Viral Load Research Articles

Identification of risk factors for suboptimal adherence in people living with HIV through measurement of medication possession ratio: a cross-sectional study.

The most significant progress in addressing the HIV/AIDS epidemic has been the development of antiretroviral therapy (ART). However, ensuring a high degree of treatment adherence is necessary to prevent resistance and disease progression. We conducted a cross-sectional study to evaluate adherence to ART through the calculation of the medication possession ratio (MPR) and to identify risk factors for suboptimal adherence in a cohort of HIV-positive patients receiving care at a Colombian healthcare institution across 16 cities. Records of 12,145 users were analyzed, and a multivariate logistic regression model was performed, considering optimal adherence (MPR > = 95%) versus suboptimal adherence (MPR < 95%) as the reference. Suboptimal adherence to ART was identified in 29% of users. Residence region, presence of HIV-defining illnesses, chronic kidney disease (CKD), co-infections such as hepatitis C, tuberculosis, and sexually transmitted infections, treatment duration of more than 5 years, and non-suppressed viral load were identified as risk factors for non-adherence. This underscores the need to identify interventions for those vulnerable groups to minimize the likelihood of non-adherence and to intervene in care models focused on the medical needs of these patients.

Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China

BackgroundThe proportion of people living with HIV (PLHIV) in Guangxi who are men who have sex with men (MSM) increased rapidly to nearly 10% in 2023; notably, over 95% of this particular population is currently receiving antiretroviral therapy (ART). This study aimed to describe the survival of MSM PLHIV, depict the characteristics and trends of changes in CD4+ T cell counts, CD4+/CD8+ T cell ratio, and viral load, and explore immunological indicators that may be related to mortality during different stages of treatment.MethodsImmunological indicators of MSM PLHIV receiving ART were extracted and categorized into baseline, mid-treatment, and last values. These were then incorporated into the Cox models in the form of repeated measurements to evaluate the associations (Adjusted-hazard ratios, aHRs) and 95% confidence intervals (95% CIs) of these immunological indicators with mortality at different stages.ResultsA total of 5,642 patients who met the criteria were enrolled in the study, and 160 died, representing a mortality of 2.8%. The first, median, and last values of the CD4+ count and the CD4+/CD8+ ratio in surviving patients were significantly greater than the corresponding values in nonsurviving patients (P < 0.001). Except for the first viral load (P = 0.379), the median and last viral loads of the former were significantly lower than those of the latter (P < 0.001). In Cox model, with 2,144 cases, immunological indicators of increased mortality risk included a baseline CD4+ count below 200 cells/µL (aHR: 4.58, 95% CI: 2.28–9.19), a median (aHR: 8.46, 95% CI: 3.05–23.46), and a final (aHR: 4.43, 95% CI: 1.06–18.45) ratio below 0.7 and a median (aHR: 9.47, 95% CI: 4.02–22.35) and final (aHR: 14.46, 95% CI: 4.50–46.50) viral load 100,000 copies/mL and above.ConclusionsMortality among MSM PLHIV on ART in Guangxi is relatively low, and both high viral loads and low CD4+/CD8+ T cell ratios during treatment and at recent follow-up are strongly predictive of a serious prognosis and should be closely monitored.

Molecular epidemiology of chicken and turkey parvovirus in Turkiye: high risk, genetic recombination signals, and first complete genome analysis.

The aim of this study was to detect chicken parvovirus (ChPV) and turkey parvovirus (TuPV) on Turkish poultry farms and examine the molecular epidemiology of these viruses. In 2023, a total of 1,060 fecal samples were collected from 76 broiler farms and 30 turkey farms across various regions of Turkiye. The overall positivity rate was 72.3% (55/76) in broiler flocks and 70% (21/30) in turkey flocks. Among these, the positivity rate was 35% (7/20) in birds showing no signs of enteritis. The findings of this study suggest that, depending on the genetic variability of regional strains or the viral load, nested-PCR-based methods may prove more effective than single-step PCR for detecting ChPV and TuPV cases. Therefore, it is recommended to incorporate nested PCR in molecular epidemiological studies to minimize the risk of overlooking positive cases. Phylogenetic analysis of the VP1, VP2, and complete genome sequences of TUR/2023/ChPV and TR/2023/TuPV revealed that both strains clustered with American strains in distinct lineages. Analysis using the recombination detection programs RDP4.0 and SimPlot 3.5.1 strongly suggested that TUR/2023/ChPV may be a recombinant of strains from China and Brazil. Despite the observed genetic variability in the VP2 protein, an examination of B-cell epitopes showed a high degree of similarity between ChPV and TuPV strains. This study represents the first documentation of the emergence and prevalence of TuPVs in Turkiye, providing complete genome sequences for both ChPV and TuPV. Given the high prevalence and genetic diversity of these viruses and their presence in clinically asymptomatic birds, it is crucial for stakeholders in the poultry industry to implement regular flock screenings for these and similar viral pathogens. Proactive measures like these are essential for mitigating the economic impact of these important pathogens and developing effective preventive strategies.

Cotton leaf curl Multan virus activates autophagy in the whitefly AsiaII7, weakening its vectorial capacity for transmission.

Autophagy plays an important role against pathogen infections in both insects and plants. Insect vectors employ autophagy as an intrinsic antiviral defense mechanism against viral infections, whereas viruses can exploit autophagy to enhance their transmission via insect vectors. The Cotton leaf curl Multan virus (CLCuMuV) is transmitted by the AsiaII7 cryptic species of Bemisia tabaci, however, the role of autophagy is involved in regulating the transmission of this virus remains unclear. In this study, it was observed that CLCuMuV infection induced autophagy in AsiaII7 whitefly, as evidenced by an elevated in the level of ATG8-II and the upregulation of Atg3, Atg8, Atg9 and Atg12. Both the administration of the autophagy inhibitor bafilomycin A1 and the silencing of Atg9 expression increased the viral load and enhanced CLCuMuV transmission. Conversely, the activation of autophagy via rapamycin feeding significantly reduced the amount of CLCuMuV and inhibited the efficiency of virus transmission. CLCuMuV infection can activate the autophagy pathway in whiteflies. The activation of autophagy leads to the subsequent degradation of the virus and suppresses CLCuMuV transmission efficiency, whereas suppression of autophagy promotes virus transmission. Our research provides insight into the potential role of autophagy in antiviral defense mechanisms. © 2025 Society of Chemical Industry.

Robust mucosal SARS-CoV-2-specific T cells effectively combat COVID-19 and establish polyfunctional resident memory in patient lungs.

Mucosal antigen-specific T cells are pivotal for pathogen clearance and immune modulation in respiratory infections. Dysregulated T cell responses exacerbate coronavirus disease 2019 severity, marked by cytokine storms and respiratory failure. Despite extensive description in peripheral blood, the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific T cells in the lungs remain elusive. Here we conducted integrated single-cell profiling of SARS-CoV-2-specific T cells in 122 bronchoalveolar lavage fluid (BALF) and 280 blood samples from 159 patients, including 27 paired BALF and blood samples from 24 patients. SARS-CoV-2-specific T cells were robustly elicited in BALF irrespective of prior vaccination, correlating with diminished viral loads, lessened systemic inflammation and improved respiratory function. SARS-CoV-2-specific T cells in BALF exhibited profound activation, along with proliferative and multi-cytokine-producing capabilities and a glycolysis-driven metabolic signature, which were distinct from those observed in peripheral blood mononuclear cells. After viral clearance, these specific T cells maintained a polyfunctional tissue-resident memory phenotype, highlighting their critical roles in infection control and long-term protection.

Acceptability and Feasibility of Self-Collected Dried Blood Spot Specimens for Viral Load Monitoring among Rural Older People Living with HIV.

Self-collected dried blood spot (DBS) samples may be useful in monitoring viral load (VL) in research studies or clinically given that they eliminate the need for participants to travel to study sites or laboratories. Despite this, little information exists about monitoring VL using DBS self-collected at home, and no information exists on DBS for this use among older rural people living with HIV (PLH), a population that could benefit from self-collection given difficulty accessing care. We report on the feasibility and acceptability of self-collected DBS samples, DBS VL results, concordance between self-reported and DBS VL, and factors associated with DBS detectable VL in a rural Southern U.S. sample of PLH aged 50 years and older. Between 2021 and 2022, 61 older rural PLH from 9 Southern U.S. states (Mage = 58, 25% female) completed survey measures and self-collected DBS specimens at home; 51 of these participants completed the same procedures at 3-month follow-up. Nearly all participants (96-98%) collected DBS specimens that could be successfully analyzed for VL, and participants found self-collection highly acceptable. Approximately one quarter of participants had quantifiable detectable VL (≥ 839 copies/mL) at each time point. Concordance between self-reported and DBS VL was 69% at baseline and 82% at follow-up; the majority of those with DBS detectable VL self-reported undetectable VL (86% at baseline and 60% at follow-up). Self-collection of DBS specimens for VL monitoring can add value to research conducted remotely, including research associated with the care of rural and/or older PLH.

Analysis of Viral Load Values in PLHIV Receiving Peer Support During Six Months of Treatment

HIV/AIDS remains one of the significant global health challenges that require long-term management for viral suppression. Antiretroviral therapy is considered the cornerstone of treatment. However, while ART has proved effective, there is limited data regarding the effectiveness of peer support on viral load outcomes. The paper, therefore, seeks to describe changes in viral load among PLHIV who received peer support over six months. We used a descriptive quantitative approach in this study; the data source was obtained from secondary data by the Ministry of Health through its SITRUS system and monitoring ART treatment in PLHIV patients. A total of 58 participants with ART treatment in health facilities with PSS were used in this study. Data were collected from several healthcare facilities and then analyzed descriptively to review the distribution of changes in viral loading within six months of treatment. Results showed that the success of viral suppression varied depending on the kind of ART treatment. However, the viral load values were lower across the board due to peer support. Therefore, peer support influenced adherence to therapy by participants irrespective of individual personalities and personal traits. Despite various treatment response rates, the general trend of the findings in this study was that peer support contributed to PLHIV's adherence to their regimes. This can be interpreted into generally better health conditions, including less viral load as a critical attribute essential for low levels of HIV transmission and the procreation of slow-onset diseases. These findings emphasize how important peer support is to increase ART adherence and viral suppression, which is key in the control of HIV according to public health strategies.

Suppressing Tymovirus replication in plants using a variant of ubiquitin.

RNA viruses have evolved numerous strategies to overcome host resistance and immunity, including the use of multifunctional proteases that not only cleave viral polyproteins during virus replication but also deubiquitinate cellular proteins to suppress ubiquitin (Ub)-mediated antiviral mechanisms. Here, we report an approach to attenuate the infection of Arabidopsis thaliana by Turnip Yellow Mosaic Virus (TYMV) by suppressing the polyprotein cleavage and deubiquitination activities of the TYMV protease (PRO). Performing selections using a library of phage-displayed Ub variants (UbVs) for binding to recombinant PRO yielded several UbVs that bound the viral protease with nanomolar affinities and blocked its function. The strongest binding UbV (UbV3) candidate had a EC50 of 0.3 nM and inhibited both polyprotein cleavage and DUB activity of PRO in vitro. X-ray crystal structures of UbV3 alone and in complex with PRO reveal that the inhibitor exists as a dimer that binds two copies of PRO. Consistent with our biochemical and structural findings, transgenic expression of UbV3 in the cytosol of A. thaliana suppressed TYMV replication in planta, with the reduction in viral load being correlated to UbV3 expression level. Our results demonstrate the potential of using UbVs to protect plants from tymovirus infection, a family of viruses that contain numerous members of significant agricultural concern, as well as other plant viruses that express functionally related proteases with deubiquitinating activity.

Safety and efficacy of switching to 4-weekly albuvirtide plus daily dolutegravir in virologically suppressed HIV-1 adults: a 24-week study.

Albuvirtide (ABT) is a long-acting fusion inhibitor. This study assessed switching to ABT 640 mg every 4 weeks plus daily Dolutegravir (DTG) in virologically suppressed adults with HIV-1. In this open-label, single-arm study, 10 participants with HIV-1 RNA <50 copies/mL switched to ABT plus DTG for 24 weeks. Safety, pharmacokinetics, viral load, and CD4+ T cell counts were assessed. No serious adverse events occurred. Albuvirtide's steady-state trough concentration was 31.1 times higher than PA-IC90. All participants maintained virological suppression. CD4+ T-cell counts increased significantly after 24 weeks (P = 0.0462). Switching to 4-weekly ABT plus daily DTG demonstrated good safety, favorable pharmacokinetics, maintained virological suppression, and improved immune recovery. These findings support ABT's potential as a long-acting agent for simplifying HIV treatment.

Antiviral therapy can effectively suppress irAEs in HBV positive hepatocellular carcinoma treated with ICIs: validation based on multi machine learning

BackgroundImmune checkpoint inhibitors have proven efficacy against hepatitis B-virus positive hepatocellular. However, Immunotherapy-related adverse reactions are still a major challenge faced by tumor immunotherapy, so it is urgent to establish new methods to effectively predict immunotherapy-related adverse reactions.ObjectiveMulti-machine learning model were constructed to screen the risk factors for irAEs in ICIs for the treatment of HBV-related hepatocellular and build a prediction model for the occurrence of clinical IRAEs.MethodsData from 274 hepatitis B virus positive tumor patients who received PD-1 or/and CTLA4 inhibitor treatment and had immune cell detection results were collected from Henan Cancer Hospital for retrospective analysis. Models were established using Lasso, RSF (RandomForest), and xgBoost, with ten-fold cross-validation and resampling methods used to ensure model reliability. The impact of influencing factors on irAEs (immune-related adverse events) was validated using Decision Curve Analysis (DCA). Both uni/multivariable analysis were accomplished by Chi-square/Fisher’s exact tests. The accuracy of the model is verified in the DCA curve.ResultsA total of 274 HBV-related liver cancer patients were enrolled in the study. Predictive models were constructed using three machine learning algorithms to analyze and statistically evaluate clinical characteristics, including immune cell data. The accuracy of the Lasso regression model was 0.864, XGBoost achieved 0.903, and RandomForest reached 0.961. Resampling internal validation revealed that RandomForest had the highest recall rate (AUC = 0.892). Based on machine learning-selected indicators, antiviral therapy and The HBV DNA copy number showed a significant correlation with both the occurrence and severity of irAEs. Antiviral therapy notably reduced the incidence of IRAEs and may modulate these events through regulation of B cells. The DCA model also demonstrated strong predictive performance. Effective control of viral load through antiviral therapy significantly mitigates the occurrence of irAEs.ConclusionICIs show therapeutic potential in the treatment of HBV-HCC. Following antiviral therapy, the incidence of severe irAEs decreases. Even in cases where viral load control is incomplete, continuous antiviral treatment can still mitigate the occurrence of irAEs.

Methylation sites of human papillomavirus 16 as potential biomarkers for cervical cancer progression

ObjectiveTo investigate the methylation levels at 13 specific sites of the human papillomavirus 16 (HPV16) L1 gene as potential biomarkers for the diagnosis of cervical cancer.MethodsSamples were collected from the gynecological outpatient and inpatient departments of the Xinjiang Uygur Autonomous Region People’s Hospital. A total of 107 women participated in this study, including 54 with cervical cancer (32 Uygur, 22 Han) and 53 with cervical inflammation (32 Uygur, 21 Han). Methylation analysis was performed using pyrosequencing to quantitatively assess methylation levels at specified CpG sites within the HPV16 L1 gene.ResultsHigh methylation levels were predominantly observed at sites 5927, 5963 and 6367 in cervical cancer cells compared with inflammatory cells. Methylation patterns exhibited no significant differences between the Han and Uygur ethnic groups but correlated with viral load and age within each group. Receiver operating characteristic curve analyses of these methylation sites indicated high diagnostic accuracy in distinguishing between high-grade lesions and less severe conditions.ConclusionsMethylation of specific CpG sites in the HPV16 L1 gene holds promise as a biomarker for cervical cancer progression. The gene locus at position 6367 has important features in the methylation pattern of cervical cancer, and high accuracy shown in diagnosis make it a potential biomarker for early diagnosis of cervical cancer.

Central arterial stiffness in young adults with perinatal HIV exposure & infection.

To compare arterial stiffness between young adults with perinatally acquired HIV (YAPHIV) and young adults perinatally HIV exposed but uninfected (YAPHEU). Cross-sectional analysis of pulse wave velocity (PWV) measures among participants with echocardiography in the PHACS Cardiac Toxicity Substudy. A total of 150 participants (95 YAPHIV, 55 YAPHEU, mean 23.4 years, 60% female, 72% Black, 24% Hispanic) had echocardiography and PWV measured. We compared PWV between groups. Among YAPHIV, we fit linear regression models to evaluate the association of measures of HIV disease severity and antiretroviral treatment (ART) with PWV. We computed correlations between PWV and measures of left ventricular structure and function. Mean PWV did not differ by group (YAPHIV 5.63 vs YAPHEU 5.39 m/s; P = 0.50). HIV control was good (82% with viral load <400 copies/ml); 91% used combination ART. Mean PWV was normal, but 3 of 95 YAPHIV (3%) had values above 11.8 m/s (level associated with cardiovascular events in adults). Weak correlations (<0.20) were observed between PWV and echocardiographic measures. Among YAPHIV, current and historical HIV severity measures were not associated with PWV. YAPHIV on protease inhibitor (PI)-based ART had higher mean PWV than those on integrase strand inhibitors (1.68 m/s higher, 95% CI -0.36, 3.72) or nonnucleoside transcriptase inhibitors (1.58 m/s higher, 95% CI -0.94, 4.11). Our data shows no difference in PWV between those perinatally exposed to and perinatally infected with HIV. Therefore, CV risk reduction guidelines should be followed to prevent CV disease in all young adults.

NK Count and Natural Cytotoxicity in Immune Nonresponders Versus Responders Living With HIV.

Despite viral suppression with antiretroviral therapy, immune nonresponders (INR) among people living with HIV (PLWH) still have a higher risk of developing AIDS-related and non-AIDS-related complications. Our study aimed to investigate the phenotype and functions of Natural Killer (NK) cells in INR, to better understand underlying mechanisms of immune nonresponse. Our cross-sectional study included PLWH aged over 45 with an undetectable HIV viral load sustained for at least 2 years. Participant CD4+ T-cell counts exceeded 500 cells/mm3 for IR or below 350 cells/mm3 for INR. We characterized NK cell subsets, performed natural cytotoxicity and ADCC assays, and phenotyped NK cells before and after functional assays. Median CD4 levels were 247.5 (IQR, 208.8-286.3) cells/mm3 and 768.5 (IQR, 673.3-957.8) cells/mm3 in the INR (n = 20) and IR (n = 40), respectively. NK cell counts were lower in INR (p = 0.00066), but the percentages were similar between IR and INR. NKG2A was the only differentially expressed marker between groups, showing higher expression in INR. Additionally, NK cell natural cytotoxicity was elevated in the INR group. Multivariate analyses associated CD4 nadir and low NK cell count with immune nonresponse. Our results do not indicate a clear role for NK-mediated ADCC in immune nonresponse. We did not objectify an association between CD8 hyperactivation and INR.

Hepatitis B virus infection and its treatment in Eastern Ethiopia.

Hepatitis B virus (HBV) infection causes acute and chronic hepatitis, compensated and decompensated cirrhosis, and hepatocellular carcinoma worldwide. The actual status of HBV infection and its treatment in certain regions of Asian and African countries, including Ethiopia, has not been well-documented thus far. Antiviral therapy for HBV infection can prevent the progression of HBV-related liver diseases and decrease the HBV-related symptoms, such as abdominal symptoms, fatigue, systemic symptoms and others. In Eastern Ethiopia, HBV-infected patients with cirrhosis were found to be positive for the HBV e antigen and to have a higher viral load than those without cirrhosis. Notably, 54.4% of patients practiced khat chewing and 18.1% consumed excessive amounts of alcohol. Tenofovir disoproxil fumarate effectively suppressed HBV DNA in those infected with HBV. It is important to elucidate the actual status of HBV infection in Eastern Ethiopia to eliminate HBV infection worldwide by 2030. HBV vaccination and the educational programs for Health Science students that provide practical strategies could help to reduce HBV infection in Eastern Ethiopia.

Bayesian Analysis of Censored Linear Mixed-Effects Models for Heavy-Tailed Irregularly Observed Repeated Measures.

The use of mixed-effect models to understand the evolution of the human immunodeficiency virus (HIV) and the progression of acquired immune deficiency syndrome (AIDS) has been the cornerstone of longitudinal data analysis in recent years. However, data from HIV/AIDS clinical trials have several complexities. Some of the most common recurrences are related to the situation where the HIV viral load can be undetectable, and the measures of the patient can be registered irregularly due to some problems in the data collection. Although censored mixed-effects models assuming conditionally independent normal random errors are commonly used to analyze this data type, this model may need to be more appropriate for accommodating outlying observations and responses recorded at irregular intervals. Consequently, in this paper, we propose a Bayesian analysis of censored linear mixed-effects models that replace Gaussian assumptions with a flexible class of distributions, such as the scale mixture of normal family distributions, considering a damped exponential correlation structure that was employed to account for within-subject autocorrelation among irregularly observed measures. For this complex structure, Stan's default No-U-Turn sampler is utilized to obtain posterior simulations. The feasibility of the proposed methods was demonstrated through several simulation studies and their application to two AIDS case studies.

Antiviral effects and mechanism of Qi pi pill against influenza viruses.

Qi pi pill (QPP), which contains Renshen, Baizhu, Fuling, Gancao, Chenpi, Shanyao, Lianzi, Shanzha, Liushenqu, Maiya, and Zexie, was recommended for preventing and treating COVID-19 in Shandong Province (China). However, the mechanism by which QPP treats infectious diseases remains unclear. This study aims to investigate the therapeutic effect of QPP invitro and on acute influenza infection in mice, exploring its mechanism of action against influenza A virus (IAV). The invitro activity of QPP was assessed using dose-response curve analysis and titer reduction assay, and its antiviral mechanism was identified invitro by real-time polymerase chain reaction (PCR), time-of-addition, and enzymatic assays. The antiviral efficacy of QPP was further evaluated invivo using BALB/c mice infected with IAV. At the same time, each single Chinese herbal medicine in QPP was evaluated to preliminarily identify those with antiviral effects. In vitro results showed that QPP exhibited a higher potency antiviral effect against both influenza A and B viruses, inhibiting viral RNA replication and release by targeting RNA-dependent RNA polymerase and neuraminidase. Additionally, QPP significantly decreased the expression of inflammatory cytokines in A549 cells. Invivo study revealed that QPP significantly reduced the lung index and viral load in lung tissue of mice infected with IAV. Renshen, Gancao, Zexie, and Lianzi were the Chinese herbal medicines from QPP that showed anti-IAV activity. The antiviral activity of QPP targets IAV replication and release, cytokine modulation in host cells, and provides protection in mice with acute influenza infection.

Macrovascular Function in People with HIV After Recent SARS-CoV-2 Infection

Background: People with HIV (PWH) are at increased risk of vascular dysfunction and cardiovascular disease (CVD). SARS-CoV-2 infection has been associated with acute CVD complications. The aim of the study was to as-sess macrovascular function as an early indicator of CVD risk in PWH after mild SARS-CoV-2 infection. Methods: PWH aged 20–60 years, with undetectable viral load (RNA &lt; 20 copies/mL), on stable anti-retroviral therapy (≥6 months) and history of mild COVID-19 (≥30 days) without any CVD manifestations prior to enrollment were recruited. Participants were excluded if they had history of diabetes mellitus, end-stage renal disease, heart or respiratory disease. Participants were matched 1:1 to pre-pandemic PWH. A health survey, surrogate measures of CVD risk, and macrovascular function (brachial artery flow-mediated vasodilation and arterial stiffness assessments via applanation tonometry) were compared between group. Results: A total of 17 PWH and history of COVID-19 (PWH/COV+) were matched with 17 PWH without COVID-19 (PWH/COV−) pre-pandemic. Mean age (45.5 years), sex (76.5% male), body mass index (27.3), and duration of HIV infection (12.2 years) were not different between groups. Both groups had comparable CVD risk factors (total cholesterol, LDL, HDL, systolic and diastolic blood pressure). There were no differences in measures of flow mediated arterial dilatation or arterial stiffness after 30 days of SARS-CoV-2 infection. Conclusions: After recent SARS-CoV-2 infection, PWH did not demonstrate evidence of macrovascular dysfunction and increased CVD risk. Results suggest that CVD risk may not be increased in people with well-controlled HIV who did not manifest CVD complications SARS-CoV-2 infection.

Crimean–Congo Hemorrhagic Fever Mimicking HELLP Syndrome in a Pregnant Woman and Her Infant in Kosovo: A Case Report

Crimean–Congo hemorrhagic fever (CCHF) is fatal in 10 to 40% of cases. It is caused by CCHF virus (CCHFV). Symptoms include fever, headache, myalgia, and often hemorrhage and other complications. This report shows that CCHF may resemble HELLP syndrome (hemolysis, elevated liver enzymes, low platelets). We report CCHF in a pregnant mother with fever and suspected HELLP syndrome, who survived, and her infant (week 36), who died six days after C-section. The high CCHF viral load and bacterial sepsis may have jointly contributed to the death of the infant. CCHF should be considered as a differential diagnosis of HELLP syndrome in regions where this viral disease is endemic.

Assessment of Torquetenominivirus (TTMV) and Torquetenomidivirus (TTMDV) as Complementary Biomarkers to Torquetenovirus (TTV)

Recent studies have identified Torquetenovirus (TTV) as a promising biomarker of immune competence, particularly in assessing the vaccine response of solid organ transplant (SOT) recipients. However, given the individual variability of viral load, it is not yet possible to define "normal levels”. Nevertheless, TTV is just one component of the broader Anelloviridae family, which also includes Torquetenominivirus (TTMV) and Torquetenomidivirus (TTMDV). This study explores whether the viremia of TTMV and TTMDV offers a stronger predictive marker for vaccine efficacy in SOT recipients. A cohort of 168 SOT patients (142 kidney and 26 lung transplant recipients) who received the BNT162B2 mRNA vaccine was examined, with viral loads quantified through virus-specific real-time PCR. While TTV remains a potentially useful biomarker for evaluating immune response, the combined analysis of all anelloviruses viremia provides deeper insights, particularly in cases where TTV is undetectable. Notably, only TTMV exhibited a pattern similar to TTV, suggesting its potential as an alternative biomarker when TTV is absent from the patient’s virome.

Point-of-care nucleic acid testing - a step forward in controlling the HIV epidemic: A review.

The HIV/AIDS epidemic, with 85.6 million infections and 40.4 million AIDS-related deaths globally, remains a critical public health challenge. Current diagnostic methods, primarily fourth-generation immunoassays, have limitations due to their long window periods, and most viral load assays require centralized testing protocols that result in delays, especially in remote regions. Point-of-care (POC) nucleic acid amplification testing (NAAT) presents a transformative approach by reducing the window period for detection to one week and significantly shortening turnaround times for viral load monitoring. This review highlights the clinical utility of POC NAAT for acute HIV infection diagnosis, its role in timely combination antiretroviral therapy adjustments, and its potential to reduce the basic reproduction number (R0), a critical threshold for suppressing the epidemic. By improving early detection and facilitating faster clinical decisions, POC NAAT enhances the effectiveness of HIV prevention and treatment programmes, particularly in high-risk and remote communities, and supports the global effort to achieve the ambitious UNAIDS 95-95-95 targets.