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Halichidis S, Aschie M, Cozaru GC, Manea M, Dobrin N, Vlad SE, Matei E, Baltatescu GI, Mitroi AF, Rosu MC, Nitu BF, Resul G, Nicolau AA, Cretu AM, Chisoi A. CMV and HIV Coinfection in Women from a Region in Eastern Europe. J Pers Med 2023; 13:1539. [PMID: 38003854 PMCID: PMC10672055 DOI: 10.3390/jpm13111539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: Human cytomegalovirus (CMV) infection is one of the most frequent opportunistic infections in immunosuppressed patients. Romania has one of the highest incidences of patients living with human immunodeficiency virus (HIV) which determines an immunosuppressive state. The aim of this study was to establish the prevalence of CMV infection among women living with HIV in Southeastern Romania and also to evaluate and correlate antiretroviral therapy (ART) with CD4 level and CMV disease evolution. (2) Methods: Seventy women living with HIV from Southeastern Romania were screened for CMV infection using antigen quantification. Of these, 50 were included in the study. First, the patients filled out a questionnaire regarding social conditions and other associated diseases. Then, we explored the statistical correlations between the data and HIV status, CD4+ cell counts, viral load, and antiretroviral therapy (ART). (3) Results: Median age of the patients was 33 years. Twenty-nine cases were diagnosed with HIV after sexual life beginning and 21 before. Most of the patients had a CD4 level over 200 cells/µL. ART duration in the CD4 under 200 cells/µL group was a bit longer than that in the CD4 over 200 cells/µL group. Forty-one patients had undetectable viremia. CD4 average value in the lot of patients with undetectable viremia was 704.71 cells/µL and in the lot with detectable viremia was 452.44 cells/µL. Viremia values correlated negatively with CD4 level. A positive correlation between IgG CMV values and ART therapy length was identified. A negative significant correlation between values of IgG CMV and values of CD4 was identified. CD4 value correlated negatively with IgG CMV values and with CMV avidity. (4) Conclusions: IgG CMV values had a weak positive correlation with ART therapy length, and a negative statistically significant correlation with values of CD4. CMV avidity has a negative correlation with CD4 value.
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Affiliation(s)
- Stela Halichidis
- Clinical Hospital of Infectious Diseases, 100 Ferdinand Blvd., 900178 Constanta, Romania; (S.H.); (B.F.N.); (G.R.)
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Street, 900470 Constanta, Romania; (M.A.); (N.D.)
| | - Mariana Aschie
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Street, 900470 Constanta, Romania; (M.A.); (N.D.)
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Georgeta Camelia Cozaru
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Mihaela Manea
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Nicolae Dobrin
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Street, 900470 Constanta, Romania; (M.A.); (N.D.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Sabina E. Vlad
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Elena Matei
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Gabriela Izabela Baltatescu
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Anca Florentina Mitroi
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Mihai Catalin Rosu
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Bogdan Florentin Nitu
- Clinical Hospital of Infectious Diseases, 100 Ferdinand Blvd., 900178 Constanta, Romania; (S.H.); (B.F.N.); (G.R.)
- SC ProDiagnostic SRL, 30 Farului Street, 90060 Constanta, Romania
| | - Ghiulendan Resul
- Clinical Hospital of Infectious Diseases, 100 Ferdinand Blvd., 900178 Constanta, Romania; (S.H.); (B.F.N.); (G.R.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Anca Antonela Nicolau
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Ana Maria Cretu
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Anca Chisoi
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
- SC ProDiagnostic SRL, 30 Farului Street, 90060 Constanta, Romania
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Waters S, Lee S, Ariyanto I, Leary S, Munyard K, Gaudieri S, Irish A, Allcock RJN, Price P. Variants of HCMV UL18 Sequenced Directly from Clinical Specimens Associate with Antibody and T-Cell Responses to HCMV. Int J Mol Sci 2022; 23:ijms232112911. [PMID: 36361707 PMCID: PMC9658343 DOI: 10.3390/ijms232112911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/13/2022] [Accepted: 10/21/2022] [Indexed: 11/28/2022] Open
Abstract
Around 80% of adults worldwide carry human cytomegaloviris (HCMV). The HCMV gene UL18 is a homolog of HLA class I genes and encodes a protein with high affinity for the NK and T-cell cytotoxicity inhibitor LIR-1. UL18 was deep sequenced from blood, saliva or urine from Indonesian people with HIV (PWH) (n = 28), Australian renal transplant recipients (RTR) (n = 21), healthy adults (n = 7) and neonates (n = 4). 95% of samples contained more than one variant of HCMV UL18, as defined by carriage of nonsynonymous variations. When aligned with immunological markers of the host’s burden of HCMV, the S318N variation associated with high levels of antibody reactive with HCMV lysate in PWH over 12 months on antiretroviral therapy. The A107T variation associated with HCMV antibody levels and inflammatory biomarkers in PWH at early timepoints. Variants D32G, D248N, V250A and E252D aligned with elevated HCMV antibody levels in RTR, while M191K, E196Q and F165L were associated with HCMV-reactive T-cells and proportions of Vδ2− γδ T-cells—populations linked with high burdens of HCMV. We conclude that UL18 is a highly variable gene, where variation may alter the persistent burden of HCMV and/or the host response to that burden.
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Affiliation(s)
- Shelley Waters
- Curtin Health Innovation Research Institute, Curtin Medical School, Curtin University, Bentley 6102, Australia
- Correspondence:
| | - Silvia Lee
- Curtin Health Innovation Research Institute, Curtin Medical School, Curtin University, Bentley 6102, Australia
- PathWest Laboratory Medicine WA, Department of Microbiology, Nedlands 6009, Australia
| | - Ibnu Ariyanto
- Virology and Cancer Pathobiology Research Center, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Shay Leary
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch 6150, Australia
| | - Kylie Munyard
- Curtin Health Innovation Research Institute, Curtin Medical School, Curtin University, Bentley 6102, Australia
| | - Silvana Gaudieri
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch 6150, Australia
- School of Human Sciences, University of Western Australia, Nedlands 6009, Australia
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Ashley Irish
- Department of Nephrology, Fiona Stanley Hospital, Murdoch 6150, Australia
| | - Richard J. N. Allcock
- School of Biomedical Sciences, University of Western Australia, Nedlands 6009, Australia
- PathWest Laboratory Medicine WA, Department of Diagnostic Genomics, Nedlands 6009, Australia
| | - Patricia Price
- Curtin Health Innovation Research Institute, Curtin Medical School, Curtin University, Bentley 6102, Australia
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Waters S, Lee S, Ariyanto I, Kresoje N, Leary S, Munyard K, Gaudieri S, Irish A, Keil AD, Allcock RJN, Price P. Sequencing of the Viral UL111a Gene Directly from Clinical Specimens Reveals Variants of HCMV-Encoded IL-10 That Are Associated with Altered Immune Responses to HCMV. Int J Mol Sci 2022; 23:4644. [PMID: 35563032 PMCID: PMC9104433 DOI: 10.3390/ijms23094644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/27/2022] [Accepted: 04/18/2022] [Indexed: 12/16/2022] Open
Abstract
Human cytomegalovirus (HCMV) is a beta-herpesvirus carried by ~80% of adults worldwide. Acute infections are often asymptomatic in healthy individuals but generate diverse syndromes in neonates, renal transplant recipients (RTR), and people with HIV (PWH). The HCMV gene UL111a encodes a homolog of human interleukin-10 (IL-10) that interacts with the human IL-10 receptor. Deep sequencing technologies were used to sequence UL111a directly from 59 clinical samples from Indonesian PWH and Australian RTR, healthy adults, and neonates. Overall, 93% of samples contained more than one variant of HCMV, as defined by at least one nonsynonymous variation. Carriage of these variants differed between neonates and adults, Australians and Indonesians, and between saliva and blood leukocytes. The variant alleles of N41D and S71Y occurred together in Australian RTR and were associated with higher T-cell responses to HCMV pp65. The variant P122S was associated with lower levels of antibodies reactive with a lysate of HCMV-infected fibroblasts. L174F was associated with increased levels of antibodies reactive with HCMV lysate, immediate-early 1 (IE-1), and glycoprotein B (gB) in Australian RTR and Indonesians PWH, suggesting a higher viral burden. We conclude that variants of UL111a are common in all populations and may influence systemic responses to HCMV.
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Affiliation(s)
- Shelley Waters
- Curtin Medical School, Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Australia; (S.W.); (S.L.); (K.M.)
| | - Silvia Lee
- Curtin Medical School, Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Australia; (S.W.); (S.L.); (K.M.)
- PathWest Laboratory Medicine WA, Department of Microbiology, Nedlands 6009, Australia;
| | - Ibnu Ariyanto
- Virology and Cancer Pathobiology Research Center, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Nina Kresoje
- School of Biomedical Sciences, University of Western Australia, Nedlands 6009, Australia; (N.K.); (R.J.N.A.)
| | - Shay Leary
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch 6150, Australia; (S.L.); (S.G.)
| | - Kylie Munyard
- Curtin Medical School, Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Australia; (S.W.); (S.L.); (K.M.)
| | - Silvana Gaudieri
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch 6150, Australia; (S.L.); (S.G.)
- School of Human Sciences, University of Western Australia, Nedlands 6009, Australia
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Ashley Irish
- Department of Nephrology, Fiona Stanley Hospital, Murdoch 6150, Australia;
| | - Anthony D. Keil
- PathWest Laboratory Medicine WA, Department of Microbiology, Nedlands 6009, Australia;
| | - Richard J. N. Allcock
- School of Biomedical Sciences, University of Western Australia, Nedlands 6009, Australia; (N.K.); (R.J.N.A.)
- PathWest Laboratory Medicine WA, Department of Diagnostic Genomics, Nedlands 6009, Australia
| | - Patricia Price
- Curtin Medical School, Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Australia; (S.W.); (S.L.); (K.M.)
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Sequencing Directly from Clinical Specimens Reveals Genetic Variations in HCMV-Encoded Chemokine Receptor US28 That May Influence Antibody Levels and Interactions with Human Chemokines. Microbiol Spectr 2021; 9:e0002021. [PMID: 34704798 PMCID: PMC8549752 DOI: 10.1128/spectrum.00020-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Human cytomegalovirus (HCMV) is a beta-herpesvirus carried by ∼80% of the world’s population. Acute infections are asymptomatic in healthy individuals but generate diverse syndromes in neonates, solid organ transplant recipients, and HIV-infected individuals. The HCMV gene US28 encodes a homolog of a human chemokine receptor that is able to bind several chemokines and HIV gp120. Deep sequencing technologies were used to sequence US28 directly from 60 clinical samples from Indonesian HIV patients and Australian renal transplant recipients, healthy adults, and neonates. Molecular modeling approaches were used to predict whether nine nonsynonymous mutations in US28 may alter protein binding to a panel of six chemokines and two variants of HIV gp120. Ninety-two percent of samples contained more than one variant of HCMV, as defined by at least one nonsynonymous mutation. Carriage of these variants differed between neonates and adults, Australian and Indonesian samples, and saliva samples and blood leukocytes. Two nonsynonymous mutations (N170D and R267K) were associated with increased levels of immediate early protein 1 (IE-1) and glycoprotein B (gB) HCMV-reactive antibodies, suggesting a higher viral burden. Seven of the nine mutations were predicted to alter binding of at least one ligand. Overall, HCMV variants are common in all populations and have the potential to affect US28 interactions with human chemokines and/or gp120 and alter responses to the virus. The findings relied on deep sequencing technologies applied directly to clinical samples, so the variants exist in vivo. IMPORTANCE Human cytomegalovirus (HCMV) is a common viral pathogen of solid organ transplant recipients, neonates, and HIV-infected individuals. HCMV encodes homologs of several host genes with the potential to influence viral persistence and/or pathogenesis. Here, we present deep sequencing of an HCMV chemokine receptor homolog, US28, acquired directly from clinical specimens. Carriage of these variants differed between patient groups and was associated with different levels of circulating HCMV-reactive antibodies. These features are consistent with a role for US28 in HCMV persistence and pathogenesis. This was supported by in silico analyses of the variant sequences demonstrating altered ligand-binding profiles. The data delineate a novel approach to understanding the pathogenesis of HCMV and may impact the development of an effective vaccine.
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Zenebe MH, Mekonnen Z, Loha E, Padalko E. Seroprevalence and associated factors of maternal cytomegalovirus in Southern Ethiopia: a cross-sectional study. BMJ Open 2021; 11:e051390. [PMID: 34675017 PMCID: PMC8532544 DOI: 10.1136/bmjopen-2021-051390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the seroprevalence and associated factors of cytomegalovirus (CMV) among pregnant women in Southern Ethiopia. DESIGN Cross-sectional study. SETTING The study was conducted in Hawassa University comprehensive and specialised hospital. Hawassa, Southern Ethiopia. PARTICIPANTS A total of 600 consecutive pregnant women attending the delivery ward were recruited for the study from August to October 2020. OUTCOME MEASURES The study assessed the rate of maternal anti-CMV IgG and IgM antibodies. The association of obstetric history, sociodemographic and behavioural characteristics with seropositivity of CMV was also evaluated based on the collected data using structured questioners. RESULTS Seropositivity for CMV IgM antibodies was 8.2% (49/600) (95% CI 6% to 10.5%), whereas the CMV IgG was 88.7% (532/600), (95% CI 89.5% to 94.0%). Seroprevalence of CMV IgM was higher in women of older age, currently unmarried, having nursery schooled children and with any of the detected curable sexually transmitted infections, while seroprevalence of CMV IgG was significantly associated only with women having nursery schooled children. Seroprevalence was not significantly associated with previous adverse pregnancy outcome, gravidity, being a child daycare occupant mother and newborn birth weight. CONCLUSION In the present study, we identified a high rate of CMV IgM and CMV IgG seroprevalence among pregnant women in Southern Ethiopia. Given that there is no existing CMV diagnosis, special attention should be designed to pregnant women in parallel to the existing antenatal care facility. Besides, training healthcare professionals will support awareness conception among pregnant women concerning the sequels of CMV infection during pregnancy.
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Affiliation(s)
- Mengistu Hailemariam Zenebe
- Medical Laboratory Sciences, Hawassa University College of Medicine and Health Sciences, Hawassa, South Ethiopia, Ethiopia
- Department of Diagnostic Sciences, Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
- Medical Laboratory Sciences, Jimma University Institute of Health, Jimma, Ethiopia
| | - Zeleke Mekonnen
- Medical Laboratory Sciences, Jimma University Institute of Health, Jimma, Ethiopia
| | - Eskindir Loha
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Chr Michelson Institute, Bergen, Norway
| | - Elizaveta Padalko
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent, Belgium
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Villa G, Lanini I, Amass T, Bocciero V, Scirè Calabrisotto C, Chelazzi C, Romagnoli S, De Gaudio AR, Lauro Grotto R. Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review. Perioper Med (Lond) 2020; 9:38. [PMID: 33292558 PMCID: PMC7722323 DOI: 10.1186/s13741-020-00169-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Abstract
A maladaptive response to surgical stress might lead to postoperative complications. A multidisciplinary approach aimed at controlling the surgical stress response may reduce procedural complications and improve patients’ quality of life in the short and long term. Several studies suggest that psychological interventions may interact with the pathophysiology of surgical stress response, potentially influencing wound repair, innate and adaptive immunity, inflammation, perception of pain, and patients’ mood. The aim of this systematic review is to summarise the effects of perioperative psychological interventions on surgical pain and/or anxiety in adult patients scheduled for elective general abdominal and/or urologic surgery. We conducted a systematic review of controlled clinical trials and observational studies involving psychological interventions for adult patients scheduled for elective general abdominal and/or urologic surgery. Only studies reporting pain and/or anxiety among outcome measures were included in the systematic review. The following psychological interventions were considered: (1) relaxation techniques, (2) cognitive-behavioural therapies, (3) mindfulness, (4) narrative medicine, (5) hypnosis and (6) coping strategies. We examined 2174 papers. Among these, 9 studies were considered eligible for inclusion in this systematic review (1126 patients cumulatively): 8 are randomised controlled trials and 1 is an observational prospective pre/post study. Psychological characteristics widely influence the pathophysiological mechanisms underlying the neuroendocrine and inflammatory response to surgical stress, potentially interfering with surgical outcomes. Psychological interventions are technically feasible and realistically applicable perioperatively during abdominal and/or urologic surgery; they influence the pathophysiological mechanisms underlying maladaptive surgical stress response and might have positive effects on patients’ surgical outcomes, such as pain and anxiety.
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Affiliation(s)
- Gianluca Villa
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Largo Brambilla 3, 50100, Florence, Italy. .,Department of Anaesthesia and intensive Care, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
| | - Iacopo Lanini
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Largo Brambilla 3, 50100, Florence, Italy
| | - Timothy Amass
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver, CO, USA
| | - Vittorio Bocciero
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Largo Brambilla 3, 50100, Florence, Italy
| | - Caterina Scirè Calabrisotto
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Largo Brambilla 3, 50100, Florence, Italy
| | - Cosimo Chelazzi
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Largo Brambilla 3, 50100, Florence, Italy.,Department of Anaesthesia and intensive Care, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Stefano Romagnoli
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Largo Brambilla 3, 50100, Florence, Italy.,Department of Anaesthesia and intensive Care, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - A Raffaele De Gaudio
- Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Largo Brambilla 3, 50100, Florence, Italy.,Department of Anaesthesia and intensive Care, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Rosapia Lauro Grotto
- Department of Health Sciences, Section of Psychology and Psychiatry, University of Florence, Largo Brambilla 3, 50100, Florence, Italy
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Udeze A, Odebisi-Omokanye M, Ajileye T. Cytomegalovirus infection among Human Immunodeficiency Virus (HIV) infected individuals on highly active anti-retroviral therapy in North-Central Nigeria. Afr Health Sci 2018; 18:1057-1065. [PMID: 30766572 PMCID: PMC6354892 DOI: 10.4314/ahs.v18i4.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) infection is common among HIV-infected individuals. Its contribution to morbidity and mortality became more apparent following introduction of highly active anti-retroviral therapy (HAART) which improved survival among HIV-infected individuals. OBJECTIVES This study aimed at determining the prevalence of both active and latent CMV infections among HIV-infected individuals on HAART in Ilorin, Nigeria. METHODS A total of 360 consented HIV-1 patients were recruited for the study. About 5ml of blood and socio-demographic data were collected from each patient. Plasma from the blood was tested for anti-CMV IgM and IgG presence using ELISA. RESULTS Of the 360 participants tested, 42 (11.7%) and 265 (73.6%) were respectively anti-CMV IgM and IgG antibodies positive representing active and latent infection rates respectively. Gender and age were the correlates of IgM seropositivity while age, occupation and marital status correlated with IgG seropositivity. Occupation, marital status, use of HAART and CD4+ count were not statistically associated with IgM level while gender, use of HAART and CD4+ count did not correlate with IgG level. CONCLUSIONS This study has demonstrated high level of latent and active CMV infection among HAART recipients in Ilorin and highlighted the need for incorporation of anti-herpes drugs in the treatment regimen.
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Affiliation(s)
- Augustine Udeze
- Virology Unit, Department of Microbiology, University of Ilorin, P.M.B 1515 Ilorin-Nigeria
| | - Mutiat Odebisi-Omokanye
- Infectious Disease, Environmental Health and Toxicity Research Group, Department of Microbiology, University of Ilorin, P.M.B 1515 Ilorin Nigeria
| | - Toluwani Ajileye
- Virology Unit, Department of Microbiology, University of Ilorin, P.M.B 1515 Ilorin-Nigeria
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Anoh AE, Mossoun A, Akoua-Koffi C, Couacy-Hymann E, Pauly M, Leendertz SA, Kouakou N'goran E, Schubert G, Weiss S, Hofmann J, Leendertz FH, Ehlers B. Seroprevalence of Cytomegalovirus Infection Among a Rural Population of Côte d'Ivoire. Viral Immunol 2018; 30:54-57. [PMID: 28055519 DOI: 10.1089/vim.2016.0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Human cytomegalovirus (HCMV) is a betaherpesvirus that can be pathogenic to humans. In particular, immunocompromised patients can develop life-threatening symptoms. In the present study, HCMV seroprevalence was investigated in a rural population of Western Côte d'Ivoire. Plasma samples collected from 166 apparently healthy subjects living in 8 villages surrounding the Taï Forest National Park were tested for anti-HCMV immunoglobulin G and M antibody with two commercial enzyme-linked immunosorbent assays. Prevalence of anti-HCMV IgG and IgM antibody was 100% and 5.4%, respectively. Anti-HCMV IgM positive was 10.2% (5/49) of the children and adolescents and 3.4% (4/117) of the adults. This observed decrease of IgM seropositivity and the seroprevalence difference between males and females (3.8% vs. 6.1%) was not statistically significant. In plasma of one IgM-positive participant, a low CMV load was detected indicating low-level replication. A second IgM-positive participant showed signs of local CMV replication. The other seven IgM-positive plasma samples likely reacted nonspecifically or due to polyclonal stimulation. Taken together, the results indicate that HCMV infection is hyperendemic in Côte d'Ivoire.
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Affiliation(s)
- Augustin Etile Anoh
- 1 CHU de Bouaké/Centre de Recherche pour le Développement, Université Alassane Ouattara de Bouake , Bouake, Côte d'Ivoire.,2 UFR Biosciences, Université Félix Houphouët Boigny , Abidjan, Côte d'Ivoire
| | - Arsène Mossoun
- 2 UFR Biosciences, Université Félix Houphouët Boigny , Abidjan, Côte d'Ivoire.,3 LANADA/Laboratoire Central de Pathologie Animale , Bingerville, Côte d'Ivoire
| | - Chantal Akoua-Koffi
- 1 CHU de Bouaké/Centre de Recherche pour le Développement, Université Alassane Ouattara de Bouake , Bouake, Côte d'Ivoire
| | | | - Maude Pauly
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany .,5 Division 12 "Measles, Mumps, Rubella and Viruses Affecting Immune-Compromised Patients," Robert Koch Institute, Berlin, Germany
| | - Siv-Aina Leendertz
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | | | - Grit Schubert
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | - Sabrina Weiss
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | - Jörg Hofmann
- 6 Labor Berlin, Department of Virology, and Institut of Medical Virology, Charité University Medicine Berlin , Berlin, Germany
| | - Fabian H Leendertz
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | - Bernhard Ehlers
- 5 Division 12 "Measles, Mumps, Rubella and Viruses Affecting Immune-Compromised Patients," Robert Koch Institute, Berlin, Germany
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9
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Waters S, Brook E, Lee S, Estiasari R, Ariyanto I, Price P. HIV patients, healthy aging and transplant recipients can reveal the hidden footprints of CMV. Clin Immunol 2017; 187:107-112. [PMID: 29108855 DOI: 10.1016/j.clim.2017.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 08/24/2017] [Accepted: 11/01/2017] [Indexed: 12/13/2022]
Abstract
Cytomegalovirus (CMV) is a β-herpesvirus. Latent infections are common in all populations. However age-associated increases in levels of CMV-reactive antibody are testament to repeated reactivations and periods of viral replication. CMV has been associated with several diseases of aging, including vasculopathy and neurocognitive impairment. These conditions occur at a younger age in persons with particularly high burdens of CMV - transplant recipients and people living with HIV. Here we define the "clinical footprints" as immunopathologies triggered by CMV that develop over many years. A high burden of CMV also drives accumulation of multifunctional terminally-differentiated αβ T-cells, a novel population of Vδ2- γδ T-cells, and a population of CD56lo NK cells lacking a key regulatory molecule. An understanding of these "immunological footprints" of CMV may reveal how they collectively promote the "clinical footprints" of the virus. This is explored here in transplant recipients, HIV patients and healthy aging.
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Affiliation(s)
- Shelley Waters
- School of Biomedical Science, Curtin University, Bentley, Australia
| | - Emily Brook
- School of Biomedical Science, Curtin University, Bentley, Australia
| | - Silvia Lee
- School of Biomedical Science, Curtin University, Bentley, Australia; Department of Microbiology, Pathwest Laboratory Medicine, Fiona Stanley Hospital, Australia
| | - Riwanti Estiasari
- Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ibnu Ariyanto
- Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Patricia Price
- School of Biomedical Science, Curtin University, Bentley, Australia; Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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10
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Mirambo MM, Senyaeli N, Mshana SE. Low humoral responses to human cytomegalovirus is associated with immunological treatment failure among HIV infected patients on highly active antiretroviral therapy. Pan Afr Med J 2017. [PMID: 29515749 PMCID: PMC5837160 DOI: 10.11604/pamj.2017.28.131.10480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Human cytomegalovirus (HCMV) is one of the opportunistic infections associated with significant morbidity and mortality among HIV/AIDS patients especially before introduction of antiretroviral therapy (ART). Little is known regarding the humoral immune response against HCMV in relation to CD4 counts among HIV infected individuals. A total of 90 achieved sera from HIV infected patients attending Bugando Medical centre care and treatment centre (CTC) aged 18 years and above were retrieved and analyzed. Sociodemographic data were collected using structured data collection tool. Detection of specific HCMV antibodies was done using Indirect Enzyme Linked Immunosorbent Assay (ELISA). Data were analyzed by using STATA version 11. A total of 90 HIV infected patients were enrolled in the study whereby 36(40%) had immunological treatment failure. The mean age of the study participants was 39±12.3 years. The Prevalence of specific HCMV IgG antibodies was 84(93.3%, 95% CI: 88-98.5) while the prevalence of specific HCMV IgM antibodies was 2(2.3% 95% CI: 0.8-5.4). The median CD4 counts at 6 months and 12 months on HAART were significantly high in treatment success group. At 12 months of HAART as CD4 counts increases the HCMV IgG index value was also found to increase significantly, p=0.04. Significant proportion of HIV infected individuals was infected with HCMV. Higher median HCMV IgG titers were observed among patients with immunological treatment success. There is a need to investigate humoral immune responses in HIV infected individuals in relation to CD4 counts against various infectious diseases in developing countries where most of these infections are endemic.
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Affiliation(s)
- Mariam Mwinjuma Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Ndealilia Senyaeli
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen Eliatosha Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
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11
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Yang R, Zhang H, Xiong Y, Gui X, Zhang Y, Deng L, Gao S, Luo M, Hou W, Guo D. Molecular diagnosis of central nervous system opportunistic infections and mortality in HIV-infected adults in Central China. AIDS Res Ther 2017; 14:24. [PMID: 28469695 PMCID: PMC5414136 DOI: 10.1186/s12981-017-0150-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/20/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND CSF PCR is the standard diagnostic technique used in resource-rich settings to detect pathogens of the CNS infection. However, it is not currently used for routine CSF testing in China. Knowledge of CNS opportunistic infections among people living with HIV in China is limited. METHODS Intensive cerebrospiral fluid (CSF) testing was performed to evaluate for bacterial, viral and fungal etiologies. Pathogen-specific primers were used to detect DNA from cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6) and John Cunningham virus (JCV) via real-time polymerase chain reaction (PCR). RESULTS Cryptococcal meningitis accounted for 63.0% (34 of 54) of all causes of meningitis, 13.0% (7/54) for TB, 9.3% (5/54) for Toxoplasma gondii. Of 54 samples sent for viral PCR, 31.5% (17/54) were positive, 12 (22.2%) for CMV, 2 (3.7%) for VZV, 1 (1.9%) for EBV, 1 (1.9%) for HHV-6 and 1 (1.9%) for JCV. No patient was positive for HSV. Pathogen-based treatment and high GCS score tended to have a lower mortality rate, whereas patients with multiple pathogens infection, seizures or intracranial hypertension showed higher odds of death. CONCLUSION CNS OIs are frequent and multiple pathogens often coexist in CSF. Cryptococcal meningitis is the most prevalent CNS disorders among AIDS. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve the diagnosis of AIDS related OIs in resource-limited developing countries, but the cost-efficacy remains to be further evaluated.
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12
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13
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Bates M, Brantsaeter AB. Human cytomegalovirus (CMV) in Africa: a neglected but important pathogen. J Virus Erad 2016; 2:136-42. [PMID: 27482452 PMCID: PMC4967964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
In Africa, human cytomegalovirus (CMV) is an important pathogen in a diverse range of patient groups. Congenital CMV infection is common, and most children undergo primary infection during the first year of life. Preliminary studies suggest that these early primary CMV infections could have population-wide effects on growth and development. In most studies of adults, CMV seroprevalence is close to 100%, but some studies have found that significant minorities of adults are seronegative. CMV is a common cause of pneumonia and meningitis in hospitalised immunosuppressed patient groups, and CMV DNAemia may be an important marker of rapid progression and poor outcomes of HIV infection, despite roll-out of antiretroviral therapy (ART). Diagnosis and treatment of CMV-related disease is broadly neglected in Africa, and no randomised clinical trials of anti-CMV drugs have been conducted to date. Autopsy is rarely performed in Africa, but identifies CMV as a frequent pathogen when it is carried out. Here we review the available literature on CMV in Africa, primarily in adult patients, and discuss this in the context of contemporary understanding of CMV as a human pathogen.
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Affiliation(s)
- Matthew Bates
- HerpeZ,
University Teaching Hospital,
Lusaka,
Zambia
- University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme,
University Teaching Hospital,
Lusaka,
Zambia
| | - Arne Broch Brantsaeter
- Department of Infectious Diseases and Department of Acute Medicine,
Oslo University Hospital Ullevål,
Oslo,
Norway
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14
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Munawwar A, Singh S. Human Herpesviruses as Copathogens of HIV Infection, Their Role in HIV Transmission, and Disease Progression. J Lab Physicians 2016; 8:5-18. [PMID: 27013807 PMCID: PMC4785766 DOI: 10.4103/0974-2727.176228] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Of eight human herpesviruses (HHVs), often, only herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) find mention in medical literature as both of these viruses are commonly associated with genital lesions and oral ulcers, commonly known as cold sores. However, role of human herpesviruses as copathogens and in aggravation and in the transmission of other human diseases, especially the Acquired immunodeficiency syndrome (HIV/AIDS) has only very recently been recognized. Therefore, screening and treating subclinical HHV infections may offer slowing of HIV infection, disease progression, and its transmission. Beside HSV-1 and HSV-2, HHV-3 a causative agent of herpes zoster remained one of the first manifestations of HIV disease before the era of highly active antiretroviral therapy (HAART). HHV-5 also known as human Cytomegalovirus infection remains a significant risk factor for HIV-associated mortality and morbidity even in HAART era. It is proposed that Cytomegalovirus viremia could be a better predictor of HIV disease progression than CD4+ T-lymphocyte count. The role of HHV-4 or Epstein-Burr virus and HHV-6, HHV-7, and HHV-8 is still being investigated in HIV disease progression. This review provides insight into the current understanding about these 8 HHVs, their co-pathogenesis, and role in HIV/AIDS disease progression. The review also covers recent literature in favor and against administering anti-HHV treatment along with HAART for slower AIDS progression and interrupted sexual transmission.
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Affiliation(s)
- Arshi Munawwar
- Department of Laboratory Medicine, Division of Clinical Microbiology and Molecular Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sarman Singh
- Department of Laboratory Medicine, Division of Clinical Microbiology and Molecular Medicine, All India Institute of Medical Sciences, New Delhi, India
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15
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Babkov DA, Khandazhinskaya AL, Chizhov AO, Andrei G, Snoeck R, Seley-Radtke KL, Novikov MS. Toward the discovery of dual HCMV-VZV inhibitors: Synthesis, structure activity relationship analysis, and cytotoxicity studies of long chained 2-uracil-3-yl-N-(4-phenoxyphenyl)acetamides. Bioorg Med Chem 2015; 23:7035-44. [PMID: 26443550 PMCID: PMC7126728 DOI: 10.1016/j.bmc.2015.09.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/15/2015] [Accepted: 09/19/2015] [Indexed: 11/20/2022]
Abstract
The need for novel therapeutic options to fight herpesvirus infections still persists. Herein we report the design, synthesis and antiviral evaluation of a new family of non-nucleoside antivirals, derived from 1-[ω-(4-bromophenoxy)alkyl]uracil derivatives--previously reported inhibitors of human cytomegalovirus (HCMV). Introduction of the N-(4-phenoxyphenyl)acetamide side chain at N(3) increased their potency and widened activity spectrum. The most active compounds in the series exhibit submicromolar activity against different viral strains of HCMV and varicella zoster virus (VZV) replication in HEL cell cultures. Inactivity against other DNA and RNA viruses, including herpes simplex virus 1/2, points to a novel mechanism of antiviral action.
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Affiliation(s)
- Denis A Babkov
- Department of Pharmaceutical & Toxicological Chemistry, Volgograd State Medical University, Pavshikh Bortsov Sq., 1, Volgograd 400131, Russia
| | | | - Alexander O Chizhov
- Zelinsky Institute of Organic Chemistry, Russian Academy of Science, Leninsky pr., 47, Moscow 119991, Russia
| | - Graciela Andrei
- Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, Leuven B-3000, Belgium
| | - Robert Snoeck
- Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, Leuven B-3000, Belgium
| | - Katherine L Seley-Radtke
- Department of Chemistry & Biochemistry, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
| | - Mikhail S Novikov
- Department of Pharmaceutical & Toxicological Chemistry, Volgograd State Medical University, Pavshikh Bortsov Sq., 1, Volgograd 400131, Russia
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16
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Wang Z, Peng X, Li M, Jin F, Zhang B, Wang H, Wei Y. Is human cytomegalovirus infection associated with essential hypertension? A meta-analysis of 11,878 participants. J Med Virol 2015; 88:852-8. [PMID: 26399974 DOI: 10.1002/jmv.24391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 01/08/2023]
Affiliation(s)
- Zuoguang Wang
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Xiaoyun Peng
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Mei Li
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Fei Jin
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Bei Zhang
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Hao Wang
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Yongxiang Wei
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
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17
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Tumwine JK. From Ebola in the slums of East and West Africa to NCDs, mental, child and reproductive health. Afr Health Sci 2015; 15:i-iii. [PMID: 25834569 PMCID: PMC4370150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
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