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BMC Infectious Diseases, 13.10.2024
Tilføjet 13.10.2024
Abstract Background The best antiviral treatment for chronic hepatitis B (CHB) poses a complex challenge. The treatment effect of the combination of nucleoside analogues (NAs) and pegylated interferon alpha (PegIFN) was still in debate. Methods We studied patients treated with NAs and PegIFN-2b at our institution from November 2019 to January 2022. Logistic regression identified independent factors influencing clinical cure. The predictive accuracy of the formula was assessed using the Receiver operating characteristic (ROC) curve at different time points (before therapy, 12 weeks, and 24 weeks into treatment). Results A total of 120 patients were enrolled in the final analysis. Among the cohort of patients under study, 71 (59.1%) patients had clinical cure while 49 (40.9%) patients did not. Hepatitis B surface antigen (HBsAg) at baseline and age were the powerful variables predicting the clearance of HBsAg. The area under the ROC (AUC) was 0.907 for pre-treatment predictive model, 0.958 for 12-week predictive model and 0.747 for 24-week predictive model. Conclusion This study provided predictive formulas for clinical cure, offering valuable insights for CHB treatment. PegIFN and NAs exhibited efficacy. Future research that explores additional factors, such as HBV genotype, in a larger cohort study is needed.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 10.10.2024
Tilføjet 10.10.2024
Abstract Background Hemodialysis (HD) patients represent a high-risk group for hepatitis B infection. It is crucial to administer hepatitis B vaccination and stimulate higher and more sustained levels of anti-HBs. Our aim is to enhance the immunogenicity and persistence by implementing high-dose and prolonged hepatitis B vaccine schedule regimen in HD patients.Methods We conducted this multicenter, randomized, parallel-controlled trial between July 2020 and February 2023 at 11 hospitals in Shanxi province, China. A total of 504 HD patients were enrolled. All participants randomly allocated in a ratio of 1:1:1 to receive recombinant HBV vaccine of 3 standard doses (20 μg) at 0-1-6 months (IM20×3 group), 4 standard doses at 0-1-2-6 months (IM20×4 group), or 4 triple doses (60 μg) at 0-1-2-6 months (IM60×4 group).Results The vaccine-elicited antibody response peaked at month 7. The follow-up outcomes ranging from month 7 to 30 revealed that the response rates of anti-HBs decreased from 85.9% (134/156) to 33.0% (33/100) in IM20×3 group, from 92.5% (135/146) to 53.9% (56/104) in IM20×4 group and from 95.4% (145/152) to 57.3% (55/96) in IM60×4 group. The duration of vaccine-induced response with 75% of patients maintained protective antibody were 21.0 months in IM20×3 group, 25.7 months in IM20×4 group (vs. IM20×3 group, P=0.056) and 29.2 months in IM60×4 group (vs. IM20×3 group, P=0.034). All the adverse reactions were mild.Conclusions The four-triple-dose hepatitis B vaccination regimens could enhance the immunogenicity and 2-year duration in HD patients.The trial was registered with Clinical Trials.gov, number NCT03962881. https://classic.clinicaltrials.gov/ct2/show/NCT03962881?term=NCT03962881&draw=2&rank=1.
Læs mere Tjek på PubMedMathias Mlewa, Helmut A. Nyawale, Shimba Henerico, Ivon Mangowi, Aminiel Robert Shangali, Anselmo Mathias Manisha, Felix Kisanga, Benson R. Kidenya, Hyasinta Jaka, Semvua B. Kilonzo, Mariam M. Mirambo, Stephen E. Mshana
PLoS One Infectious Diseases, 9.10.2024
Tilføjet 9.10.2024
by Mathias Mlewa, Helmut A. Nyawale, Shimba Henerico, Ivon Mangowi, Aminiel Robert Shangali, Anselmo Mathias Manisha, Felix Kisanga, Benson R. Kidenya, Hyasinta Jaka, Semvua B. Kilonzo, Mariam M. Mirambo, Stephen E. Mshana Background Chronic hepatitis B virus (HBV) infection is still a major public health problem. In response to the World Health Organization (WHO), Tanzania implemented immunization and treatment to achieve the eradication of HBV infection by 2030. To achieve this goal, frequent updates of demographic data, antiviral therapy eligibility, and uptake are essential. We therefore evaluated demographic data, antiviral therapy eligibility, and uptake among chronically HBV-infected patients attending at Bugando Medical Centre (BMC), Tanzania. Methods A cross-sectional study enrolled 196 chronic HBV patients from April 23, 2023, to October 10, 2023, at BMC, where 100 and 96 patients were retrospectively and prospectively enrolled, respectively. Study’s ethical clearance and permission were observed by the Catholic University of Health and Allied Sciences/Bugando Medical Centre research ethics and review committee and the Bugando Medical Centre management respectively. For all patients, socio-demographic data and whole blood samples were obtained. Full blood picture, alanine and aspartate amino transferases, and HBV viral load parameters were determined. Aspartate-Platelet Ratio Index (APRI) and Fibrosis Four (FIB-4) scores were calculated according to their respective formulas. Therapy eligibility and uptake were evaluated according to the 2015 WHO HBV prevention, treatment, and care guidelines. The data were summarized and analysed using STATA version 15. Results The median age for all patients was 39 [IQR: 32–47.5] years. Nearly all study patients, 99% (194/196), were older than 20 years old, with significant male dominance (73.5% [144/196] versus 26.5% [52/196]; p
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.10.2024
Tilføjet 9.10.2024
Abstract Background Chronic hepatitis B virus (HBV) infection remains a serious health issue, and determining the optimal time for antiviral therapy is challenging. We aimed to assess liver histological changes in patients with HBeAg-positive chronic hepatitis B (CHB) and those with HBeAg-negative CHB who had persistently normal alanine aminotransferase and to determine the association between significant liver injury and various clinical parameters. Methods We retrospectively included, in this study, 339 treatment-naïve patients with chronic HBV infections who had persistently normal alanine aminotransferase and underwent liver biopsy from 2013 to 2023. Histologic assessment was based on the Metavir scoring system to evaluate the association between clinical characteristics and the severity of liver inflammation and fibrosis. Results Among the included participants, 138 were HBeAg-positive and 201 were HBeAg-negative. Lower hepatitis B surface antigen (HBsAg) (P = 0.003) and higher aspartate aminotransferase (AST) (P = 0.002) levels were associated with significant necroinflammation, whereas increasing age (P = 0.004) and lower HBV DNA (P
Læs mere Tjek på PubMedBrochon, Jeanne; Ducruet, Thierry; Taillefer, Suzanne; Lamarre, Valérie; Renaud, Christian; Metras, Marie-Elaine; Karatzios, Christos; Puyat, Joseph H.; Singer, Joel; Valois, Silvie; Soudeyns, Hugo; Boucoiran, Isabelle; Kakkar, Fatima
AIDS, 6.10.2024
Tilføjet 6.10.2024
Objectives: While studies have demonstrated increased morbidity and mortality risk in infancy among children who are HIV-exposed and uninfected (CHEU), longitudinal data are limited. The objective of this study was to assess long-term risk of hospitalization among CHEU compared to children who are HIV-unexposed and uninfected (CHUU), and determine risk factors for hospitalization among CHEU. Design: Longitudinal cohort study (1988–2015) linking the Centre maternel et infantile sur le SIDA cohort (Montreal, Quebec) to administrative data from the Régie de l’assurance maladie du Québec (RAMQ), a universal health insurance provider in the province of Quebec. Methods: CHEU from the CMIS cohort were matched 1:3 by age, sex and postal code with CHUU controls from the RAMQ database. Incidence and causes of hospitalization between CHEU and CHUU were compared using Poisson regression. Results: 726 CHEU were matched to 2178 CHUU. Risk of first hospitalization was significantly higher among CHEU at 1 year (IRR 2.22, [1.86–2.66]), 5 years (IRR 1.62, [1.39–1.90]) and over the lifespan (IRR 1.55, [1.33–1.81]). Among CHEU, significant risk factors for hospitalization on univariate regression analysis included birth year before 2005, prematurity, small for gestational age (SGA), detectable maternal viral load (dVL) at delivery, and maternal hepatitis C co-infection. In the adjusted analysis, small for gestational age and dVL remained significant risk factors. Conclusions: CHEU had a higher rate of hospitalization than CHUU controls across their lifespan. Significant risk factors included SGA and detectable maternal dVL, suggesting a need enhanced pediatric care for these children. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.10.2024
Tilføjet 5.10.2024
Abstract Background Communities living along the shoreline and on the islands of Lake Victoria in northwestern Tanzania remain endemic for schistosomiasis and suffer from the life-threatening morbidities associated with the disease. Nevertheless, the control measures particularly the mass drug administration do not cover the adult population. The current project on Ukerewe island aims to close this gap by involving adult community members in the control program. Here we report the baseline results of S. mansoni infection and associated hepatosplenic morbidities and factors before implementing the project activities. Methods A cross-sectional analytical study was conducted with 4,043 participants aged ≥ 18 years living in 20 villages on Ukerewe island, northwestern Tanzania. Individual stool and urine samples were collected and examined using the Kato-Katz (KK) technique and point-of-care circulating cathodic antigen testing(POC-CCA) to identify S. mansoni eggs and antigens, respectively. All study participants underwent ultrasound evaluation of S. mansoni hepatosplenic morbidities using the Niamey protocol. Rapid diagnostic tests were used to diagnose HIV infection, hepatitis C and chronic hepatitis B. A questionnaire was used to collect demographic data and reported clinical symptoms of study participants. Results A total of 4,043 participants took part in the study, of which 49.7% (n = 2,009) and 50.3% (n = 2,035) were male and female, respectively. The overall prevalence of S. mansoni infection was 30.4% (95%CI:29.0-31.9%) and 84.7% (95%CI:83.3–85.9%), respectively, based on the KK technique and the POC-CCA test. The geometrical mean eggs per gram of faeces (GMepg) was 105.3 (95%CI:98.7-112.3% GMepg) with 53.9%, 32.4% and 13.7% of the participants having mild, had moderate and severe intensity of infection. The prevalence of hepatitis C, HIV, and hepatitis B was 0.4%, 2.2% and 4.7%, with 0.2%, 2.2% and 5.4% of the infected individuals coexisting with S. mansoni infection. The prevalence of splenomegaly, periportal fibrosis, hepatomegaly, and portal vein dilatation was 40.5%(95%CI: 38.8–42.1%), 48.1%(95%CI:64.4–49.7%), 66.2%(95%CI:4.6–67.7%) and 67.7%(95%CI:66.2–69.2%), with their prevalence varying depending on the demographic information and infection status of the participants. Other detectable ultrasound-related morbidities included ascites (1.7%), collateral veins (18.3%) and gall bladder wall thickness (40.4%). Age groups, gender, reported clinical characteristics, reported non-use of the drug praziquantel, liver imaging pattern, and place of residence remained independently associated with hepatosplenic morbidities. Conclusion The current study setting is endemic for S. mansoni infection and the population has a high prevalence of the disease associated hepatosplenic morbidities characterized by hepatomegaly, splenomegaly, ascites, gall bladder wall thickening, periportal fibrosis and portal vein dilatation. Several demographic, clinical and epidemiological circumstances remained independently associated with S. mansoni infection and associated morbidities. These findings call for integrative intervention efforts, starting with whole community MDA that includes all out of schools community members.
Læs mere Tjek på PubMedMara KlöhnAndré GömerQiyu HeRichard J. P. BrownDaniel TodtLin WangEike Steinmann1Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany2Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China3European Virus Bioinformatics Center (EVBC), Jena, Germany4German Centre for Infection Research (DZIF), External Partner Site, Bochum, GermanyMiguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 4.10.2024
Tilføjet 4.10.2024
Ping He, Jialei Li, Chen Wang, Jiayue Zhang, Yiyun Jiang, Hongyang Liu, Yao Zhao, Zhiwei Li, Yinjie Gao, Yijin Wang
Journal of Medical Virology, 4.10.2024
Tilføjet 4.10.2024
BMC Infectious Diseases, 28.09.2024
Tilføjet 28.09.2024
Abstract Background Hepatitis C virus (HCV) antibody self-testing (HCVST) may help expand screening access and support HCV elimination efforts. Despite potential benefits, HCVST is not currently implemented in Pakistan. This study aimed to assess the usability and acceptability of HCVST in a high HCV prevalence informal settlement in Karachi, Pakistan. Methods We performed a cross-sectional study in a hepatitis C clinic from April through June 2023. Participants were invited to perform a saliva-based HCVST (OraSure Technologies, USA) while following pictorial instructions. A study member evaluated test performance using a standardized checklist and provided verbal support if a step could not be completed. Perceived usability and acceptability were assessed using a semi-structured questionnaire. The HCVST was considered successful if the participant was able to complete all steps and correctly interpret test results. Overall concordance and positive and negative agreement were estimated in comparison with the HCVST result read by the study member (inter-reader concordance and agreement) and result of a second rapid HCV test (Abbott Diagnostics Korea Inc, South Korea) performed by a trained user (inter-operator concordance and agreement). Results The study included 295 participants of which 97 (32%) were illiterate. In total, 280 (95%, 95% CI 92–97%) HCVSTs were successful. Overall, 38 (13%) people performed the HCVST without verbal assistance, 67 (23%) needed verbal assistance in one step, 190 (64%) in two or more. Assistance was most often needed in managing the test buffer and test reading times. The inter-reader concordance was 96% and inter-operator concordance 93%. Inter-reader and inter-operator positive percent agreement were 84 and 70%, respectively. All participants reported they would use HCVST again and would recommend it to friends and family. Conclusion Saliva-based HCVST was very well accepted in this clinic-based setting. However, many people requested verbal support in several steps, highlighting the need for clear instructions for use and test devices that are simple to use, particularly in low literacy settings. Moderately low positive percent agreement with the results of a rapid test performed by a trained user highlights potential uncertainty in the accuracy of HCVST in the hands of lay users.
Læs mere Tjek på PubMedBMC Infectious Diseases, 27.09.2024
Tilføjet 27.09.2024
Jian Wang Zhiyi Zhang Li Zhu Qing Zhang Shaoqiu Zhang Yifan Pan Jiacheng Liu Fei Cao Tao Fan Ye Xiong Shengxia Yin Xiaomin Yan Yuxin Chen Chuanwu Zhu Jie Li Xingxiang Liu Chao Wu Rui Huang a Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, Chinab Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, Chinac Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, Chinad Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, Jiangsu, Chinae Department of Infectious Diseases, Huai’an No. 4 People’s Hospital, Huai’an, Jiangsu, Chinaf Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, Chinag Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, Chinah Department of Clinical Laboratory, Huai’an No. 4 People’s Hospital, Huai’an, Jiangsu, China
Virulence, 25.09.2024
Tilføjet 25.09.2024
Izzy Chiu, Damiana Cano, Matisse Leathers, Caitlin M. Turner, Dillon Trujillo, Sofia Sicro, Sean Arayasirikul, Kelly D. Taylor, Erin C. Wilson, Willi McFarland
PLoS One Infectious Diseases, 24.09.2024
Tilføjet 24.09.2024
by Izzy Chiu, Damiana Cano, Matisse Leathers, Caitlin M. Turner, Dillon Trujillo, Sofia Sicro, Sean Arayasirikul, Kelly D. Taylor, Erin C. Wilson, Willi McFarland Background Transgender women (hereafter “trans women”) face social marginalization, stigma, and discrimination and experience a high burden of HIV. More recently, trans women have been identified as having a high risk for hepatitis C (HCV) infection. The interaction between these two diseases and the risks for HIV/HCV co-infection among trans women are understudied. Objective To characterize epidemiological, behavioral, and socio-structural interactions between HIV and HCV infections among trans women. Methods This cross-sectional study examined data from a community-based survey of trans women in San Francisco recruited through respondent-driven sampling (RDS) in 2019/2020. Face-to-face interviews collected data on demographics, medical history, drug injection practices, sexual behavior, and socio-structural factors (e.g., poverty, housing insecurity, incarceration, social support). HIV and HCV antibodies were detected using oral fluid rapid tests and prior diagnosis and treatment were collected by self-report. Blood specimens were collected to confirm antibodies using ELISA. Multinomial logistic regression analysis characterized factors associated with HIV infection alone, HCV infection alone, and HIV/HCV co-infection compared to neither infection. Results Among 201 trans women recruited, HIV prevalence was 42.3%; HCV infection by history or current seroprevalence was 28.9%; evidence for both HIV and HCV infection was present for 18.9%. Two-thirds of trans women (67.2%) had been incarcerated; 30.8% had ever injected drugs. History of injection drug use and receiving emotional support from family were factors found in common for HIV infection, HCV infection, and HIV/HCV co-infection compared to no infection. Having a sexual partner who injects drugs was associated with HIV infection alone. Not lacking care due to cost and older age were associated with co-infection. Older age was also associated with HCV infection. Of trans women with HIV infection, 91.8% had accessed HIV care, whereas only 62% with HCV had accessed some form of care. Conclusions Our study found high levels of HIV, HCV, and HIV/HCV co-infection among trans women in San Francisco. We found common associations between HIV and HCV through injection practices and emotional support, but having a sexual partner who injects drugs was not associated with HCV infection alone or co-infection. We note a substantial gap in the treatment of HCV for trans women, including those in HIV care, that needs to be urgently addressed.
Læs mere Tjek på PubMedPaioni, P., Capaul, M., Brunner, A., Traytel, A., Aebi-Popp, K., Crisinel, P.-A., Duppenthaler, A., Günthard, H., Martinez De Tejada, B., Kottanattu, L., Stöckle, M., Rauch, A., Wagner, N., Hösli, I., Rudin, C., Scherrer, A., Kusejko, K., Kahlert, C. R., Swiss HIV Cohort Study (SHCS) and the Swiss Mother and Child HIV Cohort Study (MoCHiV), Abela, Aebi-Popp, Anagnostopoulos, Battegay, Baumann, Bernasconi, Braun, Bucher, Calmy, Cavassini, Ciuffi, Crisinel, Darling, Duppenthaler, Dollenmaier, Egger, Elzi, Fehr, Fellay, Francini, Furrer, Fux, Günthard, Hachfeld, Haerry, Hasse, Hirsch, Hoffmann, Hösli, Huber, Jackson-Perry, Kahlert, Kaiser, Kapfhammer, Keiser, Klimkait, Kohns, Kottanattu, Kouyos, Kovari, Kusejko, Labhardt, Martinez de Tejada, Marzolini, Metzner, Müller, Nemeth, Nicca, Notter, Paioni, Pantaleo, Perreau, Ch, Rauch, Salazar-Vizcaya, Schmid, Speck, Stöckle, Tarr, Thanh Lecompte, Trkola, Wagner, Wandeler, Weisser, Yerly, Böni, Cheseaux, Francioli, Hirschel, Kind, Ledergerber, Nadal, Rickenbach, Rudin, Schüpbach, Siegrist
BMJ Open, 23.09.2024
Tilføjet 23.09.2024
PurposeProspective, multicentric observational cohort study in Switzerland investigating measures to prevent mother-to-child transmission in pregnant women with HIV (WWH) and assessing health and development of their exposed children as well as of children with HIV (CWH) in general. ParticipantsBetween January 1986 and December 2022, a total of 1446 mother–child pairs were enrolled. During the same period, the study also registered 187 CWH and 521 HIV-exposed but uninfected children (HEU), for whom detailed maternal information was not available. Consequently, the cohort comprises a total of 2154 children. Findings to dateDuring these 37 years, research by the Swiss Mother and Child HIV Cohort Study (MoCHiV) and its international collaborators has strongly influenced the prevention of vertical transmission of HIV (eg, introduction and discontinuation of elective caesarean section, neonatal postexposure prophylaxis and breastfeeding). Contributions have also been made to the management of diagnostics (eg, p24 antigen assay) and the effects of antiretroviral treatment (eg, prematurity, growth) in HEU and CWH. Future plansMost children present within the cohort are now HEU, highlighting the need to investigate other vertically transmitted pathogens such as hepatitis B and C viruses, cytomegalovirus or Treponema pallidum. In addition, analyses are planned on the longitudinal health status of CWH (eg, resistance and prolonged exposure to antiretroviral therapy), on social aspects including stigma in CWH and HEU, and on interventions to further optimise antenatal and postpartum care in WWH.
Læs mere Tjek på PubMedDevelay, E., Wartelle-Bladou, C., Talbot, A., Khemiri, R., Parent, J., Boulanger, A., Dubreucq, S., Page, M. G.
BMJ Open, 18.09.2024
Tilføjet 18.09.2024
ObjectivesThe objective of this study was to compare and contrast the experiences of interdisciplinary attendees (spokes) and experts (hub members) from three Extension for Community Healthcare Outcomes (ECHO) programmes: hepatitis C, chronic pain and concurrent mental health and substance use disorders. DesignProspective qualitative study. SettingSingle-centre in tertiary care. ParticipantsThe team conducted 30 one-on-one interviews with spokes and 4 focus groups with hub members from three ECHO programmes. AnalysesThree analysts were involved to perform a reflexive thematic analysis. ResultsOur results showed the benefits and limitations of the three ECHOs, varying according to specificities of targeted chronic conditions. Three overarching themes were identified from the data analysis: (1) perceived impacts of an interprofessional educational setting; (2) nature of disease and interprofessional interactions as determinants of clinical practice changes in diagnoses and treatments and (3) impacts on patient engagement and care pathways. ConclusionsThe extent to which a chronic disease relies on a biopsychosocial approach, the degree of interdisciplinary care required and the simplicity/complexity of treatment algorithms influence perceived benefits and barriers to participating in ECHO programmes. These points raised by our study are important in the understanding of the successes and limitations of implementing an ECHO programme. They are essential as they provide key information for tailoring Project ECHO to the chronic disease it addresses.
Læs mere Tjek på PubMedBMC Infectious Diseases, 18.09.2024
Tilføjet 18.09.2024
Abstract Background Prior research predominantly examined the association between HIV-positive men who have sex with men (MSM) or those using injection drugs and hepatitis C virus (HCV) infection. However, limited attention has been given to understanding the association among HIV-negative MSM who do not inject drugs. This gap leaves apportion of the population unexamined, potentially overlooking important factor that may contribute to the transmission and prevalence of HCV. This study aims to investigate the relationship between non-injection drug use and HCV infection in this population. Methods In this cross-sectional study, we analyzed data on 118 MSM who reported use of non-injection drugs. The participants were recruited from two inner-city communities in Houston, TX, between 2004 and 2007 and were negative for both HIV and hepatitis B virus infection. Latent class analysis (LCA) was used to identify drug use latent classes. Multinomial logistic regression analysis was used to evaluate the association between drug use latent class and HCV infection. Results Four distinct latent classes of drug use were identified: class 1, persons ≥ 42 years of age who used only crack cocaine; class 2, persons approximately 42 years of age who used > 2 drugs; class 3, persons 5 drugs; and class 4, persons ≥ 42 years of age who used > 6 drugs. Class 4 was significantly associated with HCV infection. The odds of HCV infection in members of class 4 was 17 times higher than in class 2 members (adjusted odds ratio [aOR] = 16.9, 95% confidence interval [CI]: 1.4–205.4) and almost 22 times higher than in class 3 members (aOR = 21.8, 95% CI: 1.5–322.8). Conclusions Among MSM with non-injection drug use, the subgroup of individuals who were ≥ 42 years of age and used multiple drugs (including heroin, speedball, methamphetamine, crack cocaine, and marijuana) had a high probability of HCV infection. Public health and education programs, as well as drug treatment and rehabilitation programs, should be developed for this high-risk subgroup of individuals to prevent HCV acquisition and transmission.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.09.2024
Tilføjet 17.09.2024
Abstract Background Antiretroviral therapy (ART) for HIV infection has evolved substantially. The development of long-acting drugs, such as cabotegravir (CAB) and rilpivirine (RPV) might improve treatment satisfaction among people living with HIV (PLWH). The real-world effectiveness of long-acting ART and its effect on patient satisfaction needs to be assessed. This study investigated antiviral effectiveness and treatment satisfaction in PLWH who switched from conventional to long-acting ART (CAB + RPV). Methods This prospective cohort study included PLWH aged 18 years and older who switched to CAB + RPV and received the injections every 8 weeks between June 2022 and May 2023, after a 4-week oral lead-in phase. The eligibility criteria included viral suppression, absence of hepatitis B virus (HBV) DNA, and no prior RPV resistance mutations. Clinical data, including renal, lipid, and glucose biomarker levels, were monitored from the baseline to 44 weeks after switching. Treatment satisfaction was assessed using the HIV Treatment Satisfaction Questionnaire. A linear mixed-effects model was used to estimate changes in clinical data from baseline. Results Thirty-eight male participants were enrolled. Some participants had detectable levels of viral replication; however, all participants maintained viral suppression (HIV-RNA
Læs mere Tjek på PubMedKuniholm, Mark H.; Murenzi, Gad; Shumbusho, Fabienne; Brazier, Ellen; Plaisy, Marie K.; Mensah, Ephrem; Wandeler, Gilles; Riebensahm, Carlotta; Chihota, Belinda V.; Samala, Niharika; Diero, Lameck; Semeere, Aggrey S.; Chanyachukul, Thida; Borse, Rohidas; Nguyen, Dung T.H.; Perazzo, Hugo; Lopez-Iniguez, Alvaro; Castilho, Jessica L.; Maruri, Fernanda; Jaquet, Antoine
AIDS, 16.09.2024
Tilføjet 16.09.2024
Objective: To understand the relationship between cardiovascular disease (CVD) risk and liver steatosis and fibrosis among people living with HIV (PLWH) ≥40 years on antiretroviral therapy (ART) in low- and middle-income countries (LMIC). Design: We used cross-sectional behavioral and clinical data collected during study enrollment visits in 2020-2022 for the Sentinel Research Network of International epidemiology Databases to Evaluate AIDS (SRN of IeDEA). Methods: Ten-year CVD risk was calculated using 2019 World Health Organization non-laboratory and laboratory models. Transient elastography (TE) was used to assess liver disease. Presence of steatosis and significant fibrosis were defined by Controlled Attenuation Parameter (CAP) ≥248 dB/m and liver stiffness measurement (LSM) ≥7.1 kPa, respectively. Participants with viral hepatitis, hazardous alcohol consumption and unsuppressed HIV viral load were excluded from the analysis. Logistic regression was used to estimate odds ratios, adjusting for study site, CD4 T cell count, stavudine and didanosine exposure, and in models stratified by sex and geographic region. Results: There were 1,750 participants from nine LMIC. Median CVD risk was 3% for both non-laboratory and laboratory-based models. Adjusted odds ratios (ORs) for steatosis and significant fibrosis associated with laboratory CVD risk (≥10% vs.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.09.2024
Tilføjet 14.09.2024
Abstract Introduction In Sub-Saharan Africa alone, about 40–65% of Hepatitis B Virus infections among HCWs were a result of percutaneous occupational exposures to contaminated blood and body fluids of patients. Occupational exposure to blood and body fluids among healthcare workers is on the rise in Ghana. However, the relationship between self-reported exposures to blood and body fluids suspected to be contaminated with the hepatitis B virus and actual serological evidence of exposure remains unknown. The aim of the study however was to assess the self-reported exposure to HBV as against the serological evidence of lifetime exposure to HBV and associated factors among Ghanaian HCWs. Methods The study was a cross-sectional analytical survey that involved 340 HCWs who were recruited using a simple random sampling procedure from six cadres of staff from five districts in Greater Accra. The participants were surveyed using a validated instrument and 5mls of venous blood was aseptically withdrawn for qualitative detection of Anti-HBc. SPSS version 23.0 was used to analyze the data to obtain proportions, odds ratios and their corresponding confidence intervals with the level of significance set at 0.05. Results The response rate was 94% with Nurses and Doctors in the majority with a mean age of 35.6 ± 7.2. Self-reported exposure to HBV was 63% whereas lifetime exposure to HBV (Anti-HBc) prevalence was 8.2% (95% CI = 5.0-11.0%). Females were 60% less likely to be exposed to HBV (aOR = 0.4; 95% CI = 0.1–0.9) than their male counterparts. HCWs without training in the prevention of blood-borne infections had almost three times higher odds of being exposed to HBV in their lifetime (aOR = 2.6; 95% CI = 1.0-6.4). Conclusions The findings of this study suggest that self-reported exposure to HBV-contaminated biological materials was high with a corresponding high lifetime exposure to HBV. The female gender was protective of anti-HBc acquisition. Apart from direct interventions for preventing occupational exposures to HBV in the healthcare setting, periodic training of all categories of healthcare workers in infection prevention techniques could significantly reduce exposure to the Hepatitis B virus.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.09.2024
Tilføjet 14.09.2024
Abstract Hepatitis E virus (HEV) is an important emerging pathogen producing significant morbidity in immunosuppressed patients. HEV has been detrimental to solid organ transplant (SOT) patients, cancer patients, and HIV-positive patients, where chronic HEV infections occur. Blood-borne transfusions and multiple cases of chronic HEV infection in transplant patients have been reported in the past few decades, necessitating research on HEV pathogenesis using immunosuppressed animal models. Numerous animal species with unique naturally occurring HEV strains have been found, several of which have the potential to spread to humans and to serve as pathogenesis models. Host immunosuppression leads to viral persistence and chronic HEV infection allows for genetic adaptation to the human host creating new strains with worse disease outcomes. Procedures necessary for SOT often entail blood transfusions placing immunosuppressive patients into a “high risk group” for HEV infection. This scenario requires an appropriate immunosuppressive animal model to understand disease patterns in these patients. Hence, this article reviews the recent advances in the immunosuppressed animal models for chronic HEV infection with emphasis on pathogenesis, immune correlates, and the liver pathology associated with the chronic HEV infections.
Læs mere Tjek på PubMedInfection, 13.09.2024
Tilføjet 13.09.2024
Abstract Purpose HEV is an emerging pathogen in Europe and was previously shown to be hyperendemic in areas of Abruzzo and Lazio, Central Italy. No systematic analysis of the HEV strains responsible for human infections over several years in Central Italy has previously been reported. Aim of the study was the molecular characterization of HEV from autochthonous hepatitis E cases occurred in Abruzzo and Lazio between 2015 and 2023. Methods Samples from 118 cases collected as part of virological surveillance in Abruzzo and Lazio from 2015 to 2023 were subjected to HEV sequencing and phylogenetic analysis. Results The main observed subtype was 3f, followed by 3c and 3e. The annual subtype distribution was quite stable over the observation period, but 3f cases tended to concentrate in winter/early spring whereas 3e cases in summer. Phylogenetic clusters of highly related sequences (a) highlighted unrecognized “point source outbreaks”, (b) provided molecular support to temporally and/or geographically linked cases and (c) provided evidence for transmission of identical/highly related strains up to months/years following their first detection. Conclusions The data provide an overview of the HEV strains responsible for human infections over eight years in Central Italy. The observed subtype distribution appears to agree better with the subtype distribution reported in Italy in pigs rather than in geographically matched wild boars, suggesting pig and its derivate food was a more frequent source of infection than wild boar in Abruzzo and Lazio. Molecular characterization is essential to recognize “point source outbreaks” and to monitor HEV circulation.
Læs mere Tjek på PubMedQuan Wang, Tao Wang, Lin Cao, An Mu, Sheng Fu, Peipei Wang, Yan Gao, Wenxin Ji, Zhenyu Liu, Zhanqiang Du, Luke W. Guddat, Wenchi Zhang, Shuang Li, Xuemei Li, Zhiyong Lou, Xiangxi Wang, Zhongyu Hu, Zihe Rao
Science, 13.09.2024
Tilføjet 13.09.2024
Infection, 12.09.2024
Tilføjet 12.09.2024
Abstract Purpose HEV is an emerging pathogen in Europe and was previously shown to be hyperendemic in areas of Abruzzo and Lazio, Central Italy. No systematic analysis of the HEV strains responsible for human infections over several years in Central Italy has previously been reported. Aim of the study was the molecular characterization of HEV from autochthonous hepatitis E cases occurred in Abruzzo and Lazio between 2015 and 2023. Methods Samples from 118 cases collected as part of virological surveillance in Abruzzo and Lazio from 2015 to 2023 were subjected to HEV sequencing and phylogenetic analysis. Results The main observed subtype was 3f, followed by 3c and 3e. The annual subtype distribution was quite stable over the observation period, but 3f cases tended to concentrate in winter/early spring whereas 3e cases in summer. Phylogenetic clusters of highly related sequences (a) highlighted unrecognized “point source outbreaks”, (b) provided molecular support to temporally and/or geographically linked cases and (c) provided evidence for transmission of identical/highly related strains up to months/years following their first detection. Conclusions The data provide an overview of the HEV strains responsible for human infections over eight years in Central Italy. The observed subtype distribution appears to agree better with the subtype distribution reported in Italy in pigs rather than in geographically matched wild boars, suggesting pig and its derivate food was a more frequent source of infection than wild boar in Abruzzo and Lazio. Molecular characterization is essential to recognize “point source outbreaks” and to monitor HEV circulation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.09.2024
Tilføjet 12.09.2024
Abstract Purpose This study aims to analyze whether undergoing amniocentesis during pregnancy in women diagnosed with hepatitis B virus (HBV) infection leads to HBV transmission to newborns. Methods Retrospective data collection was conducted from June 2019 to November 2022 on expectant mothers positive for hepatitis B surface antigen (HBsAg) who underwent amniocentesis at The Third Affiliated Hospital of Sun Yat-sen University, along with data on their newborns. The study summarized the HBV infection status of newborns born to mothers with different expressions of hepatitis B e antigen (HBeAg), antiviral treatment versus no treatment, and different HBV DNA viral loads before delivery. Results In this study, 346 expectant mothers tested positive for HBsAg, along with 351 newborns (including 5 sets of twins, with 8 infants (2.28%) testing HBsAg-positive at birth. All newborns received dual immunotherapy and were followed up. At 7–12 months, retesting for HBsAg positivity and HBV DNA positivity among infants revealed that out of the infants born with HBsAg positivity, 7 cases had seroconverted to negative, while the remaining infant, who was positive for both HBsAg and HBeAg at birth, tested positive for both HBsAg and HBV DNA at 7–12 months. Thus, one case of vertical transmission of hepatitis B from mother to child occurred in this study. The proportion of infants born with HBsAg + among newborns born to HBeAg-positive mothers (4 cases, 6.06%) was significantly higher than that among newborns born to HBeAg-negative mothers (4 cases, 1.41%) (P 0.05). Among expectant mothers with viral load ≥ 6 log 10 IU/mL before delivery, 3 newborns (30.00%) were manifesting HBsAg positivity at birth, significantly higher than the group with viral load
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.09.2024
Tilføjet 11.09.2024
Abstract Background Premature infants have less physiologic reserve and often delayed vaccination compared to full-term infants. The birth dose of hepatitis B vaccine (HepB-BD) is an essential measure to achieve the goal of "zero infections" of hepatitis B virus in all newborns. However, there are few investigations of hepatitis B vaccination of preterm infants, leading to uncertainty of coverage and insufficient knowledge of factors influencing timely vaccination of this important population. Methods We obtained hepatitis B vaccine (HepB) vaccination histories of premature infants born during 2019–2021 in three provinces from the respective provincial immunization information systems. Extracted data included date of birth, sex, region, and dates of HepB administration. We conducted descriptive analyses that included basic characteristics of the study subjects, HepB-BD administration, and full-series HepB vaccination. Factors potentially influencing HepB-BD and full series vaccination were analyzed by logistic regression. Results There were 1623 premature infants included in the analytic data set. Overall HepB-BD coverage was 71.41%; coverage among premature infants born to mothers with unknown hepatitis B surface antigen (HBsAg) status was 69.57%; coverage was higher at county-level-and-above hospitals (72.02%) than hospitals below county level (61.11%). Full-series HepB coverage was 94.15%; full-series coverage among preterm infants weighing less than 2000 g at birth was 76.92%. Logistic regression showed that the HepB-BD vaccination rate was positively associated with being born to an HBsAg-positive mother and being preterm with high birth weight. Regression analysis for factors influencing full-series HepB coverage showed that being born prematurely was positively associated with full-series coverage and being premature with a very low birth weight was negatively associated with full-series coverage. Conclusions HepB-BD coverage levels in three provinces of China were less than the target of 90%, especially among premature infants born to mothers with unknown HBsAg status and at hospitals below the county level. Screening of pregnant women should be a universal normal standard. Hepatitis B vaccination training should be strengthened in hospitals to improve the HepB-BD vaccination rate of premature infants and to effectively prevent mother-to-child transmission of hepatitis B virus.
Læs mere Tjek på PubMedHung-Wei Wang, Yen-Chung Wang, Yun-Ting Huang, Ming-Yan Jiang
PLoS One Infectious Diseases, 9.09.2024
Tilføjet 9.09.2024
by Hung-Wei Wang, Yen-Chung Wang, Yun-Ting Huang, Ming-Yan Jiang Background Hepatitis C virus (HCV) infection affects men and women differently, yet few studies have investigated sex differences in long-term mortality risk among the HCV-infected population. We conducted a population-based study to elucidate all-cause and cause-specific mortality among men and women with HCV infection. Methods The study population consisted of adult participants from the 1999–2018 National Health and Nutrition Examination Survey, including 945 HCV-infected and 44,637 non-HCV-infected individuals. HCV infection was defined as either HCV seropositivity or detectable HCV RNA. Participants were followed until the date of death or December 31, 2019, to determine survival status. Results The HCV-infected population, both male and female, tended to be older, more likely to be Black, single, have lower income, lower BMI, higher prevalence of hypertension, and were more likely to be current smokers. During a median follow-up of 125.0 months, a total of 5,309 participants died, including 1,253 deaths from cardiovascular disease (CVD) and 1,319 deaths from cancer. The crude analysis showed that the risk of death from all causes and from cancer, but not from CVD, was higher in the HCV-infected population. After adjusting for potential confounders, we found that both HCV-infected men (HR 1.41, 95% CI 1.10–1.81) and women (HR 2.03, 95% CI 1.36–3.02) were equally at increased risk of all-cause mortality compared to their non-HCV infected counterparts (p for interaction > 0.05). The risk of cancer-related mortality was significantly increased in HCV-infected women (HR 2.14, 95% CI 1.01–4.53), but not in men, compared to non-HCV-infected counterparts. Among HCV-infected population, there was no difference in the risks of all-cause, CVD-related, or cancer-related death between men and women. Conclusion Both men and women with HCV infection had an increased risk of death from all causes compared to their non-HCV infected counterparts, but we did not observe a significant sex difference.
Læs mere Tjek på PubMedMatthew J. Akiyama, Yury Khudyakov, Sumathi Ramachandran, Lindsey Riback, Maxwell Ackerman, Mercy Nyakowa, Leonard Arthur, John Lizcano, Josephine Walker, Peter Cherutich, Ann Kurth
International Journal of Infectious Diseases, 8.09.2024
Tilføjet 8.09.2024
An estimated 58 million individuals are infected with Hepatitis C virus (HCV) globally [1]. Left untreated, HCV can progress to cirrhosis, hepatocellular carcinoma, and liver failure. Viral hepatitis is in the top ten causes of death globally with 1.3 million deaths in 2022 [2]. Without effective treatment and prevention interventions, 19 million viral hepatitis-related deaths are anticipated by 2030 [3]. Moreover, HCV-related mortality rates are expected to climb for the next two decades, compared to decreasing annual deaths of HIV, tuberculosis, and malaria, especially in low- and middle-income countries (LMICs) if treatment is not adequately accessible [2].
Læs mere Tjek på PubMedPiotr Rzymski, Aliyu Tijani Jibril, Laila Rahmah, Sunny O. Abarikwu, Fareeda Hashem, Abdullah Al Lawati, Fiona McGowan Martha Morrison, Leander Penaso Marquez, Kawthar Mohamed, Amjad Khan, Saima Mushtaq, Kseniia Minakova, Barbara Poniedziałek, Dorota Zarębska‐Michaluk, Robert Flisiak
Journal of Medical Virology, 6.09.2024
Tilføjet 6.09.2024
BMC Infectious Diseases, 6.09.2024
Tilføjet 6.09.2024
Abstract Background Although hepatitis B infection is highly endemic in Africa, information on its epidemiology among pregnant women in the region is limited. Therefore, this systematic review provided up-to-date information on the epidemiology of hepatitis B virus (HBsAg) infection among pregnant women in Africa. Methods A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews. The Web of Science, Scopus, PubMed, Google Scholar, and African journals online were searched to identify relevant studies published between January 1, 2015, and May 21, 2024, on hepatitis B virus infection in pregnant women living in Africa. The Joanna Briggs Institute tool was used to assess the methodological qualities of the included studies. The random effects model was used to estimate the pooled prevalence of HBV infection. I2 assessed the amount of heterogeneity. Publication bias was assessed using Egger’s test and a funnel plot. Results We included 91 studies from 28 African countries. The pooled prevalence of hepatitis B infection among pregnant women in Africa was 5.89% (95% CI: 5.26–6.51%), with significant heterogeneity between studies (I2 = 97.71%, p
Læs mere Tjek på PubMedMaria Casares-Jimenez Diana Corona-Mata Transito Garcia-Garcia Leticia Manchado-Lopez Lucia Rios-Muñoz Maria de Guia-Castro Pedro Lopez-Lopez David Caceres-Anillo Angela Camacho Javier Caballero-Gomez Ignacio Perez-Valero Marina Gallo-Marin Ana Belen Perez Rainer G. Ulrich Antonio Rivero-Juarez Antonio Rivero a Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Españab CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III. Majadahonda, Madrid, Españac Immunogenomic and Molecular Pathogenesis, Zoonoses and Emerging Diseases Unit (ENZOEM), Genetic Department, University of Cordoba, Cordoba, Spaind Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Españae Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes (ENZOEM), Universidad de Córdoba, Córdoba, Españaf Unidad de Microbiología, Hospital Universitario Reina Sofía, Córdoba, Españag Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germanyh German Centre for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Greifswald-Insel Riems, Germany
Emerg Microbes Infect, 6.09.2024
Tilføjet 6.09.2024
BMC Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
Abstract Background Aortic valve infective endocarditis (IE) is associated with significant morbidity and mortality. We aimed to describe the clinical profile, risk factors and predictors of short- and long-term mortality in patients with aortic valve IE treated with aortic valve replacement (AVR) compared with a control group undergoing AVR for non-infectious valvular heart disease. Methods Between January 2008 and December 2013, a total of 170 cases with IE treated with AVR (exposed cohort) and 677 randomly selected non-infectious AVR-treated patients with degenerative aortic valve disease (controls) were recruited from three tertiary hospitals with cardiothoracic facilities across Scandinavia. Crude and adjusted hazard ratios (HR) were estimated using Cox regression models. Results The mean age of the IE cohort was 58.5 ± 15.1 years (80.0% men). During a mean follow-up of 7.8 years (IQR 5.1-10.8 years), 373 (44.0%) deaths occurred: 81 (47.6%) in the IE group and 292 (43.1%) among controls. Independent risk factors associated with IE were male gender, previous heart surgery, underweight, positive hepatitis C serology, renal failure, previous wound infection and dental treatment (all p
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
Abstract Background Universal antiretroviral treatment (ART) for pregnant women has reduced mother-to-child transmission risk significantly. However, not all women on ART are virally suppressed during pregnancy and lactation. In addition to poor adherence to ART, co-infections particularly other sexually transmitted infections (STIs) are known to increase the risk of HIV acquisition and HIV transmission. While the prevalence of STIs during pregnancy has been well studied, the prevalence of STIs in the postpartum period and its association with HIV viral suppression are underreported. Methods In this cross-sectional study, we determined the prevalence of STIs among adolescent girls and young women (AGYW) living with HIV (WLHIV) and without HIV (WNLHIV) at their 6–14 week postnatal clinic visit in a high HIV prevalence district in South Africa. All women were examined for STI-related symptoms and had vaginal swabs collected and stored for later STI testing. Vaginal swabs were tested for Trichomonas vaginalis (T.vaginalis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoea) and herpes simplex virus-2 (HSV-2) using PCR. All women were tested for bacterial vaginosis (BV) using the Nugent scoring criteria. WLHIV had a blood sample collected for HIV viral load, Hepatitis B and syphilis. Results Included in this analysis were 82 WLHIV and 102 WNLHIV. Between 6 and 14 weeks postpartum, 40 (21.7%) AGYW tested positive for any STI and among these 15 (37.5%) were symptomatic and received empirical treatment. C. trachomatis was most commonly detected (10.9%), followed by HSV-2 (7.7%), T. vaginalis (3.8%) and N. gonorrhoea (1.6%). WLHIV were more likely to test positive for an STI (OR 2.0; 0.96–3.96) and BV (OR 4.2; 95%CI 2.1–8.1) compared to WNLHIV. Among WLHIV on ART, 70.5% had an undetectable plasma viral load (PVL) and 20.5% had a PVL > 1000 copies/ml. Testing positive for any STI or BV at the postpartum visit was not associated with PVL > 1000 copies/ml (OR 1.33; 95%CI 0.38–4.64). Conclusion We report a high prevalence of largely asymptomatic STIs and BV in the early postpartum period and STIs in WLHIV were not associated with unsuppressed PVL.The high STI positivity rate among WNLHIV has implications for HIV risk during the postpartum period, and subsequently breastfeeding transmission.
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
Abstract Background Most Chinese blood centers have implemented mini pool (MP) HBV nucleic acid testing (NAT) together with HBsAg ELISA in routine blood donor screening for HBV infection since 2015, and a few centers upgraded MP to individual donation (ID) NAT screening recently, raising urgent need for cost-benefit analysis of different screening strategies. In an effort to prevent transfusion-transmitted infections (TTIs) for HBV, cost-benefit analyses of three different screening strategies: HBsAg alone, HBsAg plus MP NAT and HBsAg plus ID NAT were performed in blood donors from southern China where HBV infection was endemic. Methods MP-6 HBV NAT and ID NAT were adopted in parallel to screen blood donors for further comparative analysis. On the basis of screening data and the documented parameters, the number of window period (WP) infection, HBV acute infection, chronic hepatitis B infection (CHB) and occult hepatitis B infection (OBI) was evaluated, and the potential prevented HBV TTIs and benefits of these three strategies were predicted based on cost-benefit analysis by an estimation model. Results Of 132,323 donations, the yield rate for HBsAg-/DNA + screened by ID NAT (0.12%) was significantly higher than that by MP NAT (0.058%, P
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