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Current Opinion in Infectious Diseases

Heather Bailey, Anna Turkova, Claire Thorne
PURPOSE OF REVIEW: Eastern Europe and Central Asia (EECA) has experienced large-scale epidemics of syphilis, hepatitis C virus (HCV) and HIV over the past few decades. Here, we review recent evidence on the epidemiology of and the response to these intersecting epidemics. RECENT FINDINGS: The HIV epidemic in EECA continues to expand, with new infections increasing by more than 50% between 2010 and 2015. HCV is now in the top 10 causes of death in EECA, with Russia accounting for more than half of the global burden of HCV infections, but access to direct-acting antivirals remains a major obstacle for control of the epidemic...
October 15, 2016: Current Opinion in Infectious Diseases
Engi F Attia, Robert F Miller, Rashida A Ferrand
PURPOSE OF REVIEW: The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV. RECENT FINDINGS: There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live...
October 7, 2016: Current Opinion in Infectious Diseases
Jessica Martin, Mark Wilcox
PURPOSE OF REVIEW: Clostridium difficile infection has attained high prominence given its prevalence and impacts on patients and healthcare institutions. Multiple new approaches to the prevention and treatment of C. difficile infection (CDI) are undergoing clinical trials. RECENT FINDINGS: Bezlotoxumab is a monoclonal antibody against toxin B that has successfully completed phase III studies, demonstrating a significant reduction in recurrent CDI when given with standard of care antibiotics...
October 7, 2016: Current Opinion in Infectious Diseases
Natali Abeywickrama-Samarakoon, Jean-Claude Cortay, Paul Dény
PURPOSE OF REVIEW: To highlight new concepts and therapeutic approaches concerning hepatitis D virus (HDV) infection. RECENT FINDINGS: Common receptor for hepatitis B virus (HBV) and HDV has been elucidated, deciphering of HDV replication is still in progress, preliminary results of phase II proof-of-concept clinical assays for entry inhibitors and cellular farnesyl transferase inhibitors are now available. SUMMARY: Hepatitis D infection remains a severe acute and chronic liver illness with the only currently approved therapy (Peg-αIFN) achieving disappointingly low rates of sustained viral response and clinical improvement...
October 7, 2016: Current Opinion in Infectious Diseases
Katherine C Konvinse, Elizabeth J Phillips, Katie D White, Jason A Trubiano
PURPOSE OF REVIEW: Antimicrobials are a leading cause of severe T cell-mediated adverse drug reactions (ADRs). The purpose of this review is to address the current understanding of antimicrobial cross-reactivity and the ready availability of and evidence for in-vitro, in-vivo, and ex-vivo diagnostics for T cell-mediated ADRs. RECENT FINDINGS: Recent literature has evaluated the efficacy of traditional antibiotic allergy management, including patch testing, skin prick testing, intradermal testing, and oral challenge...
October 7, 2016: Current Opinion in Infectious Diseases
Christopher E Jones, Áine McKnight
PURPOSE OF REVIEW: The present review will discuss recent advances in the development of anti-HIV therapies inspired by studies of the mechanisms of host restriction factor-mediated resistance to HIV infection. RECENT FINDINGS: Manipulating the interplay between host cell restriction factors and viral accessory factors that overcome them can potentially be therapeutically useful. Preliminarily successful therapies - some of which are entering clinical trials - either inhibit the ability of virus to evade restriction factor-mediated immunity, or promote intracellular levels of restriction factors...
October 5, 2016: Current Opinion in Infectious Diseases
Jiaqian Pan, Shuangmei Tong, Lei Kang, Jing Tang
PURPOSE OF REVIEW: Although available therapies can effectively inhibit hepatitis B virus (HBV) replication in patients with active chronic hepatitis B (CHB) infection, therapeutic efficacy is limited because of potential drug resistance, and an inability to mediate viral clearance and to rectify immune impairment in CHB patients. This review will summarize the state-of-the-art for anti-HBV drugs and focus on potential drugs and targets under development and evaluation. RECENT FINDINGS: New developing drugs are evaluated for their antiviral effects in the areas of interference with the viral replication cycle, elimination of closed circular DNA, modulation of host immunity and identification of the La protein and its regulator casein kinase as possible targets for the development of anti-HBV therapies...
September 26, 2016: Current Opinion in Infectious Diseases
Daniel M Forton
PURPOSE OF REVIEW: Directly acting antiviral drug (DAA) treatments represent a major advance in hepatitis C management, achieving virological cures in excess of 90%. When treatment failure occurs, it is mostly due to relapse with the emergence of resistance-associated variants. RECENT FINDINGS: Data from in-vitro studies and clinical trials have enabled characterization of the amino acid substitutions in antiviral drug targets that confer reduced susceptibility to DAAs...
September 26, 2016: Current Opinion in Infectious Diseases
William D Rawlinson, Stuart T Hamilton, Wendy J van Zuylen
PURPOSE OF REVIEW: The purpose of review is to assess the recent studies of therapy of pregnant women and neonates, aimed at preventing the consequences of congenital cytomegalovirus (CMV) infection. RECENT FINDINGS: A recent randomized controlled trial of treatment of CMV during pregnancy with hyperimmune globulin did not show significant efficacy in prevention of foetal infection and morbidity, although there was a trend towards improvement with treatment. Trials of antiviral therapy of the mother during pregnancy have involved small numbers only, confounded by ethical and practical difficulties, and further studies are needed to demonstrate whether or not antivirals are useful and well tolerated in this setting...
September 7, 2016: Current Opinion in Infectious Diseases
Christina C Chang, John R Perfect
PURPOSE OF REVIEW: Overall, 50-70% of patients with cryptococcal meningitis have raised intracranial pressure (ICP). Multiple international treatment guidelines recommend repeated therapeutic lumbar punctures as adjunctive management. Here, we review the recent evidence for the role of repeated lumbar punctures on clinical outcome in cryptococcal meningitis and also review the increasing body of data utilizing these repeated cerebrospinal fluid (CSF) samples as a window into understanding immunopathogenesis of cryptococcal meningitis...
September 6, 2016: Current Opinion in Infectious Diseases
Harry R Dalton, Nassim Kamar
PURPOSE OF REVIEW: Over the last 10 years, it has become apparent that hepatitis E virus (HEV) is a pathogen of global significance. In contrast to HEV in the developing world, HEV in developed countries is caused by HEV genotypes 3 and 4, which are enzoonotic with a porcine primary host and cause both acute and chronic infection. Chronic infection occurs in the immunosuppressed, including transplant recipients, and untreated can cause rapidly progressive cirrhosis. RECENT FINDINGS: Ribavirin has been used successfully to treat acute hepatitis E in high-risk patients...
September 6, 2016: Current Opinion in Infectious Diseases
David U Olveda, Donald P McManus, Allen G P Ross
PURPOSE OF REVIEW: Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. Despite the well known short-term benefits of treating patients for schistosomiasis, the impact of mass drug administration (MDA) campaigns to control the disease in the long term remains unresolved. RECENT FINDINGS: Many studies have advocated the success of MDA programs in order to attract donor funds for elimination efforts but such successes are often short-lived given the drug does not alter the life cycle of the organism or prevent reinfection...
August 31, 2016: Current Opinion in Infectious Diseases
Heather Isenman, Dale Fisher
PURPOSE OF REVIEW: This article reviews data, particularly from the last 2 years, addressing the prevention and treatment of vancomycin-resistant Enterococcus (VRE). We focus on infection control, particularly active screening, use of contact precautions as well as pharmacologic options for therapy. This is timely given the evolving priorities in efforts towards the prevention and treatment of multidrug-resistant organisms globally. RECENT FINDINGS: Key findings include new data regarding the impact of contact precautions on the incidence of VRE colonization and bloodstream infection, new laboratory screening methods, and novel decolonization strategies and treatments...
August 31, 2016: Current Opinion in Infectious Diseases
Gökhan Metan, Murat Akova
PURPOSE OF REVIEW: Carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide challenge and associated with a high mortality rate in critically ill patients. This review focused on rapid diagnosis, optimization of antimicrobial therapy, and implication of effective infection control precautions to reduce impact of CRE on vulnerable patients. RECENT FINDINGS: Several new diagnostic assays have recently been described for the early diagnosis of CRE. Retrospective studies are supportive for colistin plus meropenem combination for the treatment of CRE infections; however, solid evidence is still lacking...
August 31, 2016: Current Opinion in Infectious Diseases
Matteo Bassetti, Maddalena Peghin, Davide Pecori
PURPOSE OF REVIEW: Multidrug-resistant (MDR) Enterobacteriaceae are often related to the production of extended-spectrum β-lactamases (ESBLs) and carbapenemases. ESBL and carbapenemase-producing Enterobacteriaceae (CRE), in particular, represent an increasing global threat. Recommendations for the therapeutic management of MDR-related infections, however, are mainly derived from retrospective and nonrandomized prospective studies. The aim of this review is to discuss the challenges in the treatment of patients with infections because of MDR Enterobacteriaceae and provide an expert opinion while awaiting for more definitive data...
August 31, 2016: Current Opinion in Infectious Diseases
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No abstract text is available yet for this article.
October 2016: Current Opinion in Infectious Diseases
Gagandeep Kang, A Clinton White
No abstract text is available yet for this article.
October 2016: Current Opinion in Infectious Diseases
Bhabatosh Das, Gururaja P Pazhani, Anirban Sarkar, Asish K Mukhopadhyay, G Balakrish Nair, Thandavarayan Ramamurthy
PURPOSE OF REVIEW: The purpose of this review is to synopsize and highlight the recent subtle genetic changes in cholera causing toxigenic Vibrio cholerae with special reference to their virulence, integrating and conjugative elements and toxin-antitoxin systems. It is not intended to cover issues on the whole genome sequence and epidemiology of cholera. RECENT FINDINGS: Analyses have been made using major published works on genetic changes associated with potential virulence, integrating and conjugative elements and toxin-antitoxin systems of toxigenic V...
October 2016: Current Opinion in Infectious Diseases
Jesse J Waggoner, Benjamin A Pinsky
PURPOSE OF REVIEW: The definitive diagnosis of leptospirosis, which results from infection with spirochetes of the genus Leptospira, currently relies on the use of culture, serological testing (microscopic agglutination testing), and molecular detection. The purpose of this review is to describe new molecular diagnostics for Leptospira and discuss advancements in the use of available methods. RECENT FINDINGS: Efforts have been focused on improving the clinical sensitivity of Leptospira detection using molecular methods...
October 2016: Current Opinion in Infectious Diseases
Guilherme Amaral Calvet, Flavia Barreto Dos Santos, Patricia Carvalho Sequeira
PURPOSE OF REVIEW: Zika virus (ZIKV) is an arbovirus previously believed to cause only a mild and self-limiting illness. Recently, it has emerged as a new public health threat that caused a large outbreak in French Polynesia in 2013-2014 and since 2015 an explosive outbreak in Brazil, with an increase in severe congenital malformations (microcephaly) and neurological complications, mainly Guillain-Barré syndrome (GBS). Since then, it has spread through the Americas. On 1 February 2016, the WHO declared the ZIKV epidemic in Brazil a Public Health Emergency of International Concern...
October 2016: Current Opinion in Infectious Diseases
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