Risultati per: Sclerosi multipla e legame con il virus della mononucleosi

New England Journal of Medicine, Volume 391, Issue 12, Page 1096-1107, September 26, 2024.

The Pan American Health Organization (PAHO) released an epidemiological alert following an increase in Oropouche cases in previously unaffected areas during the first half of 2024. At the end of July, there were more than 8000 confirmed cases and 2 confirmed deaths throughout 5 countries in Latin America.

Objectives
To investigate the relationship between herpes simplex virus (HSV) and hearing loss using comprehensive population-based research.

Design
This cross-sectional study utilised data from the National Health and Nutrition Examination Survey (NHANES) to examine the relationship between HSV (types 1 and 2) and hearing loss. The final sample comprised 4608 participants aged 20–49 years. Weighted multivariate regression, subgroup and sensitivity analyses were employed for statistical evaluations.

Setting
Utilising the NHANES data, this cross-sectional study provides insights into the American population aged 20–49 years.

Participants
The study includes 4608 participants from the NHANES 2011–2012 and 2015–2016 cycles, focusing on those with complete data on HSV infection and hearing assessment.

Interventions (exposure)
The study analyses the association between HSV (types 1 and 2) infection and hearing loss, using weighted multivariate regression for statistical evaluations.

Results
We observed an association between HSV-1 infection and an increased likelihood of hearing impairment (OR, 1.4 (95% CI 1.1 to 1.9)). A similar association was noted for those coinfected with HSV-1 and HSV-2 (OR, 1.6 (95% CI 1.1 to 2.3)). Similarly, higher grades of hearing loss and elevated pure-tone averages were more prevalent in these groups. Notably, the association between HSV-1 and hearing impairment was more pronounced in individuals aged 20–34 (OR, 2.1 (95% CI 1.4 to 3.3); P for interaction=0.020) and those with a body mass index (BMI) below 30 (OR, 1.8 (95% CI 1.1 to 2.8); P for interaction=0.028).

Conclusions
Our findings suggest an association between HSV-1 infection or coinfections with HSV-1 and HSV-2 and the presence of hearing impairment. The association appears particularly pronounced among younger individuals and those with a lower BMI. Further prospective research is needed to explore the causal impact of HSV on auditory function.

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Comunicato del 20/09/2024 n°27

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New England Journal of Medicine, Ahead of Print.

And vaccination against shingles was associated with lower subsequent risk for vascular dementia or Alzheimer disease.

Infection with the hepatitis E virus (HEV) is the leading cause of acute viral hepatitis worldwide. With an estimated number of 20 million infections and 3.3 million symptomatic cases, accounting for 3.3% of viral hepatitis-related deaths annually, HEV poses a major public health threat.1 2 Transmission of HEV occurs mainly by the faecal-oral route in low-income and middle-income countries due to poor sanitation. Here, endemic outbreaks and sporadic cases are mainly caused by infection with genotypes 1 and 2 (HEV-1 and HEV-2), which exclusively infect humans. In developed countries, only sporadic cases of HEV infection are reported, which are attributed mostly to zoonotic genotypes 3 and 4 (HEV-3 and HEV-4) infections. As swine represents the main reservoir for HEV-3, transmission is usually linked to the consumption of undercooked pork products.3 However, due to the lack of specific antiviral therapy, thorough risk assessment is…

Objectives
In high-income countries hepatitis E virus (HEV) is an uncommonly diagnosed porcine-derived zoonoses. After identifying disproportionate chronic HEV infections in persons with cystic fibrosis (pwCF) postlung transplant, we sought to understand its epidemiology and potential drivers.

Design
All pwCF post-transplant attending our regional CF centre were screened for HEV. HEV prevalence was compared against non-transplanted pwCF and with all persons screened for suspected HEV infection from 2016 to 2022 in Alberta, Canada. Those with chronic HEV infection underwent genomic sequencing and phylogenetic analysis. Owing to their swine derivation, independently sourced pancreatic enzyme replacement therapy (PERT) capsules were screened for HEV.

Results
HEV seropositivity was similar between transplanted and non-transplanted pwCF (6/29 (21%) vs 16/83 (19%); p=0.89). Relative to all other Albertans investigated for HEV as a cause of hepatitis (n=115/1079, 10.7%), pwCF had a twofold higher seropositivity relative risk and this was four times higher than the Canadian average. Only three chronic HEV infection cases were identified in all of Alberta, all in CF lung transplant recipients (n=3/29, 10.3%). Phylogenetics confirmed cases were unrelated porcine-derived HEV genotype 3a. Ninety-one per cent of pwCF were taking PERT (median 8760 capsules/person/year). HEV RNA was detected by RT-qPCR in 44% (47/107) of PERT capsules, and sequences clustered with chronic HEV cases.

Conclusion
PwCF had disproportionate rates of HEV seropositivity, regardless of transplant status. Chronic HEV infection was evident only in CF transplant recipients. HEV may represent a significant risk for pwCF, particularly post-transplant. Studies to assess HEV incidence and prevalence in pwCF, and potential role of PERT are required.

New England Journal of Medicine, Volume 391, Issue 9, September 5, 2024.

To the Editor We read with great interest the study conducted by Schober et al, in which the objective was to assess whether rapid respiratory virus testing in emergency department patients suspected of having acute respiratory infections correlates with reduced antibiotic administration, fewer ancillary tests, shorter emergency department duration, and lower rates of emergency department revisits and hospital admissions, alongside an increase in influenza antiviral therapy. I would like to start by commending the author for adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline and registering the protocol in the International Prospective Register of Systematic Reviews (PROSPERO), which established a strong foundation for this systematic review. However, when analyzing the research methods, I identified several areas that could further strengthen the study.

In Reply We express our gratitude to Acuña-Rocha for raising 4 important points regarding the methods of our systematic review and meta-analysis of randomized clinical trials on the impact of rapid respiratory virus testing in emergency departments on clinical outcomes.

E’ stata ricoverata in ospedale a Padova