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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Improving methods for analysing anti-malarial drug efficacy trials: molecular correction based on length-polymorphic markers msp-1, msp-2 and glurp.Antimicrobial Agents and Chemotherapy
Drug efficacy trials monitor the continued efficacy of front-line drugs against falciparum malaria. Over-estimates of efficacy result in a country retaining a failing drug as first-line treatment with associated increases in morbidity and mortality, while under-estimating drug effectiveness leads to removal of an effective treatment with substantial practical and economic implications. Trials are challenging: they require long durations of follow-up to detect drug failures, and patients are frequently re-infected during that period. Molecular correction based on parasite genotypes distinguishes reinfections from drug failures to ensure the accuracy of failure rate estimates. Several molecular correction "algorithms" are proposed, but which is most accurate and/or robust remains unknown.
We used pharmacological modelling to simulate parasite dynamics and genetic signals that occur in patients enrolled in malaria drug clinical trials. We compared estimates of treatment failure obtained from a selection of proposed molecular correction algorithms against the known "true" failure rate in the model.
(i) Molecular correction is essential to avoid substantial over-estimates of drug failure rates. (ii) The current WHO-recommended algorithm consistently under-estimates the true failure rate. (iii) Newly-proposed algorithms produce more accurate failure rate estimates; the most accurate algorithm depends on the choice of drug, trial follow-up length, and transmission intensity. (iv) Long durations of patient follow-up may be counterproductive; large numbers of new infections accumulate and may be misclassified, over-estimating drug failure rate. (v) Our model was highly consistent with existing in vivo data.
The current WHO-recommended method for molecular correction and analysis of clinical trials should be re-evaluated and updated.
Inhibition of Chikungunya Virus Replication in Primary Human Fibroblasts by LXR Agonist.Antimicrobial Agents and Chemotherapy
The mosquito-borne Chikungunya virus (CHIKV) causes acute pain and joint inflammation, and in recent years, the virus has caused large epidemics in...
Impact of antibiotic gut exposure on the temporal changes in microbiome diversity.Antimicrobial Agents and Chemotherapy
Although the global deleterious impact of antibiotics on the intestinal microbiota is well known, the temporal changes in microbial diversity durin...
Management of patients with multidrug-resistant tuberculosis.Int J Tuberc
The emergence of multidrug-resistant tuberculosis (MDR-TB; defined as resistance to at least rifampicin and isoniazid) represents a growing threat ...
Curbing the diabetes and tuberculosis co-epidemic: the potential role of China.Int J Tuberc
China has been playing an increasingly important role in global health in recent decades. Substantial progress and reform has been made in the coun...
Radiological features and progression of incipient active pulmonary tuberculosis according to risk factors.Int J Tuberc
OBJECTIVES To examine the radiological features of incipient active pulmonary tuberculosis (PTB) in humans and evaluate radiological progression ac...
Burden of multidrug-resistant tuberculosis in England: a focus on prevalent cases.Int J Tuberc
SETTING The incidence of multidrug-resistant tuberculosis (MDR-TB) is routinely reported by the Public Health England, UK, but prevalence better re...
Extensively drug-resistant tuberculosis 'hotspots' and sociodemographic associations in Durban, South Africa.Int J Tuberc
BACKGROUND In KwaZulu-Natal, South Africa, the incidence of extensively drug-resistant tuberculosis (XDR-TB) is driven by the transmission of resis...
Prevalence of pulmonary tuberculosis in Tibet Autonomous Region, China, 2014.Int J Tuberc
SETTING Tibet Autonomous Region, China. OBJECTIVES To determine the prevalence of pulmonary tuberculosis (TB) in Tibet. DESIGN We conducted a p...
Prevalence of tuberculosis treatment non-adherence in Ethiopia: a systematic review and meta-analysis.Int J Tuberc
SETTING Non-adherence to treatment is one of the challenges facing global tuberculosis (TB) control. In Ethiopia, an extremely variable and high ma...
Risk factors for catastrophic costs associated with tuberculosis in rural South Africa.Int J Tuberc
SETTING Fifty-five public clinics in northern South Africa. OBJECTIVE To estimate patient costs and identify the factors associated with catastro...
Effects of aging, baseline renal function and stage of HIV infection on post-treatment changes in renal function among HIV-infected patients: a retrospective cohort study.HIV Medicine
The use of combination antiretroviral therapy (cART) increases clinical uncertainty about changes in renal function. Specifically, little is known regarding the interaction of the effects of aging, baseline renal impairment, and stages of HIV infection on post-treatment changes in renal function.
This analysis included 5533 HIV-infected patients on cART in 2004-2016. Progression to chronic kidney disease (CKD) was defined as either two consecutive estimated glomerular filtration rate (eGFR) measurements < 60 mL/min/1.73 m2 for baseline eGFR ≥ 60 mL/min/1.73 m2 (mild renal impairment or normal renal function) or a 25% decline for baseline eGFR < 60 mL/min/1.73 m2 (moderate renal impairment).
During follow-up (median 4.8 years), 130 (2.3%) of the patients progressed to CKD. A total of 20.1% of patients with baseline normal renal function progressed to mild renal impairment, while 74.0% of patients with baseline mild or moderate renal impairment improved to normal renal function. In multivariable analysis, a significant positive baseline-eGFR-by-World Health Organization (WHO)-stage interaction effect on progression to CKD in all patients was identified, indicating a cross-over effect from a reduced risk to an increased risk. A significant negative baseline-age-by-WHO-stage interaction effect on progression to mild renal impairment in patients with baseline normal renal function was identified, with adjusted hazard ratios progressively lower at older ages. In addition, there were significant associations with older age, lower baseline eGFR, Dai ethnic minority, and anaemia for both outcomes, hyperglycaemia for CKD only, and higher CD4 count, tenofovir and ritonavir-boosted lopinavir use for mild renal impairment only.
Our data suggest a complex pattern of renal function dynamics in patients on cART, which requires precise management with systematic monitoring of the interaction of the effects of sociodemographic, nephrological and HIV-specific clinical characteristics.