Infectious and inflammatory diseases have repeatedly shown strong genetic associations within the major histocompatibility complex (MHC); however, the basis for these associations remains elusive. To define host genetic effects on the outcome of a chronic viral infection, we performed genome-wide association analysis in a multiethnic cohort of HIV-1 controllers and progressors, and we analyzed the effects of individual amino acids within the classical human leukocyte antigen (HLA) proteins. We identified >300 genome-wide significant single-nucleotide polymorphisms (SNPs) within the MHC and none elsewhere. Specific amino acids in the HLA-B peptide binding groove, as well as an independent HLA-C effect, explain the SNP associations and reconcile both protective and risk HLA alleles. These results implicate the nature of the HLA–viral peptide interaction as the major factor modulating durable control of HIV infection.

Feeling lonely is associated with systemic inflammation in middle-aged community-dwelling US adults.

Background The ubiquity of the Internet is changing the way people obtain their health information. While there is an abundance of heart failure information online, the quality and health literacy demand of these information are still unknown. Objective The purpose of this study was to evaluate the quality and health literacy demand (readability, understandability, and actionability) of the heart failure information found online. Methods Google, Yahoo, Bing, Ask.com, and DuckDuckGo were searched for relevant heart failure websites. Two independent raters then assessed the quality and health literacy demand of the included websites. The quality of the heart failure information was assessed using the DISCERN instrument. Readability was assessed using seven established readability tests. Finally, understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Print Materials (PEMAT-P). Results A total of 46 websites were included in this analysis. The overall mean quality rating was 46.0 ± 8.9 and the mean readability score was 12.6 grade reading level. The overall mean understandability score was 56.3% ± 16.2. Finally, the overall mean actionability score was 34.7% ± 28.7. Conclusions The heart failure information found online was of fair quality but required a relatively high health literacy level. Web content authors need to consider not just the quality, but also the health literacy demand of the information found in their websites. This is especially important considering that low health literacy is likely prevalent among the usual audience.

Background/Objectives Current measures of cytokines involve urine, blood or saliva which have drawbacks including circadian rhythm variations and complicated collection methods. Sweat has been used to measure cytokines in young and middle-aged adults, but not older adults. We sought to determine the feasibility of using sweat to measure cytokines in older adults compared to younger adults. Design Two visit cross-sectional pilot study stratified by age group. Setting Independent living facility and Johns Hopkins University both in Maryland. Participants 23 community-dwelling adults aged 65 and older and 26 adults aged 18–40 were included. Those with active cancer treatment or with a known terminal illness diagnosis were excluded. Measurements Sweat interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) were collected using a non-invasive sweat patch worn for 72 hours by each participant. Samples were measured with a single molecule array (SIMOA) technology for ultrasensitive, multiplexed detection of proteins. Results 23 older adults and 26 younger adults with mean ages of 77±8.0 years and 28±5.5 years, respectively, completed the study. Both groups had high rates of compliance with patch wearing and removal. Higher concentrations of TNF-α, IL-6 and IL-10 were observed in older adults compared to younger adults, which remained significant after controlling for race, sex, body mass index, and chronic disease count (0.110±0.030 vs. 0.054±0.020pg/mL, 0.089±0.012 vs. 0.048±0.018pg/mL, and 0.124±0.029 vs. 0.067±0.025pg/mL, respectively). Conclusion These results suggest that sweat patches are a feasible method to collect cytokine data from older adults. Preliminary group differences in cytokine measurement between older and younger groups correspond with current literature that cytokines increase with age, suggesting that sweat measurement using the sweat patch provides a new method of exploring the impact of inflammation on aging. Further research using sweat and the sweat patch is recommended.

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