Posts filed under ‘Antivirales no HIV’

Statin use and the risk of herpes zoster: a nested case-control study using primary care data from the U.K. Clinical Research Practice Datalink.

Br J Dermatol. December 2016 V.175 N.6 P.1183-1194.

doi: 10.1111/bjd.14815.

Matthews A1, Turkson M1, Forbes H1, Langan SM1, Smeeth L1, Bhaskaran K1.

Abstract

BACKGROUND:

Statins are commonly prescribed worldwide and recent evidence suggests that they may increase the risk of herpes zoster (HZ).

OBJECTIVES:

To quantify the effect of statin exposure on the risk of HZ in the U.K.

METHODS:

A matched case-control study was conducted using data from U.K. primary care and hospital records. Patients > 18 years with an incident diagnosis of HZ were matched to up to four controls for age, sex and general practice. Patients were included in the statin exposure group if they had ever used a statin, and the daily dosage of the most recent statin prescription and the time since the most recent statin prescription were also recorded. The primary outcome was an incident diagnosis of HZ. Odds ratios (ORs) were estimated from conditional logistic regression and adjusted for potential confounders.

RESULTS:

A total of 144 959 incident cases of HZ were matched to 549 336 controls. Adjusted analysis suggested strong evidence for an increase in the risk of HZ related to statin exposure (OR 1·13, 95% confidence interval 1·11-1·15). There was also an increased risk when dosages were increased for patients who were currently or had recently been receiving statin treatment (Ptrend < 0·001), and we found an attenuation of the increased risk of HZ in previous statin users as the time since last statin exposure increased (Ptrend < 0·001).

CONCLUSIONS:

These findings are consistent with the hypothesis that statin therapy leads to an increase in the risk of HZ.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215701/pdf/BJD-175-1183.pdf

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August 24, 2018 at 4:09 pm

Herpes zoster is associated with prior statin use: a population-based case-control study.

PLoS One. October 24, 2014 V.9 N.10 P.:e111268.

doi: 10.1371/journal.pone.0111268.

Chung SD1, Tsai MC2, Liu SP3, Lin HC4, Kang JH5.

Abstract

BACKGROUND:

This study investigated the association between statin use and herpes zoster (HZ) occurrence in a population-based case-control study.

METHODS:

Study subjects were retrieved from the Taiwan Longitudinal Health Insurance Database 2000. This study included 47,359 cases with HZ and 142,077 controls. We performed conditional logistic regression analyses to calculate the odds ratio (OR) to present the association between HZ and having previously been prescribed statin.

RESULTS:

We found that 13.0% of the sampled subjects had used statins, at 15.5% and 12.1% for cases and controls, respectively (p<0.001). A conditional logistic regression analysis suggested that the adjusted OR of being a statin user before the index date for cases was 1.28 (95% confidence interval (CI): 1.24∼1.32) compared to controls. Subjects aged 18∼44 years had the highest adjusted OR for prior statin use among cases compared to controls (OR: 1.69; 95% CI: 1.45∼1.92). Furthermore, we found that the ORs of being a regular and irregular statin user before the index date for cases were 1.32 (95% CI: 1.27∼1.38) and 1.23 (95% CI: 1.181.29), respectively, compared to controls.

CONCLUSIONS:

We concluded that prior statin use was associated with HZ occurrence.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208841/pdf/pone.0111268.pdf

August 24, 2018 at 4:07 pm

Impact of postherpetic neuralgia: A six year population-based analysis on people aged 50 years or older

Journal of Infection August 2018 V.76 N.8 P.131–136

Cintia Muñoz-Quiles, Mónica López-Lacort, Alejandro Orrico-Sánchez, Javier Díez-Domingo

Highlights

  • This population-based study shows that 15.7% of HZ cases develop PHN.
  • Incidence rate of PHN was 1.19/1000 persons (≥50)-year and it was double in women.
  • The adjusted risk of developing PHN increased sharply with age and comorbidities.
  • About 32% of people will develop a HZ between ages 50–90 years.
  • About 7% of people will develop PHN between ages 50–90 years.

Objectives

To estimate the incidence and burden of postherpetic neuralgia (PHN) and to investigate risk factors for PHN in the Valencia Region of Spain.

Methods

Data were extracted from population and healthcare databases from the Valencia Region (2009–2014). Herpes zoster (HZ) and PHN were defined using ICD-9 codes and drug prescriptions in people aged ≥50 years. The risk of HZ patients for developing PHN and potential risk factors (diabetes mellitus, COPD and heart failure) were investigated. A survival analysis was developed to estimate the cumulative hazard of developing HZ and PHN between ages 50–90 years.

Results

From a total of 2,289,485 subjects, 87,086 cases of HZ were registered, 13,658 (15.7%) of whom developed PHN. PHN risk was higher in women and increased sharply with age and comorbidities as diabetes mellitus, COPD and heart failure. The cumulative risk of developing HZ between ages 50–90 years was 31.7% (95% CI: 31.3-32.1) and 6.9 (95% CI: 6.7–7.1) for PHN.

Conclusions

PHN risk was higher in women and increased with age and comorbidities. At least 32% and 7% of people will develop HZ and PHN, respectively, between ages 50–90 years. These results should be considered for vaccine policy implementation.

FULL TEXT

https://www.journalofinfection.com/article/S0163-4453(18)30107-5/fulltext

PDF

https://www.journalofinfection.com/article/S0163-4453(18)30107-5/pdf

July 28, 2018 at 7:32 pm

Characterization of influenza virus variants induced by treatment with the endonuclease inhibitor baloxavir marboxil.

Sci Rep. June 25, 2018 V.8 N.1 P.9633.      doi: 10.1038/s41598-018-27890-4.

Omoto S1, Speranzini V2, Hashimoto T3, Noshi T3, Yamaguchi H3, Kawai M3, Kawaguchi K3, Uehara T3, Shishido T3, Naito A3, Cusack S4.

Author information

1 Shionogi & Co., Ltd., Osaka, Japan. shinya.oomoto@shionogi.co.jp

2 European Molecular Biology Laboratory, Grenoble Outstation, Grenoble, France.

3 Shionogi & Co., Ltd., Osaka, Japan.

4 European Molecular Biology Laboratory, Grenoble Outstation, Grenoble, France. cusack@embl.fr

Abstract

Baloxavir acid (BXA), derived from the prodrug baloxavir marboxil (BXM), potently and selectively inhibits the cap-dependent endonuclease within the polymerase PA subunit of influenza A and B viruses. In clinical trials, single doses of BXM profoundly decrease viral titers as well as alleviating influenza symptoms. Here, we characterize the impact on BXA susceptibility and replicative capacity of variant viruses detected in the post-treatment monitoring of the clinical studies. We find that the PA I38T substitution is a major pathway for reduced susceptibility to BXA, with 30- to 50-fold and 7-fold EC50 changes in A and B viruses, respectively.

The viruses harboring the I38T substitution show severely impaired replicative fitness in cells, and correspondingly reduced endonuclease activity in vitro. Co-crystal structures of wild-type and I38T influenza A and B endonucleases bound to BXA show that the mutation reduces van der Waals contacts with the inhibitor. A reduced affinity to the I38T mutant is supported by the lower stability of the BXA-bound endonuclease. These mechanistic insights provide markers for future surveillance of treated populations.

FULL TEXT

https://www.nature.com/articles/s41598-018-27890-4

PDF

https://www.nature.com/articles/s41598-018-27890-4.pdf

June 30, 2018 at 5:47 pm

Approved: Baloxavir marboxil

WHO Drug Information 2018 V.32 N.1 P.32

One-dose treatment for influenza

Product name: Xofluza®

Dosage form: Tablet

Class: cap-dependent endonuclease inhibitor

Approval: Ministry of Health, Labour and Welfare (MHLW) of Japan

Use: Treatment of influenza types A and B

Benefits: Treatment requires only a single oral dose regardless of age.

Shionogi & Co. Ltd Press

PDF

http://www.who.int/medicines/publications/druginformation/issues/WHO_DI_32-1.pdf

 

June 30, 2018 at 5:45 pm

Westward Spread of Highly Pathogenic Avian Influenza A(H7N9) Virus among Humans, China

Emerging Infectious Diseases June 2018 V.24 N.6   

Yang et al.

Beijing Normal University, Beijing, China (Q. Yang, X. Tong, H. Tian); Shaanxi Provincial Centre for Disease Control and Prevention, Xi’an, China (W. Shi, L. Zhang, Y. Xu, J. Xu, S. Li, F. Liu, P. Yu); Xianyang Centre for Disease Control and Prevention, Xianyang, China (J. Zhang); Baoji Centre for Disease Control and Prevention, Baoji, China (K. Hu); Xi’an Centre for Disease Control and Prevention, Xi’an (C. Ma); Chinese Center for Disease Control and Prevention, Beijing (X. Zhao, X. Li); Chinese Academy of Forestry, Beijing (G. Zhang); University of Oxford, Oxford, UK (O.G. Pybus)

We report infection of humans with highly pathogenic avian influenza A(H7N9) virus in Shaanxi, China, in May 2017. We obtained complete genomes for samples from 5 patients and from live poultry markets or farms in 4 cities. Results indicate that H7N9 is spreading westward from southern and eastern China.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/24/6/17-1135_article

PDF

https://wwwnc.cdc.gov/eid/article/24/6/pdfs/17-1135.pdf

May 22, 2018 at 7:41 am

Is cytomegalovirus reactivation increasing the mortality of patients with severe sepsis?

Crit Care. 2011;15(2):138.

Kalil AC1, Florescu DF.

Author information

1 Department of Internal Medicine, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198, USA. akalil@unmc.edu

Abstract

Cytomegalovirus (CMV) is a ubiquitous virus present in approximately two-thirds of the healthy population.

This virus rarely causes an active disease in healthy individuals, but it is among the most common opportunistic infections in immunocompromised patients such as solid organ transplant recipients, patients receiving chemotherapy for cancer or patients with human immunodeficiency virus.

Critically ill patients who are immunocompetent before intensive care unit admission may also become more prone to develop active CMV infection if they have prolonged hospitalizations, high disease severity, and severe sepsis.

The development of active CMV infection in these critically ill patients has been associated with a significantly higher risk of death in several previous studies.

The present issue of Critical Care brings a new study by Heininger and colleagues in which the authors found that patients with severe sepsis who developed active CMV infection had significantly longer intensive care unit and hospital stays, prolonged mechanical ventilation, but no changes in mortality compared to patients without CMV infection.

We discuss the possible reasons for their findings (for example, selection bias and low (20%) statistical power to detect mortality endpoints), and also perform an update of our previous meta-analysis with the addition of Heininger and colleagues’ study to verify whether the higher mortality rate with CMV holds.

Our updated meta-analysis with approximately 1,000 patients shows that active CMV infection continues to be associated with a significant 81% higher mortality rate than that in critically ill patients without active CMV infection.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219353/pdf/cc10093.pdf

March 24, 2018 at 10:58 am

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