핵심논문

Transfusion-transmitted hepatitis E: What we know so far?

Review
Published on
Journal: World journal of gastroenterology
[Category] E형 간염, 핵심논문,
[키워드]
[DOI] 10.3748/wjg.v28.i1.47 PMC 바로가기 [Article Type] Review

Abstract

Hepatitis E virus (HEV) is a major cause of viral hepatitis globally. There is growing concern about transfusion-transmitted HEV (TT-HEV) as an emerging global health problem. HEV can potentially result in chronic infection in immunocompromised patients, leading to a higher risk of liver cirrhosis and even death. Between 0.0013% and 0.281% of asymptomatic blood donors around the world have HEV viremia, and 0.27% to 60.5% have anti-HEV immunoglobulin G. HEV is infectious even at very low blood concentrations of the virus. Immunosuppressed patients who develop persistent hepatitis E infection should have their immunosuppressant regimen reduced; ribavirin may be considered as treatment. Pegylated interferon can be considered in those who are refractory or intolerant to ribavirin. Sofosbuvir, a nucleotide analog, showed modest antiviral activity in some clinical studies but sustained viral response was not achieved. Therefore, rescue treatment remains an unmet need. The need for HEV screening of all blood donations remains controversial. Universal screening has been adopted in some countries after consideration of risk and resource availability. Various pathogen reduction methods have also been proposed to reduce the risk of TT-HEV. Future studies are needed to define the incidence of transmission through transfusion, their clinical features, outcomes and prognosis.

Global Disparities in Hepatitis B Elimination—A Focus on Africa

Review
Published on
Journal: Viruses
[Category] B형 간염, 핵심논문,
[키워드]
[DOI] 10.3390/v14010082 PMC 바로가기 [Article Type] Review

Abstract

In 2016, WHO member states at the World Health Assembly adopted a Global Health Sector Strategy that included a policy of eliminating viral hepatitis. Clear targets were established to assist in achieving this by 2030. The strategy, while achievable, has exposed existing global disparities in healthcare systems and their ability to implement such policies. Compounding this, the regions with most disparity are also those where the hepatitis B prevalence and disease burden are the greatest. Foundational to hepatitis B elimination is the identification of both those with chronic infection and crucially pregnant women, and primary prevention through vaccination. Vaccination, including the birth dose and full three-dose coverage, is key, but complete mother-to-child transmission prevention includes reducing the maternal hepatitis B viral load in the third trimester where appropriate. Innovations and simplified tools exist in order to achieve elimination, but what is desperately required is the will to implement these strategies through the support of appropriate investment and funding. Without this, disparities will continue.

Invalid measles vaccine dose administration and vaccine effectiveness in Ethiopia

Research
Published on
Journal: The Pan African Medical Journal
[Category] 핵심논문, 홍역,
[키워드]
[DOI] 10.11604/pamj.2021.40.229.29028 PMC 바로가기 [Article Type] Research

Abstract

Introduction Ethiopia endorsed the African regional measles elimination goal in 2012 and has been implementing measles elimination strategies. Administration of measles vaccine before the age of nine months decreases seroconversion. Ensuring administration of valid doses and monitoring vaccine effectiveness is crucial for achieving measles elimination. The objective of the study was to describe the magnitude of invalid measles dose administration and vaccine effectiveness in Ethiopia. Methods we analysed the 2016 Ethiopian Demographic and Health Survey (EDHS) immunization coverage data for Ethiopia to determine the age at measles vaccine administration and proportion of measles age invalid doses administered. The national measles surveillance data for children with birthdates that match 12-23 months old children surveyed in the EDHS 2016, were analysed to determine the Proportion of Cases Vaccinated (PCV) with one dose of measles vaccine. We estimated the effectiveness of measles vaccine by using the proportion of measles cases vaccinated (PCV) from measles surveillance data and the measles vaccination coverage among children aged 12-23 months reported in the demographic health survey (DHS) done in 2016 (Percent of Population Vaccinated for measles, PPV). The screening method was used to estimate measles vaccine effectiveness at national level and for regions which reported more than 30 measles cases among children 9-23 months of age in the 2013-2015 period. The correlation between the median age of invalid doses administered, proportion of invalid doses and measles vaccine effectiveness was analysed. Results at national level, the proportion of invalid measles dose administration was 27.6% for children aged 12-35 months surveyed in the 2016 DHS survey in Ethiopia. Among children reported in the measles case-based surveillance database with birthdates that match the children surveyed in the Ethiopian DHS 2016, the proportion of measles cases vaccinated with a single dose of measles vaccine in the 2013-2015 period was 22.7%. The vaccine effectiveness for single dose measles vaccination was estimated at 75.3%. The measles vaccine effectiveness was low for regions with high proportion of invalid dose administration and lower median age of invalid dose administration. The median age of measles dose administered before the age of nine months was significantly correlated with measles vaccine effectiveness (r=0.971, p=0.001) in the respective regions. Conclusion the proportion of invalid measles dose administration is very high in Ethiopia and is associated with lower vaccine effectiveness. Further assessment should be carried out to understand the underlying root causes for invalid dose administration, focusing on areas with high proportion of invalid measles doses. The national program should devise strategies to promote timely vaccination as per the national schedule, and to revaccinate those vaccinated before 9 months of age. The ministry of health should also strengthen the platform for immunization in the 2 nd year life, to ensure high routine immunization coverage with two doses of measles vaccine to achieve the measles elimination goal in Ethiopia.

Advances in mRNA and other vaccines against MERS-CoV

Review Article
Published on
Journal: Translational research : the journal of laboratory
[Category] COVID19(2023년), MERS, SARS, 핵심논문,
[DOI] 10.1016/j.trsl.2021.11.007 PMC 바로가기 [Article Type] Review Article

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) is a highly pathogenic human coronavirus (CoV). Belonging to the same beta-CoV genus as severe acute respiratory syndrome coronavirus-1 (SARS-CoV-1) and SARS-CoV-2, MERS-CoV has a significantly higher fatality rate with limited human-to-human transmissibility. MERS-CoV causes sporadic outbreaks, but no vaccines have yet been approved for use in humans, thus calling for continued efforts to develop effective vaccines against this important CoV. Similar to SARS-CoV-1 and SARS-CoV-2, MERS-CoV contains 4 structural proteins, among which the surface spike (S) protein has been used as a core component in the majority of currently developed MERS-CoV vaccines. Here, we illustrate the importance of the MERS-CoV S protein as a key vaccine target and provide an update on the currently developed MERS-CoV vaccines, including those based on DNAs, proteins, virus-like particles or nanoparticles, and viral vectors. Additionally, we describe approaches for designing MERS-CoV mRNA vaccines and explore the role and importance of naturally occurring pseudo-nucleosides in the design of effective MERS-CoV mRNA vaccines. This review also provides useful insights into designing and evaluating mRNA vaccines against other viral pathogens.

Measles outbreak investigation in Aweil East county, South Sudan

Research
Published on
Journal: The Pan African Medical Journal
[Category] 핵심논문, 홍역,
[키워드]
[DOI] 10.11604/pamj.2021.40.87.28370 PMC 바로가기 [Article Type] Research

Abstract

During January 2018-June 2020, Aweil East confirmed five measles outbreaks. In March 2020, Aweil East reported twenty measles IgM+ cases. Before this outbreak, Aweil East had confirmed an outbreak in late November 2019. Even after conducting outbreak reactive vaccinations (ORV) in December 2019 and February 2020, measles spread was not interrupted. The nationally supported measles follow-up campaign (MFUC) conducted in late February 2020 was deferred in Aweil East because of the February ORV. We reviewed the measles data collected through passive and active surveillance. A matched case-control study was conducted to evaluate potential exposures. Face-to-face interviews with cases and controls using a semi-structured questionnaire were used to collect demographics, disease, and exposures related data. A total of 687 cases with eight deaths; attack and case fatality rate of 123/100,000 population and 1.16%, respectively. Among the cases, 51.8% were male, the median age was four years, and 59% of cases ≥9 months were unvaccinated. Eighty point six percent (80.6%) of cases reported after the February ORV were unvaccinated. The outbreak peaked in late March 2020. Unvaccinated persons had higher odds of getting measles (adjusted odds ratio (AOR)=8.569; 95% CI [1.41- 53.4], p=0.02). Non exposed persons had a lower odd of getting measles (AOR=0.114; 95% CI [0.02-0.61], p=0.011). During 2018-2019, the accumulated number of unvaccinated children (18,587) is more than a birth cohort of the county. Persistent low routine vaccination is the most critical driver of the measles outbreaks. Low-quality ORV and the intermediate population density are secondary drivers of the outbreaks.

Interplay Between Non-Canonical NF-κB Signaling and Hepatitis B Virus Infection

Article
Published on
Journal: Frontiers in Immunology
[Category] B형 간염, 핵심논문,
[키워드]
[DOI] 10.3389/fimmu.2021.730684 PMC 바로가기 [Article Type] Article

Abstract

The non-canonical nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway is an important component of NF-κB transcription complex. Activation of this pathway mediates the development and function of host immune system involved in inflammation and viral infection. During hepatitis B virus (HBV) infection, there is a complex interaction between infected hepatocytes and the immune cells, which can hinder antiviral immune responses and is associated with pathological changes in liver tissue. Consistently, the host immune system is closely related to the severity of liver damage and the level of viral replication. Previous studies indicated that the non-canonical NF-κB signaling pathway was affected by HBV and might play an important regulatory role in the antiviral immunity. Therefore, systematically elucidating the interplay between HBV and non-canonical NF-κB signaling will contribute the discovery of more potential therapeutic targets and novel drugs to treat HBV infection.

Hepatitis A: Epidemiology, High-Risk Groups, Prevention and Research on Antiviral Treatment

Review
Published on
Journal: Viruses
[Category] A형 간염, 핵심논문,
[키워드]
[DOI] 10.3390/v13101900 PMC 바로가기 [Article Type] Review

Abstract

The hepatitis A virus (HAV) is a leading cause of acute viral hepatitis worldwide. It is transmitted mainly by direct contact with patients who have been infected or by ingesting contaminated water or food. The virus is endemic in low-income countries where sanitary and sociodemographic conditions are poor. Paradoxically, improving sanitary conditions in these countries, which reduces the incidence of HAV infections, can lead to more severe disease in susceptible adults. The populations of developed countries are highly susceptible to HAV, and large outbreaks can occur when the virus is spread by globalization and by increased travel and movement of foodstuffs. Most of these outbreaks occur among high-risk groups: travellers, men who have sex with men, people who use substances, and people facing homelessness. Hepatitis A infections can be prevented by vaccination; safe and effective vaccines have been available for decades. Several countries have successfully introduced universal mass vaccination for children, but high-risk groups in high-income countries remain insufficiently protected. The development of HAV antivirals may be important to control HAV outbreaks in developed countries where a universal vaccination programme is not recommended.

Pathogenicity of novel reassortant Eurasian avian-like H1N1 influenza virus in pigs

Article
Published on
Journal: Virology
[Category] 신종인플루엔자, 핵심논문,
[키워드]
[DOI] 10.1016/j.virol.2021.06.001 PMC 바로가기 [Article Type] Article

Abstract

Reassortant Eurasian avian-like (EA) H1N1 virus, possessing 2009 pandemic (pdm/09) and triple-reassortant (TR)-derived internal genes, namely G4 genotype, has replaced the G1 genotype EA H1N1 virus (all the genes were of EA origin) and become predominant in swine populations in China. Understanding the pathogenicity of G4 viruses in pigs is of great importance for disease control. Here, we conducted comprehensive analyses of replication and pathogenicity of G4 and G1 EA H1N1 viruses in pigs. G4 virus exhibited enhanced replication, increased duration of virus shedding, and caused more severe respiratory lesions in pigs compared with G1 virus. G4 virus, with viral ribonucleoprotein (vRNP) complex genes of pdm/09 origin, exhibited higher levels of nuclear accumulation and higher polymerase activity, which is essential for improved replication of G4 virus. These findings indicate that G4 virus poses a great threat to both swine industry and public health, and control measures should be urgently implemented.

Measles, Media and Memory: Journalism’s Role in Framing Collective Memory of Disease

Article
Published on
Journal: The Journal of Medical Humanities
[Category] 핵심논문, 홍역,
[키워드]
[DOI] 10.1007/s10912-021-09705-2 PMC 바로가기 [Article Type] Article

Abstract

Language used to describe measles in the press has altered significantly over the last sixty years, a shift that reflects changing perceptions of the disease within the medical community as well as broader changes in public health discourse. California, one of the most populous U.S. states and seat of the 2015 measles outbreak originating at Disneyland, presents an opportunity for observing these changes. This article offers a longitudinal case study of five decades of measles news coverage by the Los Angeles Times and the San Francisco Chronicle , which represented two of the largest news markets in California when the measles vaccine was released, in 1963, and during the 2015 outbreak. Measles reporting during this period displays patterns pointing to an active role for journalists in shaping public understanding of health and medical matters, especially as they recede from public memory, through the employment of available and circulating political and cultural frames. Moreover, journalistic frames in this period of reporting incorporated presentist descriptions of the disease, which imposed present values on the medical past, and which were constructed of decontextualized historical references that supported prevailing contemporary notions of the disease. Framing and the tendency toward presentism, in the context of shifting public health discourse, had the effect of communicating an increasingly severe sounding disease over time, and of shifting blame for that disease’s spread from nature to government to individuals. Journalistic framing and causal stories have much power to shape public understanding of medical matters as they recede from public memory.

Prevention of vertical transmission of hepatitis B virus infection

Review
Published on
Journal: World journal of gastroenterology
[Category] B형 간염, 핵심논문,
[키워드]
[DOI] 10.3748/wjg.v27.i26.4182 PMC 바로가기 [Article Type] Review

Abstract

Hepatitis B virus (HBV) is the leading cause of chronic viral hepatitis. Annually, almost two million children younger than 5 years acquire the infection, mostly through vertical or horizontal transmission in early life. Vertical transmission of HBV is a high efficacy phenomenon ranging, in the absence of any preventive interventions, from 70% to 90% for hepatitis e antigen positive mothers and from 10% to 40% for hepatitis e antigen-negative mothers. Maternal viraemia is a preeminent risk factor for vertical transmission of HBV. Maternal screening is the first step to prevent vertical transmission of HBV. Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection. Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low- and middle-income countries where the prevalence of the infection is at the highest.