Journal of Infection最新文献

{"title":"IFNL4 genotype and other personal characteristics to predict response to 8-week sofosbuvir-based treatment for chronic hepatitis C","authors":"","doi":"10.1016/j.jinf.2024.106258","DOIUrl":"10.1016/j.jinf.2024.106258","url":null,"abstract":"<div><h3>Background</h3><p>Shorter duration therapy for hepatitis C virus (HCV) infection might reduce treatment costs and increase the number of patients treated and cured. We determined factors associated with treatment response after an 8-week sofosbuvir-based therapy and developed a simple model to predict an individual’s likelihood of treatment success.</p></div><div><h3>Methods</h3><p>Among 2907 patients who received ledipasvir/sofosbuvir for 8 weeks, we determined failure rates by demographic and clinical characteristics, and <em>IFNL4</em>-∆G/TT genotype. We estimated the average <em>IFNL4</em> genotype-related treatment failure rate in major ancestry groups by applying our <em>IFNL4</em> genotype results to genotype distributions from reference populations. We created a treatment response model based on three personal characteristics.</p></div><div><h3>Results</h3><p>Overall, 4.4% of the patients failed treatment. We observed significantly lower failure rates for persons &lt;50 years (1.6%), females (2.6%), those carrying the <em>IFNL4</em>-TT/TT genotype (1.8%), those with HCV RNA &lt;5.8 log₁₀ copies/mL (2.0%) or HCV genotype-1B infection (2.6%). In a model based on ancestry, age and sex, the predicted probability of treatment failure ranged from 0.5% among females of East Asian ancestry &lt;50 years of age to 8.5% among males of African ancestry age ≥65 years.</p></div><div><h3>Conclusion</h3><p>Applying this algorithm at the point-of-care might facilitate HCV elimination, especially in low- and middle-income countries.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001920/pdfft?md5=03e998d5cd0e3ffa3661cca7eb8805e6&pid=1-s2.0-S0163445324001920-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect effectiveness of a novel SAR-COV-2 vaccine (SCB-2019) in unvaccinated household contacts in the Philippines: A cluster randomised analysis","authors":"","doi":"10.1016/j.jinf.2024.106260","DOIUrl":"10.1016/j.jinf.2024.106260","url":null,"abstract":"<div><h3>Background</h3><p>Though observational evidence supports indirect effects of SARS-CoV-2 vaccines, randomised experiments are lacking. To address this gap, the double-blinded, prospective follow-up of the household contacts (HHCs) of Philippine participants of the individually-randomised, placebo-controlled trial of the adjuvanted-subunit protein COVID-19 vaccine, SCB-2019, (EudraCT, 2020–004272–17; ClinicalTrials.gov, NCT04672395) was analyzed in a cluster-randomised fashion.</p></div><div><h3>Methods</h3><p>Over an eight-week period, HHCs were followed by rRT-PCR and paired rapid antibody tests (RATs) to detect symptomatic (SCI, primary) and all (ACI, secondary) SARS-CoV-2 infection. A standard analysis estimated the indirect effectiveness of SCB-2019 for each endpoint, excluding HHC RAT-positive at enrollment. A secondary analysis employed enzyme-linked immunosorbent assay (ELISA) results to correct for suspected bias.</p></div><div><h3>Findings</h3><p>SCB-2019 (N = 3470) and placebo (N = 3225) exposed HHCs contributed to at least one analysis. The standard analysis estimated that SCB-2019 reduced the risk of SCI by 83% (95% confidence/credible interval [CI: 32% to 96%), with no effect against ACI. The bias-corrected relative risk reduction was 97% (95% CI: 74% to 100%) for SCI and 79% (95% CI: 14% to 96%) for ACI, with an estimated one SARS-CoV-2 infection prevented per 4.8 households where one member received SCB-2019.</p></div><div><h3>Interpretation</h3><p>SCB-2019 demonstrated bias-corrected indirect effectiveness against SARS-CoV-2 infection among HHC, even at a modest coverage level in the household (approximately 25%). Further research into the indirect effects of SARS-CoV-2 vaccines is needed to optimize the impact of limited doses in low and middle-income settings.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001944/pdfft?md5=0c4f3fa5d01439bc9517de2f6484e1ec&pid=1-s2.0-S0163445324001944-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased 30-day all-cause mortality associated with Gram-negative bloodstream infections in England during the COVID-19 pandemic","authors":"","doi":"10.1016/j.jinf.2024.106256","DOIUrl":"10.1016/j.jinf.2024.106256","url":null,"abstract":"<div><h3>Background</h3><p>Our aim was to assess the impact of COVID-19 pandemic on mortality in patients hospitalised with Gram-negative bloodstream infections (GNBSIs).</p></div><div><h3>Methods</h3><p>A retrospective cohort study including cases of <em>Escherichia coli</em>, <em>Klebsiella</em> species and <em>Pseudomonas aeruginosa</em> in England (January 2015–December 2021) reported to UKHSA’s Second Generation Surveillance System. The outcome was 30-day all-cause mortality. Multivariable logistic regression models were built, and adjusted Odds Ratios (ORs) with 95% confidence intervals were reported.</p></div><div><h3>Results</h3><p>Total <em>E. coli</em>, <em>Klebsiella</em> spp. and <em>P. aeruginosa</em> infections were 206,030, 53,819 and 21,129, respectively. Compared to the pre-pandemic period, odds of death during the pandemic (March 2020 onwards) in <em>E. coli</em>, <em>Klebsiella</em> spp. and <em>P. aeruginosa</em> infections with no COVID-19 infection within 28-days of onset were 1.13 (1.08–1.18), 1.15 (1.07–1.25) and 1.09 (0.97–1.22), while odds in GNBSIs with an associated COVID-19 infection were 2.45 (2.26–2.66), 2.96 (2.62–3.34) and 3.15 (2.61–3.80), respectively. Asian patients with an associated COVID-19 infection were more likely to die during the pandemic compared to White patients (<em>E. coli</em>: OR 1.28 (0.95–1.71); <em>Klebsiella</em> spp. OR 1.59 (1.20–2.11); <em>P. aeruginosa</em>: OR 2.02 (1.23–3.31)).</p></div><div><h3>Conclusions</h3><p>Patients suffering from a GNBSI had increased risk of death during the pandemic, with the risk higher in patients with an associated COVID-19 infection.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001907/pdfft?md5=bd503fcccf76cb926880cc1c7e0875de&pid=1-s2.0-S0163445324001907-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Favipiravir for COVID-19 in adults in the community in PRINCIPLE, an open-label, randomised, controlled, adaptive platform trial of short- and longer-term outcomes","authors":"","doi":"10.1016/j.jinf.2024.106248","DOIUrl":"10.1016/j.jinf.2024.106248","url":null,"abstract":"<div><h3>Background</h3><p>Evidence for the effect of favipiravir treatment of acute COVID-19 on recovery, hospital admissions and longer-term outcomes in community settings is limited.</p></div><div><h3>Methods</h3><p>In this multicentre. open-label, multi-arm, adaptive platform randomised controlled trial participants aged ≥18 years in the community with a positive test for SARS-CoV-2 and symptoms lasting ≤14 days were randomised to: usual care; usual care plus favipiravir tablets (loading dose of 3600 mg in divided doses on day one, then 800 mg twice a day for four days); or, usual care plus other interventions. Co-primary endpoints were time to first self-reported recovery and hospitalisation/death related to COVID-19, within 28 days, analysed using Bayesian models. Recovery at six months was the primary longer-term outcome. Trial registration: ISRCTN86534580.</p></div><div><h3>Findings</h3><p>The primary analysis model included 8811 SARS-CoV-2 positive mostly COVID vaccinated participants, randomised to favipiravir (n = 1829), usual care (n = 3256), and other treatments (n = 3726). Time to self-reported recovery was shorter in the favipiravir group than usual care (estimated hazard ratio 1·23 [95% credible interval 1·14 to 1·33]), a reduction of 2·98 days [1·99 to 3·94] from 16 days in median time to self-reported recovery for favipiravir versus usual care alone. COVID-19 related hospitalisations/deaths were similar (estimated odds ratio 0·99 [0·61 to 1·61]; estimated difference 0% [−0·9% to 0·6%]). 14 serious adverse events occurred in the favipiravir group and 4 in usual care. By six months, the proportion feeling fully recovered was 74·9% for favipiravir versus 71·3% for usual care (RR = 1·05, [1·02 to 1·08]).</p></div><div><h3>Interpretation</h3><p>In this open-label trial in a largely vaccinated population with COVID-19 in the community, favipiravir did not reduce hospital admissions, but shortened time to recovery and had a marginal positive impact on long term outcomes.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001828/pdfft?md5=6a5cc3d76c2a0789177fd542006c3fd1&pid=1-s2.0-S0163445324001828-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and impact of persistent symptoms following SARS-CoV-2 infection among healthcare workers: A cross-sectional survey in the SIREN cohort","authors":"","doi":"10.1016/j.jinf.2024.106259","DOIUrl":"10.1016/j.jinf.2024.106259","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;p&gt;Following SARS-CoV-2 infection, some patients experience a range of long-lasting symptoms, with a specific burden on their lives and ability to work.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;p&gt;We describe the prevalence and impact of persistent symptoms pre-/post-vaccination in SIREN study participants.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;A cross-sectional study of SARS-CoV-2 positive participants was carried out within SIREN, a frequently tested UK healthcare worker cohort with vaccination and demographic data available. Participants with a SARS-CoV-2 positive PCR or anti-SARS-CoV-2 sample between 01 March 2020 and 31 September 2022 were asked via a questionnaire about symptoms and days absent from work following infection. Responses were excluded if infection dates were inconsistent with study records or missing key data. Symptom type/duration and whether infection occurred pre-/post-vaccination and during which variant period were described. Logistic regression was used to estimate factors associated with persistent symptoms (&gt;12 weeks), adjusting for vaccination and demographic factors. The median days absent from work were also determined.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Of 16,599 invitations, 6677 participants responded, and 5053 were included in the analysis. The prevalence of persistent symptoms (symptoms lasting over 12 weeks) differed by infection episode; highest for first infections (32.7%; 1557/4767) compared to second (21.6%; 214/991) and third infections (21.6%; 16/74). Most frequently reported symptoms were fatigue, tiredness, shortness of breath and difficulty concentrating. A higher prevalence of persistent symptoms was reported during the Wild-type variant period compared to the other variant periods (52.9% Wild-type vs. 20.7% Omicron, for any symptom reported during their first infection). Overall, persistent symptoms were higher among unvaccinated participants (unvaccinated 38.1% vs vaccinated 22.0%). Multivariable analysis showed that participants were less likely to report persistent symptoms in infections occurring after vaccination compared to those with an infection before vaccination in the Alpha/Delta and Omicron periods (Alpha/Delta: adjusted Odds Ratio (aOR) 0.66, CI 95% 0.51–0.87, p = aOR 0.07, CI 95% 0.01–0.65, p = 0.02). About half of participants reported that their persistent symptoms impacted their day-to-day (51.8%) and work-related (42.1%) activities ‘a little’, and 24.0% and 14.4% reported that the impact was ‘A lot’. 8.9% reported they had reduced their working hours, and 13.9% had changed their working pattern.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;p&gt;Persistent symptoms were frequent in our cohort, and there was a reduction in symptom duration in those with multiple infection episodes during later variant periods and post-vaccination. The impact of persistent symptoms resulting in reducing working hours or adjusting working patterns has important implications for workforce resilience. UK health","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001932/pdfft?md5=e3ea33cae42062e71947cf9c7d08a942&pid=1-s2.0-S0163445324001932-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procalcitonin for safe reduction of unnecessary blood cultures in the emergency department: Development and validation of a prediction model","authors":"","doi":"10.1016/j.jinf.2024.106251","DOIUrl":"10.1016/j.jinf.2024.106251","url":null,"abstract":"<div><h3>Objectives</h3><p>Blood cultures (BCs) are commonly ordered in emergency departments (EDs), while a minority yields a relevant pathogen. Diagnostic stewardship is needed to safely reduce unnecessary BCs. We aimed to develop and validate a bacteremia prediction model for ED patients, with specific focus on the benefit of incorporating procalcitonin.</p></div><div><h3>Methods</h3><p>We included adult patients with suspected bacteremia from a Dutch ED for a one-year period. We defined 23 candidate predictors for a “full model”, of which nine were used for an automatable \"basic model”. Variations of both models with C-reactive protein and procalcitonin were constructed using LASSO regression, with bootstrapping for internal validation. External validation was done in an independent cohort of patients with confirmed infection from 71 Spanish EDs. We assessed discriminative performance using the C-statistic and calibration with calibration curves. Clinical usefulness was evaluated by sensitivity, specificity, saved BCs, and Net Benefit.</p></div><div><h3>Results</h3><p>Among 2111 patients in the derivation cohort (mean age 63 years, 46% male), 273 (13%) had bacteremia, versus 896 (20%) in the external cohort (n = 4436). Adding procalcitonin substantially improved performance for all models. The basic model with procalcitonin showed most promise, with a C-statistic of 0.87 (0.86–0.88) upon external validation. At a 5% risk threshold, it showed a sensitivity of 99% and could have saved 29% of BCs while only missing 10 out of 896 (1.1%) bacteremia patients.</p></div><div><h3>Conclusions</h3><p>Procalcitonin-based bacteremia prediction models can safely reduce unnecessary BCs at the ED. Further validation is needed across a broader range of healthcare settings.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001853/pdfft?md5=e49f0fd005e16187df59fc3617f0bf8b&pid=1-s2.0-S0163445324001853-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of unintended consequences from lower antibiotic prescribing for respiratory tract infections in primary care","authors":"","doi":"10.1016/j.jinf.2024.106255","DOIUrl":"10.1016/j.jinf.2024.106255","url":null,"abstract":"<div><h3>Objectives</h3><p>About 60% of antibiotic prescribing in primary care is for respiratory tract infections (RTIs), some of which is likely unnecessary. There is limited evidence on the association between reduced antibiotic prescribing and adverse events. We aimed to identify associations between practice-level prescribing rates for RTIs in general practice, and patient-level adverse outcomes.</p></div><div><h3>Methods</h3><p>We included 1471 English General Practitioner (GP) practices, linked to hospital admissions in England, from the Clinical Practice Research Datalink for 2005 to 2019. Outcomes were hospitalisations, RTI-related re-consultations and additional antibiotic prescriptions, adjusted for practice level case-mix prescribing.</p></div><div><h3>Results</h3><p>Prescribing rates for practices falling within the lowest and highest prescribing quintiles were 52 and 139 prescriptions per 1000 RTI-related consultations. Patients from practices in the lowest prescribing quintile did not have significantly higher risk of hospitalisation, adjusted odds ratio 0·99 (95% CI 0·96 to 1·02). Re-consultations within 30 days were significantly higher for the lowest prescribing practices, adjusted odds ratio 1·209 (1·206 to 1·212). Additional antibiotic prescriptions and subsequent prescriptions upon re-consultation were significantly lower for the lowest prescribing practices, adjusted odds ratio 0·317 (0·314 to 0·321) and 0·706 (0·699 to 0·712), respectively.</p></div><div><h3>Conclusions</h3><p>Our results contribute to evidence on the safety of reduced antibiotic prescribing for RTIs in primary care. Results suggest that for the majority of practices, further reductions in RTI-related antibiotic prescribing should be possible without an increase in hospitalisation for pneumonia.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001890/pdfft?md5=6dc6ef2c1dd3c0a0c02e529e92fa08a5&pid=1-s2.0-S0163445324001890-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-packaged cold-chain ready-to-eat food as a source of sporadic listeriosis in Beijing, China","authors":"","doi":"10.1016/j.jinf.2024.106254","DOIUrl":"10.1016/j.jinf.2024.106254","url":null,"abstract":"<div><h3>Objectives</h3><p>Using a sporadic case of listeriosis suspected to have been caused by consuming a pre-packaged cold-chain ready-to-eat (RTE) food in Beijing, China in 2021 as an exemplar, this study demonstrated the importance of thoroughly investigating the source of listeriosis up to the production point for mitigating infection risk during routine monitoring of <em>Listeria</em> in food facilities and national surveillance program using whole-genome sequencing (WGS).</p></div><div><h3>Methods</h3><p>Epidemiological, laboratory, traceback, and plant investigations were used to identify the source of infection.</p></div><div><h3>Results</h3><p>WGS showed the isolate from the patient was genetically indistinguishable from that of the implicated food. During a plant investigation, <em>L. monocytogenes</em> was detected in 26% (9/35) of the environmental samples and one of two raw material samples, confirming the source.</p></div><div><h3>Conclusion</h3><p>To our knowledge, this is the first investigation in China linking a case of <em>L. monocytogenes</em> infection to a suspected food and its production environment. This report highlights the risk of <em>L. monocytogenes</em> contamination of RTE food and demonstrates the role of food safety risk monitoring in identifying potential sources of infection. Reinforcing control programs in RTE processing plants, intensified surveillance of microorganisms in food products and targeted health education is required to mitigate the infection risk.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001889/pdfft?md5=1bf63864efcbaf923016171073fd0cfc&pid=1-s2.0-S0163445324001889-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibodies to PfEMP1 and variant surface antigens: Protection after controlled human malaria infection in semi-immune Kenyan adults","authors":"","doi":"10.1016/j.jinf.2024.106252","DOIUrl":"10.1016/j.jinf.2024.106252","url":null,"abstract":"<div><h3>Objectives</h3><p>Acquisition of antibodies to <em>Plasmodium falciparum</em> variant surface antigens (VSA) expressed on infected red blood cells (iRBCs) is associated with naturally acquired immunity to malaria. We have previously shown that antibodies to VSA on iRBCs are associated with protection against parasite growth in the context of controlled human malaria infection (CHMI). This study explored whether antibodies to recombinant antigens derived from <em>Pf</em>EMP1 domains were independently associated with protection during CHMI in semi-immune Kenyan adults.</p></div><div><h3>Methods</h3><p>We used a multiplex bead assay to measure levels of IgG antibody against a panel of 27 recombinant <em>Pf</em>EMP1 antigens derived from the <em>Pf</em>EMP1 repertoire of the 3D7 parasite clone. We measured IgG levels in plasma samples collected from the CHMI participants before inoculation with Sanaria® PfSPZ Challenge, on the day of diagnosis, and 35 days post-inoculation. Univariable and multivariable Cox regression analysis was used to evaluate the relationship between the levels of antibodies to the antigens and CHMI outcome. We also adjusted for previous data including antibodies to VSA on iRBCs, and we assessed the kinetics of antibody acquisition to the different <em>Pf</em>EMP1 recombinant antigens over time.</p></div><div><h3>Results</h3><p>All study participants had detectable antibodies to multiple <em>Pf</em>EMP1 proteins before inoculation. All <em>Pf</em>EMP1 antigens were associated with protection against parasite growth to the threshold criteria for treatment in CHMI, albeit with substantial collinearity. However, individual <em>Pf</em>EMP1 antigens were not independently associated with protection following adjustment for breadth of reactivity to VSA on iRBCs and schizont extract. In addition, antibodies to <em>Pf</em>EMP1 antigens derived from group B <em>Pf</em>EMP1 were induced and sustained in the participants who could not control parasite growth.</p></div><div><h3>Conclusion</h3><p>This study shows that the breadth of antibody response to VSA on iRBCs, and not to specific <em>Pf</em>EMP1 antigens, is predictive of protection against malaria in CHMI.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001865/pdfft?md5=0622ed72b8bc70ec5f88c36e1e493fa2&pid=1-s2.0-S0163445324001865-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global temporal trends and projections of acute hepatitis E incidence among women of childbearing age: Age-period-cohort analysis 2021","authors":"","doi":"10.1016/j.jinf.2024.106250","DOIUrl":"10.1016/j.jinf.2024.106250","url":null,"abstract":"<div><h3>Background &amp; aims</h3><p>Acute hepatitis E (AHE) poses a significant threat to global public health, particularly among women of childbearing age (WCBA), who are at heightened risk for severe pregnancy-related complications. This study aimed to delineate the temporal trends and project future incidence of AHE in WCBA, providing insights crucial for targeted prevention and control strategies.</p></div><div><h3>Methods</h3><p>Data on AHE incidence from the Global Health data 2021. The age-period-cohort (APC) model was applied to analyze trends across different age groups, periods, and birth cohorts, and the Bayesian APC model was utilized for forecasting future epidemiological trajectories.</p></div><div><h3>Results</h3><p>Globally, AHE incidence numbers among WCBA rose from 2,831,075 in 1992 to 3,420,786 in 2021, while the age-standardized incidence rate (ASIR) declined from 194.66 to 179.54 per 100,000 with a global net drift of −0.28%. However, high SDI regions showed a contrasting trend with a positive net drift of 0.02%. The age effect was consistent across SDI regions and globally, showing a decrease with advancing age, while unfavorable period and cohort effects were exhibited in high-SDI region. At the national level, locations exhibited varying trends of change. The BAPC model predicted a total of 3,759,384 AHE global cases in WCBA by 2030, with an expected mild increase in the ASIR. The outlook for the management and containment of AHE is grim in certain countries, including India.</p></div><div><h3>Conclusions</h3><p>The study revealed a complex epidemiological landscape of AHE in WCBA, with increasing global incidence numbers juxtaposed against a declining ASIR. The AHE burden by 2030 remain severe among WCBA. Young WCBA and high SDI region merit particular attention. The findings underscore the need for region-specific strategies to curb the projected rise in AHE incidence and align with the 2030 WHO goals.</p></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163445324001841/pdfft?md5=463be619e8e9d5d1fac08c8058c11da4&pid=1-s2.0-S0163445324001841-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}