Recent advances of graft-versus-host disease prevention strategies have led to improved overall survival after hematopoietic cell transplantation (HCT). Whether cytomegalovirus (CMV) viral load continues to predict CMV disease, overall mortality and non-relapse mortality is poorly defined.MethodsCMV seropositive patients undergoing allogeneic HCT between 2007-2017 with weekly CMV DNA PCR surveillance and preemptive therapy were analyzed. Multivariate Cox proportional hazards models were used to estimate the association between CMV viral load by day 100 at different thresholds with CMV disease, overall and non-relapse mortality up to one year post HCT.ResultsOf 1539 patients transplanted in the study period, 1349 survived >100 days after HCT and were included in the analyses. By day 100 post-HCT, CMV reactivation at any level was observed in 76% with the lowest incidence at all levels in young children. Pediatric patients had significantly less cytomegalovirus disease compared to the adult population. CMV reactivation was associated with a higher risk of CMV disease [aHR 6.8 (3.54-13)]; it was also associated with overall and non-relapse mortality among day 100 survivors, although the association was diminished recently. The strongest correlation was still apparent between viral load and mortality in patients with a viral load >3 log10 and lymphocyte counts <300 cells/mm3.ConclusionsCMV viral load continued to be a strong predictor for CMV disease. With improved transplantation techniques, the association of viral load with overall and non-relapse mortality is diminished, but the effect was still present in patients with severe immunosuppression.

Bluesky posts about science garner more likes and reposts than similar ones on X.

Pneumonia is one of the most common nosocomial infections in the intensive care unit (ICU), with reported morbidity ranging from 6.8% to 68% (1, 2) and high mortality rates between 20.9% and 65% (2–4)...

A member of the CDC’s Advisory Committee on Immunization Practices is spreading misinformation about new antibody treatments that protect children from serious Respiratory Syncytial Virus infections.

Department of Health introduced new vaccination programme for babies last year

Cristina Garcia-Mauriño, MD, PhD, Helena Brenes-Chacon, MD, Cristina Tomatis-Souverbielle, MD, Pablo J Sanchez, MD, Octavio Ramilo, MD, Asuncion Mejias, MD

An influential U.S. medical journal is rejecting a call from Health Secretary Robert F. Kennedy Jr. to retract a large Danish study that found that aluminum ingredients in vaccines do not increase health risks for children, the journal's editor told Reuters.

In the real-world setting of the first season of vaccine implementation in England and Scotland, maternal RSVpreF vaccination was effective and equivalent to trial settings in reducing the risk of hos...

In the first sentence of their recent study (1), Gil-Gil and Berryhill cite a 2018 review article (2) to support the statement, “The clinical outcomes of antibiotic treatments involving the administra...

In the first sentence of their recent study (1), Gil-Gil and Berryhill cite a 2018 review article (2) to support the statement, “The clinical outcomes of antibiotic treatments involving the administra...

Next-generation pneumococcal conjugate vaccines (PCVs) target an expanding array of serotype antigens. We assessed the proportions of invasive pneumococcal disease (IPD) and pneumococcal acute respiratory infections (ARIs) caused by serotypes targeted by existing and pipeline PCVs, and annual U.S. pneumococcal disease burdens potentially preventable by these products.MethodsWe estimated serotype distribution and proportions of pneumococcal ARIs (acute otitis media [AOM; children only], sinusitis, non-bacteremic pneumonia) and IPD attributable to serotypes targeted by each PCV using Markov chain Monte Carlo approaches incorporating data from epidemiological studies and Active Bacterial Core Surveillance. We then estimated annual numbers of outpatient-managed ARIs, non-bacteremic pneumonia hospitalizations, and IPD cases potentially preventable by PCVs by multiplying disease incidence rates by PCV-targeted disease proportions and vaccine effectiveness estimates.ResultsIn children, PCV15, PCV20, PCV24, PCV25, and PCV31 serotypes account for 16% (95% confidence interval: 15-17%), 31% (30-32%), 34% (32-35%), 43% (42-44%), and 68% (67-69%) of pneumococcal AOM, respectively. In adults, PCV15, PCV20, PCV21, PCV24, PCV25, and PCV31 serotypes account for 43% (38-47%), 52% (47-57%), 69% (64–73%), 65% (61-70%), 62% (57-67%), and 87% (83-90%) of pneumococcal non-bacteremic pneumonia. For IPD, 42-85% of pediatric and 42-94% of adult cases were due to PCV-targeted serotypes. PCV-preventable burdens encompassed 270,000-3,300,000 outpatient-managed ARIs, 2,000-17,000 pneumonia hospitalizations, and 3,000-14,000 IPD cases annually.ConclusionsAcross pneumococcal conditions, coverage and preventable burdens were lowest for PCV15 and highest for PCV31, with PCV21 also targeting sizeable burdens of adult disease. Comparative estimates of preventable disease burden may inform future policy.