Archive for July 1, 2011

Hepatitis delta virus

Lancet July 02, 2011  V.378 N.9785 P.73 – 85


Sarah A Hughes, Heiner Wedemeyer, Phillip M Harrison 


Hepatitis delta virus (HDV) is a small, defective RNA virus that can infect only individuals who have hepatitis B virus (HBV); worldwide more than 15 million people are co-infected. There are eight reported genotypes of HDV with unexplained variations in their geographical distribution and pathogenicity. The hepatitis D virion is composed of a coat of HBV envelope proteins surrounding the nucleocapsid, which consists of a single-stranded, circular RNA genome complexed with delta antigen, the viral protein. HDV is clinically important because although it suppresses HBV replication, it causes severe liver disease with rapid progression to cirrhosis and hepatic decompensation. The range of clinical presentation is wide, varying from mild disease to fulminant liver failure. The prevalence of HDV is declining in some endemic areas but increasing in northern and centralEuropebecause of immigration. Treatment of HDV is with pegylated interferon alfa; however, response rates are poor. Increased understanding of the molecular virology of HDV will identify novel therapeutic targets for this most severe form of chronic viral hepatitis.


July 1, 2011 at 4:13 pm Leave a comment


Lancet July 02, 2011  V.378 N.9785 P.57 – 72


Stephen D Lawn, Alimuddin I Zumla

Tuberculosis results in an estimated 1·7 million deaths each year and the worldwide number of new cases (more than 9 million) is higher than at any other time in history. 22 low-income and middle-income countries account for more than 80% of the active cases in the world. Due to the devastating effect of HIV on susceptibility to tuberculosis, sub-SaharanAfricahas been disproportionately affected and accounts for four of every five cases of HIV-associated tuberculosis. In many regions highly endemic for tuberculosis, diagnosis continues to rely on century-old sputum microscopy; there is no vaccine with adequate effectiveness and tuberculosis treatment regimens are protracted and have a risk of toxic effects. Increasing rates of drug-resistant tuberculosis in eastern Europe, Asia, and sub-SaharanAfricanow threaten to undermine the gains made by worldwide tuberculosis control programmes. Moreover, our fundamental understanding of the pathogenesis of this disease is inadequate. However, increased investment has allowed basic science and translational and applied research to produce new data, leading to promising progress in the development of improved tuberculosis diagnostics, biomarkers of disease activity, drugs, and vaccines. The growing scientific momentum must be accompanied by much greater investment and political commitment to meet this huge persisting challenge to public health. Our Seminar presents current perspectives on the scale of the epidemic, the pathogen and the host response, present and emerging methods for disease control (including diagnostics, drugs, biomarkers, and vaccines), and the ongoing challenge of tuberculosis control in adults in the 21st century.


July 1, 2011 at 4:12 pm Leave a comment

Group B streptococcal vaccine for resource-poor countries

Lancet July 02, 2011  V.378 N.9785

Stephanie J Schrag, for the Global Group B Streptococcal Vaccine Working Group 

Neonatal deaths, which occur mostly in resource-poor countries during the first week of life, constitute 41% of the 8·8 million deaths in children aged less than 5 years worldwide. 1 Sepsis and pneumonia cause about a third of neonatal deaths. Maternal immunisation—the prevention cornerstone of neonatal tetanus and influenza programmes—has untapped potential to protect neonates from other infectious diseases. Group B streptococcal vaccines are uniquely suited to maternal immunisation in view of the …


July 1, 2011 at 4:10 pm Leave a comment


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