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August 2008
Vol. 18 No. 8
In the IDSA Journals

Valganciclovir to Prevent Kaposi Sarcoma?

Valganciclovir, a pro-drug for the anti-cytomegalovirus (CMV) agent ganciclovir, reduced replication of human herpesvirus-8 (HHV-8) in oropharyngeal swab samples in a randomized, double-blind, placebo-controlled crossover trial of 26 men.  Virus was detected on about half as many days in the saliva of subjects receiving valganciclovir, and the quantity of virus detected was significantly reduced. The study suggests valganciclovir should be studied for clinical efficacy in preventing Kaposi sarcoma, primary effusion lymphoma, and multicentric Castleman disease caused by HHV-8. (Casper et al., J Infect Dis. 2008;198:23-30. Commentary by Crumpacker, J Infect Dis. 2008;198:6-7.)

Genetics of Smallpox Vaccine Adverse Events

Using data from two separate smallpox vaccine trials, researchers found two genes strongly associated with systemic adverse events in both trials. One gene, MTHFR, is involved in DNA synthesis and repair and has been implicated in adverse reactions to several other pharmacological agents. The other, IRF-1, codes for an interferon regulatory factor, one of a family of proteins that viruses commonly target to suppress host immune responses. (Reif et al., J Infect Dis. 2008;198:16-22. Commentary by Relman, J Infect Dis. 2008;198:4-5.)

Iron Deficiency Protects Pregnant Women against Malaria

Iron-deficient pregnant women were less likely to have placental malaria than women with normal iron levels in a study of 445 women in Tanzania. Logistic regression analysis found iron-deficient women were 80 percent less likely (P<0.0001) to have placental malaria than women with normal iron status. The effects were most pronounced among women in their first pregnancy, and suggest the need for more study into the risks and benefits of iron supplementation for anemia. (Kabyemela et al., J Infect Dis. 2008;198:163-166. Commentary by Daily and Wiley, J Infect Dis. 2008;198:157-158.)

Control of an Institutional Outbreak of Influenza

This study compared facilities that began chemoprophylaxis for influenza A five or fewer days after the start of an outbreak with facilities that began chemoprophylaxis more than five days after the start of an outbreak. Early intervention resulted in shorter outbreaks, lower incidence rates, and lower case-fatality rates. (Rubin et al., Clin Infect Dis. 2008;47:47-52.)

Catheter Lock Solutions for Hemodialysis  

Central venous catheter-related blood stream infection is an important cause of morbidity and mortality among hemodialysis patients. This review of 16 randomized trials compared antibiotic lock solutions with heparin and found that antibiotic locks reduced bloodstream infections. (Yahav et al., Clin Infect Dis. 2008;47:83-93.)

MRSA Infection Risk in Long-term Carriers

The authors had previously found that 33 percent of new carriers of methicillin-resistant Staphylococcus aureus (MRSA) in a tertiary care center developed invasive infections in the year after acquisition. Here, they have extended the study to evaluate the risk of subsequent MRSA infection among patients known to have harbored MRSA for at least one year. A total of 23 percent of the carriers developed MRSA infection within one year. Pneumonia, soft-tissue infection, and central venous catheter infection were the most common infections. (Datta and Huang et al., Clin Infect Dis. 2008;47:176-181.)

More from the literature: the IDSA Journal Club

Don’t miss this feature to help you stay up to date on the infectious diseases literature. Each month, the IDSA Journal Club features brief summaries of key infectious diseases studies in the previous month’s major journals chosen by the new IDSA Literature Review Panel.

In addition, the “In This Issue” section of each issue of Clinical Infectious Diseases highlights several important studies from that journal. (Click for August 1 or August 15.)

For a review of other recent research in the infectious diseases literature, see “In the Literature,” by Stanley Deresinski, MD, in each issue of Clinical Infectious Diseases.

August 1:

  • TIBOLA and DEBONEL in Tuscanya
  • Chronic Hepatitis E Virus (HEV) Infection
  • Probiotics and Severe Acute Pancreatitis
  • Invasive Candidiasis in Patients with Cancer

August 15:

  • Idiopathic CD4+ Lymphocytopenia (ICL)
  • Failure of Therapy for Chronic Hepatitis C Virus (HCV) Infection: An Increased Response to Endogenous IFN Interferes with a Therapeutic Response to Exogenous IFN
  • Abacavir: Better Living through Pharmacogenomics
  • Identification of a Novel Arenavirus Transmitted by Organ

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