Search Results (1,481)

Hepatitis E virus (HEV) is recognized as one of the leading causes of acute viral hepatitis (AVH) in developing countries, where it is primarily transmitted through the consumption of contaminated food and water. Although often self-limiting, HEV infection poses a significant public health concern, particularly among pregnant women, due to its potential complications. The present study aimed to determine the seroprevalence of HEV infection in asymptomatic antenatal women attending a tertiary care center in South Punjab, Pakistan. A total of 100 asymptomatic pregnant women were screened for anti-HEV antibodies (IgM and IgG) using an ELISA kit (DIA PRO, Italy). The overall seropositivity rate was found to be 12%, indicating prior exposure to HEV infection in this cohort. Specifically, IgG antibodies were detected in 6% of women and IgM antibodies in 5%, while two women showed evidence of both IgG and IgM positivity, suggestive of recent or ongoing infection. Notably, the majority of participants reported reliance on untreated water sources irrespective of educational background, highlighting environmental risk factors. Although HEV is generally self-limiting, these findings underscore the importance of routine serological screening in antenatal populations to prevent adverse pregnancy outcomes. In addition, increased community awareness regarding transmission routes and preventive measures is essential. Given the scarcity of regional data, this study emphasizes the need for larger-scale epidemiological investigations to better understand the burden of HEV in South Punjab, Pakistan. Full article

(1) Brucellosis is a zoonotic infection that remains a significant public health concern in endemic regions. This study aimed to determine the seroprevalence of brucellosis in a tertiary care hospital, analyze associated risk factors, and evaluate the diagnostic performance of commonly used serological tests. (2) The study was based on the serological test results of 24,545 samples collected between 2020 and 2023. Rose Bengal, standard tube agglutination, and Brucellacapt tests were used for the diagnosis of brucellosis. Data were analyzed according to age, sex, clinical department, and seasonal distribution using SPSS version 25.0. (3) Overall, 367 cases (1.5%) tested positive. When the 367 seropositive cases were evaluated by year, the annual distribution showed a declining trend, decreasing from 2.5% in 2020 to 1.2% in 2023. Among the positive cases, 57.8% were female, and 36% were aged between 41 and 64 years. The infectious diseases department had the highest positivity rate (37.1%). Brucellacapt showed the highest positivity rate (90.2%), followed by Rose Bengal (76.2%). The highest monthly positivity rate was observed in October (11.4%), and seasonally in autumn (31.3%). (4) The Brucellacapt test has demonstrated high sensitivity and serves as a valuable supplementary diagnostic tool in the evaluation of brucellosis. However, its low specificity underscores the necessity for careful interpretation of positive results and supports its use in conjunction with other serological tests to enhance diagnostic accuracy. Considering seasonal and departmental variations, a combined testing approach may improve overall diagnostic accuracy. Full article

Background: Hepatitis B virus (HBV) is an infection proven to increase the risk of gastric cancer, especially among hepatitis B virus surface antigen (HBsAg) seropositive patients. However, the route through which HBV injures gastric mucosa and its mechanism of gastric carcinogenesis are still under investigation. Aims: The present study aimed to observe and evaluate associations between HBV infection with Helicobacter pylori, atrophic gastritis, and some other high-risk events for gastric cancer development. Methods: A retrospective cross-sectional study recruited participants undergoing a health check-up between 2018 and 2020 in the West China Hospital of Sichuan University. Participants were stratified into three statuses, including Group A (non-HBV infection), Group B (resolved HBV infection), and Group C (chronic HBsAg carriers or active HBV infection). Additionally, Groups A and B were categorized as HBsAg-seronegative, whereas Group C was defined as HBsAg-seropositive. High-risk events of gastric cancer included a history of gastric ulcer, Helicobacter pylori infection, serological atrophic gastritis (serum pepsinogens), hypergastrinemia (serum gastrin-17), and endoscopic findings of atrophic gastritis, gastric polyps, and gastric ulcer. Associations of HBV infection status or HBsAg seropositivity with Helicobacter pylori infection, atrophic gastritis and other high-risk events of gastric cancer were analyzed. Results: A total of 21,505 eligible observations were included, with Group C accounting for 6.1%. In Group C, the prevalence of gastric ulcer (p = 0.002) and very-high serum gastrin-17 level (p = 0.002) was significantly greater than in Group A. In multivariate analysis, both Helicobacter pylori infection (aOR = 2.79, 95% CI 2.44–3.21) and HBsAg seropositivity (aOR = 1.28, 95% CI 1.02–1.59) were significant risk factors for hypergastrinemia. No interaction was found between Helicobacter pylori co-infection risks and Group B (aOR = 1.10, 95% CI 0.84–1.43) or Group C (aOR = 1.40, 95% CI 0.66–2.95). Helicobacter pylori infection was identified as an independent risk factor for atrophic gastritis (aOR = 1.85, 95% CI 1.44–2.39). However, HBsAg seropositivity did not show a similar association with atrophic gastritis (aOR = 1.15, 95% CI 0.75–1.74). Moreover, HBV co-infection did not exert a synergistic effect on the risk of atrophic gastritis in individuals with Helicobacter pylori (aOR = 1.09, 95% CI 0.54–2.22). Additionally, multivariate analyses did not identify significant associations between HBV infection statuses and gastric polyps or ulcers. Conclusions: HBsAg seropositivity was not associated with increased risk of atrophic gastritis, gastric polyps or ulcers, or Helicobacter pylori infection, with the exception of hypergastrinemia. Additionally, HBV co-infection did not exert a synergistic effect on increasing the risk of atrophic gastritis in patients with Helicobacter pylori. Collectively, these findings suggest that the mechanism underlying the increased risk of gastric cancer in individuals with HBV may not be predominantly mediated via Helicobacter pylori infection and atrophic gastritis. Theories regarding HBV-induced genotoxicity or confounding effects warrant further investigation. Full article

Cytomegalovirus (CMV) remains a major opportunistic pathogen in individuals with HIV. The aim of this study was to investigate the seroprevalence and reactivation rates of CMV among HIV-positive individuals. A total of 300 people with HIV presenting to the Istanbul Faculty of Medicine were enrolled. Serological assessments were performed using enzyme-linked immunosorbent assay (ELISA), while molecular analyses were conducted through PCR-based methods. Sociodemographic and clinical characteristics of the patients were also evaluated. Of the participants, 90% were male, with an age range of 18–76 years. Serological testing demonstrated CMV IgG positivity in 292 patients (97.3%) and CMV IgM positivity in 11 patients (4.07%). CMV DNA was detected in 91 patients (30.3%) by molecular assays, with viral loads ranging from <150 to 2,404,678 copies/mL. CMV DNA positivity was significantly more frequent in older patients (p < 0.05) and was associated with lower CD4+ T lymphocyte counts. CMV disease was identified in 50 patients (16.7%), with organ involvement (64%) representing the most common clinical manifestation. CMV seropositivity is remarkably high in HIV-positive individuals, and reactivation rates are increased, particularly in older patients and those with advanced immunosuppression. These findings underscore the clinical relevance of routine CMV surveillance in the management of HIV infection. Full article

Background: The advancements in antiretroviral treatment (ART) have led to a 69% reduction in AIDS-related deaths. However, people living with HIV (PLWH) face age-related comorbitidies like coronary artery disease (CAD), which can be 50% higher compared to HIV-negative individuals. This study explores the prevalence and extent of early CAD in PLWH without a history of cardiovascular disease using computed tomography angiography (CTA). Methods: A 320-detector row CTA (Aquilion ONE, Canon Medical Systems) was utilized to determine prevalence of coronary atherosclerosis. Logistic regression analysis and ROC analysis were performed to predict risk factors for the presence of atherosclerosis. Results: A total of 186 individuals participated in this study, including 74 PLWH and 112 HIV-seronegative controls. A notable disparity in the occurrence of coronary atherosclerosis was observed between the two groups, with 20% of individuals in PLWH showing plaque in the coronary arteries as detected by CTA, compared to 7% in the control group (p = 0.015). In the plaque group, a significant increase in age was observed (p = 0.001) along with elevated levels of fasting blood glucose and hemoglobin A1c (p < 0.001 and p = 0.017 respectively). HIV seropositivity and age were significantly associated with the presence of plaque (aOR, 5.5 [95% CI, 1.7–25.8] and 21.7 [95% CI, 5.5–88] respectively). When evaluating age, fasting blood sugar and HbA1c through ROC analysis to predict plaque presence, age is the strongest predictor, with an AUC of 0.899 (p < 0.001, 95% CI: 0.847–0.939) and a cutoff value of 35 years. Additionally, HbA1c and fasting blood sugar had an AUC of 0.664 (p = 0.0047, 95% CI: 0.574–0.746) and 0.759 (p < 0.001, 95% CI: 0.688–0.822) respectively. Youden cutoff values were 5.5 for HbA1c and 92.4 for fasting blood sugar. Conclusions: The higher prevalence of CAD in PLWH may indicate that inflammation is a substantial risk. It is important to remember that CAD can develop early in PLWH. Moreover, including HbA1c and fasting blood sugar measurements in routine follow-up may help facilitate earlier detection of atherosclerosis. Full article

Single nucleotide polymorphisms (SNPs), as common genetic variations, can influence biological processes. Identifying these variations is crucial for recognizing high-risk subgroups, guiding preventive strategies, and enabling personalized management. Objective: This study aimed to determine the relationship between SNPs and survival, thereby identifying genetic profiles associated with increased risk. Methods: We included seropositive patients with Chagas disease who had a disease duration of >20 years and no comorbidities. DNA was extracted. A SNP panel focusing on genes involved in cardiac structure was created from the GnomAD database. Patients were followed for 8 years to assess survival. The association between SNPs and survival was evaluated, and a genetic risk score was generated. Univariate and multivariate Cox regression models assessed the association between SNPs (coded as ordinal variables) and survival time. SNPs with p < 0.05 were selected to construct a risk score, which was then assessed using Kaplan–Meier curves and median survival times. Results: A total of 182 patients were included, with 96.7% completing follow-up for a median of 5.1 years (interquartile range: 3.4–6.5). The median age was 62 years; 39.6% of patients were male, and 31% had reduced left ventricular ejection fraction. Univariate analysis showed that 3 of the 68 SNPs studied were associated with survival. Variant rs3755863 (PPARGC1A gene) was significantly associated with an increased risk of death (hazard ratio, HR = 1.94; p = 0.022). Conversely, two variants, rs7310615 (SH2B3 gene) and rs7405731 (JUP gene), showed a protective effect with significantly reduced mortality risk (HR = 0.45; p = 0.006 and HR = 0.48; p = 0.006, respectively). In multivariate analysis, rs7310615 and rs7405731 remained significantly associated with survival. A genetic risk score was constructed, assigning 0 points for homozygous wild-type, 1 point for heterozygotes, and 2 points for homozygous alternative alleles. Individual scores were calculated, and survival was estimated for each score category using Kaplan–Meier analysis and median survival times. Conclusions: Two SNPs were identified as significantly associated with survival. These findings require confirmation in larger and more diverse populations. Their validation could enable the identification of a subgroup of patients at particularly high risk. Full article

Leishmania infantum is endemic in Portugal, where dogs are the main reservoir and human visceral leishmaniosis remains a public health concern. Increasing evidence indicates that cats are also susceptible to infection and may contribute to local transmission, although nationwide data remain limited. This study aimed to estimate the seroprevalence of Leishmania spp. infection in cats in Portugal and to identify potential risk factors. Serum samples collected for unrelated clinical purposes and submitted to a veterinary diagnostic laboratory between December 2024 and March 2025, representing all districts of mainland Portugal and the Azores, were analyzed. Anti-Leishmania spp. antibodies were detected using the direct agglutination test, and associations with explanatory variables were evaluated through multivariable logistic regression. The overall seroprevalence was 8.9% (96/1080; 95%CI 7.3–10.7). One cat from Terceira Island (Azores) tested seropositive (1/10). Region was the only independent predictor of seropositivity, with cats from the Algarve showing higher odds of infection than those from other regions (adjusted OR 1.97; 95%CI 1.24–3.13; p = 0.004). These findings demonstrate widespread feline exposure consistent with known canine and human hotspots, and detection in the Azores suggests possible local transmission, supporting the inclusion of cats in multi-host surveillance within a One Health framework. Full article

Zoonotic diseases account for approximately one billion cases of illness and millions of deaths globally each year. Increasing contact between humans and competent wildlife hosts elevates the risk of zoonotic spillover. Synanthropic bird species are key players in the transmission of zoonotic pathogens, including flaviviruses such as West Nile virus (WNV) and influenza A viruses like Avian Influenza Virus (AIV). Active surveillance of sentinel birds inhabiting urban areas allows for early detection of emerging pathogens before they cause zoonotic outbreaks. Despite nesting in close proximity to humans, the role of the house martin (Delichon urbicum) in the circulation of flaviviruses and AIV remains poorly understood. Here, we analyzed the presence of antibodies against flaviviruses and AIV in a colony of house martins from southwestern Spain. In addition, we aimed to detect amplicons of the matrix and nucleoprotein genes of AIV using RT-qPCR. While none of the samples tested positive for AIV by RT-qPCR, we observed an AIV seroprevalence of 2.13% based on non-subtyped ELISA. Notably, this is the first report of AIV-seropositive D. urbicum individuals captured in Spain. Moreover, we detected a flavivirus-group seroprevalence of 24.34%, similar to rates reported in the same house martin population between 2018 and 2020, suggesting widespread circulation of flaviviruses within this synanthropic species. These results support the hypothesis that house martins may participate in the transmission of these viruses between wild bird populations and humans in urban environments. Full article

To investigate SARS-CoV-2 antibody kinetics and household transmission, infected children along with their families were tested for anti-nucleocapsid antibodies at 1, 3, 6, 9 and 12 months post-SARS-CoV-2 infection during the Ancestral, Alpha, Delta, and Omicron waves. We prospectively included SARS-CoV-2 acute infected children (n = 189). After household recruitment (n = 76 households), the total study population was 228 children and 105 adults. The median age (IQR) of children and adults was 96 (115) months and 504 (96) months, respectively. Anti-nucleocapsid (anti-N) COI (cut-off index) titers peaked at three months post-infection and declined thereafter (p-value < 0.001), and 89.2% remained seropositive at 12 months. Children displayed significantly higher anti-N COI titers than adults during the Delta (p-value: 0.018) and Omicron (p-value: 0.047) periods. Household contact anti-N positivity (evidence of infection) was associated with pediatric index cases (aOR: 1.61, 95% CI: 1.11–2.35; p-value: 0.013) and elevated early anti-N COI titers (aOR: 1.24 per log₁₀ unit, 95% CI: 1.05–1.48; p-value: 0.011). Higher secondary attacks were detected in Delta (aOR: 2.12, 95% CI: 1.19–3.77; p-value: 0.011) and Omicron (aOR: 2.75, 95% CI: 1.44–5.25; p-value: 0.002) compared to Ancestral. Waning of SARS-CoV-2 anti-N titers was faster in secondary cases (aHR: 1.62, 95% CI: 1.01–2.59; p-value: 0.047, Cox model) and during Omicron infection (aHR: 1.74 vs. Ancestral, 95% CI: 1.08–2.79; p-value: 0.023). In contrast, waning was slower in SARS-CoV-2 cases with higher baseline anti-N COI titers (aHR: 0.77, 95% CI: 0.64–0.93; p-value: 0.011). These findings demonstrate variant-specific, age-dependent antibody kinetics, emphasizing that pediatric index cases were associated with higher odds of household infection. Full article

Bovine leukemia virus (BLV) is an oncogenic deltaretrovirus that infects B cells, and its possible presence in humans has garnered increasing attention. This study included 58 participants: 11 with B-cell precursor acute lymphoblastic leukemia (B-ALL, cases) and 47 healthy individuals (controls). Researchers assessed anti-gp51 antibodies and BLV proviral DNA in bone marrow and blood samples. Seropositivity was observed only in the B-ALL group (18.2%; 2/11), while all controls were seronegative. Quantitative PCR targeting the pol gene detected proviral DNA in 74.1% of samples, with similar detection rates between cases and controls. Although proviral load was higher in controls, this difference did not reach statistical significance. Conventional and nested PCR for other viral genes revealed a differential pattern: amplification of the tax gene was significantly associated with B-ALL, whereas gag and env were not. Bayesian Chow–Liu network analyses identified dependencies among viral genes and suggested that contextual factors, such as fieldwork, may influence the association between molecular positivity and B-ALL. Sequence analyses showed that the detected BLV strains clustered with previously reported bovine and human sequences from Colombia, all within genotype 1. These findings support human exposure to BLV and raise important questions about its persistence and potential connections to hematological diseases in humans. Full article

Equine trypanosomosis remains an important veterinary concern in regions where horses play a significant economic and cultural role. In Kazakhstan, comprehensive nationwide data on the seroepidemiological status of equine trypanosomes are limited. The aim of this study was to assess the serological distribution of equine trypanosomosis across all administrative regions of Kazakhstan using complement fixation testing (CFT). A total of 6065 equine serum samples were collected from seventeen regions between 2023 and 2025. Antibodies against members of the Trypanozoon subgenus were detected using a WOAH-recommended CFT protocol. Overall seropositivity was 4.73%, with substantial regional variation ranging from 0% to 16.52%. Statistically significant differences in seroprevalence were observed between regions (p < 0.001), and mixed-effects modelling indicated considerable regional clustering. PCR testing of seropositive samples did not confirm the presence of Trypanosoma equiperdum, while one sample tested positive for Trypanosoma evansi. These findings suggest that CFT seropositivity reflects exposure to equine trypanosomes rather than confirmed dourine infection. Given the inability of CFT to reliably distinguish between T. equiperdum and T. evansi, species-level attribution remains uncertain. This study provides the first nationwide overview of serological reactivity to equine trypanosomes in Kazakhstan. The results highlight regional heterogeneity in antibody detection and underscore the need for expanded molecular surveillance and improved species-specific diagnostic tools to clarify the epidemiological status of equine trypanosomosis in the country. Full article

HTLV-1 and HTLV-2 infections are associated with various neurological manifestations, particularly HTLV-1-associated myelopathy (HAM). This descriptive, cross-sectional observational study aimed to investigate and analyze the neurological manifestations in patients treated at the Service for the Care of People Living with HTLV (Serviço de Atendimento à Pessoa Vivendo com HTLV-SAPEVH) at the Federal University of Pará. A cohort of 957 individuals underwent screening for HTLV-1/2 infection using enzyme-linked immunosorbent assay (ELISA), with seropositive samples subsequently confirmed via Western blotting or quantitative polymerase chain reaction (qPCR). HTLV-1/2 infection was confirmed in 69 individuals. Of these, fifteen individuals—diagnosed with HTLV-1 (n = 11) or HTLV-2 (n = 4) infection—who presented with neurological complaints at the first nursing consultation, were referred to a neurologist for clinical evaluation of neurological signs and symptoms. Most of the patients were female (13), ranging from 33 to 80 years of age. Neurological symptoms were present in 86.7%, and included spasticity, paraparesis, chronic pain, both motor and sensory deficits, as well as urinary disorders, predominantly affecting the thoracic spinal cord and lower limbs. Urinary symptoms were observed in 77% of symptomatic patients, often preceding other neurological signs that suggest a role as “sentinel symptoms” in the clinical screening of HTLV carriers. The results demonstrated the presence of neurological impairment in patients infected with both HTLV-1 and HTLV-2, with motor symptoms ranging from moderate to advanced. In addition, cases of cranial nerve and upper limb involvement were reported, a finding that is rarely described in the literature. The study highlights the importance of neurological assessment as early as possible in patients infected with either HTLV-1 or HTLV-2 and suggests that sphincter dysfunctions can serve as early clinical markers of future neurological impairment. Full article

The circulation of viruses of medical and veterinary importance is monitored to evaluate risks to both human and animal health. Among the species most commonly used in surveillance programs, the wild boar (Sus scrofa) plays a key role due to its high population density and its contacts with rural swine herds in the areas under investigation. In the present study, molecular (real-time PCR) and serological analyses were conducted on wild boar samples collected in the regions of Apulia, Basilicata, Campania, and Calabria. Specifically, molecular detection was applied to IAVs, FLVs, and Porcine PCV-2, while serological testing was used to assess exposure to IAVs, FLVs, and ADV. Serological results showed an 8.31% positivity for IAVs, whereas viral presence detected by PCR was 1.17%. No active infections were detected for WNV, with only a single seropositive sample (0.30%), while ADV showed a seroprevalence of 2.61%. PCV-2 was detected exclusively by molecular analysis in 66 out of 223 tested animals (29.6%). The overall objective of the study is to deepen the understanding of virus circulation in the wildlife of Southern Italy, using the wild boar as an additional sentinel species for epidemiological surveillance activities. The distinctive feature of the project lies in its multi-pathogen approach applied to a reference population distributed across a particularly wide geographical area, allowing for the simultaneous assessment of the circulation of different viruses over a large territory. Full article

Chagas disease remains a major public health concern in Latin America, with Bolivia reporting one of the highest burdens of infection. While congenital transmission has become the predominant route of new infections in several countries, vector-borne transmission persists in rural and peri-urban regions. Postrervalle, in the department of Santa Cruz, is officially classified as a low-infestation area; however, updated community-level data remain limited. We conducted a cross-sectional study in July 2023 involving 58 mothers and 104 of their children in Postrervalle. Participants underwent serological screening with three diagnostic assays, and epidemiological data were collected via structured maternal questionnaires. Logistic regression models were used to assess associations between child Trypanosoma cruzi seropositivity and maternal or household exposures during pregnancy. Seroprevalence was 15.5% among mothers and 3.8% among children. Notably, all seropositive children were born to mothers who tested seronegative, suggesting non-congenital transmission. In multivariable analysis, living in houses with mud walls during pregnancy was strongly associated with child seropositivity (adjusted OR = 38.566), while older child age also increased the odds of infection. Other maternal exposure variables showed elevated but imprecise associations. Despite its classification as a low-infestation area, Postrervalle shows serological patterns consistent with postnatal acquisition linked to domestic structural conditions that facilitate triatomine colonization. These findings overall highlight the need for integrated serological and entomological surveillance to better characterize and prevent Chagas transmission in rural communities. Full article

Background/Objectives: Hand, foot and mouth disease (HFMD) caused by enterovirus 71 (EV71) may cause severe complications and death in children. It is also a common cause of outbreaks in the Asia-Pacific Region. Incidence among children 1 to <2 years was over 3000/100,000 population in China. A systematic review and meta-analysis was performed to review evidence on vaccine efficacy (VE), immunogenicity, and safety of two doses of EV71 vaccine in children. Methods: Randomized controlled trials (RCTs) comparing EV71 vaccine with placebo or with another EV71 vaccine in children and adolescents aged ≤18 years were searched on PubMed, Medline, Embase, CENTRAL, and CNKI (Chinese) in week 5 November 2024. The reference list of each study and the websites of vaccine manufacturers were also searched. The Cochrane Risk of Bias 2 tool (RoB2) was used to assess the risk of bias. VE, immunogenicity (including seropositive rate, seroconversion rate, geometric mean titer (GMT), Geometric Mean Fold Increase (GMFI)), and rate of adverse events were analyzed. Results: A total of 4199 articles were identified, and 25 studies were finally included. VE (%) against EV71 HFMD in children aged ≤5 years at 12 months was 94.8% (95%CI 87.2–97.9) for Sinovac and 90.9% (95%CI 70.4–97.2) for Wuhan Institute of Biological Products (WIBP), while the Chinese Academy of Medical Sciences (CAMS) reported 97.4% (95%CI 92.9–99.0) at 11 months. At 1 month after the second dose, 99.19% (95%CI 98.15–99.65) of children aged ≤5 years in the vaccine group were seropositive, and 96.30% (95%CI 92.71–98.17) achieved seroconversion. GMT at 1 month after the second dose in the vaccine group was 46.78 (95%CI 26.18–83.61) times that in the placebo group. GMFI at 1 month after the second dose in the vaccine group was 28.41 (95%CI 22.18–36.39) times that of the placebo group. The rate of serious adverse events (AEs) was lower in the vaccine group than the placebo group (1.23% (95%CI 0.58–2.69) vs. 1.34% (95%CI 0.58–3.07)) at 1 month after the second dose. There was no significant difference in other adverse events between the vaccine and placebo groups. Conclusions: EV71 vaccines were effective, immunogenic and safe. Areas with a high incidence of EV71 may consider introducing EV71 vaccines. Full article