Virus In Adults Research Articles

Wolbachia-mediated antiviral protection in Drosophila larvae and adults following oral infection.

Understanding viral dynamics in arthropods is of great importance when designing models to describe how viral spread can influence arthropod populations. The endosymbiotic bacterium Wolbachia spp., which is present in up to 40% of all insect species, has the ability to alter viral dynamics in both Drosophila spp. and mosquitoes, a feature that in mosquitoes may be utilized to limit spread of important arboviruses. To understand the potential effect of Wolbachia on viral dynamics in nature, it is important to consider the impact of natural routes of virus infection on Wolbachia antiviral effects. Using adult Drosophila strains, we show here that Drosophila-Wolbachia associations that have previously been shown to confer antiviral protection following systemic viral infection also confer protection against virus-induced mortality following oral exposure to Drosophila C virus in adults. Interestingly, a different pattern was observed when the same fly lines were challenged with the virus when still larvae. Analysis of the four Drosophila-Wolbachia associations that were protective in adults indicated that only the w1118-wMelPop association conferred protection in larvae following oral delivery of the virus. Analysis of Wolbachia density using quantitative PCR (qPCR) showed that a high Wolbachia density was congruent with antiviral protection in both adults and larvae. This study indicates that Wolbachia-mediated protection may vary between larval and adult stages of a given Wolbachia-host combination and that the variations in susceptibility by life stage correspond with Wolbachia density. The differences in the outcome of virus infection are likely to influence viral dynamics in Wolbachia-infected insect populations in nature and could also have important implications for the transmission of arboviruses in mosquito populations.

Herpes zoster ophthalmicus: declining age at presentation

ObjectiveTo investigate changes in the age of occurrence of herpes zoster ophthalmicus (HZO) in patients presenting to the Massachusetts Eye and Ear Infirmary (MEEI) from 2007 through 2013.DesignRetrospective chart review.SettingAcademic...

Prevalence and genetic diversity of noroviruses in adults with acute gastroenteritis in Huzhou, China, 2013–2014

Norovirus (NoV) infection is the most common cause of nonbacterial acute gastroenteritis, which affects both adults and children. However, the molecular epidemiology of NoV in adults with acute gastroenteritis in China has not been investigated extensively. In this study, we investigated the occurrence of NoV infections and analyzed the genetic diversity of NoV in adults with acute gastroenteritis in Huzhou, China. A total of 796 fecal samples were collected from outpatients (≥16 years of age) between March 2013 and February 2014. Real-time RT-PCR was performed to detect NoV genogroups I (GI) and II (GII). For genotyping, the capsid and RNA-dependent RNA polymerase (RdRp) genes were partially amplified and sequenced for phylogenetic analysis. NoVs were detected in 26.51 % (211/796) of the specimens, with GII being predominant, representing 96.20 % of the NoV infections. At least nine genotypes were identified among GI and GII specimens, including GI.P2/GI.2, GI.P3/GI.3, GI.P4/GI.4, GII.Pe/GII.4 Sydney_2012, GII.P12/GII.3, GII.P7/GII.6, GII.P16/GII.13, GII.Pe, and GII.Pg (RdRp only). This is the first report of a GII.P16/GII.13 recombinant virus in adults in China. GII.Pe/GII.4 Sydney_2012 was the most prevalent genotype and the only GII.4 variant identified during the study period. Our findings suggested that NoV was a common causative agent of acute gastroenteritis in adults in Huzhou, China. During the study period, the NoVs circulating in adults in Huzhou were predominantly GII.4 Sydney_2012 variants and GII NoV recombinants.

Use of non-pharmaceutical interventions to reduce the transmission of influenza in adults: A systematic review.

During seasonal influenza epidemics and pandemics, virus transmission causes significant public health concern. Reduction of viral transmission by non-pharmaceutical interventions (NPI) has a significant appeal and is often recommended. However, the efficacy of such interventions is unclear. A systematic literature review was undertaken to identify and evaluate the published literature on NPI efficacy to prevent human transmission of influenza virus in adults. Reviewers assessed the quality of eligible studies utilizing the Critical Appraisal Skills Programme for bias and the Scottish Intercollegiate Guidelines Network for methodological quality. Studies were assessed for risk of bias domains of random sequence generation, allocation concealment, attribution bias, selective reporting and blinding. Relevant citations of 2247 were reduced to 100 for full-text evaluation. Only seven met all selection criteria and pooled analysis was not feasible. Of the seven studies, two were randomized controlled trials (RCT) and five were cluster RCT. The main NPI studied were disinfection and hygiene; barriers; and combined NPI. However, these seven RCT had significant design flaws. Only two studies used laboratory confirmed influenza and poor statistical power was a major problem. Positive significant interventions included professional oral hygiene intervention in the elderly and hand washing. Despite the potential for NPI in preventing influenza transmission, there is very limited data available. Hand washing and dental hygiene may be useful, but other interventions have not been fully assessed. Properly designed studies evaluating large populations including 'at risk' patients and in a variety of communities are needed.

AİDS Tedavisinde Tenofovir Disoproksil Fumarat

Tenofovir disoproxil fumarate is an antiviral drug used against HIV (Human Immunodeficiency Virus) and hepatitis B (HBV) viruses in adults. It is an acyclic nucleoside phosphonate diester analogue of adenosine monophosphate. Tenofovir is a nucleotide reverse transcriptase inhibitor and it shows activity by preventing enzymes (reverse transcriptase of HIV, DNA polymerase of hepatitis B) required for viruses in reproducing themselves. Following the oral administration, tenofovir disoproxil fumarate is rapidly absorbed and converted to tenofovir. It reaches a maximum concentration within two hours. Tenofovir disoproxil fumarate has an intracellular half-life of approximately 17 hours and it is eliminated by a combination of glomerular filtration and active tubular secretion. Due to low rate of genotypic resistance and high antiviral activity, tenofovir disoproxil fumarate has become a preferred drug for both monotherapy and combinationed therapy.

Respiratory Viruses and Torque Teno Virus in Adults with Acute Respiratory Infections

Objective: To define the molecular epidemiology of respiratory viral infections in adult patients. Methods: Nasal and throat swabs were collected from all adult patients with influenza-like illness (ILI), acute respiratory infection (ARI), or severe ARI (SARI) admitted to a tertiary hospital in Surakarta, Indonesia, between March 2010 and April 2011 and analyzed for 19 respiratory viruses and for torque teno virus (TTV) and human gyrovirus (HGyV). Results: Respiratory viruses were detected in 61.3% of the subjects, most of whom had ARI (90.8%, OR = 11.39), were hospitalized (96.9%, OR = 22.31), had asthma exacerbation (90.9%, OR = 8.67), and/or had pneumonia (80%, OR = 4.0). Human rhinovirus (HRV) A43 predominated. Influenza A H3N2, human metapneumovirus (HMPV) subtypes A1 and A2, the influenza B virus, human adenovirus B, and human coronavirus OC43 were also detected. All respiratory viruses were detected in the transition month between the rainy and dry seasons. No mixed respiratory virus infection was found. Coinfections of the influenza A H3N2 virus with TTV, HMPV with TTV, HRV with TTV, and human parainfluenza virus-3 with TTV were found in 4.7, 2.8, 19.8, and 0.9% of the samples, respectively. Conclusions: This study highlights the need to perform routine detection of respiratory viruses in adults hospitalized with ARI, asthma exacerbation, and/or pneumonia.

Analysis of Viral Etiologies in Adults with Symptomatic Upper Respiratory Infections in an Outpatient Setting

Background: Community-acquired upper respiratory infections represent a significant source of morbidity and mortality, and viruses are the primary etiologic agent. The purpose of this study was to determine the frequency and type of viruses causing severe symptomatic upper respiratory infections in adults presenting to an academic ENT office. Methods: Retrospective chart review of 37 patients who had a total of 40 respiratory nasopharyngeal samples for viral PCR analysis collected between October 2013 and October 2014. Results: Viruses were detected in 47.5% (19/40) of samples from 37 patients. The most common viruses isolated as single infections were coronavirus, influenza (A and B) and rhinovirus which were each found in 5 (12.5%) samples. Overall, both coronavirus and influenza were found in 7 (17.5%) studies each vs. 6 (15%) for rhinovirus. Co-infections were detected in 3 (7.5%) cases, either as coronavirus and influenza B (2/3) or parainfluenza and rhinovirus (1/3). Most positive tests occurred in February and March with 5 (12.5%) tests each. Conclusions: The most frequently detected viruses in adults with severe URI symptoms were coronavirus and influenza, followed closely by rhinovirus. Infections were most commonly detected in the wintertime. Viral PCR testing can be an important tool to guide treatment.

Significant cross reactive antibodies to influenza virus in adults and children during a period of marked antigenic drift.

BackgroundLittle is known about the development of cross-reactive antibodies following natural exposure to pathogens. Such knowledge is critical in the development of new universal influenza vaccines.MethodsTo study the possibility of the presence of cross-reactive antibodies to influenza viruses which underwent a major antigenic drift between the years 1999 and 2007 sera from samples of 80 children and 400 adults were selected at random from the Israeli national serum bank. The sera was obtained in 2002 and in 2007, two time points that followed a major drift in the infectious H3N2 influenza virus strain (A/Panama/2007/99 to A/Wisconsin/67/2005).ResultsIn the summer of 2002, 13% of the children had Hemagglutination Inhibition (HI) antibody titers of at least 40 and these antibodies recognized both A/Panama/2007/99 and A/Wisconsin/67/2005, where the latter strain only began to circulate in Israel in 2006. In 2007, 29% of the children had HI antibody titers of at least 40 directed against both A/Wisconsin/67/2005 and A/Panama/2007/99, even though they had never been exposed to the latter virus. Anti-A/Panama/2007/99 antibodies were detected in 58% and 68% of the 2002 and 2007 adult samples, respectively, while 8% and 39% had antibodies against A/Wisconsin/67/2005, respectively.ConclusionsThe presence of naturally occurring cross-reactive influenza virus antibodies in a significant percentage of children has important implications for the development of a universal influenza vaccine.

Serologic assay for avian-origin influenza A (H7N9) virus in adults of Shanghai, Guangzhou and Yunnan, China

Background and objectiveTo investigate serologic status for novel avian influenza A (H7N9) virus in different areas in China, we examined serum samples collected in winter of 2011 from adult population of Shanghai (eastern China), Guangzhou (southern China) and Yunnan (southwest China) for the antibody responses to this virus. Study designA total of 900 stored serum samples of adult outpatients (300 samples for each area) were subjected to anti-hemagglutinin (HA) antibodies assay using enzyme-linked immunosorbent assay (ELISA) and neutralizing antibodies assay using H7N9 pseudotyped particles (H7N9pp) and authentic H7N9 virus based neutralization test. ResultsAnti-H7 antibodies were detected in 164, 186 and 123 samples from three areas above, respectively. Among anti-H7 positive sera, 20, 42 and 13 samples had neutralizing titers of ≥10 when 8×102 focus-forming units (FFU) of H7N9 pseudotyped particles (pp) were adopted in neutralizing assay, respectively. When neutralizing antibodies were assayed using classic microneutralization (MN) test, MN titers of ≥10 were found in 7 samples from Guangzhou, but none from Shanghai and Yunnan. ConclusionLow levels of protective immunity pre-existed in some general adult population of the three areas, and pre-existing immunity against H7N9 in Guangzhou appears stronger than that in Shanghai and Yunnan.

Epidemiology of respiratory viruses in bronchoalveolar lavage samples in a tertiary hospital

BackgroundThe prevalence of respiratory viruses in adults is largely underexplored, as most studies focus on children. Additionally, in severely ill or immunocompromised adults, where respiratory infections are mostly attributed to bacteria and fungi; respiratory viruses can lead to severe complications. ObjectivesTo evaluate the epidemiology of respiratory viruses in bronchoalveolar lavage fluid (BAL) specimens from patients with lower respiratory tract disease. The study population consisted of different groups including immunocompetent patients (control patients), solid organ transplant recipients, patients with haematological malignancies and other immunocompromised adults. Study designA total of 134 BAL fluid specimens collected during 2009–2011 were retrospectively assessed with the new commercial multiplex real-time PCR FTD Respiratory 21 Plus®, targeting 18 different viruses and 2 atypical bacterial pathogens. ResultsViral or atypical bacterial pathogens were detected in 29.1% of BAL fluid specimens. Coronaviruses were most prevalent (13.4%), followed by rhinoviruses (5.2%), RSV (4.5%) and bocaviruses (3.7%). Comparing the total number of viruses detected, a statistically significant difference was observed between the control group and patients with haematological malignancies (27.5% vs. 57.1%, p<0.05). ConclusionIn conclusion, our study highlights the high prevalence of respiratory viruses in BAL fluid specimens from adult patients with lower respiratory tract disease. The methods to be used should be sensitive and cover a wide range of potential pathogens. The specific patient population can also influence the detection rates of respiratory viruses.

Evaluación de la vacuna para la prevención del herpes zóster en adultos: revisión sistemática de la literatura

IntroductionThe reactivation of the varicella-zoster virus in adults causes a rash known as herpes-zoster. Complications affecting the central nervous system and can cause postherpetic neuralgia. ObjectiveTo evaluate the efficacy and safety of the vaccine for the prevention of re-infection by varicella-zoster virus in adults. MethodsSystematic review of the literature (2005-2013). A literature search was performed in electronic databases such MedLine or Embase, and hand search in journals. Inclusion criteria were clinical trials in adults vaccinated against herpes-zoster, recording results of efficacy and safety. Quality of the studies was assessed by CASPe checklist. ResultsTwelve clinical trials of moderate quality were included. The ranges of antibody titters (GMT) were higher in the vaccinated group compared to placebo (471-810 vs. 292-391 gpELISA/mL). GMFR ranges were also higher (2.3-1.9 vs. 1). Vaccination reduced the incidence of herpes zoster, with a protective efficacy of 51-70%. Local adverse effects (60% vs. 14.7%) and systemic (13% vs. 8%) were higher in the vaccinated groups, the most frequent reactions pain, redness, and swelling. Serious adverse events and deaths were not different between groups. ConclusionsThe vaccine against herpes-zoster shows good efficacy and safety profile. Vaccine has good immunogenicity and reduces the incidence of herpes zoster and postherpetic neuralgia. Serious adverse effects are rare and occur similarly in studied groups.

British HIV Association guidelines for the management of hepatitis viruses in adults infected with HIV 2013

British <scp>HIV A</scp>ssociation guidelines for the management of hepatitis viruses in adults infected with <scp>HIV</scp> 2013

Incidence and clinical impact of respiratory viruses in adults with cystic fibrosis

BackgroundViral respiratory infection (VRI) is a common cause of pulmonary exacerbations in children with cystic fibrosis (CF). The importance of VRI in adult CF populations is unclear.ObjectiveTo determine the incidence...

The CT Appearance of Lower Respiratory Infection Due to Parainfluenza Virus in Adults

We retrospectively reviewed the CT findings of lower respiratory tract infection (LRTI) due to parainfluenza virus (PIV) to determine the imaging features of PIV infection and to identify any differences compared with the CT appearances of LRTIs due to respiratory syncytial virus (RSV), adenovirus, and influenza virus. The imaging features of LRTI from PIV over a 51-month period were retrospectively reviewed. The specific CT findings and overall pattern of infection in patients with LRTI due to PIV were recorded and were then compared with the CT appearances of RSV, adenovirus, and influenza LRTIs using data from a previous study. Twenty-four chest CT examinations of 24 patients with PIV infection were analyzed. Tree-in-bud opacities were the most common finding (13/24, 54%), and the airway-centric pattern of disease--characterized by combinations of bronchial wall thickening, tree-in-bud opacities, and peribronchiolar consolidation (bronchitis, bronchiolitis, and bronchopneumonia)--was the most common pattern (16/24, 67%). In comparison with previous data on RSV, adenovirus, and influenza virus, PIV showed tree-in-bud opacities and airway-centric patterns significantly more often than adenovirus or influenza virus. PIV and RSV showed similar CT findings and patterns of disease. Despite varying CT appearances of PIV LRTI, it most often shows airway-centric disease and is similar to the appearance of RSV infection, both of which are members of the Paramyxoviridae family of viruses.

Respiratory viral infections and effects of meteorological parameters and air pollution in adults with respiratory symptoms admitted to the emergency room

BackgroundRespiratory viral infections (RVIs) are the most common causes of respiratory infections. The prevalence of respiratory viruses in adults is underestimated. Meteorological variations and air pollution are likely to play a role in these infections.ObjectivesThe objectives of this study were to determine the number of emergency visits for influenza-like illness (ILI) and severe acute respiratory infection (SARI) and to evaluate the association between ILI/SARI, RVI prevalence, and meteorological factors/air pollution, in the city of Porto Alegre, Brazil, from November 2008 to October 2010.MethodsEleven thousand nine hundred and fifty-three hospitalizations (adults and children) for respiratory symptoms were correlated with meteorological parameters and air pollutants. In a subset of adults, nasopharyngeal aspirates were collected and analyzed through IFI test. The data were analyzed using time-series analysis.ResultsInfluenza-like illness and SARI were diagnosed in 3698 (30·9%) and 2063 (17·7%) patients, respectively. Thirty-seven (9·0%) samples were positive by IFI and 93 of 410 (22·7%) were IFI and/or PCR positive. In a multivariate logistic regression model, IFI positivity was statistically associated with absolute humidity, use of air conditioning, and presence of mold in home. Sunshine duration was significantly associated with the frequency of ILI cases. For SARI cases, the variables mean temperature, sunshine duration, relative humidity, and mean concentration of pollutants were singnificant.ConclusionsAt least 22% of infections in adult patients admitted to ER with respiratory complaints were caused by RVI. The correlations among meteorological variables, air pollution, ILI/SARI cases, and respiratory viruses demonstrated the relevance of climate factors as significant underlying contributors to the prevalence of RVI.

Childhood socioeconomic status, telomere length, and susceptibility to upper respiratory infection

Low socioeconomic status (SES) during childhood and adolescence has been found to predict greater susceptibility to common cold viruses in adults. Here, we test whether low childhood SES is associated with shorter leukocyte telomere length in adulthood, and whether telomere length mediates the association between childhood SES and susceptibility to acute upper respiratory disease in adulthood. At baseline, 196 healthy volunteers reported whether they currently owned their home and, for each year of their childhood, whether their parents owned the family home. Volunteers also had blood drawn for assessment of specific antibody to the challenge virus, and for CD8+ CD28- T-lymphocyte telomere length (in a subset, n=135). They were subsequently quarantined in a hotel, exposed to a virus (rhinovirus [RV] 39) that causes a common cold and followed for infection and illness (clinical cold) over five post-exposure days. Lower childhood SES as measured by fewer years of parental home ownership was associated with shorter adult CD8+ CD28- telomere length and with an increased probability of developing infection and clinical illness when exposed to a common cold virus in adulthood. These associations were independent of adult SES, age, sex, race, body mass, neuroticism, and childhood family characteristics. Associations with infections and colds were also independent of pre-challenge viral-specific antibody and season. Further analyses do not support mediating roles for smoking, alcohol consumption or physical activity but suggest that CD8+ CD28- cell telomere length may act as a partial mediator of the associations between childhood SES and infection and childhood SES and colds.

Comparison among nasopharyngeal swab, nasal wash, and oropharyngeal swab for respiratory virus detection in adults with acute pharyngitis

BackgroundAcute pharyngitis is frequently seen in primary care. Acute viral pharyngitis may be easily misdiagnosed as acute bacterial pharyngitis. Laboratory-confirmed diagnosis of respiratory viruses is recommended. The purpose of this study was to compare the sensitivities among oropharyngeal swab (OPS), nasopharyngeal swab (NPS), and nasal wash (NW) in adults with acute pharyngitis.MethodsOPS, NPS, and NW were obtained from each participant with acute pharyngitis. The specimens were tested for 15 respiratory viruses by TaqMan real-time polymerase chain reaction. A sample was considered to be a true positive if any of the specimens was positive. The sensitivities among samples were compared by chi-square test or Fisher’s exact test, as appropriate.ResultsOne hundred three triple samples collected consecutively by OPS, NPS, and NW were obtained. In 73 patients, one or more viruses were detected by any of the three methods. Among all viruses, the sensitivity of NPS was significantly higher than that of NW (74% vs. 49%, respectively; p < 0.01) and OPS (74% vs. 49%, respectively; p < 0.01).ConclusionsFlocked NPS collection may be the most effective alternative to NW and OPS for detection of respiratory viruses in adults with acute pharyngitis using TaqMan real-time polymerase chain reaction.

HBV Perinatal Transmission

Hepatitis B is a serious public health problem all around the world. It is a blood-borne and sexually transmitted DNA virus in adults, but mother to child transmission of hepatitis B virus also occurs in infants born to hepatitis B surface antigen positive mothers.

Treatment of Human Immunodeficiency Virus in Adults

Treatment of Human Immunodeficiency Virus in Adults

Treatment of Human Immunodeficiency Virus in Adults—Reply

Treatment of Human Immunodeficiency Virus in Adults—Reply