The increased risk of developing lung diseases in cigarette smokers has been well recognized. The association between smoking and the risk of developing pulmonary infections in HIV-1-infected patients, however, which has not been established, was evaluated in the present study. Twenty-seven cases with lower respiratory infections (15 Pneumocystis carinii pneumonia (PCP), 12 TB cases) were compared with 27 age, gender, socio-economic and HIV status-matched patients, without history of respiratory diseases. Medical history and physical examinations were obtained every 6 months. Blood was drawn for CD4 and viral load measurements. A substantial number of HIV + smokers who developed PCP (one-third) had been on highly active retroviral therapy (HAART) for more than 6 months and prophylaxis had been discontinued. Multivariate analyses indicated that in HIV-infected people, after controlling for HIV status and antiretrovirals, cigarette smoking doubled the risk for developing PCP (p = 0.01). Multivariate analyses demonstrated that long-term smoking also increased the risk (2 x) of developing tuberculosis (p = 0.04). Moreover, daily tobacco use seemed to attenuate by 40% the immune and virological response to antiretroviral therapies. These findings indicate that tobacco use significantly increases the risk of pulmonary diseases in HIV infected subjects and has a potential deleterious impact on antiretroviral treatment.

Selenium therapy may be a beneficial treatment to decrease anxiety in HIV+ drug users who exhibit a high prevalence of psychological burden.

Purple passion fruit (Passiflora edulis Sims f. edulis) is a tropical juice source. The goal of this project was to evaluate photosynthetic and physiological variability for the crop with the hypotheses that landraces contain the diversity to adapt to higher elevation nontraditional growing environments and this is dependent on specific parameters of ecological adaptation. A total of 50 genotypes of this crop were chosen from divergent sources for evaluations of their eco-physiological responses in two equatorial locations at different altitudes in the Andes Mountains, a center of diversity for the species. The germplasm included 34 landraces, 8 commercial cultivars, and 8 genebank accessions. The two locations were contrasting in climates, representing mid and high elevations in Colombia. Mid-elevation valleys are typical regions of production for passion fruit while high elevation sites are not traditional. The location effects and variables that differentiated genotypes were determined. Results showed statistically significant differences between locations and importance of physiological parameters related to photosynthesis and water use efficiency. Some landraces exhibited better water status and gas exchange than commercial types. Parameters like maximum photosynthesis, points of light saturation and compensation, darkness respiratory rate, and apparent quantum yield varied between genotype groups. The landraces, commercial types, and genebank entries also differed in content of carotenoids and chlorophylls a and b. Meanwhile, photosynthesis measurements showed that altitudinal difference had an effect on genotype-specific plant growth and adaptation. An important conclusion was that landraces contained the diversity to adapt to the new growing environment at higher altitudes.

With the exception of hemolytic anemia, the potential hematological toxicity of antiretrovirals (ARV) and combination treatments in HIV treated individuals has not been well established. We report, for the first time, hematological toxicity defined as thrombocytosis in 9% of the HIV+ patients receiving highly active antiretroviral treatment (HAART) being followed in a nutritional clinical trial. Participants were evaluated every 6 months during a 2-year period (1998-2000) and blood drawn for biochemical, hematological and immunological parameters. NK cells were negatively correlated with platelet counts in the total cohort (P = 0.018) and persistently elevated with ARVT. Chronic thrombocytosis was associated with significantly lower NK percentages (P = 0.005). Twenty-five percent of the patients with thrombocytosis developed a cardiovascular disease. Together, these results support the proposal that HAART may increase the risk of hematological dysfunction and impact the risk of cardiovascular disease.

To characterize current risk behaviors of HIV drug abusers in the highly active antiretroviral therapy (HAART) era, socio-demographic, medical and behavioral information were obtained and immune measurements determined. High-risk sexual practices were prevalent. Participants diagnosed before 1995 were 6 times more likely to have unprotected sex with HIV+ partners (p = 0.05) and 11 times more likely to use contaminated needles (p = 0.05) than participants with later diagnosis. Consistent condom use was reported by only 7% of the cohort. Many (43%) of the participants reported multiple HIV+ and HIV- concurrent partners. Most (65%), particularly women (OR = 3, p = 0.02), did so for drugs or money. Despite detectable viral loads, 36% reported unprotected anal sex. Antiretroviral-treated men, compared to non-treated, tended to have unprotected anal sex (OR = 2, p = 0.07). The continued high-risk behaviors of HIV drug users, particularly those diagnosed before 1995 and/or on antiretroviral therapy, indicates an urgent need for new public health strategies.