The authors conducted a biomonitoring study in the town of Mataró, Spain, of 104 subjects who lived near (i.e., within 0.5–1.5 km) an incinerator, 97 subjects who lived far (i.e., within 3.5 km-4.0 km) from an incinerator, and 17 workers at a new municipal solid-waste incinerator. The study commenced before the incinerator started functioning in 1995, and 2 y later (1977) the authors undertook the final part of the study. Dioxins, furans, and polychlorinated biphenyls were studied in pooled blood samples (n = 22), and individual blood and urine samples were analyzed for the detection of lead, chromium, cadmium, and mercury. In 1995, dioxin blood levels were low-both among those living close to the incinerator (mean = 13.5 ng international-dioxin toxic equivalents/kg fat) and among those living far away (mean = 13.4 ng international-dioxin toxic equivalents/kg fat). In 1997, dioxin and polychlorinated biphenyl levels had increased in both groups of residents by approximately 25% and 12%, respectively. (The increase in dioxin levels was about 10% when the authors took into account the mean of two repeated quality-control analyses.) Blood lead levels decreased, but no difference was observed for chromium, cadmium, and mercury. Minimal changes were seen among workers. Given the low dioxin stack emissions from this plant (mean = 2.5–0.98 ng international-dioxin toxic equivalents/m³) and that the blood dioxin levels did not depend on distance of residence from the incinerator, it would appear unlikely that the small increase in dioxin blood levels resulted from the incinerator's emissions.

Highly diverse HIV-1 genetic forms are circulating in Cuba, including subtypes B and G and two recombinant forms of African origin (CRF18_cpx and CRF19_cpx). Here we phylogenetically analyze pol sequences from a large collection of recent samples from Cuba, corresponding to 425 individuals from all Cuban provinces, which represents approximately 12% of prevalent infections in the country. RNA from plasma was used to amplify a pol segment by reverse transcription-polymerase chain reaction; phylogenetic analyses were performed with neighbour-joining trees and bootscanning. The distribution of genetic forms was subtype B, 41.2%; CRF19_cpx, 18.4%; BG recombinants, 11.6%; CRF18_cpx, 7.1%; subtype C, 6.1%; subtype G, 3.8%; B/CRF18 recombinants, 2.6%; subtype H, 2.1%; B/CRF19 recombinants, 1.7%; and others, 5.4%. Seventy-five (17.6%) viruses were recombinant between genetic forms circulating in Cuba. In logistic regression analyses, adjusting by gender and region, subtype B was more prevalent (OR 5.0, 95% CI 2.0-12.3) and subtype G less prevalent (OR 0.1, 95% CI 0.0-0.5) among men who have sex with men (MSM) than among heterosexuals. Within the main genetic forms of Cuba there were phylogenetic subclusters, several of which correlated with risk exposure or region. BG recombinants formed three phylogenetically related subclusters, corresponding to three different mosaic structures; most of these recombinants were from MSM from Havana City, among whom they have expanded recently, reaching 31% HIV-1 infections diagnosed in 2003. This study confirms the high HIV-1 diversity and frequent recombination in Cuba and reveals the recent expansion of diverse related BG recombinant forms in this country.