January 1, 2008

In the IDSA Journals

Promising Results of EBV Vaccine Trial

A vaccine against Epstein-Barr virus (EBV) reduced the incidence of infective mononucleosis in a Phase II trial in Belgium. Ten percent of the control group developed symptomatic infections, compared to 2 percent of those receiving the vaccine. (Sokal et al., J Infect Dis. 2007;196:1749–1753.) 

Panton-Valentine Leukocidin Production by MRSA

Because most community-acquired strains of methicillin-resistant Staphylococcus aureus (MRSA) causing necrotizing infection carry the genes for Panton-Valentine leukocidin, it has been theorized that this toxin plays an important role in the severity of the infection. A total of 31 strains of community-associated S. aureus obtained from patients with severe infections were analyzed; 29 of them produced Panton-Valentine leukocidin. The quantity of Panton-Valentine leukocidin produced in vitro did not correlate with the severity of infection. Thus, Panton-Valentine leukocidin may not be a key determinant of the severity of infection. (Hamilton et al., Clin Infect Dis. 2007;45:1550–1558.)  

Prenatal HIV screening in Alberta, Canada

In Alberta, Canada, all pregnant women are tested for HIV infection unless they specifically decline. In this study, anonymous serum samples obtained from women who had opted out of HIV testing were tested for the presence of HIV, demographic characteristics, and HIV seroprevalence. The results were compared with  those patients who agreed to HIV testing. Those individuals who opted out of HIV testing were older and had higher gravidity and parity. They were 3.3 times more likely to be HIV positive than were women who agreed to be tested. The proportion of women who opted out of HIV testing decreased over the course of the study, from 4.3 percent in 2002 to 3.6 percent in 2004. (Plitt et al., Clin Infect Dis. 2007;45:1640–1643.)

The December 1 issues of The Journal of Infectious Diseases (JID) and Clinical Infectious Diseases (CID) joined more than 230 journals from 37 countries in publishing articles on the theme of global poverty and human development. The articles were published online in October as part of an initiative led by the Council of Science Editors. JID and CID articles included:

Lopinavir-ritonavir therapy reduces HIV levels in CSF

Combination antiretroviral therapy may fail to completely suppress HIV replication in the brain, which can lead to HIV-associated neurocognitive disorders. This study tested whether treatment with lopinavir-ritonavir reduced HIV RNA levels in CSF when used by itself. Use of the two drugs alone for 3 weeks reduced HIV RNA levels in CSF by at least 10-fold in most individuals. By week 24 of the study, HIV RNA levels were below quantitation in CSF and plasma for all subjects. (Letendre et al., Clin Infect Dis. 2007;45:1511–1517.)

Maternal Intermittent Preventive Treatment of Malaria—How Often?

A study looking at malaria prevention for HIV-positive pregnant women in Zambia found that two doses of sulfadoxine-pyrimethamine given in the last two trimesters was just as effective  as monthly treatment during this period. (Hamer et al., J Infect Dis. 2007;196:1585–1594.) However, a companion study found 15 percent of mothers scheduled to receive two doses in fact received only one, and these women had significantly poorer outcomes. The authors recommend monthly treatment to ensure mothers receive at least two doses. (Gill et al., J Infect Dis. 2007;196:1577–1584.)  

JID also featured a supplement titled, “The Realities of Antiretroviral Therapy Rollout: Challenges to Successful Programmatic Implementation,” dealing with issues in southern Africa and including articles on HIV and tuberculosis coinfection and program integration, improving access to antiretrovirals and perspectives from front-line caregivers.

For a review of other recent research in the infectious diseases literature, see “In the Literature,” by Stanley Deresinski, MD, in each issue of Clinical Infectious Diseases.

December 1:

  • Halfway to 2015—But Less than Halfway to the Millennium Targets
  • Breast-Feeding and HIV Transmission
  • Predictable but Unintended Consequences: Dams and Malaria
  • Human Papillomavirus (HPV) and Cervical Cancer in Lesser Resourced Countries
  • Hepatitis B Virus (HBV) Control in China

 December 15:

  • Can We Prevent Linezolid-associated Anemia and Thrombocytopenia?
  • Projecting Bacteria into Space
  • Not All Transmissible Diseases Are Infectious—The Devil Knows

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