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[Clinical Picture] Tamponade with a thickened pericardiumEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 24-year-old Caribbean man, with no previous medical history, presented with cough, dyspnoea, and weight loss of 6 kg over the previous month. He reported a 2-month history of night sweats without fever. Physical examination revealed breath frequency of 40 breaths per min and a tachycardia of 121 beats per min, with soft heart sounds and ankle oedema. Laboratory findings showed a normal complete blood count and C-reactive protein of 107 mg/L. HIV serology was negative. Echocardiography found a tamponade with a thickened pericardium (6 mm), confirmed by a contrast-enhanced thoracic CT scan (). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Pierre Loulergue, Olivier Mir Tags: Clinical Picture Source Type: journals

[] Azole resistance in Aspergillus fumigatus: a side-effect of environmental fungicide use?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Invasive aspergillosis due to multi-azole-resistant Aspergillus fumigatus has emerged in the Netherlands since 1999, with 6·0–12·8% of patients harbouring resistant isolates. The presence of a single resistance mechanism (denoted by TR/L98H), which consists of a substitution at codon 98 of cyp51A and a 34-bp tandem repeat in the gene-promoter region, was found in over 90% of clinical A fumigatus isolates. This is consistent with a route of resistance development through exposure to azole compounds in the environment. Indeed, TR/L98H A fumigatus isolates were cultured from soil and compost, were shown to be cross-resist...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Paul E Verweij, Eveline Snelders, Gert HJ Kema, Emilia Mellado, Willem JG Melchers Source Type: journals

[Personal View] Yearly influenza vaccinations: a double-edged sword?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Yearly vaccination against seasonal influenza viruses is recommended for certain individuals at high risk of complications associated with influenza. It has been recommended in some countries, including the USA, that all children aged 6–59 months are vaccinated against seasonal influenza. However, it has been shown—mainly in animals—that infection with influenza A viruses can induce protective immunity to influenza A viruses of other unrelated subtypes. This so-called heterosubtypic immunity does not provide full protection, but can limit virus replication and reduce morbidity and mortality of the host. This type of ...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Rogier Bodewes, Joost HCM Kreijtz, Guus F Rimmelzwaan Tags: Personal View Source Type: journals

[] Acute hepatitis C and HIV coinfectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a case of a man infected with HIV with sexually acquired acute hepatitis C and discuss the immunology, natural history, and epidemiology of acute hepatitis C and coinfection with HIV. Several recent reports have documented acute hepatitis C among men who have sex with men who engage in high risk sexual practices and often have concomitant genital ulcer disease. We review treatment options for the medical management of acute hepatitis C and coinfection with HIV. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Jodie Dionne-Odom, Melissa K Osborn, Henry Radziewicz, Arash Grakoui, Kimberly Workowski Source Type: journals

[Review] Pharmacogenetics of antimalarial drugs: effect on metabolism and transportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The prevention and management of malaria is primarily based on the use of drugs. Clinical trials have however revealed that between individuals there is large variability in the pharmacokinetic profiles of many antimalarial drugs. The resulting variations in concentrations of the drug within plasma might lead to either suboptimum effectiveness or drug toxicity in some patients. The evidence is increasing that polymorphically expressed drug-metabolising enzymes, predominantly various cytochrome P450 isozymes but also drug transporters, might contribute to the variability in drug response (incomplete cure, relapse, or resist...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Reinhold Kerb, Richard Fux, Klaus Mörike, Peter G Kremsner, José Pedro Gil, Christoph H Gleiter, Matthias Schwab Tags: Review Source Type: journals

[Review] Accuracy of serological assays for detection of recent infection with HIV and estimation of population incidence: a systematic reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We systematically reviewed the accuracy of serological tests for recent infections with HIV that have become widely used for measuring population patterns incidence of HIV. Across 13 different assays, sensitivity to detect recent infections ranged from 42–100% (median 89%). Specificity for detecting established infections was between 49·5% and 100% (median 86·8%) and was higher for infections of durations longer than 1 year (median 98%, range 31·5–100·0). For four different assays, comparisons were made between assay-derived population incidence estimates and a reference incidence estimate. The median percentage di...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Rebecca Guy, Judy Gold, Jesus M García Calleja, Andrea A Kim, Bharat Parekh, Michael Busch, Thomas Rehle, John Hargrove, Robert S Remis, John M Kaldor, for the WHO Working Group on HIV Incidence Assays Tags: Review Source Type: journals

[Review] Tuberculosis and diabetes mellitus: convergence of two epidemicsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The link between diabetes mellitus and tuberculosis has been recognised for centuries. In recent decades, tuberculosis incidence has declined in high-income countries, but incidence remains high in countries that have high rates of infection with HIV, high prevalence of malnutrition and crowded living conditions, or poor tuberculosis control infrastructure. At the same time, diabetes mellitus prevalence is soaring globally, fuelled by obesity. There is growing evidence that diabetes mellitus is an important risk factor for tuberculosis and might affect disease presentation and treatment response. Furthermore, tuberculosis ...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Kelly E Dooley, Richard E Chaisson Tags: Review Source Type: journals

[Errata] ErrataEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Mebis J, Goossens H, Berneman ZN. Cefepime and mortality. Lancet Infect Dis 2009; 9: 585–86. Whereas the authors had no personal conflicts of interest to declare, for clarity they declare that Antwerp University Hospital was in receipt of a research grant from Bristol-Myers Squibb until 2008. Virga Jesse Hospital received a research grant and sponsorship for scientific symposia until 2007 and in 2008–09 received partial sponsorship for symposia from Bristol-Myers Squibb. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: The Lancet Infectious Diseases Tags: Errata Source Type: journals

[Errata] ErrataEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sutcliffe CG, van Dijk JH, Bolton C, Persaud D, Moss WJ. Effectiveness of antiretroviral therapy among HIV-infected children in sub-Saharan Africa. Lancet Infect Dis 2008; 8: 477–89. Under the heading “Mortality and loss to follow-up” (page 484), “HIV-positive caregiver” was incorrectly listed as a risk factor for death. The cited research actually shows that HIV-positive caregivers are protective against paediatric mortality compared with caregivers who were untested or not infected with HIV. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: The Lancet Infectious Diseases Tags: Errata Source Type: journals

[Media Watch] Book: Handbook of tuberculosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite the availability of cheap and effective treatments, tuberculosis continues to be a major global health problem, causing an estimated 8·8 million new cases and 1·6 million deaths every year. Efforts to control tuberculosis by the consistent use of existing interventions have met with only limited success over the past decade, slowing its rate of increase but failing to make substantial progress towards the goal of tuberculosis elimination. Several advances in clinical management, molecular biology, biochemistry, immunology, and cell biology have led to accumulation of a large body of knowledge on host–pathogen i...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Alimuddin Zumla Tags: Media Watch Source Type: journals

[Media Watch] Film: House of numbersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Released June 21, 2009. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Talha Burki Tags: Media Watch Source Type: journals

[Newsdesk] Research briefEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Influenza virus causes seasonal epidemics because it evades existing natural and vaccine-induced immunity by accumulating aminoacid changes in its attachment protein, haemagglutinin. Two studies provide new insights into this antigenic drift. In one study, researchers passage virus between naive and immunised mice and examine the changes that accumulate. In response to variations in neutralising antibody pressure between individuals, influenza virus evolves by accumulating aminoacid substitutions that adjust the avidity with which haemagglutinin binds to host cell receptors. Results suggest that an increase in paediatric i...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Jane Bradbury Tags: Newsdesk Source Type: journals

[Newsdesk] Integration of surveys for neglected tropical diseasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Limited resources and limited access to regions torn by current or recent conflict pose a challenge to neglected tropical disease (NTD) control programmes in many developing countries. As a result, many organisations have been searching for ways to maximise the efficiency of those programmes. A new study from Southern Sudan has shown feasibility of integrated field surveys to assess community needs for mass drug administration. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: David Lawrence Tags: Newsdesk Source Type: journals

[Newsdesk] New treatment for sleeping sickness still not implementedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A major advance in the treatment of sleeping sickness is still awaiting implementation 13 months after data from a successful trial was presented. Kits of the combination treatment nifurtimox–eflornithine (NECT) are sitting in a Médecins Sans Frontières (MSF) warehouse pending the resolution of legal barriers to their use. Experts are optimistic that NECT will be a major advance in the fight against sleeping sickness but are warning against complacency over the disease—in particular, the belief that sleeping sickness might be soon eradicated. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Kelly Morris Tags: Newsdesk Source Type: journals

[Newsdesk] Funding boost needed for tuberculosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
European Union member states are not adequately financing research and development for tuberculosis, according to a new report by Médicins Sans Frontières (MSF). Given current shortcomings in diagnostics and treatment, as well as the inadequate nature of the BCG vaccine, these funds are urgently required. “Governments don't recognise the potential dire consequences if the resources aren't made available”, says Mel Spigelman (TB Alliance, New York, USA). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Talha Burki Tags: Newsdesk Source Type: journals

[Newsdesk] Childhood vaccination and progress towards MDG4Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Agencies and individuals worldwide are continuing their efforts to vaccinate the world's children and their achievements are highlighted by State of the World's Vaccines and Immunization, a major report published recently by WHO, UNICEF, and The World Bank. “We have good news…”, announced Daisy Mafubelu, Assistant Director General of Family and Community Health at WHO (Geneva, Switzerland). “The number of children being vaccinated is now at an all time high—and we have the numbers to prove this.” In 2008, 106 million children received routine vaccinations for childhood killer infectious diseases including measl...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Kathryn Senior Tags: Newsdesk Source Type: journals

[Newsdesk] Responding to the renewed H1N1 pandemicEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The end of influenza season in the southern hemisphere has provided some insight into what effect pandemic influenza A H1N1 2009 might have during the northern hemisphere influenza season. The high proportion of deaths among pregnant women and people infected with HIV was notable, with severe illness also associated with pregnancy and a range of comorbidities (eg, chronic lower respiratory and metabolic diseases and obesity). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Onisillos Sekkides Tags: Newsdesk Source Type: journals

[Newsdesk] Highlights from the 47th annual meeting of the IDSAEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although the meeting is divided loosely into four official tracks—investigative, adult, paediatric, and HIV—and the programme contains a diverse set of symposia, teaching, and research presentation sessions, a few topics dominate the 47th meeting of the Infectious Diseases Society of America. Inevitably influenza features heavily, but many sessions on health-care acquired infections, antimicrobial resistance, and vaccine development mark this out as a very American conference. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Peter Hayward Tags: Newsdesk Source Type: journals

[Cross-talk] Is that Streptococcus rattus I can smell on your breath?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Microbiologists and dentists alike tend to scoff at the idea that we can lower the risk of dental caries by rinsing our mouths with antiseptics to destroy the bacteria, principally Streptococcus mutans, which promote decay. A final year BSc project done by a fellow student decades ago persuaded me of the absurdity of trying to sterilise the oral cavity in this way. 20 min after even the most vigorous swilling and gargling, the bacterial flora had returned to its original composition. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Bernard Dixon Tags: Cross-talk Source Type: journals

[Reflection and Reaction] Clostridium sordellii toxic shock syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In their recent Review, Emma Lappin and Andrew J Ferguson provide a thorough and interesting update on the pathophysiology and management of two major toxic shock syndromes caused by the Gram-positive pathogens Staphylococcus aureus and Streptococcus pyogenes. As the most common cause of Gram-positive toxic shock syndromes, it is important for health-care providers to familiarise themselves with these pathogens. However, by contrast with the broad scope implied by the title of their paper, the authors did not mention toxic shock syndrome caused by the Gram-positive bacterium Clostridium sordellii. This oversight is surpris...
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: David M Aronoff, Jimmy D Ballard Tags: Reflection and Reaction Source Type: journals

[Reflection and Reaction] Relative risk of death in the SMART studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the May issue of The Lancet Infectious Diseases, Justin Stebbing and Angus Dalgleish noted that 79 of the 85 deaths (93%) in the SMART study happened in the USA, whereas 45% of the participants were enrolled outside the USA. They concluded that it was “apparently safer to be off highly active antiretroviral therapy (HAART) outside the USA rather than on HAART within the USA”, and contemplated possible reasons for this difference. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Birgit Grund, Jacqueline Neuhaus, Andrew Phillips, for the INSIGHT SMART Study Group Tags: Reflection and Reaction Source Type: journals

[Reflection and Reaction] Preventing the spread of influenza A H1N1 2009 to health-care workersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is ongoing debate about influenza transmission and how best to reduce the risk of infection among health-care workers. For no other common infectious disease is there such varied opinion, reflecting gaps in our knowledge about a common human pathogen. This debate is based on five variables (). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Leonard A Mermel Tags: Reflection and Reaction Source Type: journals

[Reflection and Reaction] Influenza A H1N1 diagnostics: the first, the fastest, and the most reliableEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The recent emergence of pandemic influenza A H1N1 demands prompt development of well-optimised and well-evaluated diagnostic methods, permitting rapid risk assessment and measures for counteracting the spread of infection and allowing epidemiological surveillance. The perfect diagnostic method is highly specific to A H1N1 and yet robust enough to cope with small genetic changes, it should also be rapid and yet suited to high throughput analyses in case substantial demands are placed on laboratories during a pandemic. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Barbara Biere, Brunhilde Schweiger, Andreas Nitsche Tags: Reflection and Reaction Source Type: journals

[Reflection and Reaction] Influenza vaccination of childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this issue of The Lancet Infectious Diseases, Rogier Bodewes and colleagues state that influenza vaccination is beneficial for infants and young children, but at the same time they urge re-evaluation of vaccine recommendations because the inactivated vaccine available at present does not induce heterosubtypic immunity and might make infants more susceptible to pandemic influenza. Although there are numerous immunological mechanisms related to infection with influenza to be discovered, we feel that the conclusions should be put into perspective. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: Terho Heikkinen, Ville Peltola Tags: Reflection and Reaction Source Type: journals

[Leading Edge] Vaccine safety: informing the misinformedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
At the time of going to press, the first major vaccination campaigns to prevent pandemic H1N1 are getting underway. The vaccine might not have been ready in quite the volume hoped; nonetheless, for the production of vaccine in any substantial quantity in such a short time while still providing seasonal vaccine, those involved—the scientist, the pharmaceutical companies, and the chickens that laid the millions of eggs used—should be applauded. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - November 16, 2009 Category: Infectious Diseases Authors: The Lancet Infectious Diseases Tags: Leading Edge Source Type: journals

[Clinical Picture] Bone marrow involvement in Q fever—detection by fluorine-18-labelled fluorodeoxyglucose PETEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 60-year-old man was admitted to hospital with a 2-week history of fever, rigors, and headache. Apart from hypertension, his past medical history was unremarkable. He travelled abroad frequently, and had visited China where he had been exposed to a herd of goats 2 months before the current illness. On examination, he was pyrexial (38·5°C) and his liver was enlarged. His full blood count was normal, but his C-reactive protein was raised. Serum transaminases and alkaline phosphatase were mildly raised. Preliminary screening for auto-antibodies was negative. Initial parasitic and virological screening was also negative. Ce...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Lankanatha Alwis, Kottekkattu Balan, Penny Wright, Andrew Lever, Andrew Carmichael Tags: Clinical Picture Source Type: journals

[Personal View] Operational research in low-income countries: what, why, and how?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Operational research is increasingly being discussed at institutional meetings, donor forums, and scientific conferences, but limited published information exists on its role from a disease-control and programme perspective. We suggest a definition of operational research, clarify its relevance to infectious-disease control programmes, and describe some of the enabling factors and challenges for its integration into programme settings. Particularly in areas where the disease burden is high and resources and time are limited, investment in operational research and promotion of a culture of inquiry are needed so that health ...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Rony Zachariah, Anthony D Harries, Nobukatsu Ishikawa, Hans L Rieder, Karen Bissell, Kayla Laserson, Moses Massaquoi, Micheal Van Herp, Tony Reid Tags: Personal View Source Type: journals

[Review] Pathogenetic mechanisms of the intracellular parasite Mycobacterium ulcerans leading to Buruli ulcerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The necrotising skin infection Buruli ulcer is at present the third most common human mycobacteriosis worldwide, after tuberculosis and leprosy. Buruli ulcer is an emergent disease that is predominantly found in humid tropical regions. There is no vaccine against Buruli ulcer and its treatment is difficult. In addition to the huge social effect, Buruli ulcer is of great scientific interest because of the unique characteristics of its causative organism, Mycobacterium ulcerans. This pathogen is genetically very close to the typical intracellular parasites Mycobacterium marinum and Mycobacterium tuberculosis. We review data ...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Manuel T Silva, Françoise Portaels, Jorge Pedrosa Tags: Review Source Type: journals

[Review] Genetic deficiencies of innate immune signalling in human infectious diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The type-1 cytokine (interleukin 12, interleukin 23, interferon γ, interleukin 17) signalling pathway is triggered during infection by activation of phagocyte-expressed pattern-recognition receptors that recognise specific pathogen-associated molecular patterns. Triggering of this pathway results, among other things, in activation of microbicidal mechanisms in phagocytic cells. Individuals with a deficiency in one of the proteins in the pathway are unusually susceptible to otherwise poorly pathogenic, mostly environmental, mycobacteria and salmonellae. Individuals with deficiencies in other innate immune signalling protei...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Esther van de Vosse, Jaap T van Dissel, Tom HM Ottenhoff Tags: Review Source Type: journals

[Review] Progress towards a dengue vaccineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The spread of dengue virus throughout the tropics represents a major, rapidly growing public health problem with an estimated 2·5 billion people at risk of dengue fever and the life-threatening disease, severe dengue. A safe and effective vaccine for dengue is urgently needed. The pathogenesis of severe dengue results from a complex interaction between the virus, the host, and, at least in part, immune-mediated mechanisms. Vaccine development has been slowed by fears that immunisation might predispose individuals to the severe form of dengue infection. A pipeline of candidate vaccines now exists, including live attenuated...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Daniel P Webster, Jeremy Farrar, Sarah Rowland-Jones Tags: Review Source Type: journals

[Review] Male circumcision and risk of HIV infection in women: a systematic review and meta-analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Male circumcision provides long-term indirect protection to women by reducing the risk of heterosexual men becoming infected with HIV. In this Review, we summarise the evidence for a direct effect of male circumcision on the risk of women becoming infected with HIV. We identified 19 epidemiological analyses, from 11 study populations, of the association of male circumcision and HIV risk in women. A random-effects meta-analysis of data from the one randomised controlled trial and six longitudinal analyses showed little evidence that male circumcision directly reduces risk of HIV in women (summary relative risk 0·80, 95% CI...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Helen A Weiss, Catherine A Hankins, Kim Dickson Tags: Review Source Type: journals

[Errata] ErratumEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bartlett JA, Shao JF. Success, challenges, and limitations of current antiretroviral therapy in low-income and middle-income countries. Lancet Infect Dis 2009; 9: 637–49. Page 640, reference 31 should cite Zhou J, Li PC, Kumarasamy N, Boyd MA, Pujari S, on behalf of The TREAT Asia HIV Observational Database. Deferred modification of antiretroviral regimen following treatment failure in Asia: results from the TREAT Asia HIV Observational Database (TAHOD). 17th International AIDS Conference; Mexico City, Mexico; Aug 3–8, 2008. Abstract TUPE0116. Page 641, reference 84 should cite Losina E, Chang Y, Campbell E, Walensky R...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: The Lancet Infectious Diseases Tags: Errata Source Type: journals

[Media Watch] Exhibition: Microbiology's might on displayEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Colourful images of the pandemic influenza H1N1 virus have recently abounded in the media. However, none have quite looked like the translucent glass sculpture that has been on display at the Smithfield Gallery in London, UK. The exhibition has showcased a cluster of clear-glass sculptures of different viruses and the bacterium Escherichia coli. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Claire Tilstone Tags: Media Watch Source Type: journals

[Media Watch] Film: Bright starEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the 1800s—when the British Government started recording such matters—infectious diseases accounted for almost half of the country's mortality. Thousands of death certificates carried inscriptions such as scarlet fever, diphtheria, cholera, typhus, and smallpox. But one disease dominated. In 1815—the year Napoleon was finally defeated—a quarter of the deaths in the UK were due to consumption, so-called because sufferers would emaciate and weaken, coughing up blood, and losing their colour. The ancient Greek physician Aretaeus of Cappadocia described such patients as “having shoulder blades like the wings of bir...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Talha Burki Tags: Media Watch Source Type: journals

[Media Watch] Book: Clinical mycologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Serious fungal infections arise less commonly than bacterial, viral, and parasitic diseases in the clinic, but they are diverse, difficult to diagnose, and often associated with severe morbidity or mortality. A comprehensive and scholarly reference work, covering all aspects of fungal disease, is therefore an obviously desirable addition to hospital libraries and the bookshelves of infectious disease and clinical microbiology specialists. Two competitors for this role were published in 2003, both entitled Clinical Mycology. One was edited by Dismukes, Pappas, and Sobel, the other by Anaissie, McGinnis, and Pfaller. The sec...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Frank Odds Tags: Media Watch Source Type: journals

[Newsdesk] Research briefEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Influenza pandemics often start when avian influenza viruses evolve to recognise human cells. Avian and human influenza viruses enter host cells by binding to species-specific cell-surface receptors by use of their haemagglutinins, so how do avian viruses make the transition to people? An examination of the structure of receptor complexes formed by haemagglutinins from the 1957 pandemic influenza virus and from its potential avian precursors suggests that some avian haemagglutinins can bind to human receptors even though they lack the human-specific haemagglutinin mutations of the pandemic virus. This ability might have gi...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Jane Bradbury Tags: Newsdesk Source Type: journals

[Newsdesk] Not our problemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
International standards for deporting migrants infected with HIV should be reassessed, concludes a new report commissioned by Human Rights Watch (HRW). The report notes that, before deportation, migrants found to be infected with HIV in the Persian Gulf are often detained in overcrowded conditions where they are denied drugs, and that the South African authorities sometimes drop migrant workers infected with multidrug-resistant (MDR) tuberculosis or HIV at the border of their home country with neither treatment nor referral. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Talha Burki Tags: Newsdesk Source Type: journals

[Newsdesk] Universal access not a dreamEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As of December, 2008, about 4 030 000 people were receiving antiretroviral therapy for HIV/AIDS, according to the report Towards Global Access released on Sept 30. Although this represents an increase of 36% in coverage from the 3 million people receiving treatment at the end of 2007, the new estimate suggests that just 42% of people in need of antiretroviral coverage are receiving the treatment they need. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Peter Hayward Tags: Newsdesk Source Type: journals

[Newsdesk] Dengue vaccine efficacy trials in progressEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Six decades of effort to develop a dengue vaccine are finally coming to fruition with the first full-scale efficacy trial to test the Sanofi Pasteur live-attenuated vaccine candidate based on the ChimeriVax technology. “This pivotal efficacy trial will run in Ratchaburi, Thailand, where full enrolment of about 4000 4–11-year-old children has been approved by the Thai Ministry of Public Health”, reported Jean Lang (Sanofi Pasteur, Lyon, France). The first findings are expected in 2012, but the exact timing will depend on the enrolment rate and the incidence of dengue in the region. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Kathryn Senior Tags: Newsdesk Source Type: journals

[Newsdesk] Prospective antibacterial pipeline running dryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Given the rising tide of drug resistance, a new business model for the development of antibiotics is urgently needed, an expert conference hosted by the Swedish Presidency of the European Union heard on Sept 17. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Talha Burki Tags: Newsdesk Source Type: journals

[Newsdesk] HIV drug patents in the spotlightEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Access to HIV medicines has been highlighted recently, with advocates applauding decisions by India and Brazil to reject the patenting of key antiretroviral drugs. Although companies are increasingly instituting their own initiatives to increase access, calls for the pharmaceutical industry to join the UNITAID patent pool have grown louder. On Sept 30, Médecins Sans Frontières (MSF) launched a campaign calling on companies to join the UNITAID patent pool and asking the public to make the same call. As the December goal for the UNITAID implementation plan grows nearer, all parties are debating the role of patents in acces...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Kelly Morris Tags: Newsdesk Source Type: journals

[Newsdesk] National and international readiness for renewed pandemicEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
October saw the launch of a massive H1N1 vaccination campaign in the USA, just in time for the influenza season. Pandemic influenza cases have been on the rise on the USA, especially now that children are back at school; however, closing schools no longer seems a viable option. Health experts also fear that the US health-care system will not stand up to the strain of a renewed H1N1 pandemic. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Priya Shetty Tags: Newsdesk Source Type: journals

[Newsdesk] Highlights from the 49th ICAACEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The 49th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC; San Francisco, CA, USA; Sept 12–15, 2009) gave due prominence in the programme of this year's event to the evolving pandemic of influenza A H1N1. Here we report some of the influenza-related highlights of the meeting. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: John McConnell Tags: Newsdesk Source Type: journals

[Cross-talk] A well-disguised blessingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Publication of the latest book by Richard Dawkins, The Greatest Show on Earth (London: Transworld, 2009), has triggered more angry attacks on his atheism, including curious defences of a religious attitude by commentators without any discernible supernatural convictions themselves. Some true believers have insisted that they can accept evolution as a divinely creative process. Others have asserted that Dawkins is simply wrong because science and religion are categorically different views of the world. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Bernard Dixon Tags: Cross-talk Source Type: journals

[Reflection and Reaction] Has routine immunisation in Africa become endangered?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The broad picture of immunisation in Africa is one of excellent progress and enthusiastic energy, with amazing advances having been made since the turn of the century. There has been a large drop in mortality due to measles, and about a third of countries now use a three dose regimen of diphtheria-tetanus-pertussis triple vaccine (DTP3), which provides coverage of at least 80% in all districts. However, a review of immunisation in Africa found that all is not well. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Yemane Berhane, C John Clements, Jean Michel Ndiaye, Patricia Taylor Tags: Reflection and Reaction Source Type: journals

[Reflection and Reaction] Obama's research-funding stimulusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Since 2003, the US National Institutes of Health (NIH) funding for scientific and medical research has decreased steadily (after adjusting for inflation), which has created plenty of criticism and scorn within academic and scientific communities across the USA. Competition for scarce grant funding has sky-rocketed, graduate interest in investigative research has decreased, and thousands of researchers have lost their jobs. This has slowed scientific progress and has introduced numerous challenges to US medical research. For most developing countries, though, the effects seem to be drastically different. (Source: The Lancet...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Haitham M Ahmed Tags: Reflection and Reaction Source Type: journals

[Reflection and Reaction] Controlling hepatitis C with immunotherapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We read with great interest Daniel P Webster and colleagues' Review of the development of new treatments for hepatitis C. The authors emphasised the promise of new selective inhibitors of hepatitis C virus (HCV) and their acceptable side-effect profiles. However, the clinical trial of specifically targeted antiviral therapy for HCV showed that it often leads to new mutant viruses and it is unclear whether the response can be sustained off-therapy. Therefore, more effective and tolerable treatments, such as new immune-based treatments, are being actively developed to complement or replace standard treatments of HCV. (Source...
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Yin Wen, Lei Ying feng, Yang Jing, Lu Xin, Xu Zhikai Tags: Reflection and Reaction Source Type: journals

[Reflection and Reaction] Vaccine immunogenicity in injecting drug usersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Martin Schmidt commented on a Review by Stefan Baral and colleagues on vaccine immunogenicity in injecting drug users; however, Schmidt's criticism was actually directed at our paper. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: Fabio Lugoboni, Paolo Mezzelani, Gianluca Quaglio Tags: Reflection and Reaction Source Type: journals

[Leading Edge] HIV vaccine trials and tribulationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The results released on Sept 24 of the RV144 trial of a vaccine against HIV offer a glimmer of hope in a field that has experienced many disappointments. The reported vaccine efficacy of 31% for prevention of HIV infection seems promising, but still leaves the prospect of immunisation as a practical public health intervention against HIV tantalisingly out of reach. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - October 18, 2009 Category: Infectious Diseases Authors: The Lancet Infectious Diseases Tags: Leading Edge Source Type: journals

[Clinical Picture] Not always HIVEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 78-year-old man with a history of hypertension, advanced dilated cardiomyopathy, and longstanding type 2 diabetes mellitus was admitted to hospital because of heart failure. Besides clinical signs of ventricular dysfunction, physical examination showed multiple asymptomatic reddish-purple macular, papular, and nodular skin lesions with surrounding lymphoedema in the man's hands, arms (), and legs, which had been present for the past 6 months. Exploration was otherwise unremarkable. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - September 21, 2009 Category: Infectious Diseases Authors: Mariola Moreno Azofra, José Luis Peña Somovilla, Miguel Carrascosa Porras, Laura Hurtado Carrillo, Rafael Daroca Pérez Tags: Clinical Picture Source Type: journals