A META-analysis of the association between breastfeeding and risk of infant hepatitis C virus infection

Objective: To investigate the association between breastfeeding and infant acquired infection of Hepatitis C Virus(HCV). Methods: To obtain studies eligible for META-analysis, China biological medicine discs(CBMD) and MEDLINE citations were surveyed. Criteria for enrollment of published studies for META-analysis were based on principle by Abdolmaleky HM[1]. Odd ratio(OR) was calculated and summarized by fixed effect model or random effects using RevMan software. The heterogeneity of ORs was assessed using an χ2 test of goodness of fit. The significance of the pooled OR was determined by the z-test. The strength of association was summarized usingOR. An OR>1.0 indicated a positive association between the risk factor and infants HCV infection. Results:After searching in Medline and CBMD, 120 articles were enrolled for further identification. Thirty-seven were of review on relative fields and were excluded. Abstracts of remaining articles were carefully read, and finally, only 6 articles met, the standards for enrollment criteria. After analysis of the factor concerned, no significant association was found between breastfeeding and infant HCV infection, with a pooled OR equal to 0.60(95%CI = 0.22-1.60), and proved not to be of risk factors on infant acquired infection of HCV. Conclusion: Breastfeeding dose not increase the risk of infant acquired infection of HCV.

SARS-CoV-2 infection in infants under 1 year of age in Wuhan City, China

Background The clinical characteristics and outcome of COVID-19 in children are different from those in adults.We aimed to describe the characteristics of infants under 1 year of age (excluding newborns) with COVID-19.Methods We retrospectively retrieved data of 36 infants with SARS-CoV-2 infection in Wuhan Children's Hospital from January 26 to March 22,2020.Clinical features,chest imaging findings,laboratory tests results,treatments and clinical outcomes were analyzed.Results The mean age of the infected infants was 6.43 months,with a range of 2-12 months.61.11% of the patients were males and 38.89% females.86.11% of the infants were infected due to family clustering.Cough (77.78%) and fever (47.22%) were the most common clinical manifestations.Chest CT scan revealed 61.11% bilateral pneumonia and 36.11% unilateral pneumonia.47.22% of the infants developed complications.Increased leucocytes,neutrophils,lymphocytes,and thrombocytes were observed in 11.11,8.33,36.11 and 44.44% of infants,respectively.Decreased leucocytes,neutrophils,thrombocyte and hemoglobin were observed in 8.33,19.44,2.78 and 36.11% of infants,respectively.Increased C-reactive protein,procalcitonin,lactate dehydrogenase,alanine aminotransferase,creatine kinase and D-dimer were observed in 19.44,67.74,47.22,19.44,22.22 and 20.69% of infants,respectively.Only one infant had a high level of creatinine.Co-infections with other respiratory pathogens were observed in 62.86% of infants.CD3 (20.69%),CD4 (68.97%),CD19 (31.03%) and Th/Ts (44.83%) were elevated;CD8 (6.9%) and CD16+CD56 (48.28%) was reduced.IL-4 (7.69%),IL-6 (19.23%),IL-10 (50%),TNF-α (11.54%) and IFN-γ (19.23%) were elevated.Up to March 22,97.22% of infants recovered,while a critical ill infant died.When the infant's condition deteriorates rapidly,lymphocytopenia was discovered.Meanwhile,C-reactive protein,D-dimer,alanine aminotransferase,creatine kinase,creatinine,IL-6 and IL-10 increased significantly.Conclusions In the cohort,we discovered that lymphocytosis,elevated CD4 and IL-10,and co-infections were common in infants with COVID-19,which were different from adults with COVID-19.Most infants with COVID-19 have mild clinical symptoms and good prognosis.

Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness:a systematic review and meta‑analysis

Background Respiratory syncytial virus(RSV)infection in infants is a global health priority.We aimed to investigate the common manifestations of RSV infection by age group and human development index(HDI)level and to assess its association with the development of wheezing and recurrent wheezing illness.Methods We searched the literature published between January 1,2010 and June 2,2022 in seven databases.Outcomes included common manifestations and long-term respiratory outcomes of RSV infection in children.Random-and fixed-effect models were used to estimate the effect size and their 95%confidence intervals.Subgroup analysis was conducted by age and HDI levels.This review was registered in PROSPERO(CRD42022379401).Results The meta-analysis included 47 studies.The top five manifestations were cough(92%),nasal congestion(58%),rhinorrhea(53%),shortness of breath(50%),and dyspnea(47%).The clinical symptoms were most severe in infants.In our analysis,compared to very high and high HDI countries,fewer studies in medium HDI countries reported related manifestations,and no study in low HDI countries reported that.The RSV-infected infants were more likely to develop wheezing than the non-infected infants[odds ratio(OR),3.12;95%CI,2.59–3.76]and had a higher risk of developing wheezing illnesses after recovery(OR,2.60;95%CI,2.51–2.70).Conclusions Cough and shortness of breath are common manifestations of RSV infection.More attention should be given to infants and areas with low HDI levels.The current findings confirm an association between RSV infection and wheezing or recurrent wheezing illness.

Pregnancy and fetal outcomes of chronic hepatitis C mothers with viremia in China

BACKGROUND Data that assess maternal and infant outcomes in hepatitis C virus(HCV)-infected mothers are limited.AIM To investigate the frequency of complications and the associated risk factors.METHODS We performed a cohort study to compare pregnancy and fetal outcomes of HCVviremic mothers with those of healthy mothers.Risk factors were analyzed with logistic regression.RESULTS Among 112 consecutive HCV antibody-positive mothers screened,we enrolled 79 viremic mothers.We randomly selected 115 healthy mothers from the birth registry as the control.Compared to healthy mothers,HCV mothers had a significantly higher frequency of anemia[2.6%(3/115)vs 19.0%(15/79),P<0.001]during pregnancy,medical conditions that required caesarian section[27.8%(32/115)vs 48.1%(38/79),P=0.004],and nuchal cords[9.6%(11/115)vs 34.2%(27/79),P<0.001].In addition,the mean neonatal weight in the HCV group was significantly lower(3278.3±462.0 vs 3105.1±459.4 gms;P=0.006),and the mean head circumference was smaller(33.3±0.6 vs 33.1±0.7 cm;P=0.03).In a multivariate model,HCV-infected mothers were more likely to suffer anemia[adjusted odds ratio(OR):18.1,95%confidence interval(CI):4.3-76.6],require caesarian sections(adjusted OR:2.6,95%CI:1.4-4.9),and have nuchal cords(adjusted OR:5.6,95%CI:2.4-13.0).Their neonates were also more likely to have smaller head circumferences(adjusted OR:2.1,95%CI:1.1-4.3)and lower birth weights than the average(≤3250 gms)with an adjusted OR of 2.2(95%CI:1.2-4.0).The vertical transmission rate was 1%in HCV-infected mothers.CONCLUSION Maternal HCV infections may associate with pregnancy and obstetric complications.We demonstrated a previously unreported association between maternal HCV viremia and a smaller neonatal head circumference,suggesting fetal growth restriction.