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Chu ST, Kobayashi K, Bi X, Ishizaki A, Tran TT, Phung TTB, Pham CTT, Nguyen LV, Ta TA, Khu DTK, Agoh M, Pham AN, Koike S, Ichimura H. Newly emerged enterovirus-A71 C4 sublineage may be more virulent than B5 in the 2015-2016 hand-foot-and-mouth disease outbreak in northern Vietnam. Sci Rep 2020; 10:159. [PMID: 31932599 PMCID: PMC6957505 DOI: 10.1038/s41598-019-56703-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/16/2019] [Indexed: 11/08/2022] Open
Abstract
Enterovirus-A71 (EV-A71) is a common cause of hand-foot-and-mouth disease (HFMD) and, rarely, causes severe neurological disease. This study aimed to elucidate the epidemiological and genetic characteristics and virulence of EV-A71 strains isolated from children diagnosed with HFMD. Rectal and throat swabs were collected from 488 children with HFMD in Hanoi, Vietnam, in 2015-2016. From 391 EV-positive patients, 15 EVs, including coxsackievirus A6 (CV-A6; 47.1%) and EV-A71 (32.5%, n = 127), were identified. Of the 127 EV-A71 strains, 117 (92.1%) were the B5 subgenotype and 10 (7.9%) were the C4 subgenotype. A whole-genome analysis of EV-A71 strains showed that seven of the eight C4a strains isolated in 2016 formed a new lineage, including two possible recombinants between EV-A71 C4 and CV-A8. The proportion of inpatients among C4-infected children was higher than among B5-infected children (80.0% vs. 27.4%; P = 0.002). The virulence of EV-A71 strains was examined in human scavenger receptor class B2 (hSCARB2)-transgenic mice, and EV-A71 C4 strains exhibited higher mortality than B5 strains (80.0% vs. 30.0%, P = 0.0001). Thus, a new EV-A71 C4a-lineage, including two possible recombinants between EV-A71 C4 and CV-A8, appeared in 2016 in Vietnam. The EV-A71 C4 subgenotype may be more virulent than the B5 subgenotype.
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Affiliation(s)
- Son T Chu
- Department of Viral Infection and International Health, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan
| | - Kyousuke Kobayashi
- Neurovirology Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, 1568506, Japan
| | - Xiuqiong Bi
- Department of Viral Infection and International Health, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan
| | - Azumi Ishizaki
- Department of Viral Infection and International Health, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan
- Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan
| | - Tu T Tran
- Outpatient Department, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam
| | - Thuy T B Phung
- Research Biomolecular for Infectious Disease Department, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam
| | - Chung T T Pham
- Research Biomolecular for Infectious Disease Department, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam
| | - Lam V Nguyen
- Center for Pediatric Tropical Diseases, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam
| | - Tuan A Ta
- Medical Intensive Care Unit, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam
| | - Dung T K Khu
- Neonatal Intensive Care Unit, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam
| | - Masanobu Agoh
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, 8528523, Japan
| | - An N Pham
- Center for Pediatric Tropical Diseases, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam
- Department of Pediatrics, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Satoshi Koike
- Neurovirology Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, 1568506, Japan
| | - Hiroshi Ichimura
- Department of Viral Infection and International Health, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan.
- Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan.
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Pham HV, Ishizaki A, Nguyen LV, Phan CTT, Phung TTB, Takemoto K, Pham AN, Bi X, Khu DTK, Ichimura H. Two-year outcome of first-line antiretroviral therapy among HIV-1 vertically-infected children in Hanoi, Vietnam. Int J STD AIDS 2014; 26:821-30. [PMID: 25332224 DOI: 10.1177/0956462414556328] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 09/08/2013] [Indexed: 11/15/2022]
Abstract
A retrospective analysis of 86 HIV-1 vertically-infected Vietnamese children with a follow-up period >24 months after initiating antiretroviral therapy (ART) was performed from 2008 to 2012, to assess the outcome of first-line ART in resource-limited settings. Of the 86 children, 68 (79.1%) were treated successfully (plasma HIV-1 viral load [VL] <1000 copies/ml), and 63 (73.3%) had full viral suppression (VL <400 copies/ml) after 24 months of ART. No significant difference between successfully treated patients and failure groups was observed in VL, CD4(+) T-cell count or clinical stage at baseline; age at ART start; or ART regimen. All 14 children with VL >5000 copies/ml, one of four children with VL 1000-5000 copies/ml and none with VL <1000 copies/ml developed reverse transcriptase inhibitor (RTI)-resistance mutations by 24 months of ART. Y181C and M184V/I were the most dominant non-nucleoside and nucleoside RTI-resistance mutations, respectively (13/15, 86.7%). These findings suggest that VL testing after 24 months of ART can be used to efficiently differentiate ART failures among HIV-1 vertically-infected children in resource-limited settings.
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Affiliation(s)
- H V Pham
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan National Hospital of Pediatrics, Hanoi, Vietnam
| | - A Ishizaki
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - L V Nguyen
- National Hospital of Pediatrics, Hanoi, Vietnam
| | - C T T Phan
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan National Hospital of Pediatrics, Hanoi, Vietnam
| | - T T B Phung
- National Hospital of Pediatrics, Hanoi, Vietnam
| | - K Takemoto
- Department of Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan
| | - A N Pham
- National Hospital of Pediatrics, Hanoi, Vietnam
| | - X Bi
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - D T K Khu
- National Hospital of Pediatrics, Hanoi, Vietnam
| | - H Ichimura
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan Kanazawa University Innovative Preventive Medicine Joint Education and Research Center, Kanazawa University, Kanazawa, Japan
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Pham AN, Seow WK, Shusterman S. Developmental dental changes in isolated cleft lip and palate. Pediatr Dent 1997; 19:109-13. [PMID: 9106872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Isolated cleft lip and/or palate, CL(P), may be associated with multiple changes in the developing dentition. To test the hypothesis that permanent tooth formation is delayed in patients with CL(P), dental maturity was assessed from panoramic radiographs. The dental maturity ratio (DMR, dental age divided by chronological age) of a group of CL(P) patients (23 girls, 30 boys) was compared with matched control subjects (38 girls, 41 boys). The mean DMR in cleft boys (0.97 +/- 0.01) was significantly lower than in control boys (1.06 +/- 0.01), P < 0.05. The mean DMR in cleft boys was lower than in cleft girls (1.02 +/- 0.02), with a tendency toward statistical significance. No significant difference in DMR was found between the cleft versus control girls, or between the control girls and boys. Among cleft boys, the prevalence of dental age delay was 67% (20/30), with a mean delay of 0.6 +/- 0.4 years. These results suggested that CL(P) may be associated with delay in permanent tooth formation.
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Affiliation(s)
- A N Pham
- Children's Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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