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Guidelines for the management of patients with invasive fungal infections have recently been defined. In a short overview, the role of systemic antifungals in prophylaxis and therapy of invasive candidiasis and aspergillosis are reviewed. [ABSTRACT FROM AUTHOR]

Viral hepatitis affects millions of people worldwide, with host immunity deciding on the outcome of infection. In patients with haematological malignancies or recipients of haematopoietic stem cells the virus may cause life-threatening complications either due to the virus itself or to the need to interrupt or reduce the chemotherapy. The infected haematopoietic stem cell donor can also transmit viral hepatitis. Knowing complete HBV (hepatitis B virus) serostatus is essential for the right choice of treatment, prophylaxis or pre-emptive approach. Recent recommendations favour treatment using molecules with a high barrier to resistance. In HCV infection, administration of new, direct-acting antiviral agents (DAA), is safe in haematological patients. The use of DAAs in first line is recommended, either as a single treatment for indolent lymphomas or in combination with chemotherapy for aggressive lymphomas. Due to the existing risk of chronic hepatitis E in immunocompromised patients, marker screening should be performed if there are signs and symptoms of hepatitis. In the case of HEV infection, reduction in immunosuppression is recommended and if not possible or unsuccessful, treatment with ribavirin may be considered. Hepatitis A does not progress to chronicity but may be more severe in elderly and immunocompromised patients with risk of hepatic failure. The CELL (Czech Leukaemia Study Group - for Life) Working Group for the Treatment of Opportunistic Infections recommends that all patients undergo screening for hepatotropic viruses before haematological treatment and that patients or donors of haematopoietic stem cells with markers of previous or current viral hepatitis should be consulted with specialists (infectious disease specialist/hepatologists). The screening, vaccination and treatment guidelines outlined here were presented and discussed at the CELL workshop in Brno in May 2018. [ABSTRACT FROM AUTHOR]

Background Influenza causes substantial morbidity and annual vaccination is the most important prevention strategy. Accurately measuring vaccine effectiveness (VE) is difficult. The clinical syndrome most closely associated with influenza virus infection, influenza-like illness (ILI), is not specific. In addition, laboratory confirmation is infrequently done, and available rapid diagnostic tests are imperfect. The objective of this study was to estimate the joint impact of rapid diagnostic test sensitivity and specificity on VE for three types of study designs: a cohort study, a traditional case-control study, and a case-control study that used as controls individuals with ILI who tested negative for influenza virus infection. Methods We developed a mathematical model with five input parameters: true VE, attack rates (ARs) of influenza-ILI and non-influenza-ILI and the sensitivity and specificity of the diagnostic test. Results With imperfect specificity, estimates from all three designs tended to underestimate true VE, but were similar except if fairly extreme inputs were used. Only if test specificity was 95% or more or if influenza attack rates doubled that of background illness did the case-control method slightly overestimate VE. The case-control method usually produced the highest and most accurate estimates, followed by the test-negative design. The bias toward underestimating true VE introduced by low test specificity increased as the AR of influenza- relative to non-influenza-ILI decreases and, to a lesser degree, with lower test sensitivity. Conclusions Demonstration of a high influenza VE using tests with imperfect sensitivity and specificity should provide reassurance that the program has been effective in reducing influenza illnesses, assuming adequate control of confounding factors. [ABSTRACT FROM AUTHOR]