Abstract. The intracellular distribution of HIV-1 RNA transcripts in infected cells was studied using in situ hybridization detected by electron microscopy and cellular fractionation. Although viral RNA and core protein could be detected throughout the cytoplasm and nucleus, viral RNA was found in significantly increased amounts in mitochondria relative to the cytoplasm and nucleus. In contrast, cellular poly(A)RNA or viral gag proteins were not increased in the mitochondria. A cell line containing an integrated latent genome that could be induced to express viral RNA after phorbol ester stimulation showed an increase in viral RNA accumulation in mitochondria parallel with the increase in HIV expression levels. Concomitant with HIV expression, there was a decrease in mitochondrial viability. Using immunofluorescent markers to detect probes to HIV RNA transcripts and antibodies to mitochondrial proteins simultaneously in single cells, there was an inverse relationship between the amount of viral RNA and mitochondrial integrity. High levels of viral RNA in mitochondria were found in acutely (but not chronically) infected cells. We propose that HIV RNA import into mitochondria can compromise mitochondrial function.

Objectives: Torture has been documented in 132 countries, and approximately 400,000 survivors of torture reside in the United States. It is unknown if torture survivors seek medical care in emergency departments (EDs). The authors set out to estimate the prevalence of survivors of torture presenting to an urban ED.Methods: A cross-sectional survey of ED patients was performed by convenience sampling from October 2008 to September 2009 in a large urban teaching hospital in New York City. ED patients not of a vulnerable population were consented and entered into the study. Participants were asked two screening questions to ascertain if they were self-reported survivors of torture. For exploratory purposes only, these individuals were further queried about their experiences. The detailed responses of these self-reported survivors of torture were compared to the United Nations Convention Against Torture (UNCAT) definition by a blinded, independent panel.Results: Of 470 study participants, 54 individuals (11.5%, 95% confidence interval [CI] = 8.6% to 14.4%) self-reported torture. Nine (16.7%) had ongoing physical disabilities, 30 (55.6%) had recurrent intrusive and distressing memories, 42 (77.8%) never had a physician inquire about torture, and only eight (14.8%) had requested political asylum. Of these self-reported survivors of torture, 29 (53.7%) met the UNCAT definition, for an adjudicated prevalence of 6.2% (95% CI = 4.3% to 8.7%).Conclusions: Self-reported survivors of torture presented to this urban ED, and a significant proportion of them met the UNCAT definition of a torture survivor. Continuing torture-related medical and psychological sequelae were identified, yet there was a low rate of asylum-seeking. Only a minority were previously identified by a physician. These data suggest an unrecognized public health concern and an opportunity for emergency physicians to intervene and refer survivors of torture to existing community resources.

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