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Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Journal of Medical Virology, 2.12.2022
Tilføjet 3.12.2022
Lancet Infectious Diseases, 3.12.2022
Tilføjet 3.12.2022
The 2022 monkeypox outbreak has affected 110 countries worldwide, outside of classic endemic areas (ie, west Africa and central Africa). On July 23, 2022, the outbreak was classified by WHO as a public health emergency of international concern. Clinical presentation varies from mild to life-changing symptoms; neurological complications are relatively uncommon and there are few therapeutic interventions for monkeypox disease. In this Grand Round, we present a case of monkeypox with encephalitis complicated by transverse myelitis in a previously healthy woman aged 35 years who made an almost complete recovery from her neurological symptoms after treatment with tecovirimat, cidofovir, steroids, and plasma exchange.
Læs mere Tjek på PubMedInternational Journal of Infectious Diseases, 2.12.2022
Tilføjet 3.12.2022
Human monkeypox virus infection is the recently declared public health emergency of international concern (PHEIC) by the World Health Organization. Besides, there is scanty literature available on the use of antivirals in monkeypox virus infection. This systematic review compiles all evidence of various antivirals used on their efficacy, safety and summarizes their mechanisms of action.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 3.12.2022
Tilføjet 3.12.2022
AbstractWe estimated the effectiveness of a fourth dose of mRNA COVID-19 vaccine against Omicron infections and severe outcomes over time among long-term care residents in Ontario, Canada. Fourth doses provide additional protection against Omicron-related outcomes, but the protection wanes over time, with more waning seen against infection than severe outcomes.
Læs mere Tjek på PubMedClinical Infectious Diseases, 3.12.2022
Tilføjet 3.12.2022
AbstractBackgroundOld age is an important risk factor for developing cancer, but few data exist on this association in people with HIV (PWH) in sub-Saharan Africa.MethodsThe South African HIV Cancer Match study is a nationwide cohort of PWH based on a linkage between HIV-related laboratory records from the National Health Laboratory Services and cancer diagnoses from the National Cancer Registry for 2004-2014. We included PWH who had HIV-related tests on separate days. Using natural splines, we modelled cancer incidence rates as a function of age.ResultsWe included 5,222,827 PWH with 29,580 incident cancer diagnoses – most commonly cervical cancer (n = 7418), Kaposi sarcoma (n = 6380), and breast cancer (n = 2748). In young PWH, the incidence rates for infection-related cancers were substantially higher than for infection-unrelated cancers. At age 40 years, the most frequent cancer was cervical cancer in female and Kaposi sarcoma in male PWH. Thereafter, the rates of infection-unrelated cancers increased steeply, particularly among male PWH, where prostate cancer became the most frequent cancer type at older age. While Kaposi sarcoma rates peaked at 34 years (101/100,000 person-years) in male PWH, cervical cancer remained the most frequent cancer among older female PWH.ConclusionsInfection-related cancers are common in PWH in South Africa, but rates of infection-unrelated cancers overtook those of infection-related cancers after age 54 years in the overall study population. As PWH in South Africa live longer, prevention and early detection of infection-unrelated cancers becomes increasingly important. Meanwhile, control strategies for infection-related cancers, especially cervical cancer, remain essential.
Læs mere Tjek på PubMedBMJ Open, 2.12.2022
Tilføjet 3.12.2022
IntroductionThe management of mid and low rectal cancer is based on neoadjuvant chemoradiotherapy (CRT) followed by standardised surgery. There is no biomarker in rectal cancer to aid clinicians in foreseeing treatment response. The determination of factors associated with treatment response might allow the identification of patients who require tailored strategies (eg, therapeutic de-escalation or intensification). Colibactin-producing Escherichia coli (CoPEC) has been associated with aggressive colorectal cancer and could be a poor prognostic factor. Currently, no study has evaluated the potential association between intestinal microbiota composition and tumour response to CRT in mid and low rectal cancer. The aim of this study is to assess the association between response to neoadjuvant CRT and faecal intestinal microbiota composition and/or CoPEC prevalence in patients with mid or low rectal cancer.Methods and analysisThis is a non-randomised bicentric prospective clinical study with a recruitment capacity of 200 patients. Three stool samples will be collected from participants with histological-proven adenocarcinome of mid or low rectum who meet eligibility criteria of the study protocol: one before neoadjuvant treatment start, one in the period between CRT end and surgery and one the day before surgery. In each sample, CoPEC will be detected by culture in special media and molecular (PCR) approaches. The global microbiota composition will be also assessed by the bacterial 16S rRNA gene sequencing. Neoadjuvant CRT response and tumour regression grade will be described using the Dworak system at pathological examination. Clinical data and survival outcomes will also be collected and investigated.Ethics and disseminationMICARE was approved by the local ethics committee (Comité de Protection des Personnes Sud-Est II, 18 December 2019. Reference number 2019-A02493-54 and the institutional review board. Patients will be required to provide written informed consent. Results will be published in a peer reviewed journal.Trial registration numberNCT04103567.
Læs mere Tjek på PubMedNat Rev Microbiol, 2.12.2022
Tilføjet 3.12.2022
Malaria Journal, 2.12.2022
Tilføjet 2.12.2022
Abstract Background The rate of decay of the biological efficacy of insecticides used for indoor residual spraying (IRS) is an important factor when making decisions on insecticide choice for national malaria control programmes. A key roadblock to IRS programme is insecticide resistance. If resistance is detected to most of the existing insecticides used for IRS (DDT, pyrethroids, organophosphates and carbamates), the logical next choice could be neonicotinoid insecticides, as pyrethroids are used to treat nets. SumiShield™ 50WG belongs to the neonicotinoid class of insecticides and has shown promising results in several phase I, II and III trials in different settings. The aim of this study was to assess the persistence of SumiShield™ 50WG by spraying on different wall surfaces and determine its decay rates over time in Ethiopia. Methods Five huts with different wall surface types (mud, dung, paint and cement) which represented the Ethiopian house wall surfaces were used to evaluate the residual efficacy of SumiShield™ 50WG. Actellic 300CS sprayed on similar wall surfaces of another five huts was used as a comparator insecticide and two huts sprayed with water were used as a control. All huts were sprayed uniformly by an experienced spray operator; non-stop starting from the door and moving clockwise to cover the entire wall surface of the hut. The treatments were assigned to huts randomly. The residual efficacy of the insecticide formulations was evaluated against a susceptible insectary-reared population of Anopheles arabiensis using WHO cone bioassays. Results SumiShield™ 50WG resulted in mortality rates of over 80% at 120 h post-exposure on all surface types for up to nine months post-spray, while Actellic 300CS yielded mortality rates of over 80% for eight months after spray. Conclusions The results of this trial demonstrated that the residual efficacy of SumiShield™ 50WG extends up to nine months on all treated wall surface types. The long-lasting residual efficacy and unique mode of action of the SemiShield™ 50WG shows that it could be an ideal product to be considered as a potential candidate insecticide formulation for IRS in malaria endemic countries such as Ethiopia or other sub-Saharan countries where the transmission season lasts up to four months or longer.
Læs mere Tjek på PubMedMalaria Journal, 2.12.2022
Tilføjet 2.12.2022
Abstract Background Cambodia has made significant progress towards achieving malaria elimination by 2025. Cases continue to decrease and are primarily concentrated in forested areas. Forest-goers are most at risk of malaria due to their proximity to the forest, poor sleeping conditions, frequent mobility, and distance from health services. Consistent use of long-lasting insecticidal nets or hammock nets (LLINs/LLIHNs), early diagnosis and treatment of cases are central to reducing disease burden. The aim of this study was to understand forest-goers’ knowledge, attitudes, and practices related to malaria prevention and care-seeking, and to identify key behavioural determinants of LLIN/LLIHN use and prompt care-seeking within 24 h of developing a fever. Methods A mixed-methods study design consisting of a cross-sectional survey and qualitative in-depth interviews was implemented in two Cambodian provinces. Survey participants (N = 654) were recruited using respondent driven sampling. Interview participants (N = 28) were selected using purposive sampling. Findings from the survey were analysed using univariate and bivariate analysis and multivariate weighted logistic regression. Interviews were coded and analysed using thematic content analysis. Results All study participants had heard of malaria and 98% knew that malaria was transmitted by mosquitoes. LLIN/LLIHN ownership was high (94%). Although 99% of participants perceived LLIN/LLIHN use as an important malaria prevention measure, only 76% reported using one during their last visit to the forest. Only 39% of survey participants who reported seeking care did so within the recommended 24 h from fever onset during their last febrile illness. Among all study participants, 43% did not seek any healthcare during their last febrile episode. In controlled regression models, perceived community social norms were significantly associated with LLIN/LLIHN use (OR: 2.7, 96% CI 1.99–2.64) and care-seeking within 24 h of fever onset (OR: 1.7, 95% CI 1.00–2.88). Social support from other forest-goers was also significantly associated with LLIN/LLIHN use (OR: 4.9, 95% CI 1.32–18.12). Conclusions Study findings are consistent with other studies on LLIN/LLIHN use and care-seeking behaviours. While rates of LLIN/LLIHN ownership were high among the study population, rates of use were not as high. More concerning were the delayed care-seeking behaviours. Social behaviour change activities should incorporate social norms and social support as mechanisms for behaviour change given the identified positive correlations with LLIN/LLIHN use and prompt care-seeking.
Læs mere Tjek på PubMedMalaria Journal, 2.12.2022
Tilføjet 2.12.2022
Abstract Background Malaria transmission can be highly heterogeneous between and within localities, and is influenced by factors such as survival and biting frequencies of Anopheles mosquitoes. This study investigated the relationships between the biological age, distance from aquatic habitats and pyrethroid resistance status of Anopheles funestus mosquitoes, which currently dominate malaria transmission in south-east Tanzania. The study also examined how such relationships may influence malaria transmission and control. Methods Female An. funestus were collected in houses located 50–100 m, 150–200 m or over 200 m from the nearest known aquatic habitats. The mosquitoes were exposed to 1×, 5× and 10× the diagnostic doses of deltamethrin or permethrin, or to the synergist, piperonyl butoxide (PBO) followed by the pyrethroids, then monitored for 24 h-mortality. Ovaries of exposed and non-exposed mosquitoes were dissected to assess parity as a proxy for biological age. Adults emerging from larval collections in the same villages were tested against the same insecticides at 3–5, 8–11 or 17–20 days old. Findings Mosquitoes collected nearest to the aquatic habitats (50-100 m) had the lowest mortalities compared to other distances, with a maximum of 51% mortality at 10× permethrin. For the age-synchronized mosquitoes collected as larvae, the insecticide-induced mortality assessed at both the diagnostic and multiplicative doses (1×, 5× and 10×) increased with mosquito age. The highest mortalities at 1× doses were observed among the oldest mosquitoes (17–20 days). At 10× doses, mortalities were 99% (permethrin) and 76% (deltamethrin) among 8–11 day-olds compared to 80% (permethrin) and 58% (deltamethrin) among 3–5 day-olds. Pre-exposure to PBO increased the potency of both pyrethroids. The proportion of parous females was highest among mosquitoes collected farthest from the habitats. Conclusion In this specific setting, older An. funestus and those collected farthest from the aquatic habitats (near the centre of the village) were more susceptible to pyrethroids than the younger ones and those caught nearest to the habitats. These findings suggest that pyrethroid-based interventions may remain at least moderately effective despite widespread pyrethroid-resistance, by killing the older, less-resistant and potentially-infective mosquitoes. Further studies should investigate how and whether these observations could be exploited to optimize malaria control in different settings.
Læs mere Tjek på PubMedMalaria Journal, 2.12.2022
Tilføjet 2.12.2022
Abstract Background The use of insecticide-treated bed nets has been proven to be effective in reducing malaria transmission in highly endemic areas. Use of long-lasting insecticidal nets (LLINs) has been embraced by many malaria endemic countries. LLINs are up to 95% effective in inhibiting blood feeding, when used consistently even after 7 years. The challenge, however, is enhancing their consistent use, especially by the most vulnerable groups (children under 5 years and pregnant women). The study established factors associated with consistent use of bed nets for malaria control among children under 5 years in Soroti district. Methods The study employed a cross-sectional design, with multi-stage sampling of households. A total of 400 households (HH) were sampled and the HH head in each household interviewed. Key informant interviews (KIIs) were conducted with 7 key informants who were knowledgeable on the subject matter. Data analysis was done using SPSS 17.0 at Univariate, Bivariate and Multivariable levels; after entry and cleaning. Key informants’ data were summarized manually; verbatim quotes and text used to reinforce quantitative data in line with objectives. Results Only 56.8% of the 690 children under 5 years used bed nets consistently. The factors affecting consistent bed net use were age of the child, their use of bed nets the previous night, occupation of caretaker, respondents’ perceived susceptibility, perceived risk of getting malaria, size and shape of the bed nets. Rectangular nets were difficult to hang daily in huts according to most key informants. Conclusion Consistent bed net use among under fives is still below the RBM target of 85% by 2015 and can be enhanced by providing conical bed nets and setting aside a health education programme to emphasize the effectiveness of even one mosquito in spreading malaria at night to the entire household and ability of bed nets to stop transmission better than other methods.
Læs mere Tjek på PubMedTropical Medicine & International Health, 1.12.2022
Tilføjet 2.12.2022
Tropical Medicine &International Health, Volume 27, Issue 12, Page 1025-1025, December 2022.
Læs mere Tjek på PubMedInternational Journal of Infectious Diseases, 1.12.2022
Tilføjet 2.12.2022
We read with interest the Danish population-based study estimating the risk of significant drug-drug interactions (DDIs) with the antiviral component nirmatrelvir of the drug combination nirmatrelvir/ritonavir (NMV/r) in the age groups ≥65 years and ≥ 80 years (Larsen, 2022). The study highlights the potentially detrimental effects of DDIs if this antiviral treatment is used as part of polypharmacy in this elderly population at high risk for the progression of SARS-CoV-2 infection to severe COVID-19.
Læs mere Tjek på PubMedInternational Journal of Infectious Diseases, 1.12.2022
Tilføjet 2.12.2022
The study showed that simvastatin or lovastatin were used by 15.45 % of people ≥65 years and 17.70 % of people ≥80 years (Larsen 2022). Coadministration of simvastatin or lovastatin with ritonavir is contraindicated, as ritonavir increases the concentration of these statins 100-fold with risk of severe toxicity including rhabdomyolysis (1) (Marzolini et al., 2022a). In cases were coadministration of nirmatrelvir/ritonavir with a drug is contraindicated, there is 3 options either pause the drug, replace the drug, or consider another antiviral treatment of early COVID-19 (Marzolini et al., 2022b).
Læs mere Tjek på PubMedClinical Microbiology and Infection, 1.12.2022
Tilføjet 2.12.2022
The diagnosis of urinary tract infection (UTI) relies on quantitative identification of uropathogenic microorganisms in urine specimens from patients with relevant symptoms [1]. According to international guidelines, the quantitative threshold of bacteriuria compatible with symptomatic UTI is 105 bacteria·ml-1 [1]. Most urine samples are contaminated by the urogenital microbiota containing up to 102 microorganisms·ml-1 that may rapidly proliferate in urine. Consequently, this may lead to false-positive culture results, misleading diagnostic work-up, wrong diagnosis and inappropriate antibiotic therapy [2].
Læs mere Tjek på PubMedPatten, Gabriela E; Euvrard, Jonathan; Anderegg, Nanina; Boulle, Andrew; Arendse, Kirsten D; Heyden, Erin von-der; Ford, Nathan; Davies, Mary-Ann
AIDS, 2.12.2022
Tilføjet 2.12.2022
Objective: Despite improved access to antiretroviral therapy (ART) for people living with HIV (PLHIV), HIV continues to contribute considerably to morbidity and mortality. Increasingly, advanced HIV disease (AHD) is found among PLHIV who are ART-experienced.Design: Using a multi-state model we examined associations between engagement with care and AHD on ART in South Africa.Methods: Using data from IeDEA Southern Africa, we included PLHIV from South Africa, initiating ART from 2004–2017 aged >5 years with a CD4 cell count at ART start and ≥1 subsequent measure. We defined a gap as no visit for ≥18 months. Five states were defined: “AHD on ART” (CD4
Læs mere Tjek på PubMedYuan, Zhe; Giron, Leila B.; Hart, Colin; Gyampoh, Akwasi; Koshy, Jane; Hong, Kai Ying; Niki, Toshiro; Premeaux, Thomas A.; Ndhlovu, Lishomwa C.; Deleage, Claire; Montaner, Luis J.; Abdel-Mohsen, Mohamed
AIDS, 2.12.2022
Tilføjet 2.12.2022
Objective: The human endogenous protein Galectin-9 (Gal-9) reactivates latently HIV-infected cells in vitro and ex vivo, which may allow for immune-mediated clearance of these cells. However, Gal-9 also activates several immune cells, which could negatively affect HIV persistence by promoting chronic activation/exhaustion. This potential “double-edged sword” effect of Gal-9 raises the question of the overall impact of Gal-9 on HIV persistence in vivo.Design: We used the BLT (bone marrow, liver, thymus) humanized mouse model to evaluate the impact of Gal-9 on HIV persistence in vivo during antiretroviral therapy (ART).Methods: Two independent cohorts of ART-suppressed HIV-infected BLT mice were treated with either recombinant Gal-9 or PBS control. Plasma viral loads and levels of tissue-associated HIV DNA and RNA were measured by qPCR. Immunohistochemistry and HIV RNAscope were used to quantify CD4+ T, myeloid, and HIV RNA+ cells in tissues. T cell activation and exhaustion were measured by flow cytometry, and plasma markers of inflammation were measured by multiplex cytokine arrays.Results: Gal-9 did not induce plasma markers of inflammation or T cell markers of activation/exhaustion in vivo. However, the treatment significantly increased levels of tissue-associated HIV DNA and RNA compared to controls (P = 0.0007 and P = 0.011, respectively, for cohort I and P = 0.002 and P = 0.005, respectively, for cohort II). RNAscope validated the Gal-9 mediated induction of HIV RNA in tissue-associated myeloid cells, but not T cells.Conclusions: Our study highlights the overall adverse effects of Gal-9 on HIV persistence and the potential need to block Gal-9 interactions during ART-suppressed HIV infection.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedHill, Lucas A.; Abulhosn, Kari K.; Yin, Jeffrey F.; Bamford, Laura P.
AIDS, 2.12.2022
Tilføjet 2.12.2022
Objective: To describe our experience evaluating and initiating individuals on long-acting (LAI) cabotegravir/rilpivirine (CAB/RPV) and evaluate factors associated with starting LAI CAB/RPV and reasons for not starting.Design: We conducted a retrospective single center study at the UC San Diego Owen ClinicMethods: We included all individuals who expressed interest in treatment with LAI CAB/RPV between April 2021 and June 2022 who had a definitive decision made on starting LAI CAB/RPV.Results: In total 383 individuals were included with 201 (52.5%) initiating LAI CAB/RPV. Those that initiated LAI CAB/PRV were younger (p = 0.02) and were more likely to be on a two-drug regimen or 1st generation integrase inhibitor regimen and less likely to be on a protease inhibitor or multi-class regimen. The most common reasons for not starting LAI CAB/RPV were inconsistent clinic attendance or difficulty being contacted and patient choice not to start. Of those that had a proviral DNA resistance test as work up for LAI CAB/RPV (n = 135) 18.5% had a resistance mutation identified that may have impacted the activity of LAI CAB/RPV.Conclusion: Despite novel challenges over half of our cohort initiated LAI CAB/RPV. Evaluating for potential NNRTI resistance is an important part of the work up for LAI CAB/RPV and proviral DNA resistance testing can be an additional tool to identify potential resistance.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedClinical Infectious Diseases, 2.12.2022
Tilføjet 2.12.2022
AbstractBackgroundHousehold contact investigation for people newly diagnosed with tuberculosis (TB) is poorly implemented, particularly in low- and middle-income countries. Conditional cash incentives may improve uptake.MethodsWe conducted a pragmatic, cluster randomized cross-over trial of two TB contact investigation approaches (household-based and incentive-based) in 28 public primary care clinics in South Africa. Each clinic used one approach for 18 months, followed by a six-month washout period, after which the opposite approach was used. Fourteen clinics were randomized to each approach. In the household-based arm, we conducted TB screening and testing of contacts at the household. In the incentive-based arm, both index patients and up to ten of their close contacts (either within or outside the household). were given small cash incentives for presenting to study clinics for tuberculosis screening. The primary outcome was the number of people with incident tuberculosis who were diagnosed and started on treatment at study clinics.ResultsFrom July 2016 to January 2020, we randomized 28 clinics to each study arm, and enrolled 782 index tuberculosis patients and 1882 contacts in the household-based arm, and 780 index patients and 1940 contacts in the incentive-based arm. 1,413 individuals started on tuberculosis treatment in the household-based arm, and 1,510 in the incentive-based arm. The adjusted incidence rate ratio of tuberculosis treatment initiation in the incentive versus household-based arm was 1.05 (95% CI:0.97-1.13).ConclusionIncentive-based contact investigation for tuberculosis has similar effectiveness to traditional household-based approaches and may be a viable alternative or complementary approach to household-based investigation.
Læs mere Tjek på PubMedClinical Infectious Diseases, 2.12.2022
Tilføjet 2.12.2022
ABSTRACTBackgroundThis study compared admission incidence risk across waves, and the risk of mortality in the Omicron BA.4/BA.5 wave, to the Omicron BA.1/BA.2 and Delta waves.MethodsData from South Africa’s national hospital surveillance system, SARS-CoV-2 case linelist and Electronic Vaccine Data System were linked and analysed. Wave periods were defined when the country passed a weekly incidence of 30 cases/100,000 people. In-hospital case fatality ratios (CFR) in the Delta, Omicron BA.1/BA.2 and Omicron BA.4/BA.5 wave periods were compared by post-imputation random effect multivariable logistic regression models.ResultsThe CFR was 25.9% (N = 37,538/144,778), 10.9% (N = 6,123/56,384) and 8.2% (N = 1,212/14,879) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves respectively. After adjusting for age, sex, race, comorbidities, health sector and province, compared to the Omicron BA.4/BA.5 wave, patients had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR] 1.3; 95% confidence interval [CI] 1.2-1.4) and Delta (aOR 3.0; 95% CI 2.8-3.2) wave. Being partially vaccinated (aOR 0.9, CI 0.9-0.9), fully vaccinated (aOR 0.6, CI 0.6-0.7) and boosted (aOR 0.4, CI 0.4-0.5); and prior laboratory-confirmed infection (aOR 0.4, CI 0.3-0.4) were associated with reduced risks of mortality.ConclusionOverall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa’s first three waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased.
Læs mere Tjek på PubMed