Evaluation of Corneal and Retinal Toxicity in Rheumatoid Arthritis Patients Treated with Hydroxychloroquine.

INTRODUCTION: The study aimed to assess the ocular toxicity of hydroxychloroquine (HCQ) by confocal microscopy, multifocal electroretinography (mfERG), and scanning laser polarimetry with variable corneal compensation (GDxVCC) in patients with rheumatoid arthritis (RA). METHODS: A cross-sectional, comparative case series study was retrospectively conducted on 61 patients under HCQ treatment for RA without fundoscopic anomalies (group 1), 65 RA patients with no HCQ treatment (group 2), and 27 normal subjects (group 3). A comprehensive ophthalmological examination, including confocal microscopy, mfERG, and GDxVCC, was performed in the three groups. RESULTS: In group 1, the duration of treatment ranged from 19 to 96 months (54.9 ± 15.2 months). The mean cumulative dose of HCQ was 446.1 ± 164.0 g (range 114-864 g). Confocal microscopy revealed hyper-reflective abnormal particles in 45 patients (73.8%) and beaded, tortuous fibers in 34 patients (55.7%) in group 1. No corneal change was observed in the other two groups. The mfERG responses in the 6 concentric rings (R1-R6) among the three groups differed except at R3 (all p < 0.05), and data from R1-R6 were not significantly different between groups 2 and 3. The retinal nerve fiber layer thicknesses were statistically thinner in group 1 than in groups 2 and 3 (all p < 0.05). CONCLUSIONS: Early signs of corneal and neural retina structure changes were detected in patients with RA treated with HCQ. Whether these findings should be a mark of drug recession still needs further study and more evidence.

Molecular detection and phylogenetic analysis of human parechovirus in individuals with acute diarrhea and healthy controls in Guangzhou, China.

Human parechoviruses (HPeVs) are prevalent in young children; however, their effects are incompletely understood. We investigated the prevalence, genotype distribution, and phylogeny of HPeVs in individuals with diarrhea (n = 430) and healthy controls (n = 93) by the analysis of stool specimens collected from July 2013 to December 2014; 51 (11.86%) and 6 (6.45%) specimens were HPeV positive, respectively. HPeV1A occurred in 28 (6.51%) and 6 (6.45%) individuals with diarrhea and controls, respectively, whereas HPeV1B (3.95%), HPeV3 (0.23%), HPeV4 (0.70%), and HPeV14 (a rare genotype, 0.47%) were only detected in individuals with diarrhea. There was no significant difference in the rate of HPeV detection between the 2 groups; however, the mean age of HPeV infection was significantly lower in males. We conclude that HPeVs may be opportunistic pathogens associated with acute diarrhea. Immunocompromised individuals, such as children aged under 2 years and the elderly, could be vulnerable to HPeV infections.

Diversity and recombination of human parechovirus in children with acute gastroenteritis in Guangzhou, China.

Human parechovirus (HPeV), a member of Picornaviridae family, is a widespread pathogen causing a wide spectrum of diseases. Like other picornaviruses, HPeV genome recombination has been detected. A total of 322 fecal samples were collected from children outpatients in Guangzhou, China, including 42 (13.0%, 42/322) HPeV-positive samples detected in most of the infected children less than two years old. Seven HPeV genotypes (HPeV1, HPeV3, HPeV4, HPeV5, HPeV6, HPeV8 and HPeV14) were detected, among which, HPeV14, a rare genotype, was reported for the first time in children with acute gastroenteritis in China. This study revealed recombination events in eight samples. Clinical profiles did not yield statistical significance between children with HPeV infection alone and cases without pathogens detected. In conclusion, this study demonstrated that HPeV circulated in Guangzhou, China is diverse genetically, which provided evidence of recombination in HPeV in China.

The association between C-159T polymorphism in CD14 gene and susceptibility to tuberculosis: a meta-analysis.

The association between CD14 gene C-159T polymorphism and tuberculosis (TB) susceptibility remains inconclusive. To derive a more precise estimation of the correlation, we performed a meta-analysis summarize the possible at a systematic manner. PubMed, HighWire and ScienceDirect databases covering all papers (up to November 2012) were searched. Statistical analyses were conducted by Rev-Man and STATA. Random- and fixed-effect models were used to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs), based on between-study heterogeneity. Eight published case-control studies investigating the relationship between C-159T polymorphism in CD14 gene and TB susceptibility were included. Results showed that individuals with T allele have an increased risk of TB compared with those with C allele (OR (95% CI) was 1.52 (1.11, 2.08) for TT vs. TC + CC, P < 0.001; 1.27 (1.01, 1.61) for T vs. C, P = 0.04). When stratified by ethnicity, variant TT homozygote carriers had an 86% increased risk of TB in Asians (OR (95% CI) was 1.86 (1.57, 2.20) for TT vs. TC + CC, P < 0.001), but not in Caucasians (OR (95% CI) was TT vs. TC + CC: OR = 0.78, 95% CI = 0.51-1.21, P = 0.61). This meta-analysis suggests that C-159T polymorphism in CD14 gene is associated with increased risk of TB, especially in Asians, but not in Caucasians.

The risk of herpes simplex virus and human cytomegalovirus infection during pregnancy upon adverse pregnancy outcomes: A meta-analysis.

BACKGROUND AND OBJECTIVES: Herpes simplex virus (HSV) and human cytomegalovirus (HCMV) are widespread infections in humans, yet their impact on adverse pregnancy outcomes is controversial. The objective of this study was to evaluate the impact of HSV and HCMV infections during pregnancy on adverse pregnancy outcomes. METHODS: A systematic literature search was performed using Web of Science, Scopus, Medline, Embase, PubMed, and the Cochrane Library database for relevant publications up to 2nd August 2017. The odds ratio (OR) and relative risk (RR), and their corresponding 95% confidence intervals (CIs) were selected as the effect size. Statistical analysis was conducted using STATA 12.0. RESULTS: In total, 20 eligible studies were identified and included in the meta-analysis. Of these, 13 and 12 studies were related to the impact of HSV and HCMV upon adverse pregnancy outcomes, respectively. Collectively, the results indicated that HSV infection during pregnancy increased the risk of spontaneous abortion, premature birth and stillbirth with an OR of 3.81 (95% CI: 1.96-7.41), 3.83 (95% CI: 1.17-12.54), and 1.78 (95% CI: 1.08-2.95), respectively. HCMV infection during pregnancy also represented a risk factor for spontaneous abortion, premature birth and stillbirth with an OR of 1.61 (95% CI: 1.14-2.27), 1.86 (95% CI: 1.26-2.76) and 5.74 (95% CI: 2.04-16.12), respectively. CONCLUSIONS: Maternal HSV and HCMV infection during pregnancy increase the risk of spontaneous abortion, premature birth, and stillbirth.

Dengue virus infection during pregnancy increased the risk of adverse fetal outcomes? An updated meta-analysis.

OBJECTIVE: To evaluate the effect of maternal dengue virus (DENV) infection during pregnancy in premature birth, low birth weight, miscarriage and stillbirth. METHODS: Systematic electronic literature searches were conducted including PubMed, Medline, Embase, Web of science, Scopus and the Cochrane Library database, up until July 5, 2017. Effect sizes were estimated by using the relative risk (RR) or odds ratio (OR) with theirs corresponding 95% confidence interval (CI). Subgroup analyses were conducted for study design (prospective or retrospective) and clinical symptom of participants (symptomatic or asymptomatic). Statistical analysis was conducted by STATA 12.0. RESULTS: The initial systematic literature searches identified 1048 studies. After screening, fourteen studies were included. The pooled results did not suggest maternal DENV infection might increase the risk of adverse fetal outcomes with a pooled RR of 0.96 (95% CI: 0.85-1.09, I2=49.6%) for premature birth, RR of 0.99 (95%CI: 0.87-1.12, I2=35.1%) for low birth weight, OR of 1.77 (95% CI: 0.99-3.15, I2=17.5%) for miscarriage and RR of 3.42 (95% CI: 0.76-15.49, I2=54.8%) for stillbirth. Subgroup analysis of studies in symptomatic participants still did not indicate DENV infection appeared to be a risk factor for premature birth, low birth weight and miscarriage with pooled effect size of 0.99 (95% CI: 0.87-1.13, I2=49.3%), 1.22 (95% CI: 0.827-1.80, I2=55.1%) and 1.19 (95% CI: 0.56-2.55, I2=4.7%), respectively. CONCLUSIONS: Current evidence did not suggest that maternal DENV infection during pregnancy might increase the risk of premature birth, low birth weight, miscarriage and stillbirth.

Molecular Detection and Phylogenetic Characterization of Bat and Human Adenoviruses in Southern China.

Several novel adenoviruses (AdVs) have recently been identified in humans and other animal species. In this study, we report the molecular detection of and phylogenetically characterize bat and human AdVs detected in fecal or rectal swab samples collected in southern China. To detect AdVs, a 252-261 bp fragment of the DNA polymerase (DPOL) gene was amplified using nested PCR. A total of 520 rectal swab samples were collected from eight bat species in four geographic regions of southern China (Guangzhou, Yunfu, Huizhou, and Haikou city). Thirty-six (6.9%) samples from the following species tested positive for AdVs: Myotis ricketti, Miniopterus schreibersii, Scotophilus kuhlii, Taphozous melanopogon, Rhinolophus blythi, and Cynopterus sphinx. Eight novel AdVs were detected in 13.3% of the samples from C. sphinx. Of 328 fecal samples from patients with diarrhea, 16 (4.9%) were positive for classical human AdVs. Phylogenetic analysis showed that human AdVs shared low similarity (57.1-69.3%) with bat AdVs in deduced amino acid sequences of the AdV DPOL region. Thus, our study indicated that bat AdVs and human AdVs are species specific. As such, there is no evidence of cross-species transmission of AdV between bats and humans based on current data.