Biomedical subjects

Henrik Krarup

Publications and source records attributed to Henrik Krarup.

9 recordsLinked to original sources

PubMed2006

The effect of multi-vitamin/mineral supplementation on mortality during treatment of pulmonary tuberculosis: a randomised two-by-two factorial trial in Mwanza, Tanzania.

Malnutrition is common in pulmonary tuberculosis (TB), and may impair survival. The objective of this study was to assess effects of multi-vitamin/mineral (MVM) and zinc (Zn) supplementation during TB treatment on mortality. Patients diagnosed with sputum-positive pulmonary TB in Mwanza, Tanzania, were randomised, using a two-by-two factorial design, to Zn (45 mg) or placebo, and MVM (vitamins A, B, C, D, E, and selenium and copper) or placebo. Survival status was ascertained at the end of the 8-month TB treatment and supplementation period. Of 499 TB patients, 213 (43 %) had HIV. The mean weight gain at 7 months was 6.88 kg (95 % CI 6.36, 7.41). Zn and MVM combined, but neither alone (interaction, P=0.03), increased weight gain by 2.37 kg (95 % CI 0.91, 3.83), irrespective of HIV status. Survival status at 8 months was determined for 422 patients (84.6 %), of which fifty-two (12.3 %) had died. Among fifty-two deaths, there were no effects of MVM (relative risk (RR) 0.73; 95 % CI 0.43, 1.23) and Zn (RR 0.76; 95 % CI 0.46, 1.28). However, among HIV co-infected patients, marginally significant effects of both MVM (RR 0.60; 95 % CI 0.34, 1.05) and Zn (RR 0.63, 95 % CI 0.37, 1.08) were seen, and MVM and Zn combined reduced mortality (RR 0.29; 95 % CI 0.10, 0.80; interaction ratio 0.52). In conclusion, supplementation with MVM, including Zn, during treatment of pulmonary TB may reduce mortality in those co-infected with HIV. A randomised trial of the effect of the combined intervention used in this study should be conducted in a different setting to confirm the finding.

AIDS-Related Opportunistic Infections↗

PubMed2006

Geographical clustering and maintained health in individuals harbouring the mutation for Greenland familial cholestasis: A population-based study.

OBJECTIVE: Cholestasis Familiaris Groenlandica, a severe variant of progressive familial intrahepatic cholestasis type 1 (Byler disease), carries an autosomal recessive trait, and the mutation has been located. The disease is relatively common among Inuit in East Greenland. The aim of the study was to assess the carrier frequency and the possible impact on health in populations in East Greenland. MATERIAL AND METHODS: A population-based study comprising 324 Inuit and non-Inuit subjects, aged 50-69 years, living in the Ammassalik district of East Greenland was carried out to analyse the presence of the mutation on ATP8B1 at 18q21. Bilirubin and gamma-glutamyl transpeptidase levels in serum were measured, a physical examination was performed, which included body height and weight, and calculation of BMI. RESULTS: The participation rate was 96%. None of the subjects was homozygous and 12% of Inuit were heterozygous for the mutation. Harbouring the mutation did not influence height (p = 0.26), weight (p = 0.89), BMI (p = 0.65), frequency of self-reported disease (p = 0.17), or differ with gender (p = 0.57). A marked geographical clustering was found (p = 0.002) and heterozygocity for the mutation varied from 5% in a southern to 23% in a northern settlement where 1 out of 75 children could be calculated to have the disease. A physical investigation identified none with jaundice or signs of liver disease. Bilirubin and gamma-glutamyl transpeptidase levels in serum were lower among mutation-positive compared with mutation-negative Inuit. CONCLUSIONS: Heterozygosity for Greenland familial cholestasis is common among the Inuit in East Greenland but it is not a risk factor for disease in the carrier.

Adenosine Triphosphatases↗

PubMed2004

Low-dose iron supplementation does not increase HIV-1 load.

Observational data suggest that iron may increase HIV replication and the rate of progression of HIV infection. This is worrying, and may impede the international commitment to combat iron deficiency. However, it is crucial to clarify the role of iron in HIV infections, since iron is universally administered to anaemic patients and pregnant women, even in areas with high HIV prevalence. Based on a historical iron trial, we assessed the effect of 60 mg of elemental iron given twice weekly over four month on HIV-1 viral load. There was no effect on viral load, but effects of higher doses of iron cannot be excluded.

Adolescent↗

PubMed2004

Evaluation of the Malvern Spraytec with inhalation cell for the measurement of particle size distribution from metered dose inhalers.

The purpose of this study was to evaluate the Malvern Spraytec with inhalation cell attachment as a means of analyzing the particle size distribution of aerosols from pressurized metered dose inhalers (pMDIs). The aerosol particle size distribution of various commercially available, placebo, and experimental pMDI formulations was determined using Spraytec under various experimental conditions and the relevant data were compared with the Andersen cascade impactor data. The Spraytec volume median diameter (Dv 50) values for commercial chlorofluorocarbon- and hydrofluoroalkane (HFA)-based pMDIs were respectively smaller and higher compared with their reported mass median aerodynamic diameter values. It was possible to obtain a close agreement between Spraytec Dv 50 and the reported mass median aerodynamic diameter values for a solution-type pMDI formulation, Qvar 50, by equilibrating the pMDI to 55 degrees C before the measurement and using a 20-cm throat extension. Incorporation of a nonvolatile solvent propylene glycol (PG) in placebo pMDIs (15% w/w ethanol, 0.5-20.0% w/w PG in HFA 134a) showed an increase in Dv 50 with increasing concentration of PG. Furthermore, it was possible to obtain a correlation (R(2) = 0.8037) between Spraytec and Andersen cascade impactor data for the experimental nimesulide-pMDI formulations containing 0.1% w/w drug, 0.25-10% w/w PG, and 15% ethanol in HFA 134a.

Aerosols↗

PubMed2004

Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe.

The role of maternal infections, nutritional status and obstetric history in low birth weight is not clear. Thus, the objective of the present study was to assess the effects of maternal HIV infection, nutritional status and obstetric history, and season of birth on gestation length and birth size. The study population was 1669 antenatal care attendees in Harare, Zimbabwe. A prospective cohort study was conducted as part of a randomised, controlled trial. Maternal anthropometry, age, gravidity, and HIV status and load were assessed in 22nd-35th weeks gestation. Outcomes were gestation length and birth size. Birth data were available from 1106 (66.3%) women, of which 360 (32.5%) had HIV infection. Mean gestation length was 39.1 weeks with 16.6% <37 weeks, mean birth weight was 3030 g with 10.5% <2500 g. Gestation length increased with age in primigravidae, but not multigravidae (interaction, P=0.005), and birth in the early dry season, low arm fat area, multiple pregnancies and maternal HIV load were negative predictors. Birth weight increased with maternal height, and birth in the late rainy and early dry season; primi-secundigravidity, low arm fat area, HIV load, multiple pregnancies and female sex were negative predictors. In conclusion, gestation length and birth weight decline with increasing maternal HIV load. In addition, season of birth, gravidity, maternal height and body fat mass, and infant sex are predictors of birth weight.

Adipose Tissue↗

PubMed2004

Serological and molecular evidence of Rickettsia helvetica in Denmark.

Recent seroepidemiological studies and examinations of Ixodes ricinus ticks in Europe have demonstrated the presence of an emerging tick-borne infection with Rickettsia helvetica. We conducted a serosurvey in 168 Danish patients seropositive for borreliosis reflecting their exposure to I. ricinus ticks. A total of 21 patients (12.5%) had positive antibody titres to R. helvetica including 4 cases of seroconversion. None of the samples were positive for antibodies to Ehrlichia. We conclude that in humans exposed to I. ricinus ticks in Denmark the risk of acquiring rickettsial infection is for the first time demonstrated. In the same region of Denmark we collected 570 I. ricinus ticks from various sources, and examinations by PCR for Rickettsia were performed. Positive reactions were obtained in 23 ticks (4%), and R. helvetica was identified in all 13 of those for which sequencing was performed.

Animals↗

PubMed2004

Effect of multimicronutrient supplementation on gestational length and birth size: a randomized, placebo-controlled, double-blind effectiveness trial in Zimbabwe.

BACKGROUND: Multiple micronutrient deficiencies may contribute to low birth weight, which is a major global determinant of mortality. OBJECTIVE: We assessed the effect of prenatal multimicronutrient supplementation on gestational length and birth size. DESIGN: We conducted a randomized, placebo-controlled, double-blind effectiveness trial among antenatal care attendees in Harare, Zimbabwe. Pregnant women (22-35 wk of gestation) were randomly allocated to receive a multimicronutrient or placebo supplement daily until delivery. Supplementation with iron and folic acid was part of antenatal care. RESULTS: Of 1669 women, birth data were available from 1106 (66%), of whom 360 (33%) had HIV infection. The mean gestational length was 39.1 wk, and 16.6% of the women had a gestational length < 37 wk. The mean birth weight was 3030 g, and 10.5% of the infants had a birth weight < 2500 g. Multimicronutrient supplementation was associated with tendencies for increased gestational length (0.3 wk; 95% CI: -0.04, 0.6 wk; P = 0.06), birth weight (49 g; -6, 104 g; P = 0.08), and head circumference (0.2 cm; -0.02, 0.4 cm; P = 0.07) but was not associated with low birth weight (birth weight < 2500 g) (relative risk: 0.84; 0.59, 1.18; P = 0.31). The effect of multimicronutrient supplementation on birth weight was not significantly different between HIV-uninfected (26 g; -38, 91 g) and HIV-infected (101 g; -3, 205 g) subjects (interaction, P > 0.10). CONCLUSION: Antenatal multimicronutrient supplementation may be one strategy to increase birth size.

Birth Weight↗

PubMed2003

Iron, haptoglobin phenotype, and HIV-1 viral load: a cross-sectional study among pregnant Zimbabwean women.

BACKGROUND: Viral load is a determinant of HIV-1 progression and transmission. Iron status and the phenotype of haptoglobin, a heme-binding acute phase reactant, may be determinants of viral load. We aimed to describe the effect of iron status, haptoglobin phenotype (Hp), and other predictors on HIV-1 viral load. METHODS: Based on a cross-sectional study among 1669 antenatal care attenders (22-35 weeks) in Zimbabwe, 526 (31.5%) were found to be HIV infected. The role of season, age, gravidity, gestational age, malaria parasitemia, Hp, and elevated serum alpha(1)-antichymotrypsin (ACT) as well as serum ferritin, folate, retinol, and beta-carotene on HIV viral load among the 526 HIV-infected women was assessed using multiple linear regression analysis. RESULTS: The distribution of Hp 1-1 (32%), Hp 2-1 (48%), and Hp 2-2 (20%) was not different from that of 53 uninfected women. Mean viral load was 3.85 log(10) (95% CI: 3.77-3.93) genome equivalents (geq)/mL, ranging from 3.77 (95% CI: 3.64-3.90) geq/mL in women with Hp 1-1 to 4.05 (95% CI: 3.81-4.21) geq/mL in women with Hp 2-2. With elevated serum ACT controlled for, women with Hp 2-2 had viral loads twice (95% CI: 1.4-4.0, p =.002) that of women with Hp 1-1, whereas those with serum ferritin <6 micro g/L had viral loads less than one third (95% CI: 0.13-0.53, p =.013) that of women with serum ferritin >24 micro g/L. Viral loads were also higher in women enrolled in the early rainy season compared with the dry season, in gravidae 4+ compared with gravidae 1 through 3, and in those with moderately elevated compared with low serum alpha(1)-antichymotrypsin, but neither age, gestational age, serum folate, serum retinol, nor serum beta-carotene were predictors. CONCLUSION: Storage iron, Hp 2-2, and elevated ACT are independent positive predictors of HIV-1 viral load. The positive relationship between serum ferritin and viral load was not the result of an acute phase response or iron accumulation with advanced HIV infection. A possible detrimental role of iron in HIV infection would have serious public health implications.

Female↗

PubMed2002

HIV-1 viral load and elevated serum alpha(1)-antichymotrypsin are independent predictors of body composition in pregnant Zimbabwean women.

Human immunodeficiency virus (HIV) infection affects body composition, but their relationship has not been studied in pregnant women. We conducted a cross-sectional study among 1669 women receiving antenatal care between 22 and 35 wk of gestation in Harare, Zimbabwe. The role of HIV-1 status and viral load, malaria and elevated serum alpha(1)-antichymotrypsin (ACT, an acute phase protein) in weight, body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TSF), and arm muscle (AMA) and fat (AFA) area were assessed using multiple linear regression analysis. The mean (range) age was 24.4 (14-45) y and gestational age 29 (22-35) wk. HIV infection was present in 31.5% of the women, malaria parasitemia in 0.4% and 11.4% had serum ACT >0.4 g/L. There was no difference in any anthropometric variable between HIV-infected and uninfected women. However, women with viral loads (genome equivalents/mL) between 4 and 5 and >5 log(10) had 1.1 [95% confidence interval (CI): -0.3, 2.3] and 2.5 (95% CI: 0.1, 5.1) kg lower weights compared with uninfected women; this was explained by losses of both AFA and AMA. Malaria parasitemia was associated with 6 cm(2) (95% CI: 0.4; 11.8) or 25% lower AMA. Elevated serum ACT was a negative predictor of all anthropometric variables, i.e., levels between 0.3 and 0.4, 0.4 and 0.5 and >0.5 g/L were associated with 1, 2 and 6 kg lower mean body weights, respectively. Despite the limitations of a cross-sectional design, we conclude that arm fat and muscle areas, reflecting body fat and lean body mass, seem to be unaffected in the majority of HIV-infected pregnant women, but decline with increasing viral loads. The effects of viral load are not explained by elevated serum ACT, which is a strong independent predictor of all anthropometric variables.

Adolescent↗