Severe primary HIV-1 infection among black persons in Barbados

Descriptions of primary HTV-1 infection have so far been based on Caucasians living in industrialized nations. Due to studies of leptospirosis in predominantly black population of Barbados, serum was available for patients admitted with acute febrile illnesses to the Queen Elizabeth Hospital (QEH). By searching the medical records of 510 adult patients with known HIV-1 infection we identified 10 patients who had stored serum from an admission for an acute febrile illness that predated or coincided with their first HIV-1-positive test. Serological testing confirmed primary HIV-1 infection in 9 and was suggestive in the 10th patient. The clinical features of these 10 patients were in keeping with previous descriptions of primary HIV-1 infection but differed from leptospirosis cases seen at the QEH. One patient died during the seroconversion illness and another died 3 months after seroconversion. The findings suggest that severe primary HIV-1 infection could be a relatively uncommon occurence, that the condition may be misdiagnosed, and that cases may not occur until the AIDS epidemic is established.(AU)

Detection of human papilloma virus (hpv) dna in genital biopsy specimens by in situ hybridization with biotinylated probes

The presence of human papilloma virus (HPV) nucleotide sequences in paraffin sections of genital biopsies was examined by in-situ hybridization using non-isotopic, random primer biotin labeled probes representing HPV type 16. Biotin labeling of probes was performed using DNA labeling and commercially provided phenotype detection kit. Hybridization was performed under stringent conditions. The hybrids were detected by using Streptavidin and biotinylated alkaline phosphatase and visualized with an enzyme catalyzed chemiluminescent detection reaction. In-situ hybridization with biotinylated probes was a useful technique for the identification of HPV infection. The results were compared with the results obtained with dot blot hybridization probes. The background with biotinylated probes was very low. Using non radioactive robes the localization of hybrids at the cellular level was not better than dot blot labeled probes (AU)

Dengue haemorrhagic fever/dengue shock syndrome: an unwelcome arrival in Trinidad - abstract

Dengue is endemic throughout most of the Caribbean, and increased activity has been noted within recent times. The co-circulation of dengue virus serotypes 1, 2 and 4 has been a cause of concern regarding the development of dengue shock syndrome/dengue haemorrhagic fever. The clinical presentation, investigate findings and confirmatory evidence for dengue infection in four patients are described. In all cases, there were fever, marked thrombocytopenia and haemoconcentration. The youngest patient was 15 years old and the oldest was 53 years. In two cases, there was no haemorrhagic tendency but profound shock ensued. Bleeding occurred preterminally in one of these. Both patients with dengue shock syndrome died but the two cases of dengue haemorrhagic fever survived. Dengue infection was confirmed serologically in three cases and by viral isolation in the other. This, to our knowledge, is the first report of dengue haemorrhagic fever/dengue shock syndrome in Trinidad, and clinicians should be aware of the clinical features and management. It is also crucial that public health measures be put in place to minimize dengue virus-associated mortality in Trinidad (AU)

Investigation of dengue-virus serotypes involved in outbreaks in the Caribbean over a 10-year period (1983 - 1992) - abstract

The temporal distribution of dengue virus serotypes 1, 2 and 4 recovered from the investigation of 9,968 specimens obtained from several Caribbean countries over a ten-year period (1983 - 1992) were studied. The use of insect cell cultures and serotype-specific monoclones allowed dengue virus to be detected in 539 instances. Of the specimens typed, 108 (20 per cent) were serotype one, 274 (50.8 per cent), serotype 2 and 157 (29.2 per cent), serotype 4. Annual changes in the frequency of individual serotypes 1, 2 and 4 were observed, with serotype 2 being detected over the entire period of investigation, except in 1984. The use of a group-specific flavivirus antiserum demonstrated that other viruses belonging to this group may not be characterized with the monoclones currently available for designating dengue virus serotypes (AU)