The emergence of locally transmitted Plasmodium vivax malaria in Florida from May to July 2023 underscores the persistent threat of malaria reintroduction in non-endemic regions. The increasing instances of imported malaria associated with international travel, alongside the existence of competent local vectors, emphasize the critical need for public health authorities in non-endemic countries to remain vigilant and well-prepared to sustain a malaria-free status.
Considered as the last defense line against Gram-negative bacteria, colistin is particularly effective against multiple drug-resistant bacteria such as multi-drug resistance (MDR) and carbapenem-resistant Enterobacteriaceae (CRE). However, since the plasmid-mediated mobile colistin resistance-1 (mcr-1) was first reported in China in 2015, it has been widely detected from humans, animals, and the environment across 47 countries/regions worldwide by 2019, which has attracted the attention of the World Health Organization and global government departments, who formulated emergency strategies and interventions to contain its emergence and spread. At present, three kinds of colistin for clinical injection have been adopted in clinic in China. Due to drug pressure screening, the risk with Gram-negative bacteria developing resistance to colistin may corresponding increase. Therefore, rapid, accurate and sensitive detection methods are particularly needed. This review summarizes the prevalence of mcr-1, in addition to a diverse assortment of different detection techniques of colistin resistance, and analyzes the application scenarios, advantages, and challenges of different technologies, in order to provide a scientific evidence-based proof for the rapid detection of colistin resistance.
HCV/HIV co-infections were initially a contentious consideration for liver transplantation, primarily due to their suboptimal response to interferon-based treatments and unfavorable post-transplantation outcomes. The potential concern in this patient group arises from drug–drug interactions between DAAs and ARVs, with data on the effectiveness and safety of DAAs in this demographic primarily derived from isolated case studies. This extensive review assesses the safety and efficacy of DAAs in liver transplants for individuals with concurrent HIV and HCV infections.
Conducting a systematic search across multiple databases until April 2023, our primary focus was the evaluation of outcomes, specifically the proportion of sustained virologic responses at week 12 following therapy (SVR12). To gauge publication bias, we scrutinized funnel plots and conducted Egger tests.
Nine studies encompassed a participant pool of 269 individuals, with a statistical estimate of SVR12 at 92% (95% CI: 88–95). Subgroup analysis showed that the ratio of binding SVR12 of genotype (GT) 1a was 97% (95% CI: 87–100), while that of GT3 was 100% (95% CI: 92–100); 88% (95%CI: 80–95) for pre-transplant treatments; and 95% (95%CI: 91–99) for post-transplant treatments subgroup. A total of 8 patients died during SVR12 completion while 269 had a survival rate of 99% (95% CI 97–100). After one year of follow-up, four studies recorded a 98% survival rate (95% CI 94–100). Egger's test did not reveal any publication bias.
Administration of DAAs during liver transplantation for HCV patients with HIV infections has a high efficacy and safety. Early consideration of HCV therapy should be the goal for all liver transplant recipients.