Contagion®'s Top 10 Infectious Disease Articles of 2017
DEC 30, 2017 | CONTAGION® EDITORIAL STAFF
#10: Genital HSV Vaccine Provides Powerful Protection in Preclinical Trials
Around the world, about half a billion individuals are infected with herpes simplex virus type 2 (HSV-2), the virus that most commonly causes genital herpes. With a number this staggering, researchers around the world have been channeling their efforts into the development of a safe and effective vaccine that will put an end to this global pandemic once and for all.
None of the past vaccine candidates have been successful, but a new trivalent vaccine coming from scientists at the Perelman School of Medicine at the University of Pennsylvania may be the one that will change it all. In preclinical tests, the trivalent vaccine—which produces antibodies that fight three different parts of the virus—proved to provide “powerful protection” in preclinical trials, according to a recent press release.
#9: Reservoirs of Latent HIV Hinder Quest For a Cure
HIV has remained stubbornly impervious to a complete cure, and researchers have uncovered new evidence that may explain this problem, at least in part. In patients who are being treated with antiretroviral therapy (ART), it appears that a latent form of HIV residing in immune cells can continue to reproduce, potentially reactivating the virus in the body and offering resistance against ART.
According to researchers at Johns Hopkins University School of Medicine, this latent HIV has an extremely long half-life, presenting a significant obstacle to complete eradication of the disease.
In a sign that the flu season is possibly slowing in the United States, the Centers for Disease Control and Prevention (CDC) has recently reported a slight decrease in influenza activity, though the virus is still widespread in most of the country and the elderly have been hard hit this season.
In the week ending February 18, the CDC’s weekly FluView report noted that the proportion of people seeing their health care provider for influenza-like illness was 4.8%, down from the previous week’s rate of 5.2%. At the same time, flu activity is now widespread in 44 states after hitting a high of widespread activity in 46 states the prior week. While flu activity remains elevated over the baseline rate of 2.2% for influenza-like illness, the new national report offers some good news during a flu season marked by severe illness.
#7: Morgellons Found to Be Closely Linked with Lyme Disease
Morgellons disease has been a puzzle to practitioners for many years. Sufferers exhibit colorful filaments that protrude from their skin or nestle directly underneath it, resembling textile fibers in their texture and hue. Frequently, this unusual presentation led physicians to doubt that the filaments could originate from inside the skin and sufferers were traditionally thought to be delusional. Now, researchers associated with the International Lyme and Associated Diseases Society (ILADS) have examined the results of several recent studies and concluded that not only do Morgellons filaments originate inside the skin, but the disorder is also closely linked to Lyme disease.
According to Raphael B. Stricker, MD, a San Francisco physician and ILADS member, histological studies demonstrate that the filaments are comprised of keratin and collagen, proteins found in body tissues.
Read more about Morgellons and Lyme disease, here.
#6: UNC Researchers Identify New Target for Potential HIV Cure
A good deal of progress has been made in the fight against HIV. Decades ago, when an individual received an HIV diagnosis, it essentially equated to a death sentence, but now, by receiving antiretroviral therapy (ART), these individuals can live longer lives with fewer side effects. Despite this, once an individual is infected, he or she has HIV for life, and the more that researchers learn about the virus, the closer they may come to finding a cure.
Now, researchers from the Division of Infectious Diseases at the University of North Carolina, School of Medicine have made another interesting discovery. HIV does not only infect T cells—the virus can also “persist” in macrophages. According to the UNC press release, “The discovery of this additional viral reservoir has significant implications for HIV cure research.” Those who are actively working on a potential cure for HIV can utilize these findings to get a leg-up on the virus.
#5: CDC Releases Estimates on 2016-2017 Flu Vaccine Effectiveness
With several more weeks left to go in the 2016-2017 flu season in the United States, the Centers for Disease Control and Prevention (CDC) has released early data showing that this year’s flu shot has effectively reduced the risk of being infected with the virus by nearly half for those vaccinated.
The new estimates on the flu vaccine’s effectiveness (VE) for this season were recently published in the latest issue of the CDC’s Morbidity and Mortality Weekly Report. The authors of the report examined data collected on 3,144 children and adults at five study sites enrolled in the US Influenza Vaccine Effectiveness Network from November 29, 2016, to February 4, 2017. The study participants were individuals aged 6 months or older who had sought medical care for acute respiratory illness, and the percentage of those vaccinated with the seasonal flu shot ranged from 46% to 61% at the five study sites. Of the 3,144 individuals in the study group, 744 (24%) had laboratory-confirmed cases of influenza; 88% of these were cases of infection with influenza A.
Robert Bransfield, MD, DLFAPA, Associate Clinical Professor, Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, discusses the existence of chronic Lyme disease with Contagion®.
Interview Transcript (slightly modified for readability)
“Well, the term chronic Lyme disease has been around for a much longer time than post-treatment Lyme disease, that’s a relatively newer term, and there’re many other similar terms. Another term is late-stage Lyme disease. Post-treatment Lyme disease means that there’s been some degree of treatment, although it may be variable, and there’re a lot of unknowns with that because some people have been treated [with], maybe, a very brief course of antibiotics that’s been insufficient. Other people have had a significant amount [of treatment]. [With] some people there’s a true recovery, and [with] other people there may not be, so it’s confusing because it’s a very mixed, heterogeneous group.
Read the rest of the transcript and check out the clip, here.
#3: Influenza B Cases Continue to Rise in the United States
Winter is over but the same cannot be said for the 2016-2017 flu season, with the Centers for Disease Control and Prevention (CDC) expecting significant flu activity to continue in the coming weeks.
After five consecutive weeks of decreasing activity, CDC surveillance reports have noted that 36 states are still experiencing widespread flu activity. While the predominant strain of the virus continues to be influenza A (H3N2), a late-season uptick in cases of influenza B infections and a decline in influenza A is helping extend the flu season into the spring months.
#2: New Genital Herpes Drug Proves More Promising Than Existing Treatment in Clinical Trial
As what may be one of the most promising treatments for the herpes simplex virus 2 (HSV-2) in two decades, pritelivir, has demonstrated in a recent trial that it provides greater viral suppression than the present standard treatment, valacyclovir.
In the study, conducted by a research team led by Anna Wald, MD, medical director of virology research at the University of Washington, Fred Hutchinson Cancer Research Center in Seattle, patients who took pritelivir not only experienced less HSV shedding than those who took valacyclovir (2.4% vs. 5.3%), but they also had fewer lesions (1.9% vs. 3.9%), less pain, and fewer treatment-emergent adverse events (62% vs. 69%).
It can sometimes be hard to remember that just a few decades ago, contracting HIV was pretty much a death sentence. In HIV-infected individuals, the disease often progressed quickly to full-blown AIDS, and there was nothing doctors could do at that point except offer supportive care.
Fast-forward to the mid-1990s, when protease inhibitors were introduced and the death rate from HIV began a sharp decline. The multidrug “cocktails” of the 1990s and 2000s have since given way to a much simpler, more streamlined, and more effective treatment regimen that allows individuals with HIV to live a near-normal lifespan with fewer side effects than ever before. Although this is great news, the fact remains that HIV is a particularly stubborn virus. Compared with other lethal diseases such as polio or smallpox, the human body mounts an inefficient immune response to HIV, which is why a preventive vaccine remains elusive. Researchers and patients still hope for the day when HIV can be declared completely cured but is this a realistic vision, and, if so, how close are we to that goal?
The short answer, according to experts, is “We’re getting there.” However, although prevention strategies such as earlier testing of at-risk individuals and the use of pre-exposure prophylaxis have helped reduce transmission rates, the main driver of the movement to eradicate HIV has been the collection of significant advances in treatment.
Huge Gains in Treatment Spur Optimism
“Treatment has been our biggest success story to date,” said Roger Shapiro, MD, MPH, an associate professor at Harvard School of Public Health in Boston who specializes in reducing the incidence of mother-to-child HIV transmission and reducing morbidity and mortality rates in infants born infected. “Because of effective treatment, what was once a universally fatal disease can now be controlled with 1 pill, once a day,” he told Contagion™. “Ongoing research is now exploring how to push treatment even further and control the virus with longer-acting treatment or…approaches such as monoclonal antibodies—but we are not there yet.”
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