International Journal of Infectious Diseases最新文献

Background: The IFNL4-ΔG/TT (rs368234815) polymorphism controls production of the IFN-λ4 protein; the IFNL4-ΔG allele generates IFN-λ4, IFNL4-TT disrupts IFN-λ4 production. Individuals who carry IFNL4-ΔG have impaired clearance of hepatitis C virus (HCV), but less hepatic inflammation in the face of chronic hepatitis C.

Objective: To conduct a focused phenotype association study to identify additional manifestations of IFNL4-ΔG/TT.

Design: In the UK Biobank Cohort, we analyzed inpatient data from 401,239 White participants with a directly assayed IFNL4-ΔG/TT genotype, of whom 176,555 also provided primary care (outpatient) data. We selected 266 phenotypes with potential biological relevance to IFN-λ4 and created logistic regression models to estimate odds ratios (ORs) for associations between IFNL4-ΔG/TT genotype and these phenotypes in inpatients and outpatients.

Results: Three phenotypes yielded consistent findings (p<0.05) in both databases. For hepatitis A virus (HAV) infection, we found a novel protective association for IFNL4-ΔG carriers (outpatient: OR=0.77, p=0.0005; inpatient: OR=0.62, p=0.015). IFNL4-ΔG was also associated with increased risk for HCV infection (outpatient: OR=1.51, p=0.025; inpatient: OR=1.24, p=0.036) and protectively associated with giant cell arteritis (GCA; outpatient: OR=0.79, p=0.038; inpatient: OR=0.88, p=0.047). Based on calculations that combined inpatient and outpatient data and corrected for multiple comparisons, the association between IFNL4-ΔG and HAV was statistically significant (p=0.00004), while those for HCV and GCA were not.

Conclusion: We report a novel protective association between the IFNL4-ΔG allele, which generates IFN-λ4 protein, and HAV infection. Future studies might examine the mechanism for this association and the therapeutic potential of IFN-λ4 for treating infection with HAV.

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Long-term clonal dynamics of Staphylococcus aureus remain incompletely characterized, particularly with respect to differences between methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) populations. We analyzed the sequence type (ST) distribution of 800 S. aureus blood isolates collected in Korea between 1999 and 2018 using multilocus sequence typing. Temporal trends of ST72 were examined separately for MRSA and MSSA isolates and compared using interaction-based modeling and annual percent change (APC) analyses. The distribution of STs differed between MRSA and MSSA and changed over time. Among MRSA isolates, ST5 remained a predominant lineage throughout the study period. ST72 accounted for 16.9% of all isolates and increased over time in both MRSA and MSSA populations. ST72 emerged earlier and expanded more steadily among MRSA isolates, whereas its appearance among MSSA isolates showed a later onset and greater interannual variability. Although temporal slopes did not differ significantly between populations, APC estimates indicated a steeper increase of ST72 among MSSA isolates. These findings demonstrate the long-term establishment of ST72 within the Korean S. aureus population and highlight distinct population-level expansion patterns between MRSA and MSSA.

Objectives: The objective of this study was to evaluate the feasibility and efficacy of pulmonary rehabilitation in patients with PTLD in Bangladesh with a population-based approach.

Methods: Prospective population-based study in Bangladesh. All patients achieving treatment success were screened with a questionnaire to identify symptoms associated with PTLD. If the screening was positive, the patient underwent further assessments, like clinical examination, spirometry, and 6-Minutes Walking Test (6MWT). Based on the screening results, patients with moderate PTLD were considered eligible for a 6-week pulmonary rehabilitation programme.

Results: Two hundred and two patients met the inclusion criteria and were included in the analysis. After rehabilitation, forced expiratory volume in one second (FEV₁) increased from 1.28 ± 0.47 L to 1.36 ± 0.51 L (p<0.0001), forced vital capacity (FVC) increased from 2.00 ± 0.59 L to 2.10 ± 0.64 L (p<0.0001), and the distance walked in 6MWT increased from 402.8 ± 109.1 m to 456.7 ± 108.6 m (p<0.0001).

Conclusions: Pulmonary rehabilitation for PTLD is feasible and effective in a limited-resource setting such as Bangladesh. We suggest that the improvement of lung function in PTLD patients undergoing pulmonary rehabilitation should be assessed and included as an expected outcome.

Background: West Nile virus (WNV) infection has a broad and heterogeneous clinical spectrum, yet systematic syntheses focusing on clinically and laboratory-confirmed cases remain limited.

Objectives: To characterize the clinical spectrum reported in clinically recognized, laboratory-supported WNV cases, explore differences in symptom profiles according to plaque reduction neutralization test (PRNT) confirmation status, and summarize environmental risk factors described in the clinical literature.

Method: This study was registered in PROSPERO (CRD420250650535) and conducted according to PRISMA guidelines.

Results: A total of 4,062 patients with West Nile virus (WNV) infection from 39 published studies were analysed. Most patients were male (55%), with a mean age of 52. The pooled mortality proportion was 6.23%, increasing to 62% among intensive care unit patients. Central nervous system manifestations were the most frequent (39.39%), followed by systemic (31.21%) symptoms. Only 53% of reported cases were confirmed by PRNT, while the remaining cases were diagnosed using other laboratory-based methods. Cases without PRNT confirmation more often presented with nonspecific symptoms, whereas PRNT-confirmed cases showed a more consistent neurological profile.

Conclusions: West Nile virus infection is a multisystemic disease associated with substantial morbidity and mortality, particularly in neuroinvasive cases. Improved recognition of symptom patterns may facilitate earlier diagnosis. Expanding access to confirmatory diagnostic and strengthening surveillance, especially in at-risk regions, is essential to reduce misclassification bias among clinically recognised WNV cases and improve public health preparedness.

Background: Afghan refugees in Pakistan face a high burden of tuberculosis (TB) due to displacement, overcrowding, and limited healthcare access. This study evaluates the effectiveness of Active Case (ACF) Finding implemented under the Global Fund-supported Multi-Country Grant, targeting Afghan refugees in 45 refugee villages across Khyber Pakhtunkhwa and Balochistan provinces in Pakistan, during 2019 to 2024.

Methods: A longitudinal descriptive study involving secondary data from the National TB Program was conducted. Trained health workers screened communities for TB symptoms, and presumptive cases were referred for diagnosis using smear microscopy, GeneXpert, and chest X-ray. TB patients received standardized treatment and follow-up under DOT. Data were analyzed using STATA v12.1.

Results: Of 612,965 refugees, 560,000 (91%) were screened; 4,860 TB patients were identified (NNS = 115). Pulmonary TB accounted for 76% of cases; 52% were female, and 43% were aged 15-44. Treatment outcomes were available for 4,062 TB patients, with a 97% favourable outcome rate, exceeding WHO's 90% target.

Conclusion: Community-based ACF among Afghan refugees proved effective in detecting TB and achieving high treatment success. The intervention demonstrates the value of targeted outreach in improving TB care among refugees and underserved populations.

Objectives: To describe etiologies of classic fever of unknown origin (FUO) and evaluate associations of FDG PET/CT, C-reactive protein (CRP), age, and Charlson Comorbidity Index (CCI) with biopsy performance, diagnostic yield, and time to diagnosis.

Methods: Retrospective cohort of 179 adults with classic FUO. In the PET/CT subgroup (n=106), logistic regression assessed predictors of biopsy and final diagnosis; CRP discrimination was evaluated by ROC analysis; and time to diagnosis by Kaplan-Meier analysis (CCI=0 vs CCI≥3).

Results: Autoimmune/autoinflammatory diseases (31.3%), infections (30.7%), and malignancy (19.0%) predominated; 16.8% remained undiagnosed. PET/CT positivity predicted biopsy (aOR 4.85, 95% CI 1.45-16.19) but not diagnostic yield. Higher log-CRP increased odds of diagnosis (OR 2.11, 95% CI 1.28-3.48), whereas age decreased odds (OR 0.95 per year, 95% CI 0.90-0.99). CRP AUC 0.68 (cut-off 30.3 mg/L). CCI≥3 was associated with longer time to diagnosis (log-rank p=0.034).

Conclusions: PET/CT mainly facilitated biopsy, while diagnostic yield was more closely related to CRP and age. High comorbidity burden may contribute to diagnostic delay.