Laboratory-based Surveillance and Clinical Profile of Sporadic HEV Infection in Shanghai,China

The study aimed to describe the epidemiological,virological and clinical features of sporadic HEV infection in eastern China.A total of 6112 patient sera were tested for anti-HEV IgG or anti-HEV IgM during one consecutive year(between August 2018 and July 2019).HEV RNA presence was evaluated by RT-PCR and HEV sequences were phylogenetically analyzed.Clinical features of confirmed HEV-infected patients were delineated.The sero-positivity rate of anti-HEV IgG maintained stable around 40%,while an obvious winter spike of anti-HEV IgM prevalence was observed.A total of 111 patients were confirmed of HEV viremia by molecular diagnosis.Subtype 4d was predominant.Phylogenetic analyses suggest that certain strains circulate across species and around the country.Subjects with confirmed current HEV infection had a high median age(58 years)and males were predominant(62.2%).Most patients presented with jaundice(75.7%)and anorexia(68.0%).Significantly elevated levels of liver enzymes and bilirubin were observed.Remarkably,the baseline bilirubin level was positively correlated with illness severity.Pre-existing HBV carriage may deteriorate illness.The clinical burden caused by locally acquired HEV infection is increasing.Surveillance should be enforced especially during the transition period from winter to spring.Patients with higher level of bilirubin at disease onset had slower recovery from HEV infection.

Neutralizing monoclonal antibodies present new prospects to treat SARS-CoV-2 infections

The coronavirus disease 2019(COVID-19)has caused global public health and economic crises.Thus,new therapeutic strategies and effective vaccines are urgently needed to cope with this severe pandemic.The development of a broadly neutralizing antibody against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is one of the attractive treatment strategies for COVID-19.Currently,the receptor-binding domain(RBD)of the spike(S)protein is the main target of neutralizing antibodies when SARS-CoV-2 enters human cells through an interaction between the S protein and the angiotensin-converting enzyme 2 expressed on various human cells.A single monoclonal antibody(mAb)treatment is prone to selective pressure due to increased possibility of targeted epitope mutation,leading to viral escape.In addition,the antibody-dependent enhancement effect is a potential risk of enhancing the viral infection.These risks can be reduced using multiple mAbs that target nonoverlapping epitopes.Thus,a cocktail therapy combining two or more antibodies that recognize different regions of the viral surface may be the most effective therapeutic strategy.