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BMJ Open Jul 2020The aetiology and burden of viral-induced acute liver failure remains unclear globally. It is important to understand the epidemiology of viral-induced ALF to plan for...
OBJECTIVES
The aetiology and burden of viral-induced acute liver failure remains unclear globally. It is important to understand the epidemiology of viral-induced ALF to plan for clinical case management and case prevention.
PARTICIPANTS
This systematic review was conducted to synthesize data on the relative contribution of different viruses to the aetiology of viral-induced acute liver failure in an attempt to compile evidence that is currently missing in the field. EBSCOhost, PubMed, ScienceDirect, Scopus and Web of Science were searched for relevant literature published from 2009 to 2019. The initial search was run on 9 April 2019 and updated via PubMed on 30 September 2019 with no new eligible studies to include. Twenty-five eligible studies were included in the results of this review.
RESULTS
This systematic review estimated the burden of acute liver failure after infection with hepatitis B virus, hepatitis A virus, hepatitis C virus, hepatitis E virus, herpes simplex virus/human herpesvirus, cytomegalovirus, Epstein-Barr virus and parvovirus B19. Data were largely missing for acute liver failure after infection with varicella-zostervirus, human parainfluenza viruses, yellow fever virus, coxsackievirus and/or adenovirus. The prevalence of hepatitis A-induced acute liver failur was markedly lower in countries with routine hepatitis A immunisation versus no routine hepatitis A immunisation. Hepatitis E virus was the most common aetiological cause of viral-induced acute liver failure reported in this review. In addition, viral-induced acute liver failure had poor outcomes as indicated by high fatality rates, which appear to increase with poor economic status of the studied countries.
CONCLUSIONS
Immunisation against hepatitis A and hepatitis B should be prioritised in low-income and middle-income countries to prevent high viral-induced acute liver failure mortality rates, especially in settings where resources for managing acute liver failure are lacking. The expanded use of hepatitis E immunisation should be explored as hepatitis E virus was the most common cause of acute liver failure.
REGISTRATION
PROSPERO registration number: CRD42017079730.
Topics: Cytomegalovirus; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Humans; Liver Failure, Acute; Virus Diseases
PubMed: 32690747
DOI: 10.1136/bmjopen-2020-037473 -
Le Infezioni in Medicina Dec 2020To date, research on viral shedding (VS), live virus isolation and infection status remains ongoing as scientists and clinicians attempt to better understand the...
To date, research on viral shedding (VS), live virus isolation and infection status remains ongoing as scientists and clinicians attempt to better understand the coronavirus disease of 2019 (COVID-19) pandemic. Viral RNA detection at different stages of the disease, quantitative changes and patterns of viral persistence and clearance all provide context for the pathogenesis and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the highly infectious nature of SARS-CoV-2 and its impact on the global population and economy, clinicians continue to seek the best methods for controlling its spread, and data on public health preventative measures continue to emerge. In this paper we review the available evidence on the viral dynamics of SARS-CoV-2 in the URT to determine a timeline for infection based on molecular and viral culture findings and to assess the significance of persistently positive results. Keywords: viral shedding, viral load, viral culture, SARS-CoV-2, upper respiratory tract.
Topics: COVID-19; Female; Humans; Male; Nasopharynx; Nose; Oropharynx; Pandemics; Pharynx; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Saliva; Sex Distribution; Viral Load; Virus Activation; Virus Cultivation; Virus Replication; Virus Shedding
PubMed: 33257622
DOI: No ID Found -
Frontiers in Public Health 2021The viral shedding time (VST) of SARS-CoV-2 mainly determines its transmission and duration of infectiousness. However, it was heterogeneous in the existing studies.... (Meta-Analysis)
Meta-Analysis
The viral shedding time (VST) of SARS-CoV-2 mainly determines its transmission and duration of infectiousness. However, it was heterogeneous in the existing studies. Here, we performed a meta-analysis to comprehensively summarize the VST of SARS-CoV-2. We searched PubMed, Web of Science, MedRxiv, BioRxiv, CNKI, CSTJ, and Wanfang up to October 25, 2020, for studies that reported VSTs of SARS-CoV-2. Pooled estimates and 95% CIs for the VSTs were calculated using log-transformed data. The VSTs in SARS-CoV-2 infections based on different demographic and clinical characteristics, treatments and specimens were stratified by subgroup analysis. A total of 35 studies involving 3,385 participants met the inclusion criteria. The pooled mean VST was 16.8 days (95% CI: 14.8-19.4, = 99.56%) in SARS-CoV-2 infections. The VST was significantly longer in symptomatic infections (19.7 days, 95% CI: 17.2-22.7, = 99.34%) than in asymptomatic infections (10.9 days, 95% CI: 8.3-14.3, = 98.89%) ( < 0.05). The VST was 23.2 days (95% CI: 19.0-28.4, = 99.24%) in adults, which was significantly longer than that in children (9.9 days, 95% CI: 8.1-12.2, = 85.74%) ( < 0.05). The VST was significantly longer in persons with chronic diseases (24.2 days, 95% CI: 19.2-30.2, = 84.07%) than in those without chronic diseases (11.5 days, 95% CI: 5.3-25.0, = 82.11%) ( < 0.05). Persons receiving corticosteroid treatment (28.3 days, 95% CI: 25.6-31.2, = 0.00%) had a longer VST than those without corticosteroid treatment (16.2 days, 95% CI: 11.5-22.5, = 92.27%) ( = 0.06). The VST was significantly longer in stool specimens (30.3 days, 95% CI: 23.1-39.2, = 92.09%) than in respiratory tract specimens (17.5 days, 95% CI: 14.9-20.6, = 99.67%) ( < 0.05). A longer VST was found in symptomatic infections, infected adults, persons with chronic diseases, and stool specimens.
Topics: Adrenal Cortex Hormones; Adult; Asymptomatic Infections; COVID-19; Child; Comorbidity; Feces; Humans; SARS-CoV-2; Virus Shedding
PubMed: 33816427
DOI: 10.3389/fpubh.2021.652842 -
Journal of the International AIDS... Aug 2021Adolescents and young people comprise a growing proportion of new HIV infections globally, yet current approaches do not effectively engage this group, and adolescent... (Meta-Analysis)
Meta-Analysis Review
Psychosocial interventions for improving engagement in care and health and behavioural outcomes for adolescents and young people living with HIV: a systematic review and meta-analysis.
INTRODUCTION
Adolescents and young people comprise a growing proportion of new HIV infections globally, yet current approaches do not effectively engage this group, and adolescent HIV-related outcomes are the poorest among all age groups. Providing psychosocial interventions incorporating psychological, social, and/or behavioural approaches offer a potential pathway to improve engagement in care and health and behavioural outcomes among adolescents and young people living with HIV (AYPLHIV).
METHODS
A systematic search of all peer-reviewed papers published between January 2000 and July 2020 was conducted through four electronic databases (Cochrane Library, PsycINFO, PubMed and Scopus). We included randomized controlled trials evaluating psychosocial interventions aimed at improving engagement in care and health and behavioural outcomes of AYPLHIV aged 10 to 24 years.
RESULTS AND DISCUSSION
Thirty relevant studies were identified. Studies took place in the United States (n = 18, 60%), sub-Saharan Africa (Nigeria, South Africa, Uganda, Zambia, Zimbabwe) and Southeast Asia (Thailand). Outcomes of interest included adherence to antiretroviral therapy (ART), ART knowledge, viral load data, sexual risk behaviours, sexual risk knowledge, retention in care and linkage to care. Overall, psychosocial interventions for AYPLHIV showed important, small-to-moderate effects on adherence to ART (SMD = 0.3907, 95% CI: 0.1059 to 0.6754, 21 studies, n = 2647) and viral load (SMD = -0.2607, 95% CI -04518 to -0.0696, 12 studies, n = 1566). The psychosocial interventions reviewed did not demonstrate significant impacts on retention in care (n = 8), sexual risk behaviours and knowledge (n = 13), viral suppression (n = 4), undetectable viral load (n = 5) or linkage to care (n = 1) among AYPLHIV. No studies measured transition to adult services. Effective interventions employed various approaches, including digital and lay health worker delivery, which hold promise for scaling interventions in the context of COVID-19.
CONCLUSIONS
This review highlights the potential of psychosocial interventions in improving health outcomes in AYPLHIV. However, more research needs to be conducted on interventions that can effectively reduce sexual risk behaviours of AYPLHIV, as well as those that can strengthen engagement in care. Further investment is needed to ensure that these interventions are cost-effective, sustainable and resilient in the face of resource constraints and global challenges such as the COVID-19 pandemic.
Topics: Adolescent; Anti-Retroviral Agents; Antiretroviral Therapy, Highly Active; COVID-19; Female; HIV Infections; Humans; Male; Pandemics; Patient Participation; Psychosocial Intervention; Risk-Taking; SARS-CoV-2; Sexual Behavior; South Africa; Treatment Adherence and Compliance; Viral Load; Young Adult
PubMed: 34338417
DOI: 10.1002/jia2.25741 -
Andrology Jul 2021The testes are suspected target organs of SARS-CoV-2. However, the results of studies on the effect of COVID-19 on male reproduction are controversial. (Review)
Review
BACKGROUND
The testes are suspected target organs of SARS-CoV-2. However, the results of studies on the effect of COVID-19 on male reproduction are controversial.
OBJECTIVE
To summarize current research on the effects of COVID-19 on male reproduction.
METHODS
A systematic review of English literature was performed using PubMed and Ovid Embase up to 18 August 2020. Research articles on the presence of SARS-CoV-2 in semen, the effects of the virus on semen parameters and any pathological changes in the testes were evaluated.
RESULTS
Fourteen studies were included in this review. Six of 176 survivors (3.4%) and 1 of 13 decedents (7.7%) in 2 of 12 studies were positive for viral RNA in semen and testicular tissue, respectively. After stratification of patient groups, we found that the virus was detected in the relatively early stage of infection, 6-16 days after disease onset, in semen from survivors. Two of 3 studies reported that some participants had substandard semen quality after COVID-19, and 1 study found that COVID-19 may impair semen quality in a severity-related manner. Pathological analyses showed that injuries to the seminiferous tubule occurred in all decedents (N = 11). Another study found that orchitic and testis fibrin microthrombi occurred in patients with fatal disease (100%, N = 2). Scrotal discomfort of orchiepididymitis or spermatic cord inflammation has also been reported in COVID-19 patients.
CONCLUSION
Current studies suggest that semen is rarely considered a carrier of SARS-CoV-2 genetic material during the infection period but not in the semen of recovered patients. Fatal COVID-19 may cause testicular structure damage without the presence of virus.
Topics: COVID-19; Humans; Male; Reproduction; Semen; Semen Analysis; Seminiferous Tubules; Testis
PubMed: 33427404
DOI: 10.1111/andr.12970 -
Eye (London, England) Jul 2020Coronavirus disease 19 (COVID-19) has been described to potentially be complicated by ocular involvement. However, scant information is available regarding severe acute...
Coronavirus disease 19 (COVID-19) has been described to potentially be complicated by ocular involvement. However, scant information is available regarding severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and ocular structures tropism. We conducted a systematic review of articles referenced in PubMed, Cochrane Library, Web of Science and Chinese Clinical Trial Register (ChiCTR) from December 20, 2019 to April 6, 2020, providing information on the presence of SARS-CoV-2 in cornea, conjunctiva, lacrimal sac, and tears. We excluded ongoing clinical studies as for unobtainable conclusive results. Of 2422 articles, 11 met the inclusion criteria for analysis and were included in the study. None of the studies were multinational. Among the 11 selected papers there were three original articles, one review, four letters, two editorials, and one correspondence letter. Globally, 252 SARS-CoV-2 infected patients were included in our review. The prevalence of ocular conjunctivitis complicating the course of COVID-19 was demonstrated to be as high as 32% in one study only. Globally, three patients had conjunctivitis with a positive tear-PCR, 8 patients had positive tear-PCR in the absence of conjunctivitis, and 14 had conjunctivitis with negative tear-PCR. The majority of the available data regarding SARS-CoV-2 colonization of ocular and periocular tissues and secretions have to be considered controversial. However, it cannot be excluded that SARS-CoV-2 could both infect the eye and the surrounding structures. SARS-CoV-2 may use ocular structure as an additional transmission route, as demonstrated by the COVID-19 patients' conjunctival secretion and tears positivity to reverse transcriptase-PCR SARS-CoV-2-RNA assay.
Topics: Betacoronavirus; COVID-19; Conjunctiva; Conjunctivitis, Viral; Coronavirus Infections; Eye Diseases; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32424327
DOI: 10.1038/s41433-020-0926-9 -
Scientific Reports Mar 2021The prophylactic vaccines available to protect against infections by HPV are well tolerated and highly immunogenic. People with HIV have a higher risk of developing HPV... (Meta-Analysis)
Meta-Analysis
The prophylactic vaccines available to protect against infections by HPV are well tolerated and highly immunogenic. People with HIV have a higher risk of developing HPV infection and HPV-associated cancers due to a lower immune response, and due to viral interactions. We performed a systematic review of RCTs to assess HPV vaccines efficacy and safety on HIV-infected people compared to placebo or no intervention in terms of seroconversion, infections, neoplasms, adverse events, CD4+ T-cell count and HIV viral load. The vaccine-group showed a seroconversion rate close to 100% for each vaccine and a significantly higher level of antibodies against HPV vaccine types, as compared to the placebo group (MD = 4333.3, 95% CI 2701.4; 5965.1 GMT EL.U./ml for HPV type 16 and MD = 1408.8, 95% CI 414.8; 2394.7 GMT EL.U./ml for HPV type 18). There were also no differences in terms of severe adverse events (RR = 0.6, 95% CI 0.2; 1.6) and no severe adverse events (RR = 0.6, 95% CI 0.9; 1.2) between vaccine and placebo groups. Secondary outcomes, such as CD4 + T-cell count and HIV viral load, did not differ between groups (MD = 14.8, 95% CI - 35.1; 64.6 cells/µl and MD = 0.0, 95% CI - 0.3; 0.3 log10 RNA copies/ml, respectively). Information on the remaining outcomes was scarce and that did not allow us to combine the data. The results support the use of the HPV vaccine in HIV-infected patients and highlight the need of further RCTs assessing the effectiveness of the HPV vaccine on infections and neoplasms.
Topics: Adolescent; Adult; Antibodies, Viral; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; Female; HIV Infections; Humans; Male; Papillomavirus Infections; Papillomavirus Vaccines; Patient Safety; Public Health; Randomized Controlled Trials as Topic; Risk; Treatment Outcome; Viral Load; Virus Shedding; Young Adult
PubMed: 33654181
DOI: 10.1038/s41598-021-83727-7 -
Virology Journal Dec 2021Vaccination against HCV is an effective measure in reduction of virus-related public health burden and mortality. However, no prophylactic vaccine is available as of...
BACKGROUND
Vaccination against HCV is an effective measure in reduction of virus-related public health burden and mortality. However, no prophylactic vaccine is available as of yet. DNA-based immunization is a promising modality to generate cellular and humoral immune responses. The objective of this study is to provide a systematic review of HCV DNA vaccines and investigate and discuss the strategies employed to optimize their efficacies.
METHODS
MEDLINE (PubMed), Web of Science, Scopus, ScienceDirect, and databases in persian language including the Regional Information Centre for Science & Technology (RICeST), the Scientific Information Database and the Iranian Research Institute for Information Science and Technology (IranDoc) were examined to identify studies pertaining to HCV nucleic acid vaccine development from 2000 to 2020.
RESULTS
Twenty-seven articles were included. Studies related to HCV RNA vaccines were yet to be published. A variety of strategies were identified with the potential to optimize HCV DNA vaccines such as incorporating multiple viral proteins and molecular tags such as HBsAg and Immunoglobulin Fc, multi-epitope expression, co-expression plasmid utilization, recombinant subunit immunogens, heterologous prime-boosting, incorporating NS3 mutants in DNA vaccines, utilization of adjuvants, employment of less explored methods such as Gene Electro Transfer, construction of multi- CTL epitopes, utilizing co/post translational modifications and polycistronic genes, among others. The effectiveness of the aforementioned strategies in boosting immune response and improving vaccine potency was assessed.
CONCLUSIONS
The recent progress on HCV vaccine development was examined in this systematic review to identify candidates with most promising prophylactic and therapeutic potential.
Topics: Animals; Hepacivirus; Hepatitis C; Humans; Iran; Mice; Mice, Inbred BALB C; Vaccines, DNA; Viral Hepatitis Vaccines
PubMed: 34903252
DOI: 10.1186/s12985-021-01716-8 -
The Pediatric Infectious Disease Journal Sep 2020Children with coronavirus disease 2019 (COVID-19) are more likely to have mild or no symptoms compared with adults and may represent important vectors for transmitting...
BACKGROUND
Children with coronavirus disease 2019 (COVID-19) are more likely to have mild or no symptoms compared with adults and may represent important vectors for transmitting the virus. Little is known about the duration of respiratory and gastrointestinal viral shedding in children with COVID-19.
OBJECTIVE
To determine the average shedding times of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via the respiratory and gastrointestinal tracts in children.
METHODS
We performed a systematic search of Ovid MEDLINE, Embase and Cochrane CENTRAL databases for studies reporting real-time reverse transcriptase polymerase chain reaction (rt-PCR) results in children with COVID-19, then extracted and synthesized data on duration of viral shedding from symptom onset in respiratory and gastrointestinal samples.
RESULTS
Based on data compiled from 69 pediatric cases, the duration of viral shedding through the respiratory tract is up to 24 days from symptom onset with a mean of 11.1 ± 5.8 days. Of the children who underwent testing with stool PCR, rectal swab or anal swab, 86% returned a positive result. The mean duration of viral shedding via the gastrointestinal tract was 23.6 ± 8.8 days from symptom onset. In 89% of cases, viral shedding via the gastrointestinal tract persisted after nasopharyngeal or throat swabs became negative, for as long as 4 weeks.
CONCLUSIONS
To our knowledge, this is the first attempt to systematically review the duration of respiratory and gastrointestinal viral shedding of SARS-CoV-2 in pediatric patients. These findings may have important implications for infection control strategies during the COVID-19 pandemic.
Topics: Adolescent; Betacoronavirus; COVID-19; Child; Child, Preschool; Coronavirus Infections; Databases, Factual; Feces; Gastrointestinal Tract; Humans; Infant; Infant, Newborn; Nasopharynx; Pandemics; Pneumonia, Viral; RNA, Viral; Real-Time Polymerase Chain Reaction; Respiratory System; SARS-CoV-2; Virus Shedding
PubMed: 32618932
DOI: 10.1097/INF.0000000000002814 -
Medicine Jul 2020Coronavirus disease 2019 (COVID-19) is highly contagious, and the epidemic has spread to hundreds of countries around the world, and seriously threatens the life safety... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Coronavirus disease 2019 (COVID-19) is highly contagious, and the epidemic has spread to hundreds of countries around the world, and seriously threatens the life safety of people around the world. Arbidol is an antiviral drug with high potential against COVID-19, but evidence of effectiveness and safety is lacking. The systematic review protocol aims to formulate a research plan that can evaluate the efficacy and safety of arbidol for COVID-19.
METHODS
The retrieval time will be from the database establishment to June 2020. The retrieval database will include the Cochrane Library, PubMed, Embase, OVID, CNKI, Wanfang, VIP, CBM, etc. The primary outcome will be clinical efficacy, and the secondary results will be accompanying symptoms, time for the temperature to return to normal, time of novel coronavirus nucleic acid turning negative, blood sample test, Computed Tomography examination, length of hospitalization, adverse reactions, and adverse events. RevManV.5.3 software will be used for meta-analysis, and fixed effects model, random-effects model, subgroup analysis, and descriptive analysis will be adopted according to the heterogeneity of the research results.
RESULTS
To provide the latest evidence of clinical efficacy and safety of arbidol in the treatment of COVID-19.
CONCLUSION
Our study will provide the latest evidence analysis of the efficacy and safety of arbidol for COVID-19, to provide evidence-based medicine for the prevention and control of this epidemic.
REGISTRATION DETAILS
PROSPERO CRD42020189203.
Topics: Antiviral Agents; Betacoronavirus; COVID-19; Coronavirus Infections; Drug Therapy, Combination; Drugs, Chinese Herbal; Humans; Indoles; Pandemics; Pneumonia, Viral; SARS-CoV-2; Treatment Outcome; COVID-19 Drug Treatment
PubMed: 32791753
DOI: 10.1097/MD.0000000000021402