Seropositivity

血清阳性
  • 文章类型: Review
    根据循证指南,针对麻疹和水痘的疫苗通常推荐给易感HIV阳性患者,只要他们没有严重的免疫功能受损。然而,不建议进行常规筛查以确定血清学状态.我们在巴黎郊区的Avicenne大学医院咨询的HIV感染者(PLWHA)中进行了抗麻疹和抗水痘带状疱疹病毒(VZV)抗体的血清阳性率研究。血清是在2018-2020年收集的,并通过商业免疫测定法对268名患者进行了测试。大多数患者出生在撒哈拉以南非洲(55%),只有23%在欧洲。麻疹和水痘血清阳性分别存在于91.4%和96.2%的患者中。十分之一的患者对至少一种测试疾病具有血清阴性。在单变量分析中,只有年龄较小(p=0.027)与麻疹血清阴性的高风险相关,虽然到达法国的时间较短(p<0.001)和发现HIV的时间较短(p=0.007)与VZV血清阴性的风险较高相关。在多变量分析中没有发现关联。这项研究强调了在PLWHA中缺乏VZV和麻疹血清阴性的特定危险因素,并支持常规筛查的重要性。以提高免疫接种率和降低并发症的风险。
    According to evidence-based guidelines, vaccines against measles and varicella are generally recommended to susceptible HIV-positive patients, as long as they are not severely immunocompromised. However, routine screening to determine serologic status is not recommended. We conducted a seroprevalence study of anti-measles and anti-Varicella-Zoster virus (VZV) antibodies in adults living with HIV (PLWHA) consulting at Avicenne University Hospital in a Parisian suburb. Sera were collected in years 2018-2020 and tested by commercial immunoassays in 268 patients. Most of the patients were born in Sub-Saharan Africa (55 %) and only 23 % in Europe. Measles and varicella seropositivity were present respectively in 91.4 % and 96.2 % of patients. One patient in ten was seronegative to at least one of tested diseases. In the univariate analysis, only younger age (p = 0.027) was associated with a higher risk of measles seronegativity, while shorter time since arrival in France (p < 0.001) and shorter time since HIV discovery (p = 0.007) were associated with a higher risk of VZV seronegativity. In multivariate analysis no association was found. This study highlights the absence of specific risk factors for VZV and measles seronegativity in PLWHA and supports the importance of routine screening, in order to increase immunization rates and reduce risk of complications.
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  • 文章类型: Systematic Review
    背景:莱姆病(LB),由伯氏疏螺旋体(Bbsl)复杂螺旋体引起的蜱叮咬传播感染,是欧洲最常见的蜱传疾病。欧洲国家的研究已经报道了LB血清阳性率(针对Bbsl感染的抗体的患病率)和用于测试的诊断策略。我们进行了系统的文献综述,以总结欧洲当代LB血清阳性率。方法:PubMed,Embase,从2005年到2020年,我们搜索了CABIDirect(全球卫生)数据库,以确定欧洲国家报告LB血清阳性率的研究.总结了报告的单层和两层测试结果;使用算法(标准或修改的)来解释使用两层测试的研究的最终测试结果。结果:检索了来自22个欧洲国家的61篇文章。研究使用了一系列诊断测试方法和策略(48%是单层的,46%标准两层,和6%修改的两层)。在39项基于人群的研究中,其中14人具有全国代表性,血清阳性率估计范围为2.7%(挪威)至20%(芬兰)。在设计方面,研究之间存在很大的异质性,队列类型,采样周期,样本大小,和诊断,这限制了交叉研究的比较。然而,在报告暴露于蜱的人血清阳性率的研究中,这些人群的LB血清阳性率高于普通人群(40.6%vs.3.9%)。此外,在使用两层测试的研究中,一般人群LB血清阳性率在西欧(13.6%)和东欧(11.1%)高于北欧(4.2%)和南欧(3.9%).结论:尽管欧洲次区域和国家之间和内部的LB血清阳性率存在差异,在某些地理区域和特定风险人群中观察到高血清阳性率,提示重大的疾病负担和支持改善的需要,有针对性的公共卫生干预措施,如疫苗接种。需要统一的血清学检测方法和更具全国代表性的血清阳性率研究,以更好地了解欧洲Bbsl感染的患病率。
    Background: Lyme borreliosis (LB), a tick bite-transmitted infection caused by Borrelia burgdorferi sensu lato (Bbsl) complex spirochetes, is the most common tickborne disease in Europe. Studies in European countries have reported LB seroprevalence (prevalence of antibodies to Bbsl infection) and diagnostic strategies used for testing. We conducted a systematic literature review to summarize contemporary LB seroprevalence in Europe. Methods: PubMed, Embase, and CABI Direct (Global Health) databases were searched from 2005 to 2020 to identify studies reporting LB seroprevalence in European countries. Reported single-tier and two-tier test results were summarized; algorithms (standard or modified) were used to interpret final test results from studies that used two-tier testing. Results: The search yielded 61 articles from 22 European countries. Studies used a range of diagnostic testing methods and strategies (48% single-tier, 46% standard two-tier, and 6% modified two-tier). In 39 population-based studies, of which 14 were nationally representative, seroprevalence estimates ranged from 2.7% (Norway) to 20% (Finland). There was substantial heterogeneity among studies in terms of design, cohort types, periods sampled, sample sizes, and diagnostics, which limited cross-study comparisons. Nevertheless, among studies that reported seroprevalence in persons with greater exposure to ticks, LB seroprevalence was higher among these groups than in the general population (40.6% vs. 3.9%). Furthermore, among studies that used two-tier testing, general population LB seroprevalence was higher in Western Europe (13.6%) and Eastern Europe (11.1%) than in Northern Europe (4.2%) and Southern Europe (3.9%). Conclusion: Despite variations in LB seroprevalence between and within European subregions and countries, high seroprevalence was observed in certain geographic regions and particular risk groups, suggesting significant disease burden and supporting the need for improved, targeted public health interventions such as vaccination. Harmonized approaches to serologic testing and more nationally representative seroprevalence studies are needed to better understand the prevalence of Bbsl infection in Europe.
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  • 文章类型: Journal Article
    目前尚不清楚COVID-19疫苗在因疾病而免疫力下降的患者中的效果如何,移植,和透析。我们进行了一项系统评价,比较了COVID-19疫苗在实体瘤患者中的疗效,恶性血液病,自身免疫性疾病,炎症性肠病,以及接受移植或透析的患者。使用Medline/PubMed数据库进行两次文献检索。因此,21篇论文被纳入审查,血清阳性率按特定疾病类型进行总结,移植,和透析。当不同的论文研究相同类型的患者组时,我们选择了一项参与者数量较多的研究.大多数实体瘤患者在第二次接种后血清阳性率超过80%,但是在某些肿瘤如乳腺癌中发现了低血清阳性。对某些类型的血液系统恶性肿瘤和自身免疫性疾病患者的研究也报道了低血清阳性,这可能受到这些患者接受的免疫抑制治疗的影响。接受透析或移植的患者的研究报告血清阳性率低于一般人群,而所有炎症性肠病患者均转为血清阳性。将需要验证这些结果的荟萃分析,还需要研究保护免疫力下降的患者免受COVID-19感染的方法。
    It remains unclear how effective COVID-19 vaccinations will be in patients with weakened immunity due to diseases, transplantation, and dialysis. We conducted a systematic review comparing the efficacy of COVID-19 vaccination in patients with solid tumor, hematologic malignancy, autoimmune disease, inflammatory bowel disease, and patients who received transplantation or dialysis. A literature search was conducted twice using the Medline/PubMed database. As a result, 21 papers were included in the review, and seropositivity rate was summarized by specific type of disease, transplantation, and dialysis. When different papers studied the same type of patient group, a study with a higher number of participants was selected. Most of the solid tumor patients showed a seropositivity rate of more than 80% after the second inoculation, but a low seropositivity was found in certain tumors such as breast cancer. Research in patients with certain types of hematological malignancy and autoimmune diseases has also reported low seropositivity, and this may have been affected by the immunosuppressive treatment these patients receive. Research in patients receiving dialysis or transplantation has reported lower seropositivity rates than the general population, while all patients with inflammatory bowel disease have converted to be seropositive. Meta-analysis validating these results will be needed, and studies will also be needed on methods to protect patients with reduced immunity from COVID-19.
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  • 文章类型: Journal Article
    淋巴恶性肿瘤患者或接受抗CD20抗体治疗的患者对疫苗接种的体液反应受损,但mRNA疫苗对抗COVID-19的反应细节尚不清楚.这项系统评价和荟萃分析旨在描述淋巴恶性肿瘤患者或接受抗CD20抗体治疗的患者对COVID-19mRNA疫苗的反应。
    文献检索检索到52篇相关文章,随机效应模型用于分析体液和细胞反应。
    淋巴恶性肿瘤和非恶性肿瘤的抗CD20抗体治疗与较低的血清阳性率显着相关(风险比0.60[95%CI0.53-0.69];风险比0.45[95%CI0.39-0.52],分别)。一些亚型(慢性淋巴细胞白血病,治疗-初治慢性淋巴细胞白血病,骨髓瘤,和非霍奇金淋巴瘤)表现出体液反应受损。疫苗接种后6个月内的抗CD20抗体治疗降低了体液反应;此外,疫苗接种前>12个月的治疗仍损害体液应答.然而,非恶性患者的抗CD20抗体治疗未减弱T细胞应答.
    这些数据表明,患有淋巴恶性肿瘤或接受抗CD20抗体治疗的患者的体液反应受损,但细胞反应可以检测到独立于抗CD20抗体治疗。疫苗有效性的长期随访研究是必要的(PROSPERO注册号:CRD42021265780)。
    The humoral response to vaccination in individuals with lymphoid malignancies or those undergoing anti-CD20 antibody therapy is impaired, but details of the response to mRNA vaccines to protect against COVID-19 remain unclear. This systematic review and meta-analysis aimed to characterize the response to COVID-19 mRNA vaccines in patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy.
    A literature search retrieved 52 relevant articles, and random-effect models were used to analyze humoral and cellular responses.
    Lymphoid malignancies and anti-CD20 antibody therapy for non-malignancies were significantly associated with lower seropositivity rates (risk ratio 0.60 [95% CI 0.53-0.69]; risk ratio 0.45 [95% CI 0.39-0.52], respectively). Some subtypes (chronic lymphocytic leukemia, treatment-naïve chronic lymphocytic leukemia, myeloma, and non-Hodgkin\'s lymphoma) exhibited impaired humoral response. Anti-CD20 antibody therapy within 6 months of vaccination decreased humoral response; moreover, therapy > 12 months before vaccination still impaired the humoral response. However, anti-CD20 antibody therapy in non-malignant patients did not attenuate T cell responses.
    These data suggest that patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy experience an impaired humoral response, but cellular response can be detected independent of anti-CD20 antibody therapy. Studies with long-term follow-up of vaccine effectiveness are warranted (PROSPERO registration number: CRD42021265780).
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  • 文章类型: Journal Article
    类风湿性关节炎(RA)在女性中更为常见,虽然RA的病因不明,它的特点是产生自身抗体。这项研究的目的是确定女性是否比男性更容易发现RA相关的自身抗体,并确定影响性别与血清阳性之间关系的因素。
    检索数据库,并纳入RA(N≥100)的研究,如果他们报告按性别划分的RA血清阳性患者比例。使用随机效应模型进行元分析和元回归。回归的协变量是吸烟,年龄,BMI,健康评估问卷-残疾指数(HAQ-DI),和28个关节的疾病活动评分(DAS28)。
    84项研究共141,381例类风湿因子(RF)血清阳性受试者和95,749例抗瓜氨酸蛋白抗体(ACPA)血清阳性受试者符合纳入标准。参与者的平均年龄为37至68岁,女性受试者的比例为9%至92%。结果表明,与男性相比,女性血清阳性的可能性较小:RF的比值比(OR)0.84[95%CI0.77-0.91]和ACPA的OR0.88[95%CI0.81-0.95]。BMI,吸烟,平均年龄,DAS28和HAQ-DI不影响性别与血清阳性之间的关系。
    尽管有研究报告说,女性的RA疾病活动度高于男性,血清阳性预示着更糟糕的结果,女性血清阳性的可能性低于男性。
    Rheumatoid arthritis (RA) is more common in females, and although the cause of RA is unknown, it is characterized by the production of autoantibodies. The aims of this study were to determine whether RA-associated autoantibodies are more often found in females than males and to identify factors that influence the relationship between sex and seropositivity.
    Databases were searched and studies of RA (N ≥ 100) were included if they reported proportion of seropositive patients with RA by sex. Metaanalyses and metaregression were conducted using the random-effects model. Covariates regressed were smoking, age, BMI, Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Disease Activity Score in 28 joints (DAS28).
    Eighty-four studies with a total of 141,381 subjects with rheumatoid factor (RF) seropositivity and 95,749 subjects with anticitrullinated protein antibody (ACPA) seropositivity met inclusion criteria. The mean age of participants ranged from 37 to 68 years and the proportion of female subjects ranged from 9% to 92%. Results indicated that females were less likely than males to be seropositive: odds ratio (OR) 0.84 [95% CI 0.77-0.91] for RF and OR 0.88 [95% CI 0.81-0.95] for ACPA. BMI, smoking, mean age, DAS28, and HAQ-DI did not affect the relationship between sex and seropositivity.
    Although studies report that females have higher RA disease activity than males and that seropositivity predicts worse outcomes, females were less likely to be seropositive than males.
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  • 文章类型: Journal Article
    HPV疫苗对肛门生殖器癌和口咽癌的预防作用已在临床试验和现实世界数据中得到证实。我们回顾了已发表的关于HPV疫苗的长期疗效和有效性的临床试验和现实世界数据的可用论文的证据。据我们搜索,二价的最长预防效果,4价,9价疫苗在哥斯达黎加试验中有11年,未来的14年,在LTFU对V503-002的扩展研究和斯堪的纳维亚研究中进行了8年,分别。4价疫苗在观察期间的持续临床效果最长。在现实世界的数据中,在澳大利亚的一项4价疫苗研究中,疫苗有效性的最长观察期为12年.另一方面,在FUTUREII中,4价疫苗的HPV疫苗诱导的血清阳性长期持续时间最长为14年.对于二价疫苗,由于4价和9价疫苗的推出,可能没有计划额外的长期随访研究.在一些9价疫苗的研究中,由于观察时间短,结果尚未公布。预计未来还会有额外的结果。在国家免疫计划中,大多数女孩和男孩在青春期开始时接种了HPV疫苗;因此,重要的是至少在20多岁和30多岁的性活跃期之前监测疫苗效果。
    The preventive effect of HPV vaccines against anogenital and oropharyngeal cancers has been proven in both clinical trials and real-world data. We reviewed the published evidence about the long-term efficacy and effectiveness of the HPV vaccine in available papers of clinical trials and real-world data. As far as we searched, the longest period of preventive effect for the bivalent, 4-valent, and 9-valent vaccine were 11 years in the Costa Rica trial, 14 years in the FUTURE II, and 8 years in the LTFU extension study of V503-002 and the Scandinavian study, respectively. The sustained clinical effect during the observation period was longest for the 4-valent vaccine. In real-world data, the longest observation period of the vaccine effectiveness was 12 years in an Australian study for the 4-valent vaccine. On the other hand, the longest period of long-term persistence of HPV vaccine-induced seropositivity was 14 years in FUTURE II for the 4-valent vaccine. For the bivalent vaccine, additional long-term follow-up studies may not have been planned due to the launch of the 4-valent and 9-valent vaccines. In some studies of the 9-valent vaccine, the results have not yet been published because of the short observation period. The additional results are expected in the future. In a national immunization program, most girls and boys are inoculated with HPV vaccine by the time puberty begins; thus, it is important to monitor the vaccine effect at least until the sexually active period in their 20s and 30s.
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  • 文章类型: Journal Article
    This review summarizes the published data on epidemiology and burden of pertussis in South Korea as these may be under-categorized. A systematic literature review of PubMed, SCOPUS, EMBASE and KMBASE was performed to identify published literature in South Korea since 2000. Pertussis detection rates among 19 eligible studies range from 0.7% to 100% across different age groups, detection methods and study settings. Highest rates are observed in infants, while adolescents and adults with pertussis infection may suffer from persistent coughing. Vaccination uptake of pertussis booster dose among adolescents and adults remains low while seropositivity (detection of anti-pertussis immunoglobulin G), is high among adults. This review reveals a high burden of vaccine-preventable pertussis in South Korea. Besides primary childhood vaccination, strategies like maternal immunization and decennial revaccination of adults should be considered. Active testing, reporting and better utilization of vaccine registries may provide insights for decision-makers nationwide.
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  • 文章类型: Journal Article
    Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. While its exact etiology is unknown, it is generally believed that MS is caused by environmental triggers in genetically predisposed individuals. Strong and consistent evidence suggests a key role of Epstein-Barr virus (EBV), a B lymphotropic human gammaherpesvirus, in the etiology of MS. Areas covered: This review summarizes recent developments in the field of EBV and MS with a focus on potential mechanisms underlying the role of EBV in MS. PubMed was searched for the terms \'Epstein-Barr virus\' and \'multiple sclerosis\'. Expert opinion: The current evidence is compatible with the working hypothesis that MS is a rare complication of EBV infection. Under the premise of a causative role of EBV in MS, it needs to be postulated that EBV causes a specific, and likely persistent, change(s) that is necessarily required for the development of MS. However, although progress has been made, the nature of that change and thus the precise mechanism explaining the role of EBV in MS remain elusive. The mechanism of EBV in MS therefore is a pressing question, whose clarification may substantially advance the pathophysiological understanding, rational therapies, and prevention of MS.
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  • 文章类型: Journal Article
    Asthma is one of the most common chronic respiratory disease worldwide, with a negative impact on quality of life and socio-economic status of patients. There are some evidences to suggest that Toxocara infection is a neglected risk factor for childhood asthma. We performed a systematic review and meta-analysis to further understanding of this relationship. Five databases include PubMed, Science Direct, Scopus, Web of Science (ISI), and Google scholar were searched (up to October 2017) to identify the relevant studies. We used random-effects meta-analysis model to estimate the pooled odds ratio (OR) and 95% confidence intervals (CI). Heterogeneity was assessed with the Q-test and I2 statistic. A total of 17 studies including 11 studies with case-control design (1139 patients and 1023 controls) and six studies with cross-sectional design (a total of 5469 participants, 872 asthmatics, and 4597 non-asthmatics children) met the eligibility criteria. An increased risk for asthma was observed in children with Toxocara infection seropositivity (OR, 1.91; 95% CI, 1.47-2.47). In sub-group analysis, the pooled ORs were (OR, 2.13; 95% CI, 1.43-3.15) and (OR, 1.73; 95% CI, 1.23-2.44) for case-control and cross-sectional studies, respectively. Moreover, considering to specific IgE seropositivity, a pooled OR of 2.36 (95% CI, 0.93-5.98) was observed. In conclusion, this meta-analysis revealed that children infected with Toxocara spp. are more likely to have asthma compared to non-infected children. More studies (especially longitudinal studies) are needed to further investigate the impact of Toxocara spp. infection on the onset or development of asthma.
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  • 文章类型: Journal Article
    HIV status disclosure plays a crucial role in reducing risk behaviors of drug and sexual partners and thereby limiting HIV transmission. As people who inject drugs (PWID) bear a significant HIV burden and disclosure research among PWID is relatively few, we reviewed the literature to highlight what is known about disclosure among HIV-positive PWID. Searches of articles published from 2000 to 2015 yielded 17 studies addressing different aspects of disclosure, and results are presented by major themes. Our results suggest that despite the difficulties, most PWID (64-86%) disclose their HIV-positive status to trusted individuals (family members and intimate sexual partners) and to those who are known to be HIV-positive. Disclosure to non-intimate sexual partners and fellow drug users is relatively lower. Disclosure decision-making is primarily driven by the perceived positive and negative consequences of disclosure. Subsequent risk reduction practices following disclosure are influenced by the feeling of responsibility, as well as partners\' willingness to accept risk. Cultural family values, ethnicity, and different localities were several contextual factors that affect patterns of disclosure and risk behaviors of PWID. Areas for future research are recommended.
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