1
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Monin MB, Baier LI, Gorny JG, Berger M, Zhou T, Mahn R, Sadeghlar F, Möhring C, Boesecke C, van Bremen K, Rockstroh JK, Strassburg CP, Eis-Hübinger AM, Schmid M, Gonzalez-Carmona MA. Deficient Immune Response following SARS-CoV-2 Vaccination in Patients with Hepatobiliary Carcinoma: A Forgotten, Vulnerable Group of Patients. Liver Cancer 2023; 12:339-355. [PMID: 37901199 PMCID: PMC10601882 DOI: 10.1159/000529608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/06/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Data on immune response rates following vaccination for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in patients with hepatobiliary carcinoma (HBC) are rare. However, impaired immunogenicity must be expected due to the combination of chronic liver diseases (CLDs) with malignancy and anticancer treatment. Methods In this prospective, longitudinal study, 101 patients were included, of whom 59 were patients with HBC under anticancer treatment. A cohort of patients with a past medical history of gastrointestinal cancer, of whom 28.6% had HBC without detectable active tumor disease having been off therapy for at least 12 months, served as control. Levels of SARS-CoV-2 anti-spike IgG, surrogate neutralization antibodies (sNABs), and cellular immune responses were compared. In uni- and multivariable subgroup analyses, risk factors for impaired immunogenicity were regarded. Data on rates and clinical courses of SARS-CoV-2 infections were documented. Results In patients with HBC under active treatment, levels of SARS-CoV-2 anti-spike IgG were significantly lower (2.55 log10 BAU/mL; 95% CI: 2.33-2.76; p < 0.01) than in patients in follow-up care (3.02 log10 BAU/mL; 95% CI: 2.80-3.25) 4 weeks after two vaccinations. Antibody levels decreased over time, and differences between the groups diminished. However, titers of SARS-CoV-2 sNAB were for a longer time significantly lower in patients with HBC under treatment (64.19%; 95% CI: 55.90-72.48; p < 0.01) than in patients in follow-up care (84.13%; 95% CI: 76.95-91.31). Underlying CLD and/or liver cirrhosis Child-Pugh A or B (less than 8 points) did not seem to further impair immunogenicity. Conversely, chemotherapy and additional immunosuppression were found to significantly reduce antibody levels. After a third booster vaccination for SARS-CoV-2, levels of total and neutralization antibodies were equalized between the groups. Moreover, cellular response rates were balanced. Clinically, infection rates with SARS-CoV-2 were low, and no severe courses were observed. Conclusion Patients with active HBC showed significantly impaired immune response rates to basic vaccinations for SARS-CoV-2, especially under chemotherapy, independent of underlying cirrhotic or non-cirrhotic CLD. Although booster vaccinations balanced differences, waning immunity was observed over time and should be monitored for further recommendations. Our data help clinicians decide on individual additional booster vaccinations and/or passive immunization or antiviral treatment in patients with HBC getting infected with SARS-CoV-2.
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Affiliation(s)
- Malte B. Monin
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Leona I. Baier
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Jens G. Gorny
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Moritz Berger
- Institute of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Taotao Zhou
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Robert Mahn
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Farsaneh Sadeghlar
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Christian Möhring
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Christoph Boesecke
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Kathrin van Bremen
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Jürgen K. Rockstroh
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | | | | | - Matthias Schmid
- Institute of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
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2
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Monin MB, Gorny JG, Berger M, Baier LI, Zhou T, Mahn R, Sadeghlar F, Möhring C, Boesecke C, van Bremen K, Rieke GJ, Schlabe S, Breitschwerdt S, Marinova M, Schmidt-Wolf IGH, Strassburg CP, Eis-Hübinger AM, Gonzalez-Carmona MA. Impaired immunogenicity after vaccination for SARS-CoV-2 in patients with gastrointestinal cancer: does tumor entity matter? J Gastrointest Oncol 2023; 14:1218-1234. [PMID: 37435197 PMCID: PMC10331752 DOI: 10.21037/jgo-22-1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/21/2023] [Indexed: 07/13/2023] Open
Abstract
Background SARS-CoV-2 immunogenicity in patients with gastrointestinal cancer (GI cancer) following second and third vaccination was analyzed. Methods A total of 125 patients under active anticancer therapy or in follow-up care were included in this prospective study. Seroprevalence of SARS-CoV-2 anti-spike and surrogate neutralization antibodies (NABs) was measured. Results Four weeks after second vaccination, adequate titers of SARS-CoV-2 anti-spike immunoglobulin G (IgG) [≥282.0 binding antibody units (BAU)/mL] were found in 62.2% of patients under treatment versus 96.3% of patients in follow-up care (P<0.01). Sufficient titers of SARS-CoV-2 surrogate NAB (≥85.0%) were found in 32.7% of patients under treatment versus 70.6% in follow-up care (P<0.01). Titers of SARS-CoV-2 anti-spike IgG were especially low in patients with colorectal cancer (CRC). For SARS-CoV-2 surrogate NAB, patients with hepatocellular carcinoma (HCC) and with pancreaticobiliary cancer showed the lowest titers (P<0.01). SARS-CoV-2 anti-spike IgG and SARS-CoV-2 surrogate NAB were associated with a correlation coefficient of 0.93. Reaching a titer of SARS-CoV-2 anti-spike IgG ≥482.0 BAU/mL, protective levels of SARS-CoV-2 surrogate NAB (≥85.0%) could be assumed. Following booster vaccination, all patients reached effective antibody titers. Conclusions Patients with active GI cancer showed impaired immunogenicity after second SARS-CoV-2 vaccination which was overcome by booster vaccination. Our findings were tumor-related and pronounced in patients with CRC and HCC. Waning immunity over time and antibody escape phenomena by variant of concern Omicron must be considered in these especially vulnerable patients.
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Affiliation(s)
- Malte Benedikt Monin
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Jens Gabriel Gorny
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Moritz Berger
- Institute for Medical Biometry, Informatics and Epidemiology, Bonn University Hospital, Bonn, Germany
| | - Leona I. Baier
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Taotao Zhou
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Robert Mahn
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Farsaneh Sadeghlar
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Christian Möhring
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Christoph Boesecke
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Kahtrin van Bremen
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Gereon J. Rieke
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Stefan Schlabe
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Stefan Breitschwerdt
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Milka Marinova
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Ingo G. H. Schmidt-Wolf
- Department of Integrated Oncology, Center for Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany
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3
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Monin MB, Baier L, Berger M, Gorny JG, Zhou T, Mahn R, Sadeghlar F, Möhring C, van Bremen K, Boesecke C, Rockstroh J, Strassburg C, Eis-Hübinger AM, Gonzalez-Carmona MA. SARS-CoV-2 vaccination in patients with GI and hepatobiliary carcinoma: a call for booster vaccination. Gut 2022; 72:1227-1229. [PMID: 35882561 DOI: 10.1136/gutjnl-2022-328169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/20/2022] [Indexed: 12/08/2022]
Affiliation(s)
- Malte Benedikt Monin
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany .,German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Leona Baier
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Moritz Berger
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Jens Gabriel Gorny
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Taotao Zhou
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Robert Mahn
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Farsaneh Sadeghlar
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Christian Möhring
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Kathrin van Bremen
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Christoph Boesecke
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Jürgen Rockstroh
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
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Braegelmann C, Niebel D, Wenzel J, Bieber T, Eis-Hübinger AM, Wilsmann-Theis D. Interferon-beta as an enhancer of paraviral exanthema during influenza virus infection. J Eur Acad Dermatol Venereol 2020; 35:e228-e230. [PMID: 32978854 PMCID: PMC7537074 DOI: 10.1111/jdv.16954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C Braegelmann
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - D Niebel
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - J Wenzel
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - T Bieber
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | | | - D Wilsmann-Theis
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
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5
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Midgley SE, Benschop K, Dyrdak R, Mirand A, Bailly JL, Bierbaum S, Buderus S, Böttcher S, Eis-Hübinger AM, Hönemann M, Jensen VV, Hartling UB, Henquell C, Panning M, Thomsen MK, Hodcroft EB, Meijer A. Co-circulation of multiple enterovirus D68 subclades, including a novel B3 cluster, across Europe in a season of expected low prevalence, 2019/20. ACTA ACUST UNITED AC 2020; 25. [PMID: 31964463 PMCID: PMC6976881 DOI: 10.2807/1560-7917.es.2020.25.2.1900749] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Enterovirus D68 (EV-D68) was detected in 93 patients from five European countries between 1 January 2019 and 15 January 2020, a season with expected low circulation. Patients were primarily children (n = 67, median age: 4 years), 59 patients required hospitalisation and five had severe neurologic manifestations. Phylogenetic analysis revealed two clusters in the B3 subclade and subclade A2/D. This circulation of EV-D68 associated with neurological manifestations stresses the importance of surveillance and diagnostics beyond expected peak years.
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Affiliation(s)
- Sofie Elisabeth Midgley
- Department for Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Kimberley Benschop
- Centre for Infectious Disease Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Robert Dyrdak
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Audrey Mirand
- Université Clermont Auvergne, CNRS, Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Centre National de Référence des entérovirus et parechovirus - Laboratoire Associé, Laboratoire de Virologie, Clermont-Ferrand, France
| | - Jean-Luc Bailly
- Université Clermont Auvergne, CNRS, Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Sibylle Bierbaum
- Institute of Virology, University of Freiburg, Freiburg, Germany
| | - Stefan Buderus
- Department of General Pediatrics, St.-Marien-Hospital, Bonn, Germany
| | - Sindy Böttcher
- National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch-Institute, Berlin, Germany
| | | | - Mario Hönemann
- Institute of Virology, University of Leipzig, Leipzig, Germany
| | - Veronika Vorobieva Jensen
- Department for Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | | | - Cécile Henquell
- CHU Clermont-Ferrand, Centre National de Référence des entérovirus et parechovirus - Laboratoire Associé, Laboratoire de Virologie, Clermont-Ferrand, France
| | - Marcus Panning
- Institute of Virology, University of Freiburg, Freiburg, Germany
| | | | - Emma B Hodcroft
- Swiss Institute of Bioinformatics, Basel, Switzerland.,Biozentrum, University of Basel, Basel, Switzerland
| | - Adam Meijer
- Centre for Infectious Disease Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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6
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Schmithausen RM, Döhla M, Schöβler H, Diegmann C, Schulte B, Richter E, Eis-Hübinger AM, Streeck H. Characteristic Temporary Loss of Taste and Olfactory Senses in SARS-CoV-2-positive-Individuals with Mild Symptoms. Pathog Immun 2020; 5:117-120. [PMID: 32582871 PMCID: PMC7307443 DOI: 10.20411/pai.v5i1.374] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/28/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Ricarda M Schmithausen
- Institute for Hygiene and Public Health; One Health Department; Medical Faculty; University of Bonn; Venusberg Campus 1; 53127 Bonn, Germany.,contributed equally
| | - Manuel Döhla
- Institute for Hygiene and Public Health; One Health Department; Medical Faculty; University of Bonn; Venusberg Campus 1; 53127 Bonn, Germany.,contributed equally
| | - Heidrun Schöβler
- Local Health Authority; Heinsberg; Valkenburger Str. 45; 52525 Heinsberg, Germany
| | - Christin Diegmann
- Institute for Hygiene and Public Health; One Health Department; Medical Faculty; University of Bonn; Venusberg Campus 1; 53127 Bonn, Germany
| | - Bianca Schulte
- Institute of Virology; Medical Faculty; University of Bonn; Venusberg Campus 1; 53127 Bonn, Germany
| | - Enrico Richter
- Institute of Virology; Medical Faculty; University of Bonn; Venusberg Campus 1; 53127 Bonn, Germany
| | - Anna-Maria Eis-Hübinger
- Institute of Virology; Medical Faculty; University of Bonn; Venusberg Campus 1; 53127 Bonn, Germany
| | - Hendrik Streeck
- Institute of Virology; Medical Faculty; University of Bonn; Venusberg Campus 1; 53127 Bonn, Germany
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7
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Elling R, Böttcher S, du Bois F, Müller A, Prifert C, Weissbrich B, Hofmann J, Korn K, Eis-Hübinger AM, Hufnagel M, Panning M. Epidemiology of Human Parechovirus Type 3 Upsurge in 2 Hospitals, Freiburg, Germany, 2018. Emerg Infect Dis 2019; 25:1384-1388. [PMID: 31211683 PMCID: PMC6590756 DOI: 10.3201/eid2507.190257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In 2018, a cluster of pediatric human parechovirus (HPeV) infections in 2 neighboring German hospitals was detected. Viral protein 1 sequence analysis demonstrated co-circulation of different HPeV-3 sublineages and of HPeV-1 and -5 strains, thereby excluding a nosocomial outbreak. Our findings underline the need for HPeV diagnostics and sequence analysis for outbreak investigations.
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8
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Schlabe S, van Bremen K, Goldmann G, Oldenburg J, Eis-Hübinger AM, Zeitler H, Spengler U. Acute Hepatitis E Virus infection in a hemophilic patient with acquired inhibitor during immune tolerance therapy according to modified Bonn-Malmö protocol. Haemophilia 2019; 25:e117-e120. [PMID: 30694010 DOI: 10.1111/hae.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 12/16/2018] [Accepted: 01/08/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Stefan Schlabe
- Department of Internal Medicine I, University Hospital of Bonn, Bonn, Germany
- German Center for Infectious Diseases, Partner site Cologne-Bonn, Cologne, Germany
| | - Kathrin van Bremen
- Department of Internal Medicine I, University Hospital of Bonn, Bonn, Germany
- German Center for Infectious Diseases, Partner site Cologne-Bonn, Cologne, Germany
| | - Georg Goldmann
- German Center for Infectious Diseases, Partner site Cologne-Bonn, Cologne, Germany
- Institute for Experimental Hematology and Blood Transfusion, University Hospital of Bonn, Bonn, Germany
| | - Johannes Oldenburg
- German Center for Infectious Diseases, Partner site Cologne-Bonn, Cologne, Germany
- Institute for Experimental Hematology and Blood Transfusion, University Hospital of Bonn, Bonn, Germany
| | - Anna-Maria Eis-Hübinger
- German Center for Infectious Diseases, Partner site Cologne-Bonn, Cologne, Germany
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
| | - Heike Zeitler
- Department of Internal Medicine I, University Hospital of Bonn, Bonn, Germany
- German Center for Infectious Diseases, Partner site Cologne-Bonn, Cologne, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University Hospital of Bonn, Bonn, Germany
- German Center for Infectious Diseases, Partner site Cologne-Bonn, Cologne, Germany
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9
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Stecher M, Chaillon A, Eis-Hübinger AM, Lehmann C, Fätkenheuer G, Wasmuth JC, Knops E, Vehreschild JJ, Mehta S, Hoenigl M. Pretreatment human immunodeficiency virus type 1 (HIV-1) drug resistance in transmission clusters of the Cologne-Bonn region, Germany. Clin Microbiol Infect 2019; 25:253.e1-253.e4. [PMID: 30315957 PMCID: PMC6349503 DOI: 10.1016/j.cmi.2018.09.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/25/2018] [Accepted: 09/28/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES In Germany, previous reports have demonstrated transmitted human immunodeficiency virus type 1 (HIV-1) drug-resistance mutations (DRM) in 11% of newly diagnosed individuals, highlighting the importance of drug-resistance screening before the initiation of antiretroviral therapy (ART). Here, we sought to understand the molecular epidemiology of HIV DRM transmission in the Cologne-Bonn region of Germany, given one of the highest rates of new HIV diagnoses in western Europe (13.7 per 100 000 habitants). METHODS We analysed 714 HIV-1 ART-naive infected individuals diagnosed at the University Hospitals Cologne and Bonn between 2001 and 2016. Screening for DRM was performed according to the Stanford University Genotypic Resistance Interpretation. Shared DRM were defined as any DRM present in genetically linked individuals (<1.5% genetic distance). Phylogenetic and network analyses were performed to infer putative relationships and shared DRM. RESULTS The prevalence of any DRM at time of diagnosis was 17.2% (123/714 participants). Genetic transmission network analyses showed comparable frequencies of DRM in clustering versus non-clustering individuals (17.1% (85/497) versus 17.5% (38/217)). The observed rate of DRM in the region was higher than previous reports 10.8% (87/809) (p < 0.001), revealing the need to reduce onward transmission in this area. Genetically linked individuals harbouring shared DRM were more likely to live in suburban areas (24/38) than in central Cologne (1/38) (p < 0.001). CONCLUSION The rate of DRM was exceptionally high. Network analysis elucidated frequent cases of shared DRM among genetically linked individuals, revealing the potential spread of DRM and the need to prevent onward transmission of DRM in the Cologne-Bonn area.
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Affiliation(s)
- M Stecher
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - A Chaillon
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA.
| | - A M Eis-Hübinger
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
| | - C Lehmann
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - G Fätkenheuer
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J-C Wasmuth
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany; Department for Internal Medicine I, University Hospital of Bonn, Bonn, Germany
| | - E Knops
- Institute of Virology, University Hospital of Cologne, Cologne, Germany
| | - J J Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - S Mehta
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Department of Medicine, San Diego VA Medical Centre, San Diego, CA, USA
| | - M Hoenigl
- Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Division of Pulmonology and Section of Infectious Diseases, Medical University of Graz, Graz, Austria
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10
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Eis-Hübinger AM, Sasowski U, Brackmann HH, Kaiser R, Matz B, Schneweis KE. Parvovirus B19 DNA Is Frequently Present in Recombinant Coagulation Factor VIII Products. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1650716] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - U Sasowski
- The Institute of Medical Microbiology and Immunology, Germany
| | - H H Brackmann
- The Institute of Experimental Hematology and Transfusion Medicine of the Universitiy of Bonn, Germany
| | - R Kaiser
- The Institute of Medical Microbiology and Immunology, Germany
| | - B Matz
- The Institute of Medical Microbiology and Immunology, Germany
| | - K E Schneweis
- The Institute of Medical Microbiology and Immunology, Germany
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11
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Große-Bley A, Eis-Hübinger AM, Kaiser R, Oldenburg J, Brackmann HH, Schwarz TF, Schneweis KE. Serological and Virological Markers of Human Parvovirus B19 Infection in Sera of Hemophiliacs. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648903] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryIt is known that parvovirus B19 (B19) is transmitted to hemophiliacs by clotting factors prepared from human plasma. However, it is not clear whether B19 is also transmitted by the more recently used inactivated clotting factor preparations. Therefore, we investigated 69 hemophiliacs, mostly children, receiving only virus-inactivated clotting factors. 49 of them (71%) were B19 IgG-positive and 18 of the IgG-positive hemophiliacs (37%) were also B19 IgM-positive. In contrast, out of 73 age-matched controls only 10 (14%) were IgG-positive, two of them being also IgM-positive. In hemophiliacs treated before 1984 with noninactivated clotting factors, seroprevalence was very similar: 94/136 (69%) presented B19 IgG antibodies as compared to their age-matched controls with 16/50 (32%). Out of the 94 IgG-positive patients 24 (26%) were IgM-positive, whereas IgM antibodies were never found in 16 sera of 16 IgG-positive controls. In 4 out of 24 IgM positive hemophiliacs, B19 DNA was detected in the sera by using the polymerase chain reaction. However, B19 DNA was also found in 3/69 anti-B19 IgM-negative, HIV-infected hemophiliacs (all three patients in CDC stage IV). Since it seems unlikely that the results only represent passive acquisition of B19 DNA from blood products and induction of antibodies by immunization with inactivated antigen, the observations rather suggest that infection with B19 is transmitted by clotting factors, including those treated for virus inactivation.
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Affiliation(s)
- A Große-Bley
- The institute of Medical Microbiology and Immunology, Munich, Germany
| | - A M Eis-Hübinger
- The institute of Medical Microbiology and Immunology, Munich, Germany
| | - R Kaiser
- The institute of Medical Microbiology and Immunology, Munich, Germany
| | - J Oldenburg
- The institute of Experimental Hematology and Transfusion Medicine, University of Bonn, Bonn, Germany
| | - H H Brackmann
- The institute of Experimental Hematology and Transfusion Medicine, University of Bonn, Bonn, Germany
| | - T F Schwarz
- The Max v. Pettenkofer Institute for Hygiene and Medical Microbiology, University of Munich, Munich, Germany
| | - K E Schneweis
- The institute of Medical Microbiology and Immunology, Munich, Germany
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12
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Niendorf S, Jacobsen S, Faber M, Eis-Hübinger AM, Hofmann J, Zimmermann O, Höhne M, Bock CT. Steep rise in norovirus cases and emergence of a new recombinant strain GII.P16-GII.2, Germany, winter 2016. ACTA ACUST UNITED AC 2017; 22:30447. [PMID: 28181902 PMCID: PMC5388089 DOI: 10.2807/1560-7917.es.2017.22.4.30447] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 01/25/2017] [Indexed: 12/17/2022]
Abstract
Since early November 2016, the number of laboratory-confirmed norovirus infections reported in Germany has been increasing steeply. Here, we report the detection and genetic characterisation of an emerging norovirus recombinant, GII.P16-GII.2. This strain was frequently identified as the cause of sporadic cases as well as outbreaks in nine federal states of Germany. Our findings suggest that the emergence of GII.P16-GII.2 contributed to rising case numbers of norovirus gastroenteritis in Germany.
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Affiliation(s)
- S Niendorf
- Department of Infectious Diseases, Robert Koch-Institute, Berlin, Germany.,Consultant Laboratory for Noroviruses, Robert Koch-Institute, Berlin, Germany
| | - S Jacobsen
- Department of Infectious Diseases, Robert Koch-Institute, Berlin, Germany.,Consultant Laboratory for Noroviruses, Robert Koch-Institute, Berlin, Germany
| | - M Faber
- Department for Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
| | - A M Eis-Hübinger
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
| | - J Hofmann
- Institute of Medical Virology, Charité University Medicine, Berlin, and Labor Berlin, Charité-Vivantes GmbH, Berlin, Germany
| | - O Zimmermann
- Institute of Medical Microbiology, Göttingen, Germany
| | - M Höhne
- Department of Infectious Diseases, Robert Koch-Institute, Berlin, Germany.,Consultant Laboratory for Noroviruses, Robert Koch-Institute, Berlin, Germany
| | - C T Bock
- Department of Infectious Diseases, Robert Koch-Institute, Berlin, Germany
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13
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Slavov SN, Kashima S, Rocha-Junior MC, Silva-Pinto AC, Oliveira LC, Eis-Hübinger AM, Covas DT. Human parvovirus 4 in Brazilian patients with haemophilia, beta-thalassaemia major and volunteer blood donors. Haemophilia 2014; 21:e86-8. [PMID: 25311656 DOI: 10.1111/hae.12564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2014] [Indexed: 12/16/2022]
Affiliation(s)
- S N Slavov
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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14
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Drexler JF, Baumgarte S, Eschbach-Bludau M, Simon A, Kemen C, Bode U, Eis-Hübinger AM, Madea B, Drosten C. Human cardioviruses, meningitis, and sudden infant death syndrome in children. Emerg Infect Dis 2012; 17:2313-5. [PMID: 22153118 PMCID: PMC3311172 DOI: 10.3201/eid1712.111037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Cardioviruses cause myocarditis and encephalomyelitis in rodents; human cardioviruses have not been ascribed to any disease. We screened 6,854 cerebrospinal fluid and 10 myocardium specimens from children and adults. A genotype 2 cardiovirus was detected from a child who died of sudden infant death syndrome, and 2 untypeable cardioviruses were detected from 2 children with meningitis.
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15
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Modrow S, Wenzel JJ, Schimanski S, Schwarzbeck J, Rothe U, Oldenburg J, Jilg W, Eis-Hübinger AM. Prevalence of nucleic acid sequences specific for human parvoviruses, hepatitis A and hepatitis E viruses in coagulation factor concentrates. Vox Sang 2010; 100:351-8. [PMID: 21133933 DOI: 10.1111/j.1423-0410.2010.01445.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Due to their high resistance to inactivation procedures, nonenveloped viruses such as parvovirus B19, human bocavirus (HBoV), human parvovirus 4 (PARV4), hepatitis A (HAV) and hepatitis E virus (HEV) pose a particular threat to blood products. Virus transmission to patients treated with blood products presents an additional burden to disease. We determined the frequency and the amount of nucleic acid specific for nonenveloped viruses in recently manufactured preparations of commercial coagulation factor concentrates. MATERIALS AND METHODS At least three different batches of each of 13 different plasma-derived and recombinant coagulation factor products were tested for the presence and the amount of nucleic acid for parvovirus B19, HBoV, human parvovirus 4, hepatitis A virus and HEV by using quantitative polymerase chain reaction. RESULTS Whereas none of the recombinant products tested positive for any of these viruses, parvovirus B19 DNA with amounts ranging between 2×10(1) and 1.3×10(3) genome equivalents/ml was detected in five plasma-derived products. In addition to parvovirus B19 genotype 1, genotypes 2 and 3 were observed in two batches of a factor VIII/von-Willebrand factor product. In two products (one factor VIII concentrate and one activated prothrombin complex concentrate), a combination of both genotypes 1 and 2 of parvovirus B19 was detected. CONCLUSION The data show that nucleic acids from several relevant nonenveloped viruses are not found at detectable levels in coagulation factor concentrates. In some cases, parvovirus B19 DNA was detectable at low levels. Testing of the plasma pools for the full range of parvovirus genotypes is advocated for ensuring product safety.
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Affiliation(s)
- S Modrow
- Institute for Medical Microbiology and Hygiene, University of Regensburg, Franz-Josef-Strauß Allee 11, Regensburg, Germany.
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16
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Bagci S, Eis-Hübinger AM, Yassin AF, Simon A, Bartmann P, Franz AR, Mueller A. Clinical characteristics of viral intestinal infection in preterm and term neonates. Eur J Clin Microbiol Infect Dis 2010; 29:1079-84. [PMID: 20563830 DOI: 10.1007/s10096-010-0965-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 05/06/2010] [Indexed: 11/29/2022]
Abstract
The clinical presentation of the viral enteric pathogens in newborn infants has not been adequately examined. The aim of this study was to evaluate the clinical characteristics of viral intestinal infections in newborn infants. Clinical data of all term and preterm infants admitted to our tertiary neonatal intensive care unit from 1998 to 2007 with clinical signs of gastroenteritis (GE) or necrotizing enterocolitis (NEC) were retrospectively reviewed and compared between infants with different viral enteric pathogens in stool specimens. In 34 infants with signs of GE or NEC, enteropathogenic viruses were found in stool specimens. Rotavirus was detected in 12 cases, of which two infants had NEC. Compared with infants with rotavirus or norovirus, infants with astrovirus more frequently suffered from NEC (p<0.05). In addition, an acute systemic inflammatory response was significantly more common in patients with astrovirus infection (astrovirus vs. rotavirus and astrovirus vs. norovirus, p < 0.01 and p < 0.05, respectively). Of eight children infected with norovirus, one infant had a systemic acute inflammatory response and NEC. This study demonstrates that in newborn infants, intestinal rotavirus, norovirus, and astrovirus infections may be associated with severe illness such as hemorrhagic enteritis resulting in bloody diarrhea or even NEC.
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Affiliation(s)
- S Bagci
- Department of Neonatology, Children's Hospital, University of Bonn, Adenauerallee 119, Bonn, Germany.
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17
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Panning M, Eickmann M, Landt O, Monazahian M, Ölschläger S, Baumgarte S, Reischl U, Wenzel JJ, Niller HH, Günther S, Hollmann B, Huzly D, Drexler JF, Helmer A, Becker S, Matz B, Eis-Hübinger AM, Drosten C. Detection of influenza A(H1N1)v virus by real-time RT-PCR. Euro Surveill 2009. [DOI: 10.2807/ese.14.36.19329-en] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Influenza A(H1N1)v virus was first identified in April 2009. A novel real-time RT-PCR for influenza A(H1N1)v virus was set up ad hoc and validated following industry-standard criteria. The lower limit of detection of the assay was 384 copies of viral RNA per ml of viral transport medium (95% confidence interval: 273-876 RNA copies/ml). Specificity was 100% as assessed on a panel of reference samples including seasonal human influenza A virus H1N1 and H3N2, highly pathogenic avian influenza A virus H5N1 and porcine influenza A virus H1N1, H1N2 and H3N2 samples. The real-time RT-PCR assay for the influenza A matrix gene recommended in 2007 by the World Health Organization was modified to work under the same reaction conditions as the influenza A(H1N1)v virus-specific test. Both assays were equally sensitive. Clinical applicability of both assays was demonstrated by screening of almost 2,000 suspected influenza (H1N1)v specimens, which included samples from the first cases of pandemic H1N1 influenza imported to Germany. Measuring influenza A(H1N1)v virus concentrations in 144 laboratory-confirmed samples yielded a median of 4.6 log RNA copies/ml. The new methodology proved its principle and might assist public health laboratories in the upcoming influenza pandemic.
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Affiliation(s)
- M Panning
- Department of Virology, University of Freiburg, Freiburg, Germany
| | - M Eickmann
- Institute for Virology, University of Marburg, Marburg, Germany
| | - O Landt
- TIB Molbiol, Berlin, Germany
| | - M Monazahian
- Governmental Institute of Public Health of Lower-Saxony, Hannover, Germany
| | | | - S Baumgarte
- Institute for Hygiene and the Environment, Hamburg, Germany
| | - U Reischl
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - J J Wenzel
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - H H Niller
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - S Günther
- Bernhard-Nocht-Institute, Hamburg, Germany
| | - B Hollmann
- Department of Virology, University of Freiburg, Freiburg, Germany
| | - D Huzly
- Department of Virology, University of Freiburg, Freiburg, Germany
| | - J F Drexler
- Institute of Virology, Bonn Medical Centre, Bonn, Germany
| | - A Helmer
- Institute of Virology, Bonn Medical Centre, Bonn, Germany
| | - S Becker
- Institute for Virology, University of Marburg, Marburg, Germany
| | - B Matz
- Institute of Virology, Bonn Medical Centre, Bonn, Germany
| | | | - C Drosten
- Institute of Virology, Bonn Medical Centre, Bonn, Germany
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18
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Siebert SE, Müller A, Bartmann P, Heep A, Eis-Hübinger AM. Pränatale Parvovirus B19 Infektion als Ursache eines zerebralen Infarktes beim Neugeborenen. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Charbel Issa P, Eis-Hübinger AM, Klatt K, Holz FG, Loeffler KU. Oculoglandular syndrome associated with reactivated Epstein-Barr-virus infection. Br J Ophthalmol 2008; 92:740, 855. [PMID: 18523078 DOI: 10.1136/bjo.2007.132050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- P Charbel Issa
- Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str 2, 53127 Bonn, Germany.
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20
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Schneider B, Fryer JF, Oldenburg J, Brackmann HH, Baylis SA, Eis-Hübinger AM. Frequency of contamination of coagulation factor concentrates with novel human parvovirus PARV4. Haemophilia 2008; 14:978-86. [PMID: 18565125 DOI: 10.1111/j.1365-2516.2008.01800.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Human parvovirus, PARV4 was identified in a plasma sample from a patient presenting with symptoms resembling acute HIV infection. Further strains of PARV4 and those of a closely related variant virus, were identified in plasma pools used in the manufacture of blood derivatives. DNA sequence analysis of these strains demonstrated two distinct PARV4 genotypes. It has subsequently been proposed that transmission of PARV4 occurs by parenteral routes. To investigate the risk of contamination of plasma-derived coagulation factor concentrates, we analysed 169 lots for PARV4 DNA by polymerase chain reaction. Positive samples were confirmed by nucleotide sequence analysis and quantification of the viral load. Twenty-one lots, representing eight different products were administered until the beginning of the 1980s and were not virally inactivated. Two lots examined were used in 1997, and 146 lots representing 13 products had been administered between October 2000 and February 2003. PARV4 DNA was detected in 7(33%) of the formerly administered lots, in one lot used in 1997, and in 13(9%) recently used lots. PARV4 genotype 2 DNA was predominantly present in the older concentrates, whilst genotype 1 was found more frequently in recently used lots. In three lots, both PARV4 genotypes were detected. Viral loads ranged between <100 and 10(5.8) copies mL(-1) of product, with higher viral loads in the older concentrates. The results show that PARV4 contamination can be detected in an appreciable proportion of clotting factor concentrates. Further studies are needed to determine whether or not PARV4 contamination of coagulation factors causes harm to the product recipients.
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Affiliation(s)
- B Schneider
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
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21
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Bagci S, Eis-Hübinger AM, Simon A, Bierbaum G, Heep A, Schildgen O, Bartmann P, Franz A, Müller A. Klinik und Verlauf viraler gastrointestinaler Infektion bei Früh- und Neugeborenen. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1079019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Peng WM, Yu CF, Allam JP, Oldenburg J, Bieber T, Hoch J, Eis-Hübinger AM, Novak N. Inhibitory oligodeoxynucleotides downregulate herpes simplex virus-induced plasmacytoid dendritic cell type I interferon production and modulate cell function. Hum Immunol 2007; 68:879-87. [PMID: 18082566 DOI: 10.1016/j.humimm.2007.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2007] [Revised: 09/27/2007] [Accepted: 10/05/2007] [Indexed: 11/17/2022]
Abstract
Recognition of nucleic acids by TLR9 expressed by human plasmacytoid dendritic cells (PDC) plays a key role in the defense against viral infections. Upon microbial pathogen stimulation, PDC secrete large amounts of type I interferon and arbitrate thereby both innate and adaptive immune mechanisms. Unmethylated CpG motifs, which are an integral part of bacterial or viral DNA, are used in vitro and in vivo to activate the TLR9 pathway, whereas inhibitory oligodeoxynucleotide (iODN) are capable of depressing TLR9 signaling. In this study we demonstrate that TTAGGG motifs containing iODN efficiently block the TLR9 signaling in terms of herpes simplex virus (HSV)-induced type I interferon production by PDC. However, iODN, as well as control ODN, still promote PDC maturation with upregulated expression of costimulatory molecules, major histocompatibility complex molecules, and other signs for PDC maturation. Furthermore, iODN and control ODN incubated PDC demonstrate increased T-cell stimulatory functions. Coculture experiments with autologous T cells indicate that iODN-treated PDC induce more CD4(+)CD25(+)Foxp3(+) T regulatory cells from naive CD4(+) T cells and preincubation of HSV-stimulated PDC with iODN upregulated T cells' IFN-gamma production. These data indicate that iODN, while blocking type I interferon production by PDC, modify PDC activation and maturation as well as T-cell priming and stimulation. Knowledge about the different functions of iODN on PDC elucidated might be crucial for immunotherapeutic strategies in which iODN motifs are used to prevent the interaction of CpG-DNA with TLR9 to calm down specific immunological responses, because our data indicate that iODN might not only have inhibitory functions but also be effective activators of immune cells.
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Affiliation(s)
- Wen-Ming Peng
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
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23
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Völz S, Schildgen O, Müller A, Tillmann RL, Eis-Hübinger AM, Kupfer B, Bode U, Lentze ML, Simon A. Das humane Bocavirus: Erreger von Atemwegsinfektionen? Dtsch Med Wochenschr 2007; 132:1529-33. [PMID: 17607653 DOI: 10.1055/s-2007-982064] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The human Bocavirus (HBoV), the second member of the parvovirus family, which displays pathogenicity in humans, has been described in 2005 by Allander et al.. It seems to be distributed worldwide and has been isolated mainly in infants and children with respiratory tract infection. This review covers all studies published on HBoV to February 2007 and discusses this emerging viral pathogen from the perspective of inpatient medical treatment centers.
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Affiliation(s)
- S Völz
- Zentrum für Kinderheilkunde des Universitätsklinikums Bonn, Germany
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24
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Simon A, Völz S, Höfling K, Kehl A, Tillman R, Müller A, Kupfer B, Eis-Hübinger AM, Lentze MJ, Bode U, Schildgen O. Acute life threatening event (ALTE) in an infant with human coronavirus HCoV-229E infection. Pediatr Pulmonol 2007; 42:393-6. [PMID: 17352399 PMCID: PMC7167760 DOI: 10.1002/ppul.20595] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this short report we discuss the temporal association between an acute life threatening event (ALTE) and a RT-PCR confirmed coronavirus HCoV-229E infection in a 4 months old otherwise healthy infant. More detailed microbiological investigations of affected children even without apparent signs of a respiratory tract infection may help to clarify the etiology in some patients and extend our understanding of the pathogenesis. PCR-based techniques should be utilized to increase the sensitivity of detection for old and new respiratory viral pathogens in comparable cases.
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Affiliation(s)
- Arne Simon
- Children's Hospital Medical Centre, University of Bonn, Bonn, Germany.
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25
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Bagci S, Eis-Hübinger AM, Franz AR, Heep A, Bartmann P, Kupfer B, Müller A. Nachweis von Astrovirus bei Frühgeborenen mit der Nekrotisierenden Enterokolitis. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Peng WM, Jenneck C, Bussmann C, Bogdanow M, Hart J, Leung DYM, Bieber T, Eis-Hübinger AM, Novak N. Risk factors of atopic dermatitis patients for eczema herpeticum. J Invest Dermatol 2006; 127:1261-3. [PMID: 17170734 DOI: 10.1038/sj.jid.5700657] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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27
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Wilkesmann A, Schildgen O, Eis-Hübinger AM, Lentze MJ, Bode U, Simon A. [Human Metapneumovirus in hospitalized children - a review]. Klin Padiatr 2006; 219:58-65. [PMID: 16586267 DOI: 10.1055/s-2006-921344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The human Metapneumovirus (HMPV) has been discovered by von den Hoogen et al. in 2001 and seems to play an important role as etiologic agent in childhood respiratory tract infections in particular involving infants after the 6th month of life and toddlers. Duly considering the hitherto published studies and retrospective analysis of two HMPV seasons (2002-2004) at our institution this review focuses on children, who had to be hospitalized due to HMPV infection. The analysis confirmed, that among those patients there is a high proportion of children with pre-existing risk factors for a complicated clinical course, a high proportion of children with bronchiolitis or pneumonia and a relevant proportion of children with HMPV related apnoeas, most prevalent in the prematurely born. Although the first HMPV infection takes place somewhat later in infancy, the data do not show that HMPV infection is in general milder than RSV infection in hospitalized children. Clinical symptoms and radiological signs do not permit tentative conclusions on the causative agent. This underlines the necessity of specific diagnostic efforts (in case of HMPV with PCR). HMPV may cause lobar or segmental pneumonias difficult to distinguish from bacterial lower respiratory tract infection. Children admitted to the hospital with an acute exacerbation of asthma bronchiale or cystic fibrosis should not only be tested for RSV but also for HMPV. Prospective studies investigating specific therapeutic interventions or describing the impact and prevention of nosocomial HMPV in fection are awaited for. There has been one report of a meningoencephalitis possibly related to HMPV. Thus, liquor samples in such cases should be tested for HMPV too.
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Affiliation(s)
- A Wilkesmann
- Zentrum für Kinderheilkunde am Universitätsklinikum Bonn
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28
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Becker MR, Schneider B, Reber U, Pöge U, Klein B, Klehr HU, Zhou H, Fischer HP, Eis-Hübinger AM. Renal Anemia Aggravated by Long-Term Parvovirus B19 and Cytomegalovirus Infection in a Renal Transplant Patient: Case Report and Evaluation of B19 Seroprevalence in Dialysis Patients. Transplant Proc 2005; 37:4306-8. [PMID: 16387104 DOI: 10.1016/j.transproceed.2005.11.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Due to viral replication in erythroid precursor cells, severe anemia represents a major complication of B19 infection. However, cytomegalovirus (CMV) is the leading cause of virus-induced complications with a significant impact on graft outcome of renal transplant patients. Herein, we present a long-term B19 infection in a 45-year-old female renal transplant patient, which aggravated the renal anemia associated with a concomitant CMV infection. Since no data were available on the seroprevalence of this virus in pretransplant patients, we determined the B19 serostatus of 90 dialyzed pretransplant adult subjects.
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Affiliation(s)
- M R Becker
- Institute of Medical Microbiology and Immunology, University of Bonn, Bonn, Germany
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29
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Rox JM, Eis-Hübinger AM, Müller J, Vogel M, Kaiser R, Hanfland P, Däumer M. First human immunodeficiency virus-1 group O infection in a European blood donor. Vox Sang 2004; 87:44-5. [PMID: 15260822 DOI: 10.1111/j.1423-0410.2004.00529.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Abstract
BACKGROUND Maternofetal parvovirus B19 infection may result in fetal hydrops or abortion. Chronic infection has been associated with long term complications (polyarthritis, persistent aplastic anaemia, hepatitis). In pregnancy maternal immunosuppression caused by a TH2 dominant response to viral antigens has been observed. There is little information on long term reactivity to intrauterine infection. AIMS To assess the serological status in children and their mothers after maternofetal parvovirus B19 infection and development of fetal hydrops. METHODS A total of 18 children and their mothers, and 54 age matched control infants were studied. Main outcome measures were parvovirus B19 DNA, specific IgM and IgG against the virus proteins VP1/VP2, and NS-1 in venous blood. RESULTS Parvovirus B19 DNA and antiparvovirus B19 (IgM) were undetectable in all sera. A significant larger proportion of maternal sera compared to study children's sera contained IgG against the non-structural protein NS-1. Mean levels of VP1/VP2 IgG antibodies were significantly lower in the children than in their mothers (48 (36) v 197 (95) IU/ml). There was no history of chronic arthritis in mothers and children. Five women had subsequent acute but transient arthritis postpartum, which was not correlated with antibodies against NS-1. CONCLUSIONS Serological evidence of persistent infection after maternofetal parvovirus B19 disease could not be detected. Increased maternal prevalence of anti NS-1 (IgG) and increased levels of antiparvovirus B19 (IgG) may reflect prolonged viraemia compared to fetal disease.
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Affiliation(s)
- J Dembinski
- Department of Neonatology, University of Bonn, Germany.
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Dembinski J, Haverkamp F, Maara H, Hansmann M, Eis-Hübinger AM, Bartmann P. Neurodevelopmental outcome after intrauterine red cell transfusion for parvovirus B19-induced fetal hydrops. BJOG 2002; 109:1232-4. [PMID: 12452460 DOI: 10.1046/j.1471-0528.2002.02118.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess long term neurodevelopmental outcome of children after intrauterine intravascular red cell transfusion (JUT) for Parvovirus B19-induced fetal hydrops. DESIGN Data of study children were investigated retrospectively. Neurodevelopmental evaluation was performed by appropriate standard tests (Griffiths, Snijders-Oomen, Kaufmann Assessment Battery for Children tests). SETTING Tertiary care university teaching hospital. SAMPLE Twenty children who had Parvovirus-induced fetal hydrops and intrauterine transfusion of packed red blood cells (IUT). METHODS Retrospective chart analysis and standard neurodevelopmental testing. MAIN OUTCOME MEASURES Developmental quotient (DQ) and intelligence quotient (IQ) according to the age at testing. RESULTS Twenty survivors of Parvovirus B19-induced fetal hydrops successfully treated by IUT were followed until 13 months to nine years of age. On clinical follow up, no neurologic sequelae were evident. Neurodevelopmental scores of all children ranged within two standard deviations of a normal population (median 101, range 86-116) and exceeded one standard deviation in three children. There was no significant neurodevelopmental delay. CONCLUSION Children having survived successful IUT for Parvovirus B19-induced fetal anaemia and hydrops have a good neurodevelopmental prognosis. Our results support the use of IUT for correction of Parvovirus B19-induced fetal anaemia and subsequent hydrops.
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Affiliation(s)
- J Dembinski
- Department of Neonatology, University of Bonn, Germany
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32
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Montesinos-Rongen M, Hans VH, Eis-Hübinger AM, Prinz M, Schaller C, Van Roost D, Aguzzi A, Wiestler OD, Deckert M. Human herpes virus-8 is not associated with primary central nervous system lymphoma in HIV-negative patients. Acta Neuropathol 2001; 102:489-95. [PMID: 11699563 DOI: 10.1007/s004010100407] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Primary central nervous system lymphomas (PCNSL) are derived from germinal center B cells. Recent molecular studies indicate that the tumor cells or their precursors have experienced antigenic stimulation. Attractive candidates for such antigens are pathogens with the capacity to reside in the brain. The aim of the present study was to evaluate whether human herpes virus (HHV)-8 is involved in the pathogenesis of PCNSL. A series of 46 PCNSL, 31 from HIV-negative and 15 from HIV-positive patients, were analyzed using various molecular biological and immunological approaches. Nested PCR with two different protocols unequivocally demonstrated that PCNSL from HIV-negative patients did not harbor HHV-8 DNA. Among AIDS-associated PCNSL, HHV-8 DNA was found in only 1 tumor. In situ hybridization studies revealed that the lymphoma cells were HHV-8 negative in all cases. Single small mononuclear cells, most likely corresponding to bystander lymphocytes, were identified as the cellular source of HHV-8 in the HIV-positive patient with an HHV-8 PCR signal. These studies largely rule out a role for HHV-8 in the pathogenesis of PCNSL in both HIV-negative as well as HIV-positive patients.
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Abstract
Recent studies have suggested a pathogenic role of human parvovirus B19 (B19) in the development of acute fulminant liver failure in children. The hypothesis was based on the detection of B19 DNA in 8 of 10 explanted livers of children requiring liver transplantation. In the present study, explanted livers from 43 adults selected at random undergoing orthotopic liver transplantation for various reasons were examined. Pre-transplant sera were available from 40 patients of whom 35 (88%) were anti-B19 IgG-seropositive. All but one serum were negative for anti-B19 IgM antibody. By polymerase chain reaction, B19 DNA was detected in the livers of 15/35 (43%) anti-B19 IgG-positive patients, in 2/3 livers of patients with unknown anti-B19 antibody status, and in the initial transplant of an anti-B19 IgG-positive patient who underwent liver retransplantation, and whose own liver was negative for B19 DNA. In a second study group, liver and bone marrow samples from 23 autopsied adults selected at random were tested. Serum specimens were available from 22 individuals, of whom 17 (77%) were anti-B19 IgG-seropositive. All sera were negative for anti-B19 IgM antibody. B19 DNA was detected in the livers of 4/17 (24%) anti-B19 IgG-positive individuals, three of whom had also B19 DNA in their bone marrow. This is the first report demonstrating that B19 DNA is frequently present in livers of anti-B19 seropositive adults suggesting persistence of B19 in the liver. Further studies are needed to address whether B19 is an innocent bystander in the liver or whether the presence of B19 in liver is of biological and clinical significance.
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Affiliation(s)
- A M Eis-Hübinger
- Institute of Medical Microbiology and Immunology, University of Bonn, Germany.
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Abstract
BACKGROUND Early fetal herpes simplex virus (HSV) infection is rarely documented. Only the minority of affected fetuses survive this condition. PATIENT AND METHODS At 19 weeks of gestation the first episode of a genital HSV-infection of a pregnant woman was treated with local interferon beta. At 34 weeks of gestation hydrocephalus with secondary microcephaly and microphthalmia of both eyes was detected by ultrasonography. In the amniotic fluid HSV type 2 (HSV-2) was isolated and HSV-2-DNA was detected by PCR. The serum of the mother proved positive for HSV-2 (glycoprotein G2)-specific IgG-antibodies. No other infectious causes were apparent on further testing. At 35 + 4 weeks gestation a small-for-gestational-age neonate (2130 g) with microcephaly (29 cm head circumference) was born by spontaneous vaginal delivery. Scarce ulcerative skin lesions and vesicles, hepatosplenomegaly and microphthalmia were diagnosed. Furthermore, encephalomalacia with parenchymal destruction, cataract of both eyes and aplasia of the maculae and papillae were found. HSV-2-PCR was tested positive in chorionic cells and an umbilical segment of the placenta as well as in swabs from both eyes, throat, and a herpetic skin lesion collected during the first 5 days of life. HSV-IgM-antibodies were found in the umbilical cord blood. Local and intravenous treatment with aciclovir was started. The infant exhibited signs of a severely malfunctioning central nervous system. At the age of 4 months the boy suffered from generalised cerebral seizures. He died at the age of 9 months as a consequence of respiratory insufficiency with consecutive circulation failure. RESULTS The case of an intrauterine HSV-2-infection is presented. The time of onset of fetal infection was most probably at the time of the maternal disease (19 weeks of gestation). Inspite of the very early infection the fetus did not die in utero. CONCLUSIONS Especially, if a primary genital HSV-2-infection of a pregnant woman is suspected, which can be proven by serological means only several weeks after infection, systemic therapy of the mother with aciclovir should be considered since materno-fetal transmission may occur due to the risk of maternal viraemia.
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Affiliation(s)
- T Hoppen
- Zentrum für Kinderheilkunde, Abt. für Neonatologie, Universität Bonn
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35
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Wehmeier A, Eis-Hübinger AM, Maas Enriquez M, Beckmann H. Parvovirus B19 in idiopathic thrombocytopenic purpura. Vox Sang 2001; 79:118. [PMID: 11054052 DOI: 10.1159/000031224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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36
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Eis-Hübinger AM, Matz B, Effenberger W, Brackmann HH, Neipel F. Human herpesvirus 8 infection in haemophiliacs. Thromb Haemost 2000; 84:515-7. [PMID: 11019982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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37
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Abstract
Transplacental transmission of human parvovirus B19 (B19 virus) to the fetus is an important cause of intrauterine death, abortion, stillbirth, and nonimmune hydrops fetalis. Adverse outcome of pregnancy can occur after symptomatic and asymptomatic maternal infection. Only rare cases of congenital malformations and fetal disease in live-born infants have been associated with intrauterine B19 virus infection. Laboratory results obtained from paired maternal and fetal cord blood samples indicate that a reliable diagnosis of fetal B19 virus infection should be based on detection of parvovirus B19 DNA.
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Affiliation(s)
- A M Eis-Hübinger
- Institute of Medical Microbiology and Immunology, Center of Obstetrics and Gynecology, University of Bonn, Germany.
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38
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Dieck D, Schild RL, Hansmann M, Eis-Hübinger AM. Prenatal diagnosis of congenital parvovirus B19 infection: value of serological and PCR techniques in maternal and fetal serum. Prenat Diagn 1999; 19:1119-23. [PMID: 10590428] [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: 02/14/2023]
Abstract
Intrauterine infection with parvovirus B19 (B19) is associated with non-immune hydrops fetalis, miscarriage and stillbirth. Accurate laboratory tests for diagnosis of B19 infection are required to exclude other diagnoses. We analysed the diagnostic value of B19 IgM antibody testing and polymerase chain reaction (PCR) in the sera from 57 patients and their fetuses with abnormal ultrasonography. Viral DNA was found in 16 of the 58 fetuses (one twin pregnancy) whereas only 7 of these were tested positive for B19 IgM antibodies. The sera of all 16 mothers were also positive for B19 DNA. False-positive B19 IgM results were obtained from two fetuses. The study highlights the limitations of B19 IgM serology and shows for the first time that, if a sensitive PCR assay is used, DNA measurement is the best indicator of infection not only in the fetal blood but also in the maternal blood. This improves the diagnostic value of the laboratory results considerably. DNA assays are essential in cases of doubtful serological results.
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Affiliation(s)
- D Dieck
- Institute of Medical Microbiology and Immunology, University of Bonn, Bonn, Germany
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39
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Eis-Hübinger AM, Däumer M, Matz B, Schneweis KE. Evaluation of three glycoprotein G2-based enzyme immunoassays for detection of antibodies to herpes simplex virus type 2 in human sera. J Clin Microbiol 1999; 37:1242-6. [PMID: 10203464 PMCID: PMC84740 DOI: 10.1128/jcm.37.5.1242-1246.1999] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Three new glycoprotein G-based enzyme immunoassays (ETI-HSVK-G 2, Sorin Diagnostics Biomedica [assay A]; HSV Type 2 Specific IgG ELISA, Gull Laboratories, Inc. [assay B]; Cobas Core HSV-2 IgG EIA, Roche [assay C]) for the detection of herpes simplex virus (HSV) type 2 (HSV-2)-specific antibodies were evaluated. By testing sera from 25 individuals with culture-proven HSV-2 infection, the assays showed a sensitivity of 96%. The specificities, evaluated with sera from 70 HSV antibody-negative children, 75 HSV antibody-positive children, and 69 HSV antibody-negative adults, were 100% for assay A, 96.2% for assay B, and 97.8% for assay C, respectively. Discrepant results by any of the three assays, i.e., reactivity of a specimen in only one or two assays, occurred with similar frequencies for HSV-seronegative individuals as well as HSV-seropositive children and adults. For sera with discrepant results, the positive reactivity was mostly low. Thus, for determination of the prevalence of HSV-2 antibodies, only concordantly positive results were considered. On the basis of the results obtained with sera from 41 adults with culture-proven HSV-1 infection and from 173 HSV-antibody-positive pregnant women, the HSV-2 seroprevalence was 9. 8%. The results show that the new glycoprotein G2-based enzyme immunoassays are useful tools for the detection of type-specific HSV-2 antibodies. However, if only one assay is performed, careful interpretation of the results is indicated, especially if the exhibited reactivity is low, and for determination of the definitive HSV-2 serostatus, confirmatory assays may still be necessary.
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Affiliation(s)
- A M Eis-Hübinger
- Institute of Medical Microbiology and Immunology, University of Bonn, Bonn, Germany.
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40
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Eis-Hübinger AM, Sasowski U, Brackmann HH. Parvovirus B19 DNA contamination in coagulation factor VIII products. Thromb Haemost 1999; 81:476-7. [PMID: 10102490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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41
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Abstract
OBJECTIVES The aim of our study was to determine the outcome of pregnancies after intrauterine management of fetal parvovirus B19 infection. DESIGN Retrospective study. SUBJECTS A total of 37 cases of maternofetal parvovirus B19 infection, 35 of which were associated with hydrops fetalis, were referred to our tertiary level center between 1989 and 1996. With regard to fetal hydrops, no apparent cause other than parvovirus B19 infection was found in any patient. METHODS In all patients, cordocentesis was performed to assess the degree of fetal anemia. When anemia was present, cordocentesis was followed by intrauterine transfusion with packed red cells into the umbilical vein. Further management depended on the degree of fetal anemia and gestational age and included follow-up fetal blood sampling/transfusion as well as ultrasound examinations as deemed appropriate. RESULTS Packed red cell transfusion was performed in 30 patients with significant fetal anemia (Z-score 1.6-7.8 below the mean for gestational age). The fetal hemoglobin values ranged from 2.1 to 9.6 g/dl. Serum levels of platelets in the transfusion group were 9-228 x 10(9)/l with Z-scores in the range of < 1 to 3.8 below the mean. During treatment and follow-up, there were five intrauterine deaths (13.5%), one neonatal death (2.7%) and 31 live births (83.8%). CONCLUSIONS Fetal parvovirus infection can lead to marked anemia and hydrops formation. Cordocentesis allows precise assessment of fetal anemia which can then be corrected by intravenous transfusion. Under this regimen, the outcome proved favorable in the majority of fetuses, even those that were severely anemic.
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Affiliation(s)
- R L Schild
- Department of Fetal Diagnosis and Therapy, Center of Obstetrics and Gynecology, University Hospital Bonn, Germany
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42
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Abstract
A 33-year-old primigravida at 26 weeks gestation presented with fetal hydrops and fetal anemia following prior parvovirus B19 infection. The fetus required two intrauterine transfusions of packed red cells. At 35 weeks gestation, a cesarean section was performed for obstetric reasons. As a consequence of a prenatal bowel perforation, the neonate developed meconium peritonitis, for which she needed laparotomy. This case demonstrates that there may be an association between intrauterine parvovirus infection and meconium peritonitis, the latter possibly caused by vascular injury in fetal life.
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Affiliation(s)
- R L Schild
- Department of Fetal Diagnosis and Therapy, Center of Obstetrics and Gynecology, University Hospital, Bonn, Germany.
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43
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Czerny CP, Zeller-Lue C, Eis-Hübinger AM, Kaaden OR, Meyer H. Characterization of a cowpox-like orthopox virus which had caused a lethal infection in man. Arch Virol Suppl 1997; 13:13-24. [PMID: 9413522 DOI: 10.1007/978-3-7091-6534-8_2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In August 1990 an orthopox virus (OPV) had been isolated from a severe case of a generalized infection with lethal outcome in an immunosuppressed 18-year-old man. In this communication we present a detailed characterization of the causative virus strain. Based on distinct epitope configurations detected by various monoclonal antibodies the isolate could be differentiated from other OPV species and was classified as a cowpox virus (CP). This classification was confirmed by a species-specific PCR assay and by establishing physical maps for the restriction enzymes HindIII and XhoI. Based on serological data of neutralization assays, blocking-ELISAs and Western blotting analysis evidence is provided that the infection had been acquired from a stray cat.
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Affiliation(s)
- C P Czerny
- Institute for Medical Microbiology, Infectious and Epidemic Diseases, Veterinary Faculty, Ludwig-Maximilians-University, Munich, Germany
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44
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Abstract
Adenovirus-induced liver necrosis is rare. Because the era of AIDS (acquired immunodeficiency syndrome) this entity was seen predominantly in infants suffering from inborn immunodeficiency syndromes or from iatrogenic immunosuppression because of bone marrow or liver transplantation. Here, we report a case of a 30-year-old woman with AIDS who developed fever and rapidly progressing liver failure. A frozen section from a needle biopsy of the liver allowed a quick diagnosis of viral liver necrosis. The light-microscopic and electron microscopic aspects were typical of adenovirus infection and should be known to the surgical pathologist. The diagnosis was confirmed by immunohistochemistry and DNA hybridization analysis.
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Affiliation(s)
- F Dombrowski
- Pathologisches Institut, Universität Bonn, Germany
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45
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Mietz H, Eis-Hübinger AM, Sundmacher R, Font RL. Detection of varicella-zoster virus DNA in keratectomy specimens by use of the polymerase chain reaction. Arch Ophthalmol 1997; 115:590-4. [PMID: 9152125 DOI: 10.1001/archopht.1997.01100150592003] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To study the correlation of clinical findings, histopathologic features, and detection of varicella-zoster virus (VZV) DNA in keratectomy specimens. MATERIALS AND METHODS Fourteen corneal buttons from patients with a confirmed history of herpes zoster ophthalmicus were examined by use of light microscopy and the polymerase chain reaction. The polymerase chain reaction techniques included gel electrophoresis and hybridization for the detection of VZV DNA. RESULTS Seven (50%) of the 14 specimens were positive for VZV DNA. The positive findings in the specimens correlated with the clinical findings of uveitis (3/3) and the histopathologic features of chronic stromal keratitis (4/4). Patients with stromal scarring, granulomatous keratitis, and neurotrophic ulcers had negative findings. The largest interval between the initial appearance and detection of viral DNA was 51 years. CONCLUSIONS The results suggest that VZV DNA is not detectable in the cornea in every patient and at every stage of zoster keratitis. This may be due to the low number of VZV particles present in the cornea or the lack of viral DNA in the keratocytes. It remains unclear whether the VZV-related keratopathy is caused by an immunologic response to a viral antigen, the viable virus itself, or both.
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Affiliation(s)
- H Mietz
- Department of Ophthalmology, Baylor College of Medicine, Houston, Tex, USA.
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46
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Eis-Hübinger AM, Sasowski U, Brackmann HH, Kaiser R, Matz B, Schneweis KE. Parvovirus B19 DNA is frequently present in recombinant coagulation factor VIII products. Thromb Haemost 1996; 76:1120. [PMID: 8972042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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47
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Eis-Hübinger AM, Oldenburg J, Brackmann HH, Matz B, Schneweis KE. The prevalence of antibody to parvovirus B19 in hemophiliacs and in the general population. Zentralbl Bakteriol 1996; 284:232-40. [PMID: 8837383 DOI: 10.1016/s0934-8840(96)80098-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The prevalence of antibodies to parvovirus B19 (B19) was measured in the sera of 566 hemophiliacs and 524 individuals of the general population by immunofluorescence assays, using antigen expressed by the baculovirus system. In the general population, anti-B19 IgG seroprevalence was found to continuously decline from 64 percent at birth to 0 percent in the age of 9-11 months and thereupon to increase to 61 percent in the age of 12 years. In younger adults and older people, IgG seroprevalence only slowly increased with age, reaching 77 percent in people aged 60 and above. In contrast, in hemophilic children treated exclusively with virally inactivated clotting factor concentrates, neither decrease nor increase of B19 IgG antibody was detectable and the overall seroprevalence was 92 percent. In the group of hemophiliacs older than 12 years and treated before 1984 with non-inactivated clotting factor concentrates, 98 percent showed antibody to B19. Anti-B19 IgM seroprevalence was significantly higher in hemophilic than in non-hemophilic individuals older than 12 years. Since it seems to be unlikely that the high seroprevalence in hemophiliacs is acquired by immunization with inactivated viral antigen, the results suggest that infection with B19 is transmitted by clotting factor concentrates, even if subjected to virucidal methods.
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Affiliation(s)
- A M Eis-Hübinger
- Institute of Medical Microbiology and Immunology, University of Bonn, Germany
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48
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Liedtke W, Malessa R, Faustmann PM, Eis-Hübinger AM. Human herpesvirus 6 polymerase chain reaction findings in human immunodeficiency virus associated neurological disease and multiple sclerosis. J Neurovirol 1995; 1:253-8. [PMID: 9222363 DOI: 10.3109/13550289509114021] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A role for human herpesvirus 6 (HHV6) in the neurological complications associated with infection by human immunodeficiency virus (neuro-AIDS) and during multiple sclerosis (MS) is not known. For the present study, an improved PCR and immunofluorescence serology method were applied to sera and cerebrospinal fluid (CSF) from 27 neuro-AIDS, 36 MS and 24 non-inflammatory control patients. HHV6 DNA was present in 30-40% of the cellular CSF from all groups. In the acellular CSF, HHV6 could be detected in four of 36 MS, 2 of 27 neuro-AIDS and none of the control patients. HHV6 IgG was present in one of 27 neuro-AIDS, and one of 36 MS patients. HHV6 IgG was present in all patients. There was no correlation between clinical features and HHV6 PCR findings or HHV6 antibodies. The significance of the present documentation of HHV6 DNA in the acellular CSF from a minority of MS and neuro-AIDS patients remains to be determined.
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Affiliation(s)
- W Liedtke
- Department of Neurology of Essen University Hospital, Germany
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49
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Grosse-Bley A, Eis-Hübinger AM, Kaiser R, Oldenburg J, Brackmann HH, Schwarz TF, Schneweis KE. Serological and virological markers of human parvovirus B19 infection in sera of hemophiliacs. Thromb Haemost 1994; 72:503-7. [PMID: 7878623] [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: 01/27/2023]
Abstract
It is known that parvovirus B19 (B19) is transmitted to hemophiliacs by clotting factors prepared from human plasma. However, it is not clear whether B19 is also transmitted by the more recently used inactivated clotting factor preparations. Therefore, we investigated 69 hemophiliacs, mostly children, receiving only virus-inactivated clotting factors. 49 of them (71%) were B19 IgG-positive and 18 of the IgG-positive hemophiliacs (37%) were also B19 IgM-positive. In contrast, out of 73 age-matched controls only 10 (14%) were IgG-positive, two of them being also IgM-positive. In hemophiliacs treated before 1984 with non-inactivated clotting factors, seroprevalence was very similar: 94/136 (69%) presented B19 IgG antibodies as compared to their age-matched controls with 16/50 (32%). Out of the 94 IgG-positive patients 24 (26%) were IgM-positive, whereas IgM antibodies were never found in 16 sera of 16 IgG-positive controls. In 4 out of 24 IgM positive hemophiliacs, B19 DNA was detected in the sera by using the polymerase chain reaction. However, B19 DNA was also found in 3/69 anti-B19 IgM-negative, HIV-infected hemophiliacs (all three patients in CDC stage IV). Since it seems unlikely that the results only represent passive acquisition of B19 DNA from blood products and induction of antibodies by immunization with inactivated antigen, the observations rather suggest that infection with B19 is transmitted by clotting factors, including those treated for virus inactivation.
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Affiliation(s)
- A Grosse-Bley
- Institute of Medical Microbiology and Immunology, University of Bonn, Germany
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50
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Schmidt DS, Eis-Hübinger AM, Schneweis KE. The role of the immune system in establishment of herpes simplex virus latency--studies using CD4+ T-cell depleted mice. Arch Virol 1993; 133:179-87. [PMID: 8240008 DOI: 10.1007/bf01309753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The immunological mechanisms involved in establishment of herpes simplex virus (HSV) latency were studied in normal and CD4+ T-cell depleted C57BL/6J mice following intravaginal infection. During transition from acute to latent ganglionic infection two consecutive processes were observed: first, clearance of infectious virus from the ganglia, and second, reduction of the number of infected ganglia.
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Affiliation(s)
- D S Schmidt
- Institute of Medical Microbiology and Immunology, University of Bonn, Federal Republic of Germany
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