Journal of Clinical Virology

Source:  Journal of Clinical Virology    Tag:  chronic cmv
Editorial Board
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1









Fatal acute liver failure in a child due to acquired rubella infection
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Cristina Adelaide Figueiredo , Maria Isabel de Oliveira , Priscila Rodrigues Tarandachi , Werther Brunow de Carvalho , Cristina Takami Kanamura , Renata dos Santos Scatena







Chronic hepatitis B infection and risk of preterm labor: A meta-analysis of observational studies
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Qi-tao Huang , Shan-shan Wei , Mei Zhong , Li-lin Hang , Yu-yuan Xu , Geng-xi Cai , Qing Liu , Yan-hong Yu

Many epidemiological studies have found a positive association between chronic hepatitis B virus (CHB) infection and the risk of preterm labor, but the magnitude of this association varies and independent studies have reported conflicting findings. We performed a meta-analysis to ascertain the relationship between CHB infection and preterm labor. The PubMed and Embase databases were searched up to May 1st, 2014, for relevant observational studies on an association between CHB infection and the risk of preterm labor. Data were extracted and analyzed independently by two authors. The meta-analysis was performed using Stata version 10.0 software. Six observational case-control studies and 4 cohort studies, involving 6781 women with preterm labor, were identified. Based on a random-effects meta-analysis, no association between CHB infection and preterm labor was identified (odds ratio = 1.12, 95% confidence interval CI, 0.94–1.33). Our meta-analysis suggested that CHB infection is not associated with an increased risk of preterm labor.  





Deep sequencing: Becoming a critical tool in clinical virology
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Miguel E. Quiñones-Mateu , Santiago Avila , Gustavo Reyes-Teran , Miguel A. Martinez

Population (Sanger) sequencing has been the standard method in basic and clinical DNA sequencing for almost 40 years; however, next-generation (deep) sequencing methodologies are now revolutionizing the field of genomics, and clinical virology is no exception. Deep sequencing is highly efficient, producing an enormous amount of information at low cost in a relatively short period of time. High-throughput sequencing techniques have enabled significant contributions to multiples areas in virology, including virus discovery and metagenomics (viromes), molecular epidemiology, pathogenesis, and studies of how viruses to escape the host immune system and antiviral pressures. In addition, new and more affordable deep sequencing-based assays are now being implemented in clinical laboratories. Here, we review the use of the current deep sequencing platforms in virology, focusing on three of the most studied viruses: human immunodeficiency virus (HIV), hepatitis C virus (HCV), and influenza virus.  





Epidemiology and impact of HIV coinfection with Hepatitis B and Hepatitis C viruses in Sub-Saharan Africa
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Philippa C. Matthews , Anna Maria Geretti , Philip J.R. Goulder , Paul Klenerman

Human immunodeficiency virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV) are blood-borne viruses with potentially shared routes of transmission. In high-income settings, the impact of antiretroviral therapy (ART) on survival has unmasked chronic liver disease from viral hepatitis B or hepatitis C as a leading cause of morbidity and mortality in individuals with HIV infection. It is now feared that progressive liver disease may threaten the success of ART programmes in developing countries, where HCV or HBV testing and monitoring are not yet systematic among HIV-infected patients and ART use is generally blind to these co-infections. We set out to review recent data from Sub-Saharan Africa, in order to build a detailed and up-to-date picture of the epidemiology and emerging impact of HBV and HCV coinfection in countries at the heart of the HIV pandemic. There is a preponderance of HIV/HBV coinfection compared to HIV/HCV in this region, and significant caveats exist regarding the accuracy of published HCV seroprevalence surveys. Morbidity and mortality of coinfection is significant, and may be further enhanced in African populations due to the influence of host, viral and environmental factors. Careful scrutiny of the coinfection problem is vital to inform an approach to directing resources, planning public health initiatives, providing clinical care, and guiding future research.  





Molecular epidemiology of hepatitis delta virus in the Western Pacific region
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Meifang Han , Margaret Littlejohn , Lilly Yuen , Rosalind Edwards , Uma Devi , Scott Bowden , Qin Ning , Stephen Locarnini , Kathy Jackson

Background   Hepatitis delta virus (HDV) is a defective RNA virus requiring the presence of the hepatitis B virus (HBV) for the completion of its life cycle. Active replication of HDV can lead to severe hepatitis, and although present worldwide has an irregular geographical distribution, especially in the Asian Pacific region.   Objectives   The aim of this study was to determine the prevalence and molecular epidemiology of HDV isolates in Oceania following the 1998 evaluation of the hepatitis B vaccine program.   Study design   Sera collected from 184 hepatitis B surface antigen (HBsAg) positive Pacific Islanders living in Micronesia, Polynesia and Melanesia were tested for HDV RNA.   Results   Twenty of 54 patients with chronic hepatitis B (CHB) from Kiribati were positive for serum HDV RNA (37%), whilst sera from patients with CHB from Tonga (59), Fiji (42) and Vanuatu (29) were negative. The mean HDV RNA load for the 20 samples was 7.00 log 10   copies/mL. Phylogenetic analysis revealed that the Kiribati HDV isolates were of genotype 1 and clustered with a previously published isolate from Nauru forming a distinct clade of Pacific HDV. All Micronesian isolates contained a serine at codon 202 of large hepatitis delta antigen (L-HDAg) demonstrating possible relatedness to strains of HDV-1 of African origin.   Conclusions   This study has confirmed endemic HDV infection in Micronesia and identified Kiribati as having amongst the highest prevalence for HDV viraemia in patients with CHB. Further investigations are ongoing into the origins of this unique HDV Pacific strain, and its inter-relationship with HBV.  





CD8+ T cell responses specific for hepatitis B virus core protein in patients with chronic hepatitis B virus infection
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Wei Cao , Zhifeng Qiu , Ting Zhu , Yanling Li , Yang Han , Taisheng Li

Background   Chronic hepatitis B virus (HBV) infection includes a set of heterogeneous clinical patterns, and core-protein-specific T cell response is important for virus control and disease progression, yet is not well elucidated.   Objectives   To analyze the phenotypic and functional profiles of HBV-core-protein-specific CD8+ T cells in different clinical patterns of chronic HBV infection.   Study design   A total of 46 HBV patients were recruited and classified according to their clinical status. CD8+ T cell responses in different patterns of chronic HBV infections were tested with flow cytometry using overlapping 15-mer peptides covering HBV core protein. Meanwhile, the CCR7/CD27 phenotypes of these CD8+ T cells were also determined.   Results   Frequencies of gamma interferon (IFN-γ) positive CD8+ T cells in inactive HBV surface antigen (HBsAg) carriers in response to the core protein peptide pools were generally stronger than those of chronic HBV carriers and resolved individuals, especially with regards to peptide pool C13–C24. Moreover, phenotypic studies further highlighted the group of CD8+ CCR7–CD27+ T memory cells, which showed significantly higher levels of IFN-γ secretion in inactive HBsAg carriers than those in chronic hepatitis B patients, chronic HBV carriers and resolved individuals.   Conclusions   Core-protein-specific T cell response plays an important role in chronic HBV infection. Inactive HBsAg carriers showed a much stronger core-protein-specific cytotoxic T cell response than other types of chronically infected patients. CD8+ CCR7–CD27+ T memory lymphocytes may be crucial in the immune pathogenesis of chronic HBV infection.  





Mother-to-child transmission of hepatitis B virus: Evolution of hepatocellular carcinoma-related viral mutations in the post-immunization era
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Zixiong Li , Zhenyu Xie , Hongxia Ni , Qi Zhang , Wei Lu , Jianhua Yin , Wenbin Liu , Yibo Ding , Yan Zhao , Yibing Zhu , Rui Pu , Hongwei Zhang , Hongjun Dong , Yifei Fu , Qiao Sun , Guozhang Xu , Guangwen Cao

Background   Perinatal infection and immunoprophylaxis failure of hepatitis B virus (HBV) and viral mutations contributes greatly to the development of hepatocellular carcinoma (HCC). However, little is known regarding evolution of the HCC-related mutations at early stage of chronic infection.   Objective   We aimed to elucidate dynamic changes of the HCC-related mutations from maternal perinatal transmission to chronic infection in childhood.   Study design   A total of 876 hepatitis B surface antigen (HBsAg)-positive pregnant women and 95 HBsAg-positive mother–child pairs were included in this study. HBV mutant quasispecies were determined using clone sequencing. Mother-to-child transmission was identified by genotyping and phylogenestic analysis.   Results   Univariate regression analysis indicated that maternal HBeAg positivity, viral load ≥10 6  copies/mL, genotype B2, and male fetus significantly increased the risk of HBV trans-placental transmission. The immunoprophylaxis failure was confirmed in 11 (2.48%) 7-month-old infants. The HCC-risk mutations including A1762T/G1764A were present in the mothers’ and cord blood but mostly absent in the 7-month-old infants’. In the 56 mother–child pairs with 1–15 year-old children acquired the infection from their mothers, the frequencies of HBV mutations including A1762T/G1764A and G1896A in genotype B2 or C2 increased consecutively with increasing age of children. These mutations including A1762T/G1764A in genotype C2 and G1896A in genotype B2 were more frequent in mothers than in children ( P   < 0.001). T1753V, C1653T, and G1899A were infrequent in the mother–child pairs.   Conclusion   Maternally transmitted HBV without the HCC-risk mutations has advantage of infecting infants after the immunization. The HCC-related mutations are sequentially generated since chronic infection established in children.  





Comparison of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): Min-Min Yu , Qian Jiang , Ying Ji , Kai-Hua Wu , Li-Li Ju , Xun Tang , Yong-Feng Yang

Background   Infection with hepatitis B virus (HBV) during pregnancy may lead to perinatal transmission.   Objectives   To compare the efficacy and safety of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus.   Study design   All pregnant women enrolled in this study were positive for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg). Test patients underwent antiviral therapy with telbivudine or lamivudine while control patients received hepatitis B immune globulin (HBIG) injection. Results   Patients in the telbivudine group had significantly lower HBV DNA and HBeAg levels and higher HBV DNA negative conversion rates compared to those in the lamivudine group before delivery. HBV DNA negative conversion rates in patients with abnormal alanine aminotransferase (ALT) levels were significantly higher than those in patients with normal ALT levels in the telbivudine and lamivudine groups before delivery. The intrauterine HBV infection rate and the percentage of immunization failure were both 0% in the telbivudine and lamivudine groups ( χ   2  = 0, 0;  P   = 1, 1 respectively), compared to both 5% in the HBIG group ( χ   2  = 11.83, 7.86;  P   = 0.002, 0.009 respectively). The side effects of three groups in mother and child were all unobvious.   Conclusions   Telbivudine and lamivudine can reduce HBV DNA levels in pregnant women, interrupt the vertical transmission of HBV and be used safely in mothers and children.  





Urine is superior to saliva when screening for postnatal CMV infections in preterm infants
Publication date:  September 2014
Source:Journal of Clinical Virology, Volume 61, Issue 1

Author(s): J. Gunkel , T.F.W. Wolfs , J. Nijman , R. Schuurman , M.A. Verboon-Maciolek , L.S. de Vries , J.L. Murk

Background   Cytomegalovirus (CMV) is the most frequently contracted virus in preterm infants. Postnatal infection is mostly asymptomatic but is sometimes associated with severe disease. To diagnose an infection, urine or saliva samples can be tested for CMV-DNA by real-time polymerase chain reaction (rtPCR). Although the diagnostic accuracy of testing saliva samples has not been determined in preterm infants, saliva is widely used because it is easier to obtain than urine.   Objectives   To determine whether screening of saliva is equivalent to urine to detect a postnatal CMV infection in preterm infants.   Study design   Between 2010 and 2013 saliva and urine samples were collected from infants admitted to the Neonatal Intensive Care Unit of the University Medical Center Utrecht and born with a gestational age (GA) below 32 weeks. Urine samples were obtained within three weeks after birth and urine and saliva samples at term equivalent age (40 weeks GA) and tested for CMV-DNA by rtPCR. Infants with a congenital CMV infection were excluded.   Results   Of 261 preterm infants included in the study, CMV-DNA was detected in urine of 47 and in saliva of 43 children. Of 47 infants with postnatal CMV infection, CMV was detected in 42 saliva samples (sensitivity 89.4%; CI 76.9–96.5). Of 214 children without postnatal CMV infection, one saliva sample tested positive for CMV (specificity 99.5%; CI 97.4–99.9).   Conclusions Screening saliva for CMV-DNA by rtPCR is inferior to urine to diagnose postnatal CMV infections in preterm infants.