Common Viral Infections Research Articles

Early diagnosis and predicting of acute kidney injury in children with viral gastroenteritis of various agents (Literature review)

The most common viral infections causing gastroenteritis in children include rotavirus, norovirus, and the SARS-CoV-2. A typical clinical picture includes fever, vomiting, diarrhea, toxicosis and exicosis of varying severity. However, in 30—35% of cases, acute intestinal infections of viral etiology complicate of acute kidney injury (AKI), which significantly aggravates the course of the disease and affects the outcome of the disease. Currently used markers for the diagnosis of AKI are poor informative due to late detection of typical laboratory changes during the clinical picture's change. Currently, there are non-invasive biomarkers of AKI detected before changes in routine biochemical tests and can be used for early diagnosis of kidney damage. Using of these biomarkers in practice will develop of clinical and laboratory differential diagnostic criteria for early diagnosis, risk factors for the development of AKI in children with viral diarrhea of various agents, in order to start timely effective pathogenetic treatment and prevent serious complications.

Results of Routine Antenatal Screening for Cytomegalovirus at a Tertiary Center.

Cytomegalovirus (CMV) is the most common viral infection. In this study, we discussed the results of pregnant women who underwent antenatal CMV screening in a tertiary center and the value of CMV antenatal screening. For this retrospective study, the data of pregnant patients with antenatal CMV screening test results between 2019 and 2022 were obtained from hospital records. CMV immunoglobulin M (IgM), CMV IgG, anti-IgG avidity test results, amniocentesis, CMV polymerase chain reaction (PCR), and the outcome of the babies were recorded. A total of 31,912 CMV IgM and 26,969 CMV IgG tests were performed. CMV IgG seropositivity was observed in 78.99% of pregnant women, and 0.09% of the pregnant women were confirmed to have a positive CMV IgM test result. Pregnant women with positive IgM accompanying low avidity were referred to perinatology clinics for detailed ultrasonography and amniocentesis. Only 3 of the 44 pregnant women who underwent amniocentesis were confirmed to have positive CMV PCR testing. CMV screening should be preserved for pregnant women with ultrasonographic findings at high risk of congenital CMV infection.

Haploidentical Stem Cell Transplantation for Hematological Disorders: Real-World Experience from India

Haploidentical transplant (haploSCT) has its own unique complications; hence, we studied the outcome of haploSCT from a cancer hospital in India. We retrospectively analyzed the haploSCTs performed at our center between March 2015 and mid-August 2022 using posttransplant cyclophosphamide (PTCy). Ninety-nine patients (95 malignant and 4 nonmalignant) underwent 101 haploSCTs. Myeloablative (MA), nonmyeloablative (NMA), and reduced intensity conditioning (RIC) were used in 35 (34.6%), 43 (42.5%), and 23 (22.7%) transplants, respectively. The median CD34 + was 5.9 (1.8–10) ×106/kg. The median time to neutrophil and platelet engraftment was 15 (11–32) and 15.5 (9–120) days, respectively. There were 09 (8.9%) cases of primary graft rejection. Eighteen (17.8%) patients had a relapse. Acute graft versus host disease (GVHD) was observed in 33 (32.6%) cases. Blood cultures were positive in 42 (41.5%) transplants. Common viral infections were BK (47.3%) and cytomegalovirus (CMV; 65.3%). The median follow-up was 6 (0.5–89.5) months. Forty-eight (48.4%) patients had died at the last follow-up. The main causes of the death were sepsis (27 [56.2%]), relapse (10 [22.2%]), and GVHD (04 [8.8%]). The nonrelapse mortality was 37.3%. The median overall survival (OS) was 18 ± 11.46 (0–40.77) months. The 1-year OS was 56.7%, while the 2-year OS was 49.3%. We emphasize that haploSCT offers a reasonable hope of survival for patients, although infections remain a significant challenge based on our experience.

Development of a Reagent Kit for the Quantitative Determination of Hepatitis B Virus (HBV) DNA in Clinical Material by PCR with Hybridization-Fluorescence Detection

Relevance.Hepatitis B virus (HBV) is one of the most common viral infections affecting people worldwide and can lead to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Currently 3% of the world's population are infected with hepatitis B virus and are at risk of developing life-threatening liver disease. Immunological and molecular biological methods of detection of HBV are currently used in laboratory diagnostics. The polymerase chain reaction (PCR) is currently the most sensitive method for the detection and quantification of HBV. HBV DNA quantification is widely used to monitor the antiviral treatment of HBV infection.Aim.To develop a real-time PCR kit for the quantification of HBV DNA.Materials and methods.A total of 200 plasma and serum samples positive and negative for HBV were used in the development. The performance of the developed kit was compared with the use of other commercially registered HBV diagnostic kits in Russia. Additionally, the nucleotide sequences of all existing virus genotypes analysed for the selection of primers using GeneBank system.Results and discussion.Comparison analysis of the results of quantitative determination by real-time PCR in 200 clinical serum and blood plasma samples showed that the diagnostic sensitivity of the developed kit was 100% and specificity 100%. The primers developed specific to the POL gene region. The kit is capable of detecting all types of virus genotypes.Conclusions.The developed reagent kit allows detection of hepatitis B virus and determination of its quantity within 70 minutes. In addition to a large number of genotypes and subgenotypes, the virus is characterized by mutational changes in the genome, which complicates its diagnosis and, as a consequence, the ongoing therapy with drugs. Conservative regions for primer and probe selection taken into account in the development, and the sequencing results obtained are applicable to all HBV genotypes. The reagent kit is designed to monitor HBV infected patients and will allow the analysis of different HBV viral loads.

Effect of azithromycin administration in cases of acute bronchiolitis – A systematic review and meta-analysis

Acute Bronchiolitis is the most common viral lower respiratory tract infection in infants requiring hospitalization. Management is usually symptomatic and supportive with no specific treatment options. Although viral, Azithromycin by its anti-inflammatory properties might play a role in improving the clinical outcome. The objective was to assess the effect of azithromycin on length of hospital stay and duration of oxygen requirement in cases of acute bronchiolitis. Data sources such as PubMed and Google Scholar were systematically searched till June 2023. The meta-analysis included all published, randomized controlled trials that investigated the efficacy of Azithromycin over placebo in infants <24 months with acute bronchiolitis. Data extraction was guided by a predetermined checklist. Using RevMan 5 software, the mean length of hospital stay and duration of oxygen administration were pooled from the selected studies. The fixed-effect model was used to compare the length of hospital stay and the duration of oxygen administration in the Azithromycin and placebo group. Data analyses were performed in July 2023. The primary outcome was a comparison of the length of hospital stay in infants with Bronchiolitis receiving either azithromycin (intervention) or placebo (control). The secondary outcome was the assessment of the duration of oxygen requirement in both intervention and control groups.The initial search yielded 601 records of which 68 articles underwent full-text evaluation, which identified four articles and a total of 571 patients that were included. The findings did not favor the usage of azithromycin antibiotic in treatment of acute bronchiolitis (Mean deviation = 1.21, 95% CI 0.53–2.78, P = 0.80). An insignificant Q statistic (P = 0.001) indicated the absence of heterogeneity (I2 = 0%). Length of hospital stay showed an overall insignificant effect as the length of stay is almost similar in both drugs (OR = 1.04 95% CI 0.49–2.23, P = 1.00). An insignificant Q statistic (P = 1.00) indicated the absence of heterogeneity (I2 = 0%).

Pathological assessment and tissue tropism of two different Egyptian infectious bronchitis strains.

Avian infectious bronchitis is one of the most common viral infections in chickens affecting all ages. The tropism of infectious bronchitis virus (IBV) strains became broader and more variable posing major implications for the effective control of IBV infection. In this study, two IBV viruses representing classic and variant strains were inoculated intranasally into day-old SPF chicks (105 EID50/0.2ml/bird). Clinical signs were observed for 15 days post-infection (DPI). Five chicks from each group were euthanized at 2, 4, 6, 8, 10, 12, and 15 DPI for histopathology and virus antigen detection by IHC and quantitative rRT-PCR. Results revealed that both classic and variant IBV strains induced mild clinical signs with no mortalities and fewer various histopathological lesions in infected SPF chickens. Although the viruses were detected by rRT-PCR up to 12DPI, the affected tissues showed regeneration after 10DPI with IHC revealing no IBV antigen. In summary, no differences were found in the behaviour of both IBV isolates in chickens. The broad tissue tropism for both IBV strains as indicated by viral antigen detection in various organs with no clinical or gross lesion suggest that the main cause of death in IBV infection under field conditions occurs as a result of complication with secondary infections rather single IBV infection. Due to positive immunostaining in the bursa, it is thought that IBV infection has immunosuppressive consequences, hence further study is required to validate this impact.

A Retrospective Seroprevalence Study of Dengue, Chikungunya and Co-Infection virus: a Hospital Based Study from Theni, Tamil Nadu

Viral-borne diseases have recently gained significant public health importance in the current world. The Viral Research and Diagnostic Laboratory (VRDL) located at Government Theni Medical College (GTMC), Theni, Tamil Nadu, conducts the diagnosis of common virus infections. The purpose of this study is to investigate the seroprevalence of dengue (DENV) and chikungunya (CHIKV) virus infections, as well as their co-infection, in people who have clinical symptoms. From January 2018 to June 2023, serum samples were collected from clinically suspected patients at the tertiary care hospital in Theni, Tamil Nadu. DENV and CHIKV were detected using an enzyme-linked immunosorbent assay (ELISA) in all of the samples. A total of 16,997 cases were enrolled, out of which 11264/2971(26.3%) tested positive for Dengue IgM, 1395/288 (20.6%) for Dengue NS1 Ag, 19/3(15.7%) for IgG, followed by 4319/3388(8.9%) of CHIKV IgM. Fever (n = 16598, 97.6%) was the most prevalent clinical characteristic in all probable dengue and chikungunya patients. Other symptoms were chills (n = 11252, 66.1%), arthralgia (n = 10245, 60.2%), headache (n = 11354, 66.8%), and joint pain (n = 11256, 66.2%). The findings showed a lesser likelihood of acquiring both DENV and CHIKV infections at the same time; however, the risk is still not trivial. This study investigates the clinical presentation of Dengue-Chikungunya patients. The rising prevalence of dengue and chikungunya, as well as their co-infection, need thorough monitoring of endemic areas and good patient care management.

Evaluation of Daylight Methylene Blue Photodynamic Therapy in Multiple Recurrent Molluscum Contagiosum

Abstract Background Molluscum contagiosum is a common viral infection caused by DNA Poxvirus. Daylight-photodynamic therapy (DL-PDT) is defined as a photochemical reaction used to selectively destroy tissue. Objectives To evaluate the efficacy and safety of daylight methylene blue photodynamic therapy in treatment of multiple recurrent molluscum contagiosum. Subject and methods This is a single blinded controlled prospective interventional clinical study including 20 patients with molluscum contagiosum diagnosed clinically and by dermoscopy. Patients subjected to daylight methylene blue-mediated photodynamic therapy. Topical MB liposomal loaded 10% cream was applied over the lesions area with occlusion and left for 15 minutes. Two leisons were left as control in each studied patient. Patients were instructed to stay outdoors exposing their lesions and the adjacent area to daylight continuously for at least 90 minutes (if it was a sunny day) or 120 minutes (if it was an overcast or partially sunny day) between 11:00 am to 02:00 pm. Treatment sessions were done weekly for 10 weeks or till complete clearance. Follow up of the patients for 6 months after end of study to detect recurrence or appearance of new lesions. Results Daylight MB Mediated PDT response in a total of 20 (100%) studied patients showed Excellent response to treatment shown as complete clearance in 65%( no.=13) of patients, very good response to treatment in 15.0%( no.=3), good response to treatment in 10.0%( no.=2) and poor response to treatment in 10.0%( no.=2). The total number of lesions was 313. Response of the lesions in studied patents to MB-PDT was monitored by dermoscopic follow up of lesions. Lesions showed complete response in 66.5% (no. = 208) of lesions, partial response in 25.2% (no. = 79) of lesions and no response in 8.3% (no. = 26) of lesions. No serious side effects and also MB-DL/PDT is a painless treatment. No relapse was detected at the site of cleared MC or at a near site during the follow-up period of 6 months following the procedure. Conclusion Daylight-PDT using MB is effective in clearing MC lesions, also is safe, easy to carry out, economic, acceptable cosmetic results with no recurrence, convenient especially for children as it is a painless treatment.

Evaluation of Allograft Injection (Heterologous Verruca Vulgaris Lesion Extract) in the Treatment of Verruca Vulgaris

Abstract Background Warts are a common viral infection in different age groups with more than 200 types. Its pathogen is the human papillomavirus (HPV), which causes cutaneous and mucosal warts Aim of the Work This study aims to evaluate the efficacy of local allograft injection (heterologous VV lesion extract) as a treatment of verruca vulgaris. Patients and Methods This study included 30 patients with VV recruited from Ain Shams University hospital outpatient dermatology clinic in the period from November 2018 till November 2019. They were 16 females and 14 males divided into 2 groups where 15 patients; got the treatment heterologous VV lesion extract repeated every 2 weeks till resolution or reaching maximum of 4 injections. The other 15 patients (controls) received saline injection. Follow up was performed with digital photography. Results After 4 sessions of intralesional injection and through 6 months follow-up, 11 patients out of the 15 cases group underwent complete resolution of all warts, while 2 patients had mild improvement, the last 2 patients had no improvement at all. while in controls group only one patient had a spontaneous resolution, one with mild improvement, and the rest 13 subjects with no improvement at all. Some of the patients suffered side effects during treatment course, where 3 patients (20% of cases group) suffered mild erythema, 1 patient (6.7% of total cases) suffered erythema and tenderness, 2 patients (13.3% of total cases) had minor ulcers. And 9 patients (60% of total cases) had no side effects. No recurrence in cases with complete resolution occurred in 6 months follow-up to the patients. Conclusion Heterologous verruca vulgaris extract when used as a line of immunotherapy treatment in multiple verruca lesions, shows promising results in both outcome of the treatment with total complete resolution 73.3% with no recurrence in cases in a 6-months follow-up.

Clinical and Epidemiological Profile of Herpes Zoster and Its Complications in a Tertiary Care Center of Bihar: A Prospective Study.

Background Herpes zoster is a common viral infection caused by reactivation of the varicella-zoster virus (VZV) characterized by the presence of a segmental distribution of painful grouped vesicles on an erythematous base. It is associated with several complications like zoster-associated pain (ZAP), postherpetic neuralgia (PHN), pigmentary changes, scarring, secondary infections, and dermatosis as well as severe systemic complications. Aims/objectives The aim of the study was to analyze the various clinical and epidemiological patterns of herpes zoster and post-herpetic complications. Materials and methods We conducted a single-center observational cross-sectional study on 72 patients with herpes zoster and post-herpetic complications attending the dermatology outpatient department (OPD) to understand its various clinical and epidemiological patterns. A detailed history taking regarding the onset, progression, and complications of the disease, as well as the type, duration, and severity of pain, was taken, followed by a general physical, systemic, and cutaneous examination, along with investigations wherever needed. Results A total of 72 patients were included in the study, comprising 32 (44.4%) patients suffering from herpes zoster and 40 (55.5%) patients suffering from post-herpetic complaints. The minimum age was 14 years, the maximum age was 83 years, and the mean age in our study was 52 ± 17 years. The most commonly affected age group was 41-60 years. A total of 52 males and 22 females were included in the study, resulting in a male-to-female ratio of 2.3:1. The thoracic dermatome was the most commonly involved dermatome, observed in 43 (59.7%) patients, and the left side was more commonly affected, seen in 41 (56.9%) patients. Among the total 72 patients, 26 (36.1%) had co-morbidities, with hypertension (18%) being the most common, followed by diabetes mellitus (12.5%).Regarding the post-herpetic complaints encountered in our study, the most common was post-herpetic neuralgia, seen in 31 (77.5%) patients, followed by post-herpetic pigmentation (macular), observed in 22 (55%) patients, and scarring (papules, plaques, hypertrophic scar, and keloid), observed in 17 (42.5%) patients. Conclusion A broader understanding of the clinical and epidemiological factors of herpes zoster and post-herpetic complications is important as this disease constitutes a considerable burden in a tertiary care center and if not treated adequately, the after-effects might last for many years altogether. Hence, early diagnosis and initiation of adequate antiviral therapy as well as pain management is the key aspect of management.

Open-Label Observational Study of a Topical Formulation of Calcium Spirulan Contained in a Defined Extract of the Microalga Spirulina platensis in the Treatment of Children with Molluscum Contagiosum.

Molluscum contagiosum (MC) is a common viral skin infection primarily affecting children which is difficult to treat using available therapeutic approaches. The sulfated polysaccharide named calcium spirulan (Ca-SP) has demonstrated antiviral effects against herpes simplex virus in keratinocytes in vitro, and a cream containing 1.5% Ca-SP and 1% of a defined microalgae extract (Spiralin®) effectively prevented herpes labialis in a trial with susceptible individuals. This observational study aimed to show antiviral effects of a similar formulation (Spirularin® VS) against MC in children. Children with active MC lesions were treated with Spirularin® VS cream twice daily on affected skin over several months and asked to return for follow-up visits after 1 to 3 months. Clinical status of MC infection was documented at baseline and follow-up visits. Of the 31 children enrolled in the study, 26 completed treatment and returned for control visits. Spirularin® VS cream was applied twice daily over a period of 1 to 9 months (mean treatment duration 3.9 months). 19/26 (73.1%) children achieved complete clearance of MC lesions with no clinical evidence of bacterial skin infection during treatment. No irritative skin reactions or unpleasant symptoms were observed or reported. This open-label observational study suggests that a cream formulation containing 1.5% Ca-SP and 1% Spiralin® may be an effective and safe treatment option for children with active MC lesions. The high rate of complete clearance of MC lesions and lack of adverse reactions warrant further investigation in larger, controlled trials.

Application of Dengue Hemorrhagic Fever Information System (SI-DBD) for Recording and Reporting of DHF Suspects at Kota Public Health Centers in Bantaeng Regency

Background: Dengue fever is the most common viral infection transmitted by Aedes mosquitoes. This disease puts more than 3.9 billion people from 129 countries at risk of contracting dengue fever and causes 40,000 deaths each year. This study aims to analyze the effectiveness of SI-DBD applications for finding, recording, and reporting suspected cases of dengue.
 Methods: This type of research is a quasi-experiment with The Nonrandomized Control Group Pretest Posttest Design, namely there were two treatment groups (SI-DBD application users) at RT 02 and (a control group) at RT. 01, with a sample of 112 households (1:1 ratio). Data was collected through interviews and reports of suspected dengue fever.
 Results: There was an increase in reporting of suspected dengue after using the Application of the Dengue Hemorrhagic Fever Information System (SI-DBD) (233.33%). Statistical test results in the intervention group's simplicity, acceptability, data quality, and timeliness had p < 0.000, meaning that there were significant differences in all variables studied in the reporting system using the SI-DBD application. In the control group, statistical tests showed that the acceptability variable had a p < 0.0001, meaning that there were significant differences in the acceptability variable in the use of the manual system before and during the study while the variables were for simplicity, data quality, and timeliness had a p > 0.1797, 0.0833, 0.5567 means that there is no significant difference in these variables in the manual reporting system.
 Conclusion: SI-DBD application is effective for recording and reporting suspected dengue.

Congenital Cytomegalovirus and Hearing Loss: The State of the Art.

In developed countries, congenital cytomegalovirus (cCMV) infection is the most common congenital viral infection, representing the leading non-genetic cause of sensorineural hearing loss (HL). Diagnosis of cCMV infection can be performed by detection of CMV DNA in urine or saliva within 2-3 weeks after birth, or later in dried blood samples on the Guthrie card. Currently, there are many controversies regarding the preventive, diagnostic, and therapeutic approaches to cCMV infection. HL secondary to cCMV is highly variable in onset, side, degree, audiometric configuration, and threshold changes over time. Therefore, it is of paramount importance to perform a long and thorough audiological follow-up in children with cCMV infection to ensure early identification and prompt treatment of progressive and/or late-onset HL. Early cochlear implantation appears to be a valid solution not only for children with bilateral profound HL, but also for those with single-sided deafness, improving localization ability and understanding speech in noisy environments. Moreover, the decision to apply a unilateral cochlear implant in children with cCMV is strengthened by the non-negligible possibility of hearing deterioration of the contralateral ear over time.

Role of N-acetylcysteine in liver injury due to dengue fever.

Dengue fever (DF) is a common mosquito-borne viral infection which is endemic in Southeast Asia. Liver involvement may vary from asymptomatic elevation of liver enzymes to fulminant hepatitis. Although the valuable effects of N-acetylcysteine (NAC) in paracetamol toxicity and non-paracetamol liver failure have been extensively studied, its use in DF-associated hepatitis remains unclear. We made a literature search in an online format from libraries such as PubMed, Google Scholar, and EMBASE, and selected 33 articles including original research articles, case reports, and systemic analyses. The majority of the articles reviewed had a positive outcome but treatment strategies involved NAC together with supportive care. Hence, data on sole use of NAC from large randomised control trials remain unclear.

A systematical association analysis of 25 common virus infection and genetic susceptibility of COVID-19 infection

ObjectivesPrevious studies identified a number of diseases were associated with 2019 coronavirus disease (COVID-19). However, the associations between these diseases related viral infections and COVID-19 remains unknown now. MethodsIn this study, we utilized single nucleotide polymorphisms (SNPs) related to COVID-19 from genome-wide association study (GWAS) and individual-level genotype data from the UK biobank to calculate polygenic risk scores (PRS) of 487,409 subjects for eight COVID-19 clinical phenotypes. Then, multiple logistic regression models were established to assess the correlation between serological measurements (positive/negative) of 25 viruses and the PRS of eight COVID-19 clinical phenotypes. And we performed stratified analyses by age and gender. ResultsIn whole population, we identified 12 viruses associated with the PRS of COVID-19 clinical phenotypes, such as VZV seropositivity for Varicella Zoster Virus (Unscreened/Exposed_Negative: β = 0.1361, P = 0.0142; Hospitalized/Unscreened: β = 0.1167, P = 0.0385) and MCV seropositivity for Merkel Cell Polyomavirus (Unscreened/Exposed_Negative: β = −0.0614, P = 0.0478). After age stratification, we identified seven viruses associated with the PRS of eight COVID-19 clinical phenotypes in the age < 65 years group. After gender stratification, we identified five viruses associated with the PRS of eight COVID-19 clinical phenotypes in the women group. ConclusionOur study findings suggest that the genetic susceptibility to different COVID-19 clinical phenotypes is associated with the infection status of various common viruses.

Designing a bioadjuvant candidate vaccine targeting infectious bursal disease virus (IBDV) using viral VP2 fusion and chicken IL-2 antigenic epitope: A bioinformatics approach

Infectious Bursal Disease (IBD) is a common and contagious viral infection that significantly affects the poultry industry. This severely suppresses the immune system in chickens, thereby threating their health and well-being. Vaccination is the most effective strategy for preventing and controlling this infectious agent. The development of VP2-based DNA vaccines combined with biological adjuvants has recently received considerable attention due to their effectiveness in eliciting both humoral and cellular immune responses. In this study, we applied bioinformatics tools to design a fused bioadjuvant candidate vaccine from the full-length sequence of the VP2 protein of IBDV isolated in Iran using the antigenic epitope of chicken IL-2 (chiIL-2). Furthermore, to improve the antigenic epitope presentation and to maintain the three-dimensional structure of the chimeric gene construct, the P2A linker (L) was used to fuse the two fragments.Our in-silico analysis for the design of a candidate vaccine indicates that a continuous sequence of amino acid residues ranging from 105 to 129 in chiIL-2 is proposed as a B cell epitope by epitope prediction servers. The final 3D structure of the VP2-L-chiIL-2105-129 was subjected to physicochemical property determination, molecular dynamic simulation, and antigenic site determination. The results of these analyses led to the development of a stable candidate vaccine that is non-allergenic and has the potential for antigenic surface display potential and adjuvant activity. Finally, it is necessary to investigate the immune response induced by our proposed vaccine in avian hosts. Notably, increasing the immunogenicity of DNA vaccines can be achieved by combining antigenic proteins with molecular adjuvants using the principle of rational vaccine design.

Dengue virus neutralizing antibody: a review of targets, cross-reactivity, and antibody-dependent enhancement.

Dengue is the most common viral infection spread by mosquitoes, prevalent in tropical countries. The acute dengue virus (DENV) infection is a benign and primarily febrile illness. However, secondary infection with alternative serotypes can worsen the condition, leading to severe and potentially fatal dengue. The antibody raised by the vaccine or the primary infections are frequently cross-reactive; however, weakly neutralizing, and during subsequent infection, they may increase the odds of antibody-dependent enhancement (ADE). Despite that, many neutralizing antibodies have been identified against the DENV, which are thought to be useful in reducing dengue severity. Indeed, an antibody must be free from ADE for therapeutic application, as it is pretty common in dengue infection and escalates disease severity. Therefore, this review has described the critical characteristics of DENV and the potential immune targets in general. The primary emphasis is given to the envelope protein of DENV, where potential epitopes targeted for generating serotype-specific and cross-reactive antibodies have critically been described. In addition, a novel class of highly neutralizing antibodies targeted to the quaternary structure, similar to viral particles, has also been described. Lastly, we have discussed different aspects of the pathogenesis and ADE, which would provide significant insights into developing safe and effective antibody therapeutics and equivalent protein subunit vaccines.

Hepatitis B Surface Antigen (HbsAg) Prevalence and Risk Factors in Women of Childbearing Age in Eastern Algeria

Background: Hepatitis B is the most common chronic viral infection and a significant contributor to morbidity and death globally. Based on the mother's hepatitis B e antigen (HBeAg) status, the probability of perinatal HBV infection in children delivered to mothers with HBV ranges from 10% to 85%.Aim: to determine the prevalence of hepatitis B virus infection among women of childbearing age in the eastern region of Algeria and investigate risk factors for infection to recommend ways to reduce the disease's impact on neonatal morbidity and mortality.Methods: We conducted a cross-sectional study in Sétif, Algeria, from 2005 to 2007 to assess the prevalence of Hepatitis B Surface Antigen among women of childbearing age. This study is the first and only one in Algeria. Data on risk factors, obstetrics, and sociodemographic were gathered using structured questionnaire; they were subsequently tested using an enzymelinked immunosorbent assay for HBsAg. The data collected were entered and processed using Epi info 3.3.2 software. Infection prevalence, sociodemographic, clinical, obstetric and risk factors variable frequency distributions were calculated. The student's t-test and Fisher's exact test were applied, at a significance level of 5%.Results: There are834 women of childbearing age's medical records were examined for this study. 1% of HBsAg test findings were positive. Positive HBsAg didn't significantly correlate with any other variables, including age, place of residence, municipality, marital status, occupation, parity, current pregnancy, reason for current consultation, transmission risk factors (blood transfusion, recent piercing, dental care, shared personal hygiene equipment, injection with multiple use equipment, tattoo, scarification, partner characteristics). However, history of jaundice has a significant protective effect against HBsAg positive.Conclusion: Although our results classify the two municipalities studied as low prevalence areas (&lt; 2%). Prenatal HBsAg screening is strongly advised.

Spectrum of Cytomegalovirus (CMV) Infection from a Tertiary Care Neonatal ICU in Resource Limited Settings

Cytomegalovirus (CMV) infection is the most common viral infection in perinatal period, which can occur in neonates from mother, in utero (congenital) via placenta, during birth from birth canal or more commonly postnatally from maternal breast milk or blood product transmission. In premature infants in many instances it can lead to severe manifestations resulting in increased morbidities and mortality. In this case series we share our experience on the clinicodemographic profile for CMV infections in neonatal intensive care unit and subsequent challenges related to its early detection and timely treatment in resource limited settings.

Human cytomegalovirus and Epstein-Barr virus infections occurring early after transplantation are risk factors for antibody-mediated rejection in heart transplant recipients.

Antibody-mediated rejection (AMR) is a serious complication affecting the survival of patients receiving transplantation. Human cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are common viral infections that occur after transplantation, frequently emerging as viral reactivation in donor grafts or transplant recipients. The present study aimed to investigate the association between CMV and EBV infections and early-onset AMR. This study was conducted at the Heart Transplantation Center of Padova General Hospital and included a cohort of 47 heart transplant recipients (HTxs), including 24 HTxs diagnosed with AMR and 23 control HTxs with no episodes of AMR. Only early cases of CMV and/or EBV infections (1-90 days after transplantation) were considered. Fisher's exact test and logistic regression analysis were used to statistically analyze the correlation and association between AMR and CMV or EBV infection. We observed a positive statistical association between CMV and EBV infections (two-sided Fisher's exact test, p = 0.0136) and between EBV infection and AMR (two-sided Fisher's exact test, p = 0.0034). Logistic regression analysis revealed a direct statistical association between CMV and EBV infections and AMR risk (p = 0.037 and 0.006 and odds ratio = 1.72 and 2.19, respectively). AMR occurrence was associated with increased viral loads of both CMV and EBV early after transplantation. These findings suggest the role of CMV and EBV infections as relevant risk factors for AMR in HTxs for the first time.