Welcome to the WSPID 2022 Virtual Congress Calendar
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Pre-Congress days – 20-21 February
Main Congress days – 22-24 February
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INCIDENCE OF FIRST-CHOICE ANTIRETROVIRAL TREATMENT FAILURE AMONG CHILDREN IN MOZAMBIQUE, 2019
Abstract
Background
Though access to antiretroviral therapy (ART) has increased in recent years, there is limited information about the incidence of treatment failure (TF) among children in Mozambique.
Aims
We aimed to estimate the incidence of TF, the mean time to TF (MTTF), and to identify regimens associated with higher TF among children on ART, in 2019.
Methods
Data from children on ART were obtained from the national ART registry and those with TF from the national ART Committee database. The total TF incidence was calculated by dividing the number of children with TF by the total number of children on ART, in 2019. Regimen-specific incidences were obtained by multiplying the total incidence of TF by the proportion of children with TF in each regimen. The 1000-sample bootstrap was used to calculate 95% CIs.
Results
The incidence of TF was 246.0 (95% CI: 101.2-390.8) cases per 10,000 children per year. Regimens with higher incidence of TF included AZT+3TC+NVP, TDF+3TC+EFV, and ABC+3TC+NVP with 231.5 (95% CI: 96.6-366.4), 4.9 (95% CI: 2.6-7.2), and 2.2 (95% CI: 1.1-3.3) TF cases in 10,000 children per year, respectively. The MTTF was 5.4 years (95% CI: 5.2-5.6), and d4T+3TC+NVP, TDF+3TC+NVP, and AZT+3TC+LPV/r had longer MTTF of 9.5 (95% CI: 3.3-12.7), 8.3 (95% CI: 2.0-10.5), and 7.9 (95% CI: 6.2-11.8), respectively.
Conclusions
The incidence of TF among children on ART was found to be of public health concern. There is need to consider regimens containing protease inhibitors and DTG as first-choice ART among children to achieve sustained viral suppression.
MOLECULAR MECHANISM OF INNATE IMMUNE RESPONSE DURING JAPANESE ENCEPHALITIS VIRUS INFECTION
Abstract
Background
Japanese encephalitis (JE) is an arboviral disease which accounts for significant pediatric mortality annually in Asia and Australia, including India. Encephalitis is merely the result of viral invasion in CNS and pathological consequences. Neuronal loss is the outcome of both JEV infection of neurons and bystander damage caused by activated microglia. Recent studies have shown that micro RNAs (miRs) holds a major platform during JEV infection and modulate cellular pathways to determine the pathological condition.
Aims
Therefore, the present study was planned to characterize the NS3 gene of JEV GP05 and investigate the role of miRs in controlling the IL-10 expression (Th2 response) during JEV infection in macrophages.
Methods
See Methods in following Figure 1
Results
We report that miR-98, miR-27a and miR-106b might have a possible role in posttranscriptional regulation of IL-10 gene expression during JEV infection. Our analysis predicted the novel miRs having potential to bind with the 3’UTR region of IL-10 mRNA. From the predicted miRs, miR-98 and miR-27a were selected on the basis of published article showing their role in regulation of IL-10 expression. Novel microRNA miR-106b was selected on the basis of free energy and prediction from the software. Gel PCR, real time PCR (RT-PCR) and western blotting was performed to validate the data. Our results exhibited the correlation between the expression of IL-10 and three miRNAs mainly miR-98, miR-27a miR-106b during JEV infection.
Conclusions
Collectively our data suggested that miR-98, miR-27a and miR-106b might have potential role in posttranscriptional regulation of Interleukin-10 expression during Japanese encephalitis virus infection.
ZIKACTION PAEDIATRIC REGISTRY: MATERNAL CHARACTERISTICS AND CLINICAL, RADIOLOGICAL, AND FOLLOW-UP FEATURES OF CHILDREN BORN WITH CONGENITAL ZIKA INFECTION IN BRAZIL
Abstract
Background
In 2015, Brazil experienced an unexpected increase in newborns with microcephaly. Subsequently, the association between microcephaly and Congenital Zika Infection (CZI) was confirmed.
Aims
This study, part of the ZIKAction Paediatric Registry, intends to describe clinical, radiological, neurodevelopmental, and laboratory features and follow-up of children with CZI in Bahia, Brazil.
Methods
This observational study had following inclusion criteria: intrauterine exposure to ZIKV, laboratory-confirmed CZI, or meeting the definition of suspected CZI, based on clinical and radiological features.
Results
Of 129 participants, 57% were female. Most mothers (75%) had symptoms suggestive of Zika infection during pregnancy. Median gestational age at delivery was 38 weeks, with 19% delivered preterm. Median birth length and weight were 46cm and 2690g, respectively. Most infants (118, 91.5%) had microcephaly (median head circumference Z-score -3.51, IQR -4.69,-2.73), and 17 (13.2%) have arthrogryposis. During follow-up, 96% and 92% of children had hearing and ophthalmological assessments, with 21% and 57% having abnormalities respectively. Brain image was abnormal in all cases, with ventriculomegaly (70.1%), cerebral parenchyma calcifications (62.1%), and cortical atrophy (48.6%) were main findings. Median age at last follow-up was 5 years; to date, 54 (42%) participants needed hospitalization, 44 (35%) needed care in the emergency department, and two (1.5%) died.
Conclusions
CZI is an emerging disease shown to have a varied spectrum. Registry children were biased towards those with more severe disease, with several abnormalities and complications observed. Continued long-term follow-up is essential to understand the prognosis and clinical spectrum as these children reach school-age.
RESURGENCE OF CHIKUNGUNYA IN THAILAND
Abstract
Background
Chikungunya is a re-emerging infectious disease in Thailand.
Aims
We conducted this study to describe the epidemiological data of chikungunya infection in Thailand.
Methods
Analysis of the data of chikungunya patients reported to Center of Epidemiological Information, Bureau of Epidemiology, Ministry of Public Health, Thailand from January 2008 to December 2019 was done. Diagnosis of chikungunya fever adhered to clinical and laboratory criteria.
Results
From October 2008 onward, chikungunya cases were again reported in Thailand. The disease is more common in rainy season with all age groups affected. The strain in the current outbreak is African strain which is different from Asian strain in the past. The sudden onset of very high fever along with rash, and severe arthralgia especially in the small joints of hands and toes are characteristics of the disease. There was no mortality, however the high morbidity with severe arthralgia persisted for several months made the patient mentally and physically weak.
Conclusions
The implementation of effectively sustainable vector control is a key to success for prevention and control of this disease.
PEDIATRIC NASAL EPITHELIAL CELLS ARE LESS PERMISSIVE TO SARS-COV-2 REPLICATION COMPARED TO ADULT CELLS
Abstract
Background
Children typically experience more mild symptoms of COVID-19 when compared to adults. There is a strong body of evidence that children are also be less susceptible to SARS-CoV-2 infection with the original Wuhan isolate. The reasons for reduced SARS-CoV-2 symptoms and infection in children remain unclear and may be influenced by a multitude of factors, including differences in target cell susceptibility and innate immune responses.
Aims
To investigate differential infection kinetics and antiviral responses to SARS-CoV-2 infection in children and adults.
Methods
We used primary nasal epithelial cells from children and adults, differentiated at an air-liquid interface, to investigate differential infection kinetics and antiviral responses to SARS-CoV-2 infection. Viral replication was quantified by plaque assay. ACE2 protein expression were quantified by Western Blot and immunofluorescence. The cellular transcriptome of infected and uninfected cells was assessed by RNA-sequencing.
Results
Our results show that SARS-CoV-2 (both the Wuhan isolate and the more recent Alpha variant) replicates to significantly lower titers in the nasal epithelial cells of children compared to those of adults. This was associated with a heightened antiviral response to SARS-CoV-2 in the nasal epithelial cells of children. Importantly, influenza virus, a virus whose transmission is frequently associated with pediatric infections, replicated in both adult and pediatric nasal epithelial cells to comparable titres.
Conclusions
We report significantly higher SARS-CoV-2 replication in adult compared to pediatric nasal epithelial cells. Taken together, our data suggest that the nasal epithelium of children supports lower infection and replication of SARS-CoV-2 than the adult nasal epithelium.
DOES DIRECTLY ACTING ANTIVIRAL DRUG THERAPY FOR CHRONIC HCV INFECTION AFFECT THE REMISSION IN SURVIVORS OF CHILDHOOD MALIGNANCY?
Abstract
Background
The effects of the direct-acting antiviral drug therapy (DAA) for chronic hepatitis C on infected survivors of childhood cancer have not been well investigated in pediatric age groups.
Aims
We conducted a prospective multicenter study to investigate the effect of dual sofosbuvir/daclatasvir therapy on both the HCV clearance and state of cancer remission in survivors of childhood cancer infected with chronic HCV.
Methods
Consecutive chronic HCV-infected survivors of childhood malignancy were included in the study. All were treated with SOF/DCV for 12 weeks and were closely monitored for virus load, liver and kidney functions, and hematologic indices. Follow-up was continued for 48 weeks and included clinical examination, imaging studies, and laboratory investigations for evidence of any recurrence or de novo occurrence of malignant disease.
Results
A total of 49 chronic HCV infected pediatric patients were included; 29 survivors of malignant solid tumors, and 20 survivors of hematologic malignancies (leukemia/lymphoma). Their age ranged from 6 to 17 years (mean ± SD = 10.5 ± 3). All patients achieved SVR12 (100% ITT). No single relapse or recurrence was detected for the original malignant disease or the HCV infection. No de novo occurrence of malignancy was also observed throughout the follow-up period of 48 weeks.
Conclusions
SOF/DCV combined therapy might be used safely and effectively in the treatment of chronic HCV infected survivors of solid tumors or hematologic malignancy (leukemia/lymphoma) in pediatric age groups. No relapses were detected during treatment and throughout the follow up period for either the original malignant disease or the HCV infection.