The epidemiology of genital herpes is changing with evidence to suggest an increasing incidence of herpes simplex virus type 1 (HSV-1) infections. The results of 6529 HSV genital cultures taken between April 1998 and December 2001 were reviewed. Overall, HSV-1 was recovered more often than HSV-2; 1213 versus 1045. This trend was particularly striking in young women 30 years of age or less, in whom 70.8&#x25; of isolates were HSV-1. In men of the same age range, 45&#x25; of isolates were HSV-1. The proportion of women with HSV-1 declined from 73.7&#x25; in those younger than 31 years of age to 4.5&#x25; in those older than 60 years of age.These observations have important implications. The decline in the relative proportion of HSV-1 isolates from young adults may be the result of changing sexual practices, changing susceptibility or increased exposure to HSV-1 during vaginal intercourse. In this setting HSV-2 vaccines may be less likely to produce the desired reduction in the overall prevalence of genital herpes infections.

Kevin R Forward

Spencer HS Lee

Predeominace of Herpes Simplex Virus Type 1 from Patients with Genital Herpes in Nova Scotia

INTRODUCTION: The number of antiretroviral agents available for children who are failing existing therapy is limited. Data are lacking on the use of various combination regimens and the resulting viral load dynamics in such children.METHODS: Between March 1998 and March 2000, HIV-infected children younger than 18 years of age were studied in an open trial. The study regimen included ritonavir, with at least two drugs to which the virus was known or presumed to be sensitive. subjects were ritonavir-naive and were included if they had high viral loads while receiving antiretroviral therapy. Patients had clinical assessments, CD4 counts and viral load monitoring.RESULTS: Fifteen antiretroviral-experienced HIV-infected children were enrolled. Approximately 87&#x25; (13 of 15) had perinatally-acquired HIV; median age was 7.9 years (range 1.6 to 14.8). At enrolment, the median CD4 count was 557 cells/mm3 (range 57 to 1702) and the median viral load was 72,600 copies/mL (range 3626 to 796,440). The majority of children (73.3&#x25;) had increases in CD4 counts within 12 weeks. During this period, the median increase in CD4 counts over baseline was 30.0&#x25;. Approximately 73&#x25; (eight of 11) of subjects with initial improvements in CD4 counts had sustained increases at 32 to 48 weeks. Over the first 12 weeks, 60&#x25; (nine of 15) had greater than 0.5 log10 decreases in viral load. The improvement was sustained in 88.9&#x25; (eight of nine) of these patients at 32 to 48 weeks. Three patients discontinued therapy due to taste aversion.CONCLUSIONS: Among pediatric patients with high viral loads while on existing therapy, the ritonavir-containing regimen was generally well tolerated. In a significant proportion of patients, modification of therapy was associated with sustained improvements in viral loads and CD4 counts over 32 to 48 weeks.

Upton D Allen

Normand Lapointe

Stanley E Read

Jack C Forbes

Susan M King

Samia Wasfy

the Canadian Pediatric AIDS Research Group

Response to a Protease-Inhibitor (Ritonavir)-Containing Combination Antiretroviral Regimen in HIV-Infected Children

OBJECTIVE: To determine the clinical utility of diagnosing Legionella pneumonia by urinary antigen testing (LPUAT) in a low prevalence centre.DESIGN: The results of LPUATs were abstracted and analyzed from the authors' laboratory information system. Medical records were reviewed in detail for all positive tests and a random sample of 50 negative tests.SETTING: The Queen Elizabeth II Health Sciences Centre, a large university hospital complex.POPULATION STUDIED: Patients who were admitted from the emergency room with pneumonia or who had developed pneumonia in hospital and who had a LPUAT performed between April 1998 and October 2000.MAIN RESULTS: One thousand one hundred fifty-four tests were performed on 1007 patients. Seven patients had nine positive LPUATs. Three of these patients had confirmed Legionella pneumophila pneumonia. Three others had probable or possible L pneumophila pneumonia. There was one probable false positive. Six of the seven patients were already on empirical anti-L pneumophila therapy. Of the 50 negative tests reviewed in detail, 31 patients were on one of the antibiotics of choice for L pneumophila at the time the test was ordered; in 21 (68&#x25;) of these patients the negative result did not lead to a change in therapy.CONCLUSIONS: The cost to diagnose each case of Legionella pneumonia by LPUAT was approximately $5,770 and most patients were already on appropriate antibiotics. In patients with negative tests, antibiotics were often not changed in response to the test result. Rigorous screening of patients is required to increase pretest probability for LPUAT to be justified.

Michel Dionne

Todd Hatchette

Kevin Forward

Clinical Utility of a Legionella pneumophila Urinary Antigen Test in a Large University Teaching Hospital

Canadian Paediatric Society, Infectious Diseases and Immunization Committee

Transfusion and Risk of Infection in Canada

B Lynn Johnston

John M Conly

Diagnosis of Ventilator-Associated Pneumonia: Where Do We Go from Here?

Lindsay Nicolle

Experiencing West Nile Virus

Noni MacDonald

Joanne Embree

Access to Vaccines: A Call to Action

About this journal

Canadian Journal of Infectious Diseases and Medical Microbiology publishes original research articles and&nbsp;review articles related to infectious diseases of bacterial, viral and parasitic origin.

Journal profile

Meet the editorial board

Chief Editor, Professor Tingtao Chen is currently based at Nanchang University, China. His research focuses on microbial ecology, and effects of natural microorganisms and engineered bacteria on host health.

Editor spotlight

Submit to Special Issue

We currently have a number of Special Issues open for submission. Special Issues highlight emerging areas of research within a field, or provide a venue for a deeper investigation into an existing research area.

Special Issues

Author guidelines

Editorial board

Databases and indexing

Canadian Journal of Infectious Diseases and Medical Microbiology - Table of contents 2003

Canadian Journal of Infectious Diseases and Medical Microbiology | Hindawi

title

Canadian Journal of Infectious Diseases and Medical Microbiology publishes original research articles and review articles related to infectious diseases of bacterial, viral and parasitic origin.

description

Canadian Journal of Infectious Diseases and Medical Microbiology

https://images.hindawi.com/journals/cjidmm/cjidmm.banner.jpg

Canadian Journal of Infectious Diseases and Medical Microbiology