HIV and viral hepatitis coinfection analysis using surveillance data from 15 US states and two cities.

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.

Reproductive performance measures among Thoroughbred mares in central Kentucky, during the 2004 mating season.

REASON FOR PERFORMING STUDY: To improve efficiency at the farm level, a better understanding of how farm management factors impact reproductive performance is important. OBJECTIVE: To assess reproductive efficiency and effectiveness among Thoroughbred mares in central Kentucky. METHODS: A cohort of 1011 mares on 13 farms in central Kentucky was followed during the 2004 mating and 2005 foaling season. Information on farm level practices was collected via interviews with farm managers. Reproductive records were collected for each mare mated to obtain information on mare characteristics. The influence of mare age and status (maiden, foaling, barren) on Days 15 and 40 post mating pregnancy rates, foaling rates and total effective length of the mating season were assessed. The influence of stallion book size on reproductive performance measures was also examined. RESULTS: Per season pregnancy rates on Days 15 and 40 post mating and live foal rate were 92.1, 89.3 and 783%, respectively. Per cycle rates for the same time periods were 64.0, 583 and 50.8%. There were no significant associations between stallion book size and reproductive performance outcomes. The mean +/- s.d. interval from the beginning of the mating season to the last mating of the mare was 36.5 +/- 26.1 days. CONCLUSIONS: Mare age had a significant impact on efficiency of becoming pregnant, maintaining pregnancy and producing a live foal. Overall, fertility did not decrease among stallions with the largest book sizes. Total interval length of the mating season can be reduced if managers ensure maiden and barren mares are mated at the beginning of the season and foaling mares are mated at the earliest oestrus after acceptable uterine involution has been achieved. POTENTIAL RELEVANCE: Measures identified in the study can be used by owners, farm managers and veterinarians to improve mare reproductive performance and identify parameters to assist with the implementation of effective culling practices.

Impact of reproductive efficiency over time and mare financial value on economic returns among Thoroughbred mares in central Kentucky.

REASON FOR PERFORMING STUDY: There have been no studies reporting the impact of reproductive efficiency and mare financial value on economic returns. OBJECTIVE: To explore the economic consequences of differences in reproductive efficiency over time in the Thoroughbred mare. METHODS: Complete production records for 1176 mares were obtained. Production history and drift in foaling date were calculated. Multiple logistic regression was used to identify factors influencing the probability of producing a registered foal in 2005. The 'net present value' and 'internal rate of return' were calculated for economic scenarios involving different initial mare financial values, levels of reproductive efficiency, and durations of investment. RESULTS: Among mares that did not produce a foal every year (63%), the mean time before failing to produce a registered foal was 3.4 years. The majority of mares drifted later in their foaling dates in subsequent foaling seasons. Increasing mare age, foaling after 1st April, needing to be mated multiple times during the season, and producing a lower number of foals in continuous sequence during previous years decreased the probability of producing a registered foal. Over a 7 year investment period, live foals must be produced in all but one year to yield a positive financial return. Profitability was highest among mares of greatest financial value. CONCLUSIONS: Mares are long-term investments due to the extended period before there is a return on the investment. Improving our understanding of mare, stallion and management factors that affect the likelihood of producing a live foal are critical to ensuring a positive financial return. Additional work is needed to test the robustness of the study's conclusions when the cost and revenue assumptions are varied. POTENTIAL RELEVANCE: This information can assist in assessing mare profitability and developing management strategies to maximise profitability.