Human Coinfection Research Articles

Competition between Usutu virus and West Nile virus during simultaneous and sequential infection of Culex pipiens mosquitoes

ABSTRACT Usutu virus (USUV) and West Nile virus (WNV) are closely related mosquito-borne flaviviruses that are mainly transmitted between bird hosts by vector mosquitoes. Infections in humans are incidental but can cause severe disease. USUV is endemic in large parts of Europe, while WNV mainly circulates in Southern Europe. In recent years, WNV is also frequently detected in Northern Europe, thereby expanding the area where both viruses co-circulate. However, it remains unclear how USUV may affect the future spread of WNV and the likelihood of human co-infection. Here we investigated whether co-infections with both viruses in cell lines and their primary mosquito vector, Culex pipiens, affect virus replication and transmission dynamics. We show that USUV is outcompeted by WNV in mammalian, avian and mosquito cells during co-infection. Mosquitoes that were exposed to both viruses simultaneously via infectious blood meal displayed significantly reduced USUV transmission compared to mosquitoes that were only exposed to USUV (from 15% to 3%), while the infection and transmission of WNV was unaffected. In contrast, when mosquitoes were pre-infected with USUV via infectious blood meal, WNV transmission was significantly reduced (from 44% to 17%). Injection experiments established the involvement of the midgut in the observed USUV-mediated WNV inhibition. The competition between USUV and WNV during co-infection clearly indicates that the chance of concurrent USUV and WNV transmission via a single mosquito bite is low. The competitive relation between USUV and WNV may impact virus transmission dynamics in the field and affect the epidemiology of WNV in Europe.

Strongyloides venezuelensis-infection alters the profile of cytokines and liver inflammation in mice co-infected with Schistosoma mansoni

Human co-infection by helminth species is frequent, but their consequences are mostly unknown. Here, we investigate the impact of Strongyloides venezuelensis co-infection on the immune response, schistosome burden, and the associated pathology of schistosomiasis in mice. Co-infection did not alter the schistosome parasite burden, but reduced the IL-4/IL-10 ratio during acute schistosomiasis, indicating induction of modulatory mechanisms. Simultaneous infection with S. venezuelensis and S. mansoni increased the liver concentration of IFN-γ and altered the Th2/Th1 balance, leading to great infiltration of neutrophils and macrophages, which resulted in larger liver inflammation and increased serum transaminase activity in comparison with mono-infected mice. Mice infected with S. venezuelensis at two and four weeks after S. mansoni infection showed significant increase of Th1/Th2/Th17/Treg cytokines and strong cellular infiltration in the liver in comparison with mono-infected mice. However, only in mice co-infected after two weeks of schistosomiasis, the liver immune response leads to more intense Th2 polarization, increased liver inflammation, and transaminase serum activity. S. venezuelensis co-infection during chronic schistosomiasis did not significantly alter liver inflammation. Therefore, S. venezuelensis co-infection affects the host immune responses and morbidity of schistosomiasis, but the effects largely depend on the stage of the S. mansoni infection.

SIV infection aggravates malaria in a Chinese rhesus monkey coinfection model

BackgroundThe co-occurrence of human immunodeficiency virus (HIV) infection and malaria in humans in endemic areas raises the question of whether one of these infections affects the course of the other. Although epidemiological studies have shown the impact of HIV infection on malaria, the mechanism(s) are not yet fully understood. Using a Chinese rhesus macaque coinfection model with simian immunodeficiency virus (SIV) and Plasmodium cynomolgi (Pc) malaria, we investigated the effect of concurrent SIV infection on the course of malaria and the underlying immunological mechanism(s).MethodsWe randomly assigned ten Chinese rhesus monkeys to two groups based on body weight and age. The SIV-Pc coinfection animals (S + P group) were infected intravenously with SIVmac251 eight weeks prior to malaria infection, and the control animals (P group) were infected intravenously with only Pc-infected red blood cells. After malaria was cured with chloroquine phosphate, we also initiated a secondary malaria infection that lasted 4 weeks.We monitored body weight, body temperature and parasitemia, measured SIV viral loads, hemoglobin and neopterin, and tracked the CD4+, CD8+, and CD4+ memory subpopulations, Ki67 and apoptosis by flow cytometry. Then, we compared these parameters between the two groups.ResultsThe animals infected with SIV prior to Pc infection exhibited more severe malaria symptoms characterized by longer episodes, higher parasitemia, more severe anemia, greater body weight loss and higher body temperature than the animals infected with Pc alone. Concurrent SIV infection also impaired immune protection against the secondary Pc challenge infection. The coinfected animals showed a reduced B cell response to Pc malaria and produced lower levels of Pc-specific antibodies. In addition, compared to the animals subjected to Pc infection alone, the animals coinfected with SIV and Pc had suppressed total CD4+ T cells, CD4+CD28highCD95high central memory T cells, and CD4+CD28lowCD95− naïve T cells, which may result from the imbalanced immune activation and faster CD4+ T cell turnover in coinfected animals.ConclusionsSIV infection aggravates malaria physiologically and immunologically in Chinese rhesus monkeys. This nonhuman primate SIV and Pc malaria coinfection model might be a useful tool for investigating human HIV and malaria coinfection and developing effective therapeutics.

Risk Factors for Influenza Virus Related Severe Lower Respiratory Tract Infection in Children.

Influenza virus is one of the most common respiratory pathogens for all age groups and may cause seasonal outbreaks. Our aim was to identify risk groups and factors associated with severe clinical course including mortality in children with influenza-related lower respiratory tract infection (LRTI). We conducted a retrospective study in children hospitalized with influenza virus LRTI from 2008 to 2018. Data on demographic features, influenza type, viral coinfection, primary and secondary bacterial infections (SBIs), time of onset of antiviral treatment, comorbidities, hospitalization length, pediatric intensive care unit admission/invasive mechanical ventilation (IMV) need and mortality were collected from medical records. There were 280 patients hospitalized with LRTI and median hospitalization length was 9 days. Congenital heart disease, neuromuscular disease, SBIs and late-onset antiviral treatment were independent risk factors for prolonged hospital stay (P < 0.05). Pediatric intensive care unit admission was present in 20.4% (57) of the patients and 17.1% (48) of all patients required IMV. SBIs, lymphopenia, neutrophilia, immunosuppression and human bocavirus coinfection were independent risk factors for IMV support (P < 0.05). Eighteen patients died and immunosuppression, lymphopenia and SBIs were independent risk factors for mortality (P < 0.05). Presence of comorbidity, SBIs, neutrophilia and lymphopenia at admission identified as risk factors for severe influenza infections including need for IMV and death. Although several studies showed that antiviral treatment reduce hospitalization, complications and mortality, there is a lack of prospective trials and patients for antiviral therapy should be carefully chosen by the clinician.

Ivermectin concentration in breastmilk of a woman with Strongyloides stercoralis and human T-lymphotropic virus-I co-infection

Ivermectin is a widely used drug for the treatment of various neglected tropical diseases, such as lymphatic filariasis, onchocerciasis, and strongyloidiasis among others. Despite its excellent safety profile, there are few published studies of the use of ivermectin in children, pregnant and nursing women. In the present study, we report clinical data on ivermectin concentrations in breastmilk of a woman with Strongyloides stercoralis and HTLV-I coinfection. Ivermectin levels in breastmilk ranged from 1.4 to 20.8 ng/ml, with a mean of 9.26 ng/ml after a single dose of 200 µg/kg. We estimated the possible ivermectin exposure of the infant to be 1.1 µg/kg, 0.55% of the weight-adjusted percentage of the maternal dose. This value is largely under the threshold established by the World Health Organization for safe breastfeeding. Our results bolster previous findings on the secretion of ivermectin into breastmilk in healthy volunteers. The findings from this case study do not support exclusion of lactating women or interrupting lactation to accommodate it.

1633. Human Co-infection with Borrelia burgdorferi and Babesia microti Among High-Risk Hispanic/Latino Workers on Eastern Long Island, New York: A Preliminary Cross-Sectional Analysis in 2016

BackgroundLyme disease has serious public health implications and has a high prevalence in Suffolk County, NY. Furthermore, there is a high risk for coinfection with Babesiosis, a potentially life-threatening tick-borne infection in the same area. This population-based cohort study was implemented in 2016 to assess the risk factors for Borreliosis among the Hispanic/Latino work population, which gave us the opportunity to measure clinical and epidemiological features of co-infection.MethodsInvitation to participate in the study occurred during a Spanish educational lecture about tick-borne diseases. Following signed informed consent, a questionnaire and blood sample were obtained for each participant Borreliosis was defined based on 2-tiered serologic testing. Antibodies to B. microti were detected by indirect immunofluorescence assay (IFA). Between June and December 2016, 126/199 (66%) with a completed visit 1 (survey and blood draw) were included in the first analysis.ResultsSample characteristics include 60% 18–39 years old, 75% male, 79% had elementary school education or less, 86% reported having tick exposure, 79% lived in Eastern North Fork, 65% lived 10 or more years in the United States, and 48% were gardeners and landscapers. The seroprevalence for Borreliosis burgdorferi, Babesiosis microti, and co-infection were n = 13(10.3%), n = 36 (28.6%), and n = 7 (5.6%), respectively. In the univariate analysis having a fatigue severity score of <4 or having fatigue most of the time or stiff neck or joint pain or facial paralysis, or a previous diagnosis of other tick-borne diseases were associated with co-infection (Pearson chi-square, P < 0.05).ConclusionHowever, none of these factors were statistically significant in the multivariate analysis after adjusting for the above variables. In this initial study, a high prevalence of Babesiosis was found. A larger sample size may be needed to better assess the risk of coinfection in this Lyme endemic area.Disclosures All authors: No reported disclosures.

Human bocavirus infections and co-infections with respiratory syncytial virus and Rotavirus in children with acute respiratory or gastrointestinal disease

The objective of this study was to determine the frequency and seasonal distributions of HBoV detections among Iranian children presenting with acute respiratory or gastrointestinal symptoms and to compare infections among children with concomitant respiratory syncytial virus (RSV) and rotavirus (RV) infections. A cross-sectional study at Mofid Children's Hospital in Tehran, Iran, enrolled children < 3years old presenting with either acute respiratory or gastrointestinal symptoms during the period of 2017-2018. Respiratory or stool specimens collected from each group were initially tested by RT-PCR assays for RSV and RV, respectively, and all specimens were tested for HBoV by PCR assay. Clinical and demographic data were collected and statistically compared. Five hundred respiratory and stool specimens each were tested and 67 (13.4%) and 72 (14.4%) were PCR positive for HBoV, respectively. Of 128 (25.6%) respiratory specimens positive for RSV, 65% were also positive for HBoV (p = 0.019); of 169 (33.8%) stool specimens positive for RV, 62.5% were also positive for HBoV (p = 0.023). Peak circulation of all viruses was during late winter and early spring months (Jan-Mar) in gastrointestinal infections and during winter (Feb-Jan) in respiratory infections. HBoV is commonly detected among Iranian children presenting with acute respiratory or gastrointestinal symptoms and is often present as co-infections with RSV and RV, respectively.

Risk mapping of human HIV-Leishmaniasis co-infection in Morocco

BackgroundHIV/AIDS is frequently associated with opportunistic diseases such as leishmaniasis. Hence, the co-infection HIV-Leishmania spp. is the result of the geographical overlap between leishmaniasis and HIV/AIDS cases. To the best of our knowledge, this is the first report describing the spatial distribution of HIV-Leishmaniasis co-infection in Morocco where both infections are endemic. MethodsIn the current study, we discuss the HIV-Leishmania spp. co-infection vulnerability in Morocco by using the cartography tools. Thus, epidemiological data of both infections (Leishmaniasis and HIV/AIDS) in different administrative regions of Morocco were collected and co-registered for Digital maps making. Results & conclusionThe results showed a high risk of HIV-Leishmania infantum co-infection in northern and central regions in Morocco. These results should be taken into account for efficient control strategies and epidemiological surveillance of HIV –Leishmania spp. co-infection in Morocco.

Identifying Barriers to the Treatment of Chronic Hepatitis C Infection

Background and Aims: Chronic hepatitis C (CHC) viral infection has a major impact on our health care system. The emergence of direct-acting antiviral agents (DAA) has made treatment simple (oral), efficacious, and safe. However, treatment is expensive and access is variable. Despite great treatment outcomes, only a minority of patients with CHC receive antiviral therapy. This study identifies the barriers to treatment in CHC infection. Methods: Study recruited all hepatitis C antibody-positive patients between 2012 and 2016 from a large academic teaching hospital in New York City. Demographic information, clinical data, and insurance information were reviewed. Statistical analysis performed with OR and p < 0.05 reported. Result: A total of 1,548 patients with hepatitis C antibody-positive titer were included in the initial analysis. One thousand and twenty-four patients were forwarded to the final analysis after exclusion of 524 patients (for distant resolved hepatitis C viral [HCV] infection [n = 42], patients cured with interferon-based regimens [n = 94], patients with comorbid conditions [n = 176], and patients with an incomplete medical chart [n = 212]). In the intention to treat cohort of 1,024 patients, 204 patients achieved a sustained virological response after receiving DAAs (n = 204/1,024 – 20%). The majority of patients had not received DAAs (n = 816/1,024 patients – 80%). Multiple factors resulted in hepatitis C viral infection (HCV) patients not receiving DAAs including the following primary factors: (a) lost to follow-up clinic visits and poor adherence to clinic appointments (n = 548 [67%]; p value <0.0001), (b) active substance abuse (alcoholism and IV drug abuse; n = 165 [20%]; p value 0.22), (c) patients with significant psychiatric illness (n = 103 [12.7%]; p value 0.015), and subgroup analysis revealed that 188 (188/1,024 – 12%) patients had human immunodeficiency virus-1 (HIV-1) and HCV coinfection. Majority of HCV/HIV coinfected patients had not received DAAs (n = 176 [97%]; p value <0.0001, OR 4.46). The etiology of nontreatment in coinfected HIV/HCV patients was 73.3% poor adherence, 11.5% active substance abuse including alcohol and IV drug use, and 9% significant psychiatric illness and 6.2% multiple reasons for not receiving HCV treatment. Conclusion: Multifactorial barriers are preventing hepatitis C patients from receiving effective DAA therapy. Primary factors include poor compliance, substance abuse, and significant psychiatric illness, with significant overlap between these groups. Subgroup analysis showed a substantial number of high-risk patients with HIV/HCV coinfection did not receive DAA therapy. A multidisciplinary clinic approach with a hepatologist, ID physicians, social worker, and behavioral health psychologist and case manager should provide a solution to improve diagnosis and treatment with DAA.

Prevalence and genotyping of hepatitis B virus: a cross-sectional study conducted with female sex workers in the Marajó Archipelago, Brazil

In South America, the Amazon basin is considered an endemic area of hepatitis B virus (HBV) infection. However, epidemiological studies with vulnerable groups are scarce. Female sex workers (FSWs) are highly vulnerable to sexually transmitted infections due to a combination of their sexual behavior and socio-economic conditions. Thus, this study investigated the prevalence of HBV infections and HBV–hepatitis C virus, HBV–hepatitis D virus, HBV–HIV, and HBV–human T-lymphotropic virus co-infections among FSWs in the Marajó Archipelago, northern Brazil, as well as identifying the HBV genotypes circulating in this population. A total of 153 FSWs in 5 towns and 18 riverside communities were included in the study. The HBV infection and co-infections were diagnosed by enzyme-linked immunosorbent assay and real-time polymerase chain reaction. The HBV genotypes were detected by sequencing and were then analyzed phylogenetically. Most of the FSWs surveyed were single, young, heterosexual, and born locally, with low levels of education. Overall, 21 (13.7%) had been exposed to HBV, and HBV-DNA was detected in 13 (8.5%). Genotypes A (69.2%), D (23.1%), and F (7.7%) were detected. Seven cases of co-infections with other viruses were detected. These findings indicate a clear need for urgent measures to control the spread of HBV and other pathogens, and to promote the health of the local FSWs.

A study presenting the analysis of co-infection of chikungunya and dengue virus in a microbiology laboratory at tertiary care hospital in western India

Coinfection means simultaneous infection by two or more virus. Dengue and Chikungunya are viral infections caused by RNA virus (arbovirus). The transmitting vector for both viruses is Aediesaegypti. Human co-infection with DENV and CHIKV have been reported in India since 1967. DENV and CHIKV share a number of similarities in clinical presentation which includes seasonal transmission cycle. This study was carried out in Virology Department, PDU Medical College, Rajkot. A total of 3810, 2122 and 1605 hospitalized patients were serologically screened for DENV, CHIKV and both, respectively between July and October 2017 by IgM Capture ELISA. Co-infection was defined as a positive IgM assay for both infections.60 (3.73%) were IgM positive for both DENV and CHIKV. 474 (12.44%) were mono-infected with DENV and 721 (33.97%) were mono-infected with CHIKV. Simultaneous infection with Dengue and Chikungunya viruses is having more severity than single infection. Early detection and time bound Notification of the positive cases help to reduce the morbidity and mortality rate and help the health authorities to execute effective measures for prevention and control of diseases. This will also help in increasing vigilance before any epidemic. Keywords: Co infection, Dengue, Chikungunya, ELISA.

Epidemiology of Lyme borreliosis in France - both certainties and uncertainties

Epidemiological evidence for tick-borne infections, particularly those related to Lyme borreliosis, is heterogeneous. Lyme borreliosis is a tick-born zoonosis transmitted by ticks of the genus Ixodes ricinus. After tick bite, the risk of transmission of an infectious agent remains low, most often represented by Borrelia burgdorferi sensu lato; co-infections in Humans by several different infectious agents (bacterial, viral or parasitic) are possible but a priori rare. In addition, besides well-known tick-borne pathogens, new species or gender of micro-organisms are regularly described in ticks but their pathogenicity in human pathology is not described or not yet established. The clinical presentation of Lyme borreliosis is varied, with localized and disseminated forms occurring long ago after tick bite, making diagnosis sometimes difficult. The natural course of Lyme borreliosis is insufficiently known because of recommendations of antibiotherapy in case of illness; however, some historical studies seem reassuring with possible spontaneous healing and seemingly minor sequelae. The diagnosis of disseminated forms requires paraclinical examinations, in first place serology, whose sensitivity increases with time of evolution of borreliosis; this is all the more interesting as the disseminated forms are of more difficult clinical diagnosis. After antibiotherapy, the clinical course is good, the sequelae remain possible especially in case of late diagnosis or late disseminated form; however, their frequency remains unknown.

Human Papilloma Virus and Chlamydia trachomatis: Casual Acquaintances or Partners in Crime?

Interactions between microorganisms can alter subsequent disease outcomes. Human papilloma virus (HPV) and Chlamydia trachomatis (CT) establish human genital co-infections, and CT infection is a co-factor for HPV-induced cervical cancer. This review focuses upon (i) data indicating that clinically significant interactions occur and (ii) proposed mechanisms underlying these outcomes. Epidemiological surveys indicate that (i) simultaneous HPV/CT genital co-infections are common; (ii) CT co-infection accelerates HPV-induced cytopathology; and (iii) HPV infection facilitates CT infection. Single-infection studies suggest specific molecular mechanisms by which co-infection alters clinical outcomes, including (i) HPV E6/E7 protein modification of host cell pathways enhances CT replication or immune evasion and (ii) CT-mediated host cell or neutrophil dysfunctions promote HPV-mediated neoplasia. There are multiple avenues for future dissection of HPV/CT interactions. Moreover, the known and potential health consequences of co-infection highlight the need for improving current HPV vaccines and developing an effective CT vaccine.

Type I Interferon confers susceptibility to Mycobacterium tuberculosis infection within granulomas of SIV co-infected non-human primates

Abstract Mycobacterium tuberculosis (Mtb) co-infection with human immunodeficiency virus (HIV) typically results in poor disease outcome for tuberculosis (TB). While the loss of CD4+ T cells due to HIV is known to cause increased TB disease susceptibility, the mechanisms which govern the loss of disease control in co-infected individuals are not well understood particularly within the lung granulomas that keep TB contained. This study aims to profile the transcriptional patterns of lung granulomas from non-human primates (NHP) co-infected with Mtb and simian immunodeficiency virus (SIV) as a model for TB-SIV co-infection in humans. We compared the transcriptional profiles of granulomas from four Mauritian cynomolgus macaques that were infected with SIV for six months and then co-infected with Mtb for eight weeks against animals that were infected with Mtb for eight weeks. Granulomas from co-infected animals were found to have generally elevated transcripts involved in Type I interferon pathways (IFIT1), anti-bacterial effectors (defensin A, cathepsin G) and evidence of increased neutrophilic inflammation compared to Mtb-only control lung granulomas. Pathways that were downregulated in co-infected animals were related to Type II interferon signaling (IRF8). These results suggest that SIV infection alters the host immune response in ways that may be advantageous to Mtb growth by lowering IFNγ responsiveness and promoting myeloid cell-associated inflammation. We hypothesize this leads to a more permissive and less antibacterial environment that promotes bacterial survival, dissemination, and ultimately leads to increased susceptibility of co-infected individuals towards TB disease.

Life style as a risk factor of human Papillomavirus co-infections with Trichomonas vaginalis in female sex workers

BACKGROUNDAsymptomatic Trichomonas vaginalis (TV) and human papillomavirus (HPV) co-infection is perceived to have a devastating combined effect on victims. Hence, we investigated TV/ HPV co-infection and determined the risk factors associated with it in female sex workers (FSW).METHODSA cross-sectional study was used to recruit 338 subjects from 6 local government areas (LGAs) in Nigeria for 18 months. Agglutination tests for blood samples, and direct and wet examination of urine and vaginal swabs were conducted in the laboratory. Life style of FSWs was surveyed; data were analyzed with Chi-Square test (X2), paired and unpaired t-test and logistic regression analysis with statistical significance set at p&lt; 0.05.RESULTSLife style characteristics were significantly associated with HPV and TV co-infection (p &lt; 0.001). The model explained 49.9% (Nagelkerke R2) of the variance in infections among FSWs and effectively classified 93.2% of cases. Those involved in oral sex were 1.795 times more likely to be infected compared to those not involved (OR: 1.795; 95% C.I.: 1.005 – 33.525; p=0.001). Street and residential FSWs all have increased likelihood of being infected. Hard drug usage was also associated with an increased likelihood of being infected with the disease (OR: 3.582; 95% C.I.: 1.573 - 11.756; p=0.001).CONCLUSIONSLife style (hard drug usage and oral sex practices) was observed in association with HPV/ TV co-infection in FSWs with a preponderance of 49.9%. This study demonstrated the value of screening for genital infections in HPV positive subjects in order to reduce the probable synergistic effects of co-infections.

The Impact of Human Parvovirus B19 Co-Infection on Liver Function of HCV Infected Patients

Background: Human Parvovirus B19 is most known for causing disease in the pediatric population but can also affect adults. Human co-infection with Parvovirus B19 could deteriorate the prognosis of patient with chronic ill-ness. Objectives: This paper attempts to determine the prevalence of Parvovirus B19 in HCV infected patients and to evaluate the impact of Parvovirus B19 on liver enzymes activity of Hepatitis C patients. Study Design: The study population includes 74 chronic HCV (patient group) and 49 cases without viral hepatitis (control group). Nucleic acid of Parvovirus B19 was detected in Serum samples by nested polymerase chain reaction (nested-PCR) method. Results: Parvovirus B19-DNA infection was detected in 28.0% of chronic HCV patients. Parvovirus B19-HCV co-infection caused increasing in Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) activity than in B19-negative HCV patients. Conclusion: We conclude that Parvovirus B19 acted synergistically with HCV by increasing the levels alanine ami-notransferase (ALT) and Aspartate aminotransferase (AST).

Role of Epstein-Barr Virus and Human Papillomavirus Coinfection in Oral and Anogenital Carcinogenesis: Potential Tumorigenic Pathways.

Epstein-Barr virus (EBV) and human papillomavirus (HPV) have been implicated in 38% of all virus-related cancers. Over the past three decades, both have been detected in anogenital and head-and-neck squamous cell carcinomas (HNSCC), with evidence of involvement in tumor genesis and progression. Very little has been published on HPV/EBV coinfection. In this chapter, we review the literature on the role of these viruses in oral carcinoma and draw parallels with other HNSCCs and anogenital carcinomas, with emphasis on their interplay and potential signaling pathways. EBV infection seems to create an environment that favors HPV latency, supporting the claim that EBV is a cofactor in HPV-related carcinomas. In turn, under certain circumstances, HPV appears to be able to induce EBV to switch to the latent or replicative state. The main viral oncogenes expressed in these malignancies are EBNA1, EBNA2, LMP1, EBERs, and the high-risk HPV oncogenes E6 and E7. The most well-documented human proteins involved are p53, pRb, p16INK4a, p19ARF, Myc, E-cadherin, β-catenin, EGFR, MLH1, and COX-2. These proteins are directly associated not only with viral products but also with one another in the development of malignancy. Knowledge of the molecular machinery behind carcinomas coinfected with HPV and EBV may help understand how these viruses trigger carcinogenesis and subsidize the development of new biomarkers of tumor aggressiveness and prognosis, alternative surrogate virus markers, and possible therapeutic targets.

Recent Increase of Human Granulocytic Anaplasmosis and Co-Infection with Scrub Typhus or Korean Hemorrhagic Fever with Renal Syndrome in Korea.

We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome.

Hepatitis B, Hepatitis C, Human Immunodeficiency Virus, Syphilis and Coinfection Seroprevalence Among Healthy Volunteers Blood Donors in Angola, between 2011 and 2016

Hepatitis B, Hepatitis C, Human Immunodeficiency Virus, Syphilis and Coinfection Seroprevalence Among Healthy Volunteers Blood Donors in Angola, between 2011 and 2016

Prevalence of ureaplasma urealyticum, mycoplasma hominis and human papillomavirus coinfection in people attending a sexually transmitted infections (STI)/HIV reference centre in Salvador, Bahia, Brazil

Introduction: Ureaplasma urealyticum and Mycoplasma hominis are frequently found at many women’s and men’s urogenital tract, and have been associated with non-gonococcal urethritis, cervicitis, infertility, chorioaminionitis and adverse pregnancy outcomes. Some studies show high prevalence of human papillomavirus (HPV) in patients with non-gonococcal urethritis, while also presenting high frequency of Ureaplasma urealyticum infection in women with cervicalcytology abnormalities and men with genital warts. Objectives: To evaluate the prevalence of Ureaplasma urealyticum, Mycoplasma hominis and HPV coinfection in people attending a sexually transmitted infections (STI)/HIV reference centre and to identify the risk factors associated. Methods: A cross-sectional study with patients aged &gt;18 years, carried out for Ureaplasma urealyticum and Mycoplasma hominis from July 1st to December 31, 2015, in a STI/HIV reference centre from the State of Bahia, Brazil. Sociodemographic and clinical data were obtained from secondary data from patients’ charts and laboratory findings, and analyzed using SPSS 20.0. Pearson’s χ2 test or Fisher’s exact test was used to evaluate categorical variables. HPV clinical diagnosis was considered positive as the presence of genital warts. Results: In this study, 849 patients were included — 196 men and 653 women. Of the sample, 51.4% was diagnosed with at least one of the two bacteria. The prevalence of Mycoplasma hominis infection was higher in coinfection (16.7%) than in isolated infection (2.2%). The prevalence of Ureaplasma urealyticum isolated infection was 32.4%. A strong association was found between the presence of genital warts and Ureaplasma urealyticum infection, with an estimated risk of 1.230 (p=0.014). Conclusion: Our findings suggest the need for further investigation for Ureaplasma urealyticum infection in patients presenting genital warts on physical examination. In addition, in this context, greater attention should be given to women and pregnant women.