Top Infectious Disease News of the Week—January 21, 2018

#5: Ribavirin Remains Pivotal Component of Hepatitis C Treatment

We’re living in an era where there are highly effective direct-acting antivirals (DAA) available for the treatment of chronic hepatitis C virus, but ribavirin (RBV) continues to be a necessary adjunct to DAA regimens for the virus.

A new cohort study published online in Alimentary Pharmacology and Therapeutics in November confirmed the RBV steady-state serum levels that correspond to high rates of efficacy and low adverse effect.

Co-lead authors of the study Faydra Lieveld, MD, University Medical Center Utrecht, The Netherlands, and Marjolein van Tilborg, MD, PhD, Erasmus MC University Medical Center, The Netherlands, determined the RBV steady-state plasma level at 8 weeks that correspond to a sustained virologic response (SVR) to the RBV-DAA regimen at 12 weeks.

Read more about the study here.

#4: Addressing Antibiotic Resistance in Lower-Income Countries

Combating antibiotic resistance in lower- and middle-income countries (LMICs) will require particular attention to emerging One Health challenges, according to an article published January 18, 2018, in the journal Clinical Infectious Diseases.

Although traditional efforts to reduce the spread of antibiotic resistance in these countries have focused on antibiotic use in individuals, LMICs must also address the increasing roles of animal and environmental exposures in this public health crisis, write Maya Nadimpalli, PhD, University of Versailles Saint-Quentin-en-Yvelines, France, and colleagues.

“In particular, current strategies do not prioritize the impacts of increased antibiotic use for terrestrial food-animal and aquaculture production, inadequate food safety, and widespread environmental pollution,” the authors stress.

Read more here.

#3: Hepatitis C-Related Hospitalizations Rise By Almost 50%

A new report from the United States Department of Health and Human Services (HHS) shows that hospital stays for patients with hepatitis C have been on the rise since 2005, largely due to the increase of injection drug use in the opioid epidemic.

There are 3 different viruses that cause hepatitis, a condition marked by inflammation of the liver. Hepatitis C is a contagious blood-borne infection that is today mostly spread in the United States through shared needles and syringes used to inject drugs. Less commonly, the virus can spread through sexual contact or by sharing personal items such as razors with an infected individual. Acute hepatitis C develops within the first 6 months of exposure to the virus. Symptoms can include fatigue, fever, nausea, vomiting, and abdominal pain; however, up to 80% of individuals with the acute infection do not experience symptoms. When the virus persists in the body, the infection can become chronic and last a lifetime, leading to serious liver problems such as cirrhosis or cancer.

Read more about the increase in hepatitis C-associated hospitalizations, here.

#2: Influenza Exposure May Lead to Heightened Risk in Future Pandemics

Throughout the past century there have been at least 5 pandemics related to the influenza A virus and a new data analysis published in mBio by the American Society for Microbiology, suggests that individuals born at the time of a pandemic are more susceptible to death in future pandemics.

This new finding is contrary to the widely accepted idea that exposure to influenza A viruses typically creates a defense against strains of influenza.

Matthew Miller, PhD, senior author of the paper, assistant professor in the Department of Biochemistry and Biomedical Sciences at McMaster University, and senior researcher with its Michael G. DeGroote Institute of Infectious Disease Research, told EurekAlert! that the enhanced vulnerability has been poorly understood in the infectious disease community and that future studies should focus on determining the factors that are responsible for the heightened susceptibility.

Read more about influenza here.

#1: Living HIV-Positive Individuals Can Now Donate Kidneys

For many years, potential kidney donors with HIV were not allowed to donate their organs because of the risk of transmitting HIV to uninfected recipients. However, the organ-donor landscape has been changing over the past few years. Thanks to the HIV Organ Policy Equity Act, signed into law during the Obama administration in 2013, transplants between HIV-positive donors and recipients now are allowed. So far, there have been roughly 30 transplants between deceased HIV-positive donors and HIV-positive recipients in the United States, but none using a live donor—possibly in part because HIV itself is a risk factor for kidney disease and it’s been considered too dangerous for the donor.

Big changes are coming again, though, with the news that 3 medical centers in the United States, among them Johns Hopkins University, have been approved to perform kidney transplants from living HIV-positive donors to recipients who already have HIV. This is a significant development, both for patients waiting for a kidney and for individuals looking to donate a kidney. It’s preferable to use kidneys from live donors because they last twice as long, on average, as those from deceased donors. They also have a higher chance of being immediately functional in the recipient, whereas kidneys from deceased donors may not work right away, necessitating a period of dialysis.

Almost 96,000 people in the United States are on the waiting list for a kidney, and many die each year before their turn comes. About 500 to 600 HIV-positive potential donors per year have kidneys and other organs that could be used to save roughly 1000 HIV-positive individuals, said Dorry Segev, MD, PhD, professor of surgery at the Johns Hopkins School of Medicine and a transplant surgeon. “There are some people with HIV for whom it would be reasonably safe to donate a kidney,” he told Contagion^®, citing those with undetectable levels of the virus as an example. “It looks like the HIV itself is a pretty minimal risk factor if the HIV has been well controlled.” This is particularly true if donors meet other standards for donation, such as having a low body mass index.

Read the rest of the top article, here.