In Romania, the first phase of the COVID-19 vaccination campaign prioritized medical personnel, which included healthcare students. This study aimed to assess their knowledge, attitudes towards, and perception of COVID-19 vaccination. An anonymous, single-answer, 42-item online survey was conducted from 12 January until 3 March 2021, in the country’s largest University of Medicine and Pharmacy. Among the 1581 respondents (14.9% response rate), 88.5% were pro-vaccination, 7.8% were undecided, and 3.7% were vaccine resistant. The main reason for vaccine rejection was the perceived speed of vaccine development (strong agreement among the vaccine resistant, moderate agreement among the undecided, p < 0.001). Concern over long-term adverse reaction was present in only 11.5% of the respondents, significantly more frequent in the undecided and vaccine resistant. Perceived knowledge on the vaccines’ safety, efficacy, and technology correlated with a pro-vaccine attitude (p < 0.001). Most respondents had a positive stance towards vaccination in general, influencing their behaviour as future parents (99.3% of the pro-vaccination, 95.1% of the undecided, and 89.1% of the vaccine resistant will vaccinate their children, p < 0.001) and as medical professionals (99.7% of the pro-vaccination, 93.5% of those undecided, and 89.8% of the vaccine resistant would advise parents to vaccinate their children, p < 0.001). Healthcare students can thus serve as important vectors for scientifically sound information, influencing vaccine uptake in the community.

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During the first half of 2022, the World Health Organization reported an outbreak of acute severe hepatitis of unknown aetiology (AS-Hep-UA) in children, following initial alerts from the United Kingdom (UK) where a cluster of cases was first observed in previously well children aged &lt;6 years. Sporadic cases were then reported across Europe and worldwide, although in most countries incidence did not increase above the expected baseline. There were no consistent epidemiological links between cases, and microbiological investigations ruled out known infectious causes of hepatitis. In this review, we explore the evidence for the role of viral infection, superimposed on a specific host genetic background, as a trigger for liver pathology. This hypothesis is based on a high prevalence of Human Adenovirus (HAdV) 41F in affected children, together with metagenomic evidence of adeno-associated virus (Adeno-associated viruses)-2, which is a putative trigger for an immune-mediated liver injury. Roles for superantigen-mediated pathology have also been explored, with a focus on the potential contribution of SARS-CoV-2 infection. Affected children also had a high frequency of the MHC allele HLA-DRB1*04:01, supporting an immunological predisposition, and may have been vulnerable to viral coinfections due to disruption in normal patterns of exposure and immunity as a result of population lockdowns during the COVID-19 pandemic. We discuss areas of ongoing uncertainty, and highlight the need for ongoing scrutiny to inform clinical and public health interventions for this outbreak and for others that may evolve in future.

BackgroundPatients with chronic hepatitis C (CHC) often have elevated serum iron markers, which may worsen liver injury.ObjectivesThe aim of this study was to investigate the possible correlations between iron metabolism serum markers, HCV viral load, and liver disease severity in treatment-naive patients with chronic hepatitis C infection.Patients and MethodsEighty five patients with untreated hepatitis C chronic infection were investigated.ResultsTwenty one patients (24.7%) had elevated serum iron levels, and 29 subjects (34.1%) had severe liver fibrosis. Significantly elevated levels of serum iron (P < 0.05) and ferritin (P < 0.001), associated with lower levels of TIBC (P < 0.05) were detected in patients with severe fibrosis compared to no/mild fibrosis. Severe necroinflammatory activity was also significantly correlated with serum iron (P < 0.001), TIBC (P < 0.05), and ferritin levels (P < 0.001). Using multiple linear regression analysis, serum levels of ferritin and transferrin were the independent variables selected as being good predictors for advanced fibrosis and severe necroinflammatory activity. No significant correlations were detected between HCV viral load and iron markers.ConclusionsThis study revealed that serum iron markers (especially ferritin and transferrin) might be used as surrogate markers for both liver fibrosis and necroinflammatory activity.Patients with chronic hepatitis C (CHC) often have elevated serum iron markers, which may worsen liver injury.

Despite initial suboptimal ART, a significant proportion of patients subsequently treated with a lopinavir/ritonavir based regimen remained on this therapy for up to nine years.