Although these isolates appear similar to strain M1 and were also

Although these isolates appear similar to strain M1 and were also initially enriched

find more from gradient-culture systems, L70 and LD2 were isolated in Fe(III)-reducing, dilution series, whereas strain M1 was unable to reduce Fe(III) in the presence of either lactate or acetate. In addition, Geelhoed et al. (2009) reported that L70 and LD2 did not oxidize Fe(II) and suggest that these bacteria grew in Fe(II) gradient systems using Fe(III) hydroxide as a terminal electron acceptor. Regardless of slight differences in phylogeny and physiology, these reports support our contention that Dechlorospirillum sp., in addition to its more commonly known role as a perchlorate and nitrate reducer, can be enriched in Fe(II)-oxidizing, gradient cultures and may be an important member of microbial communities involved in iron redox cycling at oxic–anoxic transition zones in sediments. It would FK506 chemical structure be premature to suggest that this bacterium is capable of chemolithoautotrophic growth, however, because we have no evidence that strain M1 can fix

CO2 or can harness the energy from Fe(II) oxidation for growth. One can speculate about other mechanisms that could provide explanations for the observed Fe(II)-oxidation-dependent growth in gradient cultures. One such possibility involves the formation of reactive species, for example, OH•, O2−, or H2O2, during the chemical oxidation of Fe(II) by O2 (King et al., 1995). Such reactive species might lead to a partial breakdown of complex organic matter, for example agarose or dissolved organic matter, into smaller molecules that can be degraded heterotrophically or utilized mixotrophically. If such a mechanism was operative, propagation of cells at zones of abiotic Fe(II) oxidation would also be expected. Although Fe(II)-oxidation-dependent growth of strain M1 was clear in our studies, further work is therefore necessary to determine whether

the increase in the growth yield at the Fe(II)/Fe(III) interface Liothyronine Sodium was linked to microbial energy conservation from Fe(II) oxidation or resulted from other mechanisms. This research was supported by National Science Foundation Biogeosciences Program Grant 0525069 to F.W.P. and E. Roden and by grant EXB04-0017-0111 from the National Aeronautics and Space Administration to J.S. The authors would like to thank David Emerson and Eric Roden for useful suggestions during the initial stages of the research and Burga Braun for her assistance in rDNA sequencing and phylogenetic characterization. Fig. S1. Replicate gradient-culture vials for three different treatments after 8 days of incubation. Please note: Wiley-Blackwell is not responsible for the content or functionality of any supporting materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article. “
“In this study, we show that integration host factor protein (IHF) is required for replication of pYGK plasmids in Aggregatibacter actinomycetemcomitans.

, 1999) Additionally, the Sec system translocates proteins in a

, 1999). Additionally, the Sec system translocates proteins in a linear state while the Tat pathway exports folded proteins. Tat substrates from different bacteria participate, among other Fulvestrant purchase functions, in anaerobic metabolism, biofilm formation, cell envelope biogenesis, detoxification and virulence (Lee et al., 2006; De Buck et al., 2008b). The minimal set of components in the Escherichia coli Tat system are three proteins belonging to TatA, TatB and TatC families. The number and copies of each component may differ among bacteria (Dilks et al., 2003). Analysis of the Tat system from an increasing number of bacteria has revealed its

importance for many properties, particularly related to bacteria–eukaryotic host interactions such as plant and animal pathogenesis (De Buck et al., 2008b) and symbiosis between Rhizobium and legumes (Meloni et al., 2003). In this work, we have studied the relevance of the D. dadantii 3937 Tat system for the adaptation of this bacterium to different growth conditions, motility behaviour and interaction with the host plant. The D. dadantii reference strain 3937 (Kotoujansky et al., 1982) was cultivated at 28 °C in nutrient broth (Difco), King’s B medium (KB; King et al., 1954) or basal

medium A (Torriani, 1960). Anaerobic growth was performed using filled screw-cap tubes with medium A with glucose (2 g L−1) instead of glycerol for fermentation, or medium

A plus nitrate (0.5 g L−1) for nitrate respiration. Antibiotics were added to the media at the following concentrations find more (μg mL−1): ampicillin, 100; carbenicillin, 100; tetracycline, 10 and kanamycin, 20. The D. dadantii 3937 tatABC operon was amplified by PCR with the oligonucleotides TatSense 5′-GGCTGGGTTCCGCAAGACAC-3′ and TatAntisense 5′-CCGTAGTAACAGGACGCATA-3′ corresponding to positions 4626756 and 4622930, respectively, from D. dadantii 3937 genome. The amplified fragment (3846 bp) was cloned in pGEM-T Easy Vector (Promega), resulting in plasmid pTat. Tn7 in vitro mutagenesis was performed on pTat using the genome-priming system kit GPS-1 (New England Biolabs). A mutagenized plasmid bearing the Tn7 transposon within the tatC gene was selected and marker-exchanged Cyclin-dependent kinase 3 into the chromosome as described previously (Hugouvieux-Cotte-Pattat & Robert-Baudouy, 1992). The marker exchange was verified by PCR using the former oligonucleotides combined with oligos N and S flanking Tn7 (data not shown). The corresponding D. dadantii tatC mutant (tatC∷Tn7) was named Mtat. Standard molecular cloning techniques used in this study were performed as described previously (Sambrook & Russell, 2001). DNA sequencing of both strands of cloned tatABC was performed using the chain termination method on double-stranded DNA templates using an ABI Prism dye terminator cycle sequencing kit in a Perkin-Elmer 3100 DNA sequencer.

Phenotypic methods have traditionally been used to identify clini

Phenotypic methods have traditionally been used to identify clinically important Mucor spp. (Wang et al., 1990; Fingeroth et al., 1994; Chandra & Woodgyer, 2002). However, the fact that most published reports refer only to the genus Mucor underlines the difficulties in species identification (Ribes et al., 2000). Although observation of zygospores enhanced the identification of heterothallic Zygomycetes (Weitzman et al., 1995; Iwen et al., 2005), maintaining a library of tester strains is not easy for many laboratories and mating tests do not always yield a positive result (Schipper, 1976; Sigler et al., 2002). The Mucor isolate FM07 in yellow catfish was more like oomycete

species or some other filamentous fungi by gross examination. Under the microscope,

uniform nonseptate, broad and right-angled SCH727965 branched hyphae, globose sporangia and sporangiophores could be seen. Based on the morphological characteristics, the strain FM07 was identified as M. circinelloides. Interestingly, the ITS rRNA gene fragment of FM07 showed 100% similarity to both M. circinelloides (EF583641) and Rhizomucor variabilis (DQ118990). Voigt et al. (1999) found R. variabilis was phylogenetically very close to Mucor spp. However, R. variabilis has rhizoids and stolons and can grow well above 40 °C. These characteristics are very different from those of Mucor ABT-263 purchase spp. and were not found in strain FM07. The results identified strain FM07 as M. circinelloides. Infection trials showed that strain FM07 was pathogenic for yellow catfish by intraperitoneal and wound infection. However, the trials also revealed some differences between the two routes of infection (cf. results in Table 1). When the concentrations of sporangiospore suspension were increased, the cumulative mortality from different concentration groups went up correspondingly (30%, 45% and 90%) and the time to death of fish was

reduced (45, 28 and 19 days) in intraperitoneal ID-8 infection. In wound infection, the beginning time of death of fish from different concentration groups was similar to that in the intraperitoneal infection group, but the cumulative mortality was 100% in all wounded groups. In both experiments, when the concentration of sporangiospore suspension was increased the infected fish died more quickly. In immersion infection, there were no fish dead, although the strain FM07 was isolated from the mucus of some fish. These results suggest M. circinelloides is pathogenic to yellow catfish if a portal of entry is provided. Their infection may be associated with some primary pathogenic factor, for example trauma such as wound infection or poor environmental conditions. This phenomenon was consistent with the disease caused by M. circinelloides in humans (Chandra & Woodgyer, 2002; Iwen et al., 2007). In these cases, although M. circinelloides was reported as primary cutaneous zygomycosis, the patients all were known or suspected to have been exposed to trauma in different parts of body.

Due to the lower stimulus power in Magno stimuli and the reduced

Due to the lower stimulus power in Magno stimuli and the reduced amplitude of response in the periphery, participants underwent an additional three runs for the Magno VESPA in the periphery, whenever possible. The average number of Magno VESPA runs in the periphery was 4.48 for TD and 4.41 for ASD. The participants were instructed to maintain fixation on the center of the screen for the duration of each run. To increase the likelihood that participants fixated on the center of the

screen and to decrease boredom, they completed the following tasks. For the centrally presented stimuli, the task was to detect the occurrence of an ‘X’ of mean luminance in the center of the screen. For peripherally presented stimuli, Decitabine participants had to detect a subtle luminance FK506 solubility dmso change in a fixation cross presented in the center of the screen (this cross was

not present for the centrally presented stimuli). The inter-stimulus interval for the targets was set to random values between 6 and 24 s. Seventy-channel scalp EEG was recorded, amplified and digitized at 512 Hz using Biosemi ActiveTwo amplifiers, with a low-pass filter at 103 Hz. The acquisition of the data occurs relative to an active two-electrode reference, which drives the average potential of the participant as close as possible to the analog to digital (AD) conversion reference voltage of the AD box (for a description of the Biosemi active electrode system referencing and grounding conventions, see www.biosemi.com/faq/cms&drl.htm). Eye movements were recorded using an EyeLink 1000 system in head-free mode. In this setting, the eye-tracker corrects for small head movements and remains very accurate even with changing head position. Eye position was recorded

at 500 Hz, synchronized with the EEG recording using triggers every second. Every five blocks, or more frequently if necessary, the eye-tracker was calibrated using a nine-point grid. The recorded EEG data were filtered between 0.8 and 50 Hz using 6th order Chebyshev filters with zero phase-shift. These filters have the advantage of very high attenuation in the stop band with minimal attenuation in the pass-band (< 0.1 dB). Bad PJ34 HCl channels were determined using statistics of neighboring channels and interpolated using linear, distance-weighted interpolation. The EEG data were then referenced to the average. The raw eye-tracking data were filtered using a 4th order Butterworth low-pass filter with 15 Hz cut-off. Due to calibration error, the eye-tracker may represent the participant’s horizontal gaze position up to 1° to the left or right of the intended position. This ‘misrepresentation’ will be consistent for all blocks during a calibration period.

Therefore, boosted PIs are preferred Questions relating to PTD a

Therefore, boosted PIs are preferred. Questions relating to PTD and

pharmacokinetics in the third trimester are addressed separately. A fixed-dose combination of zidovudine, lamivudine and abacavir is an option in this setting. In an RCT in pregnant women with a CD4 cell count >200 cells/μL (with no VL restriction) zidovudine, lamivudine and abacavir (NRTI-only group) were compared with zidovudine plus lamivudine combined Ibrutinib supplier with ritonavir-boosted lopinavir (PI group). Therapy was initiated at 26–34 weeks’ gestation and continued postpartum for 6 months during breastfeeding. By delivery, 96% in the NRTI-only group and 93% in the PI group had achieved VLs <400 HIV RNA copies/mL plasma despite baseline VLs >100 000 in 15% and 13%, respectively, with significantly more women in the NRTI-only group achieving VL <50 at delivery (81%) than in the PI group (69%). Overall, the HIV MTCT rate was 1.1% by the end of the breastfeeding period with no significant difference in transmission rates between the arms, although the study was not powered to address transmission and more transmissions were reported in the NRTI-only arm [21]. PTD (see Recommendation

5.2.3) was less common in the NRTI-only arm (15%) compared with the PI arm (23%), although this did not reach statistical significance. A fixed-dose combination of zidovudine, lamivudine and abacavir is generally

well tolerated, with a low pill burden and easily discontinued. In non-pregnant Nintedanib (BIBF 1120) Alpelisib patients, higher rates of treatment failure have been reported with the combination of zidovudine, lamivudine and abacavir compared with other HAART combinations when the baseline VL is >100 000 HIV RNA copies/mL plasma (BHIVA guidelines for the treatment of HIV-1 positive adults with antiretroviral therapy 2012; www.bhiva.org/PublishedandApproved.aspx). Although these groups are not comparable, the Writing Group recommend restricting the use of zidovudine, lamivudine and abacavir for PMTCT to women with baseline VLs <100 000 HIV RNA copies/mL plasma. 5.3.4 Zidovudine monotherapy can be used in women planning a CS who have a baseline VL <10 000 HIV RNA copies/mL and CD4 cell count >350 cells/μL. Grading: 1A Data on the efficacy of zidovudine monotherapy for PMTCT are well known: a 67% reduction, in ACTG 076, in transmission to 8.3% (treatment initiated 14–28 weeks, non-breastfeeding, low CS rate, baseline CD4 cell count >200 cells/μL) [16], a 50% reduction in a Thai study to 9.4% (mean treatment only 25 days and oral zidovudine during labour) [85]; 0.8% transmission for women treated with zidovudine monotherapy and assigned to PLCS in the Mode of Delivery study [86].

Therefore, boosted PIs are preferred Questions relating to PTD a

Therefore, boosted PIs are preferred. Questions relating to PTD and

pharmacokinetics in the third trimester are addressed separately. A fixed-dose combination of zidovudine, lamivudine and abacavir is an option in this setting. In an RCT in pregnant women with a CD4 cell count >200 cells/μL (with no VL restriction) zidovudine, lamivudine and abacavir (NRTI-only group) were compared with zidovudine plus lamivudine combined PLX3397 in vitro with ritonavir-boosted lopinavir (PI group). Therapy was initiated at 26–34 weeks’ gestation and continued postpartum for 6 months during breastfeeding. By delivery, 96% in the NRTI-only group and 93% in the PI group had achieved VLs <400 HIV RNA copies/mL plasma despite baseline VLs >100 000 in 15% and 13%, respectively, with significantly more women in the NRTI-only group achieving VL <50 at delivery (81%) than in the PI group (69%). Overall, the HIV MTCT rate was 1.1% by the end of the breastfeeding period with no significant difference in transmission rates between the arms, although the study was not powered to address transmission and more transmissions were reported in the NRTI-only arm [21]. PTD (see Recommendation

5.2.3) was less common in the NRTI-only arm (15%) compared with the PI arm (23%), although this did not reach statistical significance. A fixed-dose combination of zidovudine, lamivudine and abacavir is generally

well tolerated, with a low pill burden and easily discontinued. In non-pregnant almost learn more patients, higher rates of treatment failure have been reported with the combination of zidovudine, lamivudine and abacavir compared with other HAART combinations when the baseline VL is >100 000 HIV RNA copies/mL plasma (BHIVA guidelines for the treatment of HIV-1 positive adults with antiretroviral therapy 2012; www.bhiva.org/PublishedandApproved.aspx). Although these groups are not comparable, the Writing Group recommend restricting the use of zidovudine, lamivudine and abacavir for PMTCT to women with baseline VLs <100 000 HIV RNA copies/mL plasma. 5.3.4 Zidovudine monotherapy can be used in women planning a CS who have a baseline VL <10 000 HIV RNA copies/mL and CD4 cell count >350 cells/μL. Grading: 1A Data on the efficacy of zidovudine monotherapy for PMTCT are well known: a 67% reduction, in ACTG 076, in transmission to 8.3% (treatment initiated 14–28 weeks, non-breastfeeding, low CS rate, baseline CD4 cell count >200 cells/μL) [16], a 50% reduction in a Thai study to 9.4% (mean treatment only 25 days and oral zidovudine during labour) [85]; 0.8% transmission for women treated with zidovudine monotherapy and assigned to PLCS in the Mode of Delivery study [86].

Hypertension and

diabetes were defined based on requireme

Hypertension and

diabetes were defined based on requirement for medications for these conditions. Sexual dysfunction was based on a clinical diagnosis or the use of a prescribed 5-phosphodiesterase inhibitor. The metabolic syndrome was defined using the Adult Treatment Panel III (ATP-III) criteria as the presence of at least three STAT inhibitor of the following abnormalities: (1) abdominal obesity (abdominal circumference >102 cm for men and >88 cm for women); (2) elevated triglyceride level (>150 mg/dL); (3) decreased HDL cholesterol level (<40 mg/dL for men and <50 mg/dL for women); (4) elevated blood pressure and (5) elevated fasting glucose (>110 mg/dL) [29]. Statistical analyses included descriptive statistics of the prevalence of subclinical coronary

atherosclerosis and fatty liver disease. Categorical variables were described as numbers with proportions, and continuous variables as medians with interquartile ranges (IQRs). Correlations between variables were examined using Pearson’s correlation tests. Univariate comparisons between participants with and without coronary atherosclerosis (defined by CAC scores of >0 and 0, respectively) utilized Fisher’s exact testing and rank-sum testing for categorical and continuous variables, respectively, depending on the distributions of the factors of interest. A multivariate logistic regression model was used to evaluate factors associated with CAC. Variables with a P-value <0.10 in the univariate

analyses www.selleckchem.com/products/torin-1.html were placed in the full multivariate model and a backward stepwise approach was used to derive the final model. Additional predefined logistic regression analyses were performed, including an analysis restricted to male participants, and a second analysis restricted to participants without excessive alcohol use (defined as >140 g ethanol/wk for men and >70 g ethanol/wk for women [34]). Finally, we examined the data using linear regression models to investigate factors associated with the CAC score as a continuous variable. A P-value of <0.05 was considered statistically significant. Celecoxib All analyses were performed using stata 10 (StataCorp, College Station, TX, USA). A total of 223 HIV-infected persons were evaluated, with a median age of 43 (IQR 36–50) years; 96% were male and ethnicity was Caucasian for 49%, African American for 23%, and ‘other’ for 28% (Table 1). Thirty per cent of participants had hypertension, 23% had sexual dysfunction, 6% had diabetes and 17% were current tobacco users. Only six patients (3%) had hepatitis C virus (HCV) coinfection, reflective of the low prevalence of injection drug use in our population.

memory CD4 T cells Moreover, at different times after HIV infect

memory CD4 T cells. Moreover, at different times after HIV infection, Th17 cells recirculate in response to homeostatic drain, and may show different levels depending on the patient’s phase of infection at the time of selection [14]. Apart from infectious and autoimmune diseases, IL-17A has been shown to be associated with obesity and adipocyte development, indicating that IL-17A may mediate many interactions between adipose tissue and the immune system [2]. Our study is the first

report on IL-17A levels in HIV-1-infected subjects with and without central obesity, and shows that IL-17A levels are negatively related to visceral adipose tissue thickness. This result suggests a suppressive role of this cytokine in adipose tissue development. Conversely, a recent study by Sumarac-Dumanovic et al. showed that serum IL-17A is up-regulated in obese human patients and that obesity is positively correlated with enhanced find more IL-17A expression and independent of other inflammatory factors [15]. A comparison between our results and those of Sumarac-Dumanovic et al. is complex for various reasons. First, most Ganetespib molecular weight of our study population were male, whereas the study by Sumarac-Dumanovic

et al. included only female subjects. Secondly, obesity was defined using different methods in the two studies. We assessed central obesity by measuring visceral fat thickness, whereas Sumarac-Dumanovic et al. used anthropometric indices [15]. The utility of sonography has been demonstrated based on its ability to evaluate intra-abdominal fat levels [16]. It has several advantages, such as simplicity, rapidity, availability,

safety and low cost, when compared with other techniques [8, 17]. Although unexpected, our results are consistent with recent data showing an anti-adipogenic role for IL-17A. It was Histone demethylase found recently that serum levels of IL-7 were decreased in obese subjects with metabolic syndrome [18]. The authors hypothesized a down-regulation of IL-17 by high levels of transforming growth factor (TGF)-β in subjects with metabolic syndrome [18]. IL-17A could delay the development of obesity and inhibit adipogenesis and fat development, as shown in murine models [5, 19]. Currently, the limited data on IL-17 are obtained with different methods. ELISA and flow cytometry are the main methods used for quantitating secreted cytokines, but the results are not directly comparable. The ELISA assay permits measurement of bulk cytokine secretion but does not necessarily reflect the expression of specific T-cell subsets (CD4, CD8, NK T and γδ T cells) [20]. Evaluation of other members of the IL-17 family and regulatory molecules of IL-17A (i.e. IL-6, IL-1β, TGF-β and IL-23) may clarify the biochemical process involved in the interaction between the immune system and somatic tissue. This was a cross-sectional study, and no conclusion regarding a causal relationship between IL-17A and visceral obesity can be made.

We would like to highlight this CDC report so that travel medicin

We would like to highlight this CDC report so that travel medicine providers exercise appropriate precaution in deciding whether to administer

a primary yellow fever vaccination to breastfeeding find more women, especially when their infants are less than 6 to 9 months of age. Lin H. Chen, *† Caroline Zeind, ‡ Sheila Mackell, § Trisha LaPointe, ‡ Margot Mutsch, ‖ and Mary E. Wilson * “
“We thank Dr Eisenhut for sharing with us the importance of clinical symptoms for differential diagnosis of dengue fever and dengue hemorrhagic fever with other viral hemorrhagic fever including Lassa fever and yellow fever. In this aspect, we concur that physical findings are essential in disease diagnosis and clinical management. It is however noteworthy that symptoms of Lassa fever may range from asymptomatic to hemorrhagic fever. Additionally, clinical symptoms in some patients, particularly during the early phase of disease are non-specific, ie, fever, headache, and myalgia and incubation periods may last up to 2 weeks. Similarly, symptoms of yellow fever may range from undifferentiated fever during the acute phase to hepatic impairment and other severe complications during IWR-1 the toxic phase. In recent imported cases of Lassa fever, a period

of up to 16 days (median of 10 d) was taken to identify patients as potentially infected.[1]–[3] Thus, we have highlighted the need for laboratory diagnostic tools to assist in differential diagnosis of dengue fever, particularly in travelers from Lassa fever and yellow fever endemic regions. As with Lassa fever, early intervention of dengue fever may be life-saving. In disease diagnosis, clinical diagnosis in health care settings provides frontline response and information for implementation of appropriate laboratory diagnostic tests. An overall clinical approach encompassing key components that consist of epidemiological background and patients’ travel histories, including incidences of exposure to pathogen and prevention measures taken, as well as consideration of clinical features

and laboratory test results would be essential for differential diagnosis, early disease detection, and confirmation. “
“Joob and Wiwanitkit mention the possibility that contaminated food imported from an selleck chemicals endemic country could be the source of neurocysticercosis in a nonendemic region. If they were talking about pork, that meat must had been frozen before crossing an international border (otherwise it would arrive rotten to the destiny), and it has long been demonstrated that freezing of infested pork muscles kills cysticerci rendering that meat harmless to humans[1]; moreover, people develop taeniasis (and not cysticercosis) after ingesting pork contaminated with cysticerci. There is only one example in the literature on how movement of infected pigs (not pork) from an endemic to a nonendemic country may result in a bout of neurocysticercosis in the latter.

A total of 98 patients were included in the study;

245%

A total of 98 patients were included in the study;

24.5% were diagnosed in the period 1994–1999, 39.8% in 2000–2004 and 35.7% in 2005–2009. The median follow-up time was 363 days (interquartile range 108–1946 days). The median CD4 count was 76 cells/uL (interquartile range 30–166 cells/uL) and 62% of patients had an HIV viral load >50 HIV-1 RNA copies/ml. Thirty-eight per cent of patients received high-penetrance treatment, and 58% received treatment that included protease inhibitors. In the analysis of survival at 1 year, a higher this website CPE score did not result in an improvement in survival, but the presence of protease inhibitors in the regimen was associated with a statistically significant (P = 0.03) reduction in mortality (hazard ratio 0.40; 95% confidence interval 0.18–0.91). We consider that the lower mortality observed in the protease inhibitor group may be clinically relevant, and, if this is the case, a treatment based on protease inhibitors may be indicated for patients diagnosed with PML. “
“Objective The aim of the study was to report on HIV and older people in the European Region, including new data stratified by subregion and year. Methods Data were collected from the 2008 World Health Organization Regional Office for Europe, Communicable Diseases Unit survey on HIV/AIDS and health systems. Results http://www.selleckchem.com/products/poziotinib-hm781-36b.html It was

found that 12.9% of newly reported cases of HIV infection in Western Europe in 2007 were in people aged 50 years or older. In Central Europe,

almost one-in-10 newly reported cases of HIV infection were in older people, while the proportion in Eastern Europe was 3.7% in 2007. Conclusions The issue of HIV infection among older people is of increasing concern as more people age with HIV infection as a result of the availability of combination antiretroviral therapy. The United Nations has set an ambitious goal to achieve universal access to HIV prevention, treatment, care and support Cobimetinib by 2010. In Europe, where such a lofty goal is seemingly within reach, there are still gaps in existing knowledge and we recently identified 10 priority areas for further research [1]. We drew attention to key affected groups, but now that Schmid et al. [2] have suggested that HIV prevalence and incidence among older people are surprisingly high, we look further into this matter in the European Region by presenting new data by subregion and year. In addition, the issue of health systems and older people with AIDS and people who have had HIV infection for a long time has recently been described as ‘uncharted territory’ [3]. We believe that Western European countries, with their well-developed health systems, large numbers of older people living with HIV and high coverage of antiretroviral therapy, will provide vital lessons for countries elsewhere.