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Bone Loss in HIV Infection
Opinion StatementHuman immunodeficiency virus (HIV) infection is an established risk factor for low bone mineral density (BMD) and subsequent fracture, and treatment with combination antiretroviral therapy (cART) leads to additional BMD loss, particularly in the first 1 –2 years of therapy. The prevalence of low BMD and fragility fracture is expected to increase as the HIV-infected population ages with successful treatment with cART. Mechanisms of bone loss in the setting of HIV infection are likely multifactorial, and include viral, host, and immune effects, as well as direct and indirect effects of cART, particularly ...
Source: Current Treatment Options in Infectious Diseases - February 22, 2017 Category: Infectious Diseases Source Type: research

Human Papilloma Virus Infections in Men: Focus on Vaccination and Treatment Options
Opinion statementHuman papilloma virus (HPV) infection is the most prevalent among sexually transmitted diseases (STDs). There are more than 100 types of HPV, with the possibility of infection for both male and female, affecting sexual organs, mouth, and throat. The majority of people affected are unaware of the infection. HPV is associated with a large spectrum of clinical features, such as unapparent infections, unspecific epithelial lesions, genital warts, and cancers. Although a consistent and coherent picture about the epidemiology and pathogenesis of genital HPV infections in women has been developed over the past 30...
Source: Current Treatment Options in Infectious Diseases - February 15, 2017 Category: Infectious Diseases Source Type: research

Hepatitis B, C, and Delta —Updates in Screening and Infection Prevention Opportunities for Eradication
Opinion statementHepatitis B virus (HBV) is one of the most frequent pathogen worldwide and actively infects around 300 million people in the world. There is an effective recombinant vaccine available from almost 40  years. It is able to elicit protective antibodies levels in more than 95% of the vaccinated population. Nevertheless, HBV causes a chronic disease that in most cases may not be diagnosed for many years due to the absence of clear symptoms during the acute phase as well in the chronic phase before the establishment of severe clinical pictures as liver cirrhosis and hepatocellular carcinoma. To envisage the era...
Source: Current Treatment Options in Infectious Diseases - February 13, 2017 Category: Infectious Diseases Source Type: research

Hypogonadism in the HIV-Infected Man
Opinion statementLow testosterone levels are frequently observed among men with treated and untreated HIV infection. However, the interpretations of biochemical measurements of testicular function are challenging and need to be considered in the context of the clinical presentation and scenario. The distinction between primary and secondary hypogonadism and determination of the underlying clinical pathophysiology are not always straightforward. Early recognition of clinical hypogonadism and appropriate treatment may improve clinical outcomes and quality of life for affected individuals. A principal aim of testosterone repl...
Source: Current Treatment Options in Infectious Diseases - February 13, 2017 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship: The Role of the Patient
Opinion StatementThe aim of this article is to describe the current state of the patient role in antimicrobial stewardship efforts. There is a global crisis in antimicrobial resistance (AR) for which antimicrobial use is the main driver. Antimicrobial stewardship (AS) is a critical ally in the battle against AR. The extent to which specific AS initiatives are implemented across settings varies considerably; many acute care settings have a formal antimicrobial stewardship program (ASP), but other patient care settings such as outpatient clinics or long-term care facilities are generally in the early phases of developing AS ...
Source: Current Treatment Options in Infectious Diseases - February 5, 2017 Category: Infectious Diseases Source Type: research

New Strategies to Monitor Healthcare Workers ’ Hand Hygiene Compliance
This article will review strengths and weaknesses of current methods to monitor and improve HH compliance. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - January 31, 2017 Category: Infectious Diseases Source Type: research

Enhancing the Utility of Antibiotic Susceptibility Reporting as a Tool for Antimicrobial Stewardship
Opinion StatementHospital antibiograms are a method for presenting cumulative antibiotic susceptibility data using routinely collected clinical microbiology data. They provide critical foundational knowledge to inform development of antimicrobial stewardship program (ASP) strategies but are also provided to clinicians to inform empiric antibiotic therapy selection. Earlier research has demonstrated that use of the antibiogram to direct prudent antibiotic selection is less than desired. Use by non-infectious disease practitioners has been limited, and antibiotic prescribing has not aligned with ASP goals. Over the past 5  ...
Source: Current Treatment Options in Infectious Diseases - January 29, 2017 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship Guidelines: Syndrome-Specific Strategies
Opinion statementSyndrome-specific interventions refer to systematic actions that are designed and implemented to improve treatment of specific infectious disease diagnoses such as pneumonia or urinary tract infection. The rationale behind implementation of syndrome-specific interventions is that antimicrobial stewardship programs (ASP) can apply their limited resources to focus on conditions where antimicrobial misuse is common, and utilize their expertise to develop interventions which can be operationalized by prescribers and other healthcare personnel, thus expanding ASP impact. Design and implementation of syndrome-sp...
Source: Current Treatment Options in Infectious Diseases - January 26, 2017 Category: Infectious Diseases Source Type: research

Update in Bloodstream Infection Diagnosis Using New Methods in Microbiology
Opinion statementBloodstream infections remain an important cause of morbidity/mortality worldwide. The diagnosis of these infections is time-consuming, even with the use of automated blood culture systems. Several systems based on molecular biology and, more recently, proteomics have been developed to allow rapid and accurate diagnosis of bloodstream infections. Here, we describe some recently technologies and commercial systems available to detect and to identify microorganisms and bacterial antimicrobial resistance-coding genes from positive blood culture bottles and whole-blood samples. Evaluation of clinical outcomes ...
Source: Current Treatment Options in Infectious Diseases - January 26, 2017 Category: Infectious Diseases Source Type: research

Erratum to: Hepatitis C Treatment in HIV Coinfection: Approaches, Challenges, and Future Opportunities
(Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - November 27, 2016 Category: Infectious Diseases Source Type: research

Process Development for the Care of the Person Under Investigation for Ebola Virus Disease: a Collaboration of Biocontainment Unit and Emergency Medicine Personnel
Opinion StatementPatients presenting with epidemiological risk factors for Ebola virus disease (EVD) and symptoms consistent with the disease require screening with a molecular assay. If the initial test is negative, but the patient has been symptomatic for less than 3  days, a follow-up test is required to reliably exclude the disease. During this time, persons under investigation (PUI) for EVD may have illnesses other than EVD that require further evaluation and management and well-defined processes are essential to the delivery of consistent, high-quality care for these patients while preserving the safety of healthcar...
Source: Current Treatment Options in Infectious Diseases - November 7, 2016 Category: Infectious Diseases Source Type: research

Erratum to: Treatment of Non-Tuberculous Mycobacterial Lung Disease
(Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - November 2, 2016 Category: Infectious Diseases Source Type: research

Persistence of Ebola Virus in Convalescence
Opinion statementThe recent Ebola epidemic in West Africa has had a global impact of unprecedented dimension. It resulted in a large survivor population, many of whom have suffered from lingering systemic complications during convalescence. A growing body of literature strongly suggests that the virus persists in immune privileged organs and body fluids even after clearance of the virus from plasma, and may represent a continued transmission risk during this time. Much is yet to be discovered regarding Ebola and its potential to persist in human organs after plasma clearance. The response to this public health epidemic has...
Source: Current Treatment Options in Infectious Diseases - October 25, 2016 Category: Infectious Diseases Source Type: research

Nontuberculous Mycobacteria in Cystic Fibrosis
Opinion statementNontuberculous mycobacteria (NTM) are found in approximately 10  % of cystic fibrosis (CF) patients, but only a portion will develop NTM disease. The management of CF lung disease should be optimized, including antibiotic therapy targeted to the individual’s usual airway bacteria, prior to considering treatment for NTM lung disease. Those who meet criteria fo r NTM lung disease may not necessarily require treatment and could be monitored expectantly if symptoms and radiographic findings are minimal. However, the presence ofMycobacterium abscessus complex (MABSC), severe lung disease, and/or anticipated ...
Source: Current Treatment Options in Infectious Diseases - October 21, 2016 Category: Infectious Diseases Source Type: research

A Brief History of Biocontainment
Opinion statementThe concept of clinical biocontainment, otherwise known as high-level containment care (HLCC), had its birth among a confluence of near-simultaneous events in 1969. The U.S. Army ’s Medical Research Institute of Infectious Diseases (USAMRIID) began construction of the first modern biocontainment unit that year, and opened the two-bed facility, often referred to as “the Slammer” in 1971. Over its 41-year existence, 21 persons exposed to highly hazardous infectious disea ses were admitted to the Slammer, but none ever contracted the disease to which they had been exposed. Owing, in part, to this underu...
Source: Current Treatment Options in Infectious Diseases - October 19, 2016 Category: Infectious Diseases Source Type: research