Viruses

Cystic fibrosis (CF) is an autosomal recessive genetic disorder that disrupts ion transport across epithelial surfaces, impairing mucociliary clearance and predisposing patients to chronic, often refractory bacterial infections. At the Eliava Phage Therapy Center (EPTC) in Tbilisi, Georgia, we utilize bacteriophage preparations to treat chronic pulmonary infections caused by various bacterial pathogens, including Staphylococcus aureus, Pseudomonas aeruginosa, Achromobacter xylosoxidans, and Burkholderia cepacia. This case report describes the successful treatment of a CF-related infection in a male patient with a ΔF508 mutation using Pyophage and Intestiphage preparations, as well as customized phages developed against specific P. aeruginosa isolates. The efficacy of phage therapy was assessed by evaluating clinical improvement, pulmonary function, inflammatory markers, and bacterial burden. We observed improvement across all assessed parameters, including a complete eradication of P. aeruginosa in sputum culture tests. This case highlights the potential of phage therapy as a primary antimicrobial approach for the long-term management of pulmonary infections in patients with CF.

Hepatitis C virus (HCV) infection poses a major challenge to global public health, highlighting the need for accessible and reliable diagnostic tools to support large-scale screening and early detection. In this study, a recombinant multi-epitope HCV protein was designed, expressed, and evaluated as a diagnostic antigen for the detection of anti-HCV antibodies. The synthetic gene was constructed using immunodominant regions (core, NS3, NS4, NS5A, and NS5B) representative of HCV genotypes 1a, 1b, and 3a. The recombinant protein was expressed in Escherichia coli and purified by affinity chromatography, yielding a soluble protein with an approximate molecular weight of 43 kDa and antigenicity confirmed by Western blot analysis. An enzyme-linked immunosorbent assay (ELISA) was developed in-house using the recombinant protein as the capture antibody. Diagnostic performance was evaluated using a panel of 260 human serum samples, including 127 anti-HCV reactive and 133 anti-HCV non-reactive specimens, and receiver operating characteristic (ROC) curve analysis. The assay demonstrated excellent performance with an area under the curve (AUC) of 0.968, sensitivity of 86.6%, specificity of 98.5%, and overall accuracy of 92.7%. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. The assay demonstrated excellent performance in serum samples, with an area under the curve (AUC) of 0.968, a sensitivity of 86.6%, and a specificity of 98.5%. These results demonstrate that the recombinant multi-epitope antigen represents a robust and scalable biomolecular platform for HCV serodiagnosis, contributing to strategies that expand access to hepatitis C screening.

While typically associated with benign infectious mononucleosis, Epstein–Barr virus (EBV) is now recognized as a pivotal driver of complex immunopathological disorders. By shuttling between lytic replication and strategic latency programs, EBV reprograms B-cell biology to evade immune surveillance and disrupt homeostasis. Central to this pathogenesis is the viral protein EBNA1, which triggers autoimmunity through molecular mimicry with host antigens, including GlialCAM in multiple sclerosis (MS), keratin in rheumatoid arthritis, and nuclear proteins in systemic lupus erythematosus. These autoimmune responses are further exacerbated by bystander activation and epitope spreading, fueling chronic inflammation in Crohn’s disease, type 1 diabetes, and IgA nephropathy. EBV can also promote the development of lymphoproliferative disorders, whether in immunocompetent hosts or in the context of immunosuppression; however, the emergence of EBV-positive forms within diseases that are usually EBV-negative is closely linked to an underlying state of immunosuppression. Distinct from these chronic states, EBV-associated hemophagocytic lymphohistiocytosis (HLH) represents a critical hyperinflammatory emergency in which defective cytotoxicity leads to an uncontrolled T-cell- or NK-cell-driven cytokine storm; together with chronic active EBV disease (CAEBV), HLH disproportionately affects children, and both receive particular attention in this review. More recently, emerging but not yet consolidated evidence has also suggested a possible association between EBV reactivation and long COVID. Elucidating these diverse molecular interactions is essential for developing the next generation of targeted therapies and vaccine strategies aimed at mitigating the systemic impact of this virus.