Volume 58, Issue 8, 15 April 2014

Analysis indicates that hepatitis C virus (HCV)–infected adults were at increased risk of dying prematurely, particularly from liver disease, HIV/AIDS, and drug use. Improved testing and treatment are needed to reduce premature death from HCV-related causes.

An observational cohort study using US health system data found that hepatitis C virus (HCV) is underdocumented on death certificates. Only 19% of those with known HCV infection had HCV listed on their death certificate; two-thirds had premortem indications of chronic liver disease.

In Egypt, treating hepatitis C virus–infected patients at fibrosis stages F2–F4 is effective and cost-effective. If affordable triple therapies with new direct-acting antivirals will be available in 3 years, treatment for patients at stage F1 should be delayed.

This was a multinational study to determine the appropriateness of β-lactam antibiotic dosing in critically ill patients. Of patients treated for infection, 16% did not achieve minimum concentrations targets and these patients were 32% less likely to have a positive clinical outcome.

This cohort analysis found that pregnant women with measles had significantly higher risks of adverse maternal, fetal, and neonatal outcomes compared with pregnant women without measles. Maximizing measles immunity among adult women should remain a high public health priority.

Hospitalization with H7N9 virus infection is associated with older age and chronic heart disease, and patients have a longer duration of hospitalization than patients with H5N1 or pH1N1. This suggests that host factors are an important contributor to H7N9 severity.

Supplementation with the probiotic Lactobacillus rhamnosus GG (LGG) is safe, decreases repeated episodes of diarrhea, improves intestinal permeability, and increases IgG antibody response in rotavirus diarrhea in Indian children.

Syphilis screening should begin with a treponemal immunoassay that is followed by a second, different treponemal assay as confirmation. A nontreponemal assay is unnecessary for diagnosis but can be used for determining serological activity and the effect of syphilis treatment.

This review and meta-analysis confirmed that the duration of seroprotection conferred by most licensed vaccines was shorter in patients infected with human immunodeficiency virus. Implications for the monitoring of antibody levels and timing of revaccination in these patients are therefore discussed.

With antibiotic resistance and few novel antibiotics, there is greater pressure to consider antibiotics in patients with hypersensitivity reactions. This article reviews hypersensitivity and various desensitization protocols as a strategy to safely induce drug tolerance.

A small increased risk of Guillain-Barré syndrome (GBS) has been observed following influenza vaccination but is 10-fold less than that observed following the 1976 swine-flu vaccine. The risk of GBS following influenza is much greater than the small risk following vaccination.

In patients for whom combination antiretroviral therapy failed with viremia levels 50-1000 copies/mL, HIV-1 genotyping provides reliable and reproducible results that are informative about emerging drug resistance also at low viremia levels.

This study shows that routine HIV-1 genotyping of low-level viremia samples can be performed with a reasonably high success rate and the results are predictive of future virologic outcomes and viral evolution in treatment-naive individuals.

Where HIV and food insecurity coexist, ready-to-use supplementary foods (RUSFs) are increasingly prescribed to improve patient outcomes. We found no statistically significant differences in outcome with RUSFs vs less expensive corn-soy blend plus rations for HIV patients in rural Haiti.

French armed forces in Ivory Coast experienced a recent emergence of Plasmodium ovale malaria, characterized by nonspecific clinical and biological changes and poor sensitivity of biological tools. No link with a new variant of the parasite was evidenced.

This study highlights the frequent use of methicillin-resistant Staphylococcus aureus (MRSA)–active antibiotics among patients hospitalized with MRSA-negative purulent skin and soft tissue infection (SSTI). Introduction of a rapid molecular diagnostic test in absence of an effective implementation strategy may not yield substantial potential reductions in inappropriate antibiotic utilization.