HIV-1 strains from India are highly divergent from prototypic African and US/European strains, but are linked to a South African isolate.

OBJECTIVE: To gain molecular insights into different HIV-1 strains present in two different states of India, nucleotide sequences derived from the env region of four HIV-1 strains were analysed. DESIGN: HIV-1 was isolated from high-risk patients from the states of Maharashtra (city of Bombay) and Goa. The molecular analysis of the env region encompassed all variable domains of the external glycoprotein, gp120. METHODS: Genomic DNA from cultured cells infected with each of the four Indian HIV-1 strains independently was amplified by polymerase chain reaction (PCR). PCR fragments were cloned and sequenced and a phylogenetic tree constructed. RESULTS: All four Indian HIV-1 sequences were closely related to each other. The closest related sequence to them was from a South African isolate, HIV-1NOF, with a homology of 85-87%. In the phylogenetic tree, the Indian and the South African HIV-1 sequences cluster together and constitute a subtype different from the North American/European, Central African, Uganda/Rwanda and Northern Thailand subtypes. Interestingly, the viruses of this subtype are characterized by an additional potential N-glycosylation site C-terminal to the CD4-binding domain. CONCLUSION: The low variation between the HIV-1 sequences from randomly chosen individuals from high-risk cohorts in two Indian states suggests a rapid and recent spread of HIV and, possibly, introduction of the virus by the same route, most probably heterosexual transmission. The rapid spread of HIV-1 variants in India, which form a subgroup of their own together with a South African strain, necessitate consideration of these strains in vaccine development.

Analysis of partial gag and env gene sequences of HIV type 1 strains from southern Africa.

PIP: HIV-1 is spreading at an exponential rate in southern Africa, with a current doubling time of approximately one year. An estimated 2 million of South Africa's 36 million population are already infected with HIV. Information on the extent of variability of HIV-1 sequences in the region is important for the development of vaccines, the evaluation of new therapies, and for structure/function studies of the viral genome and proteins. The authors isolated and partially sequenced local strains of the virus. The first strain sequenced was determined to be a new subtype of HIV-1, designated subtype C(2). HIV-1 subtypes B and D are also circulating within southern Africa. The derived phylogenetic trees for the various strains are presented. It is possible that southern African HIV-1 strains have evolved from Central African ones during their spread southward over time and geographic distance. The data on HIV-1 env and gag gene variability presented in this paper have implications for the design of vaccines intended for use in southern Africa and India. The results also establish new limits of variability for the virus, by extending the phylogenetic tree along a new branch.^ieng

Disseminated Herpesvirus hominis (herpes simplex) infection: retrospective diagnosis by light and electron microscopy of paraffin wax-embedded tissues.

Disseminated Herpesvirus hominis infection had previously been reported from other parts of the world, but the disease was initially recognized at necropsy in Cape Town in 1957 (McKenzie, Hansen, and Becker, 1959).The present retrospective study established that the disease had been occurring before 1957 but that its aetiology had not been recognized. An awareness of the disease, together with an adequate knowledge of the clinical history, the morbid anatomy, and histology of the lesions, usually allows a confident diagnosis to be made.

Isolation of a lymphadenopathy-associated virus from a patient with the acquired immune deficiency syndrome.

A virus similar to the lymphadenopathy-associated virus or human T-lymphotropic virus type III, which has been described in association with the acquired immune deficiency syndrome (AIDS) by several laboratories elsewhere in the world, was isolated from a Cape Town patient with lymphadenopathy and acquired immune deficiency. This virus has the characteristic morphogenesis and ultrastructure and its genome encodes the virus-specific p24 protein. It is T-lymphotropic and produces the characteristic cytopathic effect. It can be serially propagated in a human lymphocyte line of the T4+ phenotype. This isolate is being used in diagnostic immunofluorescence assays for virus-specific antibodies.

Mumps meningo-encephalitis.

Between July 1981 and June 1985, 49 cases (36 boys (73%) and 13 girls (27%] of mumps meningo-encephalitis confirmed by culture of the virus from the cerebrospinal fluid (CSF) were seen. Patients presented particularly in the late spring and early summer. A CSF cell count greater than 500 X 10(6)/l was obtained in 14 cases (28%), a total CSF protein greater than 0.8 g/l in 6 cases (12%) and a CSF glucose of less than 2.2 mmol/l in 2 cases (4%). Two cases are reported to illustrate the diagnostic problems which the infection may cause, particularly when the CSF changes resemble those of tuberculous meningitis. In 1 case neurogenic pulmonary oedema developed after a convulsion; this caused further diagnostic uncertainty.

[Traumatic Herpes hominis infection during rugby (Herpes venatorum). A discussion of four cases]. / Troumatiese Herpesviurs hominis-infeksie tydens rugby (Herpes venatorum). 'n Bespreking van vier gevalle.

Four cases of traumatic Herpesvirus hominis infection of the skin sustained during rugby are described. Attention is drawn to the importance of Herpesvirus infection of the eye, both primary and secondary, whether from self-inoculation or exogenous infection. The diagnosis must be correct so that specific treatment with idoxuridine may be considered and harmful treatment with corticosteroids may be avoided. Personal contact should be avoided during active infection. Epidemiological data show that an increasing percentage of young adults are susceptible to primary Herpesvirus infection. We are aware of undiagnosed cases and expect an increasing incidence of this type of infection.

Paediatric meningitis in the western Cape. A 3-year hospital-based prospective survey.

Between July 1981 and June 1984 1223 cases of meningitis were seen in the Department of Paediatrics, Tygerberg Hospital. The commonest form in each population group was aseptic meningitis. Positive viral cultures were obtained from the CSF in 108 cases. The median age of white children with aseptic meningitis, 64 months, was significantly greater than that of coloured children, 45 months (P greater than 0.0001), and black children, 26 months (P greater than 0.014). The commonest cause of confirmed bacterial meningitis was Neisseria meningitidis (140 cases; 11.5%), which continues to affect mainly young coloured children (median age 16.9 months). Resistance to sulphonamides was found among 21% of 114 N. meningitidis isolates. Among white children Haemophilus influenzae was responsible for 9 of the 18 cases of confirmed bacterial meningitis. Tuberculosis was responsible for 62 cases of meningitis (5%) and was a commoner cause of meningitis than either H. influenzae (47 cases) or Streptococcus pneumoniae (34 cases). Thirty-four confirmed cases of bacterial meningitis were seen in children less than 1 month old. Klebsiella species were responsible for 8 cases (24%), Escherichia coli for 6 cases (12%), group B beta-haemolytic Streptococcus for 5 cases (15%) while 4 cases each were due to N. meningitidis and Strept. pneumoniae.

Isolation of human T-lymphotropic virus type I (HTLV-I) from a black South African with Kaposi's sarcoma.

Serological evidence for HTLV-I infection in the South African population has now been confirmed by the isolation of the virus from the peripheral blood lymphocytes of an adult Tsonga male. The subject was an indigenous black man from the south-eastern Transvaal who had suffered from Kaposi's sarcoma for a decade and in whom serum antibodies against HTLV-I were demonstrated. T-lymphocyte cell lines were established from his peripheral blood lymphocytes and shown to be productively infected with HTLV-I as evidenced by: the characteristic cell morphology; the typical viral morphogenesis on ultra-thin section electron microscopy; the viral genome in DNA extracted from the cell lines; characteristic reverse transcriptase activity and viral specific proteins in the cell culture supernatant fluids. Spread of infection occurs through sexual intercourse, from mother to child, and by blood transfusion. Donated blood should be screened to contain the spread of HTLV-I infection.

Herpesvirus hominis oesophagitis and oesophageal stricture.

The literature on herpetic involvement of the oesophagus is reviewed and a case is described in which the presumptive clinical diagnosis of primary Herpesvirus hominis stomatitis and oesophagitis and subsequently oesophageal strictures was made. The differential diagnosis of an oesophageal lesion and its treatment are discussed.

Immunological studies in haemophilic children.

A majority of haemophiliacs who have received large-pool plasma products within the past 5 years have been exposed to the putative agent of the acquired immunodeficiency syndrome (AIDS)--HIV. It is not known what the risk of infection is among patients in South Africa. A study was made of 39 children with congenital coagulation disorders attending the Red Cross War Memorial Children's Hospital Haemophilia Clinic. All but 3 had been treated exclusively with small-pool lyophilised cryoprecipitate or a factor IX concentrate prepared by local blood transfusion services. Three patients had also received imported non-heat-treated commercial products FEIBA (Immuno), Autoplex, Proplex (Hyland) or Factorate (Armour). Absolute lymphocyte counts were normal in all patients but the OKT4/OKT8 ratio was reduced below 1.0 in 9 children including 2 of the 3 who had received commercial plasma concentrates. A high titre of HIV antibody was present in 2 of the 38 patients tested. Both of these children had received imported plasma concentrates and 1 shows some features of the AIDS-related complex. These results suggest that haemophiliacs who receive non-heat-treated commercial concentrates may be at greater risk of HIV infection than patients treated with locally produced plasma products.

Serum antibodies to human T-cell leukaemia virus type I in different ethnic groups and in non-human primates in South Africa.

The prevalence of humoral antibodies to human T-cell leukaemia virus type I (HTLV-I) was investigated in different ethnic groups and in non-human primates in South Africa. Serum antibody levels were determined by enzyme-linked immunosorbent assay (ELISA) using either disrupted whole HTLV-I or purified p24 core protein (p24 HTLV-I) as antigens. ELISA was complemented by direct radio-immunoprecipitation assays using either purified iodinated p24 HTLV-I or radiolabelled lysates of an HTLV-producing cell line as antigen followed by sodium dodecyl sulphate polyacrylamide gel electrophoresis of the immunoprecipitates, and by immunofluorescence using the HTLV-I-producing cell line HUT-102 as antigen. Antibodies were demonstrated in 3,5% of Asians, 3,5% of blacks and 4,1% of coloureds, but not in whites, and also in 29% of vervet monkeys and 33% of baboons. We conclude that HTLV-I or closely related viruses cause widespread infection in non-human primates in South Africa and in a lower percentage of humans, including apparently healthy blood donors. We are currently isolating retroviruses from seropositive reactors and investigating the possible relevance to disease in South Africa.

Kaposi's sarcoma in a renal allograft recipient with cytomegalovirus infection. A case report.

There are increasing reports of Kaposi's sarcoma arising in immunosuppressed patients, including renal allograft recipients. Furthermore, evidence is accumulating that cytomegalovirus infection may be an aetiological factor in Kaposi's sarcoma. We report an additional case in a renal allograft recipient treated with corticosteroids, azathioprine and niridazole, who also had active cytomegalovirus infection.

Leukaemogenesis in Down's syndrome.

Due to the fixed karyotype and documented malignancy risk in patients with Down's syndrome, recently described aetiological factors can be assigned to their proper places in a conceptual framework for leukaemogenesis in these individuals. This is a more profitable approach than those in which various types of karyotypic patterns are matched to different malignancies. It seems that viruses may play a special role, but they need interaction with other factors, most of which are present in Down's syndrome. A unifying concept which may be helpful in establishing research priorities is presented.

Morphogenesis of avian infectious bronchitis virus and a related human virus (strain 229E).

Avian infectious bronchitis virus (IBV) and strain 229E, a virus recently recovered from patients with colds, have been shown to possess a similar distinctive morphology in negatively stained preparations. An electron microscopic study of the morphogenesis of IBV in the chorioallantoic membrane and of strain 229E in WI-38 cells was performed. In infected cells, round electron-dense particles 82 mmu in diameter were observed to form by a process of budding from membranes of the endoplasmic reticulum and cytoplasmic vesicles. The particles in IBV-infected cells were similar in size and shape to those in strain 229E-infected cells but showed certain differences in internal structure. The evidence that the particles represent virions and the implications of these findings in the classification of this virus group are discussed.

Isolation of a new human herpesvirus producing a lytic infection of helper (CD4) T-lymphocytes in peripheral blood lymphocyte cultures--another cause of acquired immunodeficiency?

A new human helper (CD4) T-lymphotropic herpesvirus (HTLHV) was first isolated in February 1985 from the cultured peripheral blood lymphocytes (PBL) of a patient with the acquired immunodeficiency syndrome, and subsequently from the PBL of 1 patient with hairy cell leukaemia and 2 patients with lymphoproliferative disease associated with human T-lymphotropic virus type I infection. The viruses could be serially subcultured in umbilical cord PBL cultures in which they infected helper (CD4) T-lymphocytes producing multinucleate giant cells with intranuclear inclusions followed by cell lysis. Electron microscopy of infected cultures revealed that the isolates were herpesviruses. Specific DNA probing showed that the 4 isolates were related to one another but were distinct from cytomegalovirus, Epstein-Barr virus, Herpesvirus hominis types 1 and 2, and varicella-zoster virus. HTLHV lyses the same target cell as human immunodeficiency virus in PBL cultures suggesting that it may have a similar potential to cause acquired immune deficiency. The development of an unequivocally diagnostic serological test is a priority, so that the epidemiology and pathogenesis of HTLHV infection can be studied.