Pub Date : 2024-10-11DOI: 10.1016/j.idnow.2024.104995
Martin Martinot , Marc Astrie , Mahsa. Mohseni-Zadeh , Dominique De Briel , Benoit Jaulhac , Pierre Boyer
Objectives
Neoehrlichia mikurensis (NM) is an emerging intracellular bacterium member of the Anaplasmatacecae family. So far, only four cases have been described in France, all of them retrospectively.
Methods
This study describes two new cases of NM discovered following implementation of a biplex PCR targeting both Anaplasma and NM.
Results
Two immunocompetent patients developed a flu-like illness within 14 days after an identified tick bite. Both had negative Anaplasma PCR, but by using this biplex PCR NM, infection was diagnosed in both cases. One patient recovered spontaneously while the second was successfully treated by a seven-day course of doxycycline.
Conclusion
Present in Eastern France, NM is underdiagnosed. Biplex PCR screening of NM with A. phagocytophilum could effectively address this issue.
{"title":"Dual detection of Neoehrlichia mikurensis and Anaplasma phagocytophilum: How biplex PCR led in France to the diagnosis of neoehrlichiosis in post-tick bite fever","authors":"Martin Martinot , Marc Astrie , Mahsa. Mohseni-Zadeh , Dominique De Briel , Benoit Jaulhac , Pierre Boyer","doi":"10.1016/j.idnow.2024.104995","DOIUrl":"10.1016/j.idnow.2024.104995","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Neoehrlichia</em> mikurensis (NM) is an emerging intracellular bacterium member of the <em>Anaplasmatacecae</em> family. So far, only four cases have been described in France, all of them retrospectively.</div></div><div><h3>Methods</h3><div>This study describes two new cases of NM discovered following implementation of a biplex PCR targeting both <em>Anaplasma</em> and NM.</div></div><div><h3>Results</h3><div>Two immunocompetent patients developed a flu-like illness within 14 days after an identified tick bite. Both had negative <em>Anaplasma</em> PCR, but by using this biplex PCR NM, infection was diagnosed in both cases. One patient recovered spontaneously while the second was successfully treated by a seven-day course of doxycycline.</div></div><div><h3>Conclusion</h3><div>Present in Eastern France, NM is underdiagnosed. Biplex PCR screening of NM with <em>A.<!--> <!-->phagocytophilum</em> could effectively address this issue.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 8","pages":"Article 104995"},"PeriodicalIF":2.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-10DOI: 10.1016/j.idnow.2024.104996
Jinhua Zhang , Bei Wang , Jingjing Wang , Xiaoming Yao , Yueru Tian
{"title":"Clostridium symbiosum: A novel pathogen causing central nervous system infections in encephalitis patients","authors":"Jinhua Zhang , Bei Wang , Jingjing Wang , Xiaoming Yao , Yueru Tian","doi":"10.1016/j.idnow.2024.104996","DOIUrl":"10.1016/j.idnow.2024.104996","url":null,"abstract":"","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 8","pages":"Article 104996"},"PeriodicalIF":2.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.idnow.2024.104990
Bruce Shinga Wembulua , Viviane Marie Pierre Cisse , Daye Ka , Ndeye Fatou Ngom , Ahmadou Mboup , Ibrahima Diao , Aminata Massaly , Catherine Sarr , Kalilou Diallo , Mouhamadou Baïla Diallo , Moustapha Diop , Papa Samba Ba , Noël Magloire Manga , Stanislas Okitotsho Wembonyama , Zacharie Kibendelwa Tsongo , Moussa Seydi
Background
HIV/AIDS-related early mortality has long been a significant challenge. Subsequent to recent policy changes and treatment advancements, we aimed to assess changes in early mortality rates in 2017–19 and 2020-23 compared to 2013–16.
Methods
This is a 10-year multicenter survival study in people living with human immunodeficiency virus having initiated ART between 2013 and 2023. We used frailty-based competing risk models to estimate adjusted early (6-month and one-year) mortality hazard ratios (HRs) in people living with HIV (PwHIV) having initiated ART in 2013–16 (comparator), 2017–19, and 2020–23.
Results
We enrolled 4006 persons of whom 2281 (56.9 %) were female; median age was 40 years (IQR: 31–50); 635 (15.9 %) were at WHO clinical stage IV and 934 (23.3 %) had a CD4 count <200 cells/mm3. Median follow-up was 80.4 months (IQR: 48.6–106.7). All in all, 463 participants died (4.37 deaths per 100 person-years), including 296 at one year of follow-up (7.4 % [95 % CI: 6.6–8.2]). ART initiation in 2016–19 and 2020–23 was associated with 27 % (adjusted HR [aHR]: 0.73; 95 % CI: 0.55–0.98) and 63 % (aHR: 0.37; 95 % CI: 0.25–0.56) reductions in one-year mortality rates, respectively, compared to the 2013–16 period.
Conclusion
Early mortality risk has significantly decreased over time in Senegal. However, the proportion of PwHIV with AIDS-defining conditions remains concerning. Continued efforts to ensure early diagnosis and prompt linkage to care are needed for more impact.
{"title":"Changes in early HIV/AIDS mortality rates in people initiating antiretroviral treatment between 2013 and 2023: A 10-year multicenter survival study in Senegal","authors":"Bruce Shinga Wembulua , Viviane Marie Pierre Cisse , Daye Ka , Ndeye Fatou Ngom , Ahmadou Mboup , Ibrahima Diao , Aminata Massaly , Catherine Sarr , Kalilou Diallo , Mouhamadou Baïla Diallo , Moustapha Diop , Papa Samba Ba , Noël Magloire Manga , Stanislas Okitotsho Wembonyama , Zacharie Kibendelwa Tsongo , Moussa Seydi","doi":"10.1016/j.idnow.2024.104990","DOIUrl":"10.1016/j.idnow.2024.104990","url":null,"abstract":"<div><h3>Background</h3><div>HIV/AIDS-related early mortality has long been a significant challenge. Subsequent to recent policy changes and treatment advancements, we aimed to assess changes in early mortality rates in 2017–19 and 2020-23 compared to 2013–16.</div></div><div><h3>Methods</h3><div>This is a 10-year multicenter survival study in people living with human immunodeficiency virus having initiated ART between 2013 and 2023. We used frailty-based competing risk models to estimate adjusted early (6-month and one-year) mortality hazard ratios (HRs) in people living with HIV (PwHIV) having initiated ART in 2013–16 (comparator), 2017–19, and 2020–23.</div></div><div><h3>Results</h3><div>We enrolled 4006 persons of whom 2281 (56.9 %) were female; median age was 40 years (IQR: 31–50); 635 (15.9 %) were at WHO clinical stage IV and 934 (23.3 %) had a CD4 count <200 cells/mm<sup>3</sup>. Median follow-up was 80.4 months (IQR: 48.6–106.7). All in all, 463 participants died (4.37 deaths per 100 person-years), including 296 at one year of follow-up (7.4 % [95 % CI: 6.6–8.2]). ART initiation in 2016–19 and 2020–23 was associated with 27 % (adjusted HR [aHR]: 0.73; 95 % CI: 0.55–0.98) and 63 % (aHR: 0.37; 95 % CI: 0.25–0.56) reductions in one-year mortality rates, respectively, compared to the 2013–16 period.</div></div><div><h3>Conclusion</h3><div>Early mortality risk has significantly decreased over time in Senegal. However, the proportion of PwHIV with AIDS-defining conditions remains concerning. Continued efforts to ensure early diagnosis and prompt linkage to care are needed for more impact.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 8","pages":"Article 104990"},"PeriodicalIF":2.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Low-dose trimethoprim-sulfamethoxazole (TMP-SMX) may be a treatment option for patients with Pneumocystis jirovecii pneumonia (PCP). However, its effectiveness in patients without human immunodeficiency virus (HIV) infection has yet to be thoroughly investigated.
Methods
This retrospective cohort study used data extracted from the Japanese Diagnosis Procedure Combination inpatient database. We included immunocompromised patients without HIV having been diagnosed with PCP and had started TMP-SMX treatment between July 2010 and March 2022. We divided eligible patients into conventional-dose (15.0–20.0 mg/kg/d) and low-dose (7.5–15.0 mg/kg/d) groups and performed propensity-score overlap-weighting analysis. The primary outcome was in-hospital mortality rate. Secondary outcomes were completion of the initial treatment and use of alternatives to TMP-SMX for PCP treatment during hospitalization.
Results
Among 4449 eligible patients, 1682 (37.8 %) and 2767 (62.2 %) received conventional- and low-dose TMP-SMX treatments, respectively. No significant difference was observed in in-hospital mortality (risk difference, −1.4 %; 95 % CI, −4.5–1.7 %; P = 0.388). Low-dose TMP-SMX was associated with increased completion of initial treatment (risk difference, 4.6 %; 95 % CI, 2.3–6.9 %; P < 0.001), and reduced use of alternative agents (risk difference, −4.0 %; 95 % CI, −7.4 to −0.6 %; P = 0.020).
Conclusion
Low-dose TMP-SMX may be a treatment option for patients with non-HIV PCP.
{"title":"Outcomes of low-dose trimethoprim-sulfamethoxazole treatment in patients with non-HIV pneumocystis pneumonia: A nationwide Japanese retrospective cohort study","authors":"Jumpei Taniguchi , Shotaro Aso , Taisuke Jo , Hiroki Matsui , Kiyohide Fushimi , Hideo Yasunaga","doi":"10.1016/j.idnow.2024.104992","DOIUrl":"10.1016/j.idnow.2024.104992","url":null,"abstract":"<div><h3>Objectives</h3><div>Low-dose trimethoprim-sulfamethoxazole (TMP-SMX) may be a treatment option for patients with <em>Pneumocystis jirovecii</em> pneumonia (PCP). However, its effectiveness in patients without human immunodeficiency virus (HIV) infection has yet to be thoroughly investigated.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data extracted from the Japanese Diagnosis Procedure Combination inpatient database. We included immunocompromised patients without HIV having been diagnosed with PCP and had started TMP-SMX treatment between July 2010 and March 2022. We divided eligible patients into conventional-dose (15.0–20.0 mg/kg/d) and low-dose (7.5–15.0 mg/kg/d) groups and performed propensity-score overlap-weighting analysis. The primary outcome was in-hospital mortality rate. Secondary outcomes were completion of the initial treatment and use of alternatives to TMP-SMX for PCP treatment during hospitalization.</div></div><div><h3>Results</h3><div>Among 4449 eligible patients, 1682 (37.8 %) and 2767 (62.2 %) received conventional- and low-dose TMP-SMX treatments, respectively. No significant difference was observed in in-hospital mortality (risk difference, −1.4 %; 95 % CI, −4.5–1.7 %; <em>P</em> = 0.388). Low-dose TMP-SMX was associated with increased completion of initial treatment (risk difference, 4.6 %; 95 % CI, 2.3–6.9 %; <em>P</em> < 0.001), and reduced use of alternative agents (risk difference, −4.0 %; 95 % CI, −7.4 to −0.6 %; <em>P</em> = 0.020).</div></div><div><h3>Conclusion</h3><div>Low-dose TMP-SMX may be a treatment option for patients with non-HIV PCP.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 8","pages":"Article 104992"},"PeriodicalIF":2.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.idnow.2024.104977
Sébastien Briol , Olivier Gheysens , François Jamar , Halil Yildiz , Julien De Greef , Jean Cyr Yombi , Alexia Verroken , Leïla Belkhir
Objective
Staphylococcus aureus bacteremia (SAB) is a leading cause of community and hospital-acquired bacteremia with significant morbidity and mortality. Effective management depends on accurate diagnosis, source control and assessment of metastatic infections. [18F] FDG PET/CT has been shown to reduce mortality in high-risk SAB patients. This study aims to evaluate the impact of [18F] FDG PET/CT on outcomes in patients with SAB.
Methods
Single-center, retrospective, real-life setting study including all consecutive SAB cases from 2017 to 2019. Medical records were analyzed to collect information.
Results
Out of the 315 included patients, 132 underwent [18F] FDG PET/CT. In those patients, a clear focus of infection was more frequently identified, leading to better adapted treatments and extended hospital stays. Overall mortality rates at 30 days, 90 days and one year were 25.1 %, 36.8 % and 44.8 % respectively. Mortality was significantly lower in the [18F] FDG PET/CT group (p < 0.0001) and persisted (p < 0.05) after adjusting for imbalances between groups regarding oncologic patients and deaths within 7 days. The difference in mortality remained significant irrespective of prolonged bacteremia but was not significant with regard to hospital-acquired SAB. Supplementary analysis using the Cox proportional hazards model confirmed that [18F] FDG PET/CT was significantly associated with reduced mortality (p < 0.05).
Conclusion
In this real-life cohort, patients with SAB having undergone [18F] FDG PET/CT experienced lower mortality rates, highlighting the additional value of [18F] FDG PET/CT in SAB management. Further research is needed to identify the subpopulations that would benefit most from the integration of [18F] FDG PET/CT in their work-up.
目的：金黄色葡萄球菌菌血症（SAB）是社区和医院获得性菌血症的主要病因，发病率和死亡率都很高。有效的治疗取决于准确诊断、源头控制和转移性感染评估。研究表明，[18F] FDG PET/CT 可降低高危 SAB 患者的死亡率。本研究旨在评估 [18F] FDG PET/CT 对 SAB 患者预后的影响：单中心、回顾性、真实环境研究，包括2017年至2019年的所有连续SAB病例。分析病历以收集信息：在纳入的 315 例患者中，132 例接受了[18F] FDG PET/CT。在这些患者中，明确的感染病灶被更频繁地发现，从而导致更好的适应性治疗和住院时间的延长。30天、90天和一年的总死亡率分别为25.1%、36.8%和44.8%。[18F]FDG正电子发射计算机断层显像/CT组的死亡率明显较低（p 18F］18F] FDG PET/CT 与死亡率的降低有明显相关性（p 结论：[18F] FDG PET/CT 与死亡率的降低有明显相关性：在这个真实的队列中，接受了[18F] FDG PET/CT 的 SAB 患者死亡率较低，突出了[18F] FDG PET/CT 在 SAB 治疗中的额外价值。还需要进一步研究，以确定哪些亚人群最受益于将[18F] FDG PET/CT纳入检查。
{"title":"Impact of [18F] FDG PET/CT on outcomes in patients with Staphylococcus aureus bacteremia: A retrospective single-center experience","authors":"Sébastien Briol , Olivier Gheysens , François Jamar , Halil Yildiz , Julien De Greef , Jean Cyr Yombi , Alexia Verroken , Leïla Belkhir","doi":"10.1016/j.idnow.2024.104977","DOIUrl":"10.1016/j.idnow.2024.104977","url":null,"abstract":"<div><h3>Objective</h3><div><em>Staphylococcus aureus</em> bacteremia (SAB) is a leading cause of community and hospital-acquired bacteremia with significant morbidity and mortality. Effective management depends on accurate diagnosis, source control and assessment of metastatic infections. [<sup>18</sup>F] FDG PET/CT has been shown to reduce mortality in high-risk SAB patients. This study aims to evaluate the impact of [<sup>18</sup>F] FDG PET/CT on outcomes in patients with SAB.</div></div><div><h3>Methods</h3><div><em>S</em>ingle-center, retrospective, real-life setting study including all consecutive SAB cases from 2017 to 2019. Medical records were analyzed to collect information.</div></div><div><h3>Results</h3><div>Out of the 315 included patients, 132 underwent [<sup>18</sup>F] FDG PET/CT. In those patients, a clear focus of infection was more frequently identified, leading to better adapted treatments and extended hospital stays. Overall mortality rates at 30 days, 90 days and one year were 25.1 %, 36.8 % and 44.8 % respectively. Mortality was significantly lower in the [<sup>18</sup>F] FDG PET/CT group (p < 0.0001) and persisted (p < 0.05) after adjusting for imbalances between groups regarding oncologic patients and deaths within 7 days. The difference in mortality remained significant irrespective of prolonged bacteremia but was not significant with regard to hospital-acquired SAB. Supplementary analysis using the Cox proportional hazards model confirmed that [<sup>18</sup>F] FDG PET/CT was significantly associated with reduced mortality (p < 0.05).</div></div><div><h3>Conclusion</h3><div>In this real-life cohort, patients with SAB having undergone [<sup>18</sup>F] FDG PET/CT experienced lower mortality rates, highlighting the additional value of [<sup>18</sup>F] FDG PET/CT in SAB management. Further research is needed to identify the subpopulations that would benefit most from the integration of [<sup>18</sup>F] FDG PET/CT in their work-up.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104977"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In France, hardware infections occur in 1% of patients following orthopedic surgery. The study aimed to evaluate the quality of life (QoL) and adherence to antibiotic therapy of patients with an orthopedic hardware infection in the postoperative period.
Patients and methods
A prospective observational study was conducted at Rouen University Hospital from May 2022 to May 2023. QoL was evaluated using the Short Form Health Survey (SF-36) and therapeutic adherence using the Girerd questionnaire. These forms were filled out by patients during routine follow-up visits at 6- and 12-week follow-up. A cohort of patients with a non-hardware infection was constituted to compare cases and controls. They were paired according to age, sex, and site of index surgery.
Results
Seventy-nine patients were enrolled as cases and 158 patients as controls. At six weeks and at 12 weeks, significant decreases were observed in 8/8 and 4/8 sub scores of SF-36, respectively (p < 0.05).
Among patients discharged to their homes, at 12 weeks, 30.4 % of patients reported high therapeutic adherence compared to 66.7 % of patients discharged to postoperative care.
Conclusion
Patients treated for postoperative hardware infections following orthopedic surgery reported a significant decrease in QoL and lower therapeutic adherence, particularly when discharged to their homes.
{"title":"Quality of life and therapeutic adherence in patients treated for an orthopedic hardware infection: A prospective observational study","authors":"Baptiste Derosais , Agathe Couturaud , Elise Fiaux , Abdeljalil Zeggay , Thibaut Sabatier , Annaelle Soubieux , Franck Dujardin , Jonathan Curado","doi":"10.1016/j.idnow.2024.104976","DOIUrl":"10.1016/j.idnow.2024.104976","url":null,"abstract":"<div><h3>Objectives</h3><div>In France, hardware infections occur in 1% of patients following orthopedic surgery. The study aimed to evaluate the quality of life (QoL) and adherence to antibiotic therapy of patients with an orthopedic hardware infection in the postoperative period.</div></div><div><h3>Patients and methods</h3><div>A prospective observational study was conducted at Rouen University Hospital from May 2022 to May 2023. QoL was evaluated using the Short Form Health Survey (SF-36) and therapeutic adherence using the Girerd questionnaire. These forms were filled out by patients during routine follow-up visits at 6- and 12-week follow-up. A cohort of patients with a non-hardware infection was constituted to compare cases and controls. They were paired according to age, sex, and site of index surgery.</div></div><div><h3>Results</h3><div>Seventy-nine patients were enrolled as cases and 158 patients as controls. At six weeks and at 12 weeks, significant decreases were observed in 8/8 and 4/8 sub scores of SF-36, respectively (p < 0.05).</div><div>Among patients discharged to their homes, at 12 weeks, 30.4 % of patients reported high therapeutic adherence compared to 66.7 % of patients discharged to postoperative care.</div></div><div><h3>Conclusion</h3><div>Patients treated for postoperative hardware infections following orthopedic surgery reported a significant decrease in QoL and lower therapeutic adherence, particularly when discharged to their homes.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104976"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.idnow.2024.104980
S. Seang , P. Detruchis , E. Todesco , M-A. Valantin , L. Schneider , R. Palich , G. Peytavin , V. Pourcher , A-G. Marcelin , C. Katlama
Objective
To describe the efficacy of intermittent nucleoside analogue-based (NA) regimen to maintain HBV virological suppression in HBV/HIV-1 patients.
Methods
Conducted between 2014 and 2023, this observational retrospective study included all HBV (positive AgHbs)/HIV-1 coinfected patients with HIV RNA ≤ 50 cp/mL and HBV DNA ≤ 25 UI/mL who were switched to an intermittent (<7/7 days(D)) TDF or TAF-containing antiretroviral (ART) regimen. The primary outcome was the HBV virological success rate (SR) (proportion of patients with HBV pVL < 25 UI/mL) at W48.
Results
Among 501 HBV/HIV-1 patients, 19(3.7 %) had switched to an intermittent NA-containing regimen that included TDF/FTC or TDF/3TC or TAF/FTC or TDF alone administered 5D-a-week(n = 7), 4D-a-week(n = 7) or 3D-a-week(n = 5). HBV virological success rates were 100 % [95 %CI 82.3–100] and 100 %[95 %CI 80.5–100] at W48 and W96(n = 17), respectively; with no viral HBV or HIV rebound (61.8 months (32.4–70.3) of follow-up).
Conclusion
This case series shows the potential for intermittent NA-containing regimens to maintain long-term control of HBV replication among suppressed HBV/HIV-1 patients.
{"title":"A case series of intermittent nucleoside analogue-based (NA) regimen to maintain HBV virological suppression in coinfected HBV/HIV patients with suppressed viremia","authors":"S. Seang , P. Detruchis , E. Todesco , M-A. Valantin , L. Schneider , R. Palich , G. Peytavin , V. Pourcher , A-G. Marcelin , C. Katlama","doi":"10.1016/j.idnow.2024.104980","DOIUrl":"10.1016/j.idnow.2024.104980","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the efficacy of intermittent nucleoside analogue-based (NA) regimen to maintain HBV virological suppression in HBV/HIV-1 patients.</div></div><div><h3>Methods</h3><div>Conducted between 2014 and 2023, this observational retrospective study included all HBV (positive AgHbs)/HIV-1 coinfected patients with HIV RNA ≤ 50 cp/mL and HBV DNA ≤ 25 UI/mL who were switched to an intermittent (<7/7 days(D)) TDF or TAF-containing antiretroviral (ART) regimen. The primary outcome was the HBV virological success rate (SR) (proportion of patients with HBV pVL < 25 UI/mL) at W48.</div></div><div><h3>Results</h3><div>Among 501 HBV/HIV-1 patients, 19(3.7 %) had switched to an intermittent NA-containing regimen that included TDF/FTC or TDF/3TC or TAF/FTC or TDF alone administered 5D-a-week(n = 7), 4D-a-week(n = 7) or 3D-a-week(n = 5). HBV virological success rates were 100 % [95 %CI 82.3–100] and 100 %[95 %CI 80.5–100] at W48 and W96(n = 17), respectively; with no viral HBV or HIV rebound (61.8 months (32.4–70.3) of follow-up).</div></div><div><h3>Conclusion</h3><div>This case series shows the potential for intermittent NA-containing regimens to maintain long-term control of HBV replication among suppressed HBV/HIV-1 patients.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104980"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.idnow.2024.104978
Ellen Iileka , Maryke Geldenhuys , Juliet Charity Yauka Nyasulu
Objective
The COVID-19 pandemic severely interrupted the functioning of healthcare systems, negatively affecting the global provision of maternal and child health (MCH) services. This study aims to specify the effects of COVID-19 on these services in the Gauteng province (South Africa) and to put forward context-specific recommendations aimed at augmenting them and ensuring ongoing uninterrupted coverage, even and especially during pandemics.
Methods
In this quantitative study, a retrospective review of District Health Information System data routinely collected between February 2019 and March 2021 was conducted, comparing performance of the relevant indicators across the two-year span. The data were analyzed using Stata 16 statistical software (StataCorp). The two sample t-test with equal variance and the Mann-Whitney test were applied to evaluate the equality of the indicators.
Results
Routine MCH services were negatively impacted, with marked declines in all relevant indicators from the onset of the pandemic. There was a statistically significant decline in cervical cancer coverage and maternal postnatal visits within six days of delivery. While declines in the other critical indicators were likewise observed, they were not statistically significant.
Conclusion
The South African response to the pandemic had negative repercussions on all MCH services in the Gauteng province. The lessons to be drawn from the pandemic experience should help to strengthen health system capacities, boost service provision, and mitigate future damage to the healthcare system.
{"title":"The effects of the SARS-CoV-2 pandemic on the delivery of maternal and child health services in South Africa","authors":"Ellen Iileka , Maryke Geldenhuys , Juliet Charity Yauka Nyasulu","doi":"10.1016/j.idnow.2024.104978","DOIUrl":"10.1016/j.idnow.2024.104978","url":null,"abstract":"<div><h3>Objective</h3><div>The COVID-19 pandemic severely interrupted the functioning of healthcare systems, negatively affecting the global provision of maternal and child health (MCH) services. This study aims to specify the effects of COVID-19 on these services in the Gauteng province (South Africa) and to put forward context-specific recommendations aimed at augmenting them and ensuring ongoing uninterrupted coverage, even and especially during pandemics.</div></div><div><h3>Methods</h3><div>In this quantitative study, a retrospective review of District Health Information System data routinely collected between February 2019 and March 2021 was conducted, comparing performance of the relevant indicators across the two-year span. The data were analyzed using Stata 16 statistical software (StataCorp). The two sample <em>t</em>-test with equal variance and the Mann-Whitney test were applied to evaluate the equality of the indicators.</div></div><div><h3>Results</h3><div>Routine MCH services were negatively impacted, with marked declines in all relevant indicators from the onset of the pandemic. There was a statistically significant decline in cervical cancer coverage and maternal postnatal visits within six days of delivery. While declines in the other critical indicators were likewise observed, they were not statistically significant.</div></div><div><h3>Conclusion</h3><div>The South African response to the pandemic had negative repercussions on all MCH services in the Gauteng province. The lessons to be drawn from the pandemic experience should help to strengthen health system capacities, boost service provision, and mitigate future damage to the healthcare system.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104978"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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