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BMC Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
Abstract Background Concurrent non-alcoholic fatty liver disease (NAFLD) is common in patients with chronic HBV infection. But the impact of fatty liver on the histologic progression of HBV infection remains controversial. Methods Consecutive HBV-infected patients who underwent liver biopsy between 2016 and 2021 were included. Alcohol consumption and other types of viral hepatitis were excluded. All biopsies were scored for grading and staging by Scheuer’s score, and the steatosis was scored as an estimate of the percentage of liver parenchyma replaced by fat. Logistic regression analyses were applied to assess the associated factors for significant liver inflammation (G ≥ 2), significant fibrosis (S ≥ 2) and advanced fibrosis (S ≥ 3). Results Among the 871 HBV-infected patients, hepatic steatosis was prevalent in 255 patients (29.28%). Significant liver inflammation was present in 461 patients (52.93%). Significant fibrosis was observed in 527 patients (60.51%), while advanced liver fibrosis was observed in 171 patients (19.63%). Patients with concomitant NAFLD were more likely to have significant liver inflammation and advanced fibrosis. Fatty liver was an independent risk factor for significant liver inflammation (OR: 2.117, 95% CI: 1.500-2.988), but it could not predict the development of fibrosis. Especially, in HBV-infected patients with persistent normal ALT (immune tolerant and inactive carrier phase), the presence of significant liver inflammation was higher in NAFLD than those without NAFLD. The prevalence of advanced liver fibrosis was higher in NAFLD than non-NAFLD only in the immune tolerant phase, while NAFLD did not increase fibrosis burden in other stages of HBV infection. We developed a predictive model for significant liver inflammation with the area under receiver operating characteristic curve (AUROC) of 0.825, and a model for significant fibrosis with the AUROC of 0.760. Conclusions NAFLD is independently associated with significant liver inflammation, and increases the burden of advanced liver fibrosis in HBV-infected patients. The influence of NAFLD on the degree of liver inflammation and fibrosis is different in distinct clinical phases of chronic HBV infection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
Abstract Background The incidence of stroke is increasing among younger people with human immunodeficiency virus (HIV). The burden of stroke has shifted toward the young people living with HIV, particularly in low- and middle-income countries. People infected with herpes zoster (HZ) were more likely to suffer stroke than the general population. However, the association of HZ infection with the incidence of stroke among patients with HIV remains unclear. Methods A nested case–control study was conducted with patients with HIV registered in the Taiwan National Health Insurance Research Database in 2000–2017. A total of 509 stroke cases were 1:10 matched to 5090 non-stroke controls on age, sex, and date of first stroke diagnosis. Logistic regression models were used to estimate the odds ratio and 95% confidence intervals (CI) of stroke incidence. Results The odds ratio of stroke was significantly higher in the HIV-infected population with HZ (adjusted odds ratio [AOR]: 1.85, 95% CI: 1.42–2.41). A significantly increased AOR of stroke was associated with hypertension (AOR: 3.53, 95% CI: 2.86–4.34), heart disease (AOR: 2.32, 95% CI: 1.54–3.48), chronic kidney disease (AOR: 1.82, 95% CI: 1.16–2.85), hepatitis C virus infection (AOR: 1.49, 95% CI: 1.22–1.83), hyperlipidemia (OR: 1.41, 95% CI: 1.12–1.78), and treatment with protease inhibitors (AOR: 1.33, 95% CI: 1.05–1.69). Conclusions Our findings suggest that HZ concurrent with HIV may increase the risk of stroke. The incidence rates of stroke were independent of common risk factors, suggesting strategies for early prevention of HZ infection among people living with HIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
Abstract Background Multidrug-resistant tuberculosis (MDR–TB) remains a major public health problem in many high tuberculosis (TB) burden countries. Phenotypic drug susceptibility testing (DST) take several weeks or months to result, but line probe assays and Xpert/Rif Ultra assay detect a limited number of resistance conferring gene mutations. Whole genome sequencing (WGS) is an advanced molecular testing method which theoretically can predict the resistance of M. tuberculosis (Mtb) isolates to all anti-TB agents through a single analysis. Methods Here, we aimed to identify the level of concordance between the phenotypic and WGS-based genotypic drug susceptibility (DS) patterns of MDR–TB isolates. Overall, data for 12 anti-TB medications were analyzed. Results In total, 63 MDR–TB Mtb isolates were included in the analysis, representing 27.4% of the total number of MDR–TB cases in Latvia in 2012–2014. Among them, five different sublineages were detected, and 2.2.1 (Beijing group) and 4.3.3 (Latin American-Mediterranean group) were the most abundant. There were 100% agreement between phenotypic and genotypic DS pattern for isoniazid, rifampicin, and linezolid. High concordance rate (> 90%) between phenotypic and genotypic DST results was detected for ofloxacin (93.7%), pyrazinamide (93.7%) and streptomycin (95.4%). Phenotypic and genotypic DS patterns were poorly correlated for ethionamide (agreement 56.4%), ethambutol (85.7%), amikacin (82.5%), capreomycin (81.0%), kanamycin (85.4%), and moxifloxacin (77.8%). For capreomycin, resistance conferring mutations were not identified in several phenotypically resistant isolates, and, in contrary, for ethionamide, ethambutol, amikacin, kanamycin, and moxifloxacin the resistance-related mutations were identified in several phenotypically sensitive isolates. Conclusions WGS is a valuable tool for rapid genotypic DST for all anti-TB agents. For isoniazid and rifampicin phenotypic DST potentially can be replaced by genotypic DST based on 100% agreement between the tests. However, discrepant results for other anti-TB agents limit their prescription based solely on WGS data. For clinical decision, at the current level of knowledge, there is a need for combination of genotypic DST with modern, validated phenotypic DST methodologies for those medications which did not showed 100% agreement between the methods.
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
Abstract Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.
Læs mere Tjek på PubMedDuong Huu Tong, Bui Phuong Uyen, Lu Kim Ngan
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Duong Huu Tong, Bui Phuong Uyen, Lu Kim Ngan Introduction In recent decades, especially in higher education, blended learning has become the most commonly used active teaching strategy. Because of the COVID-19 pandemic, blended learning, which combines face-to-face and online components, is believed to overcome the shortcomings of conventional teaching methods, particularly in face-to-face interactions. Based on PRISMA guidelines, this study follows the protocol for a systematic review of blended learning applications in mathematics teacher education. This systematic review study aims to comprehend the potential of blended learning for various mathematical topics, the common blended learning models, and the benefits and challenges this teaching approach presents for educational stakeholders. Methods Searches will be performed in various electronic databases, including Scopus, ScienceDirect, Taylor & Francis Online, Mendeley, Google Scholar, and ERIC. Selected studies that satisfy the inclusion criteria will document the use of various blended learning models in a range of mathematical topics as well as the advantages and disadvantages of this method of instruction. The data extraction process will be carried out independently by various authors, and the results of the data synthesis will be reported per the chosen studies, methodological considerations, and key findings. Discussion This review will provide information about the application of blended learning and its benefits and challenges in mathematics teacher education to support educational stakeholders in mathematics teacher education.
Læs mere Tjek på PubMedZhenyu Zhang, Guizhen Liang, Kangkang Chang
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Zhenyu Zhang, Guizhen Liang, Kangkang Chang A reaction-diffusion hepatitis B virus (HBV) infection model based on the mean-reverting Ornstein-Uhlenbeck process is studied in this paper. We demonstrate the existence and uniqueness of the positive solution by constructing the Lyapunov function. The adequate conditions for the solution’s stationary distribution were described. Last but not least, the numerical simulation demonstrated that reversion rates and noise intensity influenced the disease and that there was a stationary distribution. It was concluded that the solution tends more toward the stationary distribution, the greater the reversion rates and the smaller the noise.
Læs mere Tjek på PubMedInés Mendoza, Alicia Lázaro, Alfredo Espinosa, Lorenzo Sánchez, Ana María Horta, Miguel Torralba
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Inés Mendoza, Alicia Lázaro, Alfredo Espinosa, Lorenzo Sánchez, Ana María Horta, Miguel Torralba Objective Dolutegravir plus lamivudine (2-DR) is suggested as an initial and switch option in HIV-1 treatment. The aim of this study was to analyze the effectiveness, durability, and safety of 2-DR compared to bictegravir/emtricitabine/tenofovir alafenamide (3-DR). Patients and methods This was an observational, ambispective study that included all treatment-naïve (TN) and treatment-experienced (TE) people living with HIV/AIDS (PLWH), who started 2-DR or 3-DR between 01 July 2018, and 31 January 2022. The primary endpoint was non-inferiority, at 24 and 48 weeks, of 2-DR vs 3-DR regarding the percentage of PLWH with viral load (VL)
Læs mere Tjek på PubMedTomás Franco-Bodek, Cecilia Barradas-Ortiz, Fernando Negrete-Soto, Rossanna Rodríguez-Canul, Enrique Lozano-Álvarez, Patricia Briones-Fourzán
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Tomás Franco-Bodek, Cecilia Barradas-Ortiz, Fernando Negrete-Soto, Rossanna Rodríguez-Canul, Enrique Lozano-Álvarez, Patricia Briones-Fourzán Many digenean trematodes require three hosts to complete their life cycle. For Cymatocarpus solearis (Brachycoeliidae), the first intermediate host is unknown; the Caribbean spiny lobster Panulirus argus is a second intermediate host, and the loggerhead turtle Caretta caretta, a lobster predator, is the definitive host. Trophically-transmitted parasites may alter the behavior or general condition of intermediate hosts in ways that increase the hosts’ rates of consumption by definitive hosts. Here, we examined the effects of infection by C. solearis on P. argus by comparing several physiological and behavioral variables among uninfected lobsters (0 cysts) and lobsters with light (1–10 cysts), moderate (11–30 cysts), and heavy (>30 cysts) infections. Physiological variables were hepatosomatic index, growth rate, hemocyte count, concentration in hemolymph of cholesterol, protein, albumin, glucose, dopamine (DA) and serotonin (5-HT). Behavioral variables included seven components of the escape response (delay to escape, duration of swimming bout, distance traveled in a swimming bout, swim velocity, acceleration, force exerted, and work performed while swimming). There was no relationship between lobster size or sex and number of cysts. Significant differences among the four lobster groups occurred only in concentration of glucose (lower in heavily infected lobsters) and 5-HT (higher in heavily and moderately infected lobsters) in plasma. As changes in 5-HT concentration can modify the host’s activity patterns or choice of microhabitat, our results suggest that infection with C. solearis may alter the behavior of spiny lobsters, potentially increasing the likelihood of trophic transmission of the parasite to the definitive host.
Læs mere Tjek på PubMedHalil Özekicioğlu, Burcu Yilmaz, Gamze Alkan, Suzan Oğuz, Ceren Kocabaş, Fatih Boz
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Halil Özekicioğlu, Burcu Yilmaz, Gamze Alkan, Suzan Oğuz, Ceren Kocabaş, Fatih Boz The present study attempts to explore the impacts of COVID-19 on the intra-group electronic product trade of the world’s seven largest economies. In line with this purpose, we performed a complex network analysis of the electronic product trade of the group of seven (G-7) countries and China, as well as a panel data study comprising solely the G-7 countries. In this regard, we investigated the trade networks within the G-7 countries, to which China has been added, and determined the prominent countries in the network during the pandemic to be China, the USA and Canada. The findings also revealed that China, one of the pioneering countries in electronic product trade, has the most ties in electronic products exports with the USA, the other countries with which the USA had the most ties were Japan and Germany, apart from Canada. It was discovered that Germany was the most active country in the network, following the USA, in terms of export ties and the number of export countries in its network. The panel data analysis, on the other hand, yielded two different models, namely import and export, based on 22 months of data, from March 2020 to December 2021, considering the World Health Organization’s (WHO) declaration of COVID-19 as a pandemic on March 11, 2020. The findings showed that independent variables affecting the electronic product trade within G-7 countries bore different effects in both models, that the deaths/cases ratio, the tests/cases ratio and the number of cases had adverse impacts while the population had positive impacts on exports in the first model, and that the tests/population ratio had adverse effects while the number of tests and the population had positive impacts on intra-group electronic product imports.
Læs mere Tjek på PubMedElva Jiménez-Hernández, Juan Carlos Núñez-Enriquez, José Arellano-Galindo, María de los Angeles Del Campo-Martínez, Perla Verónica Reynoso-Arenas, Alfonso Reyes-López, Alejandra Viridiana Delgado-Gaytan, María Del Socorro Méndez-Tovar, Teresa Marín-Palomares, María Teresa Dueñas-Gonzalez, Antonio Ortíz-Fernández, Inés Montero-Ponce, Laura Eugenia Espinosa-Hernández, Nora Nancy Núñez-Villegas, Ruy Pérez-Casillas, Berenice Sánchez-Jara, Angel García-Soto, Annecy Nelly Herver-Olivares, Ethel Zulie Jaimes-Reyes, Hector Manuel Tiznado-García, Octavio Martínez-Villegas, Betzayda Valdez-Garibay, Paloma Del Rocío Loza-Santiaguillo, Xochiketzalli García-Jiménez, Guadalupe Ortíz-Torres, Gabriela Jazmin Fernández-Castillo, Dulce María Aguilar-Olivares, Luis Alejandro Díaz-Padilla, Mario Alberto Noya-Rodríguez, Mariana García-Jiménez, Juan Manuel Mejía-Aranguré
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Elva Jiménez-Hernández, Juan Carlos Núñez-Enriquez, José Arellano-Galindo, María de los Angeles Del Campo-Martínez, Perla Verónica Reynoso-Arenas, Alfonso Reyes-López, Alejandra Viridiana Delgado-Gaytan, María Del Socorro Méndez-Tovar, Teresa Marín-Palomares, María Teresa Dueñas-Gonzalez, Antonio Ortíz-Fernández, Inés Montero-Ponce, Laura Eugenia Espinosa-Hernández, Nora Nancy Núñez-Villegas, Ruy Pérez-Casillas, Berenice Sánchez-Jara, Angel García-Soto, Annecy Nelly Herver-Olivares, Ethel Zulie Jaimes-Reyes, Hector Manuel Tiznado-García, Octavio Martínez-Villegas, Betzayda Valdez-Garibay, Paloma Del Rocío Loza-Santiaguillo, Xochiketzalli García-Jiménez, Guadalupe Ortíz-Torres, Gabriela Jazmin Fernández-Castillo, Dulce María Aguilar-Olivares, Luis Alejandro Díaz-Padilla, Mario Alberto Noya-Rodríguez, Mariana García-Jiménez, Juan Manuel Mejía-Aranguré Objective To identify the type of infections and risk factors for infection-related mortality (IRM) after allogeneic hematopoietic stem cell transplantation (HSCT). Methods Retrospective cohort study of patients 15 years: aHR = 3.34; 95% CI: 1.18–9.45); b) for viral infection (graft versus host disease: aHR = 5.36; 95% CI: 1.62–17.68), however, for fungal infection statistically significant predictors were not identified. Related mortality was 30% (n = 12). Increased risk for infection-related mortality was observed in patients with unrelated donor and umbilical cord stem cells recipients (HR = 3.12; 95% CI: 1.00–9.85). Conclusions Frequencies of infections and infection-related mortality appear to be similar to those reported. Unrelated donors and stem cells from umbilical cord recipients were associated with a high risk of mortality.
Læs mere Tjek på PubMedVandana Anang, Aayushi Singh, Ankush Kumar Rana, Shakuntala Surender Kumar Saraswati, Upasana Bandyopadhyay, Chaitenya Verma, Attinder Chadha, Krishnamurthy Natarajan
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Vandana Anang, Aayushi Singh, Ankush Kumar Rana, Shakuntala Surender Kumar Saraswati, Upasana Bandyopadhyay, Chaitenya Verma, Attinder Chadha, Krishnamurthy Natarajan Post translational modifications (PTMs) are exploited by various pathogens in order to escape host immune responses. SUMOylation is one of the PTMs which is involved in regulation of a variety of cellular responses. However, the effects of host SUMOylation on pathogenic bacteria largely remain elusive. We, therefore, investigated the role of SUMOylation in regulating defense responses in dendritic cells (DCs) during mycobacterial infection. Dendritic Cells of female BALB/c mice and THP-1 macrophages were used. Western blotting was performed to measure the expression of level of SUMO1, pSTAT1, pp38, pERK, Beclin-1, LC3, Bax and Cytochrome C. For bacterial burden confocal microscopy and CFU (Colony Forming Unit) were used. Flow cytometry was used for ROS and co-stimulatory molecules measurement. Cytokine level were measured using ELISA. We show that stimulation of Bone Marrow Derived Dendritic Cells (BMDCs) with mycobacterial antigen Rv3416 or live infection with Mycobacterium bovis BCG increases the SUMOylation of host proteins. Inhibition of SUMOylation significantly decreased intracellular bacterial loads in DCs. Additionally, inhibiting SUMOylation, induces protective immune responses by increasing oxidative burst, pro-inflammatory cytokine expression and surface expression of T cell co-stimulatory molecules, and activation of pSTAT1 and Mitogen Activated Protein Kinases (MAPK) proteins- pp38 and pERK. SUMOylation inhibition also increased apoptosis and autophagy in BMDCs. Intriguingly, mycobacteria increased SUMOylation of many of the above molecules. Furthermore, inhibiting SUMOylation in DCs primed T cells that in turn attenuated bacterial burden in infected macrophages. These findings demonstrate that SUMOylation pathway is exploited by mycobacteria to thwart protective host immune responses.
Læs mere Tjek på PubMedValentina Bonetto, Valeria Magnelli, Maurizio Sabbatini, Flavia Caprì, Jack J. W. A. van Loon, Sara Tavella, Maria Angela Masini
PLoS One Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
by Valentina Bonetto, Valeria Magnelli, Maurizio Sabbatini, Flavia Caprì, Jack J. W. A. van Loon, Sara Tavella, Maria Angela Masini In the age of space exploration, the effect of hypergravity on human physiology is a relatively neglected topic. However, astronauts have several experiences of hypergravity during their missions. The main disturbance of altered gravity can be imputed to cell cytoskeleton alteration and physiologic homeostasis of the body. Testis has proved to be a particularly sensible organ, subject to environmental alteration and physiological disturbance. This makes testis an organ eligible for investigating the alteration following exposure to altered gravity. In our study, mice were exposed to hypergravity (3g for 14 days) in the Large Diameter Centrifuge machine (ESA, Netherland). We have observed a morphological alteration of the regular architecture of the seminiferous tubules of testis as well as an altered expression of factors involved in the junctional complexes of Sertoli cells, responsible for ensuring the morpho-functional integrity of the organ. The expression of key receptors in physiological performance, such as Androgen Receptors and Interstitial Cells Stimulating Hormone receptors, was found lower expressed. All these findings indicate the occurrence of altered physiological organ performance such as the reduction of the spermatozoa number and altered endocrine parameters following hypergravity exposure.
Læs mere Tjek på PubMedHan‐Lin Shih, Yi‐Ting Lee, Cheuk‐Kwan Sun, Renin Chang
Journal of Medical Virology, 29.09.2023
Tilføjet 29.09.2023
Malaria Journal, 29.09.2023
Tilføjet 29.09.2023
Abstract Vector control interventions play a fundamental role in the control and elimination of vector-borne diseases. The evaluation of vector control products relies on bioassays, laboratory and semi-field tests using live insects to assess the product’s effectiveness. Bioassay method development requires a rigorous validation process to ensure that relevant methods are used to capture appropriate entomological endpoints which accurately and precisely describe likely efficacy against disease vectors as well as product characteristics within the manufacturing tolerance ranges for insecticide content specified by the World Health Organization. Currently, there are no standardized guidelines for bioassay method validation in vector control. This report presents a framework for bioassay validation that draws on accepted validation processes from the chemical and healthcare fields and which can be applied for evaluating bioassays and semi-field tests in vector control. The validation process has been categorized into four stages: preliminary development; feasibility experiments; internal validation, and external validation. A properly validated method combined with an appropriate experimental design and data analyses that account for both the variability of the method and the product is needed to generate reliable estimates of product efficacy to ensure that at-risk communities have timely access to safe and reliable vector control products.
Læs mere Tjek på PubMedDaniele Focosi, Fabrizio Maggi, Alessandra D'Abramo, Emanuele Nicastri, David J Sullivan
International Journal of Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
As a paradigm for difficult-to-treat microorganisms, many chronic viral infections require combination therapy with direct-acting antivirals (DAA) employing different mechanisms of action (MOA) for successful eradication (e.g., HCV, HIV and influenza).
Læs mere Tjek på PubMedAmer El GhaliTaylor MorrisetteSara AlosaimyKristen LucasMaria G. Tupayachi-OrtizRaaga VemulaCarly WadleJulie V. PhilleyCarlos Mejia-ChewYasir HamadRyan W. StevensJohn D. ZeuliAndrew J. WebbChristina T. FiskeAnahit SimonyanChristo L. CiminoMehriban MammadovaVirginia E. UmanaRodrigo HasbunSaira ButtKyle C. MolinaMichael ThomasEmily A. KaipJeannette BouchardTristan W. GoreCatessa HowardM. Gabriela CabanillaDana J. HolgerJeremy J. FrensMelissa BargerAaron OngKeira A. CohenMichael J. Rybak 1 Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA 2 Department of Clinical Pharmacy & Outcomes Sciences, Medical University of South Carolina College of Pharmacy, Charleston, South Carolina, USA 3 Department of Pharmacy Services, Medical University of South Carolina (MUSC) Health, Charleston, South Carolina, USA 4 Department of Medicine, Division of Pulmonary and Critical Care Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA 5 University of Texas Health Science Center, University of Texas, Tyler, Texas, USA 6 Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA 7 Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA 8 Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA 9 Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee, USA 10 Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA 11 Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA 12 Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA 13 Department of Pharmaceutical Services, University of California, San Francisco Medical Center, San Francisco, North Carolina, USA 14 College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA 15 Department of Pharmacy, West Virginia University Medicine, Morgantown, West Virginia, USA 16 Division of Infectious Diseases, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA 17 Department of Pharmacy Practice, Barry and Judy Silverman College of Pharmacy, Nova Southeastern University, Fort Lauderdale, Florida, USA 18 Department of Pharmacy Services, Cone Health, Greensboro, North Carolina, USA 19 Department of Medicine, Ventura County Medical Center, Ventura, California, USA 20 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Marlyand, USA 21 Department of Medicine, Division of Infectious Diseases, School of Medicine, Wayne State University, Detroit, Michigan, USA 22 Department of Pharmacy Services, Detroit Receiving Hospital, Detroit Medical Center, Detroit, Michigan, USA , Cesar A. Arias
Antimicrobial Agents And Chemotherapy, 29.09.2023
Tilføjet 29.09.2023
Jones, D., Kumar, S., Anstee, C., Gingrich, M., Simone, A., Ahmadzai, Z., Thavorn, K., Seely, A.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
ObjectivesAdverse events (AEs) following thoracic surgery place considerable strain on healthcare systems. A rigorous evaluation of the economic impact of thoracic surgical AEs remains lacking and is required to understand the value of money of formal quality improvement initiatives. Our objective was to conduct a systematic review of all available literature focused on specific cost of postoperative AEs following thoracic surgery. DesignSystematic review of the economic literature was performed, following recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sourcesAn economic search filter developed by the Canadian Agency for Drugs and Technologies in Health was applied, and MEDLINE, Embase and The Cochrane Library were searched from inception to January 2022. Eligibility criteriaWe included English articles involving adult patients who underwent a thoracic surgical procedure with estimated costs of postoperative complications. Eligible study designs included comparative observational studies, randomised control trials, decision analytic or cost-prediction models, cost analyses, cost or burden of illness studies, economic evaluation studies and systematic reviews and/or meta-analyses of cost analyses and cost of illness studies. Data extraction and synthesisTwo reviewers independently screened titles and abstracts in the first stage and full-text articles of included studies in the second stage. Disagreements during abstract and full-text screening stages were resolved via discussion until a consensus was reached. Studies were appraised for methodological quality using the Critical Appraisal Skills Program checklist. Results3349 studies were identified: 20 met inclusion criteria. Most were conducted in the USA (12/20), evaluating AE impact on hospital expenditures (18/20). 68 procedure-specific AE mean costs were characterised (USD$). The most commonly described were anastomotic leak (mean:range) (USD$49 278:$6 176–$133 002) and pneumonia ($12 258:$2608–$34 591) following esophagectomy, and prolonged air leak ($2556:$571–$3573), respiratory failure ($19 062:$11 841–$37 812), empyema ($30 189:$23 784–$36 595), pneumonia ($15 362:$2542–$28 183), recurrent laryngeal nerve injury ($16 420:$4224–$28 616) and arrhythmia ($6835:$5833–$8659) following lobectomy. ConclusionsHospital costs associated with AEs following thoracic surgery are substantial and varied. Quantifying costs of AEs enable future economic evaluation studies, which could help prioritising value-directed quality improvement to optimally improve outcomes and reduce costs.
Læs mere Tjek på PubMedChen, Y., Liu, J., Zhang, Q., Wang, Q., Chai, L., Chen, H., Li, D., Qiu, Y., Wang, Y., Shen, N., Wang, J., Xie, X., Li, S., Li, M.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
ObjectiveThis study aimed to analyse the burden and temporal trends of tuberculosis (TB) incidence and mortality globally, as well as the association between mortality-to-incidence ratio (MIR) and Socio-Demographic Index (SDI). DesignA retrospective analysis of TB data from 1990 to 2019 was conducted using the Global Burden of Disease Study database. ResultsBetween 1990 and 2019, there was a declining trend in the global incidence and mortality of TB. High SDI regions experienced a higher declining rate than in low SDI regions during the same period. Nearly half of the new patients occurred in South Asia. In addition, there is a sex–age imbalance in the overall burden of TB, with young males having higher incidence and mortality than females. In terms of the three subtypes of TB, drug-sensitive (DS)-TB accounted for more than 90% of the incidents and deaths and experienced a decline over the past 30 years. However, drug-resistant TB (multidrug-resistant (MDR)-TB and extensively drug-resistant (XDR)-TB) showed an overall increasing trend in age-standardised incidence rates and age-standardised mortality rates, with an inflection point after the year 2000. At the regional level, South Asia and Eastern Europe remained a high burden of drug-resistant TB incidence and mortality. Interestingly, a negative correlation was found between the MIR and SDI for TB, including DS-TB, MDR-TB and XDR-TB. Notably, central sub-Saharan Africa had the highest MIR, which indicated a higher-than-expected burden given its level of sociodemographic development. ConclusionThis study provides comprehensive insights into the global burden and temporal trends of TB incidence and mortality, as well as the relationship between MIR and SDI. These findings contribute to our understanding of TB epidemiology and can inform public health strategies for prevention and management.
Læs mere Tjek på PubMedKuper, H., Ssemata, A. S., Smythe, T., Drazdzewska, J., Waiswa, P., Kagurusi, P., Rosato, M., Mbazzi, F. B.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
IntroductionOn average, people with disabilities face many difficulties in accessing healthcare and experience worse health outcomes. Yet, evidence on how to overcome these barriers is lacking. Participatory approaches are gaining prominence as they can generate low-cost, appropriate and scalable solutions. This study protocol is for the pilot testing of the co-created Participatory Learning and Action for Disability (PLA-D) groups to assess feasibility. Methods and analysisWe will pilot test PLA-D in five groups in Luuka district, Uganda during 2023. Each group will include approximately 20 members (people with disabilities, family members, carers) who will meet every 2–3 weeks over a 9–11 month period. The groups, guided by a trained facilitator, will identify issues about health and healthcare access and plan and implement locally generated solutions (eg, raising awareness of rights, advocacy and lobbying, establishing health savings and financing schemes). We will collect diverse sources of data to assess feasibility: (1) in-depth interviews and focus group discussions with group participants, non-participants and group facilitators; (2) monitoring of group activities; (3) direct observation of groups and (4) quantitative survey of group participants at baseline and endline. Data analyses will be undertaken to assess feasibility in terms of: acceptability, demand, implementation and practicality. We will develop and refine evaluation tools in preparation for a future trial. Ethics and disseminationEthical approval for the study has been received by the London School of Hygiene & Tropical Medicine and the Uganda Virus Research Institute ethics committees. Informed consent will be obtained from all study participants, making adaptations for people with disabilities as necessary. We will reach different groups for our dissemination activities, including (1) people with disabilities (eg, community meetings); (2) policy and programme stakeholders in Uganda and international (eg, individual meetings, evidence briefs) and (3) academics (journal articles, conference/seminar presentations).
Læs mere Tjek på PubMedBarber, V. S., Peckham, N., Duley, L., Francis, A., Abhishek, A., Moss, P., Cook, J. A., Parry, H. M.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
IntroductionPeople who are immunocompromised have a poor biological response to vaccinations. This study aims to determine in patients with chronic lymphocytic leukaemia (CLL) if a 3-week pause in Bruton tyrosine kinase inhibitor therapy (BTKi) starting 1 week before delivery of SARS-CoV-2 vaccine booster, improves vaccine immune response when compared with continuation of BTKi. Methods and analysisAn open-label, randomised controlled superiority trial will be conducted in haematology clinics in approximately 10 UK National Health Service (NHS) hospitals. The sample size is 120, randomised 1:1 to intervention and usual care arms. The primary outcome is anti-spike-receptor binding domain (RBD) antibody level at 3 weeks post-SARS-CoV-2 booster vaccination. Secondary outcomes are RBD antibody levels at 12 weeks postbooster vaccination, participant global assessments of disease activity, blood films, full blood count and lactate dehydrogenase levels, impact on quality of life, self-reported adherence with request to temporarily pause or continue BTKi, T cell response against spike protein and relative neutralising antibody titre against SARS-CoV-2 viral variants. Additionally, there will be an investigation of any effects in those given influenza vaccination contemporaneously versus COVID-19 alone. The primary analysis will be performed on the as randomised groups (‘intention to treat’). The difference between the study arms in anti-spike-RBD antibody level will be estimated using a mixed effects regression model, allowing for repeated measures clustered within participants. The model will be adjusted for randomisation factor (first line or subsequent line of therapy), and prior infection status obtained from prerandomisation antinucleocapsid antibodies as fixed effects. Ethics and disseminationThis study has been approved by Leeds East Research Ethics Committee and Health Research Authority (REC Reference:22/YH/0226, IRAS ID: 319057). Dissemination will be via peer-review publications, newsletters and conferences. Results will be communicated to participants, the CLL patient and clinical communities and health policy-makers. Trial registration numberISRCTN14197181.
Læs mere Tjek på PubMedOoms, A., Al-Mossawi, H., Bennett, L., Bogale, M., Bowness, P., Francis, A., Goodyear, C., Kirkham, B. W., Lalnunhlimi, S., McInnes, I. B., Richards, D., Siebert, S., Taams, L. S., Tulunay Virlan, A., Yager, N., Coates, L. C.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
IntroductionPsoriatic arthritis (PsA) affects around 150 000 people in the UK of whom around 50% require treatment with biologics. The most used biologics for PsA target tumour necrosis factor (TNF) or interleukin-17A (IL-17A). About 50% of patients respond to each, but it is not currently possible to predict response for individual patients, necessitating sequential treatment steps. A recent proof of concept study in PsA suggested that using peripheral immunophenotype to choose therapy could improve time to treatment response. This study will test the hypothesis, within an open-label parallel-group biomarker-stratified multicentre randomised controlled trial, which the baseline proportion of CD4+T cells with an activated type 17 immunophenotype (Th17 levels) predicts response to IL-17A or TNF inhibitors in PsA. Additional analyses will identify if the model can be refined by combining additional clinical and immunophenotypic factors. Statistical modelling will be used to predict the likely effectiveness of these approaches compared with standard care. Methods and analysisPatients with PsA eligible to start their first biologic as part of standard care are recruited and baseline blood tests are taken for immunophenotyping. Participants are stratified equally by Th17 levels and randomised 1:1 to receive either TNF (adalimumab) or IL-17A (secukinumab) inhibitors. The primary analysis will establish the interaction between baseline immunophenotype and treatment on the primary outcome (achievement of minimal disease activity criteria at week 24). In secondary analysis, modelling will identify if this prediction model can be optimised further by incorporating clinical phenotypes and additional immunophenotyping techniques. Ethics and disseminationEthical approval for the study was granted by the North West Preston Research Ethics Committee (ref 21/NW/0016). Dissemination will be via conference presentations and peer-reviewed publications, aiming to impact on treatment guidelines. Trial registration numberISRCTN17228602.
Læs mere Tjek på PubMedLili TianLi WangFengying YangTiezhong ZhouHong Jianga Institute of Animal Husbandry and Veterinary Medicine, Jinzhou Medical University, Jinzhou, Chinab Clinical Medical College, Changchun University of Chinese Medicine, Changchun, China
Virulence, 29.09.2023
Tilføjet 29.09.2023
Ann Danaiya Usher
Lancet, 29.09.2023
Tilføjet 29.09.2023
Waning demand has left COVAX, the scheme to provide COVID-19 vaccines to lower-income countries, with billions of unspent dollars. What to do with the money? Ann Danaiya Usher reports.
Læs mere Tjek på PubMedRalf StemkensVeronique de JagerRodney DawsonAndreas H. DiaconKim NarunskySherman D. PadayacheeMartin J. BoereeStijn W. van BeekAngela ColbersMarieke J. H. CoenenElin M. SvenssonUwe FuhrPatrick P. J. PhillipsLindsey H. M. te BrakeRob E. Aarnoutse 1 Department of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands 2 TASK, Cape Town, South Africa 3 Division of Pulmonology and Department of Medicine, University of Cape Town and University of Cape Town Lung Institute, Cape Town, South Africa 4 Department of Pulmonary Diseases, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands 5 Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands 6 Department of Pharmacy, Uppsala University, Uppsala, Sweden 7 Clinical Pharmacology, Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany 8 UCSF Center for Tuberculosis, University of California, San Francisco, California, USA , Jared A. Silverman
Antimicrobial Agents And Chemotherapy, 29.09.2023
Tilføjet 29.09.2023
David MelnickAngela K. TalleyVipul K. GuptaIan A. CritchleyPaul B. EckburgKamal A. HamedNivedita BhattGary MooreDaren AustinChristopher M. RubinoSujata M. BhavnaniPaul G. Ambrose 1 Spero Therapeutics, Inc., Cambridge, Massachusetts, USA 2 Moore Computing Services, Inc., Little Rock, Arkansas, USA 3 GlaxoSmithKline, London, UK 4 Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA , Anne-Catrin Uhlemann
Antimicrobial Agents And Chemotherapy, 29.09.2023
Tilføjet 29.09.2023
BMC Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
Abstract Background The incidence of stroke is increasing among younger people with human immunodeficiency virus (HIV). The burden of stroke has shifted toward the young people living with HIV, particularly in low- and middle-income countries. People infected with herpes zoster (HZ) were more likely to suffer stroke than the general population. However, the association of HZ infection with the incidence of stroke among patients with HIV remains unclear. Methods A nested case–control study was conducted with patients with HIV registered in the Taiwan National Health Insurance Research Database in 2000–2017. A total of 509 stroke cases were 1:10 matched to 5090 non-stroke controls on age, sex, and date of first stroke diagnosis. Logistic regression models were used to estimate the odds ratio and 95% confidence intervals (CI) of stroke incidence. Results The odds ratio of stroke was significantly higher in the HIV-infected population with HZ (adjusted odds ratio [AOR]: 1.85, 95% CI: 1.42–2.41). A significantly increased AOR of stroke was associated with hypertension (AOR: 3.53, 95% CI: 2.86–4.34), heart disease (AOR: 2.32, 95% CI: 1.54–3.48), chronic kidney disease (AOR: 1.82, 95% CI: 1.16–2.85), hepatitis C virus infection (AOR: 1.49, 95% CI: 1.22–1.83), hyperlipidemia (OR: 1.41, 95% CI: 1.12–1.78), and treatment with protease inhibitors (AOR: 1.33, 95% CI: 1.05–1.69). Conclusions Our findings suggest that HZ concurrent with HIV may increase the risk of stroke. The incidence rates of stroke were independent of common risk factors, suggesting strategies for early prevention of HZ infection among people living with HIV.
Læs mere Tjek på PubMedGianluca ScarnoJulija MazejMattia LaffranchiChiara Di CensoIrene MattiolaArianna M. CandelottiGiuseppe PietropaoloHelena StabileCinzia FiondaGiovanna PeruzziStephen R. BrooksWanxia Li TsaiYohei MikamiGiovanni BernardiniAngela GismondiSilvano SozzaniJames P. Di SantoChristian A. J. VosshenrichAndreas DiefenbachMassimo GadinaAngela SantoniGiuseppe SciumèaDepartment of Molecular Medicine, Sapienza University of Rome, Rome 00161, ItalybLaboratory affiliated to Istituto Pasteur Italia–Fondazione Cenci Bolognetti, Rome 00161, ItalycLaboratory of Innate Immunity, Institute of Microbiology, Infectious Diseases and Immunology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Campus Benjamin Franklin, Berlin 12203, GermanydMucosal and Developmental Immunology, Deutsches Rheuma-Forschungszentrum, an Institute of the Leibniz Association, Berlin 10117, GermanyeCenter for Life Nano- & Neuro-Science, Istituto Italiano di Tecnologia, Rome 00161, ItalyfBiodata Mining and Discovery Section, Office of Science and Technology, National Institute of Arthritis, Musculoskeletal and Skin Diseases, NIH, Bethesda, MD 20892gTranslational Immunology Section, Office of Science and Technology, National Institute of Arthritis, Musculoskeletal and Skin Diseases, NIH, Bethesda, MD 20892hDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 1608582, JapaniIstituti di Ricovero e Cura a Carattere Scientifico Neuromed, Isernia 86077, ItalyjInnate Immunity Unit, Institut Pasteur, Université Paris Cité, INSERM U1223, Paris 75724, France
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 29.09.2023
Tilføjet 29.09.2023
Proceedings of the National Academy of Sciences, Volume 120, Issue 40, October 2023.
Læs mere Tjek på PubMedWilliam H K Schilling, Podjanee Jittamala, James A Watson, Simon Boyd, Viravarn Luvira, Tanaya Siripoon, Thundon Ngamprasertchai, Elizabeth M Batty, Cintia Cruz, James J Callery, Shivani Singh, Manisaree Saroj, Varaporn Kruabkontho, Thatsanun Ngernseng, Nuttakan Tanglakmankhong, Jaruwan Tubprasert, Mohammad Yazid Abdad, Wanassanan Madmanee, Jindarat Kouhathong, Kanokon Suwannasin, Watcharee Pagornrat, Nattaporn Piaraksa, Pongtorn Hanboonkunupakarn, Borimas Hanboonkunupakarn, Kittiyod Poovorawan, Manus Potaporn, Attasit Srisubat, Bootsakorn Loharjun, Walter R J Taylor, Vasin Chotivanich, Kesinee Chotivanich, Mallika Imwong, Sasithon Pukrittayakamee, Arjen M Dondorp, Nicholas P J Day, Mauro M Teixeira, Watcharapong Piyaphanee, Weerapong Phumratanaprapin, Nicholas J White, PLATCOV Collaborative Group
Lancet Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
Both molnupiravir and ritonavir-boosted nirmatrelvir accelerate oropharyngeal SARS-CoV-2 viral clearance in patients with COVID-19, but the antiviral effect of ritonavir-boosted nirmatrelvir was substantially greater. Measurement of oropharyngeal viral clearance rates provides a rapid and well tolerated approach to the assessment and comparison of antiviral drugs in patients with COVID-19. It should be evaluated in other acute viral respiratory infections.
Læs mere Tjek på PubMedCarmela Pinnetti, Eleonora Cimini, Valentina Mazzotta, Giulia Matusali, Alessandra Vergori, Annalisa Mondi, Martina Rueca, Sandro Batzella, Eleonora Tartaglia, Aurora Bettini, Stefania Notari, Marika Rubino, Massimo Tempestilli, Carlo Pareo, Laura Falasca, Franca Del Nonno, Alessandra Scarabello, Marta Camici, Roberta Gagliardini, Enrico Girardi, Francesco Vaia, Fabrizio Maggi, Chiara Agrati, Andrea Antinori
Lancet Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
A 59-year-old treatment-naive patient with advanced HIV infection presented with a severe and protracted course of mpox (formerly known as monkeypox) that did not respond to the current mpox treatment options. The patient worsened clinically, and developed new mucocutaneous lesions and necrotic evolution of pre-existing ones, along with multiple bilateral lung nodules and the appearance of a tracheal necrotic lesion. Although severe forms of mpox have been observed in people with severe immune system deficiency, including those with advanced HIV presentation, the immunological mechanisms underlying this observation have not yet been fully explained.
Læs mere Tjek på PubMedCatherine Offord
Science, 28.09.2023
Tilføjet 28.09.2023
Anna Füzy, István Parádi, Bettina Kelemen, Ramóna Kovács, Imre Cseresnyés, Tibor Szili-Kovács, Tamás Árendás, Nándor Fodor, Tünde Takács
PLoS One Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
by Anna Füzy, István Parádi, Bettina Kelemen, Ramóna Kovács, Imre Cseresnyés, Tibor Szili-Kovács, Tamás Árendás, Nándor Fodor, Tünde Takács This study aimed to survey the long-term effects of fertilization practices on the functional diversity of the soil microbiota. A 60-year fertilization experiment with mineral fertilizers, farmyard manure and combined treatments was sampled in two consecutive years in maize (Zea mays L.) and wheat (Triticum aestivum L.). Soil chemical properties, plant growth and physiological parameters were measured. The MicroRespTM method was applied to assess the community level physiological profiles (CLPPs) of the rhizosphere soil, and the arbuscular mycorrhizal fungal (AMF) colonization of the roots was determined. Samples were taken in the early vegetative stages, at flowering, and at harvest in both years. The measured parameters were analysed using multifactorial ANOVA to determine treatment effects, crop-dependent differences, and seasonality. PCA analysis was performed on the data matrix to reveal more complex correspondences, and Pearson’s product-moment correlation was used to confirm relationships between some of the measured soil and plant parameters. Fertilization treatments caused long-term changes in some biological parameters such as: MicroRespTM parameters, citrate utilization, total substrate-induced respiration value, and the ratio of utilization of amino acids and sugars. The rate of AMF colonization responded mainly to the plant nutrition status and the plant requirements, suggesting a plant-mediated effect in the case of mycorrhiza. Mineral nitrogen fertilization and soil acidification were found to be the main factors affecting the catabolic activity of soil microbiota, while AMF colonization responded to the balance of plant nutrition.
Læs mere Tjek på PubMedMarina P. Volegova, Cynthia Hermosillo, Jamie H. D. Cate
PLoS One Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
by Marina P. Volegova, Cynthia Hermosillo, Jamie H. D. Cate Improper regulation of translation initiation, a vital checkpoint of protein synthesis in the cell, has been linked to a number of cancers. Overexpression of protein subunits of eukaryotic translation initiation factor 3 (eIF3) is associated with increased translation of mRNAs involved in cell proliferation. In addition to playing a major role in general translation initiation by serving as a scaffold for the assembly of translation initiation complexes, eIF3 regulates translation of specific cellular mRNAs and viral RNAs. Mutations in the N-terminal Helix-Loop-Helix (HLH) RNA-binding motif of the EIF3A subunit interfere with Hepatitis C Virus Internal Ribosome Entry Site (IRES) mediated translation initiation in vitro. Here we show that the EIF3A HLH motif controls translation of a small set of cellular transcripts enriched in oncogenic mRNAs, including MYC. We demonstrate that the HLH motif of EIF3A acts specifically on the 5′ UTR of MYC mRNA and modulates the function of EIF4A1 on select transcripts during translation initiation. In Ramos lymphoma cell lines, which are dependent on MYC overexpression, mutations in the HLH motif greatly reduce MYC expression, impede proliferation and sensitize cells to anti-cancer compounds. These results reveal the potential of the EIF3A HLH motif in eIF3 as a promising chemotherapeutic target.
Læs mere Tjek på PubMedNaseem Cassim, Lindi Marie Coetzee, Manuel Pedro da Silva, Wendy Susan Stevens, Deborah Kim Glencross
PLoS One Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
by Naseem Cassim, Lindi Marie Coetzee, Manuel Pedro da Silva, Wendy Susan Stevens, Deborah Kim Glencross Background Coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China. Due to the rapid spread globally, it was declared a pandemic in March 2020. Social distancing and lockdown measures were introduced to limit transmission. These strategies could potentially impact the diagnosis and treatment of patients with advanced HIV who are susceptible to secondary infections like cryptococcal disease. In South Africa, reflexed cryptococcal antigenaemia (CrAg) testing and pre-emptive antifungal treatment are recommended preceding antiretroviral therapy initiation for patients with a CD4
Læs mere Tjek på PubMedKazuhiko Ikeuchi, Kazuaki Fukushima, Masaru Tanaka, Keishiro Yajima, Makoto Saito, Akifumi Imamura
PLoS One Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
by Kazuhiko Ikeuchi, Kazuaki Fukushima, Masaru Tanaka, Keishiro Yajima, Makoto Saito, Akifumi Imamura Introduction Although the rapid plasma reagin (RPR) test is used to determine treatment efficacy for syphilis, animal studies show that it decreases gradually after an initial increase even without treatment. Pre-treatment changes in RPR titer in humans and its relationship with post-treatment changes in RPR titer are not well known. Methods We retrospectively analyzed the clinical records of syphilitic patients who underwent automated RPR (Mediace) testing twice before treatment (i.e., at diagnosis and treatment initiation) within 1–3 months at an HIV/AIDS referral hospital in Japan between 2006 and 2018. The RPR values were expressed as the ratio to the value at treatment initiation. The mean monthly relative change in the RPR after treatment was calculated on the log2 scale for each patient and analyzed by multivariable linear regression. Results Sixty-eight patients were identified. The median age was 45 (interquartile range [IQR], 38–50), 98.5% (67/68) were men, and 97.1% (66/68) had HIV. The median RPR titer ratio at treatment initiation/diagnosis was 0.87 (IQR, 0.48–1.30). The RPR titer decreased more than twofold in 26.5% (18/68) and more than fourfold in 10.3% (7/68) before treatment. In the multivariable analysis, higher age (predicted monthly RPR relative change on the log2 scale 0.23/10 years [95% confidence interval [CI], 0.090–0.37]), history of syphilis (0.36 [95% CI, 0.07–0.65]), and a lower ratio of RPR at treatment initiation/diagnosis (−0.52/every 10-fold increase [95% CI, −0.81 to −0.22]) were associated with a slower RPR decrease after treatment. Conclusions In a mostly HIV patient population, RPR titer can show more than four-fold spontaneous increase or decrease within 1–3 months. Pre-treatment spontaneous decrease of RPR titer was associated with a slower decrease in post-treatment RPR titer.
Læs mere Tjek på PubMed