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1.
Emerg Microbes Infect ; 11(1): 1664-1671, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1978179

ABSTRACT

To reach the WHO target of hepatitis C virus (HCV) elimination by 2025, Taiwan started to implement free-of-charge direct-acting antiviral (DAA) treatment programme in 2017. Evaluating the progress of HCV microelimination among people living with HIV (PLWH) is a critical step to identify the barriers to HCV elimination. PLWH seeking care at a major hospital designated for HIV care in Taiwan between January 2011 and December 2021 were retrospectively included. For PLWH with HCV-seropositive or HCV seroconversion during the study period, serial HCV RNA testing was performed using archived samples to confirm the presence of HCV viremia and estimate the prevalence and incidence of HCV viremia. Overall, 4199 PLWH contributed to a total of 27,258.75 person-years of follow-up (PYFU). With the reimbursement of DAAs and improvement of access to treatments, the prevalence of HCV viremia has declined from its peak of 6.21% (95% CI, 5.39-7.12%) in 2018 to 2.09% (95% CI, 1.60-2.77%) in 2021 (decline by 66.4% [95% CI, 55.4-74.7%]); the incidence has declined from 25.94 per 1000 PYFU (95% CI, 20.44-32.47) in 2019 to 12.15% per 1000 PYFU (95% CI, 8.14-17.44) (decline by 53.2% [95% CI, 27.3-70.6%]). However, the proportion of HCV reinfections continued to increase and accounted for 82.8% of incident HCV infections in 2021. We observed significant declines of HCV viremia among PLWH with the expansion of the DAA treatment programme in Taiwan. Further improvement of the access to DAA retreatments is warranted to achieve the goal of HCV microelimination.


Subject(s)
HIV Infections , Hepatitis C, Chronic , Hepatitis C , Antiviral Agents/therapeutic use , HIV Infections/drug therapy , HIV Infections/epidemiology , Hepacivirus/genetics , Hepatitis C/drug therapy , Hepatitis C/epidemiology , Hepatitis C, Chronic/drug therapy , Humans , Retrospective Studies , Taiwan/epidemiology , Viremia/drug therapy , Viremia/epidemiology
2.
Transfus Med ; 32(5): 402-409, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1909541

ABSTRACT

BACKGROUND AND OBJECTIVES: Infections with human parvovirus B19 (B19V) are transmissible by blood components and plasma-derived medicines. The European Pharmacopoeia regulates maximum levels of virus allowed in manufacturers' plasma pools. To evaluate contamination risk prior to re-introduction of UK-sourced plasma for manufacturing, we investigated viraemia frequencies of B19V in plasma samples collected from blood donors before and during COVID-enforced lockdown. MATERIALS AND METHODS: Quantitative PCR for B19V DNA was used to screen pools of 96 anonymised plasma samples collected in England from 2017 (n = 29 505), 2020 (n = 3360) and 2021 (n = 43 200). Selected positive pools were resolved into individual samples. Data on donor notifications and related lookback investigations were collected from European countries by on-line survey in 2020. RESULTS: Screening of 76 065 donations identified 80 B19V-positive pools. While most positive samples had low viral loads (<105  IU ml-1 ), primarily from 2017 (77/29 505; 0.3%), two contained high levels of B19V DNA (1.3 × 108 and 6.3 × 106 IU ml-1 ), both likely to contaminate a final manufacturer's pool and lead to discard. The incidence of B19V infection during lockdown was reduced (1/3360 in 2020; 0/43 200 in 2021). Genomic analysis of positive pools resolved to single samples identified B19V genotype 1 in all nine samples. Seroprevalence of anti-B19V IgG antibodies was 75% (143/192). A survey of B19V screening practices in Europe demonstrated considerable variability. Two blood establishments informed infected blood donors of positive B19V results. CONCLUSION: Information on seroprevalence, incidence and viral loads of B19V viraemia is contributory the evaluation of alternative operational screening strategies for plasma testing.


Subject(s)
COVID-19 , Parvoviridae Infections , Parvovirus B19, Human , Antibodies, Viral , Blood Donors , Communicable Disease Control , DNA, Viral , Humans , Immunoglobulin G , Parvoviridae Infections/epidemiology , Parvovirus B19, Human/genetics , Seroepidemiologic Studies , Viral Load , Viremia/epidemiology
3.
Viruses ; 14(6)2022 06 03.
Article in English | MEDLINE | ID: covidwho-1884380

ABSTRACT

In South Africa, high exposure to SARS-CoV-2 occurs primarily in densely populated, low-income communities, which are additionally burdened by highly prevalent Human Immunodeficiency Virus (HIV). With the aim to assess SARS-CoV-2 seroprevalence and its association with HIV-related clinical parameters in non-hospitalized patients likely to be highly exposed to SARS-CoV-2, this observational cross-sectional study was conducted at the Gugulethu Community Health Centre Antiretroviral clinic between October 2020 and June 2021, after the first COVID-19 wave in South Africa and during the second and beginning of the third wave. A total of 150 adult (median age 39 years [range 20-65 years]) HIV-infected patients (69% female; 31% male) were recruited. 95.3% of the cohort was on antiretroviral therapy (ART), had a median CD4 count of 220 cells/µL (range 17-604 cells/µL) and a median HIV viral load (VL) of 49 copies/mL (range 1-1,050,867 copies/mL). Furthermore, 106 patients (70.7%) were SARS-CoV-2 seropositive, and 0% were vaccinated. When stratified for HIV VL, patients with uncontrolled HIV viremia (HIV VL > 1000 copies/mL) had significantly higher odds of SARS-CoV-2 seropositivity than patients with HIV VL < 1000 copies/mL, after adjusting for age, sex and ART status (p = 0.035, adjusted OR 2.961 [95% CI: 1.078-8.133]). Although the cause-effect relationship could not be determined due to the cross-sectional study design, these results point towards a higher risk of SARS-CoV-2 susceptibility among viremic HIV patients, or impaired HIV viral control due to previous co-infection with SARS-CoV-2.


Subject(s)
COVID-19 , HIV Infections , Adult , Aged , CD4 Lymphocyte Count , COVID-19/epidemiology , Cross-Sectional Studies , Female , HIV Infections/complications , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Male , Middle Aged , SARS-CoV-2 , Seroepidemiologic Studies , South Africa/epidemiology , Viral Load , Viremia/drug therapy , Viremia/epidemiology , Young Adult
4.
Lancet Gastroenterol Hepatol ; 7(5): 396-415, 2022 05.
Article in English | MEDLINE | ID: covidwho-1683802

ABSTRACT

BACKGROUND: Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends. METHODS: This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age ≥0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories. FINDINGS: Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0·7% (95% UI 0·7-0·9), corresponding to 56·8 million (95% UI 55·2-67·8) infections, on Jan 1, 2020. This number represents a decrease of 6·8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63·6 million (61·8-75·8) infections (0·9% [0·8-1·0] prevalence). By the end of 2020, an estimated 12·9 million (12·5-15·4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment. INTERPRETATION: At the beginning of 2020, there were an estimated 56·8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination. FUNDING: John C Martin Foundation, Gilead Sciences, AbbVie, ZeShan Foundation, and The Hepatitis Fund.


Subject(s)
COVID-19 , Hepatitis A , Hepatitis C , COVID-19/epidemiology , Hepacivirus , Hepatitis C/epidemiology , Humans , Infant, Newborn , Pandemics , Prevalence , Viremia/epidemiology
5.
J Infect Dis ; 225(2): 208-213, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1635423

ABSTRACT

The burden of coronavirus disease 2019 (COVID-19) in children represents a fraction of cases worldwide, yet a subset of those infected are at risk for severe disease. We measured plasma severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in a cohort of 103 children hospitalized with COVID-19 with diverse clinical manifestations. SARS-CoV-2 RNAemia was detected in 27 (26%) of these children, lasted for a median of 6 (interquartile range, 2-9) days, and was associated with higher rates of oxygen administration, admission to the intensive care unit, and longer hospitalization.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Adolescent , COVID-19/epidemiology , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Intensive Care Units , Male , Nasopharynx/virology , RNA, Viral/genetics , SARS-CoV-2/genetics , Severity of Illness Index , Viremia/epidemiology
6.
AIDS Res Ther ; 18(1): 31, 2021 06 04.
Article in English | MEDLINE | ID: covidwho-1259203

ABSTRACT

BACKGROUND: Brescia Province, northern Italy, was one of the worst epicenters of the COVID-19 pandemic. The division of infectious diseases of ASST (Azienda Socio Sanitaria Territoriale) Spedali Civili Hospital of Brescia had to face a great number of inpatients with severe COVID-19 infection and to ensure the continuum of care for almost 4000 outpatients with HIV infection actively followed by us. In a recent manuscript we described the impact of the pandemic on continuum of care in our HIV cohort expressed as number of missed visits, number of new HIV diagnosis, drop in ART (antiretroviral therapy) dispensation and number of hospitalized HIV patients due to SARS-CoV-2 infection. In this short communication, we completed the previous article with data of HIV plasmatic viremia of the same cohort before and during pandemic. METHODS: We considered all HIV-patients in stable ART for at least 6 months and with at least 1 available HIV viremia in the time window March 01-November 30, 2019, and another group of HIV patients with the same two requisites but in different time windows of the COVID-19 period (March 01-May 31, 2020, and June 01-November 30, 2020). For patients with positive viremia (PV) during COVID-19 period, we reported also the values of viral load (VL) just before and after PV. RESULTS: the percentage of patients with PV during COVID-19 period was lower than the previous year (2.8% vs 7%). Only 1% of our outpatients surely suffered from pandemic in term of loss of previous viral suppression. CONCLUSIONS: Our efforts to limit the impact of pandemic on our HIV outpatients were effective to ensure HIV continuum of care.


Subject(s)
COVID-19/epidemiology , HIV Infections/epidemiology , Pandemics , Viremia/epidemiology , COVID-19/virology , Cohort Studies , HIV Infections/virology , Humans , Inpatients , Italy/epidemiology , Outpatients , Public Health , SARS-CoV-2/isolation & purification , Viral Load , Viremia/virology
7.
Am J Med ; 134(4): 542-546, 2021 04.
Article in English | MEDLINE | ID: covidwho-917201

ABSTRACT

BACKGROUND: Patients with coronavirus disease 2019 (COVID-19) have a high prevalence of detectable troponin and myocardial injury. In addition, a subset of patients with COVID-19 has detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral loads. The objective of this study was to understand the relationship among SARS-CoV-2 viremia, detectable troponin, and myocardial injury in hospitalized patients with COVID-19. METHODS: SARS-CoV-2 plasma viral load was measured in plasma samples drawn from patients hospitalized for COVID-19 at 2 academic medical centers. Baseline characteristics and clinically obtained high-sensitivity cardiac troponin T (hs-cTnT) values were abstracted from the medical record. The main outcome was detectable hs-cTnT (≥6 ng/mL) and  myocardial injury (hs-cTnT ≥14 ng/mL; >99th percentile for assay). RESULTS: A total of 70 hospitalized patients with COVID-19 were included in this study, with 39% females and median age 58 ± 17 years; 21 patients (30%) were found to have detectable SARS-CoV-2 viral load and were classified in the viremia group. Patients with viremia were significantly older than those without viremia. All of the patients with viremia (100%) had detectable troponin during hospitalization compared with 59% of patients without viremia (P = 0.0003). Myocardial injury was seen in 76% of patients with viremia and 38% of those patients without viremia (P = 0.004). CONCLUSIONS: Hospitalized patients with COVID-19 with SARS-CoV-2 viremia have a significantly higher prevalence of detectable troponin and myocardial injury during their hospitalization compared with patients who did not. This first report of the relationship among SARS-CoV-2 viremia, detectable troponin, and myocardial injury in patients with COVID-19 points to additional mechanistic pathways that require deeper study to understand the complex interplay among these unique findings, cardiovascular outcomes, and mortality in COVID-19.


Subject(s)
COVID-19 , Heart Diseases , Myocardium/metabolism , SARS-CoV-2/isolation & purification , Troponin/blood , Viremia , Age Factors , COVID-19/blood , COVID-19/epidemiology , COVID-19/physiopathology , Cohort Studies , Female , Heart Diseases/blood , Heart Diseases/epidemiology , Heart Diseases/virology , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Prevalence , United States/epidemiology , Viral Load/methods , Viremia/diagnosis , Viremia/epidemiology , Viremia/etiology
8.
Pan Afr Med J ; 36: 188, 2020.
Article in English | MEDLINE | ID: covidwho-771215

ABSTRACT

COVID-19, caused by SARS-CoV-2 is a tester of the immune system. While it spares the healthy, it brings severe morbidity and in a few cases, mortality to its victims. This article aims at critically reviewing the key virulence factors of COVID-19 which are the viremia, cellular oxidation and immune dysfunction. The averse economic effect of certain disease control measures such as national lock-downs and social distancing, though beneficial, makes them unsustainable. Worse still is the fact that wild animals and domestic pets are carriers of SARS-CoV-2 suggesting that the disease would take longer than expected to be eradicated globally. A better understanding of the pathological dynamics of COVID-19 would help the general populace to prepare for possible infection by the invisible enemy. While the world prospects for vaccines and therapeutic agents against the SARS-CoV-2, clinicians should also seek to modulate the immune system for optimum performance. Immunoprophylactic and immunomodulatory strategies are recommended for the different strata of stakeholders combating the pandemic with the hope that morbidities and mortalities associated with COVID-19 would be drastically reduced.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/virology , Immune System/virology , Pneumonia, Viral/virology , Animals , Betacoronavirus/immunology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Humans , Oxidation-Reduction , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , SARS-CoV-2 , Viremia/epidemiology , Viremia/virology
9.
Transfusion ; 60(12): 3046-3054, 2020 12.
Article in English | MEDLINE | ID: covidwho-717337

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel human coronavirus responsible for coronavirus disease 2019 (COVID-19). The emergence of this virus in Wuhan, China, at the end of 2019 and its worldwide spread to reach the pandemic stage has raised concerns about the possible risk that it might be transmissible by transfusion. This theoretical risk is further supported by reports of the detection of viral RNA in the blood of some infected individuals. To further address this risk, a thorough PubMed literature search was performed to systematically identify studies reporting data on the detection of SARS-CoV-2 RNA in blood or its components. Complementary searches were done to identify articles reporting data on the in vitro infectivity of blood components. At least 23 articles presenting data on the detection of SARS-CoV-2 RNA in blood, plasma, or serum were identified. Of these, three studies reported on blood donors with COVID-19 infection identified after donation, and no cases of transfusion transmission were identified. A few studies mentioned results of in vitro infectivity assays of blood components in permissive cell lines, none of which were able to detect infectious virus in blood or its components. Complementary searches have identified reports demonstrating that the correlation between the presence of viral RNA in a biologic sample and infectivity requires a minimal RNA load, which is rarely, if ever, observed in blood components. Overall, the available evidence suggests that the risk of transmission of SARS-CoV-2 by transfusion remains theoretical.


Subject(s)
Blood Donors , Blood Transfusion , COVID-19/transmission , Pandemics , RNA, Viral/blood , SARS-CoV-2/isolation & purification , Transfusion Reaction/epidemiology , Viremia/transmission , CD4-Positive T-Lymphocytes/virology , COVID-19/blood , COVID-19/epidemiology , Cell Line , Endothelial Cells/virology , Humans , SARS-CoV-2/physiology , Viral Load , Viremia/blood , Viremia/epidemiology , Virus Cultivation
10.
G Ital Cardiol (Rome) ; 21(7): 483-488, 2020 Jul.
Article in Italian | MEDLINE | ID: covidwho-611790

ABSTRACT

On March 11, 2020, just after 2 months from the first cases of coronavirus disease 2019 (COVID-19) in China, the Director-General of the World Health Organization stated that COVID-19 has to be considered as a pandemic. Italian doctors were the first protagonists, after the Chinese ones, in the management of this disease. Clinical observations showed that, in addition to the respiratory infection, a systemic inflammatory response occurs, which leads to coagulation disorders and consequent venous thromboembolism as well as other thrombotic complications. We here review the available literature on this issue to better understand the pathophysiological mechanisms of coagulopathy useful to draw future clinical and therapeutic conclusions.


Subject(s)
Blood Coagulation Disorders/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Venous Thromboembolism/epidemiology , Viremia/epidemiology , Anticoagulants/therapeutic use , Blood Coagulation Disorders/drug therapy , Blood Coagulation Disorders/physiopathology , COVID-19 , Cause of Death , Comorbidity , Coronavirus Infections/diagnosis , Female , Humans , Incidence , Italy , Male , Pneumonia, Viral/diagnosis , Risk Assessment , Survival Analysis , Venous Thromboembolism/diagnosis , Venous Thromboembolism/drug therapy , Viremia/diagnosis , World Health Organization
11.
Clin Immunol ; 215: 108410, 2020 06.
Article in English | MEDLINE | ID: covidwho-38673

ABSTRACT

Infection caused by SARS-CoV-2 can result in severe respiratory complications and death. Patients with a compromised immune system are expected to be more susceptible to a severe disease course. In this report we suggest that patients with systemic lupus erythematous might be especially prone to severe COVID-19 independent of their immunosuppressed state from lupus treatment. Specifically, we provide evidence in lupus to suggest hypomethylation and overexpression of ACE2, which is located on the X chromosome and encodes a functional receptor for the SARS-CoV-2 spike glycoprotein. Oxidative stress induced by viral infections exacerbates the DNA methylation defect in lupus, possibly resulting in further ACE2 hypomethylation and enhanced viremia. In addition, demethylation of interferon-regulated genes, NFκB, and key cytokine genes in lupus patients might exacerbate the immune response to SARS-CoV-2 and increase the likelihood of cytokine storm. These arguments suggest that inherent epigenetic dysregulation in lupus might facilitate viral entry, viremia, and an excessive immune response to SARS-CoV-2. Further, maintaining disease remission in lupus patients is critical to prevent a vicious cycle of demethylation and increased oxidative stress, which will exacerbate susceptibility to SARS-CoV-2 infection during the current pandemic. Epigenetic control of the ACE2 gene might be a target for prevention and therapy in COVID-19.


Subject(s)
Coronavirus Infections/genetics , Epigenesis, Genetic , Genetic Predisposition to Disease , Lupus Erythematosus, Systemic/genetics , Pandemics , Peptidyl-Dipeptidase A/genetics , Pneumonia, Viral/genetics , Viremia/genetics , Angiotensin-Converting Enzyme 2 , Betacoronavirus/immunology , Betacoronavirus/pathogenicity , CD11a Antigen/genetics , CD11a Antigen/immunology , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Cytokines/genetics , Cytokines/immunology , DNA Methylation , Disease Progression , Host-Pathogen Interactions/genetics , Host-Pathogen Interactions/immunology , Humans , Interferon Regulatory Factors/genetics , Interferon Regulatory Factors/immunology , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/immunology , NF-kappa B/genetics , NF-kappa B/immunology , Oxidative Stress/genetics , Oxidative Stress/immunology , Peptidyl-Dipeptidase A/immunology , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Protein Binding , Receptors, KIR/genetics , Receptors, KIR/immunology , SARS-CoV-2 , Signal Transduction , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Viremia/complications , Viremia/epidemiology , Viremia/immunology
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