Radiocaesium activity concentrations in the fruit-bodies of macrofungi in Great Britain and an assessment of dietary intake habits.

Radiocaesium activity concentrations in the fruit-bodies of some species of macrofungi are higher than in many other foodstuffs. The consumption of fruit-bodies contributes significantly to radiocaesium intake of humans in some countries. In the United Kingdom, the collection of wild fungi has generally been considered to be of minor importance and there are few data on consumption rates or radiocaesium activity concentrations in most edible species. Samples of commonly eaten species in Great Britain have been collected to assess radiocaesium contamination levels and geographical variation. Concurrently, surveys of consumption habits were conducted. A total of 425 samples representing 37 different species were collected. Significantly higher radiocaesium activity concentrations occurred in mycorrhizal compared to saprotrophic or parasitic species. The highest 137Cs activity concentration of 30.5 kBq kg-1 dry wt. was determined in a sample of Hydnum repandum collected in Wales. The transfer of radiocaesium from soil to fungal fruit-bodies was highly variable, ranging over three orders of magnitude within individual species. A number of approaches to quantifying radiocaesium transfer from soil to fungal fruit-bodies were used. Although these were in general agreement with previously measured values in other countries, all the approaches gave variable results. Over 200 people responded to the dietary habits questionnaire. The median intake rate was 0.75 kg year-1 (fresh wt.) and 60% of respondents consumed only one species (generally Agaricus campestris). However, intakes of up to 26 kg year-1 were recorded and a total of 82 species were consumed. The intake of 137Cs was determined by the amount of mycorrhizal fungi in the diet rather than the total intake of fungi. Assuming median recorded 137Cs activity concentrations in each fungal species, the estimated annual committed effective dose for over 95% of respondents was < 1 microSv. Hence, currently, the consumption of wild fungi in the UK would not be expected to significantly increase the dose above that attributable to the normal diet of most consumers. However, the results of this study demonstrate that, in the event of any future accidental release of radiocaesium, the potential ingestion dose received from the consumption of wild fungi would need to be considered.

Lamivudine plus zidovudine compared with zalcitabine plus zidovudine in patients with HIV infection. A randomized, double-blind, placebo-controlled trial. North American HIV Working Party.

OBJECTIVE: To compare the safety and activity of lamivudine plus zidovudine with the safety and activity of zalcitabine plus zidovudine in patients with moderately advanced human immunodeficiency virus (HIV) infection who had received zidovudine. DESIGN: A multicenter, randomized, double-blind, three-arm, 24-week study with a blinded extension through at least 52 weeks. SETTING: 21 sites in the United States, Canada, and Puerto Rico. PATIENTS: 254 patients who had received zidovudine (median duration of previous therapy, 20 months) and had absolute CD4+ cell counts of 100 to 300 cells/mm3. INTERVENTIONS: Patients were randomly assigned to receive one of three regimens: 150 mg of lamivudine twice daily plus 200 mg of zidovudine three times daily (low-dose lamivudine group); 300 mg of lamivudine twice daily plus 200 mg of zidovudine three times daily (high-dose lamivudine group); or 0.75 mg of zalcitabine plus 200 mg of zidovudine three times daily (zalcitabine group). MEASUREMENTS: Immunologic activity was assessed primarily by changes in absolute CD4+ cell counts; virologic activity was assessed by changes in plasma HIV RNA levels as measured by reverse transcriptase polymerase chain reaction. Safety of the treatment regimens was assessed through the reporting of adverse events. RESULTS: 78% of patients completed 24 weeks of study treatment, and 63% of patients completed 52 weeks of study treatment. Changes in absolute CD4+ cell counts were significantly better for the low-dose and the high-dose lamivudine groups than for the zalcitabine group (median changes at 52 weeks were +42.5 cells/mm3 in the low-dose lamivudine group, +23.33 cells/mm3 in the high-dose lamivudine group, and -29.58 cells/mm3 in the zalcitabine group). Suppression of plasma HIV RNA levels was similar for all groups (median changes at 52 weeks were -0.48 log10 copies/mL in the low-dose lamivudine group, -0.51 log10 copies/mL in the high-dose lamivudine group, and -0.39 log10 copies/mL in the zalcitabine group). No significant differences in safety were seen among the three regimens, although the low-dose lamivudine regimen appeared to be better tolerated than the others. CONCLUSIONS: In patients with HIV infection who had previously received zidovudine, 150 mg of lamivudine plus zidovudine resulted in greater immunologic evidence of benefit than did 0.75 mg of zalcitabine plus zidovudine and was better tolerated than 300 mg of lamivudine plus zidovudine.