The performance of computer-aided detection digital chest X-ray reading technologies for triage of active Tuberculosis among persons with a history of previous Tuberculosis

alexandrossfakianakis shared this article with you from Inoreader The performance of computer-aided detection digital chest X-ray reading technologies for triage of active Tuberculosis among persons with a history of previous Tuberculosis via Clinical Infectious Diseases Advance Access Abstract Background Digital Chest X-ray (dCXR) computer-aided detection (CAD) technology uses lung shape and texture analysis to determine the probability of TB. However, many patients with previously treated TB have sequelae, which also distort lung shape and texture. We evaluated the diagnostic performance of two CAD systems for triage of active TB in patients with previously treated TB. Methods We conducted a retrospective analysis of data from a cross-sectio nal active TB case finding study. Participants ≥15 years, with ≥1 current TB symptom, and with complete data on history of previous TB, dCXR, and TB microbiological reference (Xpert MTB/RIF) were included. dCXRs were evaluated using CAD4TB (v.7.0) and qXR (v.3.0). We determined the diagnostic accuracy of both systems, overall and stratified by history of TB, using a single threshold for each system that achieved 90% sensitivity and maximized specificity in the overall population. Results Of 1,884 participants, 452 (24.0%) had a history of previous TB. The prevalence of microbiologically confirmed TB among those with and without history of previous TB was 12.4% and 16.9% respectively. Using CAD4TB, the sensitivity and specificity was 89.3% (95%CI:78.1-96.0) and 24.0% (95%CI19.9-28.5) and 90.5% (95%CI:86.1-93.3) and 60.3% (95%CI:57.4-63.0) among those with and without previous TB, respectively. Using qXR, the sensitivity and specificity was 94.6% (95%CI:85.1-98.9) and 22. 2% (95%CI:18.2-26.6) and 89.7% (95%CI:85.1-93.2) and 61.8% (95%CI:58.9-64.5) among those with and without previous TB, respectively. Conclusion The performance of CAD systems as a TB triage tool is decreased among persons previously treated for TB. View on Web

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Low spontaneous clearance rates of recently acquired hepatitis C virus in HIV-positive MSM (The PROBE-C Study)

alexandrossfakianakis shared this article with you from Inoreader Low spontaneous clearance rates of recently acquired hepatitis C virus in HIV-positive MSM (The PROBE-C Study) via Clinical Infectious Diseases Advance Access Abstract Background Using direct acting antivirals (DAA) for recently acquired hepatitis C virus (RAHCV-) infections, particularly in HIV-positive men having sex with men (MSM), dramatically reduced hepatitis C incidence. However, implementation into clinical practice is challenging. The aim of this study was to analyse spontaneous clearance (SC) rates of RAHCV and to identify predictors of SC. Methods The PROBE-C study is an observational European cohort on RAH CV-infections in HIV-positive MSM. Between 2007 and 2017, RAHCV-infections were documented with at least 12 months of follow-up. Fisher's exact, chi-square and Mann-Whitney U test were used for statistical analysis. Results 464 RAHCV-infections were documented. 457/464 (98%) cases were male, median age was 41 years (IQR 38-46). Main risk groups for HCV-transmission were MSM (98.9%). Most participants were infected with HCV-genotype (GT) 1 (78.3%). Median baseline HCV-RNA was 230,000 (135,000-474,432) IU/mL, median CD4+-T cell count was 574 (547-604) cells/µL. 92% of all cases received combination antiretroviral therapy with 91% showing suppressed HIV-RNA (<200 copies/mL). Median maximum alanine aminotransferase was 445 (402-522) U/L.SC of RAHCV-infection occurred in 55/464 (11.9%) cases. A >2log decline in HCV-RNA four weeks after diagnosis of RAHCV infection was the strongest predictor of SC (p < 0.001, sensitivity 96.4%, specificity 97.5%, PPV 8 4.1%, NPV 99.5%). Conclusions SC of RAHCV in HIV-positive MSM is only found in 11.9% of cases and a <2log drop in HCV-RNA at week four after diagnosis should prompt for early DAA-based treatment. However, immediate DAA treatment for RAHCV-infection may also be favoured in patients with ongoing transmission risk behaviour. View on Web

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Chromatin conformation of human oral epithelium can identify orofacial cleft missing functional variants

alexandrossfakianakis shared this article with you from Inoreader Chromatin conformation of human oral epithelium can identify orofacial cleft missing functional variants via International Journal of Oral Science - Issue International Journal of Oral Science, Published online: 25 August 2022; doi:10.1038/s41368-022-00194-0 Chromatin conformation of human oral epithelium can identify orofacial cleft missing functional variants View on Web

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Plasma Circulating Tumor HPV DNA and HPV-Related Oropharynx Cancer—A Caution—Reply

alexandrossfakianakis shared this article with you from Inoreader Plasma Circulating Tumor HPV DNA and HPV-Related Oropharynx Cancer—A Caution—Reply via JAMA Otolaryngology–Head & Neck Surgery Online First In Reply Dr Johnson and colleagues raise a good point, as expressed in our article, that our findings should not be inferred to suggest that circulating tumor human papillomavirus (HPV) DNA (ctHPVDNA) is ready to be used for screening. Our observation that no ctHPVDNA was detected in healthy participants with detectable salivary HPV DNA or E6 serum antibody suggests a low false-positive rate (ie, suggests good specificity). However, as pointed out in the discussion of our research letter, and by Johnson et al, it is possible that the detection methods used in our study could be insensitive, and additional research is needed to verify the finding of high specificity in our study. View on Web

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