The latest medical research on Infectious Disease

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about infectious disease gathered by our medical AI research bot.

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Tyrosine Kinase Inhibition: a New Perspective in the Fight against HIV.

Current HIV/AIDS Reports

HIV-1 infection is incurable due to the existence of latent reservoirs that persist in the face of cART. In this review, we describe the existence of multiple HIV-1 reservoirs, the mechanisms that support their persistence, and the potential use of tyrosine kinase inhibitors (TKIs) to block several pathogenic processes secondary to HIV-1 infection.

Dasatinib interferes in vitro with HIV-1 persistence by two independent mechanisms. First, dasatinib blocks infection and potential expansion of the latent reservoir by interfering with the inactivating phosphorylation of SAMHD1. Secondly, dasatinib inhibits the homeostatic proliferation induced by γc-cytokines. Since homeostatic proliferation is thought to be the main mechanism behind the maintenance of the latent reservoir, we propose that blocking this process will gradually reduce the size of the reservoir. TKIs together with cART will interfere with HIV-1 latent reservoir persistence, favoring the prospect for viral eradication.

The cost of reaching the 90-90-90 targets: are current investments enough?

Current Opinion in Cell Biology

The 90-90-90 targets were launched with the aim of reaching specific milestones by 2020. To support these targets, modeling has shown that additional resources are needed. This review examines what is known about current investments for HIV in low and middle-income countries, resource needs, and the potential for additional investment.

Reaching the 90-90-90 targets would place the global community on track to end the AIDS epidemic by 2030, significantly improving health outcomes and reducing future spending needs. Recent analyses indicate, however, that funding has slowed and there is a significant gap in resources needed to reach targets. While some studies have modeled the potential for additional HIV spending based on normative and theoretical benchmarks, there are limitations to such approaches. Others have looked at the potential to increase efficiencies. Even if spending continues at recent rates, there would still be a gap of $6.4 billion in 2020.

There is a significant gap in resources needed to reach the 90-90-90 targets by 2020. It may be possible to reduce the gap through more efficient allocation of resources. In addition, there are efforts underway to mobilize more investment. Ultimately, any gap that remains has implications for health outcomes and future spending.

Cytomegalovirus renal infection: rare manifestation of a common post-transplant viral infection -- a case series.

Transplant Infectious Disease

Cytomegalovirus is the most common viral infection in organ transplant recipients that usually affects the brain, lungs, liver, and gastrointestina...

Ganciclovir-resistant post-transplant cytomegalovirus infection due to combined deletion mutation at codons 595-596 of the UL97 gene.

Transplant Infectious Disease

The development of antiviral resistant cytomegalovirus (CMV) infection complicates the management of transplant recipients. We describe the case of...

Gastrointestinal Pathogen Colonization and the Microbiome in Asymptomatic Kidney Transplant Recipients.

Transplant Infectious Disease

In kidney transplant recipients, gastrointestinal (GI) pathogens in feces are only evaluated during diarrheal episodes. Little is known about the prevalence of GI pathogens in asymptomatic individuals in this population.

We recruited 142 kidney transplant recipients who provided a non-diarrheal fecal sample within the first 10 days after transplantation. The specimens were evaluated for GI pathogens using the BioFire® FilmArray® GI Panel (BioFire® Diagnostics, LLC; Salt Lake City, UT), which tests for 22 pathogens. The fecal microbiome was also characterized using 16S rRNA gene sequencing of the V4-V5 hypervariable region. We evaluated whether detection of Clostridioides difficile and other GI pathogens was associated with post-transplant diarrhea within the first 3 months after transplantation.

Among the 142 subjects, a potential pathogen was detected in 43 (30%) using the GI Panel. The most common organisms detected were C. difficile (n=24, 17%), enteropathogenic Escherichia coli (n=8, 6%), and norovirus (n=5, 4%). Detection of a pathogen on the GI panel or detection of C. difficile alone was not associated with future post-transplant diarrhea (P > 0.05). The estimated number of gut bacterial species was significantly lower in subjects colonized with C. difficile than those not colonized with C. difficile (P = 0.01).

Colonization with GI pathogens, particularly C. difficile, is common at the time of kidney transplantation but does not predict subsequent diarrhea. Detection of C. difficile carriage was associated with decreased microbial diversity and may be a biomarker of gut dysbiosis.

Hepatitis B virus reactivation during belatacept treatment after kidney transplantation.

Transplant Infectious Disease

We report a case of HBV reactivation following belatacept treatment in a patient who underwent kidney transplantation in 2015 for HIV-associated nephropathy (HIVAN). HIV viral load was undetectable prior to transplantation and CD4+ lymphocyte count was greater than 300/ml. Baseline HBV serology at transplantation was HBsAg negative, anti-HBcAb positive, anti-HBsAb 312 UI/l and HBeAg negative/anti-HBeAb positive. Liver function tests were normal and viral DNA was undetectable.

Two years later, the patient presented with severe acute hepatitis after a progressive disappearance of anti-HbsAb, quickly followed by HBV reactivation. Immunosuppressive treatment was drastically reduced and treatment with entecavir was started. The outcome was favorable, and HBV DNA became undetectable after 9 weeks of treatment.

This is the first report of acute hepatitis related to HBV reactivation in a kidney transplant recipient treated with belatacept. The risk for HBV reactivation in patients treated with belatacept should not be underestimated, especially in those with resolved HBV infection. This article is protected by copyright. All rights reserved.

In Sickness and in Health: Living HIV positive kidney donation from a wife to her husband, with 7 years' post-transplant follow-up.

Transplant Infectious Disease

Human immunodeficiency virus (HIV) infection was traditionally considered an absolute contraindication for kidney transplantation. After the introd...

Correlations of cytokine levels in cerebrospinal fluid and peripheral blood with outcome of HHV-6B encephalitis after hematopoietic stem cell transplantation.

Transplant Infectious Disease

Human herpesvirus (HHV)-6B encephalitis has been recognized as a serious complication after allogeneic hematopoietic cell transplantation (allo-HCT). Little is known about the pathogenic mechanism for its progression.

We retrospectively evaluated the 16 kinds of cytokines and chemokines in cerebrospinal fluid (CSF) and plasma in patients who developed HHV-6B encephalitis. Among a total of 20 patients, 12 were categorized as the poor prognosis group (died of encephalitis; n=8, retained sequelae; n=4), and other 8 patients were categorized as the good prognosis group (complete recovery; n=8).

Concentrations of CSF IL-6 and IL-8 at the onset of encephalitis were significantly higher in the poor prognosis group than in the good prognosis group (median CSF IL-6, 28.27 pg/mL vs. 14.32 pg/mL, P=0.004; median CSF IL-8, 128.70 pg/mL vs. 59.43 pg/mL, P=0.043). Regarding plasma, the concentration of each cytokine at the onset of encephalitis was not significantly different between the two groups, except IL-5. However, higher levels of IL-6, IL-7, and MCP-1, and lower levels of IL-12, were observed 1 week before the development of encephalitis in patients with poor prognosis (median IL-6; 464.17 pg/mL vs. 47.82 pg/mL, P=0.02; median IL-12; 1.63 pg/mL vs. 6.57 pg/mL, P=0.03).

We found that one week before onset of HHV-6B encephalitis, poor prognosis patients had high plasma concentrations of IL-6, IL-7, and MCP-1, and low concentrations of IL-12. At the onset of encephalitis, high concentrations of IL-6 and IL-8 in CSF were more common in the poor prognosis group, consistent with other evidence that IL-6 can have a role in CNS disturbances. Our findings show that specific cytokine status is associated with severe brain damage in patients with HHV-6B encephalitis, demonstrate prognostic value of plasma IL-6 concentrations, and suggest evaluation of anti-cytokine therapeutics in patients with HHV-6B encephalitis.

Successful Optimization of Antiretroviral Regimens in Treatment Experienced People Living with HIV Following Liver Transplantation.

Transplant Infectious Disease

Modern antiretroviral therapy (ART), extends life expectancy for people living with HIV (PLWH). However, most older PLWH (≥50 years) "aged" with HI...

The role of multilateral organizations and governments in advancing social innovation in health care delivery.

Infectious Diseases of Poverty

Despite great medical advances and scientific progress over the past century, one billion people globally still lack access to basic health care services. In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap, address equity and create social value. This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries.

The integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact. Effective partnerships, strong engagement with and endorsement by governments and communities, regulations, trust and sometimes willingness are key factors to enhance system integration, replication and dissemination of the models. Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link, integrate and synergize their efforts. Key challenges that they encountered, and lessons learnt are highlighted. Multilateral organizations and governments increasingly engage in promoting and supporting the development, testing and dissemination of social innovations to address the health care delivery gap. They play an important role in creating an enabling environment. This includes promoting the concept of social innovation in health care delivery, spreading social innovation approach and lessons learnt, fostering partnerships and leveraging resources, convening communities, health system actors and various stakeholders to work together across disciplines and sectors, and nurturing capacity in countries.

Multilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish. In supporting and disseminating social innovation approach, multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals.

PD-1 blockade and TLR7 activation lack therapeutic benefit in chronic SIV-infected macaques on antiretroviral therapy.

Antimicrobial Agents and Chemotherapy

Antiretroviral therapy (ART) limits HIV-1 replication, but does not eliminate the long-lived reservoir established shortly after viral acquisition....