Πέμπτη 25 Αυγούστου 2022

Low spontaneous clearance rates of recently acquired hepatitis C virus in HIV-positive MSM (The PROBE-C Study)

alexandrossfakianakis shared this article with you from Inoreader

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Abstract
Background
Using direct acting antivirals (DAA) for recently acquired hepatitis C virus (RAHCV-) infections, particularly in HIV-positive men having sex with men (MSM), dramatically reduced hepatitis C incidence. However, implementation into clinical practice is challenging. The aim of this study was to analyse spontaneous clearance (SC) rates of RAHCV and to identify predictors of SC.
Methods
The PROBE-C study is an observational European cohort on RAH CV-infections in HIV-positive MSM. Between 2007 and 2017, RAHCV-infections were documented with at least 12 months of follow-up. Fisher's exact, chi-square and Mann-Whitney U test were used for statistical analysis.
Results
464 RAHCV-infections were documented. 457/464 (98%) cases were male, median age was 41 years (IQR 38-46). Main risk groups for HCV-transmission were MSM (98.9%). Most participants were infected with HCV-genotype (GT) 1 (78.3%). Median baseline HCV-RNA was 230,000 (135,000-474,432) IU/mL, median CD4+-T cell count was 574 (547-604) cells/µL. 92% of all cases received combination antiretroviral therapy with 91% showing suppressed HIV-RNA (<200 copies/mL). Median maximum alanine aminotransferase was 445 (402-522) U/L.SC of RAHCV-infection occurred in 55/464 (11.9%) cases. A >2log decline in HCV-RNA four weeks after diagnosis of RAHCV infection was the strongest predictor of SC (p < 0.001, sensitivity 96.4%, specificity 97.5%, PPV 8 4.1%, NPV 99.5%).
Conclusions
SC of RAHCV in HIV-positive MSM is only found in 11.9% of cases and a <2log drop in HCV-RNA at week four after diagnosis should prompt for early DAA-based treatment. However, immediate DAA treatment for RAHCV-infection may also be favoured in patients with ongoing transmission risk behaviour.
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Chromatin conformation of human oral epithelium can identify orofacial cleft missing functional variants

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International Journal of Oral Science, Published online: 25 August 2022; doi:10.1038/s41368-022-00194-0

Chromatin conformation of human oral epithelium can identify orofacial cleft missing functional variants
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Plasma Circulating Tumor HPV DNA and HPV-Related Oropharynx Cancer—A Caution—Reply

alexandrossfakianakis shared this article with you from Inoreader

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In Reply Dr Johnson and colleagues raise a good point, as expressed in our article, that our findings should not be inferred to suggest that circulating tumor human papillomavirus (HPV) DNA (ctHPVDNA) is ready to be used for screening. Our observation that no ctHPVDNA was detected in healthy participants with detectable salivary HPV DNA or E6 serum antibody suggests a low false-positive rate (ie, suggests good specificity). However, as pointed out in the discussion of our research letter, and by Johnson et al, it is possible that the detection methods used in our study could be insensitive, and additional research is needed to verify the finding of high specificity in our study.
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