Publications by authors named "Lyall H"
Reactivation of latent varicella zoster virus in the trigeminal ganglion with involvement of the ophthalmic division of the trigeminal nerve causes herpes zoster ophthalmicus. This is rare in children and imaging is seldom performed since the diagnosis is primarily clinical. As a result, descriptions of the associated imaging abnormalities are sparse, particularly in the paediatric literature.
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- - The study aimed to examine the occurrence of drug resistance mutations related to integrase strand transfer inhibitors (INSTI-DRMs) in children and adolescents with perinatally acquired HIV who were referred to a perinatal virtual clinic.
- - Among 114 cases reviewed from October 2018 to January 2024, 90% had available resistance sequences, with significant findings showing that many had prior ART exposure and a notable percentage of those developed INSTI-DRMs, primarily from low/middle-income countries.
- - The research recommended treatment adjustments, emphasizing the need for enhanced access to effective therapies and the importance of addressing drug resistance in this patient population, particularly those with extensive treatment histories.
Article Synopsis
- A survey was conducted among 32 senior clinicians across 20 European countries to understand current practices in postnatal prophylaxis (PNP) and infant feeding guidelines.
- Twenty-three clinicians responded, revealing that all countries use risk stratification for PNP, but methods and regimens widely differ, with zidovudine being the most commonly used drug.
- There is significant variation in guidelines regarding infant feeding for babies born to HIV-positive parents, highlighting the need for harmonization in policies to minimize HIV transmission and support informed feeding choices.
Article Synopsis
- The study aimed to evaluate hearing outcomes at 24 months for infants with mild congenital cytomegalovirus (cCMV) infection, comparing those who received antiviral treatment to those who did not.
- Utilizing data from the European Registry of Children with cCMV, researchers included infants diagnosed with cCMV early in life, who had normal physical exams and mild imaging findings.
- Results showed that 34.7% of the 196 participants received antiviral treatment, but there was no significant difference in hearing loss prevalence between treated (4.6%) and untreated groups (6.3%) after two years.
Article Synopsis
- The updated UK guidelines provide management recommendations for genital herpes simplex virus (HSV) during pregnancy and the first month after birth, addressing both first episodes and recurrences of HSV.
- They also cover scenarios such as preterm pre-labour rupture of membranes and co-infection with HIV, with specific advice on caring for newborns and preventing postnatal transmission.
- Aimed at healthcare professionals in various settings, including sexual health and maternity units, these guidelines emphasize that their principles should be applied to all care environments, including community services.
This new guideline details the specific management of syphilis in pregnancy and in children. It is to be used in clinical practice alongside the BASHH UK guidelines for the management of syphilis 2024.
View Article and Find Full Text PDFPreventing perinatal HIV acquisition; current gaps and future perspectives.
Curr Opin HIV AIDS
November 2024
Purpose Of Review: Although current treatment could eradicate vertical transmission, in 2022, 130 000 infants acquired HIV globally. HIV suppression with antiretroviral therapy (ART) transforms survival for people living with HIV (PLWH), and prevents transmission, including vertical. International guidelines recommend lifelong ART for PLWH, consequently perinatal HIV acquisition reflects implementation gaps in the HIV care cascade.
View Article and Find Full Text PDF[This corrects the article DOI: 10.1016/j.lanepe.
View Article and Find Full Text PDFArticle Synopsis
- Congenital cytomegalovirus (cCMV) is prevalent globally, with 85%-90% of infected infants showing no symptoms at birth, but 10%-15% may face issues like sensorineural hearing loss later on.
- A review of studies focused on the neurodevelopmental outcomes of asymptomatic cCMV (AcCMV) in children found that they generally performed better than symptomatic cCMV children, but the understanding of their long-term neurodevelopment is still unclear.
- Most studies showed AcCMV children had comparable outcomes to CMV-uninfected children, though limitations like a lack of control groups and inconsistent definitions hindered the findings; further research with standardized methods is needed.
Article Synopsis
- During autumn/winter 2022, the UK saw an unusual rise in severe group A streptococcal infections in children, primarily manifesting as pneumonia with fluid in the lungs.
- Clinicians documented 185 cases from children under 16, revealing that most patients were healthy prior to infection, with many also suffering from respiratory viral coinfections.
- The study underscores the importance of routine vaccinations against common viruses and group A streptococcus, as well as the effectiveness of molecular testing to aid in diagnosis and reporting.
Congenital cytomegalovirus (cCMV) infection carries a significant burden with a 0.64% global prevalence and a 17-20% chance of serious long-term effects in children. Since the last guidelines, our understanding, particularly regarding primary maternal infections, has improved.
View Article and Find Full Text PDFIntroduction: Complex challenges amongst ageing cohorts of adolescents and adults living with perinatally acquired HIV (PaHIV) may impact on hospitalisation. We report hospitalisation rates and explored predictive factors for hospitalisation in adolescents and adults (10-35 years) living with PaHIV in England.
Method: Retrospective observational cohort study over a three-year period 2016-2019.
Introduction: Antiretroviral therapy (ART) is integral to HIV prevention, including averting vertical transmission. The World Health Organization (WHO) recommends ART and breastfeeding for all women living with HIV for at least 12 months post-partum [1, 2]. Much of the data on HIV transmission through breastfeeding comes from low-resource settings, with a paucity of data on breastfeeding-related HIV transmission in women living with HIV in other settings.
View Article and Find Full Text PDFPrimary infection with varicella zoster virus (VZV) in the final 3 weeks of pregnancy may cause transplacental infection and neonatal varicella. Infants are most at risk of severe disease if born from 5 days before to 2 days after onset of the maternal varicella rash. Administration of post-exposure prophylaxis with varicella zoster immunoglobulin and treatment of varicella with aciclovir for those at highest risk of progression to severe disease is advised.
View Article and Find Full Text PDFPurpose Of Review: HIV screening in pregnancy, universal suppressive antiretroviral therapy (ART) and breastfeeding avoidance can almost completely prevent vertical transmission of HIV. Breastfeeding is associated with an additional risk of transmission, although this risk is extremely low with suppressive maternal ART. This minimal risk must be balanced with the benefits of breastfeeding for women living with HIV (WLHIV) and their infants.
View Article and Find Full Text PDFCongenital syphilis is a major global cause of fetal loss, stillbirth, neonatal death, and congenital infection. In 2020, the global rate of congenital syphilis was 425 cases per 100 000 livebirths-substantially higher than WHO's elimination target of 50 cases per 100 000 livebirths. Case rates are rising in many high-income countries, but remain low compared with those in low-income and middle-income settings.
View Article and Find Full Text PDFWe performed an international survey regarding management of infants with congenital cytomegalovirus (cCMV) born at less than 32 weeks gestation or with birth weight under 1500 g. Replies from 51 level 3 neonatal intensive care units across 13 countries demonstrated striking discrepancies in screening practices, testing for cCMV, further investigations of confirmed cases, indications for initiation, and duration of treatment.
View Article and Find Full Text PDFAim: To describe the evolution of the intracranial features of congenital cytomegalovirus (cCMV) on magnetic resonance imaging (MRI).
Materials And Methods: Sixteen infants with polymerase chain reaction (PCR)-confirmed cCMV who had undergone at least two MRI examinations of the brain were identified. Two paediatric neuroradiologists reviewed the baseline studies retrospectively for intracranial features of cCMV, including white matter signal abnormalities, subependymal cysts, malformations of cortical development, and intracranial calcification.
Congenital human cytomegalovirus (CMV) infection is the most common congenital infection, affecting around 1 in 200 infants in high-income settings. It can have life-long consequences for up to one in four children, including sensorineural hearing loss and neurodisability. Despite the frequency of congenital CMV and the severity for some children, it is a little-known condition by pregnant women, families and healthcare providers.
View Article and Find Full Text PDFIntroduction: Congenital cytomegalovirus (cCMV) is the leading cause of neurodevelopmental and hearing impairment from infection. Late diagnosis results in limited treatment options and may compromise long-term outcome.
Methods: A retrospective audit of infants with cCMV referred to a Tertiary Pediatric Infectious Diseases center from 2012-2021.