AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:...AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:88;mean age 50.0±11.4 years), in whom H.pylori had been successfully eradicated, were enrolled.The mean duration of follow up was 41.2±24.0 mo. RESULTS:H.pylori reinfection occurred in 58 patients (31.2%).The average annual reinfection rate was 9.1% per patient year.No recurrence of peptic ulcer was detected at the follow up endoscopy.There were no significant differences between the H.pylori eradication regimens for the reinfection rate and no significant differences in endoscopic findings between the H.pylorirecurred group and the H.pylori-cured group.CONCLUSION:The reinfection rate in Korea is 9.1% which represents a decreasing trend.There was no relationship between H.pylori infection status and changes in endoscopic findings.There was also no recurrence or aggravation of ulcers.展开更多
BACKGROUND: Hepatitis B virus reinfection is an impor-tant problem after liver transplantation. The aim of thisstudy was to discuss the prevention of hepatitis B virus rein-fection following orthotopic liver transplan...BACKGROUND: Hepatitis B virus reinfection is an impor-tant problem after liver transplantation. The aim of thisstudy was to discuss the prevention of hepatitis B virus rein-fection following orthotopic liver transplantation.METHODS: Sixty-eight cases of chronic fulminant hepatitisB, end-stage liver cirrhosis, and liver carcinoma complicat-ed with HBV cirrhosis were given anti-viral drugs beforeand after transplantation to prevent hepatitis B virus rein-fection. Lamivudine was administered in 2 patients, lami-vudine + hepatitis B immunoglobulin ( HBIG ) in 63, andadefovir + HBIG in 3. The measurement of serum HBV,HBV DNA, liver biopsy immunohistochemistry and clini-cal study were performed.RESULTS: In 1 of the 2 patients who developed reinfectionafter lamivudine administration, serum HBsAg, HBeAb,HBcAb, HBV DNA were positive and liver biopsy immu-nohistochemistry showed HBsAg phenotype. In 2 of 63 pa-tients who developed reinfection after use of lamivudine +HBIG, serum HBsAg, HBeAb, HBcAb were positive andliver biopsy immunohistochemistry showed HBsAg pheno-type. Serum HBV DNA was positive in one of them.Three patients developed no reinfection with HBV after useof adefovir.CONCLUSIONS: Orthotopic liver transplantation is effectivein the treatment of HBV-infected diseases. Lamivudine +HBIG or adefovir + HBIG could effectively prevent hepatitisB virus reinfection.展开更多
AIM: To evaluate the frequency of Helicobacter pylori(H. pylori) reinfection in peptic ulcer patients during 9 years after H. pylori eradication.METHODS: We invited 117 peptic ulcer patients in whom eradication of H. ...AIM: To evaluate the frequency of Helicobacter pylori(H. pylori) reinfection in peptic ulcer patients during 9 years after H. pylori eradication.METHODS: We invited 117 peptic ulcer patients in whom eradication of H. pylori was confirmed 1 year after eradication treatment both by histology and by rapid urease test. In total, 57 patients were available for the study procedures: 34(59.6%) male, 23(40.4%) female; mean age 52.3 ± 13.0 years. There were 45(78.9%) patients with duodenal ulcer and 12(21.1%) with gastric ulcer. H. pylori was diagnosed by a rapid urease test and histology if endoscopy was performed. If endoscopy was refused, H. pylori was diagnosed by the C14-urea breath test and serology. H. pylori was established if at least one of the tests was positive.RESULTS: The mean follow-up was 8.9 ± 1.0 years(range, 6-12). H. pylori was established in 15 patients. In 2 H. pylori-negative patients, H. pylori was established during the follow-up period and eradicated. Therefore, we consider that reinfection occurred in 17 patients. In the per protocol analysis, reinfection was established in 17 of 57(29.8%; 95%CI: 19.2-42.2) patients during the follow-up period. The annual rate of infection was 3.36%. If all non-responders were considered H. pylori-negative, reinfection would be 14.5%(17/117), the annual ratebeing 1.63%. The mean age of patients with reinfection was 51.8 ± 14.0 years, and without reinfection was 52.5 ± 13.0 years, P > 0.05; the mean body mass index of patients with reinfection was 27.2 ± 4.1 kg/m2, and without reinfection was 25.7 ± 4.2 kg/m2, P > 0.05. There were no differences in the reinfection rates according the location of the peptic ulcer, the eradication regimen used, and smoking status.CONCLUSION: The reinfection rate of H. pylori is relatively high in Lithuania and probably related to the high prevalence of H. pylori, what may reflect differences in the socioeconomic status between Western and Eastern European countries.展开更多
BACKGROUND There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019(CoVID-19)patients.AIM To summarize the recent findings and reports of CoVID-19 reinfec...BACKGROUND There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019(CoVID-19)patients.AIM To summarize the recent findings and reports of CoVID-19 reinfection in patients previously reCoVered from the disease.METHODS This study was a systematic review of current evidence conducted in August 2020.The authors studied the probable reinfection risk of novel coronavirus(CoVID-19).We performed a systematic search using the keywords in online databases.The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)checklist to ensure the reliability and validity of this study and results.RESULTS We reviewed 31 studies.Eight studies described reCoVered patients with reinfection.Only one study reported reinfected patients who died.In 26 studies,there was no information about the status of the patients.Several studies indicated that reinfection is not probable and that post-infection immunity is at least temporary and short.CONCLUSION Based on our review,we concluded that a positive polymerase chain reaction retest could be due to several reasons and should not always be considered as reinfection or reactivation of the disease.Most relevant studies in positive retest patients have shown relative and probably temporary immunity after the reCoVery of the disease.展开更多
BACKGROUND: In recent years, liver transplantation (LT) has been acknowledged as an acceptable option for patients with hepatitis B virus (HBV) related end-stage liver diseases. However, HBV reinfection is an importan...BACKGROUND: In recent years, liver transplantation (LT) has been acknowledged as an acceptable option for patients with hepatitis B virus (HBV) related end-stage liver diseases. However, HBV reinfection is an important event affecting the long-term survival of recipients. This paper was to review the risk factors related to HBV reinfection after LT. DATA SOURCES: English literature was reviewed based on MEDLINE focusing on the potential factors related to HBV reinfection after LT. RESULTS: HBV reinfection attributes to the unfavorable prognosis after LT. Many related factors may be responsible for it, including recipent factors (ethnical background, preoperative HBV replication status, extrahepatic HBV existence status), donor factors (compromised donor liver, HLA-A, -B compatibilities), perioperative treatment (use of antiviral agents, drug resistance, virus mutation, immu-nosuppressants protocol, blood transfusion) and others. CONCLUSIONS: The successful management of HBV reinfection will only be achieved by perfect clarification of its mechanism. The new strategies include new antiviral agents, gene therapy and immune intervention, reliable use of the compromised donor livers, and so on.展开更多
BACKGROUND The association between blood levels of fructosamine(FMN)and recurrent coronavirus disease 2019(COVID-19)is currently unclear.AIM To investigate a prospective relationship between blood levels of FMN and se...BACKGROUND The association between blood levels of fructosamine(FMN)and recurrent coronavirus disease 2019(COVID-19)is currently unclear.AIM To investigate a prospective relationship between blood levels of FMN and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)reinfection.METHODS A total of 146 Chinese hospitalized patients infected with SARS-CoV-2 were consecutively collectively recruited and followed from January 2020 to May 2021.Diagnosis of COVID-19 and SARS-CoV-2 reinfection was based on the diagnostic criteria and treatment protocol in China.The levels of FMN were determined in blood and divided into tertiles based on their distribution in the cohort of COVID-19 patients.Multivariate-adjusted hazard ratios(HRs)with 95%confidence intervals(CIs)were estimated for SARS-CoV-2 reinfection across the tertiles of FMN levels.A Cox regression model was used to generate the HR for SARS-CoV-2 reinfection in the participants in the top tertile of FMN levels compared with those at the bottom.Disease-free survival was used as the time variable,and relapse was used as the state variable,adjusted for age,gender,influencing factors such as diabetes mellitus,hypertension,and corticosteroid therapy,and clinical indexes such as acute liver failure,acute kidney failure,white blood cell(WBC)count,C-reactive protein,prognostic nutritional index(PNI),and blood lipids.Kaplan-Meier analysis with log-rank tests was used to compare the survival rate between patients with elevated FMN levels(FMN>1.93 mmol/L,the top tertile)and those with nonelevated levels.RESULTS Clinical data for the 146 patients with confirmed COVID-19[age 49(39-55)years;49%males]were analyzed.Eleven patients had SARS-CoV-2 reinfection.The SARS-CoV-2 reinfection rate in patients with elevated FMN levels was significantly higher than that in patients with nonelevated FMN(17%vs 3%;P=0.008)at the end of the 12-mo follow-up.After adjustments for gender,age,diabetes mellitus,hypertension,corticosteroid therapy,WBC count,PNI,indexes of liver and renal function,and blood lipids,patients with nonelevated FMN levels had a lower risk of SARS-CoV-2 reinfection than those with elevated FMN levels(HR=6.249,95%CI:1.377-28.351;P=0.018).Kaplan-Meier analysis showed that the cumulative survival rate of patients infected with SARSCoV-2 was higher in patients with nonelevated FMN levels than in those with elevated FMN levels(97%vs 83%;log rank P=0.002).CONCLUSION Elevated levels of FMN are independently associated with SARS-CoV-2 reinfection,which highlights that patients with elevated FMN should be cautiously monitored after hospital discharge.展开更多
These three cases of reinfection syphilis all had complete medical histories, clinical symptoms, and laboratory records of prior primary or secondarysy philis infection. The author held that the main reason for reinfe...These three cases of reinfection syphilis all had complete medical histories, clinical symptoms, and laboratory records of prior primary or secondarysy philis infection. The author held that the main reason for reinfection was failure of diagnosis and treatment of sex partners.展开更多
Background:Mpox re-emerged worldwide with the multi-country outbreaks that occurred in May 2022,threat-ening the public health of human beings.Methods:This rapid systematic review summarized mpox reinfection cases doc...Background:Mpox re-emerged worldwide with the multi-country outbreaks that occurred in May 2022,threat-ening the public health of human beings.Methods:This rapid systematic review summarized mpox reinfection cases documented.Electronic databases(PubMed,MedRxiv,and Social Science Research Network)were searched without time limitation,using the key-words“mpox,”“monkeypox,”&“reinfection,”“reoccur,”“reoccurrence,”“episode,”and“relapse”.All laboratory-confirmed cases of mpox reinfection published in the literature were included in this study.Results:A total of seven publications(nine cases)from Africa,Europe,and South America were included.All mpox reinfection cases were male,with a median age of 36;88.89%of cases had unprotected sexual behaviors with other males before each illness episode.The average onset interval between the two episodes was about 4 months.Perianal lesions and lymphadenopathy were major symptoms in both episodes,and no differences in clinical severity were reported between the two episodes.The mean duration of the two episodes was approximately 22 days and 13 days,respectively;which the mean duration of the second episode was shorter than the first infection(t=2.17,p=0.0487).Sexually transmitted infections were commonly concurrent among most cases,accounting for 55.6%and 77.8%in the two episodes,respectively.Full vaccination against mpox was rare among reinfection cases.Conclusion:A second infection is possible even in a short period.Reinforcing monitoring,reducing high-risk behaviors,and heightening health education regarding mpox for high-risk populations are crucial to limit mpox spread,including persons with a history of mpox infection.展开更多
COVID-19 and Tuberculosis(TB)are among the major global public health problems and diseases with major socioeconomic impacts.The dynamics of these diseases are spread throughout the world with clinical similarities wh...COVID-19 and Tuberculosis(TB)are among the major global public health problems and diseases with major socioeconomic impacts.The dynamics of these diseases are spread throughout the world with clinical similarities which makes them difficult to be mitigated.In this study,we formulate and analyze a mathematical model containing several epidemiological characteristics of the co-dynamics of COVID-19 and TB.Sufficient conditions are derived for the stability of both COVID-19 and TB sub-models equilibria.Under certain conditions,the TB sub-model could undergo the phenomenon of backward bifurcation whenever its associated reproduction number is less than one.The equilibria of the full TBCOVID-19 model are locally asymptotically stable,but not globally,due to the possible occurrence of backward bifurcation.The incorporation of exogenous reinfection into our model causes effects by allowing the occurrence of backward bifurcation for the basic reproduction number R_(0)<1 and the exogenous reinfection rate greater than a threshold(η>η*).The analytical results show that reducing R_(0)<1 may not be sufficient to eliminate the disease from the community.The optimal control strategies were proposed to minimize the disease burden and related costs.The existence of optimal controls and their characterization are established using Pontryagin's Minimum Principle.Moreover,different numerical simulations of the control induced model are carried out to observe the effects of the control strategies.It reveals the usefulness of the optimization strategies in reducing COVID-19 infection and the co-infection of both diseases in the community.展开更多
Recent evidences show that individuals who recovered from COVID-19 can be reinfected.However,this phenomenon has rarely been studied using mathematical models.In this paper,we propose an SEIRE epidemic model to descri...Recent evidences show that individuals who recovered from COVID-19 can be reinfected.However,this phenomenon has rarely been studied using mathematical models.In this paper,we propose an SEIRE epidemic model to describe the spread of the epidemic with reinfection.We obtain the important thresholds R_(0)(the basic reproduction number)and R_(c)(a threshold less than one).Our investigations show that when R_(0)>1,the system has an endemic equilibrium,which is globally asymptotically stable.When R_(c)<R_(0)<1,the epidemic system exhibits bistable dynamics.That is,the system has backward bifurcation and the disease cannot be eradicated.In order to eradicate the disease,we must ensure that the basic reproduction number R_(0) is less than R_(c).The basic reinfection number is obtained to measure the reinfection force,which turns out to be a new tipping point for disease dynamics.We also give definition of robustness,a new concept to measure the dificulty of completely eliminating the disease for a bistable epidemic system.Numerical simulations are carried out to verify the conclusions.展开更多
Objective:To explore the treatment strategies and clinical effects for recurrent respiratory infections in children.Methods:From May 2022 to May 2024,100 pediatric patients with recurrent respiratory infections were s...Objective:To explore the treatment strategies and clinical effects for recurrent respiratory infections in children.Methods:From May 2022 to May 2024,100 pediatric patients with recurrent respiratory infections were selected in this study and evenly divided into two groups.The control group(50 patients)was treated with conventional therapy supplemented with budesonide,while the observation group(50 patients)received pidotimod treatment in addition to the control group’s treatment.Subsequently,the duration of clinical symptom improvement,respiratory function enhancement,serological index changes,reinfection status,and parental satisfaction were compared between the two groups.Results:In terms of clinical symptoms,the observation group showed significantly shorter durations of fever reduction,cough relief,tonsil swelling reduction,and disappearance of fine wet rales compared to the control group(average reduction times were 1.6 days,2.3 days,2.1 days,and 1.9 days,respectively,P<0.05).Regarding respiratory function,the observation group experienced a 12%increase in peak expiratory flow rate variability,a 0.6-liter increase in lung capacity,a 0.7-liter increase in forced lung capacity,and a 0.5-liter increase in forced expiratory volume in the first second after treatment,all significantly higher than the control group(P<0.05).Serological testing revealed that interferon-γand interleukin-2 levels increased by 15%and 18%,respectively,while interferon-α,interleukin-5,and interleukin-4 levels decreased by 10%,12%,and 9%,respectively,in the observation group,showing significant differences compared to the control group(P<0.05).Additionally,the reinfection rate in the observation group(10%)was significantly lower than that in the control group(30%),with an average reduction of two reinfections within one year and a 3.2-day shorter infection control time(P<0.05).In terms of parental satisfaction,the observation group achieved 95%,significantly higher than the 70%in the control group(P<0.05).Conclusion:The addition of pidotimod to conventional therapy for pediatric patients with recurrent respiratory infections can significantly alleviate clinical symptoms,promote the recovery of respiratory function,regulate serological indicators,effectively reduce the risk of reinfection,and improve parental satisfaction.This method deserves widespread clinical application.展开更多
Dear Editor,The duration of immune protection against SAR-CoV-2 reinfection in patients who have recovered from COVID-19 is a critical unanswered question.To determine the long-term clinical and virologic outcome in p...Dear Editor,The duration of immune protection against SAR-CoV-2 reinfection in patients who have recovered from COVID-19 is a critical unanswered question.To determine the long-term clinical and virologic outcome in patients who have recovered from COVID-19,we prospectively followed 220 patients with COVID-19 admitted to Renmin Hospital of Wuhan University between 15 January and 15 February 2020 who recovered and were followed up until 15 July 2020.展开更多
Background:Asymptomatic or symptomatic infection with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can be followed by reinfection.The protection conferred by prior infection among coronavirus disease 201...Background:Asymptomatic or symptomatic infection with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can be followed by reinfection.The protection conferred by prior infection among coronavirus disease 2019(COVID-19)patients is unclear.We assessed the incidence of SARS-CoV-2 reinfection and the protection effect of previous infection against reinfection.Methods:We searched PubMed,EMBASE,Cochrane,Scopus,Web of Science,and ClinicalTrials.gov for publications up until the end date of May 1,2021.The reinfection rate of recovered patients and the protection against reinfection were analyzed using meta-analysis.Results:Overall,19 studies of 1096 reinfection patients were included.The pooled reinfection rate was 0.65%(95%confidence interval[CI]0.39-0.98%).The symptomatic reinfection rate was a bit lower(0.37%[95%CI 0.11-0.78%],I^(2)=99%).The reinfection rate was much higher in high-risk populations(1.59%[95%CI 0.30-3.88%],I^(2)=90%).The protection against reinfection and symptomatic reinfection was similar(87.02%[95%CI 83.22-89.96%]and 87.17%[95%CI 83.09-90.26%],respectively).Conclusions:The rate of reinfection with SARS-CoV-2 is relatively low.The protection against SARS-CoV-2 after natural infection is comparable to that estimated for vaccine efficacy.These data may help guide public health measures and vaccination strategies in response to the COVID-19 pandemic.High-quality clinical studies are needed to establish the relevant risk factors in recovered patients.展开更多
Background:In light of the shift to aiming for schistosomiasis elimination,the following are needed:data on reinfection patterns,participation,and sample submission adherence of all high-risk age groups to interventio...Background:In light of the shift to aiming for schistosomiasis elimination,the following are needed:data on reinfection patterns,participation,and sample submission adherence of all high-risk age groups to intervention strategies.This study was conducted to assess prevalence,reinfections along with consecutive participation,sample submission adherence,and effect of treatment on schistosomiasis prevalence in children aged five years and below in an endemic district in Zimbabwe,over one year.Methods:The study was conducted from February 2016-February 2017 in Madziwa area,Shamva district.Following community mobilisation,mothers brought their children aged 5 years and below for recruitment at baseline and also urine sample collection at baseline,3,6,9 and 12 months follow up surveys.At each time point,urine was tested for urogenital schistosomiasis by urine filtration and children found positive received treatment.Schistosoma haematobium prevalence,reinfections as well as children participation,and urine sample submission at each visit were assessed at each time point for one year.Results:Of the 535 children recruited from the five communities,169(31.6%)participated consecutively at all survey points.The highest mean number of samples submitted was 2.9 among communities and survey points.S.haematobium prevalence significantly reduced from 13.3%at baseline to 2.8%at 12 months for all participants and from 24.9%at baseline to 1.8%at 12 months(P<0.001)for participants coming at all-time points.Among the communities,the highest baseline prevalence was found in Chihuri for both the participants coming consecutively(38.5%,10/26)and all participants(20.4%,21/103).Reinfections were significantly high at 9 months follow up survey(P=0.021)and in Mupfure(P=0.003).New infections significantly decreased over time(P<0.001).Logistic regression analysis showed that the risk of acquiring schistosomiasis was high in some communities(P<0.05).Conclusions:S.haematobium infections and reinfections are seasonal and depend on micro-geographical settings.The risk of being infected with schistosomes in pre-school aged children increases with increasing age.Sustained treatment of infected individuals in a community reduces prevalence overtime.Participation compliance at consecutive visits and sample submission adherence are important for effective operational control interventions.展开更多
One tuberculosis transmission model is formulated by incorporating exogenous reinfec- tion, relapse, and two treatment stages of infectious TB cases. The global stability of the unique disease-free equilibrium is obta...One tuberculosis transmission model is formulated by incorporating exogenous reinfec- tion, relapse, and two treatment stages of infectious TB cases. The global stability of the unique disease-free equilibrium is obtained by applying the comparison principle if the effective reproduction number for the full model is less than unity. The existence and stability of the boundary equilibria are given by introducing the invasion reproduction numbers. Furthermore, the existence and local stability of the endemic equilibrium are addressed under some conditions.展开更多
The pandemic of coronavirus disease 2019 has threatened humans for more than one and a half years.In particular,viral mutation like delta strain has led to third-or fourth-wave transmission among the countries in Asia...The pandemic of coronavirus disease 2019 has threatened humans for more than one and a half years.In particular,viral mutation like delta strain has led to third-or fourth-wave transmission among the countries in Asia,Europe,and North America.Although large-scale vaccination has been carried out in many countries,the incidence of reinfection and vaccine-past breakthrough infection is becoming an emerging challenge to humans worldwide.The related mechanisms underlying the reinfection and breakthrough infection remain unknown.In this review,we summarized the challenge and related reasons for severe acute respiratory syndrome coronavirus 2 reinfection and breakthrough infection.Simultaneously,we addressed some critical contents of the study in future.展开更多
In this paper, the model of tuberculosis （TB） with exogenous reinfection by Feng et al. （2000） is analyzed from the symmetry and singularities perspective.
Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfecti...Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfection (colonization with a new strain, more than 12 mo after eradication) is considered to be responsible for most of the cases. This observation was confirmed only in developed countries, while in developing countries a recent meta-analysis demonstrated a high rate of reinfection. The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries, respectively. Nested meta-analysis (only cases with a longer follow-up and a negative 13CUBT a year after eradication) revealed annual recurrence rate of 1.45% [relative risk (RR), 0.54] and 12.00% (RR, 0.92) in developed and developing countries, respectively. These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication, with a 46% drop in the recurrence rate after the first year post eradication, while in developing countries reinfection is more pronounced, and continue at the same rate since eradication. A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries, since reinfection is highly prevalent.展开更多
AIM:To investigate whether Helicobacter pylori(H.pylori) infection is associated with glycemic control and whether hyperglycemia is modified by eradication therapy.METHODS:The databases of Pub Med,Cochrane Library,Chi...AIM:To investigate whether Helicobacter pylori(H.pylori) infection is associated with glycemic control and whether hyperglycemia is modified by eradication therapy.METHODS:The databases of Pub Med,Cochrane Library,Chinese Bio Medicine Web Base and Chinese Science and Technology Journals were searched from inception to June 2014.Studies examining the association between H.pylori infection and glycemic control and/or the effect of eradication treatment on glycemic control in diabetic humans were eligible for inclusion.Meta-analyses were conducted using the Review Manager software version 5.2.The outcome measures are presented as weighed mean differences(WMDs) with 95% confidence intervals(CIs).Statistical heterogeneity was assessed by the Cochran Q test and the I2 statistic.RESULTS:A total of 21 relevant publications were identified.A meta-analysis of 11 studies with 513 patients with diabetes mellitus(DM) showed significantly lower glycosylated hemoglobin(Hb A1c) levels in the H.pylori-negative than H.pylori-positive DM participants(WMD = 0.43,95%CI:0.07-0.79;P = 0.02).In children and adolescents with type 1 DM(T1DM),there was a positive association between H.pylori infection and Hb A1 c level(WMD = 0.35,95%CI:0.05-0.64;P = 0.02),but there was no difference in those with type 2 DM(T2DM,WMD = 0.51,95%CI:-0.63-1.65;P = 0.38).A meta-analysis of six studies with 325 T2 DM participants showed a significant difference in the fasting plasma glucose levels between H.pylori-positive and H.pylori-negative participants(WMD = 1.20,95%CI:0.17-2.23;P = 0.02).Eradication of H.pylori did not improve glycemic control in the T2 DM participants in a threemonth follow-up period(Hb A1 c decrease:WMD =-0.03,95%CI =-0.14-0.08;P = 0.57;fasting plasma glucose decrease:WMD =-0.06,95%CI:-0.36-0.23;P = 0.68).Glycemic control was significantly better in T1 DM participants who were not reinfected than in those who were reinfected(Hb A1c:WMD = 0.72,95%CI:0.32-1.13:P = 0.00).CONCLUSION:H.pylori infection is associated with poorer glycemic control in T1 DM patients,but eradication may not improve glycemic control in DM in a short-term follow-up period.展开更多
To estimate Helicobacter pylori (H. pylori) recurrence rate in Latin America, a region with a significant H. pylori prevalence and gastric cancer burden. METHODSPubMed, LILACS, SciELO, Cochrane databases and abstracts...To estimate Helicobacter pylori (H. pylori) recurrence rate in Latin America, a region with a significant H. pylori prevalence and gastric cancer burden. METHODSPubMed, LILACS, SciELO, Cochrane databases and abstracts from relevant meetings were reviewed. Information collected included: Participants’ characteristics, recruitment strategy, diagnostic modality, treatment arms, follow-up and recurrence rates. Recurrence was calculated using 100-patients-year rates, and data were pooled using a random effects model. The I<sup>2</sup> statistic assessed between study heterogeneity. Meta-regression analyses evaluated for effect modifying variables. RESULTSLiterature search yielded 163 articles. Twelve studies involving 4848 patients from 9 countries met inclusion criteria. Four hundred and thirty-two reinfections were recorded in 5487 person-years of follow-up. Pooled analysis showed a recurrence rate of 7.9 cases per 100 person-years (95%CI: 5.3-10.5). Meta-regression revealed that neither the antibiotic schema, a second antibiotic course, nor the diagnostic modality had an impact on the observed risk of recurrence. The recurrence rate in the first year after treatment, predominantly recrudescence, was 11.2 (6.1-16.4) per 100 patient years. Recurrence in subsequent years, was only 6.2 (3.8-8.7). CONCLUSIONH. pylori recurrence rates in Latin America are significant, and with geographic variability, yet are acceptable based upon the current literature for consideration of large scale intervention trials. Further research in Latin America is warranted to evaluate the efficacy, cost-effectiveness, and potential adverse outcomes of proposed eradication programs.展开更多
文摘AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:88;mean age 50.0±11.4 years), in whom H.pylori had been successfully eradicated, were enrolled.The mean duration of follow up was 41.2±24.0 mo. RESULTS:H.pylori reinfection occurred in 58 patients (31.2%).The average annual reinfection rate was 9.1% per patient year.No recurrence of peptic ulcer was detected at the follow up endoscopy.There were no significant differences between the H.pylori eradication regimens for the reinfection rate and no significant differences in endoscopic findings between the H.pylorirecurred group and the H.pylori-cured group.CONCLUSION:The reinfection rate in Korea is 9.1% which represents a decreasing trend.There was no relationship between H.pylori infection status and changes in endoscopic findings.There was also no recurrence or aggravation of ulcers.
文摘BACKGROUND: Hepatitis B virus reinfection is an impor-tant problem after liver transplantation. The aim of thisstudy was to discuss the prevention of hepatitis B virus rein-fection following orthotopic liver transplantation.METHODS: Sixty-eight cases of chronic fulminant hepatitisB, end-stage liver cirrhosis, and liver carcinoma complicat-ed with HBV cirrhosis were given anti-viral drugs beforeand after transplantation to prevent hepatitis B virus rein-fection. Lamivudine was administered in 2 patients, lami-vudine + hepatitis B immunoglobulin ( HBIG ) in 63, andadefovir + HBIG in 3. The measurement of serum HBV,HBV DNA, liver biopsy immunohistochemistry and clini-cal study were performed.RESULTS: In 1 of the 2 patients who developed reinfectionafter lamivudine administration, serum HBsAg, HBeAb,HBcAb, HBV DNA were positive and liver biopsy immu-nohistochemistry showed HBsAg phenotype. In 2 of 63 pa-tients who developed reinfection after use of lamivudine +HBIG, serum HBsAg, HBeAb, HBcAb were positive andliver biopsy immunohistochemistry showed HBsAg pheno-type. Serum HBV DNA was positive in one of them.Three patients developed no reinfection with HBV after useof adefovir.CONCLUSIONS: Orthotopic liver transplantation is effectivein the treatment of HBV-infected diseases. Lamivudine +HBIG or adefovir + HBIG could effectively prevent hepatitisB virus reinfection.
文摘AIM: To evaluate the frequency of Helicobacter pylori(H. pylori) reinfection in peptic ulcer patients during 9 years after H. pylori eradication.METHODS: We invited 117 peptic ulcer patients in whom eradication of H. pylori was confirmed 1 year after eradication treatment both by histology and by rapid urease test. In total, 57 patients were available for the study procedures: 34(59.6%) male, 23(40.4%) female; mean age 52.3 ± 13.0 years. There were 45(78.9%) patients with duodenal ulcer and 12(21.1%) with gastric ulcer. H. pylori was diagnosed by a rapid urease test and histology if endoscopy was performed. If endoscopy was refused, H. pylori was diagnosed by the C14-urea breath test and serology. H. pylori was established if at least one of the tests was positive.RESULTS: The mean follow-up was 8.9 ± 1.0 years(range, 6-12). H. pylori was established in 15 patients. In 2 H. pylori-negative patients, H. pylori was established during the follow-up period and eradicated. Therefore, we consider that reinfection occurred in 17 patients. In the per protocol analysis, reinfection was established in 17 of 57(29.8%; 95%CI: 19.2-42.2) patients during the follow-up period. The annual rate of infection was 3.36%. If all non-responders were considered H. pylori-negative, reinfection would be 14.5%(17/117), the annual ratebeing 1.63%. The mean age of patients with reinfection was 51.8 ± 14.0 years, and without reinfection was 52.5 ± 13.0 years, P > 0.05; the mean body mass index of patients with reinfection was 27.2 ± 4.1 kg/m2, and without reinfection was 25.7 ± 4.2 kg/m2, P > 0.05. There were no differences in the reinfection rates according the location of the peptic ulcer, the eradication regimen used, and smoking status.CONCLUSION: The reinfection rate of H. pylori is relatively high in Lithuania and probably related to the high prevalence of H. pylori, what may reflect differences in the socioeconomic status between Western and Eastern European countries.
文摘BACKGROUND There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019(CoVID-19)patients.AIM To summarize the recent findings and reports of CoVID-19 reinfection in patients previously reCoVered from the disease.METHODS This study was a systematic review of current evidence conducted in August 2020.The authors studied the probable reinfection risk of novel coronavirus(CoVID-19).We performed a systematic search using the keywords in online databases.The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)checklist to ensure the reliability and validity of this study and results.RESULTS We reviewed 31 studies.Eight studies described reCoVered patients with reinfection.Only one study reported reinfected patients who died.In 26 studies,there was no information about the status of the patients.Several studies indicated that reinfection is not probable and that post-infection immunity is at least temporary and short.CONCLUSION Based on our review,we concluded that a positive polymerase chain reaction retest could be due to several reasons and should not always be considered as reinfection or reactivation of the disease.Most relevant studies in positive retest patients have shown relative and probably temporary immunity after the reCoVery of the disease.
文摘BACKGROUND: In recent years, liver transplantation (LT) has been acknowledged as an acceptable option for patients with hepatitis B virus (HBV) related end-stage liver diseases. However, HBV reinfection is an important event affecting the long-term survival of recipients. This paper was to review the risk factors related to HBV reinfection after LT. DATA SOURCES: English literature was reviewed based on MEDLINE focusing on the potential factors related to HBV reinfection after LT. RESULTS: HBV reinfection attributes to the unfavorable prognosis after LT. Many related factors may be responsible for it, including recipent factors (ethnical background, preoperative HBV replication status, extrahepatic HBV existence status), donor factors (compromised donor liver, HLA-A, -B compatibilities), perioperative treatment (use of antiviral agents, drug resistance, virus mutation, immu-nosuppressants protocol, blood transfusion) and others. CONCLUSIONS: The successful management of HBV reinfection will only be achieved by perfect clarification of its mechanism. The new strategies include new antiviral agents, gene therapy and immune intervention, reliable use of the compromised donor livers, and so on.
文摘BACKGROUND The association between blood levels of fructosamine(FMN)and recurrent coronavirus disease 2019(COVID-19)is currently unclear.AIM To investigate a prospective relationship between blood levels of FMN and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)reinfection.METHODS A total of 146 Chinese hospitalized patients infected with SARS-CoV-2 were consecutively collectively recruited and followed from January 2020 to May 2021.Diagnosis of COVID-19 and SARS-CoV-2 reinfection was based on the diagnostic criteria and treatment protocol in China.The levels of FMN were determined in blood and divided into tertiles based on their distribution in the cohort of COVID-19 patients.Multivariate-adjusted hazard ratios(HRs)with 95%confidence intervals(CIs)were estimated for SARS-CoV-2 reinfection across the tertiles of FMN levels.A Cox regression model was used to generate the HR for SARS-CoV-2 reinfection in the participants in the top tertile of FMN levels compared with those at the bottom.Disease-free survival was used as the time variable,and relapse was used as the state variable,adjusted for age,gender,influencing factors such as diabetes mellitus,hypertension,and corticosteroid therapy,and clinical indexes such as acute liver failure,acute kidney failure,white blood cell(WBC)count,C-reactive protein,prognostic nutritional index(PNI),and blood lipids.Kaplan-Meier analysis with log-rank tests was used to compare the survival rate between patients with elevated FMN levels(FMN>1.93 mmol/L,the top tertile)and those with nonelevated levels.RESULTS Clinical data for the 146 patients with confirmed COVID-19[age 49(39-55)years;49%males]were analyzed.Eleven patients had SARS-CoV-2 reinfection.The SARS-CoV-2 reinfection rate in patients with elevated FMN levels was significantly higher than that in patients with nonelevated FMN(17%vs 3%;P=0.008)at the end of the 12-mo follow-up.After adjustments for gender,age,diabetes mellitus,hypertension,corticosteroid therapy,WBC count,PNI,indexes of liver and renal function,and blood lipids,patients with nonelevated FMN levels had a lower risk of SARS-CoV-2 reinfection than those with elevated FMN levels(HR=6.249,95%CI:1.377-28.351;P=0.018).Kaplan-Meier analysis showed that the cumulative survival rate of patients infected with SARSCoV-2 was higher in patients with nonelevated FMN levels than in those with elevated FMN levels(97%vs 83%;log rank P=0.002).CONCLUSION Elevated levels of FMN are independently associated with SARS-CoV-2 reinfection,which highlights that patients with elevated FMN should be cautiously monitored after hospital discharge.
文摘These three cases of reinfection syphilis all had complete medical histories, clinical symptoms, and laboratory records of prior primary or secondarysy philis infection. The author held that the main reason for reinfection was failure of diagnosis and treatment of sex partners.
基金supported by the Chongqing Science and Technology Bureau[CSTC2021jscx-gksb-N0005]and[cstc2024ycjh-bgzxm0224].
文摘Background:Mpox re-emerged worldwide with the multi-country outbreaks that occurred in May 2022,threat-ening the public health of human beings.Methods:This rapid systematic review summarized mpox reinfection cases documented.Electronic databases(PubMed,MedRxiv,and Social Science Research Network)were searched without time limitation,using the key-words“mpox,”“monkeypox,”&“reinfection,”“reoccur,”“reoccurrence,”“episode,”and“relapse”.All laboratory-confirmed cases of mpox reinfection published in the literature were included in this study.Results:A total of seven publications(nine cases)from Africa,Europe,and South America were included.All mpox reinfection cases were male,with a median age of 36;88.89%of cases had unprotected sexual behaviors with other males before each illness episode.The average onset interval between the two episodes was about 4 months.Perianal lesions and lymphadenopathy were major symptoms in both episodes,and no differences in clinical severity were reported between the two episodes.The mean duration of the two episodes was approximately 22 days and 13 days,respectively;which the mean duration of the second episode was shorter than the first infection(t=2.17,p=0.0487).Sexually transmitted infections were commonly concurrent among most cases,accounting for 55.6%and 77.8%in the two episodes,respectively.Full vaccination against mpox was rare among reinfection cases.Conclusion:A second infection is possible even in a short period.Reinforcing monitoring,reducing high-risk behaviors,and heightening health education regarding mpox for high-risk populations are crucial to limit mpox spread,including persons with a history of mpox infection.
文摘COVID-19 and Tuberculosis(TB)are among the major global public health problems and diseases with major socioeconomic impacts.The dynamics of these diseases are spread throughout the world with clinical similarities which makes them difficult to be mitigated.In this study,we formulate and analyze a mathematical model containing several epidemiological characteristics of the co-dynamics of COVID-19 and TB.Sufficient conditions are derived for the stability of both COVID-19 and TB sub-models equilibria.Under certain conditions,the TB sub-model could undergo the phenomenon of backward bifurcation whenever its associated reproduction number is less than one.The equilibria of the full TBCOVID-19 model are locally asymptotically stable,but not globally,due to the possible occurrence of backward bifurcation.The incorporation of exogenous reinfection into our model causes effects by allowing the occurrence of backward bifurcation for the basic reproduction number R_(0)<1 and the exogenous reinfection rate greater than a threshold(η>η*).The analytical results show that reducing R_(0)<1 may not be sufficient to eliminate the disease from the community.The optimal control strategies were proposed to minimize the disease burden and related costs.The existence of optimal controls and their characterization are established using Pontryagin's Minimum Principle.Moreover,different numerical simulations of the control induced model are carried out to observe the effects of the control strategies.It reveals the usefulness of the optimization strategies in reducing COVID-19 infection and the co-infection of both diseases in the community.
基金supported by the National Natural Science Foundation of China(U21A20206)Natural Science Foundations of Henan(192102310089,202300410045).
文摘Recent evidences show that individuals who recovered from COVID-19 can be reinfected.However,this phenomenon has rarely been studied using mathematical models.In this paper,we propose an SEIRE epidemic model to describe the spread of the epidemic with reinfection.We obtain the important thresholds R_(0)(the basic reproduction number)and R_(c)(a threshold less than one).Our investigations show that when R_(0)>1,the system has an endemic equilibrium,which is globally asymptotically stable.When R_(c)<R_(0)<1,the epidemic system exhibits bistable dynamics.That is,the system has backward bifurcation and the disease cannot be eradicated.In order to eradicate the disease,we must ensure that the basic reproduction number R_(0) is less than R_(c).The basic reinfection number is obtained to measure the reinfection force,which turns out to be a new tipping point for disease dynamics.We also give definition of robustness,a new concept to measure the dificulty of completely eliminating the disease for a bistable epidemic system.Numerical simulations are carried out to verify the conclusions.
文摘Objective:To explore the treatment strategies and clinical effects for recurrent respiratory infections in children.Methods:From May 2022 to May 2024,100 pediatric patients with recurrent respiratory infections were selected in this study and evenly divided into two groups.The control group(50 patients)was treated with conventional therapy supplemented with budesonide,while the observation group(50 patients)received pidotimod treatment in addition to the control group’s treatment.Subsequently,the duration of clinical symptom improvement,respiratory function enhancement,serological index changes,reinfection status,and parental satisfaction were compared between the two groups.Results:In terms of clinical symptoms,the observation group showed significantly shorter durations of fever reduction,cough relief,tonsil swelling reduction,and disappearance of fine wet rales compared to the control group(average reduction times were 1.6 days,2.3 days,2.1 days,and 1.9 days,respectively,P<0.05).Regarding respiratory function,the observation group experienced a 12%increase in peak expiratory flow rate variability,a 0.6-liter increase in lung capacity,a 0.7-liter increase in forced lung capacity,and a 0.5-liter increase in forced expiratory volume in the first second after treatment,all significantly higher than the control group(P<0.05).Serological testing revealed that interferon-γand interleukin-2 levels increased by 15%and 18%,respectively,while interferon-α,interleukin-5,and interleukin-4 levels decreased by 10%,12%,and 9%,respectively,in the observation group,showing significant differences compared to the control group(P<0.05).Additionally,the reinfection rate in the observation group(10%)was significantly lower than that in the control group(30%),with an average reduction of two reinfections within one year and a 3.2-day shorter infection control time(P<0.05).In terms of parental satisfaction,the observation group achieved 95%,significantly higher than the 70%in the control group(P<0.05).Conclusion:The addition of pidotimod to conventional therapy for pediatric patients with recurrent respiratory infections can significantly alleviate clinical symptoms,promote the recovery of respiratory function,regulate serological indicators,effectively reduce the risk of reinfection,and improve parental satisfaction.This method deserves widespread clinical application.
文摘Dear Editor,The duration of immune protection against SAR-CoV-2 reinfection in patients who have recovered from COVID-19 is a critical unanswered question.To determine the long-term clinical and virologic outcome in patients who have recovered from COVID-19,we prospectively followed 220 patients with COVID-19 admitted to Renmin Hospital of Wuhan University between 15 January and 15 February 2020 who recovered and were followed up until 15 July 2020.
基金This study is funded by grants from the National Natural Science Foundation of China(No.72074011)the National Key Technology R&D Program of China(No.2020YFC0840800)the National Key R&D Program of China(No.2021YFC2301601).
文摘Background:Asymptomatic or symptomatic infection with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can be followed by reinfection.The protection conferred by prior infection among coronavirus disease 2019(COVID-19)patients is unclear.We assessed the incidence of SARS-CoV-2 reinfection and the protection effect of previous infection against reinfection.Methods:We searched PubMed,EMBASE,Cochrane,Scopus,Web of Science,and ClinicalTrials.gov for publications up until the end date of May 1,2021.The reinfection rate of recovered patients and the protection against reinfection were analyzed using meta-analysis.Results:Overall,19 studies of 1096 reinfection patients were included.The pooled reinfection rate was 0.65%(95%confidence interval[CI]0.39-0.98%).The symptomatic reinfection rate was a bit lower(0.37%[95%CI 0.11-0.78%],I^(2)=99%).The reinfection rate was much higher in high-risk populations(1.59%[95%CI 0.30-3.88%],I^(2)=90%).The protection against reinfection and symptomatic reinfection was similar(87.02%[95%CI 83.22-89.96%]and 87.17%[95%CI 83.09-90.26%],respectively).Conclusions:The rate of reinfection with SARS-CoV-2 is relatively low.The protection against SARS-CoV-2 after natural infection is comparable to that estimated for vaccine efficacy.These data may help guide public health measures and vaccination strategies in response to the COVID-19 pandemic.High-quality clinical studies are needed to establish the relevant risk factors in recovered patients.
基金This study was partly funded by Thrasher foundation(No.12440).
文摘Background:In light of the shift to aiming for schistosomiasis elimination,the following are needed:data on reinfection patterns,participation,and sample submission adherence of all high-risk age groups to intervention strategies.This study was conducted to assess prevalence,reinfections along with consecutive participation,sample submission adherence,and effect of treatment on schistosomiasis prevalence in children aged five years and below in an endemic district in Zimbabwe,over one year.Methods:The study was conducted from February 2016-February 2017 in Madziwa area,Shamva district.Following community mobilisation,mothers brought their children aged 5 years and below for recruitment at baseline and also urine sample collection at baseline,3,6,9 and 12 months follow up surveys.At each time point,urine was tested for urogenital schistosomiasis by urine filtration and children found positive received treatment.Schistosoma haematobium prevalence,reinfections as well as children participation,and urine sample submission at each visit were assessed at each time point for one year.Results:Of the 535 children recruited from the five communities,169(31.6%)participated consecutively at all survey points.The highest mean number of samples submitted was 2.9 among communities and survey points.S.haematobium prevalence significantly reduced from 13.3%at baseline to 2.8%at 12 months for all participants and from 24.9%at baseline to 1.8%at 12 months(P<0.001)for participants coming at all-time points.Among the communities,the highest baseline prevalence was found in Chihuri for both the participants coming consecutively(38.5%,10/26)and all participants(20.4%,21/103).Reinfections were significantly high at 9 months follow up survey(P=0.021)and in Mupfure(P=0.003).New infections significantly decreased over time(P<0.001).Logistic regression analysis showed that the risk of acquiring schistosomiasis was high in some communities(P<0.05).Conclusions:S.haematobium infections and reinfections are seasonal and depend on micro-geographical settings.The risk of being infected with schistosomes in pre-school aged children increases with increasing age.Sustained treatment of infected individuals in a community reduces prevalence overtime.Participation compliance at consecutive visits and sample submission adherence are important for effective operational control interventions.
文摘One tuberculosis transmission model is formulated by incorporating exogenous reinfec- tion, relapse, and two treatment stages of infectious TB cases. The global stability of the unique disease-free equilibrium is obtained by applying the comparison principle if the effective reproduction number for the full model is less than unity. The existence and stability of the boundary equilibria are given by introducing the invasion reproduction numbers. Furthermore, the existence and local stability of the endemic equilibrium are addressed under some conditions.
基金This work was supported by Emergency Key Program of Guangzhou Laboratory(EKPG21-30-4)National key research and development plan(2020YFC0860900).
文摘The pandemic of coronavirus disease 2019 has threatened humans for more than one and a half years.In particular,viral mutation like delta strain has led to third-or fourth-wave transmission among the countries in Asia,Europe,and North America.Although large-scale vaccination has been carried out in many countries,the incidence of reinfection and vaccine-past breakthrough infection is becoming an emerging challenge to humans worldwide.The related mechanisms underlying the reinfection and breakthrough infection remain unknown.In this review,we summarized the challenge and related reasons for severe acute respiratory syndrome coronavirus 2 reinfection and breakthrough infection.Simultaneously,we addressed some critical contents of the study in future.
文摘In this paper, the model of tuberculosis （TB） with exogenous reinfection by Feng et al. （2000） is analyzed from the symmetry and singularities perspective.
文摘Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfection (colonization with a new strain, more than 12 mo after eradication) is considered to be responsible for most of the cases. This observation was confirmed only in developed countries, while in developing countries a recent meta-analysis demonstrated a high rate of reinfection. The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries, respectively. Nested meta-analysis (only cases with a longer follow-up and a negative 13CUBT a year after eradication) revealed annual recurrence rate of 1.45% [relative risk (RR), 0.54] and 12.00% (RR, 0.92) in developed and developing countries, respectively. These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication, with a 46% drop in the recurrence rate after the first year post eradication, while in developing countries reinfection is more pronounced, and continue at the same rate since eradication. A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries, since reinfection is highly prevalent.
文摘AIM:To investigate whether Helicobacter pylori(H.pylori) infection is associated with glycemic control and whether hyperglycemia is modified by eradication therapy.METHODS:The databases of Pub Med,Cochrane Library,Chinese Bio Medicine Web Base and Chinese Science and Technology Journals were searched from inception to June 2014.Studies examining the association between H.pylori infection and glycemic control and/or the effect of eradication treatment on glycemic control in diabetic humans were eligible for inclusion.Meta-analyses were conducted using the Review Manager software version 5.2.The outcome measures are presented as weighed mean differences(WMDs) with 95% confidence intervals(CIs).Statistical heterogeneity was assessed by the Cochran Q test and the I2 statistic.RESULTS:A total of 21 relevant publications were identified.A meta-analysis of 11 studies with 513 patients with diabetes mellitus(DM) showed significantly lower glycosylated hemoglobin(Hb A1c) levels in the H.pylori-negative than H.pylori-positive DM participants(WMD = 0.43,95%CI:0.07-0.79;P = 0.02).In children and adolescents with type 1 DM(T1DM),there was a positive association between H.pylori infection and Hb A1 c level(WMD = 0.35,95%CI:0.05-0.64;P = 0.02),but there was no difference in those with type 2 DM(T2DM,WMD = 0.51,95%CI:-0.63-1.65;P = 0.38).A meta-analysis of six studies with 325 T2 DM participants showed a significant difference in the fasting plasma glucose levels between H.pylori-positive and H.pylori-negative participants(WMD = 1.20,95%CI:0.17-2.23;P = 0.02).Eradication of H.pylori did not improve glycemic control in the T2 DM participants in a threemonth follow-up period(Hb A1 c decrease:WMD =-0.03,95%CI =-0.14-0.08;P = 0.57;fasting plasma glucose decrease:WMD =-0.06,95%CI:-0.36-0.23;P = 0.68).Glycemic control was significantly better in T1 DM participants who were not reinfected than in those who were reinfected(Hb A1c:WMD = 0.72,95%CI:0.32-1.13:P = 0.00).CONCLUSION:H.pylori infection is associated with poorer glycemic control in T1 DM patients,but eradication may not improve glycemic control in DM in a short-term follow-up period.
基金Supported by In part grants from the United States National Institutes of Health,Nos.CA1255884,CA167773,CA028842(to Morgan DR)
文摘To estimate Helicobacter pylori (H. pylori) recurrence rate in Latin America, a region with a significant H. pylori prevalence and gastric cancer burden. METHODSPubMed, LILACS, SciELO, Cochrane databases and abstracts from relevant meetings were reviewed. Information collected included: Participants’ characteristics, recruitment strategy, diagnostic modality, treatment arms, follow-up and recurrence rates. Recurrence was calculated using 100-patients-year rates, and data were pooled using a random effects model. The I<sup>2</sup> statistic assessed between study heterogeneity. Meta-regression analyses evaluated for effect modifying variables. RESULTSLiterature search yielded 163 articles. Twelve studies involving 4848 patients from 9 countries met inclusion criteria. Four hundred and thirty-two reinfections were recorded in 5487 person-years of follow-up. Pooled analysis showed a recurrence rate of 7.9 cases per 100 person-years (95%CI: 5.3-10.5). Meta-regression revealed that neither the antibiotic schema, a second antibiotic course, nor the diagnostic modality had an impact on the observed risk of recurrence. The recurrence rate in the first year after treatment, predominantly recrudescence, was 11.2 (6.1-16.4) per 100 patient years. Recurrence in subsequent years, was only 6.2 (3.8-8.7). CONCLUSIONH. pylori recurrence rates in Latin America are significant, and with geographic variability, yet are acceptable based upon the current literature for consideration of large scale intervention trials. Further research in Latin America is warranted to evaluate the efficacy, cost-effectiveness, and potential adverse outcomes of proposed eradication programs.
