The prevalence, incidence and risk factors of herpes simplex virus type 2 infection among pregnant Zimbabwean women followed up nine months after childbirth

Background Herpes simplex virus type 2 (HSV-2) is the leading cause of genital ulcer disease worldwide. The virus can be transmitted to neonates and there are scarce data regarding incidence of HSV-2 among women in pregnancy and after childbirth. The aim of this study is to measure the incidence and risk factors for HSV-2 infection in women followed for 9 months after childbirth. Methods Pregnant women were consecutively enrolled late in pregnancy and followed at six weeks, four and nine months after childbirth. Stored samples were tested for HSV-2 at baseline and again at nine months after childbirth and HSV-2 seropositive samples at nine months after childbirth (seroconverters) were tested retrospectively to identify the seroconversion point. Results One hundred and seventy-three (50.9%) of the 340 consecutively enrolled pregnant women were HSV-2 seronegative at baseline. HSV-2 incidence rate during the 10 months follow up was 9.7 (95% CI 5.4-14.4)/100 and 18.8 (95% CI 13.9-26.1)/100 person years at risk (PYAR) at four months and nine months after childbirth respectively. Analysis restricted to women reporting sexual activity yielded higher incidence rates. The prevalence of HSV-2 amongst the HIV-1 seropositive was 89.3%. Risk factors associated with HSV-2 seropositivity were having other sexual partners in past 12 months (Prevalence Risk Ratio (PRR) 1.8 (95% CI 1.4-2.4) and presence of Trichomonas vaginalis (PRR 1.7 95% CI 1.4-2.1). Polygamy (Incidence Rate Ratio (IRR) 4.4, 95% CI 1.9-10.6) and young age at sexual debut (IRR 3.6, 95% CI 1.6-8.3) were associated with primary HSV-2 infection during the 10 months follow up. Conclusions Incidence of HSV-2 after childbirth is high and the period between late pregnancy and six weeks after childbirth needs to be targeted for prevention of primary HSV-2 infection to avert possible neonatal infections

Genetic and Epigenetic Factors at COL2A1 and ABCA4 Influence Clinical Outcome in Congenital Toxoplasmosis

Background: Primary Toxoplasma gondii infection during pregnancy can be transmitted to the fetus. At birth, infected infants may have intracranial calcification, hydrocephalus, and retinochoroiditis, and new ocular lesions can occur at any age after birth. Not all children who acquire infection in utero develop these clinical signs of disease. Whilst severity of disease is influenced by trimester in which infection is acquired by the mother, other factors including genetic predisposition may contribute.Methods and Findings: In 457 mother-child pairs from Europe, and 149 child/parent trios from North America, we show that ocular and brain disease in congenital toxoplasmosis associate with polymorphisms in ABCA4 encoding ATP-binding cassette transporter, subfamily A, member 4. Polymorphisms at COL2A1 encoding type II collagen associate only with ocular disease. Both loci showed unusual inheritance patterns for the disease allele when comparing outcomes in heterozygous affected children with outcomes in affected children of heterozygous mothers. Modeling suggested either an effect of mother's genotype, or parent-of-origin effects. Experimental studies showed that both ABCA4 and COL2A1 show isoform-specific epigenetic modifications consistent with imprinting.Conclusions: These associations between clinical outcomes of congenital toxoplasmosis and polymorphisms at ABCA4 and COL2A1 provide novel insight into the molecular pathways that can be affected by congenital infection with this parasite

Forekomst av rabdomyolyse hos friske forsøkspersoner etter en hard treningsøkt

Bakgrunn Forekomsten av treningsinsdusert rabdomyolyse har vært økende de siste årene. Formålet med studien var å undersøke hvor stor andel av friske forsøkspersoner som utviklet stigning i kreatinkinase (CK) og kreatinin, og utslag på urinstiks etter å ha gjennomført en hard treningsøkt, og om det var en sammenheng mellom treningsbakgrunn, smerte og CK-verdi. Vi ønsket å kartlegge den fysiologiske spredningen, samt hvilke variabler som disponerte for større biokjemiske avvik. Materiale og metode Vi rekrutterte 24 medisinstudenter ved NTNU til å gjennomføre en høyintensitets styrketreningsøkt. Deltakerne utførte totalt 8 ulike øvelser. Hver øvelse ble gjort kontinuerlig i 20 sekunder, etterfulgt av 10 sekunders pause, til sammen 6 ganger. Mellom de ulike øvelsene fikk deltakerne 1 minutt pause. Deltakerne svarte på spørreskjema, og det ble tatt urin- og blodprøver 1 dag før og 4 dager etter treningsøkten. Resultat Samtlige deltakere utviklet stigning i CK. Ved baseline var median CK 104 U/l. Ved dag 4 var den steget til 6624 U/l. Det tilkom ingen kreatininstigning. Fire personer fikk utslag for blod på urinstiks dag 4. Det ble ikke funnet noen sammenheng mellom muskelsmerte, treningsbakgrunn og CK-nivå dag 4. Tolkning Våre data viser at CK-stigning og muskelsmerte er et normalfenomen etter en hard treningsøkt, uten at det foreligger stor risiko for nyreskade. Større studier er nødvendig for å påvise sammenheng mellom treningsbakgrunn, smerte og CK-stigning