Application of machine learning for antibiotic resistance in water and wastewater: A systematic review.

Antibiotic resistance (AR) is considered one of the greatest global threats in the current century, which can only be overcome if all interconnected areas of humans, animals and the environment are taken into account as part of the One Health concept proposed by the World Health Organization (WHO). Water and wastewater are among the most important environmental media of AR sources, where the phenomena are generally non-linear. Therefore, the aim of this study was to investigate the application of machine learning-based methods (MLMs) to solve AR-induced problems in water and wastewater. For this purpose, most relevant databases were searched in the period between 1987 and 2023 to systematically analyze and categorize the applications. Accordingly, the results showed that out of 12 applications, 11 (91.6%) were for shallow learning and 1 (8.3%) for deep learning. In shallow learning category, n = 6, 50% of the applications were regression and n = 4, 33.3% were classification, mainly using artificial neural networks, decision trees and Bayesian methods for the following objectives: Predicting the survival of antibiotic-resistant bacteria (ARB), determining the order of influencing parameters on AR-based scores, and identifying the major sources of antibiotic resistance genes (ARGs). In addition, only one study (8.3%) was found for clustering and no study for association. Surprisingly, deep learning had been used in only one study (8.3%) to predict ARGs sequences. Therefore, working on the knowledge gaps of AR, especially using clustering, association and deep learning methods, would be a promising option to analyze more aspects of the related problems. However, there is still a long way to go to consider and apply MLMs as unique approaches to study different aspects of AR in water and wastewater.

Double ionic liquid reinforced g-CN nanocomposite for an enhanced adsorption of methylparaben: Mechanism, modeling, and optimization.

The efficient removal of organic pollutants, especially pharmaceuticals, from aquatic environments has attracted great attentions. Application of green, multipurpose, and inexpensive compounds is being extensively favorite as adsorbent instead of the traditional chemicals or materials. In this study, sulfonated graphitic carbon nitride was modified with two ionic liquids of polyethyleneimine and choline chloride to create a novel nanocomposite (Sg-CN@IL2 NC) and to use for removal of methylparaben (MeP) from aqueous media. After confirmation of the successful synthesized using different methods, the effective parameters for MeP removal, such as initial MeP concentration, adsorbent dose, sonication time, and temperature, as well as their interactions, were experimentally examined and modeled using response surface methodology (RSM), generalized regression neural network (GRNN), and radial basis function neural network (RBFNN). The models were then optimized using desirability function analysis (DF) and genetic algorithm (GA). The results showed that MeP adsorption: a) can be explained more accurate and reliable using GRNN (AARD% = 11.67, MAE = 15.31, RAE % = 45.42, RRSE % = 55.18, MSE = 435.86, RMSE = 20.70, and R2 = 0.995) than the others; b) reached equilibrium within 7.0 min with a maximum uptake of 267.2 mg/g at a temperature of 45 °C and a neutral pH; c) followed from Freundlich (R2 = 0.999) isotherm and PSO kinetic (R2 = 0.95) models; d) is endothermic and spontaneous; e) is mainly due to π-π stacking, electrostatic and hydrogen bonding interactions. Moreover, Sg-CN@IL2 NC showed an appropriate reusability for up to five cycles. These findings demonstrate the potential of as-prepared NC as an excellent adsorbent for removal of MeP from aqueous media.

Wastewater treatment plants: The missing link in global One-Health surveillance and management of antibiotic resistance.

INTRODUCTION: As a global public health crisis, antibiotic resistance (AR) should be monitored and managed under the One-Health concept according to the World Health Organization (WHO), considering the interconnection between humans, animals, and the environment. But this approach often remains focused on human health and rarely on the environment and its compartments, especially wastewater as the main AR receptor. Wastewater treatment plants (WWTPs) not only are not designed for reliving AR but also provide appropriate conditions for enhancing AR through different mechanisms. METHODS: By reviewing the research-based statistics on the inclusion of WWTPs in the One-Health/AR program crisis, this paper highlights the importance of paying attention to these hotspots, at first. Also, the importance and technical roadmap for the application of WWTPs in both surveillance and management of AR were provided. The current position of these facilities was also evaluated using strengths, weaknesses, opportunities, and threats (SWOT) analysis. In the end, the concluding knowledge gaps and research needs for future investigations were presented. RESULTS: Despite the fact that wastewater matrices are the hotspot for AR dissemination, WWTPs appear under-represented in One-Health/AR literature. So, of the 414434 articles retrieved for One-Health only 1.5% (n = 6321) focused on AR and about 0.04% (n = 158) on WWTPs. The potential of WWTPs inclusion in AR surveillance has been confirmed by several studies, however, when it comes to its inclusion for management of AR, more evidence should be presented, which confirmed by SWOT results. DISCUSSION: As such, WWTPs simultaneously provide opportunities for AR surveillance as it is assumed that this medium can reflect the reality of the corresponding society, and for managing unexpected crises which could impact the public. Nonetheless, there are still numerous considerations to change WWTPs role from Achilles' heel to Ajax' shield, including strengthening the research-based knowledge and conducting both surveillance and management strategies of AR under One-Health concept (One-Health/AR) in a clear straightforward framework.

ß-cyclodextrin grafted multi-walled carbon nanotubes/chitosan (MWCNT/Cs/CD) nanocomposite for treatment of methylene blue-containing aqueous solutions.

ß-cyclodextrin (CD) was grafted with multi-walled carbon nanotubes/chitosan (MWCNTs/Cs) to obtain MWCNTs/Cs/CD nanocomposite (NC) for methylene blue (MB) adsorption from aqueous media. TEM, XRD, TGA, Raman spectra, and BET & BJH analyses were utilized to characterize and confirm the successful synthesis of as-prepared NC. MB capture was investigated by considering the parameters of pH (1.9-9.0), temperature (∼16-63 °C), sonication time (∼5-15 min), MB concentration (∼1.2-48 mg/L), and NC dose (0.03-0.26 mg). The obtained responses were then modelled using CCD, generalized regression neural network (GRNN), and least squares support vector machine (LS-SVM), of which the latter found to provide most reliable and accurate results (RMSE = 0.0235, MAE = 0.020, AAD = 0.0047, and R2 = 0.999). Moreover, the genetic algorithm-based optimization results showed that under the respective values of 7.05, 45.5 °C, 10 min, 23 mg/L, 0.12 g, MWCNTs/Cs/CD NC would be able to remove 96.75% of MB with an adsorption capacity of 603 mg/g, through different mechanisms mainly electrostatic interactions. Following from Dubinin-Radushkevich (D-R) isotherm (qs = 460.66 ± 8.9 and R2 > 0.99) and intraparticle diffusion kinetic (R2 = 0.75-0.90) models indicated a chemical adsorption mechanism. Besides, thermodynamic parameters (ΔH◦ = -66.9 kJ/mol, ΔG◦ = between -3.77 kJ/mol and -8.52 kJ/mol, and ΔS◦ = 237.1818 J/mol K) confirmed an endothermic and spontaneous nature for the adsorption. These findings along with appropriate recyclability (five times), turn the as prepared NC to a promising material in removing MB from aqueous solutions.

Efficient removal of levofloxacin by a magnetic NiFe-LDH/N-MWCNTs nanocomposite: Characterization, response surface methodology, and mechanism.

Antibiotic pollutants in water bodies, was studied to remove using an oxidized, nitrogen-doped, and Fe3O4 and NiFe-LDH decorated MWCNT (magnetic NiFe-LDH/N-MWCNTs) nanocomposite (NC). The novel, engineered NC was characterized by different techniques of SEM, XRD, TEM, EDX, and XPS and then examined under different main effective parameters of NC dose, levofloxacin (LVX) concentration, pH, time, and temprature. The experimentally obtained data then evaluated using the modeling approaches of RSM, GRNN, and ANFIS. The as prepared adsorbent showed an excellent adsorption performance (removal efficiency = 95.28% and adsorption capacity = 344.83-454.55 mg/g) under the respective values of the mentioned parameters of 0.152 g, 23.01 mg/L, 12.00 min, and 37.5 °C, respectively. The comparison of the models showed that although all of them accurately predicted the removal efficiency, ANFIS presented the best capability with R2, RMSE, MSE, MAE, as well as AAD of 0.9998, 0.0082, -0.0004, 0.0069, 0.1322, respectively. The adsorption by the NC followed Freundlich isotherm (R2 = 0.9993) and PSO kinetic (>0.998) models, confirming a heterogenous chemisorption process. The thermodynamic parameters showed an endothermic and spontaneous nature for LVX removal by magnetic NiFe-LDH/N-MWCNTs NC. A high-performance efficiency, appropriate reusability (five times without loss of efficiency), as well as easy separation due to magnetic properties, makes the NC to a promising option in removing LVX from water.

Tetracycline capture from aqueous solutions by nanocomposite of MWCNTs reinforced with glutaraldehyde cross-linked poly (vinyl alcohol)/chitosan.

The presence of pharmaceuticals as the emerging contaminates needs novel approaches and new materials to be remediated. This study aimed to develop and apply MWCNTs reinforced with glutaraldehyde cross-linked poly (vinyl alcohol)/chitosan nanocomposite (MWCNTs/CS-PVA/GA NC) for removal of tetracycline (TC) as a model of antibiotics from aqueous solutions. The successful synthesis of NC was supported by techniques of SEM, XRD, TGA, FTIR, and EDX. The prepared NC was then utilized for TC adsorption under the main effective parameters of TC concentration (25-125 mg/L), sonication time (0-8 min), NC dose (1-130 mg), and tempearure (5-45 °C). The process behavior was comparably explored with different methods of central composite design (CCD), artificial neural networks (ANN), and general regression neural network (GRNN). The results showed that under the optimum settings presented by desirability function (DA), in which the respective values for the factors were 125 mg/L, 6.8 min, 130 mg, and 45 °C, the efficiency and adsorption capacity of NC is supposed to be 99.07% and ∼525 mg/g, respectively. From the models studied, although all were able to express the process with satisfactory accuracy, ANN provided the best accuracy and reliability owning to the highest R2 (0.999) and lowest RMSE, ADD, MAE. The kinetics, isotherms, and thermodynamic studies showed that the process is fast (over 4.5 min), chemisorption, heterogeneous with multilayer nature, spontaneous, feasible, and endothermic. In addition, the as prepared NC could be recycled for five times without significant fail in its performance. All in all, the developed MWCNTs/CS-PVA/GA NC can be considered as a promising candidate in dealing with aqueous solutions' pollution with antibiotic.

Effect of ozonation-based disinfection methods on the removal of antibiotic resistant bacteria and resistance genes (ARB/ARGs) in water and wastewater treatment: a systematic review.

Antibiotic resistance is considered a universal health threat of the 21st century which its distribution and even development are mainly mediated by water-based media. Disinfection processes with the conventional methods are still the most promising options to combat such crises in aqueous matrices especially wastewater. Knowing that the extent of effectiveness and quality of disinfection is of great importance, this paper aimed to systematically review and discuss ozonation (as one of the main disinfectants with large scale application) effect on removing antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) from aqueous solutions, for which no study has been reported. For this, a comprehensive literature survey was performed within the international databases using appropriate keywords which yielded several studies involving different aspects and the effectiveness extent of ozonation on ARB & ARGs. The results showed that no definite conclusion could be drawn about the superiority of ozone alone or in a hybrid form. Mechanism of action was carefully evaluated and discussed although it is still poorly understood. Evaluation of the studies from denaturation and repairment perspectives showed that regrowth cannot be avoided after ozonation, especially for some ARB & ARGs variants. In addition, the comparison of the effectiveness on ARB & ARGs showed that ozonation is more effective for resistant bacteria than their respective genes. The degradation efficiency was found to be mainly influenced by operational parameters of CT (i.e. ozone dose & contact time), solids, alkalinity, pH, and type of pathogens and genes. Moreover, the correlation between ARB & ARGs removal and stressors (such as antibiotic residuals, heavy metals, aromatic matters, microcystins, opportunistic pathogens, etc.) has been reviewed to give the optimal references for further in-depth studies. The future perspectives have also been reported.

Bilateral pleural masses in an immunocompromised patient.

We present a case of persistent pleural masses with mediastinal adenopathy in an immunocompromised patient initially biopsied, diagnosed and treated for Pneumocystis jiroveci pneumonia, ultimately requiring surgical thoracoscopy to diagnose pulmonary histoplasmosis. We discuss the diagnostic approach for pleural masses in immunocompromised patients, the limitations of tissue sampling, interpretation and methodology, and pitfalls of testing in making a pathogen-specific diagnosis.

Efficient technologies for carwash wastewater treatment: a systematic review.

Carwash wastewater (CWW) is considered as an important source of either water pollution or water consumption. Therefore, its treatment is critical not only from the prevention of environmental contamination but also from the recycling of such high-volume water source. Unfortunately, the effective treatment of CWW is almost unknown, complex, and expensive. To overcome the former challenge, this study aimed to systematically review different technologies for CWW treatment. For this, a comprehensive literature survey was conducted and 48 research articles were found suitable to be included in the investigation. The included studies were of coagulation and adsorption (n = 5), membrane-based technologies (n = 15), and electrochemical (n = 11) and combined (n = 17) systems. This comprehensive review showed that the treatment methods of advanced filtration membrane techniques, electrical and chemical coagulation, and advanced oxidation processes can be effective in the removal of pollutants from carwash wastewater (CWW). The mining of different studies, however, showed that the combined methods are the most promising option in the remediation of such wastewater.

Capture of I131 from medical-based wastewater using the highly effective and recyclable adsorbent of g-C3N4 assembled with Mg-Co-Al-layered double hydroxide.

This paper reports a very high capacity and recyclable Mg-Co-Al-layered double hydroxide@ g-C3N4 nanocomposite as the new adsorbent for remediation of radioisotope-containing medical-based solutions. In this work, a convenient solvothermal method was employed to synthesize a new nano-adsorbent, whose features were determined by energy dispersive X-ray (EDS/EDX), XRD, FESEM, TEM, TGA, BET, and FT-IR spectroscopy. The as-prepared nano-adsorbent was applied to capture the radioisotope iodine-131 mainly from the medical-based wastewater under different conditions of main influential parameters, (i.e. adsorbent dose, initial I2 concentration, sonication time, and temperature). The process was evaluated by three models of RSM, CCD-ANFIS, and CCD-GRNN. Furthermore, comprehensive kinetic, isotherm, thermodynamic, reusability cycles and optimization (by GA and DF) studies were conducted to evaluate the behavior and adsorption mechanism of I2 on the surface of Mg-Co-Al-LDH@ g-C3N4 nanocomposite. High removal efficiency (95.25%) of 131I in only 30 min (i.e. during 1/384 its half-life), along with an excellent capacity that has ever been reported (2200.70 mg/g) and recyclability (seven times without breakthrough in the efficiency), turns the nanocomposite to a very promising option in remediation of 131I-containing solutions. Besides, from the models studied, ANFIS described the process with the highest accuracy and reliability with R2 > 0.999.

Bio-inspired, high, and fast adsorption of tetracycline from aqueous media using Fe3O4-g-CN@PEI-ß-CD nanocomposite: Modeling by response surface methodology (RSM), boosted regression tree (BRT), and general regression neural network (GRNN).

Because antibiotic-containing wastewaters are able to contaminate all environmental matrices (e.g. water bodies, soil, etc.), a special attention should be paid on developing appropriate materials for their remediation. Herein, the novel nanocomposite (NC) of Fe3O4-g-CN@PEI-ß-CD was synthesized and employed effectively for the adsorptive removal of tetracycline (TC), the second most produced and employed antibiotic around the world. The successful fabrication of the nanocomposite with a high specific surface area (57.12 m2/g) was confirmed using XRD, SEM, TEM, FTIR, TGA, EDX, and BET analyses. The Fe3O4-g-CN@PEI-ß-CD NC exhibited fast adsorption rates towards TC and maximum adsorption capacity on the basis of the Langmuir model reached 833.33 mg g-1, much higher than that reported by different carbon- and/or nano-based materials. The adsorption process was modeled using the approaches of central composite design (CCD), boosted regression tree (BRT), and general regression neural network (GRNN) under various operational conditions of initial TC concentration, pH, adsorbent dose, tempreature, and time. The comparison of the models indicated good predictions of all, however, the BRT model was more accurate compared to the others, with R2 = 0.9992, RMSE = 0.0026, MAE = 0.0014, and AAD = 0.0028, proving that it is a powerful approach for modeling TC adsorption by Fe3O4-g-CN@PEI-ß-CD nanocomposite. The results showed that the order of the variables' effectiveness is as follow: pH > dose > TC concentration. The high adsorption capacity along with high efficiency (98 % in the optimized conditions by GA) ensures the potential of the as-prepared nanocomposite for in situ remediation of antibiotic-containing wastewaters.

Woman's Sexual Health Knowledge and Needs Assessment in Behavioral Clinics and Shelters in Tehran.

Objective: The aim of this study was to assess the sexual health knowledge among females seeking consultation in behavioral clinics or shelters with emphasis on sexual routs of HIV transmission. Materials and methods: In this study 250 women who have attended behavioral clinics or shelters in Tehran were recruited and a standardized questionnaire which asked about demographics, sexual partner and knowledge about HIV/STDs was used. Results: The median age of our cases was 40.82% and among them 16% were married but lived alone. Among the total 250 cases, 56% (140) were sexually active in the last 30 days, 19.2% (48) had a history of a one-night stand and 2.4% had more than 1 sexual partner. 212 cases answered questions about condom use, 60% (127) of them did not use condoms at all. For knowledge about signs and symptoms related to STDs, 63% believed that abdominal pain has no relation to STDs. Also 44%, 43%, 37%,and 40% believed that dyspareunia, dysuria, malodorous vaginal discharge and change in color of vaginal discharge, respectively had no relation to STDs and 13% of whom presented with these symptoms in the past 30 days had not seek medical evaluation. Conclusion: It is a necessity to emphasize the use of condoms among the male population however in this study it was a challenge to do so because it goes against the government's campaign of pro-natalism. Improving the knowledge of protected sex should start from the teenage years and at school to have maximum STD prevention planning. Most women in our study did not know about healthy sexual lifestyle and this shows the need of sexual health education before marriage or even at school.

A highly effective, recyclable, and novel host-guest nanocomposite for Triclosan removal: A comprehensive modeling and optimization-based adsorption study.

In this research paper, response surface methodology (RSM), generalized regression neural network (GRNN), and Adaptive Neuro-Fuzzy Inference System (ANFIS) were employed to develop prediction models for Triclosan (TCS) removal by a novel inclusion complex (host-guest complex). Hence, ß-cyclodextrin (ß-CD) and poly(ethylene glycol) (PEG) host-guest complex loaded on the multi walled carbon nanotube (MWCNT/PEG/ß-CD) was prepared and characterized by Raman, NMR, TGA, XRD, SEM, TEM, and point of zero charge (pHpzc) technique. The effects of MWCNT/PEG/ß-CD dose (g), temperature (°C), antibiotic concentration (mg L-1), and sonication time (min), each at five levels were investigated as independent factors. Central composite design (CCD) of RSM setup was applied in combination with ANFIS and GRNN training dataset for evaluation purposes. Moreover, the kinetic, isotherm equilibrium, and thermodynamic parameters of adsorption of TCS on MWNT-PEG/ß-CD nanocomposite was examined. To assess the accuracy of results, several statistics such as R2, RMSE (root mean square error), mean squared error (MSE), MAE (mean absolute error), sum of the absolute error (SAE), %AAD (absolute average deviation), average relative error (ARE), hybrid fractional error function (HYBRID), Marquart's percentage standard deviation (MPSD), and Pearson's Chi-square measure (χ) were checked. The results of ANFIS approach were found to be more trustworthy than GRNN model since better statistical analysis were attained. However, it was known that the GRNN is easier and take a little time for modeling than the ANFIS approach.

Ultrasound-assisted sorption of Pb(ii) on multi-walled carbon nanotube in presence of natural organic matter: an insight into main and interaction effects using modelling approaches of RSM and BRT.

In real-scale applications, where NPs are injected into the aqueous environment for remediation, they may interact with natural organic matter (NOM). This interaction can alter nanoparticles' (NPs) physicochemical properties, sorption behavior, and even ecological effects. This study aimed to investigate sorption of Pb(ii) onto multi-walled carbon nanotube (MWCNT) in presence of NOM. The predominant behavior of the process was examined comparatively using response surface methodology (RSM) and boosted regression tree (BRT)-based models. The influence of four main effective parameters, namely Pb(ii) and humic acid (HA) concentrations (mg L-1), pH, and time (min) on Pb removal (%) was evaluated by contributing factor importance rankings (BRT) and analysis of variance (RSM). The applicability of the BRT and RSM models for description of the predominant behavior in the design space was checked and compared using statistics of absolute average deviation (AAD), mean absolute error (MAE), root mean square error (RMSE), and multiple correlation coefficient (R 2). The results showed that although both approaches exhibited good performance, the BRT model was more precise, indicating that it could be a powerful method for the modeling of NOM-presence studies. Importance rankings of BRT displayed that the effectiveness order of the studied parameters is pH > time > Pb(ii) concentration > HA concentration. Although HA concentration showed the least effect in comparison with three other studied parameters theoretically, the experimental results revealed that Pb(ii) removal is enhanced in presence of HA (73% vs. 81.77%), which was confirmed by SEM/EDX analyses. Hence, maximum removal (R% = 81.77) was attained at an initial Pb(ii) concentration of 9.91 mg L-1, HA concentration of 0.3 mg L-1, pH of 4.9, and time of 55.2 min.

Severe aortic regurgitation masked as sepsis-induced ARDS in a patient with Streptococcus agalactiae endocarditis.

Septic shock is the most common type of shock in the intensive care unit with an associated mortality close to 50%. Infective endocarditis (IE) is a rare cause of septic shock but carries significant morbidity and mortality. Group B Streptococcus IE (GBS-IE) is an invasive infection with an incidence of approximately 1.7%. It affects immunocompromised patients such as intravenous drug users, alcoholics, those with HIV and elderly among others. IE with severe acute valvular heart disease challenges physicians when assessing fluid status during the early resuscitation in patients with septic shock. We present a case of GBS-IE complicated by severe acute aortic regurgitation with rapidly progressive acute respiratory failure in the setting of septic shock management.

Prevalence of HIV, HBV and HCV among street and labour children in Tehran, Iran.

OBJECTIVES: The existence of street and working children in Iran is undeniable. The precarious conditions of these children (including disrupted family, poverty, high prevalence of crime among relatives, family members and peers) cause social harm and high-risk behaviours, including drug addiction, selling sex or having sex with adolescents or peers. Here we explore the HIV, hepatitis B and hepatitis C status of street and working children in Tehran. METHODS: One thousand street and labour children, aged 10-18 years, were recruited by using the time-location sampling method, and semistructured questionnaires were used to find demographic information and information on HIV/AIDS-related high-risk sexual behaviours. Blood samples were collected from children, with use of the dried blood sampling method. RESULTS: 4.5% of children were HIV infected, 1.7% were infected with hepatitis B virus and 2.6% were infected with hepatitis C virus (HCV). Having parents who used drug, infected with HCV and having experience in trading sex significantly increased the likelihood of getting HIV among the street children of Tehran. CONCLUSION: HIV prevalence among street children is much higher than general population (<0.1%), and in fact ,the rate of positivity comes close to that among female sex workers in Iran. These findings must be an alarm for HIV policymakers to consider immediate and special interventions for this at-risk group.

Defluoridation of water using activated alumina in presence of natural organic matter via response surface methodology.

Adsorption by activated alumina is considered to be one of the most practiced methods for defluoridation of freshwater. This study was conducted, therefore, to investigate the effect of natural organic matters (NOMs) on the removal of fluoride by activated alumina using response surface methodology. To the authors' knowledge, this has not been previously investigated. Physico-chemical characterization of the alumina was determined by scanning electron microscope (SEM), Brunauer-Emmett-Teller (BET), Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence (XRF), and X-ray diffractometer (XRD). Response surface methodology (RSM) was applied to evaluate the effect of single and combined parameters on the independent variables such as the initial concentration of fluoride, NOMs, and pH on the process. The results revealed that while presence of NOM and increase of pH enhance fluoride adsorption on the activated alumina, initial concentration of fluoride has an adverse effect on the efficiency. The experimental data were analyzed and found to be accurately and reliably fitted to a second-order polynomial model. Under optimum removal condition (fluoride concentration 20 mg/L, NOM concentration 20 mg/L, and pH 7) with a desirability value of 0.93 and fluoride removal efficiency of 80.6%, no significant difference was noticed with the previously reported sequence of the co-exiting ion affinity to activated alumina for fluoride removal. Moreover, aluminum residual was found to be below the recommended value by the guideline for drinking water. Also, the increase of fluoride adsorption on the activated alumina, as NOM concentrations increase, could be due to the complexation between fluoride and adsorbed NOM. Graphical abstract ᅟ.

Occult hepatitis B virus infection and S gene escape mutants in HIV-infected patients after hepatitis B virus vaccination.

Hepatitis B virus (HBV) vaccination is recommended for HIV patients. Despite the relative success of HBV vaccination, breakthrough infections can occur infrequently in patients, and it can be due to occult HBV infection, vaccine unresponsiveness and/or emergence of escape mutants. This study assessed the presence of occult HBV infection and S gene escape mutants in HIV-positive patients after HBV vaccination. Ninety-two HIV-positive patients were enrolled in this study, including 52 responders to HBV vaccine and 40 non-responders. All of the cases received HBV vaccine according to routine HBV vaccination protocols. The presence of HBV-DNA was determined by real-time polymerase chain reaction (PCR). In HBV-DNA positive samples, the most conserved regions of S gene sequences were amplified by nested PCR and PCR products were sequenced. Occult HBV infection was detected in two cases. Glycine to arginine mutation at residue 145 (G145R) within the 'a' region of the S gene was detected in one of the occult HBV infection cases who was in the non-responder group. This study showed that the prevalence of occult HBV infection and vaccine escape mutants was low in our HBV-vaccinated HIV-positive patients in both responder and non-responder groups, so there was no alarming evidence indicating breakthrough HBV infection in our vaccinated HIV-positive cases.

Lack of Association between Interleukin-10 Gene Promoter Polymorphisms with HIV Susceptibility and Progression to AIDS.

BACKGROUND: Interleukin (IL)-10 is an important anti-inflammatory and immunomodulatory cytokine. Some authors believe that single nucleotide polymorphisms (SNP) in the promoter region of the IL-10 gene have been associated with susceptibility to HIV infection and progression to AIDS, but its role is not clearly defined yet. The present study was undertaken to evaluate the association between HIV infection susceptibility and progression with SNP in the promoter region of the IL-10 gene. METHODS: This study was carried out in 70 HIV infected patients (39 treatment naïve and 31 under treatment) and 31 matched healthy controls. The biallelic polymorphisms in the IL-10 gene promoter (-592 ,-1082) were analyzed by polymerase chain reaction and direct sequencing. RESULTS: At position -1082, G/A was the most common genotype and A was the most prevalent allele and at position -592, A/C was the most prevalent genotype and -592 C was the most common allele in HIV positive patients; although there was not any significant difference between cases and controls regarding genotypes and alleles of these regions. CONCLUSION: Our study showed that genetic polymorphisms of IL-10 promoter region may not associate with HIV infection outcome and the lack of this association suggests that other genes may influence on HIV infection course.