Pub Date : 2025-10-15DOI: 10.1016/j.jcv.2025.105881
Osaretin Emmanuel Asowata , Tracy McMillen , Krupa Jani , Brenden Clark , Sejal Morjaria , Mini Kamboj , N.Esther Babady
Background
Enteroviruses (EV) are associated with a range of syndromes including respiratory infections. Non-polio enteroviruses like EV-D68 can cause more severe symptoms in children, and immunocompromised individuals. The goal of this study was to determine the prevalence and genotypes of EV in a pediatric oncology patient population.
Methods
Pediatric patients (<18 years old) testing positive for Rhinovirus/Enterovirus (RV/EV) by multiplexed respiratory pathogens panels between September and December 2022 and 2023 were included in the study. RV/EV positive nasopharyngeal swabs (NPS) specimens were further characterized using pan-enterovirus RT-PCR, EV-D68 RT-PCR and Whole genome sequencing (WGS). Clinical characteristics of EV positive patients and matched controls were extracted from the clinical information system.
Results
Across the two study periods, 3.8 % (9/238) and 3.6 % (8/225) EV were identified in RV/EV positives NPS in 2022 and 2023 respectively. The most prevalent EV species were EV-D68 (3/9, 33 %) and Coxsackievirus A6 (3/9, 33 %). All three patients with EV-D68 were male with an underlying diagnosis of acute lymphoblastic lymphoma or neuroblastoma. Besides, the EV-D68 detections were only from the 2022 NPS samples. There were no differences in symptoms severity between patients with or without EV infections.
Conclusions
The prevalence of EV during the study periods was low in this patient population and not associated with severe symptoms. However, further exploration is required to understand the relationship between EV infection and patient symptoms since this study was limited by the low EV detection. Larger studies are needed to further characterize EV infections in this patient population.
{"title":"Prevalence and epidemiology of enterovirus species in a pediatric oncology patient population","authors":"Osaretin Emmanuel Asowata , Tracy McMillen , Krupa Jani , Brenden Clark , Sejal Morjaria , Mini Kamboj , N.Esther Babady","doi":"10.1016/j.jcv.2025.105881","DOIUrl":"10.1016/j.jcv.2025.105881","url":null,"abstract":"<div><h3>Background</h3><div>Enteroviruses (EV) are associated with a range of syndromes including respiratory infections. Non-polio enteroviruses like EV-D68 can cause more severe symptoms in children, and immunocompromised individuals. The goal of this study was to determine the prevalence and genotypes of EV in a pediatric oncology patient population.</div></div><div><h3>Methods</h3><div>Pediatric patients (<18 years old) testing positive for Rhinovirus/Enterovirus (RV/EV) by multiplexed respiratory pathogens panels between September and December 2022 and 2023 were included in the study. RV/EV positive nasopharyngeal swabs (NPS) specimens were further characterized using pan-enterovirus RT-PCR, EV-D68 RT-PCR and Whole genome sequencing (WGS). Clinical characteristics of EV positive patients and matched controls were extracted from the clinical information system.</div></div><div><h3>Results</h3><div>Across the two study periods, 3.8 % (9/238) and 3.6 % (8/225) EV were identified in RV/EV positives NPS in 2022 and 2023 respectively. The most prevalent EV species were EV-D68 (3/9, 33 %) and Coxsackievirus A6 (3/9, 33 %). All three patients with EV-D68 were male with an underlying diagnosis of acute lymphoblastic lymphoma or neuroblastoma. Besides, the EV-D68 detections were only from the 2022 NPS samples. There were no differences in symptoms severity between patients with or without EV infections.</div></div><div><h3>Conclusions</h3><div>The prevalence of EV during the study periods was low in this patient population and not associated with severe symptoms. However, further exploration is required to understand the relationship between EV infection and patient symptoms since this study was limited by the low EV detection. Larger studies are needed to further characterize EV infections in this patient population.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105881"},"PeriodicalIF":3.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-10DOI: 10.1016/j.jcv.2025.105880
Tayná E. Lima , Carlos A.A. Brito , Laura H.V.G. Gil , Rafael Dhalia , Franciane M.E. Teixeira , Maria N. Sato , Gabriel L. Wallau , Roberto D. Lins , Isabelle F.T. Viana
The Coronavirus disease 2019 (COVID-19) pandemic has raised concerns regarding the specificity of serological assays due to potential antibody cross-reactivity. In this study, we analyzed sera from 57 individuals infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using enzyme-linked immunosorbent assay (ELISA) to assess antibody recognition of a human immunodeficiency virus type 1 (HIV-1) envelope epitope (2F5). Cross-reactive binding to the HIV-1 antigen was detected in 38.5 % (22/57) of samples, indicating nonspecific antibody recognition. Interestingly, sera from HIV-1-infected individuals and the monoclonal anti-2F5 antibody exhibited no reactivity toward the SARS-CoV-2 Spike receptor-binding domain (RBD), indicating that cross-reactivity occurs in a unidirectional manner and does not compromise the specificity of RBD-based diagnostic assays. These findings support the specificity of RBD-targeted assays and advocate for careful interpretation of HIV-1 serological assays in individuals with recent SARS-CoV-2 infection, particularly where dual circulation occurs.
{"title":"Serological analysis of COVID-19 patients highlights cross-reactivity of antibodies with the HIV-1 2F5 epitope","authors":"Tayná E. Lima , Carlos A.A. Brito , Laura H.V.G. Gil , Rafael Dhalia , Franciane M.E. Teixeira , Maria N. Sato , Gabriel L. Wallau , Roberto D. Lins , Isabelle F.T. Viana","doi":"10.1016/j.jcv.2025.105880","DOIUrl":"10.1016/j.jcv.2025.105880","url":null,"abstract":"<div><div>The Coronavirus disease 2019 (COVID-19) pandemic has raised concerns regarding the specificity of serological assays due to potential antibody cross-reactivity. In this study, we analyzed sera from 57 individuals infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using enzyme-linked immunosorbent assay (ELISA) to assess antibody recognition of a human immunodeficiency virus type 1 (HIV-1) envelope epitope (2F5). Cross-reactive binding to the HIV-1 antigen was detected in 38.5 % (22/57) of samples, indicating nonspecific antibody recognition. Interestingly, sera from HIV-1-infected individuals and the monoclonal anti-2F5 antibody exhibited no reactivity toward the SARS-CoV-2 Spike receptor-binding domain (RBD), indicating that cross-reactivity occurs in a unidirectional manner and does not compromise the specificity of RBD-based diagnostic assays. These findings support the specificity of RBD-targeted assays and advocate for careful interpretation of HIV-1 serological assays in individuals with recent SARS-CoV-2 infection, particularly where dual circulation occurs.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105880"},"PeriodicalIF":3.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-09DOI: 10.1016/j.jcv.2025.105879
Cole Schonhofer , Calvin Ka-Fung Lo , Daniel R. Owen , Khuloud Aldhaheri , Nancy Matic , Christopher F. Lowe , David F. Schaeffer , Sara Belga , Alissa Wright
Background
Cytomegalovirus (CMV) gastrointestinal (GI) disease is traditionally diagnosed via histopathology of endoscopic tissue biopsies. The utility of tissue PCR for predicting CMV GI disease remains unclear. We conducted a 10-year retrospective single-center study comparing tissue PCR performance to histopathology for the diagnosis of CMV GI disease.
Methods
Adult patients with GI tissue biopsy between February 2014 and January 2024 were included. Qualitative tissue PCR was compared to histopathology (gold standard) to determine sensitivity, specificity, and receiver operating characteristic (ROC) curves. Log-binomial regression models were performed to evaluate potential predictors of CMV GI disease.
Results
Our study comprised 533 patients with 635 endoscopies. Underlying diagnoses included solid organ transplant, hematopoietic stem cell transplantation (HSCT), inflammatory bowel disease, and others. Histopathologic evidence of CMV disease was found in 41/635 biopsies and in 37/533 patients. Compared to histopathology, tissue PCR sensitivity was 100 % (95 % CI 91.4–100 %), and specificity was 71.7 % (67.9–75.3 %). Area under ROC curve (AUC) was 0.86 (0.84–0.88). Exclusion of specimens with cycle threshold >32 increased specificity to 82.7 % (79.4–85.6 %) but at the cost of decreased sensitivity (87.8 %, 73.8–95.9 %). Multivariable analyses demonstrated that plasma CMV DNAemia >1000 IU/mL increased risk of GI disease (risk ratio 10.9, 95 % CI 5.32–22.49) while HSCT was negatively associated (risk ratio 0.18, 95 % 0.05–0.78).
Conclusion
CMV tissue PCR correctly identified CMV GI disease in 100 % of histology-proven cases. Specificity was poor, likely reflecting detection of viral shedding. Overall, our study suggests that CMV tissue PCR should be reserved to rule out CMV GI disease in high pre-test probability settings (e.g. patients with known risk factors and compatible symptoms).
{"title":"Utility of cytomegalovirus (CMV) qualitative polymerase chain reaction from gastrointestinal biopsies in diagnosis of CMV gastrointestinal disease: A 10-year retrospective study","authors":"Cole Schonhofer , Calvin Ka-Fung Lo , Daniel R. Owen , Khuloud Aldhaheri , Nancy Matic , Christopher F. Lowe , David F. Schaeffer , Sara Belga , Alissa Wright","doi":"10.1016/j.jcv.2025.105879","DOIUrl":"10.1016/j.jcv.2025.105879","url":null,"abstract":"<div><h3>Background</h3><div>Cytomegalovirus (CMV) gastrointestinal (GI) disease is traditionally diagnosed via histopathology of endoscopic tissue biopsies. The utility of tissue PCR for predicting CMV GI disease remains unclear. We conducted a 10-year retrospective single-center study comparing tissue PCR performance to histopathology for the diagnosis of CMV GI disease.</div></div><div><h3>Methods</h3><div>Adult patients with GI tissue biopsy between February 2014 and January 2024 were included. Qualitative tissue PCR was compared to histopathology (gold standard) to determine sensitivity, specificity, and receiver operating characteristic (ROC) curves. Log-binomial regression models were performed to evaluate potential predictors of CMV GI disease.</div></div><div><h3>Results</h3><div>Our study comprised 533 patients with 635 endoscopies. Underlying diagnoses included solid organ transplant, hematopoietic stem cell transplantation (HSCT), inflammatory bowel disease, and others. Histopathologic evidence of CMV disease was found in 41/635 biopsies and in 37/533 patients. Compared to histopathology, tissue PCR sensitivity was 100 % (95 % CI 91.4–100 %), and specificity was 71.7 % (67.9–75.3 %). Area under ROC curve (AUC) was 0.86 (0.84–0.88). Exclusion of specimens with cycle threshold >32 increased specificity to 82.7 % (79.4–85.6 %) but at the cost of decreased sensitivity (87.8 %, 73.8–95.9 %). Multivariable analyses demonstrated that plasma CMV DNAemia >1000 IU/mL increased risk of GI disease (risk ratio 10.9, 95 % CI 5.32–22.49) while HSCT was negatively associated (risk ratio 0.18, 95 % 0.05–0.78).</div></div><div><h3>Conclusion</h3><div>CMV tissue PCR correctly identified CMV GI disease in 100 % of histology-proven cases. Specificity was poor, likely reflecting detection of viral shedding. Overall, our study suggests that CMV tissue PCR should be reserved to rule out CMV GI disease in high pre-test probability settings (e.g. patients with known risk factors and compatible symptoms).</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105879"},"PeriodicalIF":3.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-02DOI: 10.1016/j.jcv.2025.105877
Assad Alhaboub , Natalie M. Deschenes , Xena X. Li , Victoria R. Williams , Kevin C. Katz , So Yeon Park , Patryk Aftanas , Henry Wong , Calvin Sjaarda , Kyla Tozer , Finlay Maguire , Jerome Leis , Prameet Sheth , Robert Kozak
Introduction
Metagenomic sequencing (mGS) is a useful tool for identifying pathogens in patient samples. During nosocomial outbreaks of respiratory viruses, mGS allows for the identification of viral strains and provides insight into their genetic relatedness. Multiple bioinformatics analysis assembler are available for processing data, but a comprehensive comparison of their performance in for respiratory virus outbreaks has not been conducted.
Methods
This study sequenced samples from five separate nosocomial outbreaks of RNA respiratory viruses. RNA was extracted from the samples, and cDNA was synthesized using random hexamers, and then sequenced on an Illumina Miniseq following Nextera DNA Flex library preparation. The data from each outbreak were analyzed using four different assemblers: MEGAHIT, rnaSPAdes, rnaviralSPAdes, and coronaSPAdes, to evaluate their analytical performance.
Results
The mGS confirmed the viral identification and provided accurate strain identification for both coronavirus and parainfluenza virus samples. However, differences were observed between the assemblers in terms of the largest contigs produced and the proportion of the viral genome aligned with reference genomes. Notably, coronaSpades outperformed the other pipelines for analyzing seasonal coronaviruses, generating more complete data and covering a higher percentage of the viral genome.
Conclusion
Achieving a higher percentage of the viral genome sequence is crucial for a more detailed characterization, which is especially valuable for outbreak analysis where viral strains may only differ by a few genetic changes. Comparison of assemblers will allow for clinical laboratories to determine the bioinformatic pipeline that is optimal for helping clinicians better manage outbreaks.
宏基因组测序（metagenomics sequencing, mGS）是鉴定患者样本中病原体的一种有用工具。在医院内爆发呼吸道病毒时，mGS允许识别病毒株，并提供对其遗传相关性的见解。目前已有多个生物信息学分析汇编程序用于处理数据，但尚未对其在呼吸道病毒暴发中的性能进行全面比较。方法本研究对来自5个不同医院暴发的RNA呼吸道病毒样本进行测序。从样品中提取RNA，用随机六聚体合成cDNA，在Nextera DNA Flex文库制备后，在Illumina Miniseq上测序。使用四种不同的汇编程序（MEGAHIT、rnaSPAdes、rnaviralSPAdes和coronaSPAdes）分析每次爆发的数据，以评估它们的分析性能。结果mGS验证了病毒鉴定结果，对冠状病毒和副流感病毒样品进行了准确的毒株鉴定。然而，在产生的最大contigs和与参考基因组对齐的病毒基因组比例方面，组装者之间观察到差异。值得注意的是，coronaSpades在分析季节性冠状病毒方面优于其他管道，生成了更完整的数据，覆盖了更高比例的病毒基因组。获得更高百分比的病毒基因组序列对于更详细的特征描述至关重要，这对于病毒株可能只有少数遗传变化的爆发分析尤其有价值。组装体的比较将使临床实验室能够确定帮助临床医生更好地管理疫情的最佳生物信息管道。
{"title":"Some assembly required: Comparison of bioinformatic pipelines for analysis of viral metagenomic sequencing from nosocomial respiratory virus outbreaks","authors":"Assad Alhaboub , Natalie M. Deschenes , Xena X. Li , Victoria R. Williams , Kevin C. Katz , So Yeon Park , Patryk Aftanas , Henry Wong , Calvin Sjaarda , Kyla Tozer , Finlay Maguire , Jerome Leis , Prameet Sheth , Robert Kozak","doi":"10.1016/j.jcv.2025.105877","DOIUrl":"10.1016/j.jcv.2025.105877","url":null,"abstract":"<div><h3>Introduction</h3><div>Metagenomic sequencing (mGS) is a useful tool for identifying pathogens in patient samples. During nosocomial outbreaks of respiratory viruses, mGS allows for the identification of viral strains and provides insight into their genetic relatedness. Multiple bioinformatics analysis assembler are available for processing data, but a comprehensive comparison of their performance in for respiratory virus outbreaks has not been conducted.</div></div><div><h3>Methods</h3><div>This study sequenced samples from five separate nosocomial outbreaks of RNA respiratory viruses. RNA was extracted from the samples, and cDNA was synthesized using random hexamers, and then sequenced on an Illumina Miniseq following Nextera DNA Flex library preparation. The data from each outbreak were analyzed using four different assemblers: MEGAHIT, rnaSPAdes, rnaviralSPAdes, and coronaSPAdes, to evaluate their analytical performance.</div></div><div><h3>Results</h3><div>The mGS confirmed the viral identification and provided accurate strain identification for both coronavirus and parainfluenza virus samples. However, differences were observed between the assemblers in terms of the largest contigs produced and the proportion of the viral genome aligned with reference genomes. Notably, coronaSpades outperformed the other pipelines for analyzing seasonal coronaviruses, generating more complete data and covering a higher percentage of the viral genome.</div></div><div><h3>Conclusion</h3><div>Achieving a higher percentage of the viral genome sequence is crucial for a more detailed characterization, which is especially valuable for outbreak analysis where viral strains may only differ by a few genetic changes. Comparison of assemblers will allow for clinical laboratories to determine the bioinformatic pipeline that is optimal for helping clinicians better manage outbreaks.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105877"},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-08-05DOI: 10.1016/j.jcv.2025.105852
Long Chen, Hong Yang, Hai-Long Zhang, Xiao-Lu Shi, Bo Peng, Jun Meng
Objectives: To investigate the etiological characteristics of acute conjunctivitis in Shenzhen, China.
Methods: A total of 1234 conjunctival swabs collected between 2018 and 2024 were examined for coxsackievirus A24 variant (CVA24v), enterovirus D70 (EV-D70) and human adenovirus (HAdV). Complete VP1 sequences of CVA24v strains were determined and analyzed. HAdV was genotyped by PCR methods targeting the three genes (penton base, hexon and fiber) and sequencing. SPSS 22.0 software was used for statistical analysis.
Results: CVA24v was first detected in 2023, with a detection rate of 33.3 % (63/189). No EV-D70 was detected in 2018-2024. The annual distributions of HAdV-infected patients were 52.6 % (101/192), 62.7 % (111/177), 21.1 % (37/175), 9.0 % (14/155), 10.5 % (17/162), 15.9 % (30/189) and 21.7 % (40/184), respectively. CVA24v strains from this study clustered in a clade with significant temporal aggregation characteristic within the genotype GIV. Eight amino acid variation sites (T11A, I16L, K20I, L32P, K105R, A146T, R277G and P280S) were observed in VP1 sequences of CVA24v strains from this study when compared to the close strains. Conjunctivitis patients with one of the three symptoms (weakness, fever and blurred vision) had a higher detection rate of HAdV. Eleven known HAdV genotypes (HAdV-B3, -B14, -B21, HAdV-D8, -D37, -D42, -D53, -D64, -D85, -D115 and HAdV-E4) and 7 unknown genotypes were detected in 2020-2024, with HAdV-D37 (30.9 %), HAdV-D115 (21.1 %) and HAdV-B3 (17.1 %) being the three predominant genotypes.
Conclusions: The unique genetic characteristics were observed in Shenzhen CVA24v strains. HAdVs associated with conjunctivitis exhibited a high degree of genotypic diversity in Shenzhen, and HAdV-D115 related to conjunctivitis was first reported in this study.
{"title":"Pathogen surveillance of acute conjunctivitis reveals recent emergence of coxsackievirus A24 variants and high genotypic diversity of human adenoviruses in Shenzhen, China, 2018-2024.","authors":"Long Chen, Hong Yang, Hai-Long Zhang, Xiao-Lu Shi, Bo Peng, Jun Meng","doi":"10.1016/j.jcv.2025.105852","DOIUrl":"10.1016/j.jcv.2025.105852","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the etiological characteristics of acute conjunctivitis in Shenzhen, China.</p><p><strong>Methods: </strong>A total of 1234 conjunctival swabs collected between 2018 and 2024 were examined for coxsackievirus A24 variant (CVA24v), enterovirus D70 (EV-D70) and human adenovirus (HAdV). Complete VP1 sequences of CVA24v strains were determined and analyzed. HAdV was genotyped by PCR methods targeting the three genes (penton base, hexon and fiber) and sequencing. SPSS 22.0 software was used for statistical analysis.</p><p><strong>Results: </strong>CVA24v was first detected in 2023, with a detection rate of 33.3 % (63/189). No EV-D70 was detected in 2018-2024. The annual distributions of HAdV-infected patients were 52.6 % (101/192), 62.7 % (111/177), 21.1 % (37/175), 9.0 % (14/155), 10.5 % (17/162), 15.9 % (30/189) and 21.7 % (40/184), respectively. CVA24v strains from this study clustered in a clade with significant temporal aggregation characteristic within the genotype GIV. Eight amino acid variation sites (T11A, I16L, K20I, L32P, K105R, A146T, R277G and P280S) were observed in VP1 sequences of CVA24v strains from this study when compared to the close strains. Conjunctivitis patients with one of the three symptoms (weakness, fever and blurred vision) had a higher detection rate of HAdV. Eleven known HAdV genotypes (HAdV-B3, -B14, -B21, HAdV-D8, -D37, -D42, -D53, -D64, -D85, -D115 and HAdV-E4) and 7 unknown genotypes were detected in 2020-2024, with HAdV-D37 (30.9 %), HAdV-D115 (21.1 %) and HAdV-B3 (17.1 %) being the three predominant genotypes.</p><p><strong>Conclusions: </strong>The unique genetic characteristics were observed in Shenzhen CVA24v strains. HAdVs associated with conjunctivitis exhibited a high degree of genotypic diversity in Shenzhen, and HAdV-D115 related to conjunctivitis was first reported in this study.</p>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"180 ","pages":"105852"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jcv.2025.105875
Huimin Liu , Wenting Chen , Yongjie Liang , Jing Wang , Lijian Ran , Shilian Li , Yi Wu , Zixuan He , Xuemei Kuang , Jie Xia , Li Jiang , Xuqing Zhang , Qing Mao
Background and aims
This study aimed to evaluate the efficacy of expanding antiviral indications in preventing mother-to-child transmission (MTCT) by analyzing hepatitis B virus (HBV) markers in neonatal umbilical-cord-blood (UCB) samples.
Methods
We conducted a real-world study of pregnant women aged >30 years with chronic hepatitis B (CHB) who received antenatal care between January 2022 and June 2024. Maternal HBV markers at 24–28 weeks of gestation and serum biochemical parameters at delivery were obtained. For infants, HBV markers were measured in UCB at birth and in venous blood at 7–12 months of age. Logistic regression analysis was used to identify the maternal factors associated with UCB outcomes.
Results
A total of 171 pregnant women with CHB were included. Antiviral therapy had been started before conception in 31.0 % (53/171). At 24–28 weeks of gestation, 87.8 % (150/171) had HBV DNA <5.3 Log10 IU/mL, 56.1 % (96/171) had hepatitis B surface antigen (HBsAg) >3000 IU/mL and 32.7 % (56/171) were hepatitis B e antigen (HBeAg)-positive. At delivery, HBeAg-negative mothers had a median age of 33.4 ± 3.1 years, compared with 32.5 ± 2.9 years for those who were HBeAg-positive, respectively (t = 1.667, P = 0.970). 36 of 171 (21.1 %) infants were positive for HBsAg, including 12 of 115 born to HBeAg-negative mothers and 24 of 56 born to HBeAg-positive mothers (χ2 = 23.82, P < 0.001). 41 of 171 (24.0 %) infants were positive for HBeAg, and all were born to HBeAg-positive mothers. HBV DNA and RNA were undetectable in all UCB samples, whereas hepatitis B core antibody (HBcAb) was present in every specimen. Receiver operating characteristic curve (ROC) analysis identified maternal HBeAg levels (AUC=0.683, cut-off value=0.494 COI) and maternal HBV DNA load (AUC=0.645, cut-off value=0.311 Log10 IU/mL) as predictive of UCB HBsAg-positivity. No infants were infected with HBV, as confirmed by post-vaccination serologic testing (PVST).
Conclusions
Following the expansion of antiviral therapy indications, administering therapy to pregnant women aged >30 years with detectable HBV DNA effectively reduced HBsAg, HBV DNA and even HBV RNA level in infants’ UCB. Maternal HBeAg status was significantly associated with both HBsAg and HBeAg positivity in UCB.
{"title":"More aggressive initiation of antiviral treatment contributes to blocking mother-to-child transmission of HBV DNA & RNA in neonatal umbilical cord blood","authors":"Huimin Liu , Wenting Chen , Yongjie Liang , Jing Wang , Lijian Ran , Shilian Li , Yi Wu , Zixuan He , Xuemei Kuang , Jie Xia , Li Jiang , Xuqing Zhang , Qing Mao","doi":"10.1016/j.jcv.2025.105875","DOIUrl":"10.1016/j.jcv.2025.105875","url":null,"abstract":"<div><h3>Background and aims</h3><div>This study aimed to evaluate the efficacy of expanding antiviral indications in preventing mother-to-child transmission (MTCT) by analyzing hepatitis B virus (HBV) markers in neonatal umbilical-cord-blood (UCB) samples.</div></div><div><h3>Methods</h3><div>We conducted a real-world study of pregnant women aged >30 years with chronic hepatitis B (CHB) who received antenatal care between January 2022 and June 2024. Maternal HBV markers at 24–28 weeks of gestation and serum biochemical parameters at delivery were obtained. For infants, HBV markers were measured in UCB at birth and in venous blood at 7–12 months of age. Logistic regression analysis was used to identify the maternal factors associated with UCB outcomes.</div></div><div><h3>Results</h3><div>A total of 171 pregnant women with CHB were included. Antiviral therapy had been started before conception in 31.0 % (53/171). At 24–28 weeks of gestation, 87.8 % (150/171) had HBV DNA <5.3 Log<sub>10</sub> IU/mL, 56.1 % (96/171) had hepatitis B surface antigen (HBsAg) >3000 IU/mL and 32.7 % (56/171) were hepatitis B e antigen (HBeAg)-positive. At delivery, HBeAg-negative mothers had a median age of 33.4 ± 3.1 years, compared with 32.5 ± 2.9 years for those who were HBeAg-positive, respectively (t = 1.667, <em>P</em> = 0.970). 36 of 171 (21.1 %) infants were positive for HBsAg, including 12 of 115 born to HBeAg-negative mothers and 24 of 56 born to HBeAg-positive mothers (χ<sup>2</sup> = 23.82, <em>P</em> < 0.001). 41 of 171 (24.0 %) infants were positive for HBeAg, and all were born to HBeAg-positive mothers. HBV DNA and RNA were undetectable in all UCB samples, whereas hepatitis B core antibody (HBcAb) was present in every specimen. Receiver operating characteristic curve (ROC) analysis identified maternal HBeAg levels (AUC=0.683, cut-off value=0.494 COI) and maternal HBV DNA load (AUC=0.645, cut-off value=0.311 Log<sub>10</sub> IU/mL) as predictive of UCB HBsAg-positivity. No infants were infected with HBV, as confirmed by post-vaccination serologic testing (PVST).</div></div><div><h3>Conclusions</h3><div>Following the expansion of antiviral therapy indications, administering therapy to pregnant women aged >30 years with detectable HBV DNA effectively reduced HBsAg, HBV DNA and even HBV RNA level in infants’ UCB. Maternal HBeAg status was significantly associated with both HBsAg and HBeAg positivity in UCB.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105875"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jcv.2025.105876
Rachel Jackson , Adinah Marks , William L. Irving , Kathryn Jack
Background
Hepatitis B virus (HBV) infection is an important cause of liver disease-related mortality and morbidity. The World Health Organisation aims to eliminate this as a public health concern by 2030 and as such the key international guidelines recommend that all patients are reviewed regularly to observe for preventable signs of disease progression. This requires life-long engagement with specialist services, but some patients fall out of the care pathway and become lost to follow-up.
Objectives
This study sought to identify and re-engage patients with HBV who were lost to follow up (LTFU), defined as any HBsAg positive patient who had not been seen in the hepatology outpatient service since 31st December 2021, excluding those with acute infection.
Study design
A retrospective case finding and re-engagement healthcare service improvement exercise was conducted to identify and contact individuals with HBV diagnosed between June 2007 and the end of December 2021 who were lost-to-follow-up.
Results
One third of the HBsAg positive cohort were lost to follow-up (32.9 %, n = 506/1539). Of this group, 145 people were still living in the hospital’s catchment area, yet only 60 people could be contacted by telephone of whom 50 returned to clinic. More than 12 % of patients were HBeAg positive at their last clinic visit, and almost one quarter (23.2 %) had an abnormally raised ALT. There was extensive ethnic heterogeneity with 65 languages spoken among 474 people. We successfully re-engaged 10.07 % (51/506) back into care.
Conclusions
Patients with potentially progressive HBV-related liver disease are falling out of the care pathway with the attendant long-term problems that failure to control their infection may have.
{"title":"Identifying people with chronic hepatitis B virus who are lost to clinical follow up: A retrospective case finding and re-engagement service improvement exercise","authors":"Rachel Jackson , Adinah Marks , William L. Irving , Kathryn Jack","doi":"10.1016/j.jcv.2025.105876","DOIUrl":"10.1016/j.jcv.2025.105876","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis B virus (HBV) infection is an important cause of liver disease-related mortality and morbidity. The World Health Organisation aims to eliminate this as a public health concern by 2030 and as such the key international guidelines recommend that all patients are reviewed regularly to observe for preventable signs of disease progression. This requires life-long engagement with specialist services, but some patients fall out of the care pathway and become lost to follow-up.</div></div><div><h3>Objectives</h3><div>This study sought to identify and re-engage patients with HBV who were lost to follow up (LTFU), defined as any HBsAg positive patient who had not been seen in the hepatology outpatient service since 31st December 2021, excluding those with acute infection.</div></div><div><h3>Study design</h3><div>A retrospective case finding and re-engagement healthcare service improvement exercise was conducted to identify and contact individuals with HBV diagnosed between June 2007 and the end of December 2021 who were lost-to-follow-up.</div></div><div><h3>Results</h3><div>One third of the HBsAg positive cohort were lost to follow-up (32.9 %, n = 506/1539). Of this group, 145 people were still living in the hospital’s catchment area, yet only 60 people could be contacted by telephone of whom 50 returned to clinic. More than 12 % of patients were HBeAg positive at their last clinic visit, and almost one quarter (23.2 %) had an abnormally raised ALT. There was extensive ethnic heterogeneity with 65 languages spoken among 474 people. We successfully re-engaged 10.07 % (51/506) back into care.</div></div><div><h3>Conclusions</h3><div>Patients with potentially progressive HBV-related liver disease are falling out of the care pathway with the attendant long-term problems that failure to control their infection may have.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105876"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-22DOI: 10.1016/j.jcv.2025.105843
Manfred Accrombessi, Cheryl Johnson, Alaleh Abadpour, Jean De Dieu Anoubissi, Joseph Fokam, Araz Chiloyan, Iryna Andrianova, Hamakwa Mantina, Agai Kherbino Akec, Fatou Ousmane Sall, Abdelaye Keita, Elizabeth Telan, Adoum Fouda Abderrazzack, Chatté Adawaye, Rose Wafula, Stephen Ayisi-Addo, Monkoe S Leqheka, Jacob Lusekelo Mwambeta, Jeremie Muwonga Masidi, Dramane Kania, Anita Sands, Rachel Baggaley, Jean-François Etard, Céline Lastrucci
This study highlights the importance of verifying HIV testing algorithms to reduce the risk of misdiagnoses caused by common false reactivity. Between 2020 and 2023, WHO supported 14 countries to assess rates of false reactivity and shared false reactivity across HIV rapid diagnostic tests (RDTs) used in HIV testing services. The study involved 26,278 results from 22 different RDT products, with sample sizes ranging from 100 to 302 results per country. The number of RDT products assessed varied between 4 and 13 per country. False reactivity rates ranged from 0 % to 3.32 %, with one country reporting a high false reactivity rate of over 4 % for one RDT. Five countries have no shared false reactivity between RDTs, while the remaining eight countries shared false reactivity across one to six pairs of RDT products. These findings were used to inform national policy, with more than 90 % of countries introducing new RDT products into their HIV testing algorithm based on these results. The study concludes that rates of false reactivity and shared false reactivity between RDT products vary across countries. Therefore, conducting verification studies is crucial for updating national HIV testing algorithms and ensuring accurate diagnosis while also facilitating the market entry of new HIV testing products.
{"title":"Heterogeneity of false reactivity profiles of HIV assays while optimizing national HIV testing algorithms: Findings from a multi-country analysis.","authors":"Manfred Accrombessi, Cheryl Johnson, Alaleh Abadpour, Jean De Dieu Anoubissi, Joseph Fokam, Araz Chiloyan, Iryna Andrianova, Hamakwa Mantina, Agai Kherbino Akec, Fatou Ousmane Sall, Abdelaye Keita, Elizabeth Telan, Adoum Fouda Abderrazzack, Chatté Adawaye, Rose Wafula, Stephen Ayisi-Addo, Monkoe S Leqheka, Jacob Lusekelo Mwambeta, Jeremie Muwonga Masidi, Dramane Kania, Anita Sands, Rachel Baggaley, Jean-François Etard, Céline Lastrucci","doi":"10.1016/j.jcv.2025.105843","DOIUrl":"10.1016/j.jcv.2025.105843","url":null,"abstract":"<p><p>This study highlights the importance of verifying HIV testing algorithms to reduce the risk of misdiagnoses caused by common false reactivity. Between 2020 and 2023, WHO supported 14 countries to assess rates of false reactivity and shared false reactivity across HIV rapid diagnostic tests (RDTs) used in HIV testing services. The study involved 26,278 results from 22 different RDT products, with sample sizes ranging from 100 to 302 results per country. The number of RDT products assessed varied between 4 and 13 per country. False reactivity rates ranged from 0 % to 3.32 %, with one country reporting a high false reactivity rate of over 4 % for one RDT. Five countries have no shared false reactivity between RDTs, while the remaining eight countries shared false reactivity across one to six pairs of RDT products. These findings were used to inform national policy, with more than 90 % of countries introducing new RDT products into their HIV testing algorithm based on these results. The study concludes that rates of false reactivity and shared false reactivity between RDT products vary across countries. Therefore, conducting verification studies is crucial for updating national HIV testing algorithms and ensuring accurate diagnosis while also facilitating the market entry of new HIV testing products.</p>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"180 ","pages":"105843"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-08-06DOI: 10.1016/j.jcv.2025.105853
Anja Oštrbenk, Helle Pedersen, Mario Poljak, Jesper Bonde
A key parameter for the continued success of cervical cancer screening is quality-controlled use of human papillomavirus (HPV) tests that are clinically validated according to international guidelines. The clinical accuracy for cervical screening of the Allplex HPV HR Detection (Allplex), which concurrently detects and distinguishes 12 high-risk HPV types (16,18,31,33,35,39,45,51,52,56,58,59) and HPV66 and HPV68 was assessed on SurePath samples by comparing its performance to the second-generation comparator BD Onclarity HPV assay (Onclarity). The absolute clinical sensitivity, assessed on 76 samples derived from a screening population with underlying CIN2+, of Allplex and Onclarity was 98.7 % (95 % CI, 92.9-100.0 %) and 100.0 % (95 % CI, 95.2-100.0 %), respectively, with relative sensitivity of Allplex of 0.99 (95 % CI; 0.96-1.01). The absolute clinical specificity, assessed on 801 consecutive clinician-collected cervical samples obtained from women 30 to 59 years old attending the routine Danish cervical screening program, for Allplex and Onclarity was 92.5 % (95 % CI, 90.4-94.2 %) and 92.5 % (95 % CI, 90.4-94.2 %), respectively, with relative specificity of Allplex of 1.00 (95 % CI; 0.99-1.01). With thresholds mandated by international guidelines of ≥90 % for relative clinical sensitivity (p = 0.001) and ≥98 % for relative clinical specificity (p = 0.0018), Allplex was non-inferior to Onclarity. Excellent intra- and inter-laboratory agreement of Allplex was observed, both overall (99.2 % and 99.6 %) and at the genotype level (range: 99.6-100.0 %). By fulfilling all guideline requirements for clinical sensitivity, specificity, and reproducibility, Allplex can be considered clinically validated for primary cervical screening using clinician-collected SurePath samples. With this study, Allplex also meets the criteria for a second-generation HPV comparator test.
{"title":"The Allplex HPV HR Detection assay fulfils international guideline requirements for primary cervical screening on SurePath samples and qualifies as a second-generation HPV comparator test.","authors":"Anja Oštrbenk, Helle Pedersen, Mario Poljak, Jesper Bonde","doi":"10.1016/j.jcv.2025.105853","DOIUrl":"10.1016/j.jcv.2025.105853","url":null,"abstract":"<p><p>A key parameter for the continued success of cervical cancer screening is quality-controlled use of human papillomavirus (HPV) tests that are clinically validated according to international guidelines. The clinical accuracy for cervical screening of the Allplex HPV HR Detection (Allplex), which concurrently detects and distinguishes 12 high-risk HPV types (16,18,31,33,35,39,45,51,52,56,58,59) and HPV66 and HPV68 was assessed on SurePath samples by comparing its performance to the second-generation comparator BD Onclarity HPV assay (Onclarity). The absolute clinical sensitivity, assessed on 76 samples derived from a screening population with underlying CIN2+, of Allplex and Onclarity was 98.7 % (95 % CI, 92.9-100.0 %) and 100.0 % (95 % CI, 95.2-100.0 %), respectively, with relative sensitivity of Allplex of 0.99 (95 % CI; 0.96-1.01). The absolute clinical specificity, assessed on 801 consecutive clinician-collected cervical samples obtained from women 30 to 59 years old attending the routine Danish cervical screening program, for Allplex and Onclarity was 92.5 % (95 % CI, 90.4-94.2 %) and 92.5 % (95 % CI, 90.4-94.2 %), respectively, with relative specificity of Allplex of 1.00 (95 % CI; 0.99-1.01). With thresholds mandated by international guidelines of ≥90 % for relative clinical sensitivity (p = 0.001) and ≥98 % for relative clinical specificity (p = 0.0018), Allplex was non-inferior to Onclarity. Excellent intra- and inter-laboratory agreement of Allplex was observed, both overall (99.2 % and 99.6 %) and at the genotype level (range: 99.6-100.0 %). By fulfilling all guideline requirements for clinical sensitivity, specificity, and reproducibility, Allplex can be considered clinically validated for primary cervical screening using clinician-collected SurePath samples. With this study, Allplex also meets the criteria for a second-generation HPV comparator test.</p>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"180 ","pages":"105853"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-08-05DOI: 10.1016/j.jcv.2025.105849
Sébastien Lhomme, Isabelle Da Silva, Oriane Cabanel, Estelle Raguin, Guillaume Martin-Blondel, Nassim Kamar, Jacques Izopet, Florence Abravanel
Introduction: We evaluated the performance of the automated AltoStar JCV PCR platform for detecting and quantifying JC Polyomavirus (JCPyV) DNA in samples including urine, plasma and cerebrospinal fluid.
Methods and results: Using the NIBSC JCPyV DNA standard, the assay was linear from 1 to 6 log IU/mL standard and the limit of detection determined by Probit analysis corresponded to 9.3 [95 % CI: 7.0-16.5] IU/mL. Specificity was accessed by testing urines containing a high concentration of BK Polyomavirus; none tested positive for JCPyV. The intra-run and inter-run standard deviations were 0.02 IU/mL and 0.35 IU/mL, respectively. Lastly, clinical performance was determined by testing 45 samples quantified previously with a laboratory-developed test (LDT). The assays were concordant for 42/45 samples. One of the 3 samples that tested negative with the AltoStar assay had a low JCpyV DNA concentration. We were unable to re-test the 3 negative samples due to insufficient volume. A conservation problem could not be ruled out for the 3 samples with discordant results.
Conclusions: The AltoStar platform enables highly accurate testing for the detection and quantification of JCPyV DNA with very low limit of detection. This allowed us to shorten turnaround times and save time for technical staff.
{"title":"Performance of a commercial assay for detecting JC Polyomavirus DNA in human samples.","authors":"Sébastien Lhomme, Isabelle Da Silva, Oriane Cabanel, Estelle Raguin, Guillaume Martin-Blondel, Nassim Kamar, Jacques Izopet, Florence Abravanel","doi":"10.1016/j.jcv.2025.105849","DOIUrl":"10.1016/j.jcv.2025.105849","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated the performance of the automated AltoStar JCV PCR platform for detecting and quantifying JC Polyomavirus (JCPyV) DNA in samples including urine, plasma and cerebrospinal fluid.</p><p><strong>Methods and results: </strong>Using the NIBSC JCPyV DNA standard, the assay was linear from 1 to 6 log IU/mL standard and the limit of detection determined by Probit analysis corresponded to 9.3 [95 % CI: 7.0-16.5] IU/mL. Specificity was accessed by testing urines containing a high concentration of BK Polyomavirus; none tested positive for JCPyV. The intra-run and inter-run standard deviations were 0.02 IU/mL and 0.35 IU/mL, respectively. Lastly, clinical performance was determined by testing 45 samples quantified previously with a laboratory-developed test (LDT). The assays were concordant for 42/45 samples. One of the 3 samples that tested negative with the AltoStar assay had a low JCpyV DNA concentration. We were unable to re-test the 3 negative samples due to insufficient volume. A conservation problem could not be ruled out for the 3 samples with discordant results.</p><p><strong>Conclusions: </strong>The AltoStar platform enables highly accurate testing for the detection and quantification of JCPyV DNA with very low limit of detection. This allowed us to shorten turnaround times and save time for technical staff.</p>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"180 ","pages":"105849"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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