Infectious Diseases News Brief - February 8, 2013

Severe acute respiratory disease in health-care workers during the influenza H1N1 pandemic in Argentina

Introduction:
During the 2009 influenza H1N1virus pandemic, health-care workers were exposed to elevated risk of infection. The aim of this study was to estimate the risk for severe acute respiratory disease (SARD) in this population during the pandemic period in Argentina.

Methodology:
The researchers conducted a retrospective survey in which all members of the Argentine Society of Infectious Diseases were invited to answer an online survey providing information on health-care staff working at their hospital or health center, who were hospitalized for SARD, between May and August 2009. Results were compared to population-based SARD surveillance data obtained from the Ministry of Public Health.

Results: Fifty hospitals completed the survey. Out of a total population of 58,902 health-care workers, 41 were reported to have been hospitalized for SARD (hospitalization rate 69.6/100000), 19 of whom tested positive for H1N1 using real time polymerase chain reaction. Hospitalization rate in the general population during the same time period was 20.3/100000 (p < 0.01), thus indicating increased SARD hospitalization risk in health-care workers (OR 3.1 95% CI: 2.3 - 4.1; p < 0.01).

Conclusions:
During the 2009 pandemic, health-care workers in Argentina suffered increased risk of hospitalization due to SARD compared to the general population. The researchers recommend immunization of all personnel, as well as enforcing stricter infection control measures in hospitals to prevent future transmission of influenza H1N1virus.

Source: Severe acute respiratory disease in health-care workers during the influenza H1N1 pandemic in Argentina

Prevalent and Incident Hepatitis C Virus Infection among HIV-Infected Men Who Have Sex with Men Engaged in Primary Care in a Boston Community Health Center

Background
Sexually transmitted hepatitis C virus (HCV) infection is an emerging epidemic among HIV-infected men who have sex with men (MSM). HCV may be under-recognized in this population, historically thought to be at low risk.

Methods
The researchers determined the prevalence and incidence of HCV among HIV-infected men at Fenway Health between 1997 and 2009. They describe characteristics associated with HCV.

Results Of 1171 HIV-infected men, of whom 96% identify as MSM, 1068 (91%) were screened for HCV and 64 (6%) had a positive HCV antibody (Ab) result at initial screening. Among the 995 men whose initial HCV Ab was negative, 62% received no further HCV Ab testing. Among the 377 men who had ≥1 additional HCV Ab test, 23 (6%) seroconverted over 1,408 person-years, for an annualized incidence of 1.63/100 person-years (95% CI 0.97–2.30). Among the 87 HIV-infected MSM diagnosed with prevalent or incident HCV, 33% reported history of injection drug use, 46% non-injection drug use (NIDU) and 70% sexually transmitted infections (STI). Sixty-four (74%) of HCV-infected MSM developed chronic HCV; 22 (34%) initiated HCV treatment and 13 (59%) of treated persons achieved a sustained virologic response (SVR).

Conclusion
Prevalent and incident HCV, primarily acquired through non-parenteral means, was common in this HIV-infected population despite engagement in care. STIs and NIDU were common among HIV/HCV coinfected MSM. SVR rates were high among those who underwent HCV treatment. All sexually active and/or substance-using HIV-infected MSM should receive routine and repeated HCV screening to allow for early diagnosis and treatment of HCV.

Source: Prevalent and Incident Hepatitis C Virus Infection among HIV-Infected Men Who Have Sex with Men Engaged in Primary Care in a Boston Community Health Center