MedWorm: Antiviral Therapy

Two distinct viral infections complicating pemphigus foliaceus.

Dermatol Online J — Mon, 06 Feb 2012 12:54:18 +0100

We describe a patient with pemphigus foliaceus who developed two distinct disseminated cutaneous viral infections. Our patient is an 83-year-old female with a recent diagnosis of pemphigus foliaceus, who presented with painful ulcerations while on corticosteroids. Histopathology examination revealed disseminated herpes simplex virus (HSV). Despite adequate treatment with anti-herpetic treatment, some ulcerations failed to heal. A second biopsy revealed the presence of cytomegalovirus (CMV). This was treated successfully with appropriate antiviral therapy. In patients with autoimmune bullous disease, the development of new skin pain or new constitutional symptoms, change in primary morphology, rapid disease progression, or failure to respond to appropriate therapies should prompt the clinic...

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Long-term effects of treatment and response in patients with chronic hepatitis C on quality of life

BMC Gastroenterology — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions Main determinants of HRQL were severity of liver disease, age, gender, participating center and response to treatment. Our results do not exclude a more profound negative impact of individualized treatment compared to standard, possibly caused by higher doses and extended treatment duration in the individualized group. Antiviral therapy might have a more intense and more prolonged negative impact on females. (Source: BMC Gastroenterology)

Risk Factors for Molecular Detection of Adenovirus in Pediatric Hematopoietic Stem Cell Transplant Recipients.

Adv Data — Mon, 23 Jan 2012 05:00:00 +0100

Authors: Watson T, Macdonald D, Song X, Bromwich K, Campos J, Sande J, Debiasi RL Abstract Adenovirus (AdV) infections are a major cause of morbidity and mortality in hematopoietic stem cell transplant HSCT) patients. To evaluate the use of molecular AdV testing in HSCT at our institution and identify risk factors for AdV viremia and disease, we performed a retrospective cohort study of all HSCT patients who had undergone AdV polymerase chain reaction (PCR) testing, over a two year period. Two cohorts were identified: Cohort 1 consisted of patients testing positive for AdV (n=7); Cohort 2 consisted of patients testing negative (n=36). Overall patient characteristics were not statistically different between cohorts. The following medication exposures were identified as risk factors ...

Laparoscopic splenectomy with interferon therapy in 100 hepatitis‐C‐virus‐cirrhotic patients with hypersplenism and thrombocytopenia

Journal of Gastroenterology and Hepatology — Fri, 20 Jan 2012 20:47:11 +0100

Conclusions: Lap‐Sp permits most patients with HCV cirrhosis and hypersplenism to receive sufficient IFN therapy. Therefore, Lap‐Sp can become a strong supportive surgery for cirrhotic patients who require antiviral therapy. (Source: Journal of Gastroenterology and Hepatology)

Predicting response to therapy in chronic hepatitis C: An approach combining interleukin‐28B gene polymorphisms and clinical data

Journal of Gastroenterology and Hepatology — Fri, 20 Jan 2012 20:47:09 +0100

Conclusions: The rs12979860 SNP strongly predicts therapeutic response in CHC‐1 patients, and if associated with easy‐to‐obtain baseline criteria, provides a useful tool for the selection of candidates for antiviral therapy. IL28B haplotypes might improve the clinical usefulness of individual SNP. (Source: Journal of Gastroenterology and Hepatology)

TENS - an alternative to antiviral drugs for acute herpes zoster treatment and postherpetic neuralgia prevention.

Herpes — Fri, 20 Jan 2012 03:30:02 +0100

CONCLUSION: Study suggests TENS may be safe adjunct or even alternative to antiviral drugs for treatment of acute HZ. It looks that TENS may be at least as good as antiviral drugs for treatment of HZ, and it may be better in reducing and preventing PHN - such conclusion would necessitate controlled, prospective study. Use of TENS provided pain relief and resolution of skin lesions with no higher rate of other HZ complications compared to antiviral therapy. PMID: 22250036 [PubMed - in process] (Source: Herpes)

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Factors linked to severe thrombocytopenia during antiviral therapy in patients with chronic hepatitis c and pretreatment low platelet counts

BMC Gastroenterology — Wed, 18 Jan 2012 05:00:00 +0100

Background: Baseline low platelet count ( (Source: BMC Gastroenterology)

Broadly directed virus-specific CD4+ T cell responses are primed during acute hepatitis C infection, but rapidly disappear from human blood with viral persistence

The Journal of Experimental Medicine — Mon, 16 Jan 2012 05:00:00 +0100

Vigorous proliferative CD4+ T cell responses are the hallmark of spontaneous clearance of acute hepatitis C virus (HCV) infection, whereas comparable responses are absent in chronically evolving infection. Here, we comprehensively characterized the breadth, specificity, and quality of the HCV-specific CD4+ T cell response in 31 patients with acute HCV infection and varying clinical outcomes. We analyzed in vitro T cell expansion in the presence of interleukin-2, and ex vivo staining with HCV peptide-loaded MHC class II tetramers. Surprisingly, broadly directed HCV-specific CD4+ T cell responses were universally detectable at early stages of infection, regardless of the clinical outcome. However, persistent viremia was associated with early proliferative defects of the HCV-specific CD4+ T c...

Response rates of standard interferon therapy in chronic HCV patients of Khyber Pakhtunkhwa (KPK)

Virology Journal — Sat, 14 Jan 2012 05:00:00 +0100

Conclusion: It is concluded that the response of antiviral therapy against HCV infection in chronic HCV patients of KPK province is 74.71%. The high response rate may be due to the prevalence of IFN-responsive HCV genotypes (2 and 3) in KPK. (Source: Virology Journal)

Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy

Indian Journal of Dermatology — Sat, 14 Jan 2012 05:00:00 +0100

Ratna B Basak, Varsha Malpani, Khalid Kakish, Susan Vargese, Nageshwar Chauhan, Andreas BoeckIndian Journal of Dermatology 2011 56(6):749-751A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV) type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The ...

Central nervous system vasculitis and polyneuropathy as first manifestations of hepatitis C.

World Journal of Gastroenterology : WJG — Sat, 14 Jan 2012 05:00:00 +0100

We describe a case of peripheral neuropathy combined with an ischemic CNS event as primary manifestations of chronic HCV infection without cryoglobulinemia. Significant improvement was observed after antiviral therapy. We discuss the spectrum of neurological manifestations of HCV infection and review the literature. PMID: 22253526 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

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Boceprevir versus Telaprevir: A New Era of Directly Acting Antiviral Therapy

Current Hepatitis Reports — Thu, 12 Jan 2012 16:47:23 +0100

Abstract Boceprevir (BOC or B) and telaprevir (TVR or T), two newly approved NS3/4A protease inhibitors, have revolutionized hepatitis C therapy for genotype 1 since their availability in 2011. The new regimens are highly effective in treatment naive and treatment experienced patients. They are administered three times daily, and have an extensive list of drug-drug interactions that require vigilance with drug co-administration. The phase 3 clinical trials that led to the drugs’ approval are reviewed in detail with regard to the clinical trial design, efficacy and safety data. Both drugs utilize response guided therapy (RGT) based upon rapid virological response (RVR) and extended rapid virological response, (eRVR) and depend upon defined stopping rules to minimize the r...

The Role of Antiviral Therapy After the Resolution of Acute Herpes Simplex Keratitis or Acute Herpes Zoster Ophthalmicus [Editorial]

Archives of Opthalmology — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Archives of Opthalmology)

Genital Herpes Treatment - Virus Can Reactivate After Aggressive Antiviral Therapy

Health News from Medical News Today — Sun, 08 Jan 2012 18:00:00 +0100

According to a study in which three trials of antiviral therapy to treat genital herpes were combined, the herpes simplex virus type 2/HSV-2 can reactivate in 'breakthrough episodes' even when doses of antiviral therapy are high. The study is published Online First in The Lancet and suggests that new therapies should be conducted to successfully prevent further transmission of this common infection, which affects one in five people... (Source: Health News from Medical News Today)

HIV Type 1 Gag as a Target for Antiviral Therapy

AIDS Research and Human Retroviruses — Thu, 05 Jan 2012 21:44:00 +0100

AIDS Research and Human Retroviruses Jan 2012, Vol. 28, No. 1: 54-75. (Source: AIDS Research and Human Retroviruses)

Spanish society of liver transplantation (SETH) consensus recommendations on hepatitis C virus and liver transplantation

Liver International — Wed, 04 Jan 2012 05:00:00 +0100

AbstractIn November 2010, the Spanish Society of Liver Transplantation (Sociedad Española de Trasplante Hepático, SETH) held a consensus conference. One of the topics of debate was liver transplantation in patients with hepatitis C. This document reviews (i) the natural history of post‐transplant hepatitis C, (ii) factors associated with post‐transplant prognosis in patients with hepatitis C, (iii) the role of immunosuppression in the evolution of recurrent hepatitis C and response to antiviral therapy, (iv) antiviral therapy, both before and after transplantation, (v) follow‐up of patients with recurrent hepatitis C and (vi) the role of retransplantation. (Source: Liver International)

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[Therapy of chronic hepatitis B and C virus infections in the clinical practice].

Praxis — Wed, 04 Jan 2012 05:00:00 +0100

Authors: Panther E, Thimme R Abstract Approximately 550 million people worldwide are chronically infected with hepatitis B (HBV) or hepatitis C (HCV) virus. The clinical course of HBV and HCV infection is variable and can lead to a chronic but mild hepatitis or to liver cirrhosis and hepatocellular carcinoma (HCC)1. Therefore, antiviral therapy should be considered in patients with chronic hepatitis to prevent progression of disease. Here, we review the current indications and guidelines for antiviral therapy in chronic HBV and HCV infection. PMID: 22219073 [PubMed - in process] (Source: Praxis)

Patient time costs and out‐of‐pocket costs in hepatitis C

Liver International — Tue, 03 Jan 2012 05:00:00 +0100

ConclusionsIn HCV‐infected individuals, OOP and time costs represent a significant economic burden and fall disproportionately upon those least able to afford them. The lower cost burden among those who were successfully treated suggests that wider use of antiviral therapy may reduce economic burden in addition to improving health outcomes. (Source: Liver International)

Evolution of biomarkers of liver fibrosis and liver insufficiency in hepatitis C virus‐infected patients treated with pegylated interferon plus ribavirin and rituximab

Journal of Viral Hepatitis — Tue, 03 Jan 2012 05:00:00 +0100

Summary. Therapeutic options in hepatitis C virus (HCV)‐related vasculitis may target the viral trigger using antiviral therapy [pegylated interferon plus ribavirin (PEG‐IFN/RBV)], and/or the downstream B‐cell arm of autoimmunity with rituximab (RTX). To date, no study has compared the efficacy of RTX combined with PEG‐IFN/RBV on biomarkers of liver insufficiency in patients with severe liver fibrosis. Twenty‐eight untreated HCV‐related vasculitis patients with severe liver fibrosis (Metavir F3–F4) were included: 14 patients received RTX plus PEG‐IFN/RBV and 14 patients PEG‐IFN/RBV. The main clinical and biological data were recorded and compared at baseline, month 3 (M3), M12 and M24 of follow‐up. Baseline epidemiological, clinical, virological and immunological fea...

Menopause, and not age, is a critical factor associated with a worse response to antiviral therapy in women affected by chronic hepatitis C

International Journal of Infectious Diseases — Tue, 03 Jan 2012 05:00:00 +0100

We read with great interest the article entitled “Impact of sex on virologic response rates in genotype 1 chronic hepatitis C patients with peg-interferon alpha-2a and ribavirin treatment”. It was shown that in women affected by chronic hepatitis C and treated with antiviral therapy, the sustained virological response (SVR) rate decreases with age as a likely consequence of gradual estrogen decline. Moreover, it was reported that among young patients, SVR is higher in females than in males, while in older subjects the opposite occurs. (Source: International Journal of Infectious Diseases)

New developments in small molecular compounds for anti-hepatitis C virus (HCV) therapy.

J Zhejiang Univ Sci ... — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Tong J, Wang YW, Lu YA Abstract Infection with hepatitis C virus (HCV) affects approximately 170 million people worldwide. However, no vaccine or immunoglobulin is currently available for the prevention of HCV infection. The standard of care (SOC) involving pegylated interferon-α (PEG-IFN α) plus ribavirin (RBV) for 48 weeks results in a sustained virologic response in less than 50% of patients with chronic hepatitis C genotype 1, the most prevalent type of HCV in North America and Europe. Recently, reliable in vitro culture systems have been developed for accelerating antiviral therapy research, and many new specifically targeted antiviral therapies for hepatitis C (STAT-C) and treatment strategies are being evaluated in clinical trials. These new antiviral agents are e...

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High‐dose silibinin rescue treatment for HCV‐infected patients showing suboptimal virologic response to standard combination therapy

Journal of Viral Hepatitis — Sat, 31 Dec 2011 21:15:24 +0100

Summary. Incomplete suppression of hepatitis C virus (HCV) replication with persistence of minimal viremia (partial virologic response) leading to treatment failure can be observed in a significant proportion of HCV type 1‐infected patients during antiviral therapy. Recently, high‐dose intravenous silibinin has demonstrated strong antiviral activity against HCV. We were therefore interested in whether patients with partial virologic response can be rescued by the on‐treatment addition of a short‐term course of high‐dose intravenous silibinin infusions. Twenty patients who failed to achieve a complete virologic response to different interferon‐based regimens qualified for the rescue strategy and received 1400 mg/day silibinin infusions on two consecutive days. Complete vira...

Obstetric, clinical, and perinatal implications of H1N1 viral infection during pregnancy

International Journal of Gynaecology and Obstetrics — Mon, 26 Dec 2011 05:00:00 +0100

Conclusion: Early treatment with oseltamivir may prevent serious complications associated with H1N1 infection in pregnant women but it does not affect perinatal outcome. (Source: International Journal of Gynaecology and Obstetrics)

Rapid identification of YVDD mutants of hepatitis B virus using smart amplification process with competition probe.

Acta Virologica — Sun, 25 Dec 2011 13:48:04 +0100

Authors: Yang J, Li J, Lou GQ, Wu LJ, Feng C, Wu NP Abstract Accurate and timely detection of drug-associated viral mutants is important during antiviral therapy. Combining Smart Amplification Process (SMAP) with competition probe, an assay specifically designed to detect point mutation at codon 204 of the hepatitis B virus (HBV) polymerase gene was developed. This assay was sensitive to detect 20 copies of mutant/reaction and recognize as little as 1% of minor mutants in the viral population. The comparison of direct sequencing and SMAP method on 35 clinical specimens showed the concordance in 88% of the cases. This method provides an efficient alternative for rapid identification of HBV mutation associated with lamivudine resistance. Keywords: hepatitis B virus; YVDD mutant; SMA...

Ultrasensitive detection of rare mutations using next-generation targeted resequencing

Nucleic Acids Research — Sun, 25 Dec 2011 05:00:00 +0100

With next-generation DNA sequencing technologies, one can interrogate a specific genomic region of interest at very high depth of coverage and identify less prevalent, rare mutations in heterogeneous clinical samples. However, the mutation detection levels are limited by the error rate of the sequencing technology as well as by the availability of variant-calling algorithms with high statistical power and low false positive rates. We demonstrate that we can robustly detect mutations at 0.1% fractional representation. This represents accurate detection of one mutant per every 1000 wild-type alleles. To achieve this sensitive level of mutation detection, we integrate a high accuracy indexing strategy and reference replication for estimating sequencing error variance. We employ a statistical ...

Viruses and metabolism: alterations of glucose and glutamine metabolism mediated by human cytomegalovirus.

Advances in Virus Research — Fri, 23 Dec 2011 06:36:02 +0100

Authors: Yu Y, Clippinger AJ, Pierciey FJ, Alwine JC Abstract Recent studies of human cytomegalovirus (HCMV) infection have demonstrated that the virus significantly alters cellular metabolism, especially the utilization of glucose and glutamine. Glucose is not broken down by the tricarboxylic acid (TCA) cycle in infected cells; instead, it is used biosynthetically for fatty acid synthesis for membranes needed during the infection. In this chapter, we discuss the possibility that HCMV integrates its mechanisms for manipulating cellular signaling and stress responses to induce novel adipocyte-like differentiation in order to alter metabolism so that glucose can be used synthetically, that is, for fatty acids and lipids. This process diverts glucose from the TCA cycle and requires in...

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Outcome of antiviral therapy in Egyptian Hepatitis C Virus (HCV) genotype 4 patients with advanced liver fibrosis.

European Journal of Internal Medicine — Wed, 21 Dec 2011 17:12:29 +0100

Authors: El Khattib AA, Abdelhakam SM, Ghoraba DM, Ibrahim WA, Sayed MM PMID: 22153547 [PubMed - in process] (Source: European Journal of Internal Medicine)

New Insights into the HCV Quasispecies and Compartmentalization

Seminars in Liver Disease — Wed, 21 Dec 2011 05:00:00 +0100

Semin Liver Dis 2011; 31: 356-374DOI: 10.1055/s-0031-1297925ABSTRACTHepatitis C virus (HCV) is a hepatotropic RNA virus with an extraordinary propensity to persist in the vast majority of infected individuals. During replication, because of the inherent infidelity of the viral RNA polymerase, each progeny RNA genome contains mutations that lead to a continuous diversification of the viral population. Consequently, HCV circulates in vivo as a quasispecies, which is a dynamic distribution of divergent but closely related genomes subjected to a continuous process of genetic variation, competition, and selection. This genomic heterogeneity confers a remarkable advantage to the viral population allowing for a rapid adaptation to a changing environment when the virus is subject to selective cons...

The Conundrum of Relapse in STAT-C Therapy: Does HCV Play the Red Queen or Rip Van Winkle?

Seminars in Liver Disease — Wed, 21 Dec 2011 05:00:00 +0100

Semin Liver Dis 2011; 31: 410-419DOI: 10.1055/s-0031-1297929ABSTRACTNew treatments for chronic hepatitis C combining direct-acting antivirals (DAAs) with pegylated interferon and ribavirin (PEG-IFN/RBV) have dramatically increased the number of patients whose viral load declines to undetectable levels early in treatment. Most go on to achieve a sustained virologic response, but some patients who maintain undetectable levels of virus throughout treatment later relapse during follow-up. These data suggest that hepatitis C virus (HCV) genomes may persist in form(s) that are refractory to eradication by DAAs and PEG-IFN/RBV. Here we examine the molecular biology of HCV replication and review the clinical virology of relapse for clues as to how the virus might survive months of antiviral therap...

Vitamin D supplementation improves sustained virologic response in chronic hepatitis C (genotype 1)-naïve patients.

World Journal of Gastroenterology : WJG — Wed, 21 Dec 2011 05:00:00 +0100

CONCLUSION: Adding vitamin D to conventional Peg-α-2b/ribavirin therapy for treatment-naïve patients with chronic HCV genotype 1 infection significantly improves the viral response. PMID: 22215943 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

Right Place, Right Time: The evolving role of herpesvirus infection as a "second hit" in idiopathic pulmonary fibrosis.

American Journal of Physiology. Lung Cellular and Molecular Physiology — Fri, 16 Dec 2011 05:00:00 +0100

Right Place, Right Time: The evolving role of herpesvirus infection as a "second hit" in idiopathic pulmonary fibrosis. Am J Physiol Lung Cell Mol Physiol. 2011 Dec 16; Authors: Kropski JA, Lawson WE, Blackwell TS Abstract Over the course of the past decade, increasing evidence has implicated alveolar epithelial cell injury and dysfunction in the pathogenesis of idiopathic pulmonary fibrosis (IPF). Genetic factors, cigarette smoking, and other environmental exposures have been identified as potential factors leading to a population of vulnerable alveolar epithelial cells. In addition, molecular techniques have demonstrated herpesviruses are commonly detectable in the lungs of patients with IPF, raising suspicion that in the setting of a vulnerable alveolar epithelium, lytic...

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Comprehensive analysis of the prevalence of hepatitis B virus escape mutations in the major hydrophilic region of surface antigen

Journal of Medical Virology — Wed, 14 Dec 2011 19:13:54 +0100

AbstractEscape mutations in the major hydrophilic region (MHR) of hepatitis B surface antigen (HBsAg) are reported widely worldwide; these mutations lead to diagnostic problems, emergence of vaccine‐escape mutants, and hepatitis B immunoglobulin (HBIG) therapy failure. However, the prevalence of these mutations in different genotypes remains to be studied systematically. In the current study, 11,221 non‐redundant hepatitis B virus (HBV) sequences of 8 genotypes (from A to H), obtained from the National Center for Biotechnology Information (NCBI), were analyzed to determine the prevalence of HBsAg escape mutations that were previously described. Eight important mutations associated with diagnostic failure, P120T, T126S, Q129H, G130N, S143L, D144A, and G145A/R, were prevalent in one or m...

Can non‐invasive assessment of liver fibrosis replace liver biopsy?

Hepatology Research — Tue, 13 Dec 2011 05:00:00 +0100

Transient elastgraphy, acoustic radiation force impulse and real‐time elastography are the methods with very good or excellent diagnostic accuracy for the assessment of liver fibrosis stage. They do not provide the information on inflammatory activity, steatosis, iron deposition or other findings derived from liver biopsy. Even on account of fibrosis stage, these non‐invasive methods do not give us the estimation completely corresponding to that of liver biopsy. However they provide us useful clinical information that liver biopsy has been providing us, such as appropriate time to start antiviral therapy, prediction of response to antiviral therapy, evaluation of effects of antiviral therapy, assessment of natural course of hepatitis and estimation of prognosis of hepatitis. Recently n...

Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy

Bone Marrow Transplantation — Mon, 12 Dec 2011 05:00:00 +0100

Authors: P Ljungman, A Locasciulli, V G de Soria, A N Békássy, L Brinch, I Espigado, A Ferrant, I M Franklin, J O'Riordan, M Rovira, P Shaw & H Einsele (Source: Bone Marrow Transplantation)

Current Antiviral Therapy of Chronic HBVCurrent Antiviral Therapy of Chronic HBV

Medscape Today Headlines — Mon, 12 Dec 2011 04:00:00 +0100

The most current approaches to treating chronic hepatitis B are covered in this comprehensive new review. Alimentary Pharmacology & Therapeutics (Source: Medscape Today Headlines)

Retrospective analysis of hepatitis B virus reactivation after rituximab combination chemotherapy in patients with B-cell lymphoma

The Chinese-German Journal of Clinical Oncology — Thu, 08 Dec 2011 18:17:26 +0100

Conclusion Our experience indicates that rituximab-based therapy may cause serious HBV-related complications and even death in HBsAg-positive patients. Preemptive use of antiviral treatment enabled successful management of HBV reactivation. In HBsAg-negative and HBcAb-positive lymphoma patients the prevalence of HBV reactivation is low (1.2%). Close monitoring HBV until at least 6 months after anticancer therapy is required, prophylactic antiviral therapy needs to be evaluated further. Content Type Journal ArticlePages 721-725DOI 10.1007/s10330-011-0875-7Authors Yun Fan, Department of Chemo-therapy Center, Zhejiang Cancer Hospital, Hangzhou, 310022 ChinaChong Luo, Department of Chemo-therapy Center, Zhejiang Cancer Hospital, Hangzhou, 310022 ChinaLvhong Luo, Depart...

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Neutrophil Function and Apoptosis in Patients with Chronic Hepatitis C Treated with Pegylated Interferon α and Ribavirin

Archivum Immunologiae et Therapiae Experimentalis — Wed, 07 Dec 2011 10:56:30 +0100

Abstract The role of neutrophils in the pathogenesis of chronic hepatitis C as well as the effect of pegylated interferon α (PEG-IFN-α) and ribavirin treatment on neutrophil function is not precisely known. The study included 32 patients with CCH aged between 19 and 58 years (mean 33.5 years). Before and after 12 weeks of treatment with Peg-IFN-α and ribavirin, intracellular reactive oxygen species (ROS) level, expression of adhesion molecules CD11b/MAC-1, CD16, CD18 and CD62L on neutrophils, as well as apoptosis and necrosis of these cells were analyzed with the use of flow cytometry. During antiviral therapy, a statistically significant decrease of mean fluorescence intensity for CD16 high and CD62 and increase for CD11b/MAC-1 along with the increased a...

Hepatitis B virus reactivation in a Juvenile Rheumatoid arthritis patient under treatment and its successful management: a complicated case

Rheumatology International — Tue, 06 Dec 2011 16:59:03 +0100

Abstract Juvenile rheumatoid arthritis is a common chronic inflammatory disease in the childhood and it can differentiate rarely into spondiloarthropaties. It is one of the important causes of chronic pain and disability. Some of the drugs used for the treatment have immunosupressive activity. One of the serious side-effects of immunosupressive treatment is activation of opportunistic pathogens. Hepatitis B virus (HBV) is one of these pathogens, and the rate of carriers in the population is considerably high. It can cause liver damage and death if reactivated. Thus, the management of oppotunistic pathogens becomes a complex issue when treating rheumatic diseases with immunosupressive drugs. In this case report, we present a juvenile rheumatoid arthritis patient whose liver...

A randomized, controlled, trial of rituximab for treatment of severe cryoglobulinemic vasculitis

Arthritis and Rheumatism — Tue, 06 Dec 2011 05:00:00 +0100

Conclusion:RTX monotherapy represents a very good option for severe CV and may be maintained in the long term in most patients. (Source: Arthritis and Rheumatism)

A randomized controlled trial of rituximab following failure of antiviral therapy for hepatitis C‐associated cryoglobulinemic vasculitis

Arthritis and Rheumatism — Tue, 06 Dec 2011 05:00:00 +0100

CONCLUSIONSTherapy with rituximab was well tolerated and effective treatment for patients with HCV‐associated cryoglobulinemic vasculitis in whom antiviral therapy fails to induce remission. (Source: Arthritis and Rheumatism)

Dynamic changes in HCV RNA levels and viral quasispecies in a patient with chronic hepatitis C after telaprevir-based treatment

Journal of Clinical Virology — Tue, 06 Dec 2011 05:00:00 +0100

Conclusion: In this case report, significant viral load reductions resulted in a genetic bottleneck leading to a reduction of variability in the hepatitis C viral population. We hypothesize that the reduction in viral heterogeneity potentially led to a reduced viral capacity to adapt to a host immune response leading to a transient loss of detectable HCV-RNA. (Source: Journal of Clinical Virology)

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Amino acid-anticodon binding specificity: rationale for a new class of therapeutic agent.

Drug Discovery Today — Fri, 02 Dec 2011 05:00:00 +0100

Authors: Melzer MS Abstract In this article a new class of anticancer and antiviral drugs is discussed. These new drugs consist of small di- and tri-peptides, designed to bind to single-stranded (ss) regions that are crucial for the expression of genes such as the c-myc oncogene in cancers and start sites (and other ss regions) of viral pathogenic genes. The components (i.e. the amino acids and the sequences they form) of these peptides could be dictated by the specific binding of amino acids to their ss anticodons in tRNA. Cancer cell viability depends on the continued overexpression of the c-myc oncogene, and thus this gene is a target of opportunity for anticancer agents. Sharply reducing the overexpression of c-myc leads to the death of cancer cells. To achieve this end the fol...

Long‐term outcome of hepatitis C virus infections acquired after pediatric liver transplantation

Liver Transplantation — Thu, 01 Dec 2011 05:00:00 +0100

In conclusion, despite the limitations of our series, de novo HCV infections after pediatric LT seem to have a slow histological progression. Even with genotype 1, the patients have a good long‐term prognosis and respond well to treatment. Nevertheless, chronic rejection during antiviral therapy may develop. In addition, SVC may occur in this population. Liver Transpl, 2011. © 2011 AASLD. (Source: Liver Transplantation)

The green tea polyphenol, epigallocatechin‐3‐gallate, inhibits hepatitis C virus entry

Hepatology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: The green tea molecule, EGCG, potently inhibits HCV entry and could be part of an antiviral strategy aimed at the prevention of HCV reinfection after liver transplantation. (HEPATOLOGY 2011) (Source: Hepatology)

Changes in epidemiology, clinical features and severity of influenza A (H1N1) 2009 pneumonia in the first post‐pandemic influenza season

Clinical Microbiology and Infection — Thu, 01 Dec 2011 05:00:00 +0100

In conclusion, significant epidemiological changes and an increased severity of influenza A (H1N1) 2009 pneumonia were found in the first post‐pandemic influenza season. Physicians should consider influenza A (H1N1) 2009 when selecting microbiological testing and treatment in patients with pneumonia in the upcoming influenza season. (Source: Clinical Microbiology and Infection)

Antiviral therapy for recurrent hepatitis C reduces recurrence of hepatocellular carcinoma following liver transplantation

Transplant International — Thu, 01 Dec 2011 05:00:00 +0100

In conclusions, HCC recurrence rate and related deaths were significantly lower in patients that received post‐transplant antiviral therapy for recurrent HCV. (Source: Transplant International)

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High plasma CXCL10 levels are associated with HCV-genotype 1, and higher insulin resistance, fibrosis, and HIV viral load in HIV/HCV coinfected patients.

Cytokine — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: Plasma CXCL10 levels were influenced by several characteristics of patients related to HIV and HCV infections, insulin resistance, and liver fibrosis, indicating that CXCL10 may play an important role in the pathogenesis of both HCV and HIV infections. PMID: 22136974 [PubMed - as supplied by publisher] (Source: Cytokine)

The Effect and Safety of the Treatment of Recurrent Hepatitis C Infection After Orthotopic Liver Transplantation With Pegylated Interferon α2b and Ribavirin

Transplantation Proceedings — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: The antiviral treatment combination using PEG-IFN and RIB for recurrent hepatitis C is effective procedure. The SVR of 33% after 12 months of treatment with significant improvement in HAI grading and staging and stable HAI in all treated patients favor early initiation and 12-month administration of antiviral treatment. Furthermore, all patients with BR without VR, who underwent antiviral treatment for a further 6 months, achieved a VR. However, the optimal duration of treatment needs to be investigated in large prospective studies. (Source: Transplantation Proceedings)

[Treatment of chronic hepatitis C virus infection. A study of best predictors for response.]

Revista Espanola de Quimioterapia — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: The SVR was higher than in other studies. The genotype and EVR were independent factors to predict the effect of antiviral therapy. The EVR had a high NPV and the complete EVR a high PPV. PMID: 22173189 [PubMed - as supplied by publisher] (Source: Revista Espanola de Quimioterapia)

Effect of Ribavirin on Junin Virus Infection in Guinea Pigs

Zoonoses and Public Health — Thu, 01 Dec 2011 05:00:00 +0100

SummaryJunin virus (JUNV) is the aetiological agent of Argentine haemorrhagic fever. The pathogenesis of the infection is not well understood, no licensed vaccines exist and no specific antiviral therapy is available. Previous studies have demonstrated the ability of ribavirin to delay and reduce JUNV disease and virus burden in guinea pigs without preventing death. Based on available data, we performed three different studies to determine the efficacy of ribavirin against JUNV in the guinea pig model with a focus on survival. Different doses and treatment schedules of ribavirin were tested in a lethal model of JUNV infection. Our results show that prolonged treatment with high doses of ribavirin significantly reduces the mortality in guinea pigs infected with JUNV. These results may be us...

Penile herpes zoster: an unusual location for a common disease.

Braz J Infect Dis — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: Penile herpes zoster should not be overlooked in patients with unilateral vesicular rash. PMID: 22218522 [PubMed - in process] (Source: Braz J Infect Dis)

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Methylenetetrahydrofolate reductase homozygosis and low‐density lipoproteins in patients with genotype 1 chronic hepatitis C

Journal of Viral Hepatitis — Mon, 28 Nov 2011 11:10:22 +0100

Summary. Methylenetetrahydrofolate reductase status, homocysteine and lipoproteins levels have been associated with severity of disease and both rapid and sustained virological response (SVR) in patients with genotype 1 chronic hepatitis C (CHC). We aimed to assess the association of homocysteine and MTHFR status with serum cholesterol levels and their potential links to both histological findings and virological response, in patients with genotype 1 hepatitis C virus (HCV). A total of 119 consecutive patients were evaluated by biopsy and metabolic measurements. A total of 103 healthy blood donors were used as controls. Serum homocysteine and MTHFR C677T mutation were also evaluated. All patients underwent antiviral therapy with PEG‐IFN alfa‐2a plus ribavirin. HCV‐RNA was assessed...

Diabetes Mellitus Following Liver Transplantation in Patients With Hepatitis C Virus: Risks and Consequences

American Journal of Transplantation — Mon, 28 Nov 2011 05:00:00 +0100

Recurrent hepatitis C virus (HCV) infection of the allograft occurs universally following liver transplantation. Longitudinal natural history studies have identified several pre‐ and posttransplant factors associated with more rapid fibrosis progression, including baseline host and viral factors, donor factors and posttransplant immunosuppression effects, such as metabolic syndrome. Evidence accumulated over the past two decades indicates that HCV has metabolic associations, in particular insulin resistance and diabetes mellitus. Approximately half of HCV‐positive liver transplant recipients develop posttransplant diabetes mellitus (PTDM), which is associated with accelerated fibrosis progression and poorer graft and patient survival outcomes. This review summarizes the risks and conse...

Clinical Course and Outcomes of Varicella-Zoster Virus Meningitis: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Reactivation of latent varicella-zoster virus (VZV) infection most commonly manifests as herpes zoster. A range of other manifestations of reactivation of VZV infection has been described. Reports of acute meningitis due to VZV reactivation have increased in recent years, in the context of the increasing use of polymerase chain reaction (PCR) for detection of VZV in cerebrospinal fluid (CSF). VZV reactivation accounts for approximately 5-11% of cases of acute aseptic meningitis. The natural history of VZV meningitis and the role of antiviral therapy are poorly defined. We sought to contribute to the knowledge of the natural history of VZV meningitis and the role of antiviral therapy by reviewing the clinical course, treatment, and outcomes of a series of consecutive patients with this cond...

Reliability and validity of a self‐efficacy instrument for hepatitis C antiviral treatment regimens

Journal of Viral Hepatitis — Thu, 24 Nov 2011 05:00:00 +0100

Summary. Self‐efficacy or confidence in one’s ability to successfully engage in goal‐directed behaviour has been shown to influence medication adherence across many chronic illnesses. In the present study, we investigated the psychometric properties of a self‐efficacy instrument used during treatment for chronic hepatitis C viral infection (HCV). Baseline (n = 394) and treatment week 24 (n = 254) data from the prospective, longitudinal Viral Resistance to Antiviral Therapy of Chronic Hepatitis C study were examined. Baseline participants were randomly split into two equal‐sized subsamples (S1 and S2). Initial exploratory and confirmatory factor analyses (EFA/CFA) were performed on S1, while S2 was used to validate the factor structure of the S1 results using CFA. An ad...

Vitamin D Deficiency in Patients with Chronic Liver Disease and Cirrhosis

Current Gastroenterology Reports — Wed, 23 Nov 2011 17:36:47 +0100

Abstract Vitamin D is now widely recognized to have multiple extraskeletal health functions. The liver is one of the major organs involved in its metabolism. Recent studies have demonstrated a very high prevalence of vitamin D deficiency and insufficiency in patients with chronic liver disease and cirrhosis. There is an emerging interest to explore the relationship between vitamin D deficiency and prevalence and severity of non-alcoholic liver disease and response to antiviral therapy in hepatitis C. In this review, we discuss the current status of our understanding of vitamin D metabolism and vitamin D deficiency in patients with chronic liver disease and cirrhosis. Content Type Journal ArticleCategory Liver (BR Bacon, Section Editor)Pages 1-7DOI 10.1007/s11894-011-02...

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Novel inpatient surveillance in tertiary paediatric hospitals in New South Wales illustrates impact of first‐wave pandemic influenza A H1N1 (2009) and informs future health service planning

Journal of Paediatrics and Child Health — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions: PAEDS is a valuable surveillance tool that documented the impact of the H1N1 (2009) pandemic in NSW children's hospitals. High numbers of complications, often in previously well children, suggest an important role for early diagnosis, antiviral therapy and influenza vaccination. Observed regional differences identify areas potentially at greater risk in a subsequent wave. (Source: Journal of Paediatrics and Child Health)

Risk factors for hepatocellular carcinoma in a cohort infected with hepatitis B or C

Journal of Gastroenterology and Hepatology — Tue, 22 Nov 2011 09:13:25 +0100

Conclusion: This large population‐based study confirms known risk factors for HCC. The association with older age highlights the potential impact of HBV and HCV screening of at‐risk groups and early clinical assessment. Additional research is required to evaluate the impact of improving antiviral therapy on HCC risk. (Source: Journal of Gastroenterology and Hepatology)

Decrease in alpha-fetoprotein levels predicts reduced incidence of hepatocellular carcinoma in patients with hepatitis C virus infection receiving interferon therapy: a single center study

Journal of Gastroenterology — Tue, 22 Nov 2011 06:57:48 +0100

Conclusions Achieving sustained virological response (SVR) by interferon therapy reduces the incidence of HCC in hepatitis C patients treated with interferon. Among non-SVR patients, a decrease in the AFP integration value by interferon therapy closely correlates with reduced risk of HCC incidence after treatment. Content Type Journal ArticleCategory Original Article—Liver, Pancreas, and Biliary TractPages 1-8DOI 10.1007/s00535-011-0505-8Authors Yukio Osaki, Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-53 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555 JapanYoshihide Ueda, Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507 JapanHiroyuki Marusawa...

YKL‐40 genetic polymorphisms and the risk of liver disease progression in patients with advanced fibrosis due to chronic hepatitis C

Liver International — Tue, 22 Nov 2011 05:00:00 +0100

ConclusionsA reduced frequency of the protective YKL‐40 promoter polymorphism was not observed in the HALT‐C Trial patient population. The absence of an association between YKL‐40 promoter polymorphisms and baseline liver disease severity as well as with the risk of liver disease progression over time suggests that this polymorphism is not associated with disease progression in CHC patients with established fibrosis. (Source: Liver International)

Molecular modeling study on the resistance mechanism of HCV NS3/4A serine protease mutants R155K, A156V and D168A to TMC435.

Antiviral Research — Tue, 22 Nov 2011 05:00:00 +0100

Authors: Xue W, Pan D, Yang Y, Liu H, Yao X Abstract Hepatitis C virus (HCV) NS3/4A protease represents an attractive drug target for antiviral therapy. However, drug resistance often occurs, making many protease inhibitors ineffective and allowing viral replication to occur. Herein, based on the recently determined structure of NS3/4A-TMC435 complex, atomic-level models of the key residue mutated (R155K, A156V and D168A) NS3/4A-TMC435 complexes were constructed. Subsequently, by using molecular dynamics simulations, binding free energy calculation and substrate envelope analysis, the structural and energetic changes responsible for drug resistance were investigated. The values of the calculated binding free energy follow consistently the order of the experimental activities. More ...

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Is There Any Value to Hepatitis B Virus Genotype Analysis?

Current Gastroenterology Reports — Mon, 21 Nov 2011 18:06:05 +0100

In conclusion, genotyping of chronic HBV infections can help practicing physicians identify those at risk of disease progression and determine optimal anti-viral therapy. Content Type Journal ArticleCategory Liver (BR Bacon, Section Editor)Pages 1-10DOI 10.1007/s11894-011-0233-5Authors Sudeep Tanwar, Centre for Hepatology, University College London Royal Free Campus, Rowland Hill Street Hampstead, London, NW3 2PF UKGeoffrey Dusheiko, Centre for Hepatology, University College London Royal Free Campus, Rowland Hill Street Hampstead, London, NW3 2PF UK Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports)

Role of hepatic HCV–RNA level on the severity of chronic hepatitis C and response to antiviral therapy

Journal of Clinical Virology — Fri, 18 Nov 2011 05:00:00 +0100

Conclusions: Hepatic HCV–RNA level was not associated with severity of liver disease. High level was strongly associated with HCV genotype independently from response to therapy. (Source: Journal of Clinical Virology)

Intensive strategy to prevent CMV disease in seropositive umbilical cord blood transplant recipients

Blood — Thu, 17 Nov 2011 05:00:00 +0100

Seropositive umbilical cord blood transplant (UCBT) recipients are at increased risk for CMV complications. To reduce CMV complications, we adopted an intensive strategy that consisted of ganciclovir administered before transplantation (5 mg/kg intravenously daily from day –8 to day –2), high-dose acyclovir (2 g, 3 times daily) after transplanta-tion, and biweekly monitoring with a serum CMV PCR for preemptive therapy. Hazard rates and cumulative incidence of CMV complications along with days treated were compared in high-risk CMV-seropositive UCBT recipients who received the intensive strategy and a historical cohort who received a standard strategy. Of 72 seropositive patients, 29 (40%) received standard prophylaxis and 43 (60%) the new intensive approach. The hazard rate (HR...

The Impact of Antiviral Therapy and the Influence of Metabolic Cofactors on the Outcome of Chronic HCV Infection

Clinical and Developmental Immunology — Wed, 16 Nov 2011 12:13:12 +0100

Natural history of HCV related chronic hepatitis is influenced and modified by many factors: virus features, coinfections and host characteristics. In particular, a peculiar genetic background of the host by conditioning the occurrence of intracellular metabolic derangements (i.e., insulin resistance) might contribute to accelerate the rate of progression to cirrhosis and eventually the occurrence of hepatocellular carcinoma (HCC) and death. Likely, direct interplays between virus genotype and host genetic background might be hypothesized at this level. Morbidity and mortality in cirrhosis is primarily associated with complications of liver cirrhosis (ascites, hepatic encephalopathy, jaundice, and gastroesophageal bleeding) and HCC occurrence. Therefore the main goal of therapy is to clear...

Rapid and specific influenza virus detection by functionalized magnetic nanoparticles and mass spectrometry

Journal of Nanobiotechnology — Wed, 16 Nov 2011 05:00:00 +0100

Conclusions: The assay combining efficient magnetic separation and MALDI-MS readout offers a rapid and sensitive method for virus screening. Direct on-MNP detection by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) provided high sensitivity (~103 EID50 per mL) and a timely diagnosis within one hour. The magnetic nanoparticles encapsulated with monoclonal antibodies could be used as a specific probe to distinguish different subtypes of influenza. (Source: Journal of Nanobiotechnology)

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The 2009 Influenza Pandemic: Promising Lessons for Antiviral Therapy For Future Outbreaks.

Current Medicinal Chemistry — Wed, 16 Nov 2011 05:00:00 +0100

Authors: Bavagnoli L, Maga G Abstract The influenza A virus is the main circulating influenza virus in the human population. It can cause disease also in birds and other mammals and is responsible for annual epidemics and occasional pandemics. The most known and deadly pandemic was the "Spanish flu" (influenza type A/H1N1), which struck the human population between 1918 and 1919, with probably the heaviest toll ever recorded in terms of human lives. The most recent flu pandemic, caused in 2009 by the swine-origin reassortant virus (pH1N1), has raised several critical issues in terms of our preparedness in responding fast to new pandemic influenza strains. Probably, the most instructive lesson that has been learned from the 2009 pandemic, was that the speed of manufacturing and dist...

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Liver International — Tue, 15 Nov 2011 05:00:00 +0100

AbstractDespite a decline in cases of acute hepatitis B and the low hepatitis B virus (HBV) chronicity rates in adults, still some patients progress to HBV‐related fulminant liver failure. In this review, we discuss treatment options that may prevent the progression of severe acute hepatitis B to fulminant liver failure and death. In severe acute HBV with prolonged prothrombin time and increased bilirubin, interferon failed to be effective while antiviral treatment, particularly with lamivudine, appears to improve survival (mean survival almost 80%). Outcome without antiviral therapy has remained considerably poor, whereas there is no convincing evidence of amelioration of HBV‐targeted immunity. Of note, most patients who died or required transplantation despite lamivudine therapy, wer...

Quantitation of hepatitis delta virus using a single-step internally controlled real-time RT-qPCR and a full-length genomic RNA calibration standard.

Journal of Virological Methods — Tue, 15 Nov 2011 05:00:00 +0100

This study describes the development and evaluation of a novel single-step real-time RT-qPCR assay for HDV RNA quantitation which incorporates a Brome Mosaic virus internal control to prevent false negatives and under-reporting due to inhibitors or due to inefficient RNA purification, reverse transcription or PCR amplification. The assay has a dynamic range of ≥7log(10) and is designed to detect all HDV genotypes. The 95% detection limit is ∼3800 HDV RNA copies/ml, 700 copies/ml being detectable in 20% of repeats. Both intra-assay and inter-assay variability are low (CV 8% and 17%, respectively). Plasma HDV RNA was detected in 75% of 59 HDV antibody-positive samples with titres ranging from 8.4×10(4) to 4.4×10(8) copies/ml. The assay described provides a reliable and sensitive quanti...

Inhibition of fatty acid synthase by amentoflavone reduces coxsackievirus B3 replication

Archives of Virology — Thu, 10 Nov 2011 16:48:34 +0100

Abstract Coxsackievirus B3 (CVB3) is a human pathogen that causes acute and chronic infections, but an antiviral drug to treat these diseases has not yet been developed for clinical use. Several intracellular pathways are altered to assist viral transcription, RNA replication, and progeny release. Among these, fatty acid synthase (FAS) expression is increased. In order to test the potential of FAS inhibition as an anti-CVB3 strategy, several experiments were performed, including studies on the correlation of CVB3 replication and FAS expression in human Raji cells and an analysis of the time and dose dependence of the antiviral effect of FAS inhibition due to treatment with amentoflavone. The results demonstrate that CVB3 infection induces an up-regulation of FAS expression...

Severity of pandemic H1N1 2009 influenza virus infection may not be directly correlated with initial viral load in upper respiratory tract

Influenza and Other Respiratory Viruses — Thu, 10 Nov 2011 05:00:00 +0100

Conclusion Given that patients with severe pH1N1 infection may have relatively lower initial viral load in the upper respiratory tract, cautious interpretation of negative RIDT results is particularly warranted in this patient population. (Source: Influenza and Other Respiratory Viruses)

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Potential application of marine algae as antiviral agents in medicinal foods.

Advances in Food and Nutrition Research — Wed, 09 Nov 2011 07:40:04 +0100

Authors: Kim SK, Vo TS, Ngo DH Abstract Viral diseases, caused by pathogenic virus infections, are still the leading cause of death in humans worldwide. Although many antiviral agents have been developed and are used for treatment of infectious diseases, emergence of drug resistance, side effects, and the necessity for extensive clinical use are the main reasons for failure of antiviral therapy. Therefore, the development of new antiviral agents with diverse kinds of antiviral actions is required. The search for new antiviral agents focuses on not only synthetic compounds but also natural products such as plants, insects, animal organs, and their components. Recently, a great deal of interest has been expressed regarding marine algae as potential antiviral agents. This contribution...

GSK presents phase III results for eltrombopag in hepatitis C virus related thrombocytopenia

GSK news — Mon, 07 Nov 2011 20:49:58 +0100

Findings from the ENABLE clinical trials, which evaluated the ability of eltrombopag to raise and maintain platelet levels in patients with chronic hepatitis C virus (HCV) infection and low platelet levels that would preclude initiation of interferon-based antiviral therapy, were presented today at the 62nd Annual Meeting of the American Association for the Study of Liver Diseases in San Francisco. (Source: GSK news)

Pandemic A/H1N1v Influenza 2009 in hospitalized children: a multicenter Belgian survey

BMC Infectious Diseases — Mon, 07 Nov 2011 05:00:00 +0100

Conclusion: Although influenza A/H1N1v infections were generally self-limited, pediatric burden of disease was significant. Compared to other countries experiencing different health care systems, our Belgian cohort was younger and received less frequently antiviral therapy; disease course and mortality were however similar. (Source: BMC Infectious Diseases)

AASLD: HCV Testing by Birth Cohort Cost-Effective (CME/CE)

MedPage Today Public Health — Fri, 04 Nov 2011 20:37:47 +0100

SAN FRANCISCO (MedPage Today) -- Birth-cohort screening for hepatitis C virus infection proved highly cost-effective, even when universal treatment with direct-acting antiviral therapy was factored in, according to a study reported here. (Source: MedPage Today Public Health)

Rationale, challenges, and participants in a Phase II trial of a botanical product for chronic hepatitis C.

Clinical Trials — Fri, 04 Nov 2011 04:00:00 +0100

CONCLUSIONS: The challenges identified and addressed during development of this United States multicenter Phase II trial to evaluate silymarin for treatment of patients with chronic hepatitis C infection who had failed to respond successfully to previous IFN-based therapy are common and must be addressed to conduct rigorous trials of botanical products. Clinical Trials 2011; XX: 1 -11. http://ctj.sagepub.com. PMID: 22058086 [PubMed - as supplied by publisher] (Source: Clinical Trials)

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The Cost-Effectiveness of Birth-Cohort Screening for Hepatitis C Antibody in U.S. Primary Care Settings.

Annals of Internal Medicine — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: Birth-cohort screening for HCV in primary care settings was cost-effective. Primary Funding Source: Division of Viral Hepatitis, Centers for Disease Control and Prevention. PMID: 22056542 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)

Human herpesvirus 6 in biopsies from patients with gastrointestinal symptoms after allogeneic stem cell transplantation

Annals of Hematology — Wed, 02 Nov 2011 16:58:15 +0100

Abstract Gastrointestinal complications are frequent after allogeneic stem cell transplantation (allo-SCT). Main differential diagnoses are graft-versus-host disease (GvHD) and viral infections. In this retrospective analysis, we included 50 patients with severe vomiting or diarrhea in the first year after allo-SCT. One hundred two biopsies obtained by colonoscopy or endoscopy of the upper gastrointestinal tract were analysed by conventional histology for signs of GvHD and by qualitative polymerase chain reaction (PCR) for viral DNA of human herpesvirus 6 (HHV-6) and other virus of the herpes family. DNA of HHV-6 was detected in 38 of 75 initial samples (51%) and in 19 of 27 follow-up biopsies (70%). In the initial samples (n = 75), HHV-6 DNA was detected in 20/37 (54%)...

Utilization of hepatitis B core antibody‐positive donor liver grafts

HPB: official journal of the International Hepato Pancreat Biliary Association — Wed, 02 Nov 2011 04:00:00 +0100

Conclusions: The practice of transplanting HBcAb+ grafts incurs low risk for infection using current methods of prophylaxis. The highest mortality risk was in the early postoperative period, specifically in patients with very high MELD scores. This probably reflects the practice of using positive serology grafts in emergent situations. (Source: HPB: official journal of the International Hepato Pancreat Biliary Association)

Adenoviral load diagnostics by quantitative polymerase chain reaction: techniques and application

Reviews in Medical Virology — Tue, 01 Nov 2011 04:00:00 +0100

SUMMARYHuman adenoviruses (HAdV) can cause fatal complications such as disseminated disease especially in a post‐transplant setting. With conventional methods, disseminated HAdV disease could only be diagnosed with delay. Quantification of the HAdV load by real‐time PCR in peripheral blood promised to solve this diagnostic dilemma. Here we review the development, applications and significance of quantitative HAdV PCR.The high genetic divergence of the 56 HAdV types was a major obstacle for developing a quantitative HAdV PCR covering all types. Several protocols focused either on a few, probably predominating types or tried to detect all known HAdV types by using a bundle of assays or a few multiplexed PCRs. Alternatively, generic quantitative real‐time HAdV PCR protocols using primer...

Impact of erythropoietin on sustained virological response to peginterferon and ribavirin therapy for HCV infection: a systematic review and meta‐analysis

Journal of Viral Hepatitis — Sun, 30 Oct 2011 04:00:00 +0100

Summary. Anaemia is a common complication of antiviral therapy for chronic hepatitis C virus (HCV) infection that necessitates dose reductions or therapy discontinuation. Administration of erythropoietin (EPO) is an alternative to ribavirin (RBV) dose reduction, but its advantage in terms of sustained virological response (SVR) has not been determined yet. In a systematic way, randomized studies were identified that evaluated the effect of EPO administration vs RBV dose reduction on virological response in patients who developed anaemia during anti‐HCV therapy. The random‐effects model was employed to run meta‐analysis. SVR was set as the end point of interest. Data were abstracted from four studies containing 257 patients who developed anaemia during therapy. One hundred and twen...

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[Interferon α therapy in patients with chronic hepatitis C infection : Biopsychosocial consequences.]

Der Nervenarzt — Sat, 29 Oct 2011 04:00:00 +0100

CONCLUSION: Hepatitis C is associated with an increased prevalence of psychiatric disorders, particularly depression. INF-alpha patients having low levels of life satisfaction in the domains "self-concept" (skills, appearance, self-confidence, vitality …), "employment" and "physical health and constitution" seem to face a major risk of depression. PMID: 22033579 [PubMed - as supplied by publisher] (Source: Der Nervenarzt)

Anemia is not predictive of sustained virological response in liver transplant recipients with hepatitis C virus who are treated with pegylated interferon and ribavirin

Liver Transplantation — Fri, 28 Oct 2011 05:41:57 +0100

In conclusion, anemia is a very frequent complication in LT patients during antiviral therapy and is associated with increased RBV dose reduction but not with an SVR. Predictors of anemia include MMF or CSA immunosuppression, high viremia, and renal insufficiency. Liver Transpl 17:1318–1327, 2011. © 2011 AASLD. (Source: Liver Transplantation)

Management of Recurrent Hepatitis C Infection after Liver Transplantation

Clinics in Liver Disease — Wed, 26 Oct 2011 20:44:51 +0100

Recurrence of hepatitis C virus remains a near-universal phenomenon after liver transplantation (LT) and is responsible for the high morbidity and low survival seen in these patients. The severity of recurrent disease varies depending on multiple factors, only some of which are modifiable. Antiviral therapy is associated with improved outcomes, but viral clearance is only attainable in a small percentage of this patient population. This patient population is in need of new therapeutic options, and it remains to be seen whether direct-acting antiviral agents will be the answer to this ongoing therapeutic question. (Source: Clinics in Liver Disease)

Hepatitis C treatment and erotomania

General Hospital Psychiatry — Mon, 24 Oct 2011 04:00:00 +0100

We present a patient who began a clinical picture of erotomania that involved his doctor a few days after treatment of interferon and ribavirin was started. He stalked his doctor, forcing the police and the court to intervene. Nevertheless, once antipsychotic treatment was established, symptoms remitted, and the patient continued antiviral treatment successfully. (Source: General Hospital Psychiatry)

Elevated effector cell sensitivity to Treg‐cell suppression that is not associated with reduced Th17‐cell expression distinguishes HIV+ asymptomatic subjects from progressors

European Journal of Immunology — Mon, 17 Oct 2011 04:00:00 +0100

AbstractSuppression mediated by regulatory T (Treg) cells is a balance between Treg‐cell suppressive potency versus sensitivity of effector cells to Treg‐cell suppression. We assessed if this balance, along with Treg‐cell number relative to the Treg‐cell counter‐regulatory cytokine IL‐17, differs between asymptomatic HIV+ subjects versus those who progress onto disease. Cross‐over studies comparing Treg‐cell potency, measured by effector cell proliferation or IFN‐ã expression, from HIV‐infected versus control subjects to suppress the proliferation of allogeneic control effector cells demonstrated increased sensitivity of CD4+CD25‐ effector cells from asymptomatic HIV+ subjects to suppression, rather than an increase in the suppressive potential of their CD4+CD25+ Tre...

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Response to tenofovir monotherapy in chronic hepatitis B patients with prior suboptimal response to entecavir

Journal of Viral Hepatitis — Mon, 17 Oct 2011 04:00:00 +0100

In conclusion, suboptimal response to ETV is rare (approximately 3%). TDF monotherapy is safe and very effective in the management of HBV patients with SOR to ETV. (Source: Journal of Viral Hepatitis)

Elevated effector cell sensitivity to Treg-cell suppression that is not associated with reduced Th17-cell expression distinguishes HIV+ asymptomatic subjects from progressors.

European Journal of Immunology — Mon, 17 Oct 2011 04:00:00 +0100

Authors: Thorborn GS, Pomeroy L, Ishohanni H, Peters BS, Vyakarnam A Abstract Suppression mediated by regulatory T (Treg) cells is a balance between Treg-cell suppressive potency versus sensitivity of effector cells to Treg-cell suppression. We assessed if this balance, along with Treg-cell number relative to the Treg-cell counter-regulatory cytokine IL-17, differs between asymptomatic HIV+ subjects versus those who progress onto disease. Cross-over studies comparing Treg-cell potency, measured by effector cell proliferation or IFN-ã expression, from HIV-infected versus control subjects to suppress the proliferation of allogeneic control effector cells demonstrated increased sensitivity of CD4+CD25- effector cells from asymptomatic HIV+ subjects to suppression, rather than an incr...

Inhibition of viral RNA synthesis in canine distemper virus infection by proanthocyanidin A2.

Antiviral Research — Thu, 13 Oct 2011 04:00:00 +0100

In this study, we evaluated the in vitro antiviral activity against CDV of proanthocyanidin A2 (PA2), a phenolic dimer belonging to the class of condensed tannins present in plants. Our results showed that PA2 exerted in vitro antiviral activity against CDV with a higher selectivity index compared to ribavirin, included in our study for the previously tested anti-CDV activity. The time of addition assay led us to observe that PA2 was able to decrease the viral RNA synthesis and to reduce progeny virus liberation, at different times post infection suggesting multiple mechanisms of action including inhibition of viral replicative complex and modulation of the redox milieu. These data suggest that PA2, isolated from the bark of Aesculus hippocastanum, has potential usefulness as an anti-CDV c...

Detailed analysis of mucosal herpes simplex virus-2 replication kinetics with and without antiviral therapy

Journal of Antimicrobial Chemotherapy — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions HSV-2-targeted antiviral therapy limits episode severity by decreasing the rate of early viral expansion and the likelihood of episode re-expansion. Late clearance of episodes in the immunocompetent host is not affected by antiviral therapy, suggesting that local immune response is critical for clearance of episodes both on and off treatment. (Source: Journal of Antimicrobial Chemotherapy)

The potential role of pre‐transplant HBcigG seroposivity as predictor of clinically relevant cytomegalovirus infection in patients with lymphoma undergoing autologous hematopoietic stem cell transplantation: A study from the rome transplant network

American Journal of Hematology — Tue, 11 Oct 2011 04:00:00 +0100

AbstractDespite the increased use of intensive immunosuppressive chemo‐immunotherapies in patients with lymphoma observed in the last decade, current data on Cytomegalovirus (CMV) infection following autologous stem cell transplantation (Auto‐SCT) are very limited. To address this peculiar aspect, a retrospective study on a cohort of 128 adult patients consecutively transplanted for lymphoma in 3 Hematology Institutions was performed with the aim to determine the incidence of and the risk factors for CMV symptomatic infection and/or end‐organ disease. Sixteen patients (12.5%) required specific antiviral therapy and 4/16 died (25%); transplant‐related mortality (TRM) was significantly influenced by CMV infection (P=0.005). In univariate analysis, a pre‐transplant HBcIgG seropositi...

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Small interfering RNAs targeting viral structural envelope protein genes and the 5ʹ-UTR inhibit replication of bovine viral diarrhea virus in MDBK cells.

Acta Virologica — Mon, 10 Oct 2011 17:20:02 +0100

Authors: Mishra N, Rajukumar K, Kalaiyarasu S, Behera SP, Nema RK, Dubey SC Abstract Bovine viral diarrhea viruses (BVDVs) are important pathogens of cattle that occur worldwide, and for which no antiviral therapy is available. In the present study, the inhibitory effect of small interfering (si) RNAs on bovine viral diarrhea virus 1 (BVDV-1) replication in cultured bovine cells was explored. Four synthetic siRNAs were designed to target structural envelope region genes (Erns, E1, and E2) and one cocktail of siRNA was generated to target the 5ʹ-UTR of the BVDV-1 genome. The inhibitory effects of siRNAs were assessed by determination of infectious viral titer, viral antigen and viral RNA. The siRNA cocktail and three of the synthetic siRNAs produced moderate anti-BVDV-1 effect in v...

Rapid clinical change in lesions of atypical cutaneous lymphoproliferative disorder in an HIV patient: A case report and review of the literature.

Dermatol Online J — Mon, 10 Oct 2011 11:40:02 +0100

CONCLUSION: The working-theory of a reactive etiology for this condition might explain the evolution in appearance following initiation of HAART. The presence of papules with a dusky targetoid center suggests that this condition should be considered in the differential diagnosis with syphilis or atypical erythema multiforme in HIV patients. PMID: 21971269 [PubMed - in process] (Source: Dermatol Online J)

Clinical study on prevention of HBV re‐infection by entecavir after liver transplantation

Clinical Transplantation — Mon, 10 Oct 2011 04:00:00 +0100

Conclusion: ETV is superior to LAM for preventing HBV re‐infection following LT. (Source: Clinical Transplantation)

NK Cells Prevalence, Subsets and Function in Viral Hepatitis C

Archivum Immunologiae et Therapiae Experimentalis — Wed, 05 Oct 2011 05:44:35 +0100

Abstract Innate immunity appears to play an important role in the pathogenesis of viral hepatitis C. Among various cell subsets of this immunity natural killer (NK) cells raised particular interest. These cells are abundant in liver, possess significant cytotoxic potential and show links with adaptive immunity. They play important role, particularly in the acute phase of viral infections, including hepatitis C. They exhibit various types of receptors, either inhibitory or activating, that are able to react with distinct ligands on infected cells. Homozygosity of some receptors, namely KIR2DL3 reacting with recipient HLA-C1 antigens is a herald of good prognosis in hepatitis C virus (HCV) infection. In the early stage of the latter, both the prevalence and the cytotoxicity ...

Triple combination antiviral drug for pandemic H1N1 in critically ill patients on mechanical ventilation.

Antimicrobial Agents and Chemotherapy — Mon, 03 Oct 2011 04:00:00 +0100

Authors: Kim WY, Suh GY, Huh JW, Kim SH, Kim MJ, Kim YS, Kim HR, Ryu YJ, Han MS, Ko YG, Chon GR, Lee KH, Choi SH, Hong SB, Abstract Recent in vitro study showed that the three compounds of antiviral drugs with different mechanisms of action (amantadine, ribavirin, and oseltamivir) could result in synergistic antiviral activity. However, no clinical studies have evaluated the efficacy and safety of combination antiviral therapy in patients with severe influenza illness. 245 adult patients who were critically ill with confirmed pandemic influenza A/H1N1 2009 (pH1N1) infection and were admitted to one of the intensive care units (ICUs) of 28 hospitals in Korea were reviewed. Patients who required ventilator support and received either triple combination antiviral drug (TCAD) therapy ...

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Disseminated Adenovirus Disease in Immunocompromised Patient Successfully Treated with Oral Ribavirin: A Case Report

Archivum Immunologiae et Therapiae Experimentalis — Sat, 01 Oct 2011 06:45:54 +0100

This report describes the detection and treatment of human adenovirus (HAdVs) disseminated disease in the case of a 46-year-old immunocompromised female having myelodysplastic syndrome with refractory cytopenia with multilineage dysplasia: International Prognostic Scoring System 1. Serum and urine samples were tested for the presence of adenoviral DNA using the quantitative real-time polymerase chain reaction (PCR) assay. For additional confirmation, sequencing of PCR products was also performed. With real-time PCR, we detected HAdV DNA in both serum and urine samples. The viral level constantly decreased with applied oral ribavirin therapy. As the result of sequencing, HAdVs type 11 was determined. Surveillance of adenovirus by real-time PCR is useful in detecting and monitoring di...

Review article: current antiviral therapy of chronic hepatitis B

Alimentary Pharmacology and Therapeutics — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions The current treatment strategy of chronic hepatitis B is now standard: initial selection of entecavir, tenofovir, or peginterferon alfa‐2a. Future studies are required to determine if combination therapy using two oral agents or peginterferon with an oral agent with a high genetic barrier to resistance might be superior to standard current monotherapy. (Source: Alimentary Pharmacology and Therapeutics)

Identification of respiratory virus in infants with congenital heart disease by comparison of different methods.

Revista do Instituto de Medicina Tropical de Sao Paulo — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Kanashiro TM, Vilas Boas LS, Thomaz AM, Tozetto-Mendoza TR, Setsuko M, Machado CM Abstract Respiratory virus infections are the main cause of infant hospitalization and are potentially severe in children with congenital heart disease (CHD). Rapid and sensitive diagnosis is very important to early introduction of antiviral treatment and implementation of precautions to control transmission, reducing the risk of nosocomial infections. In the present study we compare different techniques in the diagnosis of respiratory viruses in CHD infants. Thirty-nine samples of nasopharyngeal aspirate were obtained from CHD infants with symptoms of respiratory infection. The Multiplex PCR (Seeplex® RV 12 ACE Detection) driven to the detection of 12 respiratory viruses was compared with t...

Recommendations for and compliance with social restrictions during implementation of school closures in the early phase of the influenza A (H1N1) 2009 outbreak in Melbourne, Australia

BMC Infectious Diseases — Fri, 30 Sep 2011 04:00:00 +0100

Conclusions: Levels of compliance with recommendations in our sample were high compared with other studies, likely due to heightened public awareness of a newly introduced virus of uncertain severity. The variability of reported recommendations highlighted the difficulties inherent in implementing a targeted reactive strategy, such as that employed in Melbourne, on a large scale during a public health emergency. This study emphasizes the need to understand how public health measures are implemented when seeking to evaluate their effectiveness. (Source: BMC Infectious Diseases)

Antiviral Drugs for Viruses Other Than Human Immunodeficiency Virus

Mayo Clinic Proceedings — Fri, 30 Sep 2011 04:00:00 +0100

This article provides an overview of clinically available antiviral drugs for the primary care physician, with a special focus on pharmacology, clinical uses, and adverse effects. (Source: Mayo Clinic Proceedings)

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Management of Chronic Hepatitis B in Special Populations: Immunosuppressed Patients and Chronic Kidney Disease

Current Hepatitis Reports — Thu, 29 Sep 2011 06:17:32 +0100

Abstract Hepatitis B virus (HBV) infection remains an important cause of liver disease in the population with chronic kidney disease, including patients on long-term dialysis and renal transplant (RT) recipients. Diminished survival due to hepatitis B has been observed after RT. A thorough evaluation, including liver biopsy as well as assessment of serum markers of HBV replication (ie, hepatitis B e antigen and/or HBV DNA) is required before transplantation. Tolerance to interferon is poor both in dialysis patients and after renal transplant. Oral antiviral therapy now permits safe and potent antiviral treatment of HBV-related liver disease in chronic kidney disease patients with prevention of progressive liver disease. Preliminary evidence shows an improved survival of HB...

A human monoclonal antibody targeting SR‐BI precludes hepatitis C virus infection and viral spread in vitro and in vivo.

Hepatology — Tue, 27 Sep 2011 04:00:00 +0100

Conclusion:Using in vitro cell culture and human liver‐chimeric mouse models, we show that a human monoclonal antibody targeting the HCV co‐receptor SR‐BI completely prevents infection and intrahepatic spread of multiple HCV genotypes. This strategy may be an efficacious way to prevent infection of allografts following liver transplantation in chronic HCV patients, and may even hold promise for the prevention of virus rebound during or following anti‐viral therapy. (HEPATOLOGY 2011.) (Source: Hepatology)

A Human monoclonal antibody targeting scavenger receptor class B type I precludes hepatitis C virus infection and viral spread in vitro and in vivo

Hepatology — Tue, 27 Sep 2011 04:00:00 +0100

Conclusion: Using in vitro cell culture and human liver‐chimeric mouse models, we show that a human mAb targeting the HCV coreceptor SR‐BI completely prevents infection and intrahepatic spread of multiple HCV genotypes. This strategy may be an efficacious way to prevent infection of allografts following liver transplantation in chronic HCV patients, and may even hold promise for the prevention of virus rebound during or following antiviral therapy. (HEPATOLOGY 2011) (Source: Hepatology)

Hepatic steatosis in chronic hepatitis C patients infected with genotype 2 is associated with insulin resistance, hepatic fibrosis and affects cumulative positivity of serum hepatitis C virus RNA in peginterferon and ribavirin combination therapy

Hepatology Research — Mon, 26 Sep 2011 04:00:00 +0100

Conclusions: In CH‐C patients infected with genotype 2 treated by PEG‐IFNα2b and RBV combination therapy, hepatic steatosis >10% was associated with increased insulin resistance, advanced hepatic fibrosis and higher cumulative positivity of serum HCV RNA, which lead to a higher risk of non‐SVR. (Source: Hepatology Research)

Immune-mediated myelitis associated with Hepatitis virus infections

Journal of Neuroimmunology — Mon, 26 Sep 2011 04:00:00 +0100

Abstract: Virus-induced spinal cord damage results from a cytolytic effect on anterior horn cells or from predominantly cellular immune-mediated damage of long white matter tracts. Infection with the hepatitis virus group, most notably hepatitis C virus, has infrequently been associated with the occurrence of myelitis. The pathogenesis of hepatitis virus-associated myelitis has not been clarified: virus-induced autoimmunity (humoral or cell-mediated, possibly vasculitic) seems the most likely disease mechanism. Limited available information offers no evidence of direct hepatitis virus infection of the spinal cord. Virus neuropenetration may occur after virus-infected mononuclear cells penetrate the blood–brain barrier, but a true neurolytic effect has not been demonstrated. Attacks of ac...

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Serum Level of IP-10 Increases Predictive Value of IL28B Polymorphisms for Spontaneous Clearance of Acute HCV Infection

Gastroenterology — Mon, 26 Sep 2011 04:00:00 +0100

Conclusions: The combination of serum level of IP-10 and SNPs in IL28B can identify patients with AHC who are most likely to undergo spontaneous clearance and those in need of early antiviral therapy. (Source: Gastroenterology)

PharmAthene Awarded 50% Profit Split on Worldwide Sales of Smallpox Antiviral Therapy by Delaware Chancery Court

Drugs.com - Pharma News — Thu, 22 Sep 2011 22:07:04 +0100

ANNAPOLIS, Md., Sept. 22, 2011 /PRNewswire/ -- PharmAthene, Inc. (NYSE Amex: PIP) today announced a significant decision in its litigation against SIGA Technologies in the Delaware Court of Chancery. PharmAthene filed the lawsuit against SIGA in... (Source: Drugs.com - Pharma News)

Diagnostic accuracy of transient elastography (FibroScan) versus the aspartate transaminase to platelet ratio index in assessing liver fibrosis in chronic hepatitis B: The role in primary care setting

Journal of Clinical Pathology — Thu, 22 Sep 2011 04:00:00 +0100

Conclusion APRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available. (Source: Journal of Clinical Pathology)

HIV Type 1 Gag as a Target for Antiviral Therapy

AIDS Research and Human Retroviruses — Wed, 21 Sep 2011 15:50:24 +0100

AIDS Research and Human Retroviruses , Vol. 0, No. 0. (Source: AIDS Research and Human Retroviruses)

The Management of Chronic Hepatitis B in Asian Americans

Digestive Diseases and Sciences — Wed, 21 Sep 2011 05:48:15 +0100

Abstract Hepatitis B virus (HBV) infection is common with major clinical consequences worldwide. In Asian Americans, the HBsAg carrier rate ranges from 7 to 16%; HBV is the most important cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Patients are first diagnosed at different stages of clinical disease, which is categorized by biochemical and virologic tests. Patients at risk for liver complications should be identified and offered antiviral therapy. The two antiviral agents recommended for first-line treatment of chronic hepatitis B (CHB) are entecavir and tenofovir. The primary goal of therapy is sustained suppression of viral replication to achieve clinical remission, reverse fibrosis, and prevent and reduce progression to end-stage liver dis...

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Emergence of the rtA181T/sW172* mutant increased the risk of hepatoma occurrence in patients with lamivudine-resistant chronic hepatitis B

BMC Cancer — Wed, 21 Sep 2011 04:00:00 +0100

Conclusions: Emergence of the rtA181T/sW172* mutant in LAM-resistant patients increased the risk of HCC development in the subsequent courses of antiviral therapy. (Source: BMC Cancer)

Relationship between adherence to hepatitis C virus therapy and virologic outcomes: a cohort study.

Annals of Internal Medicine — Tue, 20 Sep 2011 04:00:00 +0100

Conclusion: Early and sustained virologic responses increased with higher levels of adherence to interferon and ribavirin therapy. Adherence to therapy with both antivirals decreased over time, but more so for ribavirin. Primary Funding Source: National Institutes of Health, Agency for Healthcare Research and Quality, and Department of Veterans Affairs. PMID: 21930852 [PubMed - in process] (Source: Annals of Internal Medicine)

Treatment of chronic hepatitis C GT 1 patients at an academic center in europe involved in prospective controlled trials ‐ is there a selection bias?

Hepatology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusions: Baseline characteristics slightly favor study‐patients, but IL28B‐genotype and treatment adherence were the most important factors determining outcome. Thus applicability of results of controlled studies has to be tested in a “real world” setting. (HEPATOLOGY 2011.) (Source: Hepatology)

Long‐Term outcome of hepatitis c infection acquired following pediatric liver transplantation

Liver Transplantation — Mon, 19 Sep 2011 04:00:00 +0100

In conclusion, despite the limitations of our series, de novo HCV infection following pediatric LT seems to have slow histologic progression, with good long‐term prognosis and response to treatment, even in cases of genotype 1. Nevertheless, chronic rejection during antiviral therapy may develop. In addition, SVC may occur in this population. Liver Transpl, 2011. © 2011 AASLD. (Source: Liver Transplantation)

Treatment of chronic hepatitis C genotype 1 patients at an academic center in europe involved in prospective, controlled trials: Is there a selection bias?

Hepatology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusions: Baseline characteristics slightly favored study patients, but IL28B GT and treatment adherence were the most important factors determining outcome. Thus, the applicability of the results of controlled studies has to be tested in a “real‐world” setting. (HEPATOLOGY 2011 (Source: Hepatology)

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[Fatty liver and hepatitis C virus infection].

Orvosi Hetilap — Fri, 16 Sep 2011 09:08:59 +0100

Authors: Lakatos M, Hagymási K, Lengyel G Abstract Hepatitis C virus infection is a common liver disease worldwide, leading to the development of steatosis, cirrhosis and hepatocellular carcinoma. In patients with chronic hepatitis C virus infection the prevalence of steatosis has been estimated to be about 55%. Development of steatosis is due to both viral and metabolic factors. Hepatitis C virus proteins moderate a number of intracellular pathways, however, further studies are required to understand these mechanisms. Obesity and insulin resistance may allow the virus to resist antiviral treatment. This review discusses the relationship among steatosis, insulin resistance and the response to antiviral therapy. Orv. Hetil., 2011, 152, 1513-1519. PMID: 21896442 [PubMed - in pro...

Current trends in management of hepatitis B virus reactivation in the biologic therapy era.

World Journal of Gastroenterology : WJG — Wed, 14 Sep 2011 04:00:00 +0100

Authors: Mastroianni CM, Lichtner M, Citton R, Borgo CD, Rago A, Martini H, Cimino G, Vullo V Abstract Hepatitis B virus (HBV) reactivation represents an emerging cause of liver disease in patients undergoing treatment with biologic agents. In particular, the risk of HBV reactivation is heightened by the use monoclonal antibodies, such as rituximab (anti-CD20) and alemtuzumab (anti-CD52) that cause profound and long-lasting immunosuppression. Emerging data indicate that HBV reactivation could also develop following the use of other biologic agents, such as tumor necrosis factor (TNF)-α inhibitors. When HBV reactivation is diagnosed, it is mandatory to suspend biologic treatment and start antiviral agents immediately. However, pre-emptive antiviral therapy prior to monoclonal antib...

Rising burden of Hepatitis C Virus in Hemodialysis Patients

Virology Journal — Tue, 13 Sep 2011 04:00:00 +0100

Conclusion: This study suggesting that i) the prevalence of HCV does not differentiate between past and present infection and continued to be elevated ii) HD patients may be a risk for HCV due to the involvement of multiple routes of infections especially poor blood screening of transfused blood and low standard of dialysis procedures in Pakistan and iii) need to apply infection control practice. (Source: Virology Journal)

The natural history of hepatitis C virus infection acquired during childhood

Liver International — Mon, 12 Sep 2011 23:08:26 +0100

ConclusionAlthough HCV can lead to liver transplantation and death during childhood, the vast majority of patients with disease acquired during childhood have slowly progressive disease. There is no clear indication for antiviral therapy in the majority of children with HCV infection. (Source: Liver International)

The determination of GGT is the most reliable predictor of nonresponsiveness to interferon-alpha based therapy in HCV type-1 infection

Journal of Gastroenterology — Mon, 12 Sep 2011 15:52:37 +0100

Conclusions These findings prove the predictive sensitivity of GGT as an independent indicator of nonresponsiveness even at levels that are slightly above the normal range. This new predictive parameter may help to improve individualized therapy in HCV type-1 infection. Content Type Journal ArticleCategory Original Article—Liver, Pancreas, and Biliary TractPages 1-10DOI 10.1007/s00535-011-0458-yAuthors Viola Weich, Universitätsklinikum Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Berlin, GermanyEva Herrmann, Institut für Biostatistik und mathematische Modellierung, Goethe-Universität Frankfurt, Frankfurt, GermanyTje Lin Chung, Institut für Biostatistik und mathematische Modellierung, Goethe-Universität Frankfurt, Frankfurt, GermanyChristoph...

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Does interferon and ribavirin combination therapy ameliorate growth hormone deficiency in HCV genotype-4 infected patients?

Clinical Biochemistry — Mon, 12 Sep 2011 04:00:00 +0100

CONCLUSION: We concluded that Egyptian HCV genotype-4 infected patients have growth hormone insufficiency. Besides, we found that response to interferon/ribavirin treatment has an impact on growth hormone levels. PMID: 21933670 [PubMed - as supplied by publisher] (Source: Clinical Biochemistry)

Polymorphism near the IL28B gene in Korean hepatitis C virus-infected patients treated with peg-interferon plus ribavirin

Journal of Clinical Virology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: These results demonstrate that the genotypes rs12979860 CC and rs8099917 TT were more frequently observed in Korean patients compared to other ethnicities, and suggest that the genetic characteristics of patients may be prognostic factor that predicts antiviral response to PEG-IFN therapy for chronic hepatitis C. (Source: Journal of Clinical Virology)

HCV Therapy Can Cause Mild Depression to SpikeHCV Therapy Can Cause Mild Depression to Spike

Medscape Medical News Headlines — Fri, 09 Sep 2011 16:00:00 +0100

Depressive symptoms may worsen during antiviral therapy among patients with hepatitis C virus, and notable changes in patients with subclinical depressive symptoms at baseline may be of most concern. Reuters Health Information (Source: Medscape Medical News Headlines)

Mechanisms Involved in the Development of Chronic Hepatitis C as Potential Targets of Antiviral Therapy.

Current Pharmaceutical Biotechnology — Fri, 09 Sep 2011 04:00:00 +0100

Authors: Jackowiak P, Figlerowicz M, Kurzyńska-Kokorniak A, Figlerowicz M Abstract At present, about 3% of the human population are infected with Hepatitis C virus (HCV). The first, acute stage of the disease is usually asymptomatic. However, only 15-25% of the infected eliminate the virus, while the remaining patients develop chronic hepatitis C (CHC). After 10-30 years of CHC, cirrhosis occurs in 20-30% of patients; 5-10% of this group eventually suffer from hepatocellular carcinoma. Unfortunately, up till now no effective methods protecting against HCV or allowing for efficient CHC treatment have been elaborated. This is primarily because not much is known about the mechanism of CHC emergence and the factors affecting anti-HCV therapy. There are several lines of evidence that s...

Goals of Antiviral Therapy for Hepatitis B: HBeAg Seroconversion, HBsAg Seroconversion, Histologic Improvement, and Possible Impact on Risk of Hepatocellular Carcinoma

Current Hepatitis Reports — Wed, 07 Sep 2011 15:48:13 +0100

Abstract A major goal of antiviral therapy in patients with chronic hepatitis B (CHB) is to achieve durable suppression of viral replication. By maintaining undetectable serum HBV DNA levels, one hopes to improve the clinical outcome of these CHB patients. Recent studies have demonstrated that prolonged viral suppression using first-line antiviral medications such as entecavir or tenofovir is associated with a significant reduction in necroinflammation, fibrosis, and even reversal of cirrhosis. Thus, durable suppression of viral replication might decrease the rates of developing cirrhosis, hepatocellular carcinoma, and most importantly, the mortality from complications associated with HBV-related liver diseases. The first-line medications, entecavir, tenofovir and pegylate...

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Nucleos(t)ide analogue treatment reduces apoptotic activity in patients with chronic hepatitis B

Journal of Clinical Virology — Wed, 07 Sep 2011 04:00:00 +0100

Conclusion: Decline of cell death parameters in association with decline of HBV-DNA and HBs-Antigen indicates a reduction in overall cell death activity during Nuc treatment supporting the concept that response to Nuc therapy reduces necroinflammatory activity and progression of liver disease. (Source: Journal of Clinical Virology)

Occult HCV or delayed viral clearance from lymphocytes of Chronic HCV genotype 3 patients after interferon therapy

Genetic Vaccines and Therapy — Tue, 06 Sep 2011 04:00:00 +0100

Conclusion: True occult hepatitis C virus does not exist in our cohort. Residual viremia at the EOT stage merely reflects a difference in viral kinetics in various compartments that remains a target of immune response even after the end of antiviral therapy and is eventually cleared out at the sustained viral response (SVR). (Source: Genetic Vaccines and Therapy)

Kinetics of viral loads and risk of hepatitis B virus reactivation in hepatitis B core antibody-positive rheumatoid arthritis patients undergoing anti-tumour necrosis factor alpha therapy

Annals of the Rheumatic Diseases — Mon, 05 Sep 2011 04:00:00 +0100

Conclusion HBV reactivation can occur in both HBsAg-positive and HBsAg-negative/HBcAb-positive patients with detectable HBV DNA, so-called occult HBV infection, during anti-TNFα therapy. Antiviral prophylaxis may effectively reduce HBV reactivation in HBsAg-positive RA patients undergoing anti-TNFα therapy. (Source: Annals of the Rheumatic Diseases)

Characterization of drug-resistance mutations in HBV D-genotype chronically infected patients, naïve to antiviral drugs.

Antiviral Research — Mon, 05 Sep 2011 04:00:00 +0100

Authors: Salpini R, Svicher V, Cento V, Gori C, Bertoli A, Scopelliti F, Micheli V, Cappiello T, Spanò A, Rizzardini G, De Sanctis GM, Sarrecchia C, Angelico M, Perno CF Abstract Presence of drug-resistance mutations in drug-naïve hepatitis B virus (HBV) infected patients can seriously compromise response to antiviral treatment. Therefore, our study was aimed at defining the prevalence of HBV drug-resistance in a population of 140 patients, all infected with HBV-D-genotype (the most common HBV-genotype in Eastern Europe, Mediterranean countries and Middle East) and naïve to antiviral therapy. HBV reverse-transcriptase (RT) region was sequenced and analyzed for 20 mutations, confirmed by in vitro studies as associated with resistance to nucleos(t)ide HBV-RT inhibitors (rtL80I/V-r...

Current management and recommendations for access to antiviral therapy of herpes labialis

Journal of Clinical Virology — Mon, 05 Sep 2011 04:00:00 +0100

Abstract: Herpes labialis is a common skin infective condition, worldwide, which is primarily caused by HSV-1. Recurrent episodes of herpes labialis, also known as cold sores, can be frequent, painful, long-lasting and disfiguring for infected patients. At present, there are two types of antivirals for the treatment of herpes labialis, topical and oral, which are available over the counter or as prescription-only. The aim of antiviral therapy is to block viral replication to enable shortening the duration of symptoms and to accelerate healing of the lesions associated with herpes labialis. This review examines the evidence for the effectiveness of current topical and oral antivirals in the management of recurrent episodes of herpes labialis. In most countries, oral antivirals for herpes la...

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Insidious Course of Cytomegalovirus Infection in Hand Transplant Recipient: Case Report, Diagnostics, and Treatment

Transplantation Proceedings — Thu, 01 Sep 2011 04:00:00 +0100

Abstract: Cytomegalovirus (CMV) infection is common in solid organ and composite tissue transplant recipients and so becomes an ever more important issue for clinicians of every specialty. In this article we describe a case of CMV infection in a hand transplant recipient, which led to an episode of acute rejection early posttransplantation that was unresponsive to antiviral therapy. Our observations support the guidelines of matching CMV-positive donors with CMV-positive recipients only; however, the possible consequences related to CMV disease make a strong point to advocate the use of CMV prophylaxis in all hand transplant recipients. (Source: Transplantation Proceedings)

Molecular epidemiology of hepatitis B virus.

The Korean Journal of Internal Medicine — Thu, 01 Sep 2011 04:00:00 +0100

In conclusion, genotyping of HBV is useful in identifying chronic hepatitis B patients who are at increased risk of disease progression, thereby enabling physicians to optimize antiviral therapy for these patients. PMID: 22016585 [PubMed - in process] (Source: The Korean Journal of Internal Medicine)

Durability of antiviral therapy for chronic hepatitis C after achieving sustained virological response.

Korean J Hepatol — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Heo J PMID: 22102383 [PubMed - in process] (Source: Korean J Hepatol)

Hepatitis B: Modern End Points of Treatment and the Specter of Viral Resistance

Gastroenterology Clinics of North America — Wed, 31 Aug 2011 23:00:00 +0100

The ultimate goal of treating a chronic infectious disease is the eradication of the infectious agent to prevent organ damage or death. The natural history of untreated chronic hepatitis B may result in the development of cirrhosis, followed by hepatic decompensation and death. Hepatocellular carcinoma (HCC) can also occur in patients with chronic hepatitis B virus (HBV) infection, with or without the presence of cirrhosis. Antiviral therapy with oral nucleos(t)ide analog (NUC) agents suppress viral replication but do not directly act on the covalently closed circular DNA that resides within infected hepatocytes; thus, current oral therapy rarely eradicates HBV infection. Although these oral antiviral agents are well-tolerated with minimal side effects, prolonged viral suppression runs the...

Use of antiviral therapy in surveillance: impact on outcome of hepatitis B‐related hepatocellular carcinoma

Liver International — Mon, 29 Aug 2011 23:00:00 +0100

ConclusionThis study provides evidence that commencement of antiviral therapy during the surveillance period is associated with improvement in overall survival in HBV‐related HCC. (Source: Liver International)

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Influenza-Like Illness in Hospitalized Pregnant and Postpartum Women During the 2009-2010 H1N1 Pandemic.

Obstetrics and Gynecology — Sun, 28 Aug 2011 00:19:36 +0100

CONCLUSION:: Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency. LEVEL OF EVIDENCE:: II. PMID: 21860288 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)

The effect of cytokine profiles on the viral response to re-treatment in antiviral-experienced patients with chronic hepatitis C virus infection.

Antiviral Research — Fri, 26 Aug 2011 04:00:00 +0100

CONCLUSIONS: We found a successful second round therapy in antiviral-experienced patients appears to be associated with the host immune response. Dominant Th1-polar cytokines, especially IFN-γ, is a potential predictor of viral responsiveness. PMID: 21889543 [PubMed - as supplied by publisher] (Source: Antiviral Research)

Dynamics of Cytomegalovirus (CMV) Plasma DNAemia in Initial and Recurrent Episodes of Active CMV Infection in the Allogeneic Stem Cell Transplantation Setting: Implications for Designing Preemptive Antiviral Therapy Strategies

Biology of Blood and Marrow Transplantation — Thu, 25 Aug 2011 04:00:00 +0100

Preemptive antiviral therapy strategies for active cytomegalovirus (CMV) infection occurring in allogeneic stem cell transplant recipients should be optimized to avoid overtreatment. The current study was aimed at determining whether the analysis of the kinetics of CMV DNA load in plasma may provide useful information for the therapeutic management of active CMV infection in this setting. A total of 59 consecutive patients were included in the study, of which 40 (67.8%) developed 1 (n = 21) or more (n = 19) episodes of CMV DNAemia. The need for antiviral therapy for initial or secondary episodes of CMV DNAemia could not be predicted on the basis of the CMV DNA load value in the first plasma testing positive by polymerase chain reaction (PCR). In contrast, in the absence of antiviral thera...

Hepatitis C

Medicine — Thu, 25 Aug 2011 00:23:17 +0100

Abstract: Hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. Over 180 million people worldwide have chronic HCV infection and are at risk of developing its life-threatening complications. Acute infection is usually asymptomatic with most patients unaware that they have contracted the virus. Some patients clear the virus spontaneously, but most become chronic carriers. If carriers are identified they may be candidates for antiviral therapy, the main goal being prevention of cirrhosis, liver failure and hepatocellular carcinoma by eradicating the virus. During the past decade there has been impressive progress in the efficacy of treatment. With the current standard of care, pegylated interferon alpha and ribavirin, a sustained virological r...

Hepatitis B

Medicine — Thu, 25 Aug 2011 00:23:16 +0100

Abstract: Hepatitis B virus (HBV) infection is a global health problem. Around 400 million people are chronically infected with HBV, which is a major cause of liver cirrhosis and liver failure. The interaction between the virus and host immune responses defines the clinical course of infection. The natural history of HBV is not linear and the clinical spectrum varies from an asymptomatic carrier state to fulminant hepatic failure. Immunization programmes have resulted in a dramatic decline in the incidence and prevalence of chronic hepatitis B infection in many countries. For those with infection, the timing of treatment and the choice of antiviral therapy depend on the patient profile. The main goal of antiviral therapy is to prevent liver cirrhosis. Antiviral treatment is with interfero...

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Recent Developments of Peptidomimetic HIV-1 Protease Inhibitors.

Current Medicinal Chemistry — Wed, 24 Aug 2011 23:00:00 +0100

Authors: Qiu X, Liu ZP Abstract HIV protease plays a crucial role in the viral life cycle by processing the viral Gag and Gag-Pol polyproteins into structural and functional proteins essential for viral maturation. Inhibition of HIV-1 protease leads to the production of noninfectious virus particles and hence is an important therapeutic target for antiviral therapy in AIDS patients. Among many strategies to combat this disease, highly active antiretroviral therapy (HAART) with HIV protease inhibitors (PIs) in combination with reverse transcriptase inhibitors and fusion inhibitor continues to be the first line treatment for control of HIV infection. However, the rapid emergence of drug-resistant HIV-1 strains and the appearance of cross-resistance are severely limiting the long-term...

Reply

Clinical Gastroenterology and Hepatology — Wed, 24 Aug 2011 04:00:00 +0100

I would like to thank Giannini and coworkers for their thoughtful comments on the potential improved sustained virologic response (SVR) rates that can possibly be obtained also in end-stage renal disease (ESRD) patients on hemodialysis with combination antiviral therapy, including ribavirin. When we were initially planning the “Hemodialysis patients: Efficacy with low-dose Pegasys” (HELPS) trial, none of the data on combination therapy in ESRD patients referred to by Giannini had been published. Neither was there a dose-ranging study of peginterferon alfa-2a, nor any larger prospective study on peginterferon alfa-2a in hepatitis C virus (HCV)-infected ESRD patients at all. So the decision was made to take one step at a time and conduct a solid study to evaluate the efficacy and safety ...

Small molecule inhibitors reveal Niemann–Pick C1 is essential for Ebola virus infection

Nature AOP — Tue, 23 Aug 2011 23:00:00 +0100

Small molecule inhibitors reveal Niemann–Pick C1 is essential for Ebola virus infection Nature advance online publication 24 August 2011. doi:10.1038/nature10380 Authors: Marceline Côté, John Misasi, Tao Ren, Anna Bruchez, Kyungae Lee, Claire Marie Filone, Lisa Hensley, Qi Li, Daniel Ory, Kartik Chandran & James Cunningham Ebola virus (EboV) is a highly pathogenic enveloped virus that causes outbreaks of zoonotic infection in Africa. The clinical symptoms are manifestations of the massive production of pro-inflammatory cytokines in response to infection and in many outbreaks, mortality exceeds 75%. The unpredictable onset, ease of transmission, rapid progression of disease, high mortality and lack of effective vaccine or therapy have created a high level of public con...

Small interfering RNA targeting for infected‐cell polypeptide 4 inhibits herpes simplex virus type 1 replication in retinal pigment epithelial cells

Clinical and Experimental Ophthalmology — Mon, 22 Aug 2011 04:00:00 +0100

Conclusions: Infected‐cell polypeptide 4‐targeting small interfering RNA can inhibit herpes simplex virus type 1 replication in retina epithelial cells, providing a foundation for development of RNA interference as an antiviral therapy. (Source: Clinical and Experimental Ophthalmology)

SiRNA Targeting for ICP4 Inhibits HSV‐1 Replication in Retinal Pigment Epithelial Cells

Clinical and Experimental Ophthalmology — Sun, 21 Aug 2011 23:00:00 +0100

Conclusions: ICP4‐targeting siRNA can inhibit HSV‐1 replication in RPE cells, providing a foundation for development of RNAi as an antiviral therapy. (Source: Clinical and Experimental Ophthalmology)

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Perioperative reactivation of hepatitis B virus replication in patients undergoing partial hepatectomy for hepatocellular carcinoma

Journal of Gastroenterology and Hepatology — Sun, 21 Aug 2011 23:00:00 +0100

Conclusion. Hepatectomy could reactivate HBV replication during the perioperative period, especially in patients who did not receive any antiviral therapy. A close monitoring of HBV DNA during the perioperative period was necessary irrespective of the preoperative HBV DNA level. Once HBV was reactivated, antiviral therapy should be given. (Source: Journal of Gastroenterology and Hepatology)

Application of kinase bypass strategies to nucleoside antivirals.

Antiviral Research — Sun, 21 Aug 2011 23:00:00 +0100

This article reviews the history of kinase bypass strategies applied to nucleoside antivirals and the evolution of different tissue targeted prodrug strategies, highlighting clinically relevant examples. PMID: 21878354 [PubMed - as supplied by publisher] (Source: Antiviral Research)

Parvovirus B19-induced Type II Mixed Cryoglobulinemia

The American Journal of Medicine — Sun, 21 Aug 2011 10:02:52 +0100

We report on a patient with type II mixed cryoglobulinemia due to acute infection with parvovirus B19 who was treated successfully with lenalidomide. (Source: The American Journal of Medicine)

Update on Diagnosis and Treatment within the Four Clinical Phases of Chronic Hepatitis B Infection

Current Hepatitis Reports — Fri, 19 Aug 2011 05:51:46 +0100

Abstract Four phases of chronic hepatitis B virus [1] infection have been identified: immune tolerant, immune active, inactive, and hepatitis B surface antigen (HBsAg) clearance. These phases are defined by using a combination of hepatitis B “e” antigen (HBeAg) status, alanine aminotransferase (ALT) level, and HBV DNA level. To determine the extent of liver inflammation and fibrosis needed to decide whether antiviral therapy is necessary often requires a liver biopsy. Recent studies have found that levels of HBsAg can also be used to determine the phase of HBV and can even predict persons who may remain in the inactive phase over time. Non invasive markers including transient elastography can detect a proportion of those with a high probability of severe fibrosis and mi...