Conclusion:Perioperative mortality and morbidity is high in HIV patients undergoing abdominal aortic surgery. Hypoalbuminemia and low CD4 lymphocyte counts are associated with poor clinical outcomes.Summary: The authors assessed outcome in HIV patients undergoing aortic reconstruction for occlusive or aneurysmal disease. This retrospective study covered an 11-year period, with patients identified through hospital and clinic records. The authors identified 48 HIV-positive patients (mean age 53 Ϯ 13 years) who underwent an abdominal aortic procedure during the study period. There were 20 operations for aneurysm and 28 for occlusive disease. There were no intraoperative deaths. Sixteen patients (33%) had postoperative complications, and 7 patients (15%) died in the hospital. Follow-up was for a mean of 41 months. Survival rates for aneurysm patients at 60 months were 43.2% Ϯ 5.3% and for occlusive disease patients, 46.3% Ϯ 7.4% (P ϭ NS). Multivariable analysis indicated low CD4 lymphocyte counts (Ͻ200/L, P Ͻ 0.05) and hypoalbuminemia (Ͻ3.5g/dL, P Ͻ 0.05) were risk factors for perioperative complication. The incidence of late graft infection was 10%. All patients with graft infection died, either from complications of the graft infection or its treatment.Comment: Everyone likes to publish good results. It is, however, sometimes the responsible thing to publish horrible results. Clearly the results of aortic surgery in patients with HIV infection are significantly inferior to what one would expect in patients without HIV infection. The message: aortic reconstruction in patients with HIV infection should be undertaken only for compelling indications.

$ These authors contributed equally to this work. AbstractSouthern China experienced few cases of H7N9 during the first wave of human infections in the spring of 2013. The second and now the third waves of H7N9 infections have been localized mostly in Southern China with the Guangdong province an epicenter for the generation of novel H7N9 reassortants. Clusters of human infections show human-to-human transmission to be a rare but well-documented event. A recent cluster of infections involving hospital health care workers stresses the importance of care givers utilizing personal protective equipment in treating H7N9 infected or suspected patients.

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BackgroundInfluenza H7N9 has become an endemic pathogen in China where circulating virus is found extensively in wild birds and domestic poultry. Two epidemic waves of Human H7N9 infections have taken place in Eastern and South Central China during the years of 2013 and 2014. In this study, we report on the first four human cases of influenza H7N9 in Shantou, Guangdong province, which occurred during the second H7N9 wave, and the subsequent analysis of the viral isolates.MethodsViral genomes were subjected to multisegment amplification and sequenced in an Illumina MiSeq. Later, phylogenetic analyses of influenza H7N9 viruses were performed to establish the evolutionary context of the disease in humans.ResultsThe sequences of the isolates from Shantou have closer evolutionary proximity to the predominant Eastern H7N9 cluster (similar to A/Shanghai/1/2013 (H7N9)) than to the Southern H7N9 cluster (similar to A/Guangdong/1/2013 (H7N9)).ConclusionsTwo distinct phylogenetic groups of influenza H7N9 circulate currently in China and cause infections in humans as a consequence of cross-species spillover from the avian disease. The Eastern cluster, which includes the four isolates from Shantou, presents a wide geographic distribution and overlaps with the more restricted area of circulation of the Southern cluster. Continued monitoring of the avian disease is of critical importance to better understand and predict the epidemiological behaviour of the human cases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-0829-8) contains supplementary material, which is available to authorized users.

The H7N9 influenza virus causes a severe form of disease in humans. Neuraminidase inhibitors, including oral oseltamivir and injectable peramivir, are the first choices of antiviral treatment for such cases; however, the clinical efficacy of these drugs is questionable. Animal experimental models are essential for understanding the viral replication kinetics under the selective pressure of antiviral agents. This study demonstrates the antiviral activity of peramivir in a mouse model of H7N9 avian influenza virus infection. The data show that repeated administration of peramivir at 30 mg/kg of body weight successfully eradicated the virus from the respiratory tract and extrapulmonary tissues during the acute response, prevented clinical signs of the disease, including neuropathy, and eventually protected mice against lethal H7N9 influenza virus infection. Early treatment with peramivir was found to be associated with better disease outcomes.