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Dilemmas and Pitfalls in Rubella Laboratory Diagnostics in Low Prevalence or Elimination Settings
Opinion statementThe changing epidemiology of rubella in populations with either low prevalence levels, or where rubella elimination has been achieved, has challenged laboratory diagnostics. This review will discuss the challenges in identification of acute rubella and outline appropriate confirmatory testing, particularly for cases with low pretest probability. Implementation of pre-analytical screening processes can mitigate follow-up testing required to confirm false positive antibody results, and laboratories should consider not accepting requests for testing that do not have appropriate travel or clinical history. The...
Source: Current Treatment Options in Infectious Diseases - October 18, 2016 Category: Infectious Diseases Source Type: research

Drug Interactions Associated with HIV and HCV Medications
Opinion StatementThe management of HCV in the setting of HIV co-infection has been transformed with the availability of the direct-acting antivirals. Cure rates for HCV in co-infection are greater than 90  % in all genotypes. Even difficult to treat patients with cirrhosis can be successfully treated with newer regimens. Consensus guidelines are available to assist providers in selecting appropriate regimens. Despite their widespread success, drug interactions when combining HIV and HCV medications are complex, but manageable. In this review, an in-depth description of how DAAs and HIV medications are metabolized is provi...
Source: Current Treatment Options in Infectious Diseases - October 18, 2016 Category: Infectious Diseases Source Type: research

Hepatitis C Treatment in HIV Coinfection: Approaches, Challenges, and Future Opportunities
Opinion statementHuman immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection is a significant cause of morbidity and mortality in people living with HIV/AIDS. Indeed, HCV is more likely to progress to end-organ dysfunction in HIV-infected people, and fibrosis progresses more quickly in this population than in the general population. While historical treatments combining interferon and ribavirin were less efficacious in HIV/HCV coinfection, modern direct-acting antiviral (DAA) therapies have shown similar clinical efficacy in HIV/HCV coinfection as in HCV monoinfection. In light of these findings, HIV/HCV-coi...
Source: Current Treatment Options in Infectious Diseases - October 16, 2016 Category: Infectious Diseases Source Type: research

New Era of TB Drug Discovery and Its Impact on Disease Management
Opinion statementTuberculosis (TB) is a devastating infectious disease that continues to plague the world, despite improved hygiene, massive vaccination efforts and an arsenal of chemotherapeutic agents.Mycobacterium tuberculosis (Mtb), the causative agent of TB, is a slow-growing bacterium that naturally resists most currently known antibiotics. Emergences of ever-increasing drug-resistant Mtb strains threaten our ability to control the disease. Unfortunately, lethargic drug development efforts led to the approval of only one new TB drug in the last 50  years by the US Food and Drug Administration. This dismal progress w...
Source: Current Treatment Options in Infectious Diseases - October 13, 2016 Category: Infectious Diseases Source Type: research

Management of Hepatitis C Virus —Genotypes 4, 5, and 6 Using Direct Antiviral Agents: Review of Current Status
Opinion StatementA small number of studies were done on Hepatitis C virus genotypes 4, 5, and 6; that is why limited data were available on the most effective management for these patients. In the past, treatment of this kind of patients depended on the use of the suboptimal regimen of interferon with ribavirin achieving moderate efficacy with numerous side effects. However, with the introduction of the new directly acting antiviral drugs (DAAs), multiple agents became available for treatment showing high success rates, excellent tolerability, and few adverse events. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - October 13, 2016 Category: Infectious Diseases Source Type: research

Treatment of Non-Tuberculous Mycobacterial Lung Disease
Opinion statementTreatment of non-tuberculous mycobacterial lung disease (NTM-LD) is challenging for several reasons including the relative resistance of NTM to currently available drugs and the difficulty in tolerating prolonged treatment with multiple drugs. Yet-to-be-done, large, multicenter, prospective randomized studies to establish the best regimens will also be arduous because multiple NTM species are known to cause human lung disease, differences in virulence and response to treatment between different species and strains within a species will make unbias randomization difficult, the need to distinguish relapse fr...
Source: Current Treatment Options in Infectious Diseases - October 10, 2016 Category: Infectious Diseases Source Type: research

Japanese Surveillance Systems and Treatment for Influenza
Opinion statementInfluenza management and surveillance programs in Japan possess several unique features. The national influenza surveillance is affiliated with National Epidemiological Surveillance for Infectious Diseases (NESID) and features sentinel outpatient surveillance, virological surveillance, and reports on hospitalization, mortality, and influenza-associated encephalopathy. Of note, information on the number of student absences and class/grade/school closures due to influenza are also reported to the government and made publically available. A private online influenza surveillance portal by volunteer doctors pro...
Source: Current Treatment Options in Infectious Diseases - October 9, 2016 Category: Infectious Diseases Source Type: research

Treatment of Early Hepatitis C Infection in HIV-Infected Men —When to Treat, Whom, and with What?
Opinion StatementThere has been an expanding international epidemic of sexually transmitted hepatitis C virus (HCV) infection among HIV-infected men who have sex with men (MSM) since the turn of the twenty-first century, resulting in a progressively increasing number of these men presenting with early HCV infection in need of treatment. We and others have recently performed studies using short-course treatment with direct-acting antiviral (DAA) regimens in patients with early HCV infection that found similar or better cure rates compared to historical studies treating patients with chronic HCV. These studies provide furthe...
Source: Current Treatment Options in Infectious Diseases - October 9, 2016 Category: Infectious Diseases Source Type: research

Hepatitis C Treatment in People Who Inject Drugs
Opinion statementThe introduction of interferon-free direct-acting antiviral therapy for HCV has been a defining moment in medicine. These new medications have begun the discussion about potential hepatitis C elimination. In the developed world, the majority of new and existing hepatitis C infections occur among people who inject drugs. Although considerable barriers exist to link and engage people who inject drugs in medical care, these barriers should not exclude them from hepatitis C treatment. It has been clearly demonstrated that people who inject drugs can be effectively treated for hepatitis C with high rates of adh...
Source: Current Treatment Options in Infectious Diseases - October 9, 2016 Category: Infectious Diseases Source Type: research

Influenza Seasonality
SummaryThe seasonality of influenza continues to attract many studies, yet there is likely to be no definitive explanation that covers all regions, climates and populations, at all times. The influenza seasonality in each area is most likely the result of a number of factors contributing to different degrees to the observed incidence and timing of influenza infections. However, despite the massive growth in the human population and its global mobility over the last 40 –50 years, it is remarkable how the patterns of seasonal influenza incidence have remained relatively unchanged in temperate, subtropical and tropical reg...
Source: Current Treatment Options in Infectious Diseases - October 4, 2016 Category: Infectious Diseases Source Type: research

Preparing a Hospital for Ebola Virus Disease: a Review of Lessons Learned
Opinion StatementThe 2014 Ebola epidemic provided unique insight into how modern hospitals must prepare to handle a disease associated with high transmissibility and mortality. Given the cost and resources required for hospital preparedness, a tiered approach was taken with US hospitals to facilitate a coordinated response. Effective patient screening at points of entry should be prioritized by all hospitals during an Ebola epidemic. Emphasis should be placed on healthcare worker training in safety protocols (particularly doffing personal protective equipment) and preparing to manage significant volumes of highly infectiou...
Source: Current Treatment Options in Infectious Diseases - September 30, 2016 Category: Infectious Diseases Source Type: research

Treatment of hepatitis C in renal impairment and renal transplant
Opinion statementChronic hepatitis C infection is a major cause of morbidity and mortality in the USA. Treatment options have progressed from interferon-based regimens with moderate efficacy and many adverse effects to the use of directly-acting antiviral agents that are highly efficacious with limited side effect profiles. There is a disproportionate number of patients with end-stage renal disease who are infected with hepatitis C and have an increased risk of cirrhosis and hepatocellular carcinoma, while suffering from a lower quality of life. Renal transplant patients with hepatitis C additionally have an increased risk...
Source: Current Treatment Options in Infectious Diseases - September 29, 2016 Category: Infectious Diseases Source Type: research

A Clinician ’s Guide to the Treatment of Vancomycin Resistant Enterococci Bacteremia and Endocarditis
< h3 class= " a-plus-plus " > Opinion statement < /h3 > < p class= " a-plus-plus " > Treatment of serious enterococcal infections is often difficult due to the inherent high level of antimicrobial resistance seen among some species including a rising level of high level aminoglycoside resistance (HLAR), vancomycin resistance (VRE), and multidrug resistance. Prior to the turn of this century, therapeutic options were limited and relied primarily on the use of ampicillin, aminoglycosides, and vancomycin. Over the past two decades, treatment has changed with the introduction of new antimicrobials with activity against VRE and...
Source: Current Treatment Options in Infectious Diseases - July 27, 2016 Category: Infectious Diseases Source Type: research

Update on Treatment for Cystic Echinococcosis of the Liver
< h3 class= " a-plus-plus " > Opinion Statement < /h3 > < p class= " a-plus-plus " > Cystic echinococcosis (CE) is a chronic, complex, and neglected disease. Its treatment depends on a number of factors, such as location, size, and stage of the cysts, and availability of therapeutic options. Despite the wealth of scientific literature on treatment for echinococcosis, the current management of the disease is based on poor to moderate quality of evidence and recommendation strength. In addition, therapeutic strategies have been developed over time without systematic and adequate evaluation of their efficacy, effectiveness, a...
Source: Current Treatment Options in Infectious Diseases - July 22, 2016 Category: Infectious Diseases Source Type: research

Zika Virus: Where Is the Treatment?
(Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - July 7, 2016 Category: Infectious Diseases Source Type: research