The provision of local HIV services for HIV-infected adults is good in England, with over 80% of patients living within 5 km of a service. More than a quarter of diagnosed HIV-infected patients travelled beyond local HIV services in 2007. Patients who were most likely

to travel to non-local services included those living in the least deprived areas, those living in rural areas, and those Selleckchem Silmitasertib who first attended HIV services before 2007. A recent study in North-West England focusing on use of the nearest HIV service concluded that 50% of HIV-infected patients travelled to an HIV service beyond their closest one [5]. We believe that analysing the use of ‘non-closest site’ overestimates the number who travelled to care, as many patients live within close proximity of multiple services. Our method, which categorized services as either ‘local’ or ‘non-local’ for each patient, more accurately reflects travelling for HIV care beyond local services. Using this method, we estimated that 28% of patients resident in the North West travelled to non-local services. PLX4032 cell line Patients living in the least deprived areas were twice as likely to travel to non-local sites compared with those living in the most deprived areas. This supports local findings from the North West of England [5]. Deprived areas are in part defined by high rates of unemployment and income deprivation [8]; patients living

in these areas may therefore experience financial difficulty in travelling beyond local services [11]. Over 40% of the diagnosed HIV-infected population in England live in the most deprived areas. A recent study found that 31% of people living with HIV in the UK experienced

insufficient finances to live else on and more than 10% had difficulty meeting travel costs [13]. Patients who had been attending HIV care for more than a year were 50% more likely to attend non-local services compared with those who first attended HIV care in 2007. This may be because patients may not become aware of the choices available to them until they have adjusted to their HIV diagnosis. Patients living in an urban area were almost 25% more likely to travel beyond local services. This may be because the next nearest service for patients living in rural areas is a substantial distance further to travel. Patients who were infected through blood/blood products were more likely to travel to non-local services. As a result of comorbidities, these patients may be more likely to need to attend specialist services that are not provided locally. While associations with ethnicity and risk group remained significant, these were weaker predictors of attending non-local HIV care. This analysis cannot definitively ascertain whether the quarter of HIV-infected patients who travelled beyond local services did so out of choice or necessity.

N2O/O2 (Linde Gas Therapeutics, AGA, Kolding, Denmark) was administered using an Analgisor® (Drager S&W,

Denmark) with double mask and a scavenging system according to the BMS-777607 molecular weight following recommended scheme[11]: An induction phase of 5 min of pure O2. Five minutes with increasing concentration of N2O. Five minutes with at concentration of 50% N2O and 50% O2. Five minutes of pure O2. The mask was removed. Atmospheric air (Linde Gas Therapeutics, AGA, Kolding, Denmark) was used as a placebo. The children were carefully monitored for oversedation. Both the dentist and the chair-side dental assistant had extensive experience in the use of N2O/O2. Each test session took approximately 55 min. The analysis was based on the average of the three replicates of each measurement of each test. The difference between the average measurement in session 2 and the corresponding average in session 1 was computed for each test. For Selleck DAPT each measurement in each test, the unadjusted (crude) effect of the NO2/O2 was assessed by comparing the differences in Group A with the differences in Group B using a t-test. The crude effect of NO2/O2 was estimated as half the difference between the average difference in Group A and the average difference in Group B[12].

Analysis of covariance was used to assess the NO2/O2 effect on tooth-pulp pain sensitivity and on muscle pressure pain threshold adjusted for the effect of NO2/O2 on reaction time. The study was approved by The Central Denmark Region Committees on Biomedical Research Ethics (Record # M-20070261), Danish Medicines Agency (record # 2012014352; EudraCT Number: 2009-009917-16); The Danish Data protection Agency (Record # 2009-41-3521). GCP-unit, Aarhus University Hospital, Aarhus, Denmark (record # 2008/275), and registered in ClinicalTrials.gov (record # NCT01022294). A total of 78 children participated in the information meetings. Of these, 20 children withdrew from the study before the initiation of

the study for various reasons: two had left the school; four disliked the effect of N2O/O2; two had had a traumatic injury to both upper central incisors; for one child, the consent was eventually withdrawn by the mother; for one child, consent could for practical reasons not Aldehyde dehydrogenase be obtained from the father; one child continued to break the appointment for the information meeting; one had left for vacation; one had orthodontic appliances; one was very nervous; and six eventually refused to participate. Of these, two children could not complete the study due to a feeling of unpleasant dizziness, resulting in a total of 56 children completing the entire trial. More than half of the 56 children, who completed the study, were 12 years of age, and almost 60% were boys (Table 1). Three (5.4%) children had a non-Danish ethnic background, and 22 (39.3%) had previous experience with N2O/O2 inhalation sedation. In 51 (91.

2), with most isolates sampled from the same host grouping together. In support, the host is known to have a significant impact on the genetic structure of pathogen populations, especially in pathosystems characterized by the rapid breakdown of race-specific resistance (McDonald et al., 1989). Finally, while Newton et al. (2001) and Bouajila et al. (2007) indicated no clear relationship between genetic and pathogenic variation using RAPD and AFLP markers, the calculated degree of coincidence between pathotype and SSR haplotypes (Table 4) allowed the determination of pathogenicity in 52% of the isolates by fingerprinting with seven microsatellite loci. A similar

discrepancy in the SSR haplotype and pathogenicity has also been reported ICG-001 manufacturer by Takeuchi & Fukuyama (2009). In addition, many SSR alleles were shown to be linked to virulence (Table 3). These may serve as rapid

molecular tools for pathogen detection, without the inoculation that requires long incubation periods before ultimate disease assessment. This investigation was cosponsored by ICARDA-ETH Zurich. The authors acknowledge the support and the use of facilities of ETH – Institute of Integrative Biology ‘Phytopathology Group’, where this work was carried out. We are grateful to Dr Bruce for providing SSR primers. “
“The plant hormone ethylene has been reported to inhibit the Agrobacterium tumefaciens-mediated transformation efficiency of many plants. In this study, an acdS gene that encodes 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase, an enzyme that Mitomycin C breaks down ACC, the direct precursor of ethylene biosynthesis in all higher plants, was introduced into A. tumefaciens GV3101∷pMP90. It was found that the presence of active ACC deaminase in A. tumefaciens reduced ethylene levels produced by plant tissues during the process of infection Resveratrol and cocultivation, and significantly increased the transformation efficiency of three commercial canola cultivars: Brassica napus cv. Westar, B. napus cv. Hyola 401 and B. napus cv. 4414RR. Agrobacterium tumefaciens is an important tool for plant genetic engineering. However, the low

transformation efficiency of many commercially important crops is the main factor limiting its use. Among various factors, ethylene produced by plants is one that inhibits A. tumefaciens-mediated transformation efficiency. For example, it has been reported that reducing the ethylene level increased the expression of the vir genes of A. tumefaciens, thereby increasing gene delivery efficiency (Nonaka et al., 2008a). Moreover, application of ethylene inhibitors such as aminoethoxyvinylglycine or silver ions in the tissue culture medium has been reported to improve the transformation efficiency of many plant species, such as bottle gourd, cauliflower, apricot and apple trees (Chakrabarty et al., 2002; Burgos & Alburquerque, 2003; Han et al., 2005; Petri et al., 2005; Seong et al., 2005).

At baseline, half of the patients had a history of previous ARV treatment failure. Most (62%) had an ARV regimen containing PI3K inhibitor LPV/r at study entry. The top three PI-based regimens switched at study entry were zidovudine (ZDV)/stavudine (d4T)+lamivudine (3TC)+LPV/r (20%), ZDV/d4T+3TC+nelfinavir (NFV) (19%), and tenofovir (TDF)+3TC/emtricitabine (ETC)+LPV/r (11%). At study entry, the top three ATV/r regimens were TDF+3TC/FTC+ATV/r (29%), ZDV/d4T+3TC+ATV/r (20%), and abacavir (ABC)+3TC+ATV/r (20%). 3TC (60%) and TDF (44%) were the most common ARV drugs administered

with ritonavir-boosted ATV. Once-daily regimens were used in 131 patients (72%). The proportions of patients with undetectable HIV RNA as per the local HIV testing LOQ (20–400 copies/mL) were 82% (ITT) and 95% (on treatment) at 12 months; the Seliciclib mw results were the same for patients with HIV RNA<50 copies/mL at those sites with LOQ<20 or 50 copies/mL. Treatment failure and virological failure rates at month 12 were 18% (n=32) and 7% (n=13), respectively. The use of ritonavir in the regimen switched at study entry and previous failure with all three drug classes were the risk factors associated with virological failure at month 12 in the bivariate analysis. Only the latter was significantly associated with virological failure (odds ratio 3.72; 95% confidence interval 1.12–12.38) in the

multivariate analysis (using a logistic regression model). The median (IQR) change in CD4 T-lymphocyte count from baseline at month 12 was +8 cells/μL (−74 to 131 cells/μL) and the median CD4 T-lymphocyte count at 12 months was 560 cells/μL (426–746 cells/μL). Median times to virological failure and treatment failure were 131 days (117–241 days) and 157 days (123–250 days), respectively (Fig. 2). As a result of the observational nature of the study, patients were followed

using the routine practice of each participating centre. Consequently, some patients remained in the study for >12 months and, in 11 cases, >15 months. Nevertheless, no cases of virological failure after month 12 were observed, and only one patient discontinued treatment (at month 14). There were two deaths during the study (Fig. 1 and Table 2); neither was related to the study treatment (lung cancer and myocardial infarction). The overall incidence of adverse events of any grade was 26% (n=48): 27 were related to ATV/r but only seven (3.8%) moderate-to-severe adverse events Tenoxicam were considered to be ATV/r-related. Adverse event-related discontinuation was 1%, and only one event was possibly related to ATV/r (vomiting). Hyperbilirubinaemia or jaundice of any grade was reported for 11% of patients, but was of moderate grade in only 2% of patients and mild in all other cases, and none discontinued the study for this reason. There were no cases of diarrhoea. The proportion of patients with aspartate aminotransferase (AST) and alanine aminotransferase (ALT) plasma levels above 200 U/L during the first 12 months of follow-up was 1.6% and 4.

5 Comparisons of certain characteristics between VFRs and non-VFRs are shown in Table 2. VFRs represent the largest category of travelers for each of the three diseases. Among VFRs, 40% of cases were under 20 years of age, compared to less than 6% among non-VFRs (p < 0.000). In Canada, only 11% of VFRs were under 20 years of age in 2008,5 but in our study, this age group accounted for 16.9% of malaria cases, 50% of typhoid cases, and 65.2% of hepatitis A cases among VFRs.

The median age of cases among VFRs is 32 years for malaria (vs 37.5 y among non-VFRs), 19.5 years for typhoid fever (vs 34.5 y), and 15.5 years for hepatitis A (vs 37 y). As for trip duration, 73% of cases among VFRs had traveled for 30 days or more, compared ATM signaling pathway to 51.8% of non-VFRs (p < 0.000). No case among VFRs was reported with a trip of 1 week or less. However, it is worrisome to note that a Hydroxychloroquine concentration fair proportion of cases among VFRs occurred following a trip of intermediate length, ie, from 15 to 29 days, which is almost 30% of the malaria cases and 21.2% of the typhoid cases. The proportion of hepatitis A cases reported following a trip of 14 days or less is clearly higher among non-VFRs

(61.7%) compared to VFRs (1.6%). The highest proportion of cases among VFRs occurred in the 3rd quarter, between July 1 and September 30: 31.3% of malaria cases, 41.2% of typhoid cases, and 56.1% of hepatitis A cases (Table 3). This seasonal variation in cases among VFRs differs significantly (p = 0.004) from non-VFRs. In terms of gender, no statistically significant difference

was found between VFR and non-VFR cases. Pre-travel consultation data is to be interpreted with care due to lack of information in most cases (222/309), and even when it is available, we cannot rule out social desirability bias in the answer. Table 4 shows the main regions of acquisition reported for the three diseases under study, for VFRs and non-VFRs. Among VFRs, 79.8% of cases traveled to Africa or the Indian subcontinent, compared to 49.2% of cases among non-VFRs. Virtually all (91.6%) of the malaria cases among VFRs were acquired in Africa, particularly in sub-Saharan Africa. The Plasmodium falciparum type accounts for 86.4% of malaria cases among VFRs. The vast majority (76.6%) of typhoid fever cases among VFRs were reported by travelers Fludarabine supplier who had visited the Indian subcontinent. For hepatitis A, over 60% of cases among VFRs were acquired in Africa (including 31.9% in North Africa) or the Indian subcontinent. For non-VFRs, 60% of cases contracted hepatitis A while visiting so-called sunshine destinations favored by Quebecers, namely Cuba, Mexico, and the Dominican Republic. Data were compared with Provost et al.7 and De Serres et al.19 studies. Since 2000 to 2002, the proportion of malaria cases attributed to VFRs more than doubled (52.9% vs 25%), and for typhoid, it increased to 94.4% from 86%.

, 1990). The procedure

that we applied has been described previously (Dagerlind et al., 1992), and was used with minor modifications as described by Karlstedt et al. (2001). Briefly, the oligoprobe, complementary to the mouse HDC mRNA (5′-CCGTGTCTGACATGTGCTTGAAGATTCTTCACCCCGAAGGACCGAATCAC-3′), was labelled with deoxyadenosine 5′-triphosphate, [α-33P] at its 3′-end by using terminal deoxynucleotide transferase (Promega, Madison, WI, USA), according to the manufacturer’s instructions. Everolimus price Non-incorporated nucleotides were removed by purification with Sephadex G-50 QuickSpin cartridges (Roche). The brain sections, eight per mouse, were hybridized with the probe at 56 °C for 24 h. After a series of high-stringency washes that removed a non-hybridized probe, Kodak BioMax films were exposed to the sections and the 14C-standards for 10 days. Quantitative selleck inhibitor analysis of the autoradiograms was performed with the mcid 6.0 platform (Imaging Research, St Catharines, Canada). Quantitation was performed with 14C-calibration standards (Amersham) in the linear range of the calibration curve, as described previously (Lintunen et al., 1998). The region of interest was defined as the intensity window with the lower threshold determined as three standard deviations from the mean pixel density distribution of the background area,

and the upper threshold as a maximum value of the calibration value. Average values were used as an intensity measure. The specificity of this probe has been established previously (Karlstedt et al., 2001). The assay used here was a combination of methods for the simultaneous determination

of histamine and 1-methylhistamine levels (Miyamoto et al., 2004), HDC activity (Niimi et al., 1997), and HNMT activity (Scott et al., 1991). The animals (36 male 8-week-old C57BL/6J mice and 30 male 8-week-old CBA/J mice) were kept in groups of three (100 lux at the cage bottom) for 2 weeks before the experiment. Mice were Thymidine kinase killed at ZT 4, 8, 12 (lights on), 16, 20 and 24 (lights off) by decapitation, and the following brain structures were collected: medulla oblongata, pons, cerebellum, midbrain, hypothalamus, thalamus, hippocampus, striatum, and cortex, all according to the mouse brain stereotaxic atlas (Paxinos & Franklin, 2004). Brain areas were dissected on ice, and samples were snap frozen in liquid nitrogen and stored at −80 °C prior to analysis. Samples were homogenized with a Vibracell sonicator (Sonics, Newtown, CT, USA) on ice in 10 volumes of the homogenization solution, consisting of 115 μm phenylmethanesulfonyl fluoride, 100 μm dithiothreitol and 100 nm 3-methylhistamine (internal standard) in a 0.1 m potassium phosphate buffer (pH 7.0). Sixty microlitres of the homogenate was immediately mixed with HClO4 (final concentration 0.

Most-at-risk populations have been specifically targeted, and it has been recommend that MSM should be tested annually, or more often depending on sexual behavior [1]. In Portugal, HIV testing is available at hospitals, primary care centers, tuberculosis and drug treatment centres, Ferroptosis assay and private laboratories. Free anonymous HIV testing is also available through outreach teams, and at 18 designated testing centres, one in each health region. In addition, Lisbon has established a community, peer-based site that provides free anonymous counseling and testing specifically targeted at MSM. Information about HIV testing among MSM in Portugal

is scarce. Our objective was to describe HIV testing behavior and context in a large sample of MSM participating in the European MSM

Internet Survey (EMIS). EMIS methods have been described in detail elsewhere [3]. In brief, EMIS was a joint project of academic, governmental and non-governmental partners from 38 countries in Europe to simultaneously run an online survey in 25 different languages during summer 2010. EMIS was approved by the Research Ethics Committee of the University of Portsmouth, UK(REC application number 08/09:21). Data for the Portuguese sample were extracted and those for 5187 participants were analysed. Associations were examined Etoposide mouse using odds ratios (aOR) and 95% confidence intervals (95%CI), crude and adjusted for age, country of birth, educational level, sexual orientation disclosure, and UAI (unprotected anal intercourse) in the previous 12 months. The proportion of EMIS participants in Portugal tested for HIV infection during their lifetime was 72% (n = 3723), and 65% of those without known infection had tested for HIV in the last 12 months. Among those ever tested, 11% were diagnosed with HIV. Among recently tested men who remained HIV negative at the time of survey, family doctors at National Health Service primary care centres were the most common providers of testing (37%), followed by community HIV testing service (19%), hospitals (17%), private practice (15%) and blood banks while donating blood (7%). A high proportion (90%) were satisfied

with the Staurosporine mouse way the testing service maintained confidentiality and ensured respectful treatment (92%) at their last HIV test. However, only about half were satisfied with the counselling received and 38% reported not having received any counselling. Ever testing was most frequent among men aged 35–44 years and least frequent among those under 25 (83% vs. 52%, respectively; P < 0.001). However, among those ever tested, previous year testing was most frequent in men under 25 (77%). Compared to those who had never been tested, men who had ever performed an HIV test had higher educational level, identified themselves as gay/homosexual more frequently and were out to most acquaintances (Table 1). Also, HIV testing was more frequent among participants living with a male partner (83% vs.

hep-druginteractions.org) GPP 8.3.1 We recommend starting ART in HIV-positive patients with

KS. 1A   We recommend starting ART in HIV-positive patients with non-Hodgkin lymphoma (NHL). 1B   We suggest starting ART in HIV-positive patients with cervical cancer. 1C   We recommend starting ART in HIV-positive patients who are commencing radiotherapy or chemotherapy for cervical cancer. 1D 8.3.2 We suggest starting ART in HIV-positive patients with non-AIDS-defining malignancies (NADMs). 2C   We recommend starting ART in HIV-positive PD 332991 patients who are commencing immunosuppressive radiotherapy or chemotherapy for NADMs. 1C 8.3.3 We recommend that potential pharmacokinetic interactions between ARVs and systemic anticancer therapy be checked before administration (with tools such as: http://www.hiv-druginteractions.org). GPP   We suggest avoiding ritonavir-boosted ART in HIV-positive BTK inhibitor patients who are to receive cytotoxic chemotherapy agents that are metabolized by the cytochrome P450 (CYP450) enzyme system. 2C   We recommend against the use of ATV in HIV-positive patients who are to receive irinotecan. 1C   We suggest avoiding ARV agents in HIV-positive patients who are to receive cytotoxic chemotherapy agents that have overlapping toxicities. 2C 8.4.2 We recommend patients with symptomatic HIV-associated NC disorders start ART irrespective

of CD4 lymphocyte count. 1C 8.4.3 We recommend patients with HIV-associated NC disorders start standard combination ART regimens. 1C 8.4.4 In patients with ongoing or worsening NC impairment despite ART we

recommend the following best practice management: GPP • Reassessment for confounding conditions. • Assessment of cerebrospinal fluid (CSF) HIV RNA, CSF HIV genotropism and genotyping of CSF HIV RNA. • In subjects with detectable CSF HIV RNA, modifications Oxymatrine to ART should be based on plasma and CSF genotypic and genotropism results. 8.5.1 We recommend patients with HIVAN start ART immediately irrespective of CD4 cell count. 1C   We recommend patients with end-stage kidney disease who are suitable candidates for renal transplantation start ART irrespective of CD4 cell count. 1C 8.5.2 We recommend against the use of ARV drugs that are potentially nephrotoxic, in patients with stages 3–5 chronic kidney disease (CKD) if acceptable alternative ARV agents are available. GPP   We recommend dose adjustment of renally cleared ARV drugs in patients with reduced renal function. GPP 8.6.4 We suggest avoiding: ABC, FPV/r and LPV/r in patients with a high cardiovascular disease (CVD) risk, if acceptable alternative ARV drugs are available. 2C 8.7.2 We recommend therapy-naïve HIV-positive women who are not pregnant start ART according to the same indicators as in men (see Section 4: When to Start) 1A 8.7.

In the two reported cases,

symptoms appeared between 11 and 14 days after exposure, respectively. This is much shorter than might be expected according to the literature. Both patients presented with fever, cough, urticaria, and eosinophilia, manifestations that are most commonly associated with acute schistosomiasis (Katayama fever)6 and occasionally with other helminth infections in returned travelers.7 Helminth infections Small molecule library are difficult to diagnose during the invasive stage. In the reported cases, the diagnosis was made about 3 weeks after the onset of symptoms by positive agar-plate stool cultures in both patients, the presence of Strongyloides stercoralis larvae in the stools of one patient and a serologic ICG-001 diagnosis in the other.1 When faced with a returned traveler from the tropics with eosinophilia, an helminth infection should be at the top of a differential diagnosis. Not only are serologic tests frequently not positive early in the infection but also they may lack specificity, particularly in the case of strongyloidiasis8; both schistosomiasis and filariasis may lead to false positive tests for strongyloidiasis. Repeat stool examinations (and urinalyses

in case of Schistosoma haematobium schistosomiasis) may be necessary to detect parasites in the first few weeks after exposure. Even then, tests may be negative because of a long prepatent period (eg, 2 mo in schistosomiasis). Chronic strongyloidiasis is usually asymptomatic or gives rise to mild gastrointestinal symptoms, most often peptic ulcer-like symptoms. Of greater concern is its potential to become a fulminant, fatal illness in appropriate circumstances. Strongyloides hyperinfection syndrome and dissemination result from decreased cell-mediated immunity, including that associated with corticosteroid treatment and HTLV1.5,9 Methocarbamol Disseminated strongyloidiasis carries mortality rates from 50% to 87%, even with treatment.3 This

infection is now considered the leading cause of death from a parasitic disease in the United States.10 In Western countries chronic, usually asymptomatic, strongyloidiasis was classically associated with immigration. However, it is now increasingly seen in tourists. In a series of 43 travelers with strongyloidiasis in Canada, the infection was associated with visiting friends and relatives in 37% of the cases, tourism in 30%, and immigration in 21%.11 These results may illustrate an epidemiological change in the acquisition of strongyloidiasis in Canada; on the other hand, they may be the result of referral bias. However, it is interesting to note that in an older series of 76 persons in Canada with confirmed strongyloidiasis, nonmigrants made up only 4% of the cases, whereas 96% were persons who had immigrated a median of 48 months (range 2–480 mo) prior to presentation.

In addition, glutathione peroxidase was increased in those with liver disease, as measured by APRI and FIB-4, in response to increased oxidative stress, a finding that is consistent with other studies that have shown elevation of glutathione peroxidase in mild-to-moderate PD-0332991 price liver disease [38]. In vitro and animal studies have demonstrated that oxidative stress generated in hepatocytes is one of the important factors that stimulate hepatic stellate cell proliferation and the accumulation of collagen, initiating and facilitating the fibrogenic process [39]. Thus, in addition to the immunosuppression

and antioxidant deficiencies caused by HIV and HCV, the elevated oxidative stress observed in HIV/HCV coinfection may contribute to a more rapid progression of liver fibrosis by stimulating HCV replication and increasing the production of reactive oxygen species in hepatocytes [6,10,36,37]. Oxidative stress is a nonspecific pathogenic state of imbalance in the pro-oxidant–antioxidant balance produced by infected hepatocytes during the formation of traumatic and inflammatory lesions [8]. Oxidative stress, exacerbated by immunosuppression, Ivacaftor mw concomitant exposure to viral infections, and depletion of antioxidants, causes hepatic cell damage [40]. Our results show that HIV/HCV coinfection, which is a condition characterized by immunosuppression resulting

from HIV infection and concomitant exposure to HCV, is also accompanied by significantly lower plasma levels of vitamins A and E and zinc, which are significantly lower than those found either

in HIV or HCV monoinfection [41,42]. In addition, more advanced liver disease, as estimated using the APRI index, was significantly associated with lower vitamin A, regardless of HCV status. Levels of other antioxidants decreased with higher indexes of liver disease, but correlations did not reach significance, potentially because of small sample sizes. Use of addictive drugs produces significant alterations in markers of HIV disease progression [43] and in nutritional indices [44], as shown Decitabine supplier in our earlier studies, which demonstrated that drug use was associated with multiple deficiencies in antioxidant micronutrients, including vitamins A, E and C, zinc and selenium [45]. While a relatively large percentage of the present study participants consumed alcohol, cigarettes and illicit drugs, the proportion of patients using illicit drugs did not differ between the groups, and thus was not likely to cause the differences in oxidative stress and plasma antioxidant micronutrient levels found between the HIV/HCV-coinfected and HIV-monoinfected groups. Vitamins A and E and zinc are part of the wide array of enzymatic and nonenzymatic antioxidant defences that have been found in reduced amounts both in plasma [14,41,46] and in liver biopsies of patients with chronic HCV infection [14].