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Objectives: Despite successful antiretroviral (ARV) therapy, people living with HIV (PLWH) may show signs of premature/accentuated aging. We compared established biomarkers of aging in PLWH, appropriately-chosen HIV-negative individuals, and blood donors, and explored factors associated with biological age advancement.Design: Cross-sectional analysis of 134 PLWH on suppressive ARV therapy, 79 lifestyle-comparable HIV-negative controls aged ≥45 years from the Co-morBidity in Relation to AIDS (COBRA) cohort, and 35 age-matched blood donors (BD).Methods: Biological age was estimated using a validated algorithm based on ten biomarkers. Associations between ‘age advancement’ (biological minus chronological age) and HIV status/parameters, lifestyle, cytomegalovirus (CMV), hepatitis B (HBV) and hepatitis C virus (HCV) infections were investigated using linear regression.Results: The average (95% CI) age advancement was greater in both HIV-positive [13.2 (11.6, 14.9) years] and HIV-negative [5.5 (3.8, 7.2) years] COBRA participants compared to BD [-7.0 (-4.1, -9.9) years, both p's < 0.001)], but also in HIV-positive compared to HIV-negative participants (p < 0.001). Chronic HBV, higher anti-CMV IgG titer and CD8+ T-cell count were each associated with increased age advancement, independently of HIV-status/group. Among HIV-positive participants, age advancement was increased by 3.5 (0.1, 6.8) years among those with nadir CD4+ < 200 cells/μL and by 0.1 (0.06, 0.2) years for each additional month of exposure to saquinavir.Conclusions: Both treated PLWH and lifestyle-comparable HIV-negative individuals show signs of age advancement compared to BD, to which persistent CMV, HBV co-infection and CD8+ T-cell activation may have contributed. Age advancement remained greatest in PLWH and was related to prior immunodeficiency and cumulative saquinavir exposure. published

Background: HIV-infected individuals may be at risk for the premature onset of age-associated noncommunicable comorbidities. Being HIV-positive, having comorbidities and being of higher age may adversely impact health-related quality of life (HRQL). We investigated the possible contribution of HIV infection, comorbidities and age on HRQL and depression. Methods: HIV-infected individuals and uninfected controls from the AGEhIV Cohort Study were screened for the presence of comorbidities. They completed the Short Form 36-item Health Survey to assess HRQL and the nine-item Patient Health Questionnaire to assess depression. Linear and logistic regression were used to investigate to which extent comorbidities, aging and HIV infection were independently associated with HRQL and depression. Results: HIV-infected individuals (n = 541) reported significantly worse physical and mental HRQL and had a higher prevalence of depression than HIV-uninfected individuals (n = 526). A higher number of comorbidities and HIV-positive status were each independently associated with worse physical HRQL, whereas HIV-positive status and younger age were independently associated with worse mental HRQL and more depression. The difference in physical HRQL between HIV-positive and HIV-negative individuals did not become greater with a higher number of comorbidities or with higher age. Conclusion: In a cohort of largely well suppressed HIV-positive participants and HIV-negative controls, HIV-positive status was significantly and independently associated with worse physical and mental HRQL and with an increased likelihood of depression. Our finding that a higher number of comorbidities was independently associated with worse physical HRQL reinforces the importance to optimize prevention and management of comorbidities as the HIV-infected population continues to age.

Background The aims of this study were to identify common patterns of comorbidities observed in people living with HIV (PLWH), using a data-driven approach, and evaluate associations between patterns identified. Methods A wide range of comorbidities were assessed in PLWH participating in 2 independent cohorts (POPPY: UK/Ireland; AGEhIV: Netherlands). The presence/absence of each comorbidity was determined using a mix of self-reported medical history, concomitant medications, health care resource use, and laboratory parameters. Principal component analysis (PCA) based on Somers’ D statistic was applied to identify patterns of comorbidities. Results PCA identified 6 patterns among the 1073 POPPY PLWH (85.2% male; median age [interquartile range {IQR}], 52 [47–59] years): cardiovascular diseases (CVDs), sexually transmitted diseases (STDs), mental health problems, cancers, metabolic disorders, chest/other infections. The CVDs pattern was positively associated with cancer (r = .32), metabolic disorder (r = .38), mental health (r = .16), and chest/other infection (r = .17) patterns (all P < .001). The mental health pattern was correlated with all the other patterns (in particular cancers: r = .20; chest/other infections: r = .27; both P < .001). In the 598 AGEhIV PLWH (87.6% male; median age [IQR], 53 [48–59] years), 6 patterns were identified: CVDs, chest/liver, HIV/AIDS events, mental health/neurological problems, STDs, and general health. The general health pattern was correlated with all the other patterns (in particular CVDs: r = .14; chest/liver: r = .15; HIV/AIDS events: r = .31; all P < .001), except STDs (r = –.02; P = .64). Conclusions Comorbidities in PLWH tend to occur in nonrandom patterns, reflecting known pathological mechanisms and shared risk factors, but also suggesting potential previously unknown mechanisms. Their identification may assist in adequately addressing the pathophysiology of increasingly prevalent multimorbidity in PLWH.

Human immunodeficiency virus (HIV)-infected individuals may be at increased risk of age-associated noncommunicable comorbidities (AANCCs). Cross-sectional analyses of AANCC prevalence (including cardiovascular, metabolic, pulmonary, renal, bone, and malignant disease) and risk factors in a prospective cohort study of HIV type 1-infected individuals and HIV-uninfected controls, who were aged ≥45 years and comparable regarding most lifestyle and demographic factors. HIV-infected participants (n = 540) had a significantly higher mean number of AANCCs than controls (n = 524) (1.3 [SD, 1.14] vs 1.0 [SD, 0.95]; P < .001), with significantly more HIV-infected participants having ≥1 AANCC (69.4% vs 61.8%; P = .009). Hypertension, myocardial infarction, peripheral arterial disease, and impaired renal function were significantly more prevalent among HIV-infected participants. Risk of AANCC by ordinal logistic regression was independently associated with age, smoking, positive family history for cardiovascular/metabolic disease, and higher waist-to-hip ratio, but also with HIV infection (odds ratio, 1.58 [95% confidence interval, 1.23-2.03]; P < .001). In those with HIV, longer exposure to CD4 counts

Bij het ontwateren en rijpen van nuttig toepasbare baggerspecie wordt veelvuldig gebruikt gemaakt van doorgangsdepots. Op initiatief van de waterschappen is een alternatief ontwikkeld voor de bodembescherming met behulp van een folie. Met een minerale bodembeschermingslaag kan eveneens een verwaarloosbaar bodemrisico bereikt worden. Een generieke regeling bleek vooralsnog niet haalbaar.

Temporal and spatial variations in particulate PolyChlorinated Biphenyl (PCB) and Polycyclic Aromatic Hydrocarbons (PAH) concentrations were studied in the Scheldt estuary during a one-year period (May 1995-June 1996). This sampling campaign was arecurrence of a campaign held almost a decade ago. Both PCB and PAH concentrations in the Scheldt river were substantially lower in the 90's, but the Scheldt is still one of the most severely polluted rivers in the North Sea area. The annual input into the estuary was approximately 40 kg for total PCBs (sum of 8 congeners) and 3300 kg for total PAHs (19 compounds). The fraction transported to the North Sea is relatively small: 10-20 %.In the most recent sampling campaign the behaviour of particulate PCBs and PAHs found earlier was confirmed: as a result of the mixing of riverine with marine particulates the concentrations of the micropollutants generally decrease with increasing salinities, The quicker restoration of dissolved oxygen in the upper estuary gave rise to a more intense degradation of organic matter, and, probably as a result of cometabolism, degradation of low molecuiar weight PAH. Typical calculated half lives were 260 days for pyrene and 390 for fluoranthene.

Het gebruik van ruimtelijke informatie in simulatiemodellen is een reeds ontgonnen terrein. Echter een generieke koppeling is niet eenvoudig. Het modelleren zit meestal juist in het in geschikte vorm aanbieden van ruimtelijke informatie. In dit rapport wordt een aanzet gegeven tot een architectuur om zo'n generieke koppeling tussen ruimtelijke informatie en simulatiemodellen tot stand te brengen.

The behaviour of some organic micropollutants in the abiotic compartments water, particulate matter and bottom sediments of the Scheldt estuary, S.W. Netherlands, was studied between 1986 and 1989. Special attention was given to two individual PolyChlorinated Biphenyl congeners (PCB 52 and PCB 153), two Polycyclic Aromatic Hydrocarbons (PAHs) fluoranthene and benzo(a)pyrene and y-HCH. Dissolved PCBs and y-HCH behave conservatively during estuarine mixing. The concentration of y-HCH in the freshwater is extremely high in spring compared to the other seasons. Dissolved fluoranthene does not behave conservatively. The concentration of dissolved fluoranthene in the freshwater endmember shows a seasonal dependence with highest concentrations in winter and lowest in summer. Benzo(a)pyrene could hardly be detected in the dissolved phase with the methods used. PCBs and PAHs in particulate matter and sediments behave essentially conservatively as a result of the mixing of riverine particulates with high, and marine particulates with low organic micropollutant contents. Particulate fluoranthene is removed at low salinities under (nearly) anoxic conditions probably by microbial degradation. The rivers Scheldt and Rupel appear to be the major sources for the compounds studied. However, in particular the organic micropollutant contents of the sediments indicate that important emissions along the estuary were or are still present. Measurements of individual PCBs and PAHs in the

Between May 1986 and January 1989, samples were taken on three occasions from the heavily polluted Scheldt estuary, in order to determine the pathways and fate of organic micropollutants. One group parameter (cholinesterase inhibition activity, CHOL) and 30 individual compounds (including chlorobenzenes, chloronitrobenzenes, volatile halocarbons and pesticides) were detected on at least one occasion. Another 10 organic pollutants were identified and quantified by GC/MS analysis. Many other, as yet unidentified, compounds were also present. The River Scheldt appeared to be the major source for most pollutants, although additional emissions along the estuary were also detected. Most pollutants were removed from the water during estuarine mixing (non-conservative behaviour), probably due to various processes, such as volatilization, degradation and photolysis. The fractional loss for most volatile halocarbons was ∼ 75%, but in some cases 100% (e.g., trichloromethane). The fractional loss for CHOL was seasonally dependent: 5–10% in winter, and 35–40% in summer months. For most compounds, reasonable agreement was found when observed sediment-water partition coefficients (Koc) were compared with predicted values. Pronounced deviations were observed, however, indicating non-equilibrium conditions, probably because of slow sorption kinetics. The concentrations measured in the inflowing freshwater were compared with recently published ecotoxicological freshwater quality objectives. The results show that some organic pollutants (e.g., hexachlorobenzene, CHOL, lindane, 1,1,1-trichloroethane) exceeded the published ecotoxicological risk values in all samples, suggesting that these pollutants may have an impact on the ecosystem of the Scheldt estuary.