Epidemiology and natural history of hepatitis C virus infection among children and young people

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Neurological complications of Zika virus infection

Introduction: Zika virus (ZIKV) disease is a vector-borne infectious disease transmitted by Aedes mosquitoes. Recently, ZIKV has caused outbreaks in most American countries.

Areas covered: Publications about neurological complications of ZIKV infection retrieved from pubmed searchers were reviewed, and reference lists and relevant articles from review articles were also examined. Vertical/intrauterine transmission leads to congenital infection and causes microcephaly and congenital ZIKV syndrome. ZIKV preferentially infects human neural progenitor cells and triggers cell apoptosis. ZIKV RNA has been identified in foetal brain tissue and brains of microcephalic infants who died; amniotic fluid and placentas of pregnant mothers; and umbilical cord, cerebro-spinal fluid and meninges of newborns. The increase in the number of Guillain-Barre syndrome (GBS) cases during the ZIKV outbreak in the Americas provides epidemiological evidence for the link between ZIKV infection and GBS. Less frequently reported ZIKV neurological complications include encephalitis/meningoencephalitis, acute disseminated encephalomyelitis, myelitis, cerebrovascular complications (ischemic infarction; vasculopathy), seizures and encephalopathy, sensory polyneuropathy and sensory neuronopathy. Analysis of GBS incidence could serve as an epidemiological ‘marker’ or sentinel for ZIKV disease and other neurological complications associated to ZIKV.

Expert commentary: An expanding spectrum of neurological complications associated with ZIKV infection is being recognised.     

Global epidemiology of viral hepatitis and national needs for complete control

Introduction. The World Health Organization recognizes that viral hepatitis is not only a massive public health issue but also a huge opportunity to improve quality of life and equity at a global level. Viral hepatitis causes about 1.5 million deaths each year and significantly affects the quality of life of hundreds of millions of people. To date, frail individuals in high-income countries and people living in low-income settings are paying the heaviest tool.

Areas covered. Here we present a broad discussion on current knowledge and topical issues about the hepatitis pandemic. The report includes a structured overview of global epidemiology, including the definition of specific local epidemic profiles for each hepatitis agents (HAV, HBV, HCV, and HEV), and a perspective about the critical actions needed for achieving a complete control.

Expert commentary. The control of viral hepatitis is currently, ethically urgent and even economically convenient. There is a wide consensus that viral hepatitis can be controlled through comprehensive intervention tailored on local needs addressing the issue of viral hepatitis as a unique public health issue. These strategies should include: (1) primary prevention (including vaccination and improved infection control), (2) improving diagnosis rate, and (3) management of existing cases of infections.     

Novel vaccine concept based on back-boost effect in viral infection

A novel vaccine concept is discussed based on recent evidence of a “back-boost” effect in Influenza infection. The initial immune response to the infection is imprinted through an immune memory pathway. The immune memory in the back-boost mechanism could be used in reversed order as a “forward-boost” in the proposed vaccine concept.     

Improvement of BCG protective efficacy with a novel chimpanzee adenovirus and a modified vaccinia Ankara virus both expressing Ag85A

A replication-deficient chimpanzee adenovirus expressing Ag85A (ChAdOx1.85A) was assessed, both alone and in combination with modified vaccinia Ankara also expressing Ag85A (MVA85A), for its immunogenicity and protective efficacy against a Mycobacterium tuberculosis (M.tb) challenge in mice. Naïve and BCG-primed mice were vaccinated or boosted with ChAdOx1.85A and MVA85A in different combinations. Although intranasally administered ChAdOx1.85A induced strong immune responses in the lungs, it failed to consistently protect against aerosol M.tb challenge. In contrast, ChAdOx1.85A followed by MVA85A administered either mucosally or systemically, induced strong immune responses and was able to improve the protective efficacy of BCG. This vaccination regime has consistently shown superior protection over BCG alone and should be evaluated further.     

Vaccine introduction in the Democratic People's Republic of Korea

The feasibility of mass vaccination campaigns for Japanese encephalitis and Haemophilus influenzae type b infections was explored in the Democratic People's Republic of Korea using pilot vaccination studies. The experiences from these initial studies were then used to support larger vaccination campaigns in children at risk of these infections. We discuss the challenges and requirements for the inclusion of additional vaccines into the existing expanded program on immunization in the country.     

山西省运城市2012年蚊媒病毒的分离鉴定

目的 了解山西省运城市蚊虫及蚊媒病毒的种类和分布。方法 2012年8月在山西省运城市临猗县和永济市采集蚊虫标本, 经鉴定分类和分批研磨后, 利用细胞(C6/36和BHK21)培养方法分离病毒, 对阳性分离物使用蚊媒病毒种属特异引物进行RT-PCR扩增鉴定。结果 采集4属7种10 455只蚊虫, 临猗县和永济市优势蚊种分别为淡色库蚊(91.96%)和三带喙库蚊(72.85%)。经鉴定分析, 从标本中分离到15株基因Ⅰ型乙型脑炎病毒(JEV)、4株库蚊黄病毒(CxFV)、3株淡色库蚊浓核病毒(CppDNV)和1株盖塔病毒(GETV)。结论 首次从山西省分离GETV和CxFV;三带喙库蚊仍是运城市优势蚊种, 目前当地自然循环的JEV仍以基因Ⅰ型为主。     

Anti-tumor effect of the alphavirus-based virus-like particle vector expressing prostate-specific antigen in a HLA–DR transgenic mouse model of prostate cancer

The goal of this study was to determine if an alphavirus-based vaccine encoding human Prostate-Specific Antigen (PSA) could generate an effective anti-tumor immune response in a stringent mouse model of prostate cancer. DR2bxPSA F₁ male mice expressing human PSA and HLA-DRB1^*1501 transgenes were vaccinated with virus-like particle vector encoding PSA (VLPV–PSA) followed by the challenge with Transgenic Adenocarcinoma of Mouse Prostate cells engineered to express PSA (TRAMP–PSA). PSA-specific cellular and humoral immune responses were measured before and after tumor challenge. PSA and CD8 reactivity in the tumors was detected by immunohistochemistry. Tumor growth was compared in vaccinated and control groups. We found that VLPV–PSA could infect mouse dendritic cells in vitro and induce a robust PSA-specific immune response in vivo. A substantial proportion of splenic CD8 T cells (19.6 ± 7.4%) produced IFNγ in response to the immunodominant peptide PSA_65–73. In the blood of vaccinated mice, 18.4 ± 4.1% of CD8 T cells were PSA-specific as determined by the staining with H-2D^b/PSA_65–73 dextramers. VLPV–PSA vaccination also strongly stimulated production of IgG2a/b anti-PSA antibodies. Tumors in vaccinated mice showed low levels of PSA expression and significant CD8+ T cell infiltration. Tumor growth in VLPV–PSA vaccinated mice was significantly delayed at early time points (p = 0.002, Gehan–Breslow test). Our data suggest that TC-83-based VLPV–PSA vaccine can efficiently overcome immune tolerance to PSA, mediate rapid clearance of PSA-expressing tumor cells and delay tumor growth. The VLPV–PSA vaccine will undergo further testing for the immunotherapy of prostate cancer.     

曲美他嗪联合黄芪注射液治疗急性病毒性心肌炎疗效观察

目的 分析曲美他嗪联合黄芪注射液对急性病毒性心肌炎患者的临床治疗效果.方法 将60例急性病毒性心肌炎患者按照随机双盲的原则均分为对照组和观察组(n=30).对照组患者治疗上给予注射用辅酶A静脉滴注,1次/d,1次300单位,三磷酸腺苷二钠片,口服,3次/d,1次2片;维生素C注射液,静脉滴注,3次/d,1次250 mg;1,6二磷酸果糖注射液静脉滴注,1次/d,1次5 g;观察组患者在上述常规治疗的基础上同时给予曲美他嗪和黄芪注射液治疗,口服,3次/d,1次1片,黄芪注射液静脉滴注,1次/d,1次30 mL.比较2组患者的临床治疗有效率及心电图改善情况.结果 对照组患者的临床治疗总有效率70.00%明显低于观察组90.00%,差异有统计学意义(P<0.05);经过治疗,对照组患者的ST-T改善情况总有效率70.00%明显差于观察组90.00%.结论 对于急性病毒性心肌炎患者在常规治疗的基础上加用曲美他嗪和黄芪注射液,不仅提高临床治疗效果,而且有助于患者心肌缺血情况的改善.