Journal of Clinical Virology最新文献_第2页

Performance evaluation of the Abbott Alinity Hepatitis C antigen next assay in a US urban emergency department population 雅培 Alinity 丙型肝炎抗原下一步测定在美国城市急诊科人群中的性能评估。

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-30 DOI: 10.1016/j.jcv.2024.105743

John Prostko , Richard Rothman , Yu-Hsiang Hsieh , Sandra Pearce , Mark Kilbane , Karl McAuley , Edwin Frias , Russell Taylor , Hussain Ali , Carsten Buenning , Jessica Grieshaber , Jenna Bedrava , David Daghfal

Introduction

HCV antibody assays have been used to screen for HCV, but confirmation of acute infection is dependent on RNA or core antigen testing. The aim of the study was to compare the performance of five HCV test methods, including RNA testing, on a US emergency department population.

Methods

Clinical performance metrics were calculated on 708 consenting Johns Hopkins Emergency Department patients who self-reported an increased risk for HCV infection. Detection times of antibody, antigen, and RNA testing were compared using 89 samples from commercially available seroconversion panels. Testing was performed on the Abbott Alinity HCV Ag Next (RUO), Roche Elecsys HCV Duo, Abbott ARCHITECT Anti-HCV, and Elecsys Anti-HCV II assays. RNA testing was performed on the Abbott m2000 system.

Results

Overall, 21 (3.0%) participants tested positive for HCV on at least one test, 11 (52.4%) had chronic, 1 (4.8%) had an acute, and 3 (14.3%) had resolved infections. The Alinity HCV Ag Next assay demonstrated 99.43% specificity when compared to RNA testing. The Alinity HCV Ag Next assay also detected 91.67% of the active infections compared to RNA testing, while the Elecsys HCV Duo Ag assay detected only 58.33%. The seroconversion panel testing demonstrated that the Alinity HCV Ag Next assay detects an infection within 0.8 days of an RNA result.

Conclusion

The Alinity HCV Ag Next assay demonstrated excellent concordance to RNA testing in a US urban E.D. population. This data supports the utility of Alinity HCV Ag Next in diagnosis of active HCV infections.

导言：HCV抗体检测已被用于筛查HCV，但急性感染的确诊则依赖于RNA或核心抗原检测。本研究的目的是在美国急诊科人群中比较包括 RNA 检测在内的五种 HCV 检测方法的性能：方法：对约翰霍普金斯大学急诊科的 708 名自述感染 HCV 风险增高并征得同意的患者计算临床性能指标。使用 89 份来自市售血清转换面板的样本比较了抗体、抗原和 RNA 检测的检测时间。雅培 Alinity HCV Ag Next (RUO)、罗氏 Elecsys HCV Duo、雅培 ARCHITECT Anti-HCV 和 Elecsys Anti-HCV II 分析仪进行了检测。RNA 检测在雅培 m2000 系统上进行：总体而言，21 名参与者（3.0%）至少有一次检测结果呈 HCV 阳性，其中 11 人（52.4%）为慢性感染，1 人（4.8%）为急性感染，3 人（14.3%）为已解决感染。Alinity HCV Ag Next 检测法与 RNA 检测法相比，特异性高达 99.43%。与 RNA 检测相比，Alinity HCV Ag Next 检测法还能检测出 91.67% 的活动感染，而 Elecsys HCV Duo Ag 检测法只能检测出 58.33%。血清转换面板检测表明，Alinity HCV Ag Next 检测试剂盒能在 RNA 检测结果出来后的 0.8 天内检测出感染：结论：Alinity HCV Ag Next 检测法与 RNA 检测法在美国城市 E.D.Population 中的一致性非常好：这些数据支持 Alinity HCV Ag Next 在诊断活动性 HCV 感染中的实用性。

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引用次数: 0

Standardization and evaluation of an in-house ELISA for the detection of rabies antibody in a tertiary care centre in South India 印度南部一家三级医疗中心用于检测狂犬病抗体的内部酶联免疫吸附试验的标准化和评估

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-28 DOI: 10.1016/j.jcv.2024.105742

Kalpana Thangavelu, Hubert D-J Daniel, Rajesh Kannangai, Asha Mary Abraham, Selva Kumar Velladurai, Dr. Shoba Mammen

Background

Rapid fluorescent focus inhibition test (RFFIT), a neutralization-based assay for detecting rabies antibodies, is the gold standard. The National Action Plan for Dog Mediated Rabies Elimination (NAPRE) is a national program that strategizes the establishment of enzyme-linked immunosorbent assays (ELISA) to detect rabies antibodies.

Objective

We developed an in-house ELISA to screen for rabies antibodies using rabies vaccine antigen to study vaccine response among health care workers (HCWs) who received pre-exposure prophylaxis and a few animal bite victims who received post-exposure prophylaxis with rabies vaccine.

Study design

A prospective study was carried out from April to September 2023 at the Department of Clinical Virology of a tertiary care center in South India. A total of 161 serum specimens, which included 155 serum samples from study participants and 6 samples from a reference laboratory (as controls), were obtained during the study period. Rabies antibody was determined by the in-house standardized ELISA developed using the rabies vaccine and compared with the reference assay, RFFIT. The accuracy indices of the in-house ELISA were estimated by MedCalc software (version 22.023).

Results

A panel of 86 positive and 75 negative serum samples was used for evaluating the in-house standardized ELISA. The sensitivity, specificity, positive and negative predictive values of the in-house ELISA were 98.8 %, 100 %, 100 %, and 98.7 % respectively. The accuracy of the in-house ELISA is 99.4 %.

Conclusion

ELISA can be a practically feasible and less expensive assay compared to RFFIT which is a cumbersome procedure with a long turn-around time of 3–4 days.

背景快速荧光聚焦抑制试验（RFFIT）是一种基于中和的狂犬病抗体检测方法，是检测狂犬病抗体的黄金标准。消灭犬媒狂犬病国家行动计划（NAPRE）是一项国家计划，其战略是建立酶联免疫吸附试验（ELISA）来检测狂犬病抗体。研究设计 2023 年 4 月至 9 月，南印度一家三级医疗中心的临床病毒学部门开展了一项前瞻性研究。研究期间共采集了 161 份血清样本，其中 155 份来自研究参与者，6 份来自参考实验室（作为对照）。狂犬病抗体通过使用狂犬病疫苗开发的内部标准化酶联免疫吸附测定法进行测定，并与参考测定法 RFFIT 进行比较。用 MedCalc 软件（22.023 版）估算了内部 ELISA 的准确性指数。内部 ELISA 的灵敏度、特异性、阳性预测值和阴性预测值分别为 98.8%、100%、100% 和 98.7%。内部 ELISA 的准确率为 99.4%。结论 ELISA 与 RFFIT 相比，是一种实际可行且成本较低的检测方法，后者程序繁琐，周转时间长达 3-4 天。

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引用次数: 0

Detection of yellow fever virus genome in urine following natural infection or vaccination: review of current knowledge 1985–2023. 自然感染或接种疫苗后尿液中黄热病病毒基因组的检测：1985-2023 年现有知识回顾。

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-24 DOI: 10.1016/j.jcv.2024.105740

Zsofia Igloi , Laura Pezzi , Remi N. Charrel , Marion Koopmans

Background

Yellow fever virus (YFV) is endemic in the (sub)tropical regions of Africa and South America and is prone to cause epidemics. Molecular testing of YFV by reverse transcription-polymerase chain reaction (RT-PCR) was recently adopted by WHO using blood. Urine is a non-invasive diagnostic specimen which has been proven to be useful in diagnosing several flavivirus infections. Until now, systematic data on the usefulness of urine in YFV molecular diagnostics was lacking.

Methods

We have carried out an extensive literature search using key words “yellow fever AND urine” in PubMed/Medline, Embase and Web of Science.

Results

The search resulted initially in 113 publications. All titles and abstracts were screened and 15 were analyzed in detail. After natural infection (10 articles), the detection ratio of YFV in blood with RT-PCR was 61 % (105/171 samples) vs. 59 % (139/234) in urine from patients with mild/severe infections. YFV could be first detected at average 4.3 days in blood vs. 6.1 days in urine and last detected till 17.2 vs. 31.1 days respectively (significant difference p < 0.05). Viral load over time in blood was not statistically different from urine. Virus could be isolated from blood, urine and semen. Following vaccination, virus was detected longer in patients with vaccine adverse events (VAE) compared to healthy vaccinees (average 34 vs. 25 days, not significant p > 0.05).

Conclusion

YFV can be detected in urine later but longer. Thus, we see added value for YF molecular diagnostics and sequencing and recommend it besides blood as a standard specimen, especially for late samples post onset.

背景黄热病病毒（YFV）是非洲和南美洲（亚）热带地区的地方病，容易引发流行病。世卫组织最近采用血液通过反转录聚合酶链反应（RT-PCR）对黄热病病毒进行分子检测。尿液是一种非侵入性诊断样本，已被证明可用于诊断多种黄病毒感染。到目前为止，还缺乏关于尿液在黄热病病毒分子诊断中的作用的系统数据。方法我们在 PubMed/Medline、Embase 和 Web of Science 中使用关键词 "黄热病和尿液 "进行了广泛的文献检索。对所有标题和摘要进行了筛选，并对 15 篇文章进行了详细分析。自然感染后（10 篇文章），用 RT-PCR 法检测血液中 YFV 的比例为 61%（105/171 个样本），而检测轻度/重度感染患者尿液中 YFV 的比例为 59%（139/234 个样本）。血液中首次检测到 YFV 的平均时间为 4.3 天，而尿液中为 6.1 天；最后检测到 YFV 的平均时间为 17.2 天，而尿液中为 31.1 天（显著差异 p <0.05）。血液中的病毒载量与尿液中的病毒载量没有统计学差异。病毒可从血液、尿液和精液中分离出来。接种疫苗后，与健康接种者相比，疫苗不良事件（VAE）患者检测到病毒的时间更长（平均 34 天对 25 天，差异不显著 p > 0.05）。因此，我们认为 YF 分子诊断和测序具有附加值，建议除血液外将其作为标准样本，尤其是发病后的晚期样本。

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引用次数: 0

Clinical accuracy of OncoPredict HPV Quantitative Typing (QT) assay on self-samples OncoPredict HPV 定量分型 (QT) 分析法在自采样本上的临床准确性

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-21 DOI: 10.1016/j.jcv.2024.105737

Ardashel Latsuzbaia , Marianna Martinelli , Chiara Giubbi , Kate Cuschieri , Hana Elasifer , Anna D. Iacobone , Fabio Bottari , Andrea F. Piana , Roberto Pietri , Giancarlo Tisi , Franco Odicino , Clementina E. Cocuzza , Marc Arbyn , European VALHUDES working group

Background

The VALHUDES initiative was established to assess the clinical accuracy of HPV assays to detect cervical precancers using urine and vaginal self-samples compared to cervical clinician-collected samples. Here, the clinical performance of OncoPredict HPV Quantitative Typing (QT) assay (OncoPredict QT) was evaluated.

Methods

490 women referred to colposcopy self-collected a urine and a vaginal specimen using Colli-Pee and FLOQSwab, respectively. Subsequently, a colposcopy was performed, and a cervical sample was collected with Cervex-Brush, followed by biopsy if clinically indicated. Vaginal samples were transported dry and resuspended in 5 mL of eNAT medium, whilst cervical brushings were immediately transferred in 20 mL ThinPrep.

Results

The clinical sensitivity of OncoPredict HPV QT testing for CIN2+ in urine and vaginal self-samples was similar to cervical samples (ratios of 0.99 [95 % CI 0.94–1.05] and 1.00 [95 % CI 0.96–1.04]), respectively, when manufacturer's cut-offs were applied. The specificity for <CIN2 on both self-samples was lower than on cervical samples (urine/cervical ratio = 0.91 [95 % CI 0.84–0.98]; vaginal/cervical ratio = 0.90 [95 % CI 0.84–0.98]). Cut-off optimisation improved specificity without compromising sensitivity. Median viral load values adjusted for cellularity were significantly higher in cervical samples compared to urine or vaginal self-samples, in general for all 12 high-risk HPV and in particular for HPV16, 18, 31, 33, 35, 45, 51, 58 (p < 0.05). No difference was observed in median viral loads between urine and vaginal samples.

Conclusion

Following cut-off optimisation OncoPredict HPV QT assay demonstrated similar accuracy on self-collected versus cervical samples.

背景VALHUDES计划旨在评估使用尿液和阴道自取样本检测宫颈癌前病变的HPV测定与宫颈临床医生采集样本相比的临床准确性。方法 490 名转诊至阴道镜检查的妇女分别使用 Colli-Pee 和 FLOQSwab 自取了尿液和阴道样本。随后进行阴道镜检查，用 Cervex-Brush 采集宫颈样本，如有临床指征则进行活检。结果当采用制造商的临界值时，OncoPredict HPV QT 检测尿液和阴道自取样本中 CIN2+ 的临床灵敏度与宫颈样本相似（比率分别为 0.99 [95 % CI 0.94-1.05] 和 1.00 [95 % CI 0.96-1.04]）。两种自检样本的<CIN2特异性均低于宫颈样本（尿液/宫颈比值=0.91 [95 % CI 0.84-0.98]；阴道/宫颈比值=0.90 [95 % CI 0.84-0.98]）。临界值优化提高了特异性，但并不影响灵敏度。与尿液或阴道自检样本相比，宫颈样本经细胞调整后的病毒载量中位值明显较高，一般来说，所有 12 种高风险 HPV 都是如此，尤其是 HPV16、18、31、33、35、45、51 和 58（p <0.05）。尿液样本和阴道样本的病毒载量中位数没有差异。结论经过截断点优化后，OncoPredict HPV QT 检测法在自取样本和宫颈样本中显示出相似的准确性。

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引用次数: 0

International external quality assessment study for detection of monkeypox virus by PCR supporting laboratory preparedness during the 2022–2023 mpox outbreak and beyond 通过 PCR 检测猴痘病毒的国际外部质量评估研究，支持实验室在 2022-2023 年猴痘爆发期间及以后做好准备。

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-21 DOI: 10.1016/j.jcv.2024.105741

Rosina Ehmann , Oliver Donoso Mantke , Elaine McCulloch , Amani Yousef , Alastair Ricketts , Harry Staines , Joachim J. Bugert , Roman Wölfel , Hubert G.M. Niesters

Background

Diagnostic capabilities and correspondent External Quality Assessments (EQA) are key for outbreak preparedness. To support diagnostic facilities with a quality assessment of newly established monkeypox virus (MPXV) molecular diagnostic workflows, Quality Control for Molecular Diagnostics (QCMD) and the Bundeswehr Institute of Microbiology (IMB) piloted an international EQA study conducting four challenges from autumn 2022 to summer 2023 during the global mpox outbreak.

Objectives

To assess the performance (sensitivity/specificity) of molecular assays used by diagnostic laboratories.

Study design

Inactivated EQA panels were prepared and distributed containing seven samples of clade Ia and clade IIb MPXV strains at different viral concentrations, two specificity controls with other zoonotic orthopoxviruses (vaccinia and cowpox virus) and a negative control. Assessment was based on reported qualitative testing results.

Results

In this outbreak-related EQA study, a total of 192 laboratories from 37 countries reported 346 qualitative datasets. Overall, core samples were correctly detected by approximately 92 % of participants in all four challenges. While sensitivity performance was acceptable in at least 90 % of datasets correctly reported even for educational MPXV-positive samples with low viral concentration [10² genome equivalents (GE)/mL], several laboratories reported the educational specificity controls as false positives or were unable to differentiate MPXV from related orthopoxviruses.

Conclusions

Mpox is now a globally occurring infection with a demand for quality-assured diagnostic capabilities. The newly established EQA scheme presented here, offers a multi-purpose panel for orthopoxviruses with a focus on MPXV which will continue to ensure diagnostic quality in clinical settings with up-to-date sample panels.

背景：诊断能力和相应的外部质量评估（EQA）是防范疫情爆发的关键。为支持诊断机构对新建立的猴痘病毒（MPXV）分子诊断工作流程进行质量评估，分子诊断质量控制中心（QCMD）和德国联邦国防军微生物研究所（IMB）在2022年秋季至2023年夏季全球猴痘疫情暴发期间开展了一项国际外部质量评估试点研究，进行了四次挑战：评估诊断实验室使用的分子检测方法的性能（灵敏度/特异性）：研究设计：制备并分发了灭活的 EQA 面板，其中包含七份不同病毒浓度的 Ia 支和 IIb 支 MPXV 株样本、两份含有其他人畜共患病正痘病毒（疫苗和牛痘病毒）的特异性对照和一份阴性对照。评估基于报告的定性检测结果：在这项与疫情相关的 EQA 研究中，共有来自 37 个国家的 192 个实验室报告了 346 个定性数据集。总体而言，在所有四项挑战中，约 92% 的参与者都能正确检测出核心样本。即使是病毒浓度较低的MPXV阳性教育样本[102基因组当量（GE）/毫升]，至少有90%的数据集报告正确，灵敏度表现尚可接受，但一些实验室报告的教育特异性对照为假阳性，或无法将MPXV与相关正痘病毒区分开来：结论：MPXV 现已成为一种全球性感染，需要有质量保证的诊断能力。本文介绍的新建立的 EQA 计划提供了一个以 MPXV 为重点的骨痘病毒多用途样本库，它将继续确保临床环境中最新样本库的诊断质量。

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引用次数: 0

Validation, implementation and quality control of a Torque Teno Virus qPCR in a multinational clinical trial 在一项跨国临床试验中验证、实施和控制 Torque Teno 病毒 qPCR。

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-16 DOI: 10.1016/j.jcv.2024.105738

E.J. Gore , L. Gard , P. Bourgeois , D. Kulifaj , E. McCulloch , P.G. Spezia , H.G.M. Niesters , F. Maggi , G. Bond , C. Van Leer-Buter , TTVguideTX consortium partners

Background

Immunosuppressive medication after organ transplantation is usually dosed through therapeutic drug monitoring. Trough levels of antirejection medication however, do not adequately predict rejection or infections. The TTVguideIT trial is a multinational clinical trial evaluating the safety of Torque Teno Virus (TTV) load assessed by qPCR, as an alternative to trough level tacrolimus dosing.

Methods

Prior to, and during the clinical trial, the inter-and intra-laboratory variability, accuracy, and precision of the TTV R-GENE® assay was evaluated through analysis of internal quality control (IQC), external quality assessment (EQA) and linearity panels performed by the thirteen participating clinical virology laboratories, each using their standard testing platforms.

Results

IQC samples with a target of 4 log₁₀ copies/mL (cp/mL) were tested by the participating laboratories 130 times during the implementation phase and 987 times during the trial phase. They showed excellent accuracy, with an inter-laboratory standard deviation (SD) of 0.17 log₁₀ cp/mL, and an intra-laboratory SD of 0.03 to 0.20 log₁₀ cp/mL during the implementation phase, and an inter-laboratory SD of 0.19 log₁₀ cp/mL, and an intra-laboratory SD 0.07 to 0.18 log₁₀ cp/mL during the trial phase. Three EQA panels and three linearity panels showed similarly small variability during implementation as well as within the trial phase.

Conclusion

This data shows that TTV load measurement can be standardized for use in a multinational clinical trial. By using IQC, LP and EQA samples, the quality and integrity of the assay can be compared between laboratories and precise and accurate results can be generated.

背景：器官移植后的免疫抑制药物通常通过治疗药物监测来确定剂量。然而，抗排斥药物的低浓度水平并不能充分预测排斥或感染。TTVguideIT 试验是一项多国临床试验，旨在评估通过 qPCR 评估托克替诺病毒（TTV）载量的安全性，以替代谷值水平的他克莫司剂量：方法：在临床试验之前和期间，通过分析参与试验的 13 家临床病毒学实验室使用各自的标准检测平台进行的内部质量控制 (IQC)、外部质量评估 (EQA) 和线性分析，评估了 TTV R-GENE® 检测方法在实验室内部和实验室之间的变异性、准确性和精密度：参与实验室在实施阶段检测了 130 次目标值为 4 log10 copies/mL (cp/mL) 的 IQC 样品，在试验阶段检测了 987 次。在实施阶段，实验室间标准偏差（SD）为 0.17 log10 cp/mL，实验室内标准偏差为 0.03 至 0.20 log10 cp/mL；在试验阶段，实验室间标准偏差为 0.19 log10 cp/mL，实验室内标准偏差为 0.07 至 0.18 log10 cp/mL。三个 EQA 面板和三个线性度面板在实施期间和试验阶段也显示出类似的小变异性：这些数据表明，TTV 负荷测量可标准化用于跨国临床试验。通过使用 IQC、LP 和 EQA 样品，可以在不同实验室之间比较检测的质量和完整性，并得出精确和准确的结果。

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引用次数: 0

Parvovirus B19 remains an underestimated pathogen among infections during gestation in Argentina: Insights through the study of symptomatic and asymptomatic pregnant patients and newborns from Córdoba 副病毒 B19 仍是阿根廷妊娠期感染中被低估的病原体：通过对科尔多瓦有症状和无症状孕妇及新生儿的研究得出的启示。

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-16 DOI: 10.1016/j.jcv.2024.105739

María Belén Colazo Salbetti , Gabriel Boggio , Néstor Dicuatro , Ana Paula Gudiño , Nicolás Olivera , Mauro Pedranti , María Beatriz Isa , Ariel Bertoldi , María José Miranda , Gonzalo Rodriguez Lombardi , Paola Sicilia , Gonzalo Castro , Laura Moreno , María Pilar Adamo

Background

Parvovirus B19 (B19 V) infection during pregnancy can cause adverse fetal outcomes. Our aim was to characterize both clinical and asymptomatic maternal and neonatal cases by studying virological and serological markers of B19 V infection, and to sequence the complete genome of the circulating virus in Argentina.

Methods

Symptomatic patients were included based on maternal and/or fetal-neonatal signs attributable to B19 V infection during gestation. Pregnant patients were analyzed in either the timely diagnosis group (TD, samples obtained when symptoms were present and infection was suspected) or the retrospective diagnosis group (RD, samples collected immediately postpartum), and newborns were analyzed at birth. A sample of asymptomatic individuals was also analyzed. Diagnostic tests (PCR/qPCR/serology) and sequencing were performed on archived serum samples from 2018 to 2023, and clinical data were obtained from medical records.

Results

We studied 328 symptomatic patients, including 185 pregnant patients (73 TD and 112 RD) and 143 newborns. Among them, we identified 27/328 (8.2 %) positive cases (B19V+): 12/73 (16.4 %) in the TD group, 6/112 (5.4 %) in the RD group, and 9/143 (6.3 %) newborns. Within the 77 mother-newborn pairs included, there were 8 (10.4 %) B19 V infections and 6 cases of vertical transmission. Additionally, B19 V infection was detected in 26/310 (8.4 %) asymptomatic patients. Phylogenetic analysis identified genotype 1a as a circulating strain in Argentina.

Conclusions

Our findings highlight the need to raise awareness and enhance diagnostic approaches in Argentina to more effectively identify and manage B19 V infections during pregnancy in our region.

背景：妊娠期感染 Parvovirus B19（B19 V）会对胎儿造成不良影响。我们的目的是通过研究 B19 V 感染的病毒学和血清学标志物来描述临床和无症状孕产妇和新生儿病例的特征，并对阿根廷流行病毒的完整基因组进行测序：方法：根据孕产妇和/或胎儿-新生儿在妊娠期间因 B19 V 感染而出现的体征，纳入有症状的患者。对孕妇的分析分为及时诊断组（TD，在出现症状并怀疑感染时采集样本）或回顾诊断组（RD，产后立即采集样本），新生儿则在出生时进行分析。此外，还对无症状者的样本进行了分析。对2018年至2023年的存档血清样本进行了诊断测试（PCR/qPCR/血清学）和测序，并从病历中获取了临床数据：我们研究了 328 名有症状的患者，包括 185 名孕妇（73 名 TD 和 112 名 RD）和 143 名新生儿。其中，我们发现了27/328（8.2%）例阳性病例（B19V+）：TD组12/73（16.4%）例，RD组6/112（5.4%）例，新生儿9/143（6.3%）例。在 77 对母婴中，有 8 例（10.4%）B19 V 感染和 6 例垂直传播。此外，在 26/310 例（8.4%）无症状患者中检测到 B19 V 型感染。系统发育分析确定基因型 1a 是阿根廷的一种流行菌株：我们的研究结果凸显了在阿根廷提高人们对 B19 V 感染的认识和加强诊断方法的必要性，以便更有效地识别和处理本地区的妊娠期 B19 V 感染。

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引用次数: 0

Opt-out HIV screening in adults attending the Emergency Department of a London teaching hospital 在伦敦一家教学医院急诊科就诊的成人中选择不接受艾滋病毒筛查。

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-08 DOI: 10.1016/j.jcv.2024.105735

Raissa Rachman , Tanzina Haque , Tristan J Barber , Fiona Burns , Jessica Pinto , Alan Hunter , Russell Durkin , Jennifer Hart

Background

Opt-out Emergency Department blood borne virus (EDBBV) screening was introduced at the Royal Free Hospital under the NHSEI (NHS England and NHS Improvement) programme to expand opt-out testing in local authority areas with high HIV prevalence. This initiative was part of the “Toward Zero” policy towards ending HIV transmission in England by 2030.

Methods

All patients attending the Royal Free Hospital Emergency Department (ED) aged 16 and over were screened for blood borne viruses (HIV/HBV/HCV) unless they opted out. We looked at HIV data from patients seen in ED between the initiation of EDBBV testing on the 12^th of April and 12^th of August 2022. Hepatitis B and C data was reviewed in a separate study.

Outcome

A total of 12,208 samples from 10,641 patients were screened for HIV. Amongst these samples there were 88 which were positive, giving a seroprevalence of 0.84 %. There were 48 patients who were already known to local HIV services, 35 were known to HIV services outside of our Trust and 5 were new diagnoses.

Conclusion

Our results confirmed our local HIV prevalence to be very high, as per the UK Health Security Agency and supports the need for HIV testing. Opt-out ED BBV screening has been a highly effective method for identifying people living with HIV who are unaware of their status.

背景：根据英国国家医疗服务体系（NHSEI）和英国国家医疗服务体系改进（NHS Improvement）计划，皇家自由医院引入了急诊科血液传播病毒（EDBBV）选择性筛查，在艾滋病高发地区扩大选择性检测范围。这一举措是 "迈向零 "政策的一部分，旨在到 2030 年在英格兰杜绝 HIV 传播：所有在皇家自由医院急诊科（ED）就诊的 16 岁及以上患者都要接受血液传播病毒（HIV/HBV/HCV）筛查，除非他们选择不接受筛查。我们研究了自 2022 年 4 月 12 日开始进行 EDBBV 检测至 8 月 12 日期间急诊科就诊患者的 HIV 数据。乙肝和丙肝数据在另一项研究中进行了审查：共对来自 10,641 名患者的 12,208 份样本进行了艾滋病毒筛查。在这些样本中，有 88 份呈阳性，血清阳性率为 0.84%。其中有 48 名患者已在当地的 HIV 服务机构接受过检测，35 名患者在信托基金以外的 HIV 服务机构接受过检测，5 名患者是新诊断出的：我们的结果证实，根据英国卫生安全局的数据，我们当地的 HIV 感染率非常高，因此有必要进行 HIV 检测。选择不接受 ED BBV 筛查是一种非常有效的方法，可以识别不知道自己感染情况的 HIV 感染者。

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引用次数: 0

Metagenomic characterization of viruses in the serum of children with newly diagnosed cancer 新诊断癌症儿童血清中病毒的元基因组特征

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-06 DOI: 10.1016/j.jcv.2024.105736

Gustaf Leijonhufvud , Tatiany Aparecida Teixeira Soratto , Gabriel Machado Matos , Amanj Bajalan , Claudia Eichler-Jonsson , Britt Gustafsson , Gordana Bogdanovic , Tobias Allander , Gustaf Ljungman , Björn Andersson

Background and Objectives

A large cohort of pediatric patients with various forms of childhood cancer was investigated for the presence of viruses using metagenomics. A total of 476 patient samples, collected between 1989 and 2018, were analyzed, representing various pediatric oncological diagnoses and a control group of non-malignant diagnoses.

Study design

The study was carried out using metagenomic sequencing of serum samples. Viruses were identified and analyzed using bioinformatics methods, followed by Polymerase chain reaction (PCR) confirmation

Results

The results indicate that a wide range of viruses can be detected in the bloodstream of children with newly diagnosed cancer. Nine viral genomes were identified: Human Pegivirus (HPgV), Hepatitis C virus, Parechovirus 1, Rhinovirus C, Human papillomavirus 116, Human polyomavirus 10, Parvovirus B19, and different variants of Torque Teno Virus (TTV). In this study, a previously unknown virus was found belonging to the Iflavirdae family in the order Picornavirales. HPGV was significantly more common in patients with leukemia compared to other conditions.

Conclusions

These results highlight the abundance of systemic virus infections in children, and the value of metagenomic sequencing for hypothesis forming regarding the associations between virus infections and cancer.

背景与目的研究人员利用元基因组学方法对患有各种形式儿童癌症的大量儿科患者进行了调查，以确定是否存在病毒。共分析了 1989 年至 2018 年间收集的 476 份患者样本，这些样本代表了各种儿科肿瘤诊断和非恶性诊断对照组。结果结果表明，在新诊断癌症患儿的血液中可以检测到多种病毒。共鉴定出九种病毒基因组：人类佩吉病毒 (HPgV)、丙型肝炎病毒、帕雷奇病毒 1、鼻病毒 C、人类乳头瘤病毒 116、人类多瘤病毒 10、副病毒 B19 和托克特诺病毒 (TTV) 的不同变种。在这项研究中，发现了一种以前未知的病毒，属于短小病毒目伊夫拉病毒科。结论：这些结果凸显了儿童全身性病毒感染的广泛性，以及元基因组测序在病毒感染与癌症相关性假设形成方面的价值。

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引用次数: 0

High-risk HPV mRNA testing on self-samples offered to those who do not attend for organised cervical screening – real world data from the Dumfries and Galloway region in Scotland 对未参加有组织宫颈筛查者进行高风险 HPV mRNA 自采样检测--来自苏格兰邓弗里斯和加洛韦地区的真实数据

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology

Pub Date : 2024-10-03 DOI: 10.1016/j.jcv.2024.105734

William Forson , Ramya Bhatia , Heather Currie , Hana Elasifer , Linzi Connor , Allan Wilson , Kate Cuschieri

Background

HPV self sampling can act as a tool to engage women in cervical screening and population based studies can inform optimal implementation of this approach.

Methods

Self sampling kits were mailed to women who had defaulted from routine screening resident in an entire territorial health board in Scotland. Kit return rates and compliance to colposcopy follow up in those who were HPV mRNA positive were assessed. Concordance of the self-sample with samples taken later at colposcopy was measured alongside PPV of an mRNA positive result for CIN2+.

Results

Of 4173 women invited to participate, 20.5 %, returned their kit and a greater return rate with increasing age was observed. HPV mRNA positivity was 12.0 %, and invalidity rate was approximately 3 %. Compliance to colposcopy follow up was 88.3 % and the PPV for an mRNA test for CIN2+ on a self sample was 25.6 %. hr-HPV concordance on the initial swab and the follow up swab and liquid based cytology (LBC) sample taken at colposcopy was 67.1 % and 30 % respectively.

Conclusions

HPV self sampling using a “mail to all” approach is feasible in Scotland although only 1 in 5 actively responded to the offer. Future work to monitor screening behaviours in those who were invited but did not engage initially will help quantify any additional benefit(s) incurred.

背景 HPV 自我采样可以作为一种工具，吸引妇女参与宫颈筛查，而基于人群的研究可以为这种方法的最佳实施提供信息。对 HPV mRNA 阳性者的工具包回收率和阴道镜随访依从性进行了评估。结果在应邀参加筛查的 4173 名妇女中，20.5% 的人退回了试剂盒，而且随着年龄的增长，退回试剂盒的比例也在增加。HPV mRNA 阳性率为 12.0%，无效率约为 3%。对阴道镜随访的依从性为 88.3%，对自我样本进行 CIN2+ mRNA 检测的 PPV 为 25.6%。初次拭子与阴道镜随访拭子和液基细胞学 (LBC) 样本的 hr-HPV 一致性分别为 67.1% 和 30%。未来对那些收到邀请但最初未参与筛查的人的筛查行为进行监测的工作将有助于量化所产生的任何额外益处。

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引用次数: 0