RESUMO
BACKGROUND: The long-term clinical course of patients with an enterovirus central nervous system infection (ECI) is poorly understood. METHODS: We performed a nationwide population-based cohort study of all Danish patients with ECI diagnosed 1997-2016 (nâ =â 1745) and a comparison cohort from the general population individually matched on date of birth and sex (nâ =â 17â 450). Outcomes were categorized into mortality and risk of cancer and likely measures of neurological sequelae: neuropsychiatric morbidities, educational landmarks, use of hospital services, employment, receipt of disability pension, income, number of sick leave days, and nursing home residency. RESULTS: Mortality in the first year was higher among patients with ECI (mortality rate ratioâ [MRR] =â 10.0; 95% confidence interval [CI], 4.17-24.1), but thereafter mortality was not higher (MMRâ =â 0.94; 95% CI, 0.47-1.86). Long-term outcomes for patients with ECI were not inferior to those of the comparison cohort for risk of cancer, epilepsy, mental and behavioral disorders, dementia, depression, school start, school marks, high school education, use of hospital services, employment, receipt of disability pension, income, days of sick leave, or nursing home residency. CONCLUSIONS: Diagnosis of an ECI had no substantial impact on long-term survival, health, or social/educational functioning.
Assuntos
Infecções do Sistema Nervoso Central/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Emprego/estatística & dados numéricos , Infecções por Enterovirus/epidemiologia , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Infecções do Sistema Nervoso Central/virologia , Criança , Pré-Escolar , Estudos de Coortes , Dinamarca/epidemiologia , Pessoas com Deficiência/psicologia , Escolaridade , Enterovirus/isolamento & purificação , Infecções por Enterovirus/virologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Vigilância de Evento Sentinela , Sobreviventes/psicologia , Adulto JovemRESUMO
We describe a rare case of hepatitis A virus (HAV) replication in feces despite presence of hepatitis A antibodies in an acute myeloid leukemia (AML) patient after transfusion with HAV contaminated platelets. The patient has been vaccinated against HAV years before the AML diagnosis. Transient infection and reshedding should thus be considered in antibody-positive hematological patients. Transfusion associated HAV transmission is rare, and little evidence exists on the clinical consequences and possible effect of treatment with immunoglobulin. Further reporting on fecal shedding despite antibodies are needed, as HAV antibody levels are used as course of action for post-exposure prophylaxis and infection control.