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A less than one-month-old infant with symptoms of rhinitis died unexpectedly in his sleep. He was not born prematurely and had no known underlying disease. Cerebrospinal fluid, nasopharyngeal and lung samples, and rectal swab were found to be positive for subgroup A rhinovirus, while the blood was negative. This case highlights the important finding that the rhinovirus, a common pathogen associated with upper respiratory tract infections, can sometimes, as the only pathogen, lead to complications such as a cerebrospinal infection and be involved in the sudden infant death syndrome (SIDS). Vigilance is necessary in case of viral infections in the infant's environment, and measures of hygiene and protection must be encouraged in order to reduce the risk of the SIDS. [ABSTRACT FROM AUTHOR]

Seoul virus (SEOV), a hantavirus and the etiologic agent of a mild-to-moderate hemorrhagic fever with a renal syndrome, is associated worldwide with brown rats (Rattus norvegicus), a commensal rodent that [...]

The LDL receptor (LDL-R) has been proposed as the viral receptor for Hepatitis C virus (HCV). This hypothesis has been based exclusively on in vitro studies. In human mononuclear cells, LDL-R gene expression has been demonstrated to be parallel and be coordinately regulated to gene expression in the human liver. The purpose of the current study was to determine the mononuclear cell surface expression of the LDL receptor in patients with HCV chronic infection according to viral load. Sixty-eight consecutive untreated chronic hepatitis C patients were studied to determine the mononuclear cell surface expression of the LDL-R. LDL-Rs were quantified at the surface of mononuclear cells in fresh blood samples taken after fasting using flow cytometry. LDL-R expression was significantly associated with LDL-cholesterol (r = -0.25; P = 0.03) and HCV-viral load (r = 0.37, P = 0.002). In multivariate analysis, the LDL-R expression was significantly associated with HCV viral load, whereas genotype, age, body mass index, and fibrosis were not. In conclusion, our data provided by a human study, suggest that the LDL-R may be one of the receptors implicated in HCV replication. fibrosis; lipoproteins; cytometry doi:10.1152/ajpendo.00091.2007

Thrombotic manifestations are a hallmark of many auto-immune diseases (AID), specially of warm autoimmune hemolytic anemia (wAIHA), as 15 to 33% of adults with wAIHA experience venous thromboembolic events (VTE). However, beyond the presence of positive antiphospholipid antibodies and splenectomy, risk factors for developing a VTE during wAIHA have not been clearly identified. The aim of this retrospective study was to characterize VTEs during wAIHA and to identify risk factors for VTE. Forty-eight patients with wAIHA were included, among whom 26 (54%) had secondary wAIHA. Eleven (23%) patients presented at least one VTE, that occurred during an active phase of the disease for 10/11 patients (90%). The frequency of VTE was not different between primary and secondary AIHA (23.7 vs. 19.2%; p = 0.5). The Padua prediction score based on traditional risk factors was not different between patients with and without VTE. On multivariate analysis, total bilirubin ≥ 40 μmol/L [odds ratio (OR) = 7.4; p = 0.02] and leucocyte count above 7x109/L (OR = 15.7; p = 0.02) were significantly associated with a higher risk of thrombosis. Antiphospholipid antibodies were screened in 9 out the 11 patients who presented a VTE and were negative. Thus, the frequency of VTE is high (23%) during wAIHA and VTE preferentially occur within the first weeks of diagnosis. As no clinically relevant predictive factors of VTE could be identified, the systematic use of a prophylactic anticoagulation should be recommended in case of active hemolysis and its maintenance after hospital discharge should be considered. The benefit of a systematic screening for VTE and its procedure remain to be determined. [ABSTRACT FROM AUTHOR]

Background: The emergence of new strains in RNA viruses is mainly due to mutations or intra and inter-genotype homologous recombination. Non-homologous recombinations may be deleterious and are rarely detected. In previous studies, we identified HCV-1b strains bearing two tandemly repeated V3 regions in the NS5A gene without ORF disruption. This polymorphism may be associated with an unfavorable course of liver disease and possibly involved in liver carcinogenesis. Here we aimed at characterizing the origin of these mutant strains and identifying the evolutionary mechanism on which the V3 duplication relies. Methods: Direct sequencing of the entire NS5A and E1 genes was performed on 27 mutant strains. Quasispecies analyses in consecutive samples were also performed by cloning and sequencing the NS5A gene for all mutant and wild strains. We analyzed the mutant and wild-type sequence polymorphisms using Bayesian methods to infer the evolutionary history of and the molecular mechanism leading to the duplication-like event. Results: Quasispecies were entirely composed of exclusively mutant or wild-type strains respectively. Mutant quasispecies were found to have been present since contamination and had persisted for at least 10 years. This V3 duplication-like event appears to have resulted from non-homologous recombination between HCV-1b wild-type strains around 100 years ago. The association between increased liver disease severity and these HCV-1b mutants may explain their persistence in chronically infected patients. Conclusions: These results emphasize the possible consequences of non-homologous recombination in the emergence and severity of new viral diseases. [ABSTRACT FROM AUTHOR]

In the autumn of 2020, a short-lived epidemic of a spike del69-70 deletion variant of SARS-CoV-2 was identified, with most cases (n = 95) found in Montceau-les-Mines, France. This spike gene target failure (SGTF) variant spread quickly in nursing homes. The Alpha variant, which also harbors this deletion, appeared in Burgundy in January 2021 after the disappearance of the Montceau-les-Mines del69-70 variant. Our findings illustrate the risk of the fast spread of geographically isolated variants and reinforce the need for the continuous tracking of outbreaks. In some cases, these studies may reveal emerging variants that affect public health or vaccine development. [ABSTRACT FROM AUTHOR]

Little is known about the epidemiology of Aichi virus, which is a new member of the family Picornaviridae, in the genus Kobuvirus. We report here on seroprevalence in France. Sera were screened using an enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G. Of 972 sera tested, seroprevalence ranged from 25% for the 7-month-to-9-year-old age group to about 85% for the 30-to-39-year-old age group and older age groups. Our ELISA correlated well with the microneutralization technique. This study shows that Aichi virus is quite frequent in France and that seroconversion occurs before the age of 40. [ABSTRACT FROM AUTHOR]

The LDL receptor (LDL-R) has been proposed as the viral receptor for Hepatitis C virus (HCV). This hypothesis has been based exclusively on in vitro studies. In human mononuclear cells, LDL-R gene expression has been demonstrated to be parallel and be coordinately regulated to gene expression in the human liver. The purpose !f the current study was to determine the mononuclear cell surface expression of the LDL receptor in patients with HCV chronic infection according to viral load. Sixty-eight consecutive untreated chronic hepatitis C patients were studied to determine the mononuclear cell surface expression of the LDL-R. LDL-Rs were quantified at the surface of mononuclear cells in fresh blood samples taken after fasting using flow cytometry. LDL-R expression was significantly associated with LDL-cholesterol (r = -0.25; P = 0.03) and HCV-viral load (r = 0.37, P = 0.002). In multivariate analysis, the LDL-R expression was significantly associated with HCV viral load, whereas genotype, age, body mass index, and fibrosis were not. In conclusion, our data provided by a human study, suggest that the LDL-R may be one of the receptors implicated in HCV replication. [ABSTRACT FROM AUTHOR]

Objectives: A prospective study was performed to assess the intermediate and long-term efficacy of intralesional cidofovir therapy associated with surgical excision in laryngeal papillomatosis in adults. Methods: Endoscopy with intralesional injection of cidofovir 5 mg/mL was performed 3 times at 4-week intervals. The concentration was later increased to 7.5 mg/mL and the interval between injections shortened to 2 weeks. Further treatment was performed at 3 or 6 months, depending on the evolution of the papillomas. After complete remission, the treatment was stopped and the patients were reviewed every 6 months. Results: Nineteen patients completed the protocol, with a mean of 4.5 injections each. Complete remission was obtained in 17 cases (89%) after a mean of 3.8 procedures. Remission was stable after a mean follow-up of 24 months (range, 8 to 57 months). With higher cidofovir concentrations at shorter intervals, patients needed fewer injections to achieve remission (mean, 2.1 versus 4.7 injections). Conclusions: The effectiveness of intralesional cidofovir therapy in adult-onset recurrent respiratory papillomatosis was impressive. Once obtained, complete remission was stable on intermediate or long-term follow-up. The concentration and the interval between injections seemed to influence the number of injections necessary to achieve remission. [ABSTRACT FROM AUTHOR]

Background: Although immune modulation is a promising therapeutic avenue in coronavirus disease 2019 (COVID-19), the most relevant targets remain to be found. COVID-19 has peculiar characteristics and outcomes, suggesting a unique immunopathogenesis.Methods: Thirty-six immunocompetent non-COVID-19 and 27 COVID-19 patients with severe pneumonia were prospectively enrolled in a single center, most requiring intensive care. Clinical and biological characteristics (including T cell phenotype and function and plasma concentrations of 30 cytokines) and outcomes were compared.Results: At similar baseline respiratory severity, COVID-19 patients required mechanical ventilation for significantly longer than non-COVID-19 patients (15 [7-22] vs. 4 (0-15) days; p = 0.0049). COVID-19 patients had lower levels of most classical inflammatory cytokines (G-CSF, CCL20, IL-1β, IL-2, IL-6, IL-8, IL-15, TNF-α, TGF-β), but higher plasma concentrations of CXCL10, GM-CSF and CCL5, compared to non-COVID-19 patients. COVID-19 patients displayed similar T-cell exhaustion to non-COVID-19 patients, but with a more unbalanced inflammatory/anti-inflammatory cytokine response (IL-6/IL-10 and TNF-α/IL-10 ratios). Principal component analysis identified two main patterns, with a clear distinction between non-COVID-19 and COVID-19 patients. Multivariate regression analysis confirmed that GM-CSF, CXCL10 and IL-10 levels were independently associated with the duration of mechanical ventilation.Conclusion: We identified a unique cytokine response, with higher plasma GM-CSF and CXCL10 in COVID-19 patients that were independently associated with the longer duration of mechanical ventilation. These cytokines could represent the dysregulated immune response in severe COVID-19, as well as promising therapeutic targets. ClinicalTrials.gov: NCT03505281. [ABSTRACT FROM AUTHOR]

Hypoxemic pneumonia in AIDS patients is mainly caused by Pneumocystis carinii, Toxoplasma gondii and CMV, although the significance of CMV recovery in BALF is often unclear. Since lung involvement generally occurs during reactivation, T. gondii is not expected to be demonstrated in patients without evidence of past infection with this agent. We report a fatal case of pneumonia revealing a T. gondii primary infection diagnosed thanks to the PCR analysis of the BALF. [ABSTRACT FROM AUTHOR]

This meta -analysis aimed to estimate the prevalence of human metapneumovirus (hMPV) infections in patients hospitalized for acute respiratory infection (ARI) and to study factors associated with this prevalence. Medline and ScienceDirect databases were searched for prospective observational studies that screened hospitalized patients with ARI for hMPV by RT-PCR, with data available at December 27, 2014. The risk of bias was assessed regarding participation rate, definition of ARI, description of diagnostic technique, method of inclusion identical for all subjects, standardized and identical sampling method for all subjects, analysis performed according to the relevant subgroups, and presentation of data sources. Random-effect meta -analysis with arcsine transformation and meta -regressions was used. In the 75 articles included, the prevalence of hMPV among hospitalized ARI was 6.24% (95% CI 5.25–7.30). An effect of the duration of the inclusion period was observed (p = 0.0114), with a higher prevalence of hMPV in studies conducted during periods of 7–11 months (10.56%, 95% CI 5.97–16.27) or complete years (7.55%, 95% CI 5.90–9.38) than in periods of 6 months or less (5.36%, 95% CI 4.29–6.54). A significant increase in the incidence with increasing distance from the equator was observed (p = 0.0384). hMPV should be taken into account as a possible etiology in hospitalized ARI. [ABSTRACT FROM AUTHOR]

Objective. – To evaluate the diagnosis value of systematic serological testing for Lyme borreliosis in patients with recent-onset inflammatory joint disease, in a non-endemic area.Methods. – Inclusion of patients hospitalised in a French rheumatology department for recent-oncet (disease duration < 1 year) inflammatory joint disease, and living in a non-endemic area. For all patients, a careful medical history, including tick bite and erythema migrans, physical examination, electrocardiogram, and detection of serum antibodies to Borrelia burgdorferi (ELISA) were obtained.Results. – Ninety patients (39 men, 51 women, mean age = 48.1 years ± 17.9, mean disease duration = 4.3 months ± 4.3) were included. A tick bite was reported in one patient (1.1%), and erythema migrans in none. ELISA serological testing for Bb was negative in all cases.Conclusion. – These results suggest that screening for Lyme disease cannot be recommended in patients with early-onset inflammatory joint disease, living in a non-endemic area and with no clinical history suggestive of Lyme arthritis. Similar studies on larger populations are needed to confirm this conclusion. [Copyright &y& Elsevier]

Objective. – To evaluate the diagnostic usefulness of routine Lyme serology in patients who live in nonendemic areas and present with early inflammatory joint disease.Methods. – All patients admitted to a rheumatology department of a nonendemic area of France for evaluation of joint disease with onset within the last year. The evaluation included a medical history, a thorough physical examination, an electrocardiogram, and an ELISA for antibodies to Borrelia burgdorferi.Results. – We included 90 patients, 51 women and 39 men, with a mean age of 48.1 ± 17.9 years. Mean duration of joint symptoms was 4.3 ± 4.3 months, with a median of 3 months. A patient (1.1%) reported a tick bite and no patients had a history of erythema migrans. Lyme serology was negative in all 90 patients.Conclusion. – These results do not support routine Lyme serology in patients living in nonendemic areas and presenting with early inflammatory joint disease. However, Lyme serology remains appropriate in patients with features suggestive of Lyme disease. Given that Lyme disease is amenable to curative treatment, a larger study is in order to confirm our findings. [Copyright &y& Elsevier]

Background/Aims: The evolution of hepatitis B virus (HBV) serological patterns and the clinical relevance of isolated anti-HBc pattern are not well established in HIV infected patients.Methods: A cohort of 240 patients was followed for 6.9±3.4 years, with iterative HBV serologic assays performed (mean interval of 2.2 years).Results: Five patients without HBV markers at baseline subsequently developed positive anti-HBs (incidence 0.66/100 patient-year), as did two patients with chronic HBs antigenemia (incidence 1.66/100 patient-year). Only one patient with isolated anti-HBc pattern developed HBs chronic antigenemia. Persistent isolated anti-HBc pattern was observed in 37 patients (13 with detectable blood HBV DNA) and was strongly associated with positive hepatitis C virus (HCV) viremia (hazard ratio=9.5, confidence interval 95%: 4.5–20.0, P<0.0001). Hepatic lesions were more severe in HCV infected patients with persistent isolated anti-HBc pattern than in those without (Knodell score 9.2±4.6 versus 6.7±5.0, P=0.04). In time updated analysis, this pattern was not associated with an increased risk of hepatotoxicity, by contrast with HCV infection or positive HBs antigenemia.Conclusions: In HIV infected patients, HBV serological status must be systematically and regularly assessed, and systematic HBV vaccination must be proposed in those without HBV marker. Isolated anti-HBc pattern must be considered in the management of hepatitis C, but not for antiretroviral therapy. [Copyright &y& Elsevier]