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Celik D, van Bremen K, Breitschwerdt S, Elamouri F, Swan T, Boesecke C, Rockstroh JK, Ingiliz P. Hepatitis delta in HIV/hepatitis B coinfection: A call for action. HIV Med 2024; 25:319-321. [PMID: 37968830 DOI: 10.1111/hiv.13581] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Didem Celik
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Education and Research Hospital, University of Health Sciences, Izmir, Turkey
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Kathrin van Bremen
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Sven Breitschwerdt
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | | | - Tracy Swan
- GlobalHealth Consultant, Barcelona, Spain
| | - Christoph Boesecke
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Jürgen K Rockstroh
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Patrick Ingiliz
- Hepatology Department, Henri-Mondor University Hospital, Créteil, France
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Mersch M, Schlabe S, Breitschwerdt S, Laufenberg J, Emmert D, Aldabbagh S, Boesecke C, Monin MB. A fatal course of COVID-19 during the Omicron surge: can you estimate your patients' SARS-CoV-2 immune status? Infection 2024; 52:271-273. [PMID: 37932523 PMCID: PMC10810928 DOI: 10.1007/s15010-023-02120-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
We present a case of an ultimately fatal course of COVID-19 (coronavirus disease-19) in an 81-year-old female patient during the Omicron surge. The patient did not represent the typical patient at risk for severe COVID-19 with significant causes of immunodeficiency. However, she had been skeptical about the vaccination for severe acute respiratory syndrome virus-2 (SARS-CoV-2) and had refused it. Moreover, there had been no previous COVID-19 episodes. Our case report illustrates that with regard to SARS-CoV-2, immunologically naive patients are still at risk for severe and/or even fatal courses of COVID-19. We call to implement both, recommendations for SARS-CoV-2 vaccinations as well as for antiviral treatment.
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Affiliation(s)
- Martin Mersch
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Stefan Schlabe
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Bonn, Germany
| | - Sven Breitschwerdt
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Bonn, Germany
| | - Judith Laufenberg
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Bonn, Germany
| | - Dorian Emmert
- Institute of Virology, Bonn University Hospital, Bonn, Germany
| | | | - Christoph Boesecke
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Bonn, Germany
| | - Malte Benedikt Monin
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Bonn, Germany.
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Hübner YR, Spuck N, Berger M, Schlabe S, Rieke GJ, Breitschwerdt S, van Bremen K, Strassburg CP, Gonzalez-Carmona MA, Wasmuth JC, Rockstroh JK, Boesecke C, Monin MB. Antiviral treatment of COVID-19: which role can clinical parameters play in therapy evaluation? Infection 2023; 51:1855-1861. [PMID: 37555885 PMCID: PMC10665228 DOI: 10.1007/s15010-023-02081-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Affiliation(s)
- Yannis R Hübner
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Nikolai Spuck
- Faculty of Medicine, Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Moritz Berger
- Faculty of Medicine, Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Stefan Schlabe
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, 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, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), partner-site Cologne-Bonn, Bonn, Germany
| | - Sven Breitschwerdt
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, 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, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), partner-site Cologne-Bonn, Bonn, Germany
| | - Christian P Strassburg
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Maria A Gonzalez-Carmona
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jan-Christian Wasmuth
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, 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, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), partner-site Cologne-Bonn, Bonn, Germany
| | - Christoph Boesecke
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), partner-site Cologne-Bonn, Bonn, Germany
| | - Malte B Monin
- Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- German Centre for Infection Research (DZIF), partner-site Cologne-Bonn, Bonn, Germany.
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Rieke GJ, Monin MB, Breitschwerdt S, Boesecke C, Schlabe S. Confirmed SARS-CoV-2 Reinfection After 1 Year in a Patient with X-linked Agammaglobulinaemia. Infect Dis (Lond) 2022. [DOI: 10.17925/id.2022.1.1.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Though a comprehensive analysis of the immunity following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been performed, little is known about the duration of this protection and the risk of reinfection. This lack of knowledge is of particular interest for patients with impaired immune function. In this report, we describe the course of infection of a 30-year-old male patient with X-linked agammaglobulinaemia, who was reinfected with SARS-CoV-2 after a primary infection 12 months earlier. The initial course of infection took place in April 2020 with the typical symptoms of an upper respiratory tract infection accompanied by compatible changes in laboratory values and computed tomography. With no anti-viral treatment options at that time of the pandemic, only symptomatic therapy could be offered. Twelve months later (April 2021), the patient presented with a short course of fever and headache. Laboratory testing showed elevated C-reactive protein levels, while leukocytes, lymphocytes and lactate dehydrogenase levels were within range. The patient was admitted, and antibiotic treatment was started partially because procalcitonin levels were slightly elevated as well. The SARS-CoV-2 polymerase chain reaction was positive, and therapy with the monoclonal SARS-CoV-2 antibodies casirivimab/imdevimab (1,200 mg/1,200 mg, respectively) were initiated. The course of infection was mild, but low-flow oxygen had to be administered. It was not possible to distinguish between the contribution of the administered antibodies and the role of cytotoxic T-cells in the course of infection. Variant screenings confirmed the Wuhan strain of the virus for the first episode and the alpha variant for the second episode, thus confirming reinfection and ruling out long-term shedding. Neutralizing antibodies seem to play a crucial role in viral clearance and infection prevention, assuming patients with agammaglobulinaemia are at higher risk for a severe course of coronavirus disease 2019. Still, the specific role of neutralizing antibodies and cytotoxic T-cells is not fully understood. Reinfection among this patient population has only been described occasionally. Our case described a reinfection, which was confirmed by variant-testing. In addition, it gave insight into the rapid progression of testing and into specific anti-viral therapy over 1 year of the pandemic.
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van Bremen K, Hoffmann C, Mauss S, Lutz T, Ingiliz P, Spinner CD, Scholten S, Schwarze-Zander C, Berger F, Breitschwerdt S, Schneeweiss S, Busch F, Wasmuth JC, Fätkenheuer G, Lehmann C, Rockstroh JK, Boesecke C. Obstacles to HBV functional cure: Late presentation in HIV and its impact on HBV seroconversion in HIV/HBV coinfection. Liver Int 2020; 40:2978-2981. [PMID: 33012099 DOI: 10.1111/liv.14684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/08/2020] [Accepted: 09/25/2020] [Indexed: 12/15/2022]
Abstract
Several cohorts have shown that long-term tenofovir-containing combination antiretroviral therapy (cART) leads to higher HBsAg seroclearance rates in HIV/HBV coinfected patients vs HBV-monoinfected patients under tenofovir disoproxil fumarate (TDF)-based therapy. We have analysed data on determinants of HBsAg loss in a retrospective multicentric cohort of 359 HIV/HBV coinfected patients. Median CD4 T-cell count at baseline was 359/ul (321-404), CDC stage was C in 20% (n = 70). Most patients (68%) were ART-naïve when TDF- or tenofovir alafenamide (TAF)-containing cART was initiated (baseline). After a median follow-up of 11 years HBsAg loss had occurred in 66/359 (18%) patients. However, patients with stage CDC C (P ≤ .001), lower CD4 gain (P = .043) and not receiving TDF/FTC (P = .008) were less likely to lose HBsAg. Long-term TDF-containing cART appears to achieve higher rates of HBsAg seroclearance compared to published data for HBV monoinfected subjects. However, late presentation for HIV and poor immune recovery significantly impair HBV seroconversion rates.
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Affiliation(s)
- Kathrin van Bremen
- Bonn University Hospital, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne, Germany
| | | | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | | | | | - Christoph D Spinner
- German Centre for Infection Research (DZIF), Bonn-Cologne, Germany.,School of Medicine, Technical University of Munich, Munchen, Germany
| | | | - Carolynne Schwarze-Zander
- Bonn University Hospital, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Florian Berger
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | | | | | | | - Jan-Christian Wasmuth
- Bonn University Hospital, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Gerd Fätkenheuer
- German Centre for Infection Research (DZIF), Bonn-Cologne, Germany.,Cologne University Hospital, Cologne, Germany
| | - Clara Lehmann
- German Centre for Infection Research (DZIF), Bonn-Cologne, Germany.,Cologne University Hospital, Cologne, Germany
| | - Jürgen K Rockstroh
- Bonn University Hospital, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Christoph Boesecke
- Bonn University Hospital, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne, Germany
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