Borne Viruses Research Articles

Opt-out HIV screening in adults attending the Emergency Department of a London teaching hospital

BackgroundOpt-out Emergency Department blood borne virus (EDBBV) screening was introduced at the Royal Free Hospital under the NHSEI (NHS England and NHS Improvement) programme to expand opt-out testing in local authority areas with high HIV prevalence. This initiative was part of the “Toward Zero” policy towards ending HIV transmission in England by 2030. MethodsAll patients attending the Royal Free Hospital Emergency Department (ED) aged 16 and over were screened for blood borne viruses (HIV/HBV/HCV) unless they opted out. We looked at HIV data from patients seen in ED between the initiation of EDBBV testing on the 12th of April and 12th of August 2022. Hepatitis B and C data was reviewed in a separate study. OutcomeA total of 12,208 samples from 10,641 patients were screened for HIV. Amongst these samples there were 88 which were positive, giving a seroprevalence of 0.84%. There were 48 patients who were already known to local HIV services, 35 were known to HIV services outside of our trust and 5 were new diagnoses. ConclusionOur results confirmed our local HIV prevalence to be very high as per the UK Health Security Agency and supports the need for HIV testing. Opt-out ED BBV screening has been a highly effective method for identifying people living with HIV who are unaware of their status.

Development of simplex and quintuplex RT-PCR for simultaneous detection of soybean viruses

Five simplex and a multiplex-RT-PCR (m-RT-PCR) protocols were developed for detection and differentiation of bean pod mottle virus (BPMV), cherry leaf roll virus (CLRV), raspberry ringspot virus (RpRSV), soybean mosaic virus (SMV) and tomato ringspot virus (ToRSV) infecting soybean. The simplex RT-PCR protocols produced virus-specific amplicons of 538 bp for BPMV, 139 bp for CLRV, 298 bp for RpRSV, 403 bp for SMV, and 282 bp for ToRSV, with sensitivity down to 10−4 diluted cDNA. Further, to detect all the five viruses simultaneously in a single tube a quintuplex RT-PCR protocol was optimized with as low as 10−3 diluted cDNA and 0.05 µM primer. To validate the reliability of the simplex RT-PCR protocol, imported soybean samples were tested by ELISA as well as RT-PCR. The results revealed that the developed protocol could detect the viruses in imported soybean, and found to be efficient than ELISA in resolving ambiguity in detection of seed borne viruses. The developed simplex and quintuplex RT-PCR protocol will be quite helpful for the diagnosis of soybean germplasm co-infected with viruses during the quarantine processing for ensuring virus free long term seed conservation in the National Gene Bank as well as for quarantine certification.

Overdose prevention centres as spaces of safety, trust and inclusion: A causal pathway based on a realist review.

Overdose prevention centres (OPC) are non-residential spaces where people can use illicit drugs (that they have obtained elsewhere) in the presence of staff who can intervene to prevent and manage any overdoses that occur. Many reviews of OPCs exist but they do not explain how OPCs work. We carried out a realist review, using the RAMESES reporting standards. We systematically searched for and then thematically analysed 391 documents that provide information on the contexts, mechanisms and outcomes of OPCs. Our retroductive analysis identified a causal pathway that highlights the feeling of safety - and the immediate outcome of not dying - as conditions of possibility for the people who use OPCs to build trust and experience social inclusion. The combination of safety, trust and social inclusion that is triggered by OPCs can - depending on the contexts in which they operate - generate other positive outcomes, which may include less risky drug use practices, reductions in blood borne viruses and injection-related infections and wounds, and access to housing. These outcomes are contingent on relevant contexts, including political and legal environments, which differ for women and people from racialised minorities. OPCs can enable people who live with structural violence and vulnerability to develop feelings of safety and trust that help them stay alive and to build longer term trajectories of social inclusion, with potential to improve other aspects of their health and living conditions.

Analysing HCV incidence trends in people who inject drugs using serial behavioural and seroprevalence data: A modelling study

IntroductionThe introduction of new direct-acting antivirals for hepatitis C virus (HCV) infection, has enabled the formulation of a HCV elimination strategy led by the World Health Organisation (WHO). Guidelines for elimination of HCV target a reduction in incidence, but this is difficult to measure and needs estimating. MethodsSerial cross-sectional bio-behavioural sero-surveys provide information on an individual's infection status and duration of exposure and how these change over time. These data can be used to estimate the rate of first infection through appropriate statistical models. This study utilised updated HCV seroprevalence information from the Unlinked Anonymous Monitoring survey, an annual survey of England, Wales and Northern Ireland monitoring the prevalence of blood borne viruses in people who inject drugs. Flexible parametric and semiparametric approaches, including fractional polynomials and splines, for estimating incidence rates by exposure time and survey year were implemented and compared. ResultsIncidence rates were shown to peak in those recently initiating injecting drug use at approximately 0.20 infections per person-year followed by a rapid reduction in the subsequent few years of injecting to approximately 0.05 infections per person-year. There was evidence of a rise in incidence rates for recent initiates between 2011 and 2020 from 0.17 infections per person-year (95 % CI, 0.16–0.19) to 0.26 infections per person-year (0.23–0.30). In those injecting for longer durations, incidence rates were stable over time. ConclusionsFractional polynomials provided an adequate fit with relatively few parameters, but splines may be preferable to ensure flexibility, in particular, to detect short-term changes in the rate of first infection over time that may be a result of treatment effects. Although chronic HCV prevalence has declined with treatment scale up over 2016–2020, there is no evidence yet of a corresponding fall in the rate of first infection. Seroprevalence and risk behaviour data can be used to estimate and monitor HCV incidence, providing insight into progress towards WHO defined elimination of HCV.

Vaccine approaches and treatment aspects against Crimean Congo hemorrhagic fever.

Crimean-Congo hemorrhagic fever [CCHF] is a severe infectious viral disease caused by a tick borne virus which can lead to fatal hemorrhagic disease in humans. It has been reported from some continents including Africa, Asia and Europe. Virus is transmitted to human mainly through tick bite, whose acquire infection from reservoirs wild and domesticated mammalians and ostriches. Currently no approved vaccine or drug is available for CCHF and prevention is mainly based on biosecurity measures. Ribavirin is the only approved drug that has been used in some countries to treat human disease, however some new studies did not prove the Ribavirin efficacy. Different strategies to design effective vaccines, have been conducted through years, from inactivated virus to nucleotide-based ones including DNA and mRNA vaccines. In this study we review of pioneering vaccine candidate platforms.

Hepatitis C virus reinfection incidence among gay and bisexual men with HIV in Australia from 2016 to 2020.

There is some concern that hepatitis C virus (HCV) reinfection might impact HCV micro-elimination efforts among gay and bisexual men (GBM) with HIV. However, there is a limited understanding of reinfection incidence in the context of unrestricted government-funded HCV treatment. We aimed to estimate HCV reinfection incidence among GBM with HIV in Australia from 2016 to 2020. Data were from 39 clinics participating in ACCESS, a sentinel surveillance network for blood borne viruses and sexually transmissible infections across Australia. GBM with HIV who had evidence of treatment or spontaneous clearance with at least one positive HCV RNA test, a subsequent negative HCV RNA test, and at least one additional HCV RNA test between 1st January 2016 and 31st December 2020 were eligible for inclusion. A new HCV RNA positive test and/or detectable viral load was defined as a reinfection. Generalised linear modelling was used to examine trends in reinfection. Among 12 213 GBM with HIV who had at least one HCV test, 540 were included in the reinfection incidence analysis, of whom 38 (7%) had evidence of reinfection during the observation period. Over 1124 person-years of follow-up, the overall rate of reinfection was 3.4/100PY (95% CI 2.5-4.6). HCV reinfection incidence declined on average 30% per calendar year (Incidence Rate Ratio 0.70, 95% CI 0.54-0.91). HCV reinfection incidence has declined among GBM with HIV in Australia since government-funded unrestricted DAAs were made available. Ongoing HCV RNA testing following cure and prompt treatment for anyone newly diagnosed is warranted to sustain this.

Neofunctionalization driven by positive selection led to the retention of the loqs2 gene encoding an Aedes specific dsRNA binding protein

BackgroundMosquito borne viruses, such as dengue, Zika, yellow fever and Chikungunya, cause millions of infections every year. These viruses are mostly transmitted by two urban-adapted mosquito species, Aedes aegypti and Aedes albopictus. Although mechanistic understanding remains largely unknown, Aedes mosquitoes may have unique adaptations that lower the impact of viral infection. Recently, we reported the identification of an Aedes specific double-stranded RNA binding protein (dsRBP), named Loqs2, that is involved in the control of infection by dengue and Zika viruses in mosquitoes. Preliminary analyses suggested that the loqs2 gene is a paralog of loquacious (loqs) and r2d2, two co-factors of the RNA interference (RNAi) pathway, a major antiviral mechanism in insects.ResultsHere we analyzed the origin and evolution of loqs2. Our data suggest that loqs2 originated from two independent duplications of the first double-stranded RNA binding domain of loqs that occurred before the origin of the Aedes Stegomyia subgenus, around 31 million years ago. We show that the loqs2 gene is evolving under relaxed purifying selection at a faster pace than loqs, with evidence of neofunctionalization driven by positive selection. Accordingly, we observed that Loqs2 is localized mainly in the nucleus, different from R2D2 and both isoforms of Loqs that are cytoplasmic. In contrast to r2d2 and loqs, loqs2 expression is stage- and tissue-specific, restricted mostly to reproductive tissues in adult Ae. aegypti and Ae. albopictus. Transgenic mosquitoes engineered to express loqs2 ubiquitously undergo developmental arrest at larval stages that correlates with massive dysregulation of gene expression without major effects on microRNAs or other endogenous small RNAs, classically associated with RNA interference.ConclusionsOur results uncover the peculiar origin and neofunctionalization of loqs2 driven by positive selection. This study shows an example of unique adaptations in Aedes mosquitoes that could ultimately help explain their effectiveness as virus vectors.

Outbreaks of dengue in India since 2012

Dengue is an arthropod - borne virus which belongs to Flaviviridae family cause a range of different illness from mild symptoms to severe deadly Dengue Hemorrhagic fever/Dengue shock syndrome. Dengue is a self-limiting disease. The sharp raise in population, inadequate steps to eradicate mosquito breeds and Climatic changes – Delayed monsoon and heavy rainfall are the most important factors that leads to the drastic increase of Dengue cases in India. Approximately 94198 cases and 91 deaths were reported in India. According to World Health Organization Dengue is considered as a major global public health challenge for tropical and subtropical nations. This article summarizes the State wise dengue burden, Prevalence and Incidence. This article also includes some Global strategies for dengue prevention and control.

Design and testing of Hepatitis Delta Ribozymes for suppression of Chikungunya virus infection in cell cultures.

Chikungunya virus is an emerging pathogen with widespread distribution in regions of Africa, India, and Asia that threatens to spread into temperate climates following the introduction of its major vector, Aedes albopictus. Recent cases have been documented in Europe, the Caribbean, and the Americas. Chikungunya virus causes a disease frequently misdiagnosed as Dengue fever, with potentially life-threatening symptoms that can result in long term debilitating arthritis. There have been ongoing investigations of possible therapeutic interventions for both acute and chronic symptoms, but to date none have proven effective in reducing the severity or lasting effects of this disease. Recently, a promising vaccine candidate has received accelerated approval, indicating the importance of remedies to this emerging worldwide health threat. Nonetheless, therapeutic interventions for Chikungunya and other mosquito borne virus diseases are urgently needed yet remain elusive. The increasing risk of spread from endemic regions via human travel and commerce, coupled with the absence of a vaccine or approved therapeutic, puts a significant proportion of the world population at risk for this disease. In this report we explore the possibility of using Specific On/oFf Adapter Hepatitis Delta Virus Ribozymes as antivirals in cells infected with Chikungunya virus. The results we obtained suggest there could be some role in using these ribozyme molecules as antiviral therapies for not only Chikungunya virus, but potentially other viruses as well.

Mosquito borne virus USUTU as potential threat to human health.

USUV in Europe is detected in vectors (mosquitoes) and has a reservoir in vertebrates. There are known fatal epidemics among birds, especially blackbirds. Currently, USUV also causes rare infections in humans. However, the emergence of clinical cases, including severe neurological symptoms, and the finding of seroprevalence in asymptomatic people (e.g. blood donors, forest workers), indicate that USUV, due to its neurotropism, may become a potential public health problem. Therefore, it is very important to monitor cases infections in humans, migratory and resident birds and other animals that may constitute a reservoir of the virus, but also detection of the virus in mosquitoes (vectors), including alien and invasive species, as well as the impact of climatic factors on the ability to spread the virus in the Europe. There is currently no evidence of virus transmission during transfusion or transplantation, but the potential risk of virus transmission from an asymptomatic blood donor to an mmunocompromised recipient must be considered. Although the occurrence of USUV in European countries is currently not a significant threat, surveillance and screening of blood donors for USUV should be carried out during the period of vector activity and during WNV epidemics, as well as in patients with symptoms of meningitis and encephalitis.

Provision of Timely Alternative Multidisciplinary Protocols for Patients Refusing Blood or Blood Products

Blood components and products are life-saving therapeutics but with inherent, life-threatening risks. There are patients who do not accept blood products for different reasons, including fear of blood borne viruses, transfusion reactions and religious beliefs. It is important to determine the standard of care and outcomes for such patients, within any clinical setting. The aim of this audit was to evaluate adherence to the agreed standard of care for patients who do not accept blood transfusion. Methods All patients who refused transfusions between 2019 and 2021 were included. Scanned forms and Electronic Patient Records were used to gather data. Expected care standards were: (1) a multidisciplinary team (MDM) led alternative care plan, agreed at least 3 weeks prior to the intervention/ procedure, to prepare for blood loss, and (2) that the MDM should involve: either a surgeon or physician, anaesthetist (if the treatment is surgical or antenatal), haematologist or transfusion practitioner and the patient. Results There were 195 patients referred to MDMs, of which 105 were surgical (54%), 52 were interventional (27%) and 38 were antenatal (19%). Of these, 188 (96%) were sent before a procedure (or birth) with the remaining 7 (4%) referred for ongoing treatment of medical patients, i.e. with severe anaemia. In 72 patients (38%) the MDM did take place ≥3 weeks before the procedure (similar to the results from the first cycle of the audit, in 2017-18 = 40%). Almost 85% (165) of MDM included all relevant stakeholders. Discussion The delay in timely referral for MDM led alternative care plan was likely due to a lack of awareness of transfusion policies, and potentially could lead to cancellation of the procedure or unavailability of alternative protocols in an emergent scenario during surgery or intervention. Conclusion Improvement was required for safer procedures and outcomes, by investment in training, regular refreshers/ updates for staff and electronic protocols/ prompts.

60 Blood Borne Virus testing in a central London Emergency Department: A quality improvement project interim report

60 Blood Borne Virus testing in a central London Emergency Department: A quality improvement project interim report

Recent increases in crack injection and associated risk factors among people who inject psychoactive drugs in England and Wales

BackgroundCrack use is higher in the United Kingdom (UK) than other European countries. Crack is a stimulant with a short half-life, requiring frequent injection to maintain its euphoric effects, thus increasing the risk of blood borne viruses (BBVs) and skin and soft tissue infections (SSTIs). We assessed trends in the prevalence of current crack injection among people who inject drugs (PWID) and investigated harms and other factors associated with its use. MethodsWe used data from the annual Unlinked Anonymous Monitoring Survey of PWID, which recruits people who have ever injected psychoactive drugs through specialist services. Participants provide a biological sample and self-complete a questionnaire. We included participants from England and Wales who had injected in the past month. We examined trends in crack injection over time (2011–2021) and factors associated with crack injection using multivariable logistic regression (2019–2021). ResultsThe proportion of people self-reporting crack injection in the past month almost doubled between 2011–2020/21, from 34 % (416/1237) to 57 % (483/850). Crack injection was more frequently reported by males than females (adjusted odds ratio 1.46, 95 % confidence interval: 1.15–1.87) and injected alongside heroin (6.67, 4.06–10.97) more frequently than alone. Crack injection was independently associated with injecting equipment sharing (1.64, 1.30–2.07), groin injection (2.03, 1.60–2.56) in the past month, overdosing in the past year (1.90, 1.42–2.53), homelessness in the past year (1.42, 1.14–1.77) and ever having hepatitis C infection (1.64, 1.31–2.06). ConclusionCrack injection has increased significantly over the past decade in England and Wales. People injecting crack are more likely to engage in behaviours that increase the risk of BBV and SSTI acquisition, such as needle/syringe sharing, groin injection and polydrug use. Harm reduction and drug treatment services should adapt to support the needs of this growing population of people injecting stimulants.

Cannabis sativa: 2023-Outbreak and Re-emergence of Nipah virus (NiV) in India: Role of Hemp oil

This review paper highlights and updates the outbreak of Nipah virus (NiV), an emerging zoonotic bat borne virus that can cause severe respiratory illness and deadly encephalitis in humans. Nipah virus (NiV) outbreak was first reported in 1998 from Malaysia and then recorded in Bangladesh, India, Philippines, Singapore and Thailand. A recent fifth outbreak of Nipah virus (NiV) during August-September 2023 in Kerala State, India brought this emerging-re-emerging virus into the spotlight again. Due to the lack of vaccines and drugs with proven effectiveness against Nipah virus (NiV), treatment of patients is limited to supportive and prophylactic. Fruit bats are the main reservoir for this virus, which can cause disease in humans and animals. Nipah virus (NiV) can be transmitted from bats or livestock to humans, typically via contaminated food (fruit or raw date palm sap), and person-to-person through respiratory secretions. Hemp seed oil has gained remarkable popularity due to its perceived therapeutic properties, particularly antiviral properties for potential health benefits. During the recent outbreak of Nipah virus (NiV), the local traditional healers in India used hemp oil as the mouth wash for controlling throat infections, head ache, vomiting and suggested for the consumption of hemp seeds and oil as the functional food. However, clinical trials and scientific data supporting antiviral activity of Cannabis oil (CBD oil) against Nipah virus (NiV) is lacking. Therefore, further research should focus on exploring the molecular mechanisms of hemp oil against Nipah virus (NiV) is warranted. Multicenter clinical trials should be performed to validate the efficacy of hemp oil alone or in the form of formulations for the treatment of viral infections.

Insights from the scale-up and implementation of the Deadly Liver Mob program across nine sites in New South Wales, Australia, according to the RE-AIM framework

BackgroundThe Deadly Liver Mob (DLM) program is a peer-led health promotion program that aims to improve access to screening and treatment for blood borne viruses and sexually transmissible infections for Aboriginal and Torres Strait Islander Australians. In this paper, we used client and staff insights to explore the successes and challenges of implementing the DLM program according to the RE-AIM framework, which explores real-world implementation of interventions according to reach, effectiveness, adoption, implementation, and maintenance.MethodsClients and staff were recruited through the DLM program. Semi-structured interviews were conducted with four Aboriginal and Torres Strait Islander and 11 non-Aboriginal or Torres Strait Islander health workers, as well as 33 Aboriginal and Torres Strait Islander clients of the program.ResultsFindings show the positive effects of the DLM program, in creating a culturally safe and sensitive environment for Aboriginal and Torres Strait Islander clients to access care. In particular, the employment of frontline Aboriginal and Torres Strait Islander workers to deliver the education was touted as one of the primary successes of the program, in enabling workers to build trust between clients and mainstream health systems, which has the flow on effect of encouraging clients to go through to screening. The use of the RE-AIM framework illustrates the challenges of implementing real-world interventions across various locations, such as the difficulties in delivering DLM in regional and remote areas due to covering large geographic areas with minimal public transport available.ConclusionsThe data emphasise the need for interventions to be adaptable and flexible, altering elements of the program to suit local and community needs, such as by offering mobile and outreach services to enable access across regional and rural areas. The findings of this evaluation have been used to develop tools so that the learnings from DLM can be shared with others who may be hoping to implement DLM or other similar programs.

Mathematical modeling of Dengue virus serotypes propagation in Mexico.

The Dengue virus (DENV) constitutes a major vector borne virus disease worldwide. Prediction of the DENV spread dynamics, prevalence and infection rates are crucial elements to guide the public health services effort towards meaningful actions. The existence of four DENV serotypes further complicates the virus proliferation forecast. The different serotypes have varying clinical impacts, and the symptomatology of the infection is dependent on the infection history of the patient. Therefore, changes in the prevalent DENV serotype found in one location have a profound impact on the regional public health. The prediction of the spread and intensity of infection of the individual DENV serotypes in specific locations would allow the authorities to plan local pesticide spray to control the vector as well as the purchase of specific antibody therapy. Here we used a mathematical model to predict serotype-specific DENV prevalence and overall case burden in Mexico.

FRI-182 - Improving blood borne virus screening in immigration removal centres in the UK

FRI-182 - Improving blood borne virus screening in immigration removal centres in the UK

Commonly Reported Mosquito-Borne Viruses in the United States: A Primer for Pharmacists.

Mosquito-borne diseases are a public health concern. Pharmacists are often a patient's first stop for health information and may be asked questions regarding transmission, symptoms, and treatment of mosquito borne viruses (MBVs). The objective of this paper is to review transmission, geographic location, symptoms, diagnosis and treatment of MBVs. We discuss the following viruses with cases in the US in recent years: Dengue, West Nile, Chikungunya, LaCrosse Encephalitis, Eastern Equine Encephalitis Virus, and Zika. Prevention, including vaccines, and the impact of climate change are also discussed.

ROLE OF PLATELET TRANSFUSION IN DENGUE PATIENTS WITHS BLEEDING TEN

Introduction: Dengue fever and dengue hemorrhagic fever (1) are usually a benign condition caused by an arthropod borne virus and bleeding is one of the dreaded complications associated with higher mortality in DHF/DSS (1) Dysfunction of platelets are Prothrombotic complications associated with severe cases of dengue. Thus, platelets could be considered cells that are active against the anti DENV immune response. Platelet transfusion is given in those patients who are either bleeding or having other hemorrhagic symptoms along with thrombocytopenia. AProspective study was conducted of 100 dengue positive patients with bleeding tendency in department of pathology, Government medical college and Sir. T. Hospital, Bhavnagar, Gujarat during period of July 2020 to MAY 2021.The patient who received multiple platelet transfusions showed post transfusion platelet increment of >0.5x105/mm3 from each unit

In silico Evaluation of SNPs and Molecular Modelling Study in Dengue

Dengue may be a spectrum of disease caused by 5 serotypes of the foremost current arthropod- borne virus touching humans nowadays. The term dengue came into general use solely once 1828. Dengue viruses (DV) belong to family Flaviviridae and there are 5 serotypes of the virus observed as DV-1, DV-2, DV-3, DV-4 and DV5. DV could be a positive-stranded encapsulated polymer virus and consists of 3 structural macromolecule genes that write in code the nucleocapsid or core (C) macromolecule, a membrane-associated (M) macromolecule, associate degree enclosed (E) conjugated protein and 7 non-structural (NS) proteins. It is transmitted mainly by Aedes aegypti mosquito and also by Ae. Albopictus. The present strategy of bioinformatics analysis is to exploit the current data available both on gene and genome-wide association study (GWAS) meta-analysis of dengue to integrate these at novel levels of understanding of gene network interactions and expression levels. The study revealed 2 studies of dengue from GWAS with a total of 2 unique genes, namely MICB and PLCE1 that were mapped to discrete genomic locations of human genome which represented 15 rsIDs (SNPs) associated with MICB gene and 5 rsIDs (SNPs) associated with PLCE1 gene. The consensus results of the online tools like SIFT ,SNP & GO, PANTHER , Ployphen2.0 and I- mutant for structure and functional studies depicted rs1051788, rs1051788, rs41293883 and rs45583740 of MICB gene to be deleterious/ diseased and effecting the structure and function of MICB gene which may the reason for occurrence of dengue in human counterpart. The DAVID bioinformatics functional enrichment analysis reported 234 genes and 468 GO terms for biological processes (BP).In this study a total of 307 genes pertaining to dengue and its associated diseases were mined from various databases like GWAS, GEO & Jeans lab disease database. Out of 307 genes only 22 genes were consider for interaction study with different drug molecules as they are treated as the key factors that play a vital role in dengue.