migratory birds to investigate the effect of multiple external oil exposures on the flight performance and body mass change of birds over a series of repeated flights from 136.8km flight distance. Oiled pigeons took significantly longer to return home, lost more weight during flight, and were unable to recover their weight, resulting in reduction of body weight overtime. Based on our data, migratory birds that were oiled, even partially, by the Deepwater Horizon oil spill likely took longer to complete migration and were likely in poor body condition, increasing their risk of mortality and reproductive failure.


Assuntos
Peso Corporal/efeitos dos fármacos , Columbidae/fisiologia , Voo Animal/efeitos dos fármacos , Comportamento de Retorno ao Território Vital/efeitos dos fármacos , Petróleo/toxicidade , Poluentes Químicos da Água/toxicidade , Migração Animal/efeitos dos fármacos , Animais , Columbidae/crescimento & desenvolvimento , Ecossistema , Golfo do México , Poluição por Petróleo/efeitos adversos , Testes de Toxicidade
2.
Ecotoxicol Environ Saf ; 146: 98-103, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28596040

RESUMO

In 2010, the Deepwater Horizon oil spill released 134 million gallons of crude oil into the Gulf of Mexico making it the largest oil spill in US history. The three month oil spill left tens of thousands of birds dead; however, the fate of tens of thousands of other migratory birds that were affected but did not immediately die is unknown. We used the homing pigeon as a surrogate species for migratory birds to investigate the effects of a single external oiling event on the flight performance of birds. Data from GPS data loggers revealed that lightly oiled pigeons took significantly longer to return home and spent more time stopped en route than unoiled birds. This suggests that migratory birds affected by the oil spill could have experienced long term flight impairment and delayed arrival to breeding, wintering, or crucial stopover sites and subsequently suffered reductions in survival and reproductive success.


Assuntos
Columbidae/fisiologia , Voo Animal/efeitos dos fármacos , Poluição por Petróleo/efeitos adversos , Petróleo/toxicidade , Poluentes Químicos da Água/toxicidade , Migração Animal/efeitos dos fármacos , Animais , Relação Dose-Resposta a Droga , Golfo do México , Reprodução/efeitos dos fármacos , Testes de Toxicidade
3.
Environ Res ; 149: 179-188, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27208469

RESUMO

The sodium iodide-symporter (NIS) mediates uptake of iodide into thyroid follicular cells. This key step in thyroid hormone synthesis is inhibited by perchlorate, thiocyanate (SCN) and nitrate (NO3) anions. When these exposures occur during pregnancy the resulting decreases in thyroid hormones may adversely affect neurodevelopment of the human fetus. Our objectives were to describe and examine the relationship of these anions to the serum thyroid indicators, thyroid stimulating hormone (TSH) and free thyroxine (FT4), in third trimester women from the initial Vanguard Study of the National Children's Study (NCS); and to compare urine perchlorate results with those in pregnant women from the National Health and Nutritional Examination Survey (NHANES). Urinary perchlorate, SCN, NO3, and iodine, serum TSH, FT4, and cotinine were measured and a food frequency questionnaire (FFQ) was administered to pregnant women enrolled in the initial Vanguard Study. We used multiple regression models of FT4 and TSH that included perchlorate equivalent concentration (PEC, which estimates combined inhibitory effects of the anions perchlorate, SCN, and NO3 on the NIS). We used multiple regression to model predictors of each urinary anion, using FFQ results, drinking water source, season of year, smoking status, and demographic characteristics. Descriptive statistics were calculated for pregnant women in NHANES 2001-2012. The geometric mean (GM) for urinary perchlorate was 4.04µg/L, for TSH 1.46mIU/L, and the arithmetic mean for FT4 1.11ng/dL in 359 NCS women. In 330 women with completed FFQs, consumption of leafy greens, winter season, and Hispanic ethnicity were significant predictors of higher urinary perchlorate, which differed significantly by study site and primary drinking water source, and bottled water was associated with higher urinary perchlorate compared to filtered tap water. Leafy greens consumption was associated with higher urinary NO3 and higher urinary SCN. There was no association between urinary perchlorate or PEC and TSH or FT4, even for women with urinary iodine <100µg/L. GM urinary perchlorate concentrations in the full sample (n=494) of third trimester NCS women (4.03µg/L) were similar to pregnant women in NHANES (3.58µg/L).


Assuntos
Antitireóideos/farmacologia , Exposição Ambiental , Nitratos/urina , Percloratos/urina , Simportadores/antagonistas & inibidores , Tiocianatos/urina , Tireotropina/sangue , Tiroxina/sangue , Adulto , Feminino , Humanos , Inquéritos Nutricionais , Gravidez , Terceiro Trimestre da Gravidez , Testes de Função Tireóidea , Estados Unidos , Adulto Jovem
4.
Environ Res ; 129: 32-8, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24529000

RESUMO

Environmental phenols are a group of chemicals with widespread uses in consumer and personal care products, food and beverage processing, and in pesticides. We assessed exposure to benzophenone-3, bisphenol A (BPA), triclosan, methyl- and propyl parabens, and 2,4- and 2,5-dichlorophenol or their precursors in 506 pregnant women enrolled in the National Children's Study (NCS) Vanguard Study. We measured the urinary concentrations of the target phenols by using online solid-phase extraction-isotope dilution high performance liquid chromatography-tandem mass spectrometry. NCS women results were compared to those of 524 similar-aged women in the National Health and Nutrition Examination Survey (NHANES) 2009-2010, and to 174 pregnant women in NHANES 2005-2010. In the NCS women, we found significant racial/ethnic differences (p<0.05) in regression adjusted mean concentrations of benzophenone-3, triclosan, 2,4- and 2,5-dichlorophenol, but not of BPA. Urinary 2,4- and 2,5-dichlorophenol concentrations were highly correlated (r=0.66, p<0.0001). Except for BPA and triclosan, adjusted mean concentrations were significantly different across the 7 study sites. Education was marginally significant for benzophenone-3, triclosan, propyl paraben, and 2,5-dichlorophenol. Urinary concentrations of target phenols in NCS pregnant women and U.S. women and pregnant women were similar. In NCS pregnant women, race/ethnicity and geographic location determined urinary concentrations of most phenols (except BPA), suggesting differential exposures. NCS Main Study protocols should collect urine biospecimens and information about exposures to environmental phenols.


Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Exposição Ambiental/análise , Poluentes Ambientais/urina , Fenóis/urina , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adolescente , Adulto , Criança , Cromatografia Líquida de Alta Pressão , Monitoramento Ambiental/métodos , Feminino , Financiamento Governamental , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Gravidez , Extração em Fase Sólida , Espectrometria de Massas em Tandem , Estados Unidos , Adulto Jovem
5.
J Pediatric Infect Dis Soc ; 13(8): 387-395, 2024 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-38808862

RESUMO

BACKGROUND: Antiretroviral therapy (ART) is known to improve child survival and growth in children living with HIV (CLHIV). We investigated growth outcomes in children with severe nonedematous acute malnutrition (SAM) and without SAM (mild malnutrition and normal nutrition) after initiation of ART in both groups and nutritional support. MATERIAL AND METHODS: IMPAACT P1092 enrolled CLHIV aged 6 to <36 months with World Health Organization (WHO)-defined SAM or without SAM across 5 sites in Sub-Saharan Africa and followed them for 48 weeks. The enrollment was conducted in four countries: Malawi, Tanzania, Uganda, and Zimbabwe between October 2015 and September 2017. Weight, height, and mid-upper arm circumference (MUAC) were measured at baseline through 48 weeks. WHO weight-for-length/height Z-scores (WFL/H Z-score) were calculated. SAM children received readily available therapeutic food per WHO guidelines. All participants were initiated on a triple-ART regimen. SAM children entered the study after initial nutritional rehabilitation. RESULTS: Fifty-two CLHIV, 25 in the SAM cohort and 27 in the without SAM cohort, were enrolled. WFL/H Z-scores and MUAC in the SAM cohort increased significantly at weeks 24 and 48 [WFL/H Z-scores: mean change (95% CI) 2.34 (1.77, 2.91) and 2.73 (2.09, 3.37), both P < .001; MUAC: mean change (95% CI) 2.63 (1.98, 3.28) and 3.53 (2.83, 4.24) cm, P < .001]. At week 48, mean SAM height was 4 cm shorter and mean weight 1 kg lighter than without SAM [post hoc mean differences -4.11 (95% CI -8.60, 0.38) cm and -0.92 (95% CI -2.22, 0.39) kg]. CONCLUSIONS: CLHIV with SAM who undergo WHO nutritional rehabilitation can achieve significant growth and WFL/H Z-score improvements but continued intensive anthropometric monitoring is needed as SAM may still be behind those without SAM.


Assuntos
Infecções por HIV , Desnutrição Aguda Grave , Humanos , Lactente , Infecções por HIV/tratamento farmacológico , Infecções por HIV/complicações , Masculino , Desnutrição Aguda Grave/reabilitação , Feminino , Pré-Escolar , Apoio Nutricional/métodos , Antirretrovirais/uso terapêutico , Fármacos Anti-HIV/uso terapêutico , Uganda
6.
Lancet HIV ; 11(4): e211-e221, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38538160

RESUMO

BACKGROUND: Combined intramuscular long-acting cabotegravir and long-acting rilpivirine constitute the first long-acting combination antiretroviral therapy (ART) regimen approved for adults with HIV. The goal of the IMPAACT 2017 study (MOCHA [More Options for Children and Adolescents]) was to assess the safety and pharmacokinetics of these drugs in adolescents. METHODS: In this phase 1/2, multicentre, open-label, non-comparative, dose-finding study, virologically suppressed adolescents (aged 12-17 years; weight ≥35 kg; BMI ≤31·5 kg/m2) with HIV-1 on daily oral ART were enrolled at 15 centres in four countries (Botswana, South Africa, Thailand, and the USA). After 4-6 weeks of oral cabotegravir (cohort 1C) or rilpivirine (cohort 1R), participants received intramuscular long-acting cabotegravir or long-acting rilpivirine every 4 weeks or 8 weeks per the adult dosing regimens, while continuing pre-study ART. The primary outcomes were assessments of safety measures, including all adverse events, until week 4 for oral cabotegravir and until week 16 for long-acting cabotegravir and long-acting rilpivirine, and pharmacokinetic measures, including the area under the plasma concentration versus time curve during the dosing interval (AUC0-tau) and drug concentrations, at week 2 for oral dosing of cabotegravir and at week 16 for intramuscular dosing of cabotegravir and rilpivirine. Enrolment into cohort 1C or cohort 1R was based on the participant's pre-study ART, meaning that masking was not done. For pharmacokinetic analyses, blood samples were drawn at weeks 2-4 after oral dosing and weeks 4-16 after intramuscular dosing. Safety outcome measures were summarised using frequencies, percentages, and exact 95% CIs; pharmacokinetic parameters were summarised using descriptive statistics. This trial is registered at ClinicalTrials.gov, NCT03497676, and is closed to enrolment. FINDINGS: Between March 19, 2019, and Nov 25, 2021, 55 participants were enrolled: 30 in cohort 1C and 25 in cohort 1R. At week 16, 28 (97%, 95% CI 82-100) of the 29 dose-evaluable participants in cohort 1C and 21 (91%; 72-99) of the 23 dose-evaluable participants in cohort 1R had reported at least one adverse event, with the most common being injection-site pain (nine [31%] in cohort 1C; nine [39%] in cohort 1R; none were severe). One (4%, 95% CI 0-22) participant in cohort 1R had an adverse event of grade 3 or higher, leading to treatment discontinuation, which was defined as acute rilpivirine-related allergic reaction (self-limiting generalised urticaria) after the first oral dose. No deaths or life-threatening events occurred. In cohort 1C, the week 2 median cabotegravir AUC0-tau was 148·5 (range 37·2-433·1) µg·h/mL. The week 16 median concentrations for the every-4-weeks and every-8-weeks dosing was 3·11 µg/mL (range 1·22-6·19) and 1·15 µg/mL (<0·025-5·29) for cabotegravir and 52·9 ng/mL (31·9-148·0) and 39·1 ng/mL (27·2-81·3) for rilpivirine, respectively. These concentrations were similar to those in adults. INTERPRETATION: Study data support using long-acting cabotegravir or long-acting rilpivirine, given every 4 weeks or 8 weeks, per the adult dosing regimens, in virologically suppressed adolescents aged 12 years and older and weighing at least 35 kg. FUNDING: The National Institutes of Health and ViiV Healthcare.


Assuntos
Fármacos Anti-HIV , Dicetopiperazinas , Infecções por HIV , Adolescente , Criança , Humanos , Infecções por HIV/tratamento farmacológico , Piridonas , Rilpivirina/efeitos adversos , Rilpivirina/uso terapêutico
7.
BMC Nutr ; 9(1): 121, 2023 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-37919816

RESUMO

BACKGROUND: Micronutrient deficiencies from malabsorption, gut infections, and altered gut barrier function are common in children living with the human immunodeficiency virus (CLHIV) and may worsen with severe acute malnutrition (SAM). Exploratory data of baseline zinc and selenium levels and changes over 48 weeks in children living with HIV by nutritional status are presented. METHODS: Zinc, selenium, serum protein and albumin levels measured at study entry and over 48 weeks were compared between children aged 6 to < 36 months who were living with HIV and had SAM or mild malnutrition-normal nutrition. Children with SAM were enrolled after 10-18 days of nutritional rehabilitation. Two-sided t-tests were used to compare levels and changes in levels of micronutrients and proteins by nutritional status. RESULTS: Fifty-two participants, 25 with and 27 without SAM, of median (Q1,Q3) age 19 (13,25) and 18 (12,25) months respectively, were enrolled. Zinc deficiency was present at entry in 2/25 (8%) of those who had SAM. Mean (SD) baseline zinc levels were [52.2(15.3) and 54.7(12.0) µg/dL] for the SAM and non-SAM cohorts respectively while selenium levels were similar [92.9(25.0), 84.3(29.2) µg/L]. Mean changes of zinc and selenium from study entry to week 48 were similar between the children with and without SAM. There was no significant difference between baseline protein levels [75.2(13.2), 77.3(9.4) g/L] and the mean change from study entry to 48 weeks was also similar between the two groups; with a mean difference of 4.6 g/L [95% CI, (-2.4,11.6)]. Children with SAM compared to those without had significantly lower serum albumin levels at study entry with similar levels at 48 weeks. CONCLUSIONS: Children with severe malnutrition who were initiated/switched to zidovudine/lamivudine/boosted lopinavir following 10 to 18 days of nutritional rehabilitation showed normal baseline levels of selenium and zinc, and had comparable selenium levels after 48 weeks. There was a strong positive correlation in entry and week 48 selenium levels within each cohort and for zinc in the non-SAM cohort. These data support the current WHO recommended approach to management of severe malnutrition in CLHIV who are initiated on combination antiretroviral treatment. TRIAL REGISTRATION: Registered with ClinicalTrials.gov Identifier NCT01818258 26/03/2013.

8.
J Infect Dis ; 204 Suppl 1: S179-89, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21666159

RESUMO

UNLABELLED: BACKGROUND.: ACTG (Pediatric AIDS Clinical Trials Group) 225, a multicenter, randomized, open-label trial in the United States evaluated reactogenicity and immunogenicity of 2 vaccination regimens: monovalent measles vaccine (Attenuvax) at 6 months of age and measles, mumps, and rubella, live attenuated (MMRII) vaccine at 12 months of age (2D), or only MMRII at 12 months of age (1D) in human immunodeficiency virus-infected (HIV-infected) (POS) and uninfected (NEG) children in the pre-highly active antiretroviral therapy (pre-HAART) period. METHODS: Plaque-reduction neutralization (PRN) of measles-neutralizing antibody titers were evaluated at study weeks 0, 6, 26, 32, 52, and 130 (∼3 years of age). RESULTS: The 110 subjects included: 65 2DNEG; 30 1DNEG; 7 2DPOS and 8 1DPOS. Vaccinations (n=175) were associated with no adverse experiences >Grade 2 except for Grade 3 fever (n=2, 1 1DPOS and 1 1DNEG). Six weeks after Attenuvax, all 2DPOS subjects (7/7) seroresponded (PRN titers ≥120 mIU/mL) with median titers significantly exceeding 2DNEG titers (2115 vs 628 mIU/mL, respectively; P=.023). At ∼3 years of age, 67% 1DPOS (4/6) and 83% 2DPOS (4/5) subjects maintained titers ≥120 mIU/mL. Prevaccination titers ≥25 mIU/mL among 2DNEG subjects correlated inversely with the likelihood of achieving titers ≥120 mIU/mL (56% vs 90%; P=.004). CONCLUSIONS: Among HIV-infected children pre-HAART, Attenuvax at 6 months was well tolerated and immunogenic. These data support the current World Health Organization (WHO) recommendation to administer a first dose of measles vaccine at 6 months of age to HIV-infected children.


Assuntos
Anticorpos Neutralizantes/sangue , Infecções por HIV/complicações , Vacina contra Sarampo/efeitos adversos , Vacina contra Sarampo/imunologia , Sarampo/prevenção & controle , Anticorpos Antivirais/sangue , Contagem de Linfócito CD4 , Pré-Escolar , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Esquemas de Imunização , Transmissão Vertical de Doenças Infecciosas , Masculino , Sarampo/complicações , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola/imunologia , Gravidez , Estados Unidos/epidemiologia , Vacinas Atenuadas/efeitos adversos , Vacinas Atenuadas/imunologia , Proteínas da Matriz Viral/imunologia
9.
Pediatr Infect Dis J ; 41(11): 885-890, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-35980827

RESUMO

BACKGROUND: Treatment and prophylaxis options for neonatal HIV are limited. This study aimed to develop a population pharmacokinetic model to characterize the disposition of maraviroc in neonates to inform dosing regimens and expand available options. METHODS: Using maraviroc concentrations from neonates who received either a single dose or multiple doses of 8 mg/kg of maraviroc in the first 6 weeks of life, a population pharmacokinetic model was developed to determine the effects of age, sex, maternal efavirenz exposure and concomitant ARV therapy on maraviroc disposition. The final model was used in Monte Carlo simulations to generate expected exposures with recommended dosing regimens. RESULTS: A total of 396 maraviroc concentrations, collected in the first 4 days of life, at 1 week, at 4 weeks and at 6 weeks, from 44 neonates were included in the analysis. After allometrically scaling for weight, age less than 4 days was associated with a 44% decreased apparent clearance compared with participants 7 days to 6 weeks of life. There were no differences identified in apparent clearance or volume of distribution from ages 7 days to 6 weeks, sex, maternal efavirenz exposure or concomitant nevirapine therapy. Monte Carlo simulations with FDA-approved weight band dosing resulted in the majority of simulated patients (84.3%) achieving an average concentration of ≥75 ng/mL. CONCLUSIONS: While maraviroc apparent clearance is decreased in the first few days of life, the current FDA-approved maraviroc weight band dosing provides maraviroc exposures for neonates in the first 6 weeks of life, which were consistent with adult maraviroc exposure range. Maraviroc provides another antiretroviral treatment option for very young infants.


Assuntos
Infecções por HIV , Nevirapina , Adulto , Alcinos , Benzoxazinas/uso terapêutico , Ciclopropanos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Maraviroc/uso terapêutico
10.
J Infect Dis ; 202(2): 291-301, 2010 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-20533872

RESUMO

BACKGROUND: Mitochondrial dysfunction has been associated with both human immunodeficiency virus (HIV) infection and exposure to antiretroviral therapy. Mitochondrial dysfunction has not been widely studied in HIV-infected children. We estimated the incidence of clinically defined mitochondrial dysfunction among children with perinatal HIV infection. METHODS: Children with perinatal HIV infection enrolled in a prospective cohort study (Pediatric AIDS Clinical Trials Group protocols 219 and 219C) from 1993 through 2004 were included. Two clinical case definitions of mitochondrial dysfunction, the Enquête Périnatale Française criteria and the Mitochondrial Disease Classification criteria, were used to classify signs and symptoms that were consistent with possible mitochondrial dysfunction. Adjusted odds ratios of the associations between single and dual nucleoside reverse-transcriptase inhibitor use and possible mitochondrial dysfunction were estimated using logistic regression. RESULTS: Overall, 982 (33.5%) of 2931 children met 1 or both case definitions of possible mitochondrial dysfunction. Mortality was highest among the 96 children who met both case definitions (20%). After adjusting for confounders, there was a higher risk of possible mitochondrial dysfunction among children who received stavudine regardless of exposure to other medications (odds ratio, 3.44 [95% confidence interval, 1.91-6.20]) or who received stavudine-didanosine combination therapy (odds ratio, 2.23 [95% confidence interval, 1.19-4.21]). Exposure to lamivudine and to lamivudine-stavudine were also associated with an increased risk of mitochondrial dysfunction. CONCLUSIONS: Receipt of nucleoside reverse-transcriptase inhibitors, especially stavudine and lamivudine, was associated with possible mitochondrial dysfunction in children with perinatal HIV infection. Further studies are warranted to elucidate potential mechanisms of nucleoside reverse-transcriptase inhibitor toxicities.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/fisiopatologia , Doenças Mitocondriais/fisiopatologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Humanos , Recém-Nascido , Masculino , Doenças Mitocondriais/complicações , Doenças Mitocondriais/epidemiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Estudos Prospectivos , Análise de Regressão , Estavudina/uso terapêutico , Estados Unidos , Zidovudina/uso terapêutico
11.
Front Glob Womens Health ; 2: 574327, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34816174

RESUMO

Zika virus (ZIKV) infection may adversely affect pregnancies of women living with HIV (WLHIV). Because no study to date has focused on maternal and child effects of HIV and ZIKV co-infection in pregnant women, we undertook the International Prospective Cohort Study of HIV and Zika in Infants and Pregnancy (HIV ZIP). The aims of this two-phase study of pregnant women and their infants are to compare the incidence of ZIKV infection among pregnant women with and without HIV infection and to determine the risk of adverse maternal and child outcomes associated with ZIKV/HIV co-infection at clinical sites in Brazil, Puerto Rico, and the continental United States. Phase I was designed to enroll pregnant women/infant pairs who were: (1) infected with HIV only, (2) infected with ZIKV only, (3) infected with HIV and ZIKV, and (4) not infected with either HIV or ZIKV. A key goal of this phase was to assess the feasibility of enrolling 200 women/infant pairs within a year, with a target of 150 WLHIV, 50 HIV-uninfected women, and a minimum of 20 who were co-infected with HIV and ZIKV. If the feasibility of Phase I proved successful, Phase II would enroll up to 1,800 additional pregnant women/infant pairs to the same four groups. Enrolled women in both phases were to be followed throughout their pregnancy and up to 6 weeks post-partum. Infants were also to be followed for 1 year after birth. To date, Phase 1 data collection and follow-up have been completed. Delineation of possible harmful effects of HIV/ZIKV co-infection will allow the formulation of standard-of-care recommendations to minimize adverse effects but enable the continuation of preventive HIV therapy. Furthermore, while the prospective HIV ZIP study was developed before the COVID pandemic, it is especially relevant today since it can be easily adapted to provide critically important information on the impact of COVID-19 infection or other still unrecognized new agents among pregnant women and their offspring worldwide.

12.
AIDS ; 35(3): 419-427, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33252481

RESUMO

OBJECTIVE: The aim of this study was to evaluate safety and pharmacokinetics of maraviroc administered with standard antiretroviral prophylaxis to HIV-1 exposed infants and to determine the appropriate dose of maraviroc during the first 6 weeks of life. DESIGN: A phase I, multicentre, open-label study enrolling two sequential cohorts. METHODS: IMPAACT 2007 participants enrolled by day 3 of life and were stratified by exposure to maternal efavirenz. Cohort 1 participants received two single 8 mg/kg maraviroc doses 1 week apart with pharmacokinetic sampling after each dose. Cohort 2 participants received 8 mg/kg maraviroc twice daily through 6 weeks of life with pharmacokinetic sampling at weeks 1 and 4. Maraviroc exposure target was Cavg at least 75 ng/ml. Laboratory and clinical evaluations assessed safety. RESULTS: Fifteen Cohort 1 and 32 Cohort 2 HIV-exposed neonates were enrolled (median gestational age 39 weeks, 51% male). All 13 evaluable Cohort 1 infants met the pharmacokinetic target. Median exposure for the 25 evaluable Cohort 2 infants met the pharmacokinetic target but variability was high, with 17-33% of infants below target at Weeks 1 and 4. Pharmacokinetic target achievement was similar between efavirenz exposure strata. No Grade 3+ toxicities, early study or treatment discontinuations due to maraviroc occurred. CONCLUSION: Median maraviroc exposure met the Cavg target in neonates receiving 8 mg/kg twice daily, although exposures were variable. Maternal efavirenz use did not impact maraviroc exposure and no discontinuations were due to maraviroc toxicity/intolerance. No infants acquired HIV-1 infection during follow-up. Maraviroc 8 mg/kg twice daily appears well tolerated during the first 6 weeks of life.


Assuntos
Infecções por HIV , HIV-1 , Adulto , Antirretrovirais/uso terapêutico , Estudos de Coortes , Cicloexanos/efeitos adversos , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Recém-Nascido , Masculino , Maraviroc
13.
Pediatr Infect Dis J ; 40(5): 446-452, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33464021

RESUMO

BACKGROUND: Severe acute malnutrition (SAM) may alter the pharmacokinetics (PK), efficacy, and safety of antiretroviral therapy. The phase IV study, IMPAACT P1092, compared PK, safety, and tolerability of zidovudine (ZDV), lamivudine (3TC), and lopinavir/ritonavir (LPV/r) in children with and without SAM. MATERIALS AND METHODS: Children living with HIV 6 to <36 months of age with or without World Health Organization (WHO)-defined SAM received ZDV, 3TC, and LPV/r syrup for 48 weeks according to WHO weight band dosing. Intensive PK sampling was performed at weeks 1, 12, and 24. Plasma drug concentrations were measured using liquid chromatography tandem mass spectrometry. Steady-state mean area under the curve (AUC0-12h) and clearance (CL/F) for each drug were compared. Grade ≥3 adverse events were compared between cohorts. RESULTS: Fifty-two children were enrolled across 5 sites in Africa with 44% (23/52) female, median age 19 months (Q1, Q3: 13, 25). Twenty-five children had SAM with entry median weight-for-height Z-score (WHZ) -3.4 (IQR -4.0, -3.0) and 27 non-SAM had median WHZ -1.0 (IQR -1.8, -0.1). No significant differences in mean AUC0-12h or CL/F were observed (P ≥ 0.09) except for lower 3TC AUC0-12h (GMR, 0.60; 95% CI, 0.4-1.0; P = 0.047) at week 12, higher ZDV AUC0-12h (GMR, 1.52; 1.2-2.0; P = 0.003) at week 24 in the SAM cohort compared with non-SAM cohort. Treatment-related grade ≥3 events did not differ significantly between cohorts (24.0% vs. 25.9%). CONCLUSION: PK and safety findings for ZDV, 3TC, and LPV/r support current WHO weight band dosing of syrup formulations in children with SAM.


Assuntos
Fármacos Anti-HIV/farmacocinética , Infecções por HIV/tratamento farmacológico , Lamivudina/farmacocinética , Lopinavir/farmacocinética , Ritonavir/farmacocinética , Zidovudina/farmacocinética , África Subsaariana/epidemiologia , Fármacos Anti-HIV/sangue , Área Sob a Curva , Pré-Escolar , Cromatografia Líquida/instrumentação , Estudos de Coortes , Combinação de Medicamentos , Vias de Eliminação de Fármacos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Infecções por HIV/complicações , Humanos , Lactente , Lamivudina/sangue , Lopinavir/sangue , Masculino , Segurança do Paciente , Ritonavir/sangue , Desnutrição Aguda Grave/complicações , Espectrometria de Massas em Tandem/instrumentação , Zidovudina/sangue
14.
Bull Environ Contam Toxicol ; 84(6): 677-81, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20449724

RESUMO

Homing pigeons (Columba livia) were used as a model to assess the effects of chlorpyrifos and aldicarb on flight times at sub-lethal, environmentally relevant concentrations. A significant increase in flight times of birds dosed with aldicarb and with chlorpyrifos was observed. Plasma cholinesterase activity was measured over time following exposure to either compound. The results suggest that the time of peak inhibition would correlate with migratory flight activity after exposure. In total, the results of these studies show that sub-lethal exposure to cholinesterase-inhibiting pesticides can affect the flying ability of non-target avian species.


Assuntos
Migração Animal/efeitos dos fármacos , Inibidores da Colinesterase/toxicidade , Columbidae/fisiologia , Poluentes Ambientais/toxicidade , Comportamento de Retorno ao Território Vital/efeitos dos fármacos , Atividade Motora/efeitos dos fármacos , Aldicarb/toxicidade , Animais , Clorpirifos/toxicidade , Colinesterases/sangue , Colinesterases/metabolismo , Columbidae/sangue , Columbidae/metabolismo , Relação Dose-Resposta a Droga , Testes de Toxicidade
16.
J Clin Microbiol ; 46(9): 2945-9, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18614660

RESUMO

Collecting whole blood on filter paper simplifies the processing, transport, and storage of specimens used for the diagnosis of human immunodeficiency virus type 1 (HIV-1) and other tests. Specimens may be collected in tropical or rural areas with minimal facilities for handling specimens. To compare simulated tropical conditions with freezer storage, we examined the stability of HIV-1 DNA in dried blood spots (DBS) stored in humid heat and at -20 degrees C. DBS were created by spotting 50-microl aliquots of whole blood on 903 filter paper. DNA was extracted from DBS at baseline and after 2, 6, or 12 months of storage at -20 degrees C or at 37 degrees C with approximately 85% humidity. The DNA was tested undiluted or diluted using the Amplicor HIV-1 DNA PCR (Roche), version 1.5. Each reaction was scored positive, negative, or indeterminate based on optical density. Results were compared between storage conditions and over time. A total of 1,832 reactions from 916 DBS were analyzed, including 100 DBS at baseline, 418 stored at -20 degrees C, and 398 stored at 37 degrees C. A chi-square test showed fewer positive reactions for DBS stored at 37 degrees C (55%) than for those stored at -20 degrees C (78%) (P < 0.0001). Samples stored at -20 degrees C showed little change in the probability of detection of HIV-1 DNA over time; the odds ratio (OR) was 0.93 after storage for 1 year. Samples stored at 37 degrees C demonstrated a significant change in detection at 1 year (OR, 0.29). We conclude that exposure of DBS to 37 degrees C and high humidity impaired the recovery of HIV-1 DNA from DBS, whereas DNA recovery was preserved when DBS were stored frozen.


Assuntos
Criopreservação , DNA Viral/genética , HIV-1/genética , Manejo de Espécimes , Temperatura Alta , Humanos , Umidade
17.
PLoS One ; 13(8): e0191276, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30133439

RESUMO

A growing body of evidence suggests that prenatal environment is important in Autism Spectrum Disorder (ASD) etiology. In this study, we compare placental shape features in younger siblings of children with ASD, who themselves are at high ASD risk, to a sample of low risk peers. Digital photographs of the fetal placenta surface and of the sliced placental disk from 129 high ASD risk newborns and from 267 newborns in the National Children's Study Vanguard pilot were analysed to extract comparable measures of placental chorionic surface shape, umbilical cord displacement and disk thickness. Placental thickness measures were moderately higher in siblings of ASD cases. The placentas of ASD-case siblings were also rounder and more regular in perimeter than general population placentas. After stratification by sex, these across-group differences persisted for both sexes but were more pronounced in females. No significant differences were observed in cord insertion measures. Variations in placental shape features are generally considered to reflect flexibility in placental growth in response to changes in intrauterine environment as the placenta establishes and matures. Reduced placental shape variability observed in high ASD risk siblings compared to low-risk controls may indicate restricted ability to compensate for intrauterine changes.


Assuntos
Transtorno do Espectro Autista/patologia , Placenta/patologia , Transtorno Autístico/patologia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Masculino , Tamanho do Órgão , Fotografação , Placenta/anormalidades , Gravidez , Fatores de Risco , Irmãos , Cordão Umbilical/anormalidades , Cordão Umbilical/patologia
18.
Integr Environ Assess Manag ; 13(5): 870-876, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28195437

RESUMO

Access to water along a bird's migratory flyway is essential during the vital process of migration. Because of the scarcity of water in some environments, there is potential for migratory birds to encounter and drink from contaminated bodies of water. Ingestion of contaminated water may cause injury and compromise flying ability, leading to a disruption of migration. To determine injury to birds from potential exposure, it is essential to know not only the concentration of a given contaminant in the water but also the quantity and rate of water consumption by the birds. Homing pigeons (Columba livia) were used in a series of experiments to determine differences in drinking behavior after various flights and after periods of resting. Results from the present study demonstrate that homing pigeons' water consumption is dramatically different when assessed according to activity, flight distance, and time elapsed after flight. This suggests that the drinking rates of birds during migration are extremely important and much greater than estimated using traditional exposure assessment procedures. Thus, exposure to contaminants via drinking water may be greatly underestimated, and the rate of water consumption should be considered when estimating potential exposure risk to avian species. Integr Environ Assess Manag 2017;13:870-876. © 2017 SETAC.


Assuntos
Columbidae , Água Potável/química , Exposição Ambiental/estatística & dados numéricos , Poluentes da Água/análise , Poluição da Água/estatística & dados numéricos , Migração Animal , Animais , Exposição Ambiental/análise
19.
Environ Pollut ; 230: 530-539, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28704750

RESUMO

The Deepwater Horizon oil spill was the largest in U.S. history, contaminating thousands of miles of coastal habitat and affecting the lives of many avian species. The Gulf of Mexico is a critical bird migration route area and migrants that were oiled but did not suffer mortality as a direct result of the spill faced unpredictable fates. This study utilized homing pigeons as a surrogate species for migratory birds to investigate the effects a single low level external oiling event has on the flight performance and behavior of birds flying repeated 161 km flights. Data from GPS data loggers showed that lightly oiled pigeons changed their flight paths, increased their flight durations by 2.6 fold, increased their flight distances by 28 km and subsequently decreased their route efficiencies. Oiled birds also exhibited reduced rate of weight gain between flights. Our data suggest that contaminated birds surviving the oil spill may have experienced flight impairment and reduced refueling abilities, likely reducing overall migration speed. Our findings contribute new information on how oil spills affect avian species, as the effects of oil on the flight behavior of long distance free-flying birds have not been previously described.


Assuntos
Columbidae/fisiologia , Voo Animal/efeitos dos fármacos , Comportamento de Retorno ao Território Vital/efeitos dos fármacos , Poluição por Petróleo/efeitos adversos , Petróleo/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Ecossistema , Monitoramento Ambiental , Golfo do México
20.
Int J Environ Res Public Health ; 13(4): 376, 2016 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-27043585

RESUMO

Epidemiologic studies can measure exposure to volatile organic compounds (VOCs) using environmental samples, biomarkers, questionnaires, or observations. These different exposure assessment approaches each have advantages and disadvantages; thus, evaluating relationships is an important consideration. In the National Children's Vanguard Study from 2009 to 2010, participants completed questionnaires and data collectors observed VOC exposure sources and collected urine samples from 488 third trimester pregnant women at in-person study visits. From urine, we simultaneously quantified 28 VOC metabolites of exposure to acrolein, acrylamide, acrylonitrile, benzene, 1-bromopropane, 1,3-butadiene, carbon disulfide, crotonaldehyde, cyanide, N,N-dimethylformamide, ethylbenzene, ethylene oxide, propylene oxide, styrene, tetrachloroethylene, toluene, trichloroethylene, vinyl chloride, and xylene exposures using ultra high performance liquid chromatography coupled with an electrospray ionization tandem mass spectrometry (UPLC-ESI/MSMS) method. Urinary thiocyanate was measured using an ion chromatography coupled with an electrospray ionization tandem mass spectrometry method (IC-ESI/MSMS). We modeled the relationship between urinary VOC metabolite concentrations and sources of VOC exposure. Sources of exposure were assessed by participant report via questionnaire (use of air fresheners, aerosols, paint or varnish, organic solvents, and passive/active smoking) and by observations by a trained data collector (presence of scented products in homes). We found several significant (p < 0.01) relationships between the urinary metabolites of VOCs and sources of VOC exposure. Smoking was positively associated with metabolites of the tobacco constituents acrolein, acrylamide, acrylonitrile, 1,3-butadiene, crotonaldehyde, cyanide, ethylene oxide, N,N-dimethylformamide, propylene oxide, styrene, and xylene. Study location was negatively associated with the toluene metabolite N-acetyl-S-(benzyl)-L-cysteine (BMA), and paint use was positively associated with the xylene metabolites 2-methylhippuric acid (2MHA) and 3-Methylhippuric acid & 4-methylhippuric acid (3MHA + 4MHA). A near-significant (p = 0.06) relationship was observed between acrylamide metabolites and observation of incense.


Assuntos
Poluentes Atmosféricos/urina , Gravidez/urina , Compostos Orgânicos Voláteis/urina , Biomarcadores/urina , Cromatografia Líquida de Alta Pressão , Monitoramento Ambiental , Feminino , Humanos , Fumar/urina , Espectrometria de Massas por Ionização por Electrospray , Poluição por Fumaça de Tabaco , Estados Unidos
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