The investigation and management of which has slowly evolved over the last two decades, necessitating a rethink of diagnostic criteria. The Children’s Arthritis and Rheumatology Research Alliance (CARRA) and the United Kingdom Juvenile DM Cohort are leading

data generators in this field, supplemented in this issue of the Journal see more by two smaller cohorts of JDM from the diverse APLAR region.[1, 2] Prasad et al.[1] from India and Gowdie et al.[2] from Australia report a prevalence of muscle weakness, Gottron’s papules, and heliotrope rash not so greatly different from the initial 1975 descriptions by Bohan and Peter,[3, 4] and very similar to the 2011 description of European and Latin American patients with JDM,[5] in spite of different time period and sociocultural diversities. This two cohorts provide useful insights into the diverse clinical manifestations over and above those currently used for diagnostic classification, and both emphasise dysphagia and dysphonia. Disease manifestations may change between early and late childhood, with the UK JDM cohort reporting that children with disease onset before age 5 years were more likely to present with oedema and ulcerative skin disease.[6]

Navitoclax mouse Gowdie et al.[2] found nail fold changes in 68% of their cohort unlike the finding of reduced nailfold capillary density virtually in all JDM patients in a longitudinal study by Schmeling et al.[7] Although capillaroscopic change seems to be a marker of both skin and muscle disease activity,[8] and has been suggested as a diagnostic criterion, it requires

further refinement and precision to become a clinically useful tool in JDM.[9] The dreadful complication of calcinosis cutis occurs in 20% to 40% of cases and more so with increasing disease duration.[10, 11] Delayed or inadequate therapy and persistent skin inflammation are thought to be predisposing factors.[12] None of the children in the Australian series [2] had calcinosis at diagnosis, though 18% had developed this probably in the PAK6 more chronic phase. The Indian series[1] had 27% of their children with calcinosis at presentation or during follow up, which has been reported by other Indian studies, and is higher than reports from other countries [13] possibly due to a delayed diagnosis and initiation of treatment, thereby a higher cumulative period of active disease and accrual of damage. Indeed, the median duration of symptoms prior to diagnosis in the Indian study was 9.25 months [1] as compared to 2.8 months in the Australian report [2] and 5 months in the cohort of 384 children of United states pooled from 55 paediatric rheumatology clinics.[13] The factors influencing the variation in time to diagnosis and initiation of therapy which favourably impacts on both mortality and morbidity warrant further study.

, 2010a, b; Leng et al., 2011). In this study, we found a new natural compound, apigenin, which inhibits the expression of α-hemolysin both in vitro and in vivo at a low concentration. Apigenin has only slight antimicrobial activity against S. aureus, which is thought to reduce selective pressure against the growth of this species. Moreover, it can significantly protect the alveolar epithelial cells against α-hemolysin-mediated cell injury at 4 μg mL−1, and it can release the pulmonary infection in a murine model. Because of the decrease in levels of α-hemolysin,

the quantity of cytokines found in the alveolar lavage fluid is also greatly reduced. From our study of the quantitative PLX4032 clinical trial RT-PCR, we can conclude in general that all the effects we observed may be related to the apigenin-induced inhibition of the agr two-component system, which occurs in a dose-dependent

manner. Consequently, we can infer from the data shown in this study that apigenin, combined with β-lactam antibiotics, is a promising candidate for use in the treatment of S. aureus pneumonia. We thank Timothy J. Foster for kindly providing S. aureus strains 8325-4 and DU 1090. This work was supported by the National Nature Science Foundation of China (No. 31130053), the National 863 programme (No. 2012AA020303), and the State Key Laboratory Ponatinib for molecular virology and genetic engineering (No. 2011KF02). J.D. and J.Q. contributed equally to this Sclareol work. “
“The nematophagous

fungus Arthrobotrys oligospora is a potential biological agent against parasitic gastrointestinal nematodes. Its subtilisin-like serine proteases play an important role in nematode cuticle breach. In this study, the cDNA of the mature serine protease XAoz1 from A. oligospora XJ-XAo1 was expressed in Pichia pastoris to assess the in vitro nematicidal activity of recombinant XAoz1 (reXAoz1) on Caenorhabditis elegans and Haemonchus contortus. The cDNA sequence of the protease XAoz1 was amplified by reverse transcription polymerase chain reaction (RT-PCR) and inserted into the vector pPIC9K for expression in P.pastoris GS115. Our results show that the reXAoz1 had a molecular mass of 50 kDa after 3 days of 1.5%-methanol induction at 28 °C. The highest specific protease activity was achieved at 12 168 U mg−1 protein. The reXAoz1 had the highest hydrolytic activity at pH 6.5–9.5 with an optimal pH at 8.5. Moreover, the purified reXAoz1 displayed a highly toxic and biological activity to immobilize C. elegans and H. contortus by degrading their cuticles and inducing death. “
“Despite the obvious importance of viral transmission and ecology to medicine, epidemiology, ecology, agriculture, and microbiology, the study of viral bioaerosols and community structure has remained a vastly underexplored area, due to both unresolved technical challenges and unrecognized importance.

, 1999), although this see more has not been demonstrated for the elicitin 6 precursor proteins identified by our blast analysis. However, SpHtp1 aligns only with the C-terminal region of the elicitin 6 precursor proteins identified by the blast analysis, containing an xPTx repeat region, and not with INF1, which is the highly expressed elicitin in mycelium stages from P. infestans (Kamoun et al., 1997) (Fig. S3). Moreover, blast of SpHtp1 against INF1 results in an E-value of 8.7. interpro analysis shows that the

xPTx repeat region is observed in a variety of proteins; however, it is not known whether they are homologous to each other and no specific function of this repeat region has been identified so far. In vitro transcript analysis showed that SpHtp1 is expressed in all life stages of S. parasitica, but compared with the transcript levels in mycelia, SpHtp1 transcripts are more abundant in zoospores/cysts and germinating cysts when normalized to transcript levels of the reference gene SpTub-b (Fig. 1c). In the RTG-2 model system, it was observed that SpHtp1 transcript

levels were very high at time point 0, representing the addition of the zoospores/cysts as an inoculum source. A decrease over time was observed, representing germination and subsequent mycelial growth (Fig. 1c). Similar results were obtained when other reference genes were used. However, the SpTub-b transcript levels showed the lowest variation between the life stages (Fig. S4). These results selleck chemicals indicate that SpHtp1 is predominantly expressed in the preinfection stages and in the very early stages of infection. To investigate whether SpHtp1 is secreted and where the protein is located during the infection of S. parasitica

on RTG-2 cells, a final bleed polyclonal antiserum was generated that was directed against a peptide of the SpHtp1 sequence (Fig. 1a). Western blot analysis showed that the Bcl-w antiserum recognized SpHtp1 synthesized in E. coli and a protein band of the same size in a protein fraction isolated from infected RTG-2 cells (Fig. S5). Several other bands in the protein samples isolated from uninfected and infected RTG-2 cells were recognized by the final bleed polyclonal antiserum, but these were also detected with the preimmune antiserum. Subsequent fluorescent immunolocalization studies on S. parasitica-infected RTG-2 cells resulted in SpHtp1 detection inside fish cells, surrounding the host nucleus, that are in close contact with the S. parasitica hyphae (Figs 2 and 3). This localization pattern was neither observed in infected RTG-2 cells treated with only preimmune antiserum nor in uninfected RTG-2 cells treated with preimmune or the final bleed polyclonal antiserum (Fig. 2), thereby demonstrating that the immunolocalization pattern in the infected cells of RTG-2 is only derived from translocated SpHtp1. Z-scans of fish cells that are in contact with hyphae from S.

4%, n = 544) or to allow information to be shared with an NHS organisation (55.3%, n = 553), but the majority were willing to allow sharing of information with their doctor (80.8%, n = 808). There was a general trend showing that more people who had experienced a service were willing to use it in future (>93%) compared to <65% among those with no previous experience (p < 0.001for all services). Similarly most of those who had previously given a pharmacist permission to telephone them and to share advice (>93%) were willing to do so again, which was significantly higher than willingness in participants who had no previous experience of these

aspects IBET762 of care (p < 0.001 all aspects). The public lack awareness of pharmacy-based medicines-related advisory services. Despite this the use of private consultation rooms for their delivery was generally accepted as was the pharmacist sharing information with the participants’ practitioner. Permission to telephone with advice or to share information with an NHS organisation was viewed as acceptable to a small majority of participants. Previous experience significantly increases willingness for future participation as has been shown elsewhere. Public awareness and previous experience are key facilitators for the future uptake of these

GSK2118436 pharmacy-based medicine-related services. Active recruitment and promotion of these services is necessary to ensure ongoing and wider accessibility to these services. 1. Pharmaceutical Service Negotiating Committee. Aylesbury 2011 New Medicines Service http://www.psnc.org.uk/pages/nms.html 2. Saramunee K, General public views on community pharmacy Edoxaban services in public health. (2013) Liverpool John Moores University “
“Chi Huynh1, Yogini Jani1,2, Ian Chi Kei Wong1,3, Maisoon Ghaleb4, Alice Lo5, Joanne Crook6, Vijay Tandle7, Stephen Tomlin1,8 1Centre for Paediatric Pharmacy Research,

UCL School of Pharmacy, London, UK, 2University College London Hospitals NHS Foundation Trust, London, UK, 3Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China, 4University of Hertfordshire, Hertfordshire, UK, 5Barts Health NHS Trust, London, UK, 6Chelsea and Westminster NHS Foundation Trust, London, UK, 7University North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK, 8Evelina Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK Medication follow up study involving parents of paediatric patients with a chronic condition post hospital discharge across five hospitals in England (four in London and one in North Tees) From the follow ups, 67 (37%) paediatric patients had at least one discrepancy post discharge, of which 12% (22/182) were unintentional. A clinical severity assessment of the unintended medication discrepancies found 64% of patients had at least one moderately severe and 36% patients had one minor discrepancy.

Plates were incubated at 28 °C for 48 h. Each strain was tested in duplicate, and the experiment was repeated a minimum of two GPCR Compound Library cell line times to ensure the reproducibility of the results. The plasmid pHIRR containing the full length, wild-type irr gene fused to 6× his at the N-terminus was constructed to produce a wild-type recombinant N-terminal 6× His-tagged Irr fusion protein (wild-type His-Irr). The 6× His tag allows IrrAt recombinant protein levels to be monitored. The amino acid residues important for the function of IrrAt were assessed by site-directed mutagenesis of residues

H38, H45, H65, D86, H92, H93, H94, D105 and H127, either individually or in combination (Table 1). These nine amino acid residues of IrrAt were selected for mutagenesis because they correspond to metal-binding or haem-binding sites of proteins in the Fur family (Rudolph et al., 2006a). A comparison of the amino acid sequences of Fur proteins from P. aeruginosa and H. pylori and the Irr proteins IrrBj, IrrRl and IrrAt is shown in Fig. 1. Western blot analysis using an anti-RGS-His monoclonal antibody was performed to check the expression of the 6× His-tagged proteins. A single band with the expected Dasatinib purchase size of the 6× His-tagged Irr fusion protein was detected.

The results confirmed that the wild-type His-Irr and all of the mutant His-Irr proteins were successfully produced in A. tumefaciens (Fig. S1). Interestingly, mutations in the C-terminal region at residue D105 or H127 affected the electrophoretic mobility, resulting in slightly faster migration of the mutant proteins than the wild-type His-Irr protein (Fig. S1). IrrAt is a repressor of mbfA, and the irr mutant strain (WK074) has constitutively high expression of mbfA (Ruangkiattikul et al., 2012). The mbfA promoter-lacZ transcriptional fusion was used to assess the repressive activity of

the mutant His-Irr proteins. Expression of mbfA-lacZ from the plasmid pPNLZ01 in wild-type NTL4 cells and irr mutant WK074 cells grown in minimal MTMR9 AB medium was determined using a β-galactosidase (β-Gal) activity assay. The β-Gal activities obtained from the NTL4 and WK074 cells expressing the plasmid vector pBBR1MCS-4 (pBBR) were approximately 3.9 ± 0.6 and 14.0 ± 3.9 U mg protein−1, respectively. WK074 cells harbouring the plasmid pHIRR had low levels of β-Gal activity of approximately 0.3 ± 0.1 U mg protein−1, indicating that the wild-type His-Irr protein was functional and able to repress the expression of mbfA-lacZ. The level of β-Gal activity in the complemented strain (WK074 harbouring pHIRR) was much lower than that in the wild-type strain (NTL4 harbouring pBBR). This difference was a result of high expression of wild-type His-Irr from the expression vector causing strong repression of mbfA-lacZ. In contrast, high expression of mbfA-lacZ in WK074 cells could not be reversed by expression of the His-Mur negative control (pHMUR) (14.4 ± 1.9 U mg protein−1).

Mûr, Dr A. Payà, Dr M. A. López-Vilchez and Dr R. Carreras (Hospital del Mar, Universidad www.selleckchem.com/PARP.html Autonoma, Barcelona, Spain); Dr N. H. Valerius and Dr V. Rosenfeldt (Hvidovre Hospital, Hvidovre, Denmark); Dr O. Coll, Dr A. Suy and Dr J. M. Perez (Hospital Clínic, Barcelona, Spain); Dr C. Fortuny and Dr J. Boguña (Hospital Sant Joan de Deu, Barcelona, Spain); Dr V. Savasi, Dr S. Fiore and Dr M. Crivelli (Ospedale L. Sacco, Milan, Italy); Dr A. Viganò, Dr V. Giacomet, Dr C. Cerini, Dr C. Raimondi and Professor G. Zuccotti (Department of Pediatrics, L. Sacco Hospital, University of Milan, Milan, Italy); Dr S. Alberico, Dr M. Tropea and Dr C. Businelli (IRCCS

Burlo Garofolo, Trieste, Italy); Dr G. P. Taylor and Dr E. G. H. Lyall (St Mary’s Hospital, London, UK); Ms Z. Penn (Chelsea and Westminster Hospital, London, UK); Drssa W. Buffolano and Dr R. Tiseo (Pediatric Dept, Federico II University,

Naples, Italy), Professor P. Martinelli, Drssa M. Sansone, Dr G. Maruotti and Dr A. AZD1208 cell line Agangi (Obstetric Dept, Federico II University, Naples, Italy); Dr C. Tibaldi, Dr S. Marini, Dr G. Masuelli and Professor C. Benedetto (University di Torino, Torino, Italy); Dr T. Niemieç (National Research Institute of Mother & Child, Warsaw, Poland); Professor M. Marczynska, Dr S. Dobosz, Dr J. Popielska and Dr A. Oldakowska (Medical University of Warsaw, Infectious Diseases Hospital, Warsaw, Poland); Dr R. Malyuta, Dr I. Semenenko and Ms T. Pilipenko (ECS Ukraine co-ordinating centre). “
“The aim of the study was to describe the relationship between preterm delivery (PTD; < 37 weeks of gestation)

and antiretroviral Quinapyramine therapy in a single-centre cohort of pregnant women with HIV infection. A retrospective analysis of data for 331 women who received care in a dedicated HIV antenatal clinic between 1996 and 2010 was carried out. Data on first CD4 cell count and viral load (HIV-1 RNA copies/mL) recorded in pregnancy, class and timing of antiretroviral therapy, gestational age at delivery, and risk factors for and causes of PTD were available from a clinical database. Overall, 13.0% of deliveries were preterm, of which 53% were severe preterm (< 34 weeks of gestation). The lowest rate of PTD was observed in women treated with zidovudine monotherapy (6.2%). Higher rates of PTD were observed in women starting combination antiretroviral therapy (cART) in pregnancy compared with women conceiving while on cART [odds ratio (OR) 2.52; 95% confidence interval (CI) 1.22–5.20; P = 0.011]. Of the women who were eligible for zidovudine monotherapy on the basis of CD4 counts and HIV viral load but who were treated with short-term cART to prevent HIV mother-to-child transmission, 28.6% delivered preterm. Women on short-term cART remained at the highest risk of PTD compared with zidovudine monotherapy in multivariate analysis (OR 5.00; 95% CI 1.49–16.79; P = 0.015). The causes of PTD are multiple and poorly understood.

42 Murine typhus

was also confirmed in a Czech traveler after his return from Egypt.43 The patient was suffering from fever lasting for 4 days, strong headache, dry cough, and on the 7th and 8th day he appeared with find more transient maculopapular rash. The fever dropped after 15 days when doxycycline was given and no response was observed to the previously administered antibiotics—amoxicillin/clavulanate, clarithromycin, and ofloxacin. This was the first documented case of R typhi infection in Egypt and confirmed the previous sero-epidemic studies which proposed that murine typhus was probably endemic in this country.44 Moreover, in Cyprus, although to date many cases of murine typhus have been described, the first identification was done in a Swede who developed fever, severe headache, myalgia, Peptide 17 ic50 and rash.45 Three weeks before the onset of the symptoms she had stayed in a hotel in Cyprus where she got numerous bites from insects in her bed. The patient was treated with ciprofloxacin; her

condition improved remarkably within 24 hours after the start of the treatment and was afebrile within 3 days.45 A case of murine typhus was reported in Florence in 1991 in a person who was reportedly bitten by an unidentified insect during a trip to Sicily about 2 weeks before the onset of symptoms.34 Besides tropical areas where murine typhus is known as a frequent cause of fever of unknown origin, the Mediterranean area has also been considered as a risk area for travelers. As a result, clinicians who may see patients returning from the Mediterranean area should be aware that murine typhus

is present in this area and considered as an R typhi infection in differential diagnosis of patients with febrile illnesses. The authors state they have no conflicts of interest to declare. “
“We read with interest the article by Houdon and colleagues1 reporting two patients with imported acute neuroschistosmiasis due to Schistosoma mansoni. Both patients presented with neurological signs revealing acute schistosomiasis (AS), others and the diagnosis of acute disseminated encephalomyelitis (ADEM) was raised to explain these symptoms. However, the diagnosis of eosinophilia-induced cerebral vasculitis appears to be more likely than that of ADEM for many reasons: patient’s histories (which started with neurological signs), clinical presentation (association with other signs), high eosinophilia (1900 and 2100/mm3, respectively), and the brain magnetic resonance imaging aspects (suggesting border zone infarcts). Indeed, ADEM is considered as a postinfectious disorder because it is usually preceded (7–14 days, 2 days to 4 weeks, according to the authors) by a febrile episode (or an antigenic challenge), most commonly related to a viral or bacterial infection (mostly nonspecific upper respiratory tract infection) or sometimes a vaccination.

Correlates of unsigned prediction error when the US was unexpectedly presented or omitted were observed in both centromedial amygdala and substantia nigra/ventral tegmental areas, whereas the basolateral amygdala blood oxygen level-dependent response during the CSs was negatively correlated with subsequent prediction error, and hence was related to prediction accuracy. The work nicely demonstrates convergence of human and animal research concerning fundamental issues of learning in the questions posed (what are the consequences of the confirmation

and violation of learned expectancies for information processing), the approaches taken (quantitative modeling based on well-documented theories of learning), and the behavioral and neural processing results obtained, despite differences in species, behavioral measures, and measures of brain activity. http://www.selleckchem.com/products/AZD6244.html The use of common approaches and theoretical perspectives across human and animal studies, each with their www.selleckchem.com/products/nu7441.html own strengths and shortcomings, may provide a unified approach to understanding

relations between cognitive and affective processing. “
“Cover Illustration: Mouse optic nerve remodeling after trauma. Triple immunostaining for GFAP (green) in astrocytes, β3Tubulin (red) in axons, and Dapi (blue) in cell nuclei revealed apparent Dapagliflozin retraction of astrocytic processes from the

lesion site on EphA4 KO optic nerve sections. For details see the article of Joly et al. (The Ephrin receptor EphA4 restricts axonal sprouting and enhances branching in the injured mouse optic nerve. Eur. J. Neurosci., 40, 3021–3031). “
“In the published paper of Cotrufo et al. (2012 ), in the Acknowledgement section, the grant 2010/149 (Ministerio de Sanidad, Plan nacional de Drogas) should be included. “
“This Corrigendum corrects a disassembly of Figure 1D in the published paper of Liu et al. (2013). “
“The acquisition of mature neuronal phenotypes by progenitors residing in different germinal sites along the neuraxis is thought to be regulated by the expression of region-specific combinations of transcription factors or proneural genes. Nevertheless, heterotopic transplantation experiments suggest that fate choices of uncommitted cells can be changed after exposure to a novel neurogenic environment. However, whether progenitors taken from one region of the CNS can switch their fate to acquire features typical of a foreign site has remained controversial. This issue has been recently addressed by James Goldman’s group, by transplanting progenitors isolated from the forebrain subventricular zone to the prospective white matter (PWM) of the postnatal cerebellum (Milosevic et al., 2008).

Advances in genomic tools such as tiling arrays, comparative Staurosporine nmr genome hybridization microarrays (array CGH), and ultra-high-throughput sequencing

are now allowing researchers to have a better understanding of the genotypic changes associated with adaptation [for review see (Dettman et al., 2012)], such as drug resistance (Selmecki et al., 2010). The applications of these tools to time-course isolates obtained in vitro and in vivo will yield the necessary correlations between genotypic and phenotypic changes in resistant strains and help researchers to gain a firmer grasp on the evolutionary trajectories of fungal pathogens during exposure HM781-36B chemical structure to antifungal agents. In addition to the aforementioned factors (e.g. population size, relative fitness coefficients, rate of beneficial mutations, etc.)

that contribute to the population dynamics during adaptive evolution, additional factors such as dosing regimens and the mode of action of the antifungal agent may also contribute to the population dynamics during the emergence of drug resistance in C. albicans. A series of in vivo studies in murine model shed some light on the importance of some of these factors on antifungal drug resistance in C. albicans (Andes et al., 2006). Andes et al. (2006) investigated the impact of different fluconazole (a fungistatic agent) dosing regimens, using different dose levels and dosing intervals, on the outgrowth of resistant strain with different initial ratios of drug-resistant and susceptible strains in a murine model; they found a lower but more frequent dosage of fluconazole led to less frequent outgrowth of the resistant strain compared with higher but more infrequent dosage. Another study by the same

group revealed a similar effect of dosing regimen on drug resistance emergence when they evolved an initially drug-susceptible strain of C. albicans in a murine model (Andes et al., 2006). Results from these studies suggest different selection strategies may have different impacts on the expansion of drug-resistant genotypes click here within the population, leading to different population dynamics and ultimately to different evolutionary outcomes. In addition, they found that if the initial population contained at least 10% of the drug-resistant clone, the evolving population behaved phenotypically as entirely drug resistant, suggesting that the population structure prior to drug exposure is an important factor in determining the evolutionary outcome of the population (Andes et al., 2006). The mode of action of the antifungal agent may also be a contributing factor on the emergence of drug resistance.

Given that no ARV drug is licensed for use in

pregnancy apart from ZDV in the third trimester, a discussion regarding the potential unknown long- and short-term effects on an unborn child should be had with any woman of childbearing potential who commences any ARV drug regimen. Further details can be found in the BHIVA pregnancy guidelines [210]. Significant pharmacokinetic and pharmacodynamic interactions have been reported between ARV drugs and hormonal agents. Inducers of hepatic enzymes by ARVs may result in increased breakdown of ethinyl oestradiol and progestogens that can compromise contraceptive and hormone replacement therapy efficacy. Additional contraceptive measures or different ARV BMN 673 manufacturer regimens may be required in these circumstances. Potential DDIs should be checked using various resources, including specialist HIV pharmacists, web-based PD0325901 datasheet tools such as the University of Liverpool website on HIV drug interactions and medical information departments in pharmaceutical companies. There is no significant interaction between ETV and the combined oral contraceptive pill, and no interaction is anticipated with RAL. Hormonal contraceptive agents, which have been shown not to have a significant interaction or where there is no anticipated interaction

include depot medroxyprogesterone acetate, and the levonorgestrol IUS (Mirena coil). There is very little evidence to guide prescribing ART in HIV-positive women experiencing virological failure on ART, with most studies recruiting approximately 10% of women. One study investigating DRV/r in ART-experienced patients recruited a large proportion of women and was powered to show a difference in virological efficacy between men and women; this showed higher discontinuation rates among women than men, with nausea being cited

as a particular problem, but overall there was no difference in virological efficacy [236]. A further study has reported similar efficacy and tolerability of RAL in ART-experienced HIV-positive women [217]. In HIV-positive women experiencing virological failure on ART, the same principles Adenosine triphosphate of management and recommendations apply as per HIV-positive men experiencing virological failure (see Section 7: Management of virological failure). “
“Current British HIV Association (BHIVA) guidelines recommend that all patients with a CD4 count <350 cells/μL are offered highly active antiretroviral therapy (HAART). We identified risk factors for delayed initiation of HAART following a CD4 count <350 cells/μL. All adults under follow-up in 2008 who had a first confirmed CD4 count <350 cells/μL from 2004 to 2008, who had not initiated treatment and who had >6 months of follow-up were included in the study. Characteristics at the time of the low CD4 cell count and over follow-up were compared to identify factors associated with delayed HAART uptake.