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Valcarcel-Valdivia B, Enriquez-Vera D, Piedra LE, Holguín A, De la Cruz Ku G. Treatment outcomes of patients with classic and AIDS-related Kaposi Sarcoma: a single-center real-world experience. Clin Exp Med 2023; 23:5463-5471. [PMID: 37940724 DOI: 10.1007/s10238-023-01246-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
The recommended first-line chemotherapy agents for managing Kaposi sarcoma (KS) in high-income countries are expensive and often unavailable in developing nations such as Peru. Limited data exist on whether management practices in these countries affect patient outcomes. We assessed the real-world treatment approaches and outcomes of patients with KS in Peru. We retrospectively reviewed the medical records of patients with acquired immunodeficiency syndrome-related KS (AIDS-related KS; n = 95) and classic KS (CKS; n = 81) diagnosed at a tertiary center between 2000 and 2014 in Lima, Peru. We used the Kaplan-Meier method to estimate overall survival (OS) rates. The median follow-up was 64 months for AIDS-related KS and 88 months for CKS. The median age of patients with AIDS-related KS was 35 years (range 20-63 years) and 70 years (range 33-91 years) for those with CKS. Most individuals had an Eastern Cooperative Oncology Group performance status of ≥ 2 (AIDS-related KS 75%; CKS 85%). Seventy-six percent and 40% of individuals with AIDS-related KS and CKS, respectively, received systemic chemotherapy. The most common first-line drug was paclitaxel, with relatively optimal overall response rates (ORRs) for AIDS-related KS (n = 64/72, 89%; ORR 61%) and CKS (n = 24/32, 75%; ORR 50%). The 5-year OS rates were 71% in the AIDS-related KS cohort and 81% in the CKS cohort. The findings from this real-world study may inform clinical practices and highlight the need for increased access to effective treatments and clinical trials for patients with KS in Peru and other developing countries.
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Affiliation(s)
- Bryan Valcarcel-Valdivia
- Cancer Research Networking, Universidad Científica del Sur, Lima, Peru
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | - Daniel Enriquez-Vera
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima, Peru
| | | | - Alexis Holguín
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Pesqué L, Delyon J, Lheure C, Baroudjian B, Battistella M, Merlet P, Lebbé C, Vercellino L. Yield of FDG PET/CT for Defining the Extent of Disease in Patients with Kaposi Sarcoma. Cancers (Basel) 2022; 14:cancers14092189. [PMID: 35565319 PMCID: PMC9102885 DOI: 10.3390/cancers14092189] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/15/2022] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
Abstract
Simple Summary The potential role of positron emission tomography/computed tomography with fluorodeoxyglucose (FDG PET/CT) for assessing the extent of Kaposi sarcoma is not well studied. We analyzed FDG PET/CTs performed on 75 patients referred to our department for Kaposi sarcoma staging or restaging. FDG PET/CTs detected most lymph nodes, bone, and muscle lesions, whereas digestive and mucous lesions could be missed. Most cutaneous lesions can be identified when whole-body FDG PET/CT (including lower limbs) is performed. Thus, a true whole-body FDG PET/CT can be recommended for staging purposes in patients with active Kaposi sarcoma and, if positive, be useful for therapeutic evaluation and follow-up. Abstract Background: Positron emission tomography/computed tomography with fluorodeoxyglucose (F-18) (FDG PET/CT) is increasingly used in Kaposi sarcoma (KS), but its value has not been assessed. Objectives: In this study, we aimed to evaluate the diagnostic accuracy of FDG PET/CT to define the extent of disease in KS. Methods: Consecutive patients with KS referred to our department for FDG PET/CT were included. The diagnostic accuracy of FDG PET/CT for cutaneous and extra-cutaneous KS staging was assessed on a per lesion basis compared to staging obtained from clinical examination, standard imaging, endoscopy, histological analyses, and follow-up. Results: From 2007 to 2017, 75 patients with FDG PET/CT were analyzed. The sensitivity and specificity of FDG PET/CT for the overall detection of KS lesions were 71 and 98%, respectively. Sensitivity and specificity were 100 and 85% for lymph nodes, 87 and 98% for bone, 87 and 100% for lungs, and 100 and 100% for muscle involvement, whereas sensitivity was only 17% to detect KS digestive involvement. The sensitivity of the diagnostic for KS cutaneous involvement increased from 73 to 88% when using a whole-body examination. Conclusion: FDG PET/CT showed good sensitivity and specificity for KS staging (digestive involvement excepted) and could be used for staging patients with active KS.
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Affiliation(s)
- Louise Pesqué
- Nuclear Medicine Department, Saint Louis University Hospital, Assistance-Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010 Paris, France; (L.P.); (P.M.)
| | - Julie Delyon
- Department of Dermatology, Saint Louis University Hospital, Assistance-Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010 Paris, France; (J.D.); (B.B.); (C.L.)
- INSERM HIPI Team 1, U976, Saint Louis University Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France;
- Université de Paris Cité, 75006 Paris, France;
| | - Coralie Lheure
- Université de Paris Cité, 75006 Paris, France;
- Department of Dermatology, Cochin University Hospital, 27, Rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - Barouyr Baroudjian
- Department of Dermatology, Saint Louis University Hospital, Assistance-Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010 Paris, France; (J.D.); (B.B.); (C.L.)
| | - Maxime Battistella
- INSERM HIPI Team 1, U976, Saint Louis University Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France;
- Université de Paris Cité, 75006 Paris, France;
- Department of Pathology, Saint Louis University Hospital, Assistance-Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Pascal Merlet
- Nuclear Medicine Department, Saint Louis University Hospital, Assistance-Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010 Paris, France; (L.P.); (P.M.)
- Université de Paris Cité, 75006 Paris, France;
| | - Céleste Lebbé
- Department of Dermatology, Saint Louis University Hospital, Assistance-Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010 Paris, France; (J.D.); (B.B.); (C.L.)
- INSERM HIPI Team 1, U976, Saint Louis University Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France;
- Université de Paris Cité, 75006 Paris, France;
| | - Laetitia Vercellino
- Nuclear Medicine Department, Saint Louis University Hospital, Assistance-Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010 Paris, France; (L.P.); (P.M.)
- Université de Paris, INSERM, UMR_S942 MASCOT, 75006 Paris, France
- Correspondence: ; Tel.: +33-142499411
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Akanbi MO, Bilaver LA, Achenbach C, Hirschhorn LR, Rivera AS, Silas OA, Agaba PA, Agbaji O, Shehu NY, Sagay SA, Hou L, Murphy RL. Analyses of Kaposi Sarcoma trends among adults establishing initial outpatient HIV care in Nigeria: 2006-2017. Infect Agent Cancer 2022; 17:10. [PMID: 35313941 PMCID: PMC8935748 DOI: 10.1186/s13027-022-00424-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/11/2022] [Indexed: 12/24/2022] Open
Abstract
Background The incidence of Human Immunodeficiency Virus (HIV)-associated Kaposi Sarcoma (KS) in the pre-antiretroviral therapy (ART) population remains high in several countries in sub-Saharan Africa. We examined trends of KS prevalence in adults, establishing initial outpatient HIV care from 2006 to 2017 in Nigeria. Methods We analyzed data of 16,431 adults (age ≥ 18 years) enrolled for HIV care from January 1, 2006, to December 31, 2017, in a large clinic in Jos, Nigeria. KS at enrollment was defined as KS recorded in the electronic health record within 30 days of clinic enrollment. Time trends were compared among four periods: 2006–2008, 2009–2011, 2012–2014, and 2015–2017 using logistic regression models. Annual trends were analyzed using join point regression and restricted splines. Results The study population had a mean age 35.1 (standard deviation, SD 9.5) years, and were 65.7% female (n = 10,788). The mean CD4 cell count was 220 (95% CI 117–223). The overall KS prevalence at entry was 0.59% (95% CI 0.48–0.72). Compared to 2006–2008, KS prevalence was significantly higher in 2009–2011 (adjusted odds ratio 5.07 (95% CI 3.12–8.24), p < 0.001), but remained unchanged in subsequent periods. Male sex and low CD4 T-cell count independently increased odds for KS. Conclusions Despite ART expansion, KS at enrollment showed no significant decline. The low CD4 cell count, across all periods, indicates delay in enrollment for HIV care, which increases KS risk. Interventions aimed at early HIV diagnosis and linkage to ART is critical to KS risk reduction in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-022-00424-4.
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Affiliation(s)
- Maxwell O Akanbi
- Department of Internal Medicine, McLaren Hospital, 401 S Ballenger Hwy, Flint, MI, 48532, USA. .,Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria.
| | - Lucy A Bilaver
- Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Chad Achenbach
- Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Lisa R Hirschhorn
- Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Adovich S Rivera
- Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Olugbenga A Silas
- Department of Pathology, College of Human Sciences, University of Jos, Jos, Nigeria
| | - Patricia A Agaba
- Department of Family Medicine, College of Human Sciences, University of Jos, Jos, Nigeria
| | - Oche Agbaji
- Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Nathan Y Shehu
- Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Solomon A Sagay
- Department of Obstetrics and Gynecology, College of Human Sciences, University of Jos, Jos, Nigeria
| | - Lifang Hou
- Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Prevention Diseases (Cancer Epidemiology and Prevention), Northwestern University Feinberg School of Medicine, Chicago, USA.,Institute for Global Health, Center for Global Oncology, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Robert L Murphy
- Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, USA
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Adinani H, Campbell L, El-Mallawany NK, Slone J, Mehta P, Bacha J. Use of Paclitaxel to Successfully Treat Children, Adolescents, and Young Adults with Kaposi Sarcoma in Southwestern Tanzania. CHILDREN-BASEL 2021; 8:children8040275. [PMID: 33918352 PMCID: PMC8067189 DOI: 10.3390/children8040275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/14/2022]
Abstract
Treating Kaposi sarcoma (KS) in children, adolescents, and young adults (AYA) remains a challenge in low- and middle-income countries (LMIC) where chemotherapy options and availability are limited. We describe a retrospective cohort review of pediatric patients with KS treated with paclitaxel in Mbeya, Tanzania, between 1 March 2011 and 31 December 2019. Paclitaxel was given to patients who had KS relapse, a contraindication to bleomycin, vincristine, and doxorubicin (ABV), special circumstances in which a clinician determined that paclitaxel was preferable to ABV, or experienced treatment failure, defined as persistent KS symptoms at the completion of treatment. All patients also received multidisciplinary palliative care. Seventeen patients aged 5.1–21.3 years received paclitaxel, of whom 47.1% (8/17) had treatment failure, 29.4% (5/17) received paclitaxel as initial treatment, and 23.5% (4/17) had relapsed. All HIV positive patients (16/17) were given anti-retroviral therapy (ART) and 87.5% (14/16) achieved viral load <1000 cp/mL. At censure, 82.3% (14/17) of patients were alive—71.4% (10/14) achieved complete clinical remission and 28.6% (4/14) achieved a partial response. The median follow up was 37.3 months (range 8.0–83.5, IQR 19.7–41.6), and no patients were lost to follow up. In this cohort, high rates of long-term survival and favorable outcomes were possible with paclitaxel treatment.
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Affiliation(s)
- Hamidu Adinani
- Department of Health and Social Welfare, Tanzania Ministry of Health, Community De-velopment, Gender, Elderly and Children, Tarime District, Mara Region 31401, Tanzania;
| | - Liane Campbell
- Department of Pediatrics, Baylor College of Medicine Children’s Foundation—Tanzania, Mbeya 53107, Tanzania;
- Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children’s Hospital, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.E.-M.); (J.S.); (P.M.)
- Correspondence: ; Tel.: +255-759-339918
| | - Nader Kim El-Mallawany
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.E.-M.); (J.S.); (P.M.)
- Global HOPE, Texas Children’s Cancer and Hematology Centers, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Jeremy Slone
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.E.-M.); (J.S.); (P.M.)
- Global HOPE, Texas Children’s Cancer and Hematology Centers, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Parth Mehta
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.E.-M.); (J.S.); (P.M.)
- Global HOPE, Texas Children’s Cancer and Hematology Centers, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Jason Bacha
- Department of Pediatrics, Baylor College of Medicine Children’s Foundation—Tanzania, Mbeya 53107, Tanzania;
- Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children’s Hospital, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.E.-M.); (J.S.); (P.M.)
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5
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Shen J, Zhu M, Li S, Wang Q, Wu J, Li Y, Wang Q, Bian X, Yang L, Jiang X, Xie J, Lu Y, Wang K, Li L. Incidence and Risk Factors for Suicide Death among Kaposi's Sarcoma Patients: A Surveillance, Epidemiology, and End Results Analysis. Med Sci Monit 2020; 26:e920711. [PMID: 32148334 PMCID: PMC7083084 DOI: 10.12659/msm.920711] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background The suicide risk of patients with cancer is higher than the general population. Our research aimed to explore the Surveillance, Epidemiology, and End Results (SEER) database to define incidence and quest risk factors for death of suicide in patients with Kaposi’s sarcoma (KS) in the United States (US). Material/Methods We screened KS patients without human immunodeficiency virus status in the SEER database from 1980 to 2016, calculated the standardized mortality ratios of them by comparing the rates with those of the US general population from 1980 to 2016, and identified relevant suicide risk factors by univariable and multivariable logistic regression analyses. Results The suicide rates of KS patients and US general population were 115.31 (110 suicides among 21 405 patients) and 15.1 per 100 000 person-years, respectively, thus the standardized mortality ratio was 7.64 (95% confidence interval [CI], 6.28–9.21). The multivariate analysis showed that black race (versus white race, hazard ratio [HR]: 0.43, 95% CI: 0.21–0.89, P=0.022), advanced age at diagnosis (≥55 years versus 18–44 years, HR: 0.31, 95% CI: 0.14–0.66, P=0.002), and chemotherapy (versus no chemotherapy, HR: 0.60, 95% CI: 0.37–0.96, P=0.032) were protective factors for suicide among KS patients. Conclusions Clinicians and caregivers can apply our findings to identify KS patients with high suicide risk characteristics (white race, age of 18–44 years, non-chemotherapy) and exert timely interventions during patient diagnosis, treatment, and follow-up to reduce the suicide rate in this population.
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Affiliation(s)
- Jian Shen
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Mingjian Zhu
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Sihao Li
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University Medical School, Hangzhou, Zhejiang, China (mainland)
| | - Qiangqiang Wang
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Jingjing Wu
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Yating Li
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Qing Wang
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Xiaoyuan Bian
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Liya Yang
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Xianwan Jiang
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Jiaojiao Xie
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Yanmeng Lu
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Kaiceng Wang
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
| | - Lanjuan Li
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).,Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland)
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