At the time of writing, FIND has listed four CE-marked SARSCoV-2 antigen tests. We evaluated the recently CE-approved rapid POCT SD-Biosensor for SARS-CoV-2 nucleoprotein detection in nasopharyngeal secretions from 330 patients admitted to the Emergency Room for a suspect of COVID-19 and travelers returning home from high risk countries. Sensitivity, specificity, accuracy, negative and predictive values were consistent with the use of the test to mass-screening for SARS-CoV-2 surveillance.
Hepatitis B virus (HBV) recurrence after liver transplantation is significantly reduced by prophylaxis with hepatitis B immune globulins (HBIG) or antiviral drugs in nonreplicating patients and by the combination of both drugs in replicating patients. However, the load of HBV DNA, which defines replicating status in patients undergoing liver transplantation, remains unclear. This study analyzes the correlation between the viral load, tested with a single amplified assay, at the time of liver transplantation, and the risk of hepatitis B recurrence in 177 HBV carriers who underwent transplantation in a single center from 1990 to 2002. Overall, HBV relapsed after surgery in 15 patients (8.5%) with a 5-and 8-year actuarial rate of recurrence of 8% and 21%, respectively. After liver transplantation hepatitis B recurred in 9% of 98 selected subjects treated only with immune globulins and in 8% of 79 viremic patients who received immune globulins and lamivudine (P ؍ NS). A linear correlation was observed between recurrence and viral load at the time of surgery. In transplant patients with HBV DNA higher than 100,000 copies/mL, 200-99,999 copies/mL, and DNA undetectable by amplified assay, hepatitis B recurred in 50%, 7.5%, and 0% of patients, respectively. Overall, a viral load higher than 100,000 copies/mL at the time of liver transplantation was significantly associated with hepatitis B recurrence (P ؍ .0003). options. The introduction of high doses of hepatitis B immune globulins (HBIG) or of lamivudine (LAM) as post-LT mono-prophylaxis has reduced the risk of hepatitis B recurrence to a variable cumulative rate ranging between 10% and 50%. During prophylaxis with LAM or HBIG a strict correlation between hepatitis recurrence and hepatitis B virus (HBV) DNA load at the time of surgery has been found, which is related to the emergence of viral mutants that are unresponsive to therapy, such as surface antigen (HBsAg) mutants and tyrosine-methionine-aspartate-aspartate (YMDD)-mutants. 1 -5 Moreover, neither HBV recurrence nor graft failure have been observed in patients with HBV DNA undetectable by polymerase chain reaction at the time of surgery and treated with HBIG. 6 The risk of hepatitis B recurrence can be reduced to less than 10% by using LAM before and after LT, in association with HBIG. 7 -13 Moreover, although LAM therapy before transplantation can improve liver function and decrease mortality, 14 long-term antiviral therapy can select YMDD mutants whose management needs the use of alternative drugs, such as adefovir dipivoxil (ADV), to reduce HBV recurrence after LT. 15 -19 However, a variety of issues still remain controversial. In particular, doubts remain as to what virological status has to be achieved in patients undergoing LT and which HBV DNA assays have to be performed. This study analyzes 177 HBsAg carriers who underwent transplantation in a single center between 1990 and 2002 with the aim of evaluating the prognostic role of the HBV DNA viral load at the time of surgery on the risk of hepati...
Background The disease caused by the “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) was named Coronavirus Disease 19 (COVID-19) and classified as a global public health emergency. The evidence related to the impact of COVID-19 on pregnancy are limited to the second and the third trimester of pregnancy, while data on the first trimester are scant. Many viral infections can be harmful to the fetus during the first trimester of pregnancy, and whether SARS-CoV-2 is one of them is still unknown. Objective(s) With this study we evaluated SARS-CoV-2 infection as a risk factor for early pregnancy loss in first trimester of pregnancy. Furthermore, COVID-19 course in the first trimester was assessed. Study design Between February 22 and May 21, 2020, we conducted a case-control study at S. Anna Hospital, Turin, among first trimester pregnant women, paired for last menstruation. The cumulative incidence of COVID-19 was compared between women with spontaneous abortion (case group, n=100) and those with ongoing pregnancy (control group, n=125). Current or past infection was determined by detection of SARS-CoV-2 from nasopharingeal swab and SARS-CoV-2 IgG/IgM antibodies in blood sample. Patient demographics, COVID-19-related symptoms, and the main risk factors for abortion were collected. Results Twenty-three of the 225 women (23/225, 10.2%) tested positive for COVID-19 infection. There was no difference in the cumulative incidence of COVID-19 between the cases (11/100, 11%) and the controls (12/125, 9.6%) (p=0.73). Logistic regression analysis confirmed that COVID-19 was not an independent predictor of early pregnancy loss (Odd Ratio 1.28, confidence interval 0.53-3.08). COVID-19 related symptoms in the first trimester were fever, anosmia, ageusia, cough, arthralgia and diarrhea; no pneumonia or Hospital admission due to COVID-19-related symptoms were recorded. No difference in the incidence of symptoms was noted between the two groups. Conclusion(s) SARS-CoV-2 infection during the first trimester of pregnancy does not appear to predispose to early pregnancy loss; its cumulative incidence did not differ between women with spontaneous abortion and women with ongoing pregnancy. COVID-19 appears to have a favorable maternal course at the beginning of pregnancy, consistent with what has been observed during the second and the third trimester.
COVID‐19 pandemic dramatically impacted transplantation landscape. Scientific societies recommend against the use of donors with active SARS‐CoV‐2 infection. Italian Transplant Authority recommended to test recipients/donors for SARS‐CoV‐2‐RNA immediately before liver transplant (LT) and, starting from November 2020, grafts from deceased donors with active SARS‐CoV‐2 infection were allowed to be considered for urgent‐need transplant candidates with active/resolved COVID‐19. We present the results of the first 10 LTs with active COVID‐19 donors within an Italian multicenter series. Only two recipients had a positive molecular test at LT and one of them remained positive up to 21 days post‐LT. None of the other eight recipients was found to be SARS‐CoV‐2 positive during follow‐up. IgG against SARS‐CoV‐2 at LT were positive in 80% (8/10) of recipients, and 71% (5/7) showed neutralizing antibodies, expression of protective immunity related to recent COVID‐19. In addition, testing for SARS‐CoV‐2 RNA on donors’ liver biopsy at transplantation was negative in 100% (9/9), suggesting a very low risk of transmission with LT. Immunosuppression regimen remained unchanged, according to standard protocol. Despite the small number of cases, these data suggest that transplanting livers from donors with active COVID‐19 in informed candidates with SARS‐CoV‐2 immunity, might contribute to safely increase the donor pool.
Human papillomavirus (HPV) is recognised as necessary for the development of cervical cancer. An age-stratified random sample of 1013 women, aged 25-70 years, participating in the organised cervical screening programme in Turin, Italy was tested for 36 HPV types using polymerase chain reaction (PCR) with the general primers GP5+/GP6+. The overall HPV prevalence was 8.8%. Highrisk types were found in 7.1% of women and multiple infections in 1.1%. HPV-16 was the most common type (32.6% of HPVpositive women). HPV prevalence (any type) was 13-14% at ages 25-39 years, 11.5% at age 40-44 years, and approximately 5% among older women. After age-adjustment, HPV prevalence was significantly increased in single vs married, (Odds Ratio (OR) = 2.23; 95% Confidence Interval (CI): 1.28-3.89) and decreased in parous vs nulliparous women (OR = 0.49; 95% CI: 0.31-0.78). However, the association with marital status and parity was restricted to women less than 45 years of age. In conclusion, overall, the female population of Turin showed an HPV prevalence that is intermediate compared with worldwide levels.
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