Reviews in Medical Virology最新文献

The recent review by Zhang et al. provides a valuable consolidation of clinical evidence linking Dengue virus (DENV), Chikungunya virus (CHIKV), and SARS-CoV-2 to bone-related diseases. While their work aptly highlights this emerging clinical paradigm, our letter offers a critical analysis to propel the field from descriptive association to mechanistic causation. We identify and dissect several substantive gaps in the current narrative. Firstly, we challenge the prevailing yet often circumstantial evidence for direct viral infection of bone cells, arguing for the need to distinguish between productive infection and passive viral presence. Secondly, we call for a more nuanced deconstruction of the "cytokine storm" hypothesis, urging the identification of master regulators and a clearer delineation between viral persistence and virally-induced autoimmunity in driving chronic pathology, such as post-CHIKV arthritis. Furthermore, we emphasise the critical need for longitudinal studies to define the long-term trajectory of bone health post-SARS-CoV-2 infection, distinguishing transient from permanent metabolic defects. Finally, we propose a unified, comparative research framework utilising advanced models to uncover fundamental principles of virus-bone interactions. This critical perspective underscores the necessity of a deeper, mechanism-driven investigative agenda to inform future therapeutic strategies.

Human cytomegalovirus (CMV), a member of the Herpesviridae family, is a ubiquitous pathogen that causes mild or asymptomatic infection in healthy individuals but leads to severe complications in immunocompromised patients and congenitally infected newborns. CMV exhibits marked neurotropism, and infection of the central nervous system (CNS) can result in a broad spectrum of neurological manifestations, including encephalitis, cognitive impairment, and developmental anomalies such as microcephaly, cerebral palsy, and sensorineural hearing loss. Though the clinical importance of CMV on the nervous system is well known and studied, the molecular mechanisms underlying CMV neuropathogenesis remain incompletely understood. In this review we present current knowledge on CMV infection of the CNS, highlighting the viral and host determinants that influence neurotropism, latency, immune evasion, and neural injury. We discuss important molecular pathways involved in viral entry, replication, and host immune modulation that contribute to CNS pathology. The article summarises recent insights from in vitro and in vivo models elucidating how CMV interacts with cells of CNS to disrupt neurodevelopment and brain homoeostasis. Furthermore, we review the neurological manifestations of CMV with emphasis on long term neurological sequelae of congenital and acquired CMV infection, as well as characteristic radiological findings associated with CMV neuroinfection. Understanding the complex interplay between CMV and the host nervous system is essential for identifying therapeutic targets and developing effective preventive strategies. This review aims to provide a comprehensive overview of CMV neuropathogenesis and to identify critical knowledge gaps that can guide future research on CMV-associated neurological disease.

Kidney transplantation is recognised by the World Health Organisation as the most effective therapy for end-stage renal disease, offering substantial improvements in survival and quality of life. However, the immunosuppression required to prevent graft rejection predisposes recipients to opportunistic infections, among which cytomegalovirus (CMV) remains a leading cause of morbidity and mortality. To determine the incidence of CMV infection in kidney transplant recipients and identify clinical and laboratory predictors and associated risk factors. A systematic review and meta-analysis, registered in PROSPERO (CRD42024524165), was conducted in accordance with PRISMA guidelines. PubMed, Web of Science, and LILACS databases were searched up to 6 March 2024 for cohort studies reporting CMV incidence post-kidney transplantation. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Publication bias was evaluated using funnel plots, Egger's test, Kendall's tau, and the fail-safe N. Fifteen studies met the inclusion criteria, comprising 3888 patients with a mean age of 45.1 years and a mean follow-up of 7.14 months. The pooled incidence of CMV infection was 42% (95% CI: 30%-54%), with high heterogeneity (I² = 98.75%; p < 0.001). Sensitivity analysis confirmed the robustness of the results, and no significant publication bias was detected. The main risk factors were: advanced age, paediatric age (< 5 years), donor-recipient serodiscordance (D+/R-), post-transplant lymphopenia, and reduced cell-specific immunity defect. CMV infection remains a common and clinically significant complication following kidney transplantation. With a high incidence and strong association with specific laboratory and clinical predictors. Individualised prevention strategies and early virological and immunological monitoring, especially in high-risk groups, are essential to reduce morbidity and mortality and preserve graft function. PROTOCOL REGISTRATION: PROSPERO: CRD42024524165.

Cytomegalovirus (CMV) is a common herpesvirus that is transmitted from person to person via bodily fluids, including urine, saliva, blood and semen. If a pregnant woman acquires CMV for the first time (maternal primary infection) or has CMV reactivation or reinfection with a new strain in pregnancy, a resulting congenital infection can cause damage to the developing foetus. CMV is the leading infectious cause of newborn disability in high income countries, where an estimated 1 in 200 babies are born with congenital infection. Around 20% of children with congenital CMV will experience significant long-term impacts, most commonly sensorineural hearing loss but also developmental delay, epilepsy and cerebral palsy. Hygiene precautions are the only effective primary prevention strategy, and it is widely recommended that all pregnant women, and those planning a pregnancy, should receive information about these strategies to help reduce the risk of infection. However, most women do not receive counselling about CMV. Here we explore commonly reported health professional capability and motivational barriers to antenatal CMV counselling and the perspectives of pregnant women and people with lived experience of CMV. This review provides an overview on what has been shared by pregnant women and those with lived experience in the literature and dispels some misconceptions about the acceptability and feasibility of CMV hygiene precautions.

Parainfluenza virus (PIV) is a common cause of respiratory illness in children and immunocompromised adults, but little is known about its epidemiology or disease burden in the general adult population. This review evaluates published global epidemiological and disease burden for PIV in adults, including high-risk patients (immunocompromised or with chronic illnesses), and identifies existing data gaps. A PRISMA systematic review of publications from 2014 to 2023 in PubMed reporting PIV prevalence and disease burden (including hospitalisations, mortality) in adults (≥ 18 years) and high-risk patients was performed. Sixty-five studies were included; which skewed towards Asia, Europe, and North America, highlighting a data gap in global PIV prevalence. Overall prevalence of PIV (all strains) ranged from 0 to 15.2% [median 2%] in the general adult population (not considered high-risk but tested for infection). PIV3 was the most prevalent strain (0.6-15.2% [2.9]), followed by PIV4 (0.4-6.5% [1.9]), PIV1 (0.5-2.8% [1.1]), and PIV2 (0-2.9% [1.1]). PIV prevalence was generally higher in high-risk adults (up to 41% in certain risk groups) and those aged ≥ 65. Mortality rates ranged from 2 to 40% in those high-risk, while need for respiratory assistance ranged from 0.9% to 64.2% and hospitalisation from 3.7% to 45.3%. None of the studies reported cost-related healthcare resource utilisation. Variability of study designs, data stratification, and patient populations in the selected studies challenged evaluating the true prevalence of PIV and its burden. PIV infection carries an underappreciated burden, with substantial morbidity and mortality risks, especially in high-risk patients. Significant knowledge gaps exist regarding global prevalence and economic burden in the general adult population.

Influenza's rapid evolution, driven by its segmented RNA genome, high mutation rate, and extensive animal reservoirs, underpins its capacity to cause recurring epidemics and unpredictable pandemics. Recent advances in artificial intelligence (AI) and machine learning (ML) are transforming influenza forecasting by enabling the prediction of viral evolution and the optimisation of public health preparedness. This review synthesises insights from historical data (1890-2025) and contemporary research to examine the evolving role of AI in influenza prediction. It highlights major developments including transformer-based models for viral evolution, real-time integration of mobility and environmental data, hybrid quantum, which are classical algorithms, and multimodal data fusion frameworks, it also consideres critical risk modifiers such as meteorological variation, armed conflict, and host genetics. Importantly, the review distinguishes between retrospective, proof-of-concept analyses and prospective, real-time forecasting applications, clarifying their respective contributions to operational public health preparedness and informed decision-making.

Oncogenic viruses, with their significant capacity to drive malignant transformation, are currently known as a major factor involved in cardiovascular diseases (CVDs) by intricate immunometabolic and inflammatory processes. In this context, viral pathogens such as Hepatitis B and C viruses (HBV/HCV), Human Cytomegalovirus (HCMV), Human Papillomavirus (HPV), Epstein-Barr Virus (EBV), and Human T-Lymphotropic Virus (HTLV) have been detected in vascular tissues and are hypothesised to contribute to endothelial dysfunction, atherogenesis, and myocarditis. These viruses can modulate host cell signalling, induce chronic inflammation, and promote oxidative stress, thereby accelerating vascular remodelling and plaque instability. Emerging evidence also suggests that viral oncogenes interfere with cardiomyocyte survival pathways and disrupt vascular smooth muscle cell homoeostasis. Despite growing interest, the causal relationship between oncoviral infection and cardiovascular disease remains underexplored, and current clinical guidelines do not address viral-driven cardiopathology. This review synthesises current mechanistic insights and highlights epidemiological links, aiming to bridge gaps between oncology and cardiovascular virology. Understanding the dual oncogenic and cardiotropic potential of these viruses may open new therapeutic perspectives and support the development of targeted antiviral and immunomodulatory strategies for cardiovascular prevention in high-risk populations.

The extensive use of plastics since the industrial revolution has raised significant environmental and health concerns. Despite their advantages in terms of durability, affordability, and ease of production, the accumulation of plastics has resulted in considerable pollution. The SARS-CoV-2 pandemic further exacerbated plastic consumption, particularly in medical supplies, intensifying the plastic waste crisis. The majority of plastics are not recycled and eventually degrade into microplastics (MPs) and nanoplastics (NPs), which pose substantial risks to ecosystems and human health. MPs and NPs enter the body through inhalation, ingestion, or skin contact and have been found in biological samples such as blood, faeces, and lung fluids. Their presence has been linked to diseases affecting the lungs, cardiovascular system, and intestines, as well as cancer and viral infections. This review highlights how MPs and NPs contribute to the spread of infectious diseases by creating a habitat called the "plastisphere," which promotes microbial growth and serves as a reservoir for pathogens, emphasising their effects on viral persistence, infection dynamics, and immune modulation. Unlike previous reviews mainly focused on toxicological or microbiological aspects, this work integrates environmental, virological, and immunological evidence to outline how MPs/NPs may reshape virus-host interactions. By identifying critical knowledge gaps, such as the quantitative impact of MPs/NPs on viral stability and immune disruption, this review provides a background for future experimental and epidemiological research. This value-added perspective not only advances scientific understanding but also supports policy development in waste management.