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Ana Sofía Herrera-Van Oostdam, Julio E. Castañeda-Delgado, Juan José Oropeza-Valdez, Juan Carlos Borrego, Joel Monárrez-Espino, Jiamin Zheng, Rupasri Mandal, Lun Zhang, Elizabeth Soto-Guzmán, Julio César Fernández-Ruiz, Fátima Ochoa-González, Flor M. Trejo Medinilla, Jesús Adrián López, David S. Wishart, José A. Enciso-Moreno, Yamilé López-Hernández
PLoS One Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
by Ana Sofía Herrera-Van Oostdam, Julio E. Castañeda-Delgado, Juan José Oropeza-Valdez, Juan Carlos Borrego, Joel Monárrez-Espino, Jiamin Zheng, Rupasri Mandal, Lun Zhang, Elizabeth Soto-Guzmán, Julio César Fernández-Ruiz, Fátima Ochoa-González, Flor M. Trejo Medinilla, Jesús Adrián López, David S. Wishart, José A. Enciso-Moreno, Yamilé López-Hernández
Viral sepsis has been proposed as an accurate term to describe all multisystemic dysregulations and clinical findings in severe and critically ill COVID-19 patients. The adoption of this term may help the implementation of more accurate strategies of early diagnosis, prognosis, and in-hospital treatment. We accurately quantified 110 metabolites using targeted metabolomics, and 13 cytokines/chemokines in plasma samples of 121 COVID-19 patients with different levels of severity, and 37 non-COVID-19 individuals. Analyses revealed an integrated host-dependent dysregulation of inflammatory cytokines, neutrophil activation chemokines, glycolysis, mitochondrial metabolism, amino acid metabolism, polyamine synthesis, and lipid metabolism typical of sepsis processes distinctive of a mild disease. Dysregulated metabolites and cytokines/chemokines showed differential correlation patterns in mild and critically ill patients, indicating a crosstalk between metabolism and hyperinflammation. Using multivariate analysis, powerful models for diagnosis and prognosis of COVID-19 induced sepsis were generated, as well as for mortality prediction among septic patients. A metabolite panel made of kynurenine/tryptophan ratio, IL-6, LysoPC a C18:2, and phenylalanine discriminated non-COVID-19 from sepsis patients with an area under the curve (AUC (95%CI)) of 0.991 (0.986–0.995), with sensitivity of 0.978 (0.963–0.992) and specificity of 0.920 (0.890–0.949). The panel that included C10:2, IL-6, NLR, and C5 discriminated mild patients from sepsis patients with an AUC (95%CI) of 0.965 (0.952–0.977), with sensitivity of 0.993(0.984–1.000) and specificity of 0.851 (0.815–0.887). The panel with citric acid, LysoPC a C28:1, neutrophil-lymphocyte ratio (NLR) and kynurenine/tryptophan ratio discriminated severe patients from sepsis patients with an AUC (95%CI) of 0.829 (0.800–0.858), with sensitivity of 0.738 (0.695–0.781) and specificity of 0.781 (0.735–0.827). Septic patients who survived were different from those that did not survive with a model consisting of hippuric acid, along with the presence of Type II diabetes, with an AUC (95%CI) of 0.831 (0.788–0.874), with sensitivity of 0.765 (0.697–0.832) and specificity of 0.817 (0.770–0.865).
Læs mere Tjek på PubMedKeiko Kabasawa, Junta Tanaka, Tomoyo Komata, Katsuhiro Matsui, Kazutoshi Nakamura, Yumi Ito, Ichiei Narita
PLoS One Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
by Keiko Kabasawa, Junta Tanaka, Tomoyo Komata, Katsuhiro Matsui, Kazutoshi Nakamura, Yumi Ito, Ichiei Narita
The COVID-19 pandemic might affect many aspects of the community and a range of psychiatric risk factors due to life changes, including people’s behaviors and perceptions. In this study, we aim to identify specific life changes that correlate with psychological distress within the social context of the COVID-19 pandemic in Japan. In July 2020, workers (company employees and civil servants) in Japan were recruited from local institutions that had not had any confirmed COVID-19 cases as well as neighborhoods that had only a few cases. Participants completed a COVID-19 mental health survey (N = 609; 66.9% male). Psychological distress was identified based on Kessler-6 scores (≥13). Life changes were assessed by an open-ended question about life changes in participants and their family, workplace, and community due to the COVID-19 pandemic. A convergent mixed-method approach was used to compare the context of perceived life changes in participants with psychological distress and those without. As a result, 8.9% of participants had psychological distress, and sex and age categories were different between those with psychological distress and those without. Among the participants who responded to the open-ended question, the biggest life change was “staying at home,” and the next biggest life changes were “event cancellations” and “increased workload” in participants with psychological distress, and “no changes” and “mask-wearing” in those without psychological distress, respectively. Regarding emotional/perceptual changes, “stress,” “fear,” and “anger” were more frequently reported by participants with psychological distress than those without (P
Læs mere Tjek på PubMedNungruthai Suntronwong, Preeyaporn Vichaiwattana, Lakkhana Wongsrisang, Sirapa Klinfueng, Sumeth Korkong, Thanunrat Thongmee, Nasamon Wanlapakorn, Yong Poovorawan
PLoS One Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
by Nungruthai Suntronwong, Preeyaporn Vichaiwattana, Lakkhana Wongsrisang, Sirapa Klinfueng, Sumeth Korkong, Thanunrat Thongmee, Nasamon Wanlapakorn, Yong Poovorawan
Assessing the seroprevalence of the high-risk individuals against the influenza virus is essential to evaluate the progress of vaccine implementation programs and establish influenza virus interventions. Herein, we identified the pre-existing cross-protection of the circulating seasonal influenza viruses among the older-aged population. A cross-sectional study was performed base on the 176 residual sera samples collected from older adults aged 60 to 95 years without a history of vaccination in rural Thailand in 2015. Sera antibody titers against influenza A and B viruses circulating between 2016 and 2019 were determined by hemagglutination inhibition assay. These findings indicated the low titers of pre-existing antibodies to circulating influenza subtypes and showed age-independent antibody titers among the old adults. Moderate seropositive rates (HAI ≥ 1:40) were observed in influenza A viruses (65.9%A(H3N2), 50.0% for A(H1N1) pdm09), and found comparatively lower rates in influenza B viruses (14% B/Yam2, 21% B/Yam3 and 25% B/Vic). Only 5% of individuals possessed broadly protective antibodies against both seasonal influenza A and B virus in this region. Our findings highlighted the low pre-existing antibodies to circulating influenza strains in the following season observed in older adults. The serological study will help inform policy-makers for health care planning and guide control measures concerning vaccination programs.
Læs mere Tjek på PubMedMalaria Journal, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
Volatile pyrethroids (VPs) are proven to reduce human–vector contact for mosquito vectors. With increasing resistance to pyrethroids in mosquitoes, the efficacy of VPs, such as transfluthrin, may be compromised. Therefore, experiments were conducted to determine if the efficacy of transfluthrin eave-positioned targeted insecticide (EPTI) depends on the resistance status of malaria vectors.
Methods
Ribbons treated with 5.25 g transfluthrin or untreated controls were used around the eaves of an experimental hut as EPTI inside a semi-field system. Mosquito strains with different levels of pyrethroid resistance were released simultaneously, recaptured by means of human landing catches (HLCs) and monitored for 24-h mortality. Technical-grade (TG) transfluthrin was used, followed by emulsifiable concentrate (EC) transfluthrin and additional mosquito strains. Generalized linear mixed models with binomial distribution were used to determine the impact of transfluthrin and mosquito strain on mosquito landing rates and 24-h mortality.
Results
EPTI treated with 5.25 g of either TG or EC transfluthrin significantly reduced HLR of all susceptible and resistant Anopheles mosquitoes (Odds Ratio (OR) ranging from 0.14 (95% Confidence Interval (CI) [0.11–0.17], P < 0.001) to 0.57, (CI [0.42–0.78] P < 0.001). Both TG and EC EPTI had less impact on landing for the resistant Anopheles arabiensis (Mbita strain) compared to the susceptible Anopheles gambiae (Ifakara strain) (OR 1.50 [95% CI 1.18–1.91] P < 0.001) and (OR 1.67 [95% CI 1.29–2.17] P < 0.001), respectively. The EC EPTI also had less impact on the resistant An. arabiensis (Kingani strain) (OR 2.29 [95% CI 1.78–2.94] P < 0.001) compared to the control however the TG EPTI was equally effective against the resistant Kingani strain and susceptible Ifakara strain (OR 1.03 [95% CI 0.82–1.32] P = 0.75). Finally the EC EPTI was equally effective against the susceptible An. gambiae (Kisumu strain) and the resistant An. gambiae (Kisumu-kdr strain) (OR 0.98 [95% CI 0.74–1.30] P = 0.90).
Conclusions
Transfluthrin-treated EPTI could be useful in areas with pyrethroid-resistant mosquitoes, but it remains unclear whether stronger resistance to pyrethroids will undermine the efficacy of transfluthrin. At this dosage, transfluthrin EPTI cannot be used to kill exposed mosquitoes.
Læs mere Tjek på PubMedMalaria Journal, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
Indoor Residual Spray (IRS) against vector mosquitoes is a primary means for combating malaria transmission. To combat increased patterns of resistance to chemicals against mosquito vectors, alternative candidate insecticide formulations should be screened. With mortality as the primary endpoint, the persistence of residual efficacy of a polymer-enhanced pyrethroid suspension concentrate containing deltamethrin (K-Othrine® PolyZone—KOPZ) applied at 25 mg active ingredient (ai)/m2 was compared with a microencapsulated organophosphate suspension formulation of pirimiphos-methyl (Actellic® 300CS—ACS) applied at 1 g ai/m2.
Methods
Following standard spray application, periodic contact bioassays were conducted for at least 38 weeks on four types of wall surfaces (unbaked clay, baked clay, cement, and painted cement) sprayed with either KOPZ or ACS in simulated semi-field conditions. Similarly, two types of existing walls in occupied houses (painted cement and baked clay) were sprayed and examined. A colonized strain of female Anopheles arabiensis mosquitoes were exposed to treated or untreated surfaces (controls) for 30 min. For each wall surface test period, 40 treatment mosquitoes (4 cones × 10) in semi-field and 90 (9 cones × 10) in ‘natural’ house conditions were used per wall. 30 mosquitoes (3 cones × 10) on a matching unsprayed surface served as the control. Insecticide, wall material, and sprayed location on wall (in houses) were compared by final mortality at 24 h.
Results
Insecticide, wall material, and sprayed location on wall surface produced significant difference for mean final mortality over time. In semi-field conditions, KOPZ produced a 72% mean mortality over a 38-week period, while ACS gave 65% (p < 0.001). Painted cement wall performed better than other wall surfaces throughout the study period (73% mean mortality). In the two occupied houses, KOPZ provided a mean mortality of 88%, significantly higher than ACS (p < 0.001). KOPZ provided an effective residual life (≥ 80% mortality) between 7.3 and 14 weeks on experimental walls and between 18.3 and 47.2 weeks in houses, while ACS persisted between 3 and 7.6 weeks under semi-field conditions and between 7.1 and 17.3 weeks in houses. Household painted cement walls provided a longer effective residual activity compared to baked clay for both formulations. Greater mortality was recorded at the top and middle sections of sprayed wall compared to the bottom portion near the floor.
Conclusion
KOPZ provided longer residual activity on all surfaces compared to ACS. Painted cement walls provided better residual longevity for both insecticides compared to other surfaces. Insecticides also performed better in an occupied house environment compared to semi-field constructed walls. This study illustrates the importance of collecting field-based observations to determine appropriate product active ingredient formulations and timing for recurring IRS cycles.
Læs mere Tjek på PubMedMalaria Journal, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
Artemisinin-based combination therapy (ACT) was deployed in 2005 as an alternative to chloroquine and is considered the most efficacious treatment currently available for uncomplicated falciparum malaria. While widespread artemisinin resistance has not been reported to date in Africa, recent studies have reported partial resistance in Rwanda. The purpose of this study is to provide a current systematic review and meta-analysis on ACT at Mali study sites, where falciparum malaria is highly endemic.
Methods
A systematic review of the literature maintained in the bibliographic databases accessible through the PubMed, ScienceDirect and Web of Science search engines was performed to identify research studies on ACT occurring at Mali study sites. Selected studies included trials occurring at Mali study sites with reported polymerase chain reaction (PCR)-corrected adequate clinical and parasite response rates (ACPRcs) at 28 days. Data were stratified by treatment arm (artemether–lumefantrine (AL), the first-line treatment for falciparum malaria in Mali and non-AL arms) and analysed using random-effects, meta-analysis approaches.
Results
A total of 11 studies met the inclusion criteria, and a risk of bias assessment carried out by two independent reviewers determined low risk of bias among all assessed criteria. The ACPRc for the first-line AL at Mali sites was 99.0% (95% CI (98.3%, 99.8%)), while the ACPRc among non-AL treatment arms was 98.9% (95% CI (98.3%, 99.5%)). The difference in ACPRcs between non-AL treatment arms and AL treatment arms was not statistically significant (p = .752), suggesting that there are potential treatment alternatives beyond the first-line of AL in Mali.
Conclusions
ACT remains highly efficacious in treating uncomplicated falciparum malaria in Mali. Country-specific meta-analyses on ACT are needed on an ongoing basis for monitoring and evaluating drug efficacy patterns to guide local malaria treatment policies, particularly in the wake of observed artemisinin resistance in Southeast Asia and partial resistance in Rwanda.
Læs mere Tjek på PubMedMalaria Journal, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
Malaria elimination is the goal for Bioko Island, Equatorial Guinea. Intensive interventions implemented since 2004 have reduced prevalence, but progress has stalled in recent years. A challenge for elimination has been malaria infections in residents acquired during travel to mainland Equatorial Guinea. The present article quantifies how off-island contributes to remaining malaria prevalence on Bioko Island, and investigates the potential role of a pre-erythrocytic vaccine in making further progress towards elimination.
Methods
Malaria transmission on Bioko Island was simulated using a model calibrated based on data from the Malaria Indicator Surveys (MIS) from 2015 to 2018, including detailed travel histories and malaria positivity by rapid-diagnostic tests (RDTs), as well as geospatial estimates of malaria prevalence. Mosquito population density was adjusted to fit local transmission, conditional on importation rates under current levels of control and within-island mobility. The simulations were then used to evaluate the impact of two pre-erythrocytic vaccine distribution strategies: mass treat and vaccinate, and prophylactic vaccination for off-island travellers. Lastly, a sensitivity analysis was performed through an ensemble of simulations fit to the Bayesian joint posterior probability distribution of the geospatial prevalence estimates.
Results
The simulations suggest that in Malabo, an urban city containing 80% of the population, there are some pockets of residual transmission, but a large proportion of infections are acquired off-island by travellers to the mainland. Outside of Malabo, prevalence was mainly attributable to local transmission. The uncertainty in the local transmission vs. importation is lowest within Malabo and highest outside. Using a pre-erythrocytic vaccine to protect travellers would have larger benefits than using the vaccine to protect residents of Bioko Island from local transmission. In simulations, mass treatment and vaccination had short-lived benefits, as malaria prevalence returned to current levels as the vaccine’s efficacy waned. Prophylactic vaccination of travellers resulted in longer-lasting reductions in prevalence. These projections were robust to underlying uncertainty in prevalence estimates.
Conclusions
The modelled outcomes suggest that the volume of malaria cases imported from the mainland is a partial driver of continued endemic malaria on Bioko Island, and that continued elimination efforts on must account for human travel activity.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
A series of social and public health measures have been implemented to contain coronavirus disease 2019 (COVID-19) in China. We examined the impact of non-pharmaceutical interventions against COVID-19 on mumps incidence as an agent to determine the potential reduction in other respiratory virus incidence.
Methods
We modelled mumps incidence per month in Sichuan using a seasonal autoregressive integrated moving average (ARIMA) model, based on the reported number of mumps cases per month from 2017 to 2020.
Results
The epidemic peak of mumps in 2020 is lower than in the preceding years. Whenever compared with the projected cases or the average from corresponding periods in the preceding years (2017–2019), the reported cases in 2020 markedly declined (P < 0.001). From January to December, the number of mumps cases was estimated to decrease by 36.3% (33.9–38.8%), 34.3% (31.1–37.8%), 68.9% (66.1–71.6%), 76.0% (73.9–77.9%), 67.0% (65.0–69.0%), 59.6% (57.6–61.6%), 61.1% (58.8–63.3%), 49.2% (46.4–52.1%), 24.4% (22.1–26.8%), 30.0% (27.5–32.6%), 42.1% (39.6–44.7%), 63.5% (61.2–65.8%), respectively. The total number of mumps cases in 2020 was estimated to decrease by 53.6% (52.9–54.3%).
Conclusion
Our study shows that non-pharmaceutical interventions against COVID-19 have had an effective impact on mumps incidence in Sichuan, China.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
Intestinal parasitic infections are amongst the most common infections worldwide and have been identified as one of the most significant causes of morbidity and mortality among disadvantaged populations. This comparative cross-sectional study was conducted to assess the prevalence of intestinal protozoan infections and to identify the significant risk factors associated with intestinal parasitic infections in Laghouat province, Southern Algeria.
Methods
A comparative cross-sectional study was conducted, involving 623 symptomatic and 1654 asymptomatic subjects. Structured questionnaires were used to identify environmental, socio demographic and behavioral factors. Stool specimens were collected and examined using direct wet mount, formalin-ether concentration, xenic in vitro culture and staining methods.
Results
A highly significant difference of prevalence was found between symptomatic (82.3%) and asymptomatic subjects (14.9%), with the majority attributable to protozoan infection. The most common species in the symptomatic subjects were Blastocystis spp. (43.8%), E. histolytica/dispar (25.4%) and Giardia intestinalis (14.6%) and more rarely Enterobius vermicularis (02.1%), Teania spp. (0.6%) and Trichuris trichiura (0.2%), while in asymptomatic population Blastocystis spp. (8%), Entamoeba coli (3.3%) and Entamoeba histolytica/dispar (2.5%) were the most common parasites detected with no case of helminth infection. Multivariate log-linear analysis showed that contact with animals was the main risk factor for transmission of these protozoa in both populations. Furthermore, living in rural areas was significantly associated with combined protozoan infection in the asymptomatic population, whereas, in the symptomatic population an increasing trend of protozoan infection was detected in the hot season. In addition, Blastocystis spp. and G. intestinalis infection were found to be associated with host sex and contact with animals across the study period.
Conclusions
Based on these results, several strategies are recommended in order to effectively reduce these infections including good animal husbandry practices, health education focused on good personal hygiene practices and adequate sanitation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
Hepatitis A is one of the most common infectious causes of acute hepatitis, and currently, a neglected global public health problem necessitating an urgent response in Somalia. Hepatitis A infection and its rare complication of acute liver failure in children are largely based on very limited data. The aim of the study was therefore to investigate the Hepatitis A infection and its rare complication of acute liver failure in children in Somalia.
Methods
This retrospective study was conducted on children aged 0–18 years who were admitted to the pediatric departments of the Somalia Mogadishu-Turkey Training and Research Hospital, Somali, from June 2019 and December 2019. Patients who were tested for hepatitis A infection during the study period and had complete data were included. Children with chronic disease, primary or secondary immunodeficiency, blood transfusion history, and missing data were excluded. Abstracted data including patients' demographics, clinical presentation, laboratory results, ultrasonographic findings, length of hospital stay, clinical course and outcome were retrieved from the hospital database system.
Results
Of the 13,047 children, 219 were analyzed. Of the 219 Hepatitis A cases, 25 (11%) were diagnosed with pediatric acute liver failure (PALF). The mean age of children with Hepatitis A was 6.7 years. The majority of cases were reported in the 5–9 (39.7%) year age range. Hepatic encephalopathy, length of hospital stay, levels of albumin, and values of PT, aPPT, and INR were significantly higher in children with acute live failure. The presence of cholecystitis and cholecystitis with ascites in the sonographic evaluation were poor prognostic markers for acute liver failure.
Conclusions
This study revealed hepatitis A virus infection and its related acute liver failure among hospitalized children in Somalia of which 11% had PALF. Hence, the introduction of Hepatitis A vaccination, which is the main public health tool, into the national immunization program, the improvement of hygiene conditions, raising awareness of the disease, and increasing health literacy are necessary to prevent the consequence of the Hepatitis A virus in children.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
Estimating population prevalence and incidence of prior SARS-CoV-2 infection is essential to formulate public health recommendations concerning the COVID-19 pandemic. However, interpreting estimates based on sero-surveillance requires an understanding of the duration of elevated antibodies following SARS-CoV-2 infection, especially in the large number of people with pauci-symptomatic or asymptomatic disease.
Methods
We examined > 30,000 serology assays for SARS-CoV-2 specific IgG and IgM assays acquired longitudinally in 11,468 adults between April and November 2020 in the COVID-19 Community Research Partnership.
Results
Among participants with serologic evidence for infection but few or no symptoms or clinical disease, roughly 50% sero-reverted in 30 days of their initial positive test. Sero-reversion occurred more quickly for IgM than IgG and for antibodies targeting nucleocapsid protein compared with spike proteins, but was not associated with age, sex, race/ethnicity, or healthcare worker status.
Conclusions
The short duration of antibody response suggests that the true population prevalence of prior SARS-CoV-2 infection may be significantly higher than presumed based on earlier sero-surveillance studies. The impact of the large number of minimally symptomatic COVID-19 cases with only a brief antibody response on population immunity remains to be determined.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
The outbreak of coronavirus disease 2019 (COVID-19) posed an enormous threat to public health. The use of antiviral drugs in patients with this disease have triggered people’s attentions. Whether interferon alfa-2b or lopinavir/ritonavir (LPV/r) plus interferon alfa-2b treatment can against SARS-CoV-2 was unknown. The objectives of this study was to evaluate the efficacy and safety of interferon alfa-2b and LPV/r plus interferon alfa-2b for SARS-CoV-2 infection in adult patients hospitalized with COVID-19.
Methods
This is a retrospective cohort study of 123 patients confirmed SARS-CoV-2 infection by PCR on nasopharyngeal swab and symptoms between Jan. 13 and Apr. 23, 2020. All patients received standard supportive care and regular clinical monitoring. Patients were assigned to standard care group (n = 12), interferon alfa-2b group (n = 44), and combination LPV/r plus interferon alfa-2b group (n = 67). The primary endpoints were duration of required oxygen support and virus clearance time. Associations between therapies and these outcomes were assessed by Cox proportional hazards regression.
Results
Baseline clinical characteristics were not significantly different among the three groups (P > 0.05). No significant associations were observed between LPV/r/interferon alfa-2b and faster SARS-CoV-2 RNA clearance (HR, 0.85 [95% confidence interval (CI) 0.45–1.61]; P = 0.61 in interferon alfa-2b group vs HR, 0.59 [95% CI 0.32–1.11]; P = 0.10 in LPV/r plus interferon alfa-2b group). Individual therapy groups also showed no significant association with duration of required oxygen support. There were no significant differences among the three groups in the incidence of adverse events (P > 0.05).
Conclusions
In patients with confirmed SARS-CoV-2 infection, no benefit was observed from interferon alfa-2b or LPV/r plus interferon alfa-2b treatment. The findings may provide references for treatment guidelines of patients with SARS-CoV-2 infection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
Abstract
Background
In a previous retrospective observational study, a 3-day regimen of oseltamivir as post-exposure prophylaxis (PEP) for preventing transmission of influenza in wards was shown to be comparable to 7- to 10-day regimens provided index cases were immediately separated from close contacts. In order to confirm the efficacy of a 3-day regimen, we started to conduct a prospective, multi-center, single-arm trial.
Methods
This study is a prospective, multi-center, single-arm study designed by the Sectional Meeting of Clinical Study, Japan Infection Prevention and Control Conference for National and Public University Hospitals. Index patients with influenza are prescribed a neuraminidase inhibitor and are discharged immediately or transferred to isolation rooms. The close contacts are given oseltamivir as 75 mg capsules once daily for adults or 2 mg/kg (maximum of 75 mg) once daily for children for 3 days as PEP. All close contacts are monitored for development of influenza for 7 days after starting PEP.
Discussion
A 3-day regimen of oseltamivir as PEP has advantages over 7- to 10-day regimens in terms of costs, medication adherence and adverse effects.
Trial registration The Institutional Review Board of Hokkaido University Hospital for Clinical Research, 015-0518, registered on November 11, 2016. UMIN Clinical Trials Registry, UMIN000024458, disclosed on October 31, 2016. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000027881. Japan Registry of Clinical Trials, jRCTs011180015, disclosed on March 14, 2019. https://jrct.niph.go.jp/latest-detail/jRCTs011180015
Læs mere Tjek på PubMedEmerging Infectious Diseases, 30.08.2021
Tilføjet 30.08.2021
Paola Magro, Carlo Cerini, Aldorada da Gloria, Stelio Tembe, Francesco Castelli, Lina Rachele Tomasoni
Tropical Medicine & International Health, 29.08.2021
Tilføjet 30.08.2021
Sabine Heinz, Antonios Kolimenakis, Olaf Horstick, Laith Yakob, Antonios Michaelakis, Michael Lowery Wilson
Tropical Medicine & International Health, 29.08.2021
Tilføjet 30.08.2021
Arit Udoh, Basira Kankia Lawal, Mary Akpan, Kamilu Sarki Labaran, Ekpedeme Ndem, Unoma Ohabunwa, Olubukola Tikare, Umar Idris Ibrahim, Kosisochi Amorha, Eneyi Kpokiri
Tropical Medicine & International Health, 29.08.2021
Tilføjet 30.08.2021
Liu, Dan; Liu, Jiaojiao; Xu, Tingting; Qiao, Hongwei; Qi, Yu; Gao, Yuxun; Ailixire, ; Gao, Lei; Li, Chunlin; Xia, Mingrui; Li, Hongjun
AIDS, 20.08.2021
Tilføjet 30.08.2021
Objectives:
We used simian immunodeficiency virus (SIV) -infected nonhuman primates to investigate longitudinal changes of brain volume caused by SIV and the effect of combined antiretroviral treatment (cART). In addition, the relation between viral load (VL), immune status, and brain volume were explored.
Design:
A longitudinal study of two healthy controls (HC), five SIVmac239-infected macaques received cART (SIV+cART+) at 40 days post innoculation, and five SIVmac239-infected macaques received no therapy (SIV+cART-).
Methods:
Structural T1-weighted MRI, blood and cerebrospinal fluid testing were acquired at multiple time points for 48 weeks post infection (wpi). Brain volume was estimated using region of interest (ROI)-based analysis. Volume differences were compared among three groups. Linear regression models tested the associations between brain volumes and biomarkers (VL, CD4+ T-cell count, CD4+/CD8+ ratio).
Results:
In our model, brain volume alteration in SIV-infected macaques can be detected at 12 wpi in several brain regions. As the infection progresses, the SIV+cART- macaques displayed generalized gray matter atrophy at the endpoint. Though initiate cART right after acute infection, SIV+cART+ macaques still displayed brain atrophy but showed signs of reversible. Plasma VL is mainly associated with subcortical nucleus volume while CD4+ T-cell count and CD4+/CD8+ ratio in plasma were associated with widespread cortical volume.
Conclusion:
The SIVmac239-infected Chinese origin macaque is a valid model for neuroHIV. Brain atrophy caused by SIV infection can be relieved, even reversed, by cART. Our model also provides new insights into understanding the pathogenesis of brain injury in people living with human immunodeficiency virus.
Correspondence to Hongjun Li, MD, Beijing Youan Hospital, Capital Medical. E-mail: lihongjun00113@ccmu.edu.cn; Mingrui Xia, PhD, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China. E-mail: mxia@bnu.edu.cn; Chunlin Li, PhD, School of Biomedical Engineering, Capital Medical University, Beijing,100069, China. E-mail: lichunlin1981@163.com.
Received 8 January, 2021
Revised 7 August, 2021
Accepted 10 August, 2021
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.AIDSonline.com).
Copyright © 2021 Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedBoswell, Michael T.; Yindom, Louis-Marie; Hameiri-Bowen, Dan; Mchugh, Grace; Dauya, Ethel; Bandason, Tsitsi; Mujuru, Hilda; Esbjörnsson, Joakim; Ferrand, Rashida A.; Rowland-Jones, Sarah
AIDS, 20.08.2021
Tilføjet 30.08.2021
Objective:
Untreated perinatal HIV-1 infection is often associated with rapid disease progression in children with HIV (CWH), characterised by a high viral loads and early mortality. TRIM22 is a host restriction factor which directly inhibits HIV-1 transcription, and with genotype variation reported as associated disease progression in adults. We tested the hypothesis that TRIM22 genotype is associated with disease progression in CWH.
Design:
ART-naïve CWH, aged 6 to 16 years, were recruited from primary care clinics in Harare, Zimbabwe. We performed a candidate gene association study of TRIM22 genotype and haplotypes with markers of disease progression and indicators of advanced disease.
Methods:
TRIM22 exons three and four were sequenced by Sanger sequencing and single nucleotide polymorphisms were associated with markers of disease progression (CD4 + T cell count and viral load) and clinical indicators of advanced HIV disease (presence of stunting and chronic diarrhoea). Associations were tested using multivariate linear and logistic regression models.
Results:
A total of 241 children, median age 11.4 years, 49% female, were included. Stunting was present in 16% of participants. Five SNPs were analysed including rs7935564, rs2291842, rs78484876, rs1063303 and rs61735273. The median CD4 + count was 342 (IQR: 195 - 533) cells/μL and median HIV-1 viral load 34 199 (IQR: 8211 – 90 662) IU/mL. TRIM22 genotype and haplotypes were not associated with CD4 + T cell count, HIV-1 viral load, stunting or chronic diarrhoea.
Conclusion:
TRIM22 genotype was not associated with markers of HIV disease progression markers or advanced disease in CWH.
Correspondence to Michael T. Boswell, MBChB, MSc, DPhil, University of Pretoria School of Medicine, Pretoria, Gauteng South Africa. E-mail: boswell.michaelt@gmail.com
Received 10 May, 2021
Revised 30 July, 2021
Accepted 3 August, 2021
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.AIDSonline.com).
Copyright © 2021 Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedCrowell, Trevor A.; Daud, Ibrahim I.; Maswai, Jonah; Owuoth, John; Sing’oei, Valentine; Imbach, Michelle; Dear, Nicole; Sawe, Fred; Eller, Leigh Anne; Polyak, Christina S.; Ake, Julie A.; for the AFRICOS Study Group
AIDS, 20.08.2021
Tilføjet 30.08.2021
Among 582 participants in Western Kenya who were retrospectively tested from January through March 2020, 19 (3.3%) had detectable SARS-CoV-2 antibodies. The prevalence of detectable SARS-CoV-2 antibodies was similar between participants with and without HIV (3.1% vs. 4.0%, p = 0.68). One participant reported a cough in the preceding week but others denied symptoms. These may represent cross-reactivity or asymptomatic infections that predated the first reported COVID-19 cases in Kenya.
Correspondence to Trevor A. Crowell, MD, PhD, U.S. Military HIV Research Program, 6720A Rockledge Drive, Suite 400 Bethesda, MD 20817. Tel: +301 500 3990; fax: +301 500 3666; e-mail: tcrowell@hivresearch.org
Received 23 June, 2021
Accepted 3 August, 2021
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.AIDSonline.com).
Copyright © 2021 Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedAuguste, Peter E.; Mistry, Hema; McCarthy, Noel D.; Sutcliffe, Paul A.; Clarke, Aileen E.
AIDS, 20.08.2021
Tilføjet 30.08.2021
Objective:
The aim of this study was to estimate the cost-effectiveness of screening strategies for predicting LTBI that progresses to active TB in people living with HIV.
Design:
We developed a decision-analytical model that comprised a decision tree covering diagnosis of LTBI and a Markov model covering progression to active TB. The model represents the lifetime experience following testing for LTBI, and discounting costs, and benefits at 3.5% per annum in line with UK standards. We undertook probabilistic and one-way sensitivity analyses.
Setting:
UK National Health Service and Personal Social Service perspective in a primary care setting.
Participants:
Hypothetical cohort of adults recently diagnosed with HIV.
Interventions:
Interferon-gamma release assays and tuberculin skin test.
Main outcome measure:
Cost per quality-adjusted life year (QALY).
Results:
All strategies except T-SPOT.TB were cost-effective at identifying LTBI, with the QFT-GIT -ve followed by TST5 mm strategy being the most costly and effective. Results indicated that there was little preference between strategies at a willingness-to-pay threshold of £20,000. At thresholds above £40,000 per QALY, there was a clear preference for the QFT-GIT -ve followed by TST5 mm, with a probability of 0.41 of being cost-effective. Results showed that specificity for QFT-GIT and TST5 mm were the main drivers of the economic model.
Conclusion:
Screening for LTBI has important public health and clinical benefits. Most of the strategies are cost-effective. These results should be interpreted with caution due to the paucity of studies included in the meta-analysis of test accuracy studies. Additional high-quality primary studies are needed to have a definitive answer about which strategy is the most effective.
Correspondence to Peter E. Auguste, Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, CV4 7AL. Tel: +44 0 2476 150648; e-mail: p.auguste@warwick.ac.uk
Received 12 November, 2020
Revised 18 June, 2021
Accepted 18 August, 2021
Copyright © 2021 Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedRichart, Valèria; Fernández, Irene; de Lazzari, Elisa; Berrocal, Leire; Fehér, Csaba; Plana, Montserrat; Leal, Lorna; García, Felipe
AIDS, 20.08.2021
Tilføjet 30.08.2021
Objective:
We analyzed the incidence rate of long-term events in patients on ART previously exposed to therapy interruption.
Design:
A single-center cohort study involving participants in antiretroviral therapy interruptions (ARTI) clinical trials (n = 10) was conducted.
Methods:
Non-AIDS events after ART resumption were analyzed. A control group not exposed to ARTI was randomly selected from the same cohort and a propensity score (PS) of belonging to ARTI group was estimated based on age, gender, CD4 nadir value, time from HIV diagnosis to ARTI, time from HIV diagnosis to starting ART and time of suppressed viral load, and used to adjust effect estimates.
Results:
One hundred and eighty-one patients were included, 136 in ARTI and 45 in the control arm. Median time of known HIV-1 infection was 21 years and median time from ART resumption to first non-AIDS event was 5.2 years. A significantly higher proportion of patients with ARTI had an event as compared with control group [raw percentages: 43% (n = 53) vs 23% (n = 10), p = 0.015]. These differences were confirmed when only the non-AIDS events occurring after ART resumption were analyzed (aHR = 2.43, 95% CI 1.15–5.12). The logistic model adjusted for the PS indicated that patients with an ARTI had a four-fold higher risk of having at least one non-AIDS event (p = 0.002).
Conclusions:
We found a higher risk of having at least one non-AIDS event years after ART resumption in HIV-infected patients exposed to ARTI as compared with controls. These data should be taken in consideration for future functional cure clinical trials.
Correspondence to Lorna Leal, MD, PhD, Infectious Diseases Department – HIV Unit, Hospital Clínic, Villarroel, 170, 08036 Barcelona, Spain. Tel: +34932275586; fax: +34934514438; e-mail: laleal@clinic.cat
Received 1 February, 2021
Revised 4 August, 2021
Accepted 13 August, 2021
Copyright © 2021 Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedOlalla-Sierra, Julián; Martín-Escalante, María Dolores; García-Alegría, Javier; Rubio-Rivas, Manuel; de Miguelcampo, Borja; Zurita-Etayo, María; Arbones-Fernández, Laia; Alcalá-Pedrajas, José N.; Roldán-Silvestre, Alicia; Cortés-Rodríguez, Begoña; Casas-Rojo, José Manuel; Núñez-Cortés, Jesús Millán; on behalf of the SEMI-COVID-19 Network
AIDS, 20.08.2021
Tilføjet 30.08.2021
Objective:
To compare COVID-19 hospitalization outcomes between persons with and without HIV.
Design:
Retrospective observational cohort study in 150 hospitals in Spain.
Methods:
Patients admitted from 1 March to 8 October 2020 with COVID-19 diagnosis confirmed by SARS-CoV-2 positive polymerase chain reaction test in respiratory tract samples. The primary data source was the COVID-19 Sociedad Española de Medicina Interna's registry (SEMI-COVID-19). Demographics, comorbidities, vital signs, laboratory parameters, and clinical severity as well as treatments received during admission, treatment duration, ICU admission, use of invasive mechanical ventilation, and death were recorded. Factors associated with mortality and the composite of ICU admission, invasive mechanical ventilation, and death, were analyzed.
Results:
Data from 16 563 admissions were collected, 98 (0.59%) of which were of persons with HIV infection. These patients were younger, the percentage of males was higher, and their Charlson comorbidity index was also higher. Rates of mortality and composite outcome of Intensive Care Unit admission, invasive mechanical ventilation or death were lower among patients with HIV infection. In the logistic regression analysis, HIV infection was associated with an adjusted odds ratio of 0.53 (95% CI: 0.29-0.96) for the composite outcome.
Conclusion:
HIV infection was associated with a lower probability of ICU admission, invasive mechanical ventilation, or death.
Correspondence to Julián Olalla-Sierra, MD, PhD, Internal Medicine Department, Costa del Sol Hospital, Marbella (Málaga), Spain. Ctra Nal 340, km 187. 29603 Marbella (Spain). E-mail: Julio.olalla@gmail.com
Received 15 April, 2021
Revised 28 July, 2021
Accepted 9 August, 2021
Copyright © 2021 Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedVishwanathan, Sundaram Ajay; Zhao, Chunxia; Luthra, Roopa; Khalil, George K.; Morris, Monica M.; Dinh, Chuong; Gary, Michelle J.; Mitchell, James; Spreen, William R.; Pereira, Lara E.; Heneine, Walid; García-Lerma, J. Gerardo; McNicholl, Janet M.
AIDS, 20.08.2021
Tilføjet 30.08.2021
Objective:
We had previously shown that long-acting cabotegravir (CAB-LA) injections fully protected macaques from vaginal simian HIV (SHIV) infection. Here, we reassessed CAB-LA efficacy in the presence of depot medroxyprogesterone acetate and multiple sexually transmitted infections (STI) that are known to increase HIV susceptibility in women.
Design:
Two macaque models of increasing vaginal STI severity were used for efficacy assessment.
Methods:
The first study (n = 11) used a double STI model that had repeated exposures to two vaginal STI, Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV). Six animals were CAB-LA treated and 5 were controls. The second study (n = 9) included a triple STI model with repeated exposures to CT, TV and syphilis, and the contraceptive, depot medroxyprogesterone acetate (DMPA). Six animals were CAB-LA treated and three were controls. All animals received up to 14 vaginal SHIV challenges. A survival analysis was performed to compare the number of SHIV challenges to infection in the drug-treated group compared to untreated controls over time.
Results:
All 6 CAB-LA treated animals in both models, the double STI or the triple STI-DMPA model, remained protected after 14 SHIV vaginal challenges while the untreated animals became SHIV-infected after a median of 2 challenges (log-rank p
Læs mere Tjek på PubMedPeters van Ton, Annemieke M.; Meijer-van Leijsen, Esther M. C.; Bergkamp, Mayra I.; Bronkhorst, Ewald M.; Pickkers, Peter; de Leeuw, Frank-Erik; Tuladhar, Anil M.; Abdo, Wilson F.
Critical Care Medicine, 23.08.2021
Tilføjet 30.08.2021
Objectives:
Given the strong association between systemic inflammation and cognitive decline, we aimed to determine whether nonneurologic infections are associated with accelerated cognitive decline and structural changes in the brain using pre- and post-infection neuropsychologic assessments and repeated brain MR images.
Design:
Additional analysis of the prospective observational Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort study.
Setting:
Single-center study at the Radboud university medical center, Nijmegen, The Netherlands, between January 2006 and September 2015.
Patients:
Five-hundred three participants (50–85 yr old) with cerebral small vessel disease were included and followed for 9 years.
MEASUREMENTS AND MAIN RESULTS:
Participants underwent repeated cognitive measurements and brain MRI. Infectious events were collected. Sepsis episodes were analyzed, and additionally, patients were stratified in three groups: having had a severe infectious episode (e.g., sepsis or hospitalization for infection), a mild, or no infectious episode. Development of dementia, trajectories of cognition, and structural brain changes on MRI in the subsequent follow-up periods were compared between the groups. Complete infectious data were available from 331 patients (mean age 64 ± 8 yr, 57% males). Twenty-nine participants (9%) suffered from a sepsis episode, 69 (21%) from a severe, 201 (61%) from a mild, and 61 (18%) had no infectious episode during follow-up. After correction for age, baseline cognition, and brain volume, each sepsis episode remained associated with an 82% increased risk to develop dementia within the follow-up period (hazard ratio, 1.82; 95% CI, 1.07–3.10; p = 0.027). Infections had no effect on the trajectory of structural changes to the brain after correction for baseline differences.
Conclusions:
In this 9-year observational follow-up study, sepsis episodes were associated with subsequent development of dementia. Nonneurologic infections had no effect on the trajectory of structural cerebral changes.
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal).
Drs. Meijer-van Leijsen and de Leeuw disclosed work for hire. Dr. de Leeuw received funding from a clinical established investigator grant from the Dutch Heart Foundation (2014T060) and by a Vidi innovational grant from The Netherlands ZonMw (grant number 016126351). Dr. Tuladhar received funding from the Dutch Heart Foundation (grant number 2016T044). Dr. Abdo received funding from a research grant from the Netherlands Organization for Health Research and Development (ZonMw Clinical Fellowship Grant 90715610). The remaining authors have disclosed that they do not have any potential conflicts of interest.
For information regarding this article, E-mail: f.abdo@radboudumc.nl
Copyright © by 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Læs mere Tjek på PubMedHong-Mei Li, Zhi-Qiang Qin, Robert Bergquist, Men-Bao Qian, Shang Xia, Shan Lv, Ning Xiao, Juerg Utzinger, Xiao-Nong Zhou
International Journal of Infectious Diseases, 29.08.2021
Tilføjet 30.08.2021
BMC Infectious Diseases, 28.08.2021
Tilføjet 29.08.2021
Abstract
Background
Transcatheter edge-to-edge mitral valve repair using the MitraClip device is increasingly used for high surgical risk patients with severe mitral regurgitation (MR). Previous guidelines for infective endocarditis prophylaxis prior to dental procedures focused on high-risk patients, but without explicit recommendation for MitraClip recipients. We believe this could be the first reported case to identify Streptococcus oralis as the causative organism.
Case presentation
An 87-year-old male with severe MR treated with two MitraClip devices three months prior to index admission, presented with worsening malaise and intermittent chills on a background of multiple comorbid conditions. The patient had dental work a month prior to presentation, including a root canal procedure, without antibiotic prophylaxis. Vitals were significant for fever and hypotension. On physical examination, there was a holosystolic murmur at the apex radiating to the axilla, bilateral pitting edema in the lower extremities, and elevated jugular venous pulsation. A transthoracic echocardiogram showed severe MR with a possible echodensity on the mitral valve, prompting a transesophageal echocardiogram, which demonstrated a pedunculated, mobile mass on the posterior leaflet of the mitral valve. Five blood cultures grew gram positive cocci in pairs and chains, later identified as Streptococcus oralis, with minimum inhibitory concentration to penicillin 0.06 mg/L. Initial empiric antibiotics were switched to ceftriaxone 2 gr daily and subsequent blood cultures remained negative. However, the patient developed pulmonary edema and worsening hemodynamic instability requiring vasopressors. As surgical risk for re-operation was considered prohibitive, the decision was made to continue medical management and comfort-directed care. The patient died a week later.
Conclusions
Despite low incidence, infective endocarditis should be included in the differential among MitraClip recipients. The explicit inclusion of this growing patient population in the group requiring prophylaxis prior to dental procedures in the 2020 ACC/AHA valvular heart disease guidelines is an important step forward.
Læs mere Tjek på PubMedJenny L. Schnyder, Hanna K. de Jong, Martin P. Grobusch
Clinical Microbiology and Infection, 29.08.2021
Tilføjet 29.08.2021
Shortages in vaccine supplies are a major health problem of global concern, particularly during epidemics and pandemics, such as COVID-19. At the time of writing, merely 13.0% of the world’s population had been fully immunised against SARS-CoV-2, leaving 6.9 billion people worldwide still unprotected [1]. Therefore, dose-sparing approaches such as intradermal (ID) vaccination should be considered in mass immunisations. Numerous studies over the past decades showed that for several vaccines (e.g.
Læs mere Tjek på PubMedLi‐Bo Liu, Man Li, Na Gao, Jia‐Yuan Shen, Zi‐Yang Sheng, Dong‐Ying Fan, Hong‐Ning Zhou, Xiao‐Xiong Yin, Jia‐Rong Mao, Jin‐Yong Jiang, Pei‐Gang Wang, Jing An
Journal of Medical Virology, 28.08.2021
Tilføjet 29.08.2021
Umaima Wasim, Muhammad Junaid Tahir, Ahsun Rizwan Siddiqi, Abdul Jabbar, Irfan Ullah
Journal of Medical Virology, 28.08.2021
Tilføjet 29.08.2021
Rongdong Huang, Ruihuan Gan, Dongjuan Zhang, Jianxiong Xiao
Journal of Medical Virology, 28.08.2021
Tilføjet 29.08.2021
Sarosh Sarwar, Upasana Maskey, Pawan Kumar Thada, Manaal Mustansir, Azza Sarfraz, Zouina Sarfraz
Journal of Medical Virology, 28.08.2021
Tilføjet 29.08.2021
Xiaohui Li, Hongwei Ji, Di Wang, Lihe Che, Li Zhang, Liang Li, Qing Yin, Quan Liu, Feng Wei, Zedong Wang
Journal of Medical Virology, 28.08.2021
Tilføjet 29.08.2021
Montserrat Laguno, María Martínez-Rebollar, Martina Casanova, Elisa De Lazzari, Ana González-Cordón, Berta Torres, Alexy Inciarte, Lorena de la Mora, Ainoa Ugarte, Juan Ambrosioni, José Luís Blanco, Esteban Martínez, Josep Mallolas
Clinical Microbiology and Infection, 28.08.2021
Tilføjet 28.08.2021
HCV therapy with direct-acting antivirals (DAA) achieves high rates of sustained virological response in people living with HIV PLWH. The information on its long-term clinical impact is scarce. The aim of this study was to analyse liver fibrosis and immune response evolution after DAA treatment.
Læs mere Tjek på PubMed