Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Nuevos diagnósticos de VIH en adolescentes en España

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 29-02-2024. Tesis formato europeo (compendio de artículos)El diagnóstico precoz del VIH y la supresión de la carga viral con la terapia antirretroviral(TAR) son los pilares principales para el control de la epidemia VIH/SIDA. Ambos procesos presentan desafíos en adolescentes. Hay pocos estudios sobre esta población en Europa. Objetivos: El objetivo de esta memoria es estudiar los factores relacionados con la presentación tardía (PT) y las características virológicas, como las resistencias transmitidas (RT) y las desarrolladas en TAR con inhibidores de la integrasa (INI), en adolescentes en España. Materiales y métodos: En el capítulo I y II se estudiaron los adolescentes con diagnóstico de VIH de 12 a 19años, incluidos en las cohortes CoRISpe y CoRIS, desde 2004 hasta 2019. Se consideraron PT aquellos que presentaban CD4 <350 células/mm3 o un evento SIDA en los seis meses siguientes al diagnóstico, y PT confirmada (PTc) cuando los CD4 bajos se confirmaron en los 3 meses. Para el capítulo II se seleccionaron a los adolescentes que tenían secuenciasVIH-1 pol anteriores al TAR. En el capítulo III se analizaron los pacientes menores de 18 años con exposición a INI entre 2007 y 2019...Early diagnosis of HIV and viral load suppression with antiretroviral therapy (ART) are the cornerstones for the control of the HIV/AIDS epidemic. Both processes are challenging in adolescents, and there are few studies on this population in Europe. Objectives: The objective of this report is to study the factors related to late presentation (LP) and virological characteristics, such as transmitted drug resistance (TDR) and resistance developed with integrase inhibitor (INI)-based ART, in adolescents in Spain. Materials and Methods: In chapters I and II, adolescents with an HIV diagnosis between the ages of 12 and 19, included in the CoRISpe and CoRIS cohorts from 2004 to 2019, were studied. LP was defined as having CD4 counts <350 cells/mm3 or an AIDS-defining event within six months of diagnosis, and confirmed LP (LPc) when low CD4 counts were confirmed within 3 months. For chapter II, adolescents with available HIV-1 pol sequences before starting ART were selected. In chapter III, patients under 18 years with exposure to INIs between 2007 and 2019 were analyzed...Fac. de MedicinaTRUEunpu

Immunogenicity of the Conjugate Meningococcal ACWY-TT Vaccine in Children and Adolescents Living with HIV

2023 Descuento MDPIBackground: Children and adolescents living with HIV (CALHIV) are at high risk of meningococcal infections and may present lower immune responses to vaccines. The objectives of this study were to assess the immunogenicity of the quadrivalent Men ACWY-TT vaccine (Nimenrix®) in CALHIV after a two-dose schedule and to describe possible HIV-related factors that may affect the immunogenic response. Methods: A multicenter prospective study was designed, including CALHIV followed in five hospitals in Madrid, between 2019 and 2021. Two doses of the Men ACWY-TT vaccine were administered. Serum bactericidal antibody (SBA) assays using rabbit complement (rSBA) against serogroups C, W, and Y were used to determine seroprotection and vaccine response (the proportion achieving a putative protective titer of ≥eight or a ≥four-fold rise in titer from baseline). Serum was collected at baseline, and at 3 and 12 months after vaccination. Results: There were 29 CALHIV included, 76% of whom were perinatally infected. All were receiving TAR and presented a good immunovirological and clinical status overall. At baseline, 45% of CALHIV had seroprotective titers to at least one serogroup, with individual seroprotection rates of 24%, 28%, and 32% against C, W, and Y, respectively. After a two-dose schedule, vaccine response was 83% for each serogroup, eliciting a vaccine response to all serogroups in 69% of them. One year after vaccination, 75% of CALHIV maintained seroprotective titers against the C serogroup, and 96% against W and Y. None of the HIV-related characteristics analyzed could predict vaccine response or antibody duration. Conclusions: CALHIV who received effective TAR and presented a good immuno-virological situation achieved an appropriate vaccine response after two doses of the Men ACWY-TT vaccine, and antibody-mediated protection against serogroups C, W, and Y was maintained in more than 70% of the patients one year after vaccination.Familia Alonso FoundationInstituto de Salud Carlos IIISpanish AIDS Research NetworkDepto. de MedicinaFac. de MedicinaTRUEpubDescuento UC