Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
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Ebola virus disease (EVD) is characterised by systemic viral replication, immuno-suppression, abnormal inflammatory responses, large volume fluid and electrolyte losses, and high mortality in under-resourced settings. There are various therapeutic strategies targeting EVD including vaccines utilizing different antigen delivery methods, antibody-based therapies and antiviral drugs. These therapies remain experimental, but received attention following their use particularly in cases treated outside West Africa during the 2014-15 outbreak, in which 20 (80%) out of 25 patients survived. Emerging data from current trials look promising and are undergoing further study, however optimised supportive care remains the key to reducing mortality from EVD.
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Review
Cervical cancer screening of HPV vaccinated populations: Cytology, molecular testing, both or none.
Cervical cancer control includes primary prevention through vaccination to prevent human papillomavirus (HPV) infection and secondary prevention through screening to detect and treat cervical precancerous lesions. This review summarizes the evidence for the population impact of vaccines against oncogenic HPV types in reducing the prevalence of cervical precancerous lesions. We examine the gradual shift in screening technology from cervical cytology alone to cytology and HPV cotesting, and finally to the recognition that HPV testing can serve alone as the new screening paradigm, particularly in the initial post-vaccination era. ⋯ Cervical precancerous lesions will become a very rare condition following the widespread implementation of HPV vaccines with broader coverage in the number of preventable oncogenic types. Irrespective of screening technology, the false positive results will far outnumber the true positive ones, a tipping point that will herald a new period when the harms from cervical cancer screening will outweigh its benefits. We present a conceptual framework to guide decision making when we reach this point within 25-30 years.
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Ebolaviruses and Marburgviruses (family Filoviridae) are among the most virulent pathogens for humans and great apes causing severe haemorrhagic fever and death within a matter of days. This group of viruses is characterized by a linear, non-segmented, single-stranded RNA genome of negative polarity. ⋯ The overall progress is promising given the little attention that these pathogen have achieved in the past; however, more is to come over the next decade given the more recent interest in these pathogens as potential public and animal health concerns. Licensing of therapeutic and prophylactic options may be achievable over the next 5-10 years.
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Extensive research in the last 20 years has unveiled some of the factors associated with the emergence of pandemic influenza A viruses. Nonetheless, numerous extrinsic and virological factors are yet to be fully understood, especially with reference to their interconnection and interdependence. Knowledge gathered so far has motivated the scientific community to embrace the One Health-One Flu concept and to explore new scientific approaches in the field of influenza infections in order to make educated decisions when it comes to pandemic preparedness. As a result of this awareness, risk assessment methodology is currently being explored as a new tool to estimate the pandemic potential of influenza viruses circulating in animals, underlining the urgency for interdisciplinary collaboration and the need to share updated and high quality scientific and surveillance data.
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Review Meta Analysis
Risk of hepatitis B virus (HBV) reactivation in non-Hodgkin lymphoma patients receiving rituximab-chemotherapy: a meta-analysis.
The addition of Rituximab to standard chemotherapy (C) has been reported to improve the end of treatment outcome in non-Hodgkin lymphoma (NHL) patients. Nevertheless, rituximab has been associated with hepatitis B virus reactivation (HBV-R). ⋯ Rituximab therapy may increase the risk of developing HBV-R in NHL patients with HBcAb(+).