Current Opinion in Infectious Diseases

Publisher: Lippincott, Williams & Wilkins

Journal description

Current impact factor: 5.01

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 5.006
2013 Impact Factor 5.034
2012 Impact Factor 4.87
2011 Impact Factor 4.93
2010 Impact Factor 5.167
2009 Impact Factor 4.723
2008 Impact Factor 4.35
2007 Impact Factor 4.754
2006 Impact Factor 4.795
2005 Impact Factor 4.258
2004 Impact Factor 4
2003 Impact Factor 2.674
2002 Impact Factor 1
2001 Impact Factor 0.82
2000 Impact Factor 0.778
1999 Impact Factor 0.923
1998 Impact Factor 0.874
1997 Impact Factor 0.706
1996 Impact Factor 0.935
1995 Impact Factor 0.749
1994 Impact Factor 0.675
1993 Impact Factor 0.294
1992 Impact Factor 0.239

Impact factor over time

Impact factor

Additional details

5-year impact 4.48
Cited half-life 5.40
Immediacy index 0.74
Eigenfactor 0.01
Article influence 1.61
ISSN 1473-6527

Publisher details

Lippincott, Williams & Wilkins

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  • Post-print
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    • 12 months embargo
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    • Pre-print must be removed upon acceptance for publication
    • Post-print may be deposited in personal website or institutional repository
    • Publisher's version/PDF cannot be used
    • Must include statement that it is not the final published version
    • Published source must be acknowledged with full citation
    • Set statement to accompany deposit
    • Must link to publisher version
    • NIH authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 12 months embargo (see policy for details)
    • Wellcome Trust and HHMI authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 6 months embargo (see policy for details)
    • Publisher last reviewed on 19/03/2015
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: This review summarizes recent important and interesting articles investigating the challenging treatment of the parasitic infection, leishmaniasis. In addition, it compares and contrasts leishmaniasis clinical practice treatment guidelines. Studies show that, in contrast to experience in India, visceral leishmaniasis in East Africa requires higher doses of liposomal amphotericin for effective treatment results and that pentavalent antimonial drugs remain efficacious. A retrospective study of visceral leishmaniasis in organ transplant patients suggests that there may be a role for secondary prophylaxis after treatment akin to HIV coinfection recommendations. The pros and cons of oral therapy with miltefosine, which cuts across leishmaniasis syndromes in its spectrum, are discussed. Cutaneous leishmaniasis clinical practice guidelines vary, although the recent European guidelines favor species-directed therapy. Leishmaniasis remains a neglected tropical disease, with a need for additional clinical trials with better design and reported endpoints to lead evidence-based treatment recommendations - especially in cutaneous leishmaniasis and leishmaniasis in the immunocompromised host.
    Current Opinion in Infectious Diseases 10/2015; 28(5):426-37. DOI:10.1097/QCO.0000000000000194
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    ABSTRACT: Purpose of review: Fever and neutropenia is the most common complication in the treatment of childhood cancer. This review will summarize recent publications that focus on improving the management of this condition as well as those that seek to optimize translational research efforts. Recent findings: A number of clinical decision rules are available to assist in the identification of low-risk fever and neutropenia however few have undergone external validation and formal impact analysis. Emerging evidence suggests acute fever and neutropenia management strategies should include time to antibiotic recommendations, and quality improvement initiatives have focused on eliminating barriers to early antibiotic administration. Despite reported increases in antimicrobial resistance, few studies have focused on the prediction, prevention, and optimal treatment of these infections and the effect on risk stratification remains unknown. A consensus guideline for paediatric fever and neutropenia research is now available and may help reduce some of the heterogeneity between studies that have previously limited the translation of evidence into clinical practice. Summary: Risk stratification is recommended for children with cancer and fever and neutropenia. Further research is required to quantify the overall impact of this approach and to refine exactly which children will benefit from early antibiotic administration as well as modifications to empiric regimens to cover antibiotic-resistant organisms.
    Current Opinion in Infectious Diseases 09/2015; DOI:10.1097/QCO.0000000000000208
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    ABSTRACT: Purpose of review: To discuss current understanding of the mechanisms of human T-lymphotropic virus type-1 (HTLV-1) tumorigenesis and current and potential treatment strategies for adult T-cell leukaemia/lymphoma (ATL), an aggressive malignant disease of CD4 cells caused by HTLV-1. Recent findings: Treatment of the aggressive subtypes of ATL remains inadequate, with little improvement in overall survival in the 30 years since HTLV-1 was discovered. Detailed analysis of the clonal expansion of HTLV-1 has provided new insight into pathogenesis. Most HTLV-1-infected cells, including ATL, express CCR4 which can be targeted. Reports of antitumour effects with allogeneic bone marrow transplantation provide a rationale for novel immunotherapy approaches. Progress has been made in the indolent subtypes of ATL with the use of 'antiviral' therapies. Summary: ATL has poor prognosis. There is a major, urgent, unmet clinical need to identify HTLV carriers who will develop ATL to develop biomarkers of transforming disease and disease progression and to provide novel treatment approaches within the context of clinical trials. Several strategies now include putative or actual antiviral therapy. Potentially, the risk of ATL would be reduced by eliminating some or all infected clones. HTLV-1 infection, and hence ATL, can be prevented by antenatal HTLV-1 screening.
    Current Opinion in Infectious Diseases 09/2015; DOI:10.1097/QCO.0000000000000207
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    ABSTRACT: Purpose of review: Hepatitis B is a major cause of hepatocellular carcinoma and liver cirrhosis. Interferon (IFN)-based therapies provide the highest likelihood of achieving off-treatment virological and serological control although their use is often avoided because of the side-effect profile. We review recent developments regarding the use of IFN in the treatment of chronic hepatitis B, including proposed strategies to enhance efficacy while limiting treatment exposure for patients who are unlikely to achieve acceptable treatment endpoints. Recent findings: The utility of host genetics (human leukocyte antigen associations and interleukin 28B) is yet to be defined. In hepatitis B e antigen (HBeAg)-positive disease, add-on IFN therapy to patients on entecavir may allow curtailment of nucleos(t)ide analogue treatment. In HBeAg-negative disease, an on-treatment stopping rule that measures decline of hepatitis B surface antigen and hepatitis B virus DNA at 12 and 24 weeks may identify up to two-thirds of poor responders. Prolonging IFN therapy to 96 weeks in patients with HBeAg-negative disease may improve virological and serological response rates. The combination of telbivudine and IFN therapy is contraindicated because of high rates of peripheral neuropathy. Summary: These findings need to be confirmed in larger trials before they can be instituted into routine clinical practice.
    Current Opinion in Infectious Diseases 09/2015; DOI:10.1097/QCO.0000000000000209
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    ABSTRACT: Purpose of review: Recent studies suggest that contemporary antibiotic dosing is unlikely to achieve best outcomes for critically ill patients because of extensive pharmacokinetic variability and altered pharmacodynamics. Dose adaptation is considered quite challenging because of unpredictable dose-exposure relationships. Consequently, individualization of antibiotic dosing has been advocated. Herein, we describe recent developments in the optimization of antibiotic dosing in the critically ill. Recent findings: Conventional doses of many antibiotics frequently result in sub or supratherapeutic exposures in the critically ill. Clinical studies continue to illustrate that dose-exposure relationships are highly variable in severely ill patients. Dose optimization based on pharmacokinetic/pharmacodynamic principles can effectively improve antibiotic exposure. Therapeutic drug monitoring (TDM) with adaptive feedback is likely to be the most robust approach to optimize dosing for individual patients. This more accurate approach to dosing is made possible with the user-friendly dosing software that is emerging. Summary: The scope of TDM is broadening from the traditional focus on prevention of toxicity, to include optimization of antibiotic exposure thereby improving patient outcomes. However, the evidence relating TDM practice with improved clinical outcome remains limited. Well designed, multicentre, randomized controlled studies are warranted.
    Current Opinion in Infectious Diseases 09/2015; DOI:10.1097/QCO.0000000000000206
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    ABSTRACT: Purpose of review: Invasive fungal disease (IFD) is an important cause of morbidity and mortality in immunocompromised patients. In contrast to adults, detailed information of pharmacokinetics and pharmacodynamics of many antifungal compounds is lacking in pediatric patients, and antifungal agents that have been proven to be effective in adults have not been licensed for children. We therefore review the current literature on drugs and dosing for antifungal prophylaxis in the pediatric age group. Recent findings: Although there are only few compounds approved for antifungal prophylaxis in children, an increasing number of reports describe safety and suggest efficacy of agents given to prevent IFD in the pediatric population. Owing to the small number of children included in most studies, however, evidence for efficacy has to be extrapolated from studies in adults. In addition, most studies do not address the optimal dosage of a compound to prevent IFD (optimal balance between efficacy and toxicity). Summary: Although there is a wide use of prophylactic antifungal agents in children, future studies need to establish the optimal dosing of each compound.
    Current Opinion in Infectious Diseases 09/2015; DOI:10.1097/QCO.0000000000000210
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    ABSTRACT: Purpose of review: Neutropenic fever is the most common infective complication in patients receiving cytotoxic chemotherapy, and may result in severe sepsis, septic shock and mortality. Advancements in approaches to empiric antimicrobial therapy and prophylaxis have resulted in improved outcomes. Mortality may, however, still be as high as 50% in high-risk cancer populations. The objective of this review is to summarize factors associated with reduced mortality in patients with neutropenic fever, highlighting components of clinical care with potential for inclusion in quality improvement programs. Recent findings: Risks for mortality are multifactorial, and include patient, disease and treatment-related factors. Historically, guidelines for management of neutropenic fever have focused upon antimicrobial therapy. There is, however, a recognized need for early identification of sepsis to enable timely administration of antibiotic therapy and for this to be integrated with a whole of systems approach within healthcare facilities. Use of Systemic Inflammatory Response Syndrome criteria is beneficial, but validation is required in neutropenic fever populations. Summary: In the context of emerging and increasing infections because of antimicrobial-resistant bacteria in patients with neutropenic fever, quality improvement initiatives to reduce mortality must encompass antimicrobial stewardship, early detection of sepsis, and use of valid tools for clinical assessment. C-reactive protein and procalcitonin hold potential for inclusion into clinical pathways for management of neutropenic fever.
    Current Opinion in Infectious Diseases 09/2015; DOI:10.1097/QCO.0000000000000202
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    ABSTRACT: Purpose of review: Despite the availability of new antifungals and improved antifungal formulations, there is a continued need for the development of new drugs to treat invasive fungal infections. In high-risk populations, including heavily immunocompromised patients, those with multiple comorbidities, and patients in intensive care settings, invasive fungal infections remain a significant problem, and are associated with high morbidity and mortality. In addition, concerns of increasing antifungal resistance to available agents further highlight the need for new drugs to treat these infections. Recent findings: Recent studies have reported potent in-vitro activity for several investigational agents, including both yeasts and moulds. This in-vitro activity has also translated into in-vivo efficacy in animal models of various invasive fungal infections, including those caused by isolates that are resistant to clinically available agents. These agents include those with mechanisms of action similar to available agents and those that target fungi by novel means. Summary: Several new antifungal agents are currently in various stages of development. This is promising, as there is a continued need for new agents to treat invasive fungal infections. Which ones will receive approval for clinical use and their impact in patients with these infections remain unknown.
    Current Opinion in Infectious Diseases 09/2015; DOI:10.1097/QCO.0000000000000203
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    ABSTRACT: Purpose of review: We highlight recent advances relevant to understanding norovirus infections in the tropics, both in populations living in developing settings and travelers to these regions. Recent findings: Because of the decrease in diarrheal disease associated with the global rollout of vaccines against rotavirus, norovirus is emerging as the predominant cause of diarrhea morbidity among children in the tropics, and evidence suggests that it contributes to adult disease in endemic populations and travelers. In addition to identifying potential target populations for preventive measures, we provide an update on norovirus vaccine development and concepts related to their implementation in low-income and middle-income countries. Summary: These current concepts related to norovirus-attributable disease burden, clinical significance, and economic impact can potentially be applied to tailoring efforts to prevent and mitigate the effects of this important enteropathogen.
    Current Opinion in Infectious Diseases 08/2015; 28(5):408-16. DOI:10.1097/QCO.0000000000000197
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    ABSTRACT: The mechanisms of immunity against intestinal pathogens are not well understood. Innate-like lymphocytes are a group of recently discovered cells that do not fit into either side of the historical innate-adaptive classification. They are enriched in the intestinal mucosa and participate in gut homeostasis and defense against infections. We will review recent developments in innate-like T lymphocytes and innate lymphoid cells, specifically as they relate to responses to intestinal infections. Recent studies have uncovered further details into antigen presentation to γδ T cells and mucosal-associated invariant T cells, the role of invariant natural killer T cells and mucosal-associated invariant T cells in intestinal infections, and how innate lymphoid cells maintain gut homeostasis and protection. Innate-like lymphocytes play a major role in the critical early response to intestinal infections and maintaining gut homeostasis. Further studies of the roles these cells play in the human intestinal mucosa will aid in the development of therapeutics against intestinal infections.
    Current Opinion in Infectious Diseases 08/2015; 28(5). DOI:10.1097/QCO.0000000000000189
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    ABSTRACT: The emergence of artemisinin resistance in Southeast Asia (SEA), where artemisinin combination therapies (ACTs) are beginning to fail, threatens global endeavors to control and eliminate Plasmodium falciparum malaria. Future efforts to prevent the spread of this calamity to Africa will benefit from last year's tremendous progress in understanding artemisinin resistance. Multiple international collaborations have established that artemisinin resistance is associated with slow parasite clearance in patients, increased survival of early-ring-stage parasites in vitro, single-nucleotide polymorphisms (SNPs) in the parasite's kelch protein gene (K13), parasite 'founder' populations sharing a genetic background of four additional SNPs, parasite transcriptional profiles reflecting an 'unfolded protein response' and decelerated parasite development, and elevated parasite phosphatidylinositol-3-kinase activity. In Western Cambodia, where the K13 C580Y mutation is approaching fixation, the frontline ACT is failing to cure nearly half of patients, likely due to partner drug resistance. In Africa, where dozens of K13 mutations have been detected at low frequency, there is no evidence yet of artemisinin resistance. In SEA, clinical and epidemiological investigations are urgently needed to stop the further spread of artemisinin resistance, monitor the efficacy of ACTs where K13 mutations are prevalent, identify currently-available drug regimens that cure ACT failures, and rapidly advance new antimalarial compounds through preclinical studies and clinical trials.
    Current Opinion in Infectious Diseases 07/2015; 28(5). DOI:10.1097/QCO.0000000000000199
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    ABSTRACT: There is a need for improved diagnosis and for more rapidly assessing the presence, prevalence, and spread of newly emerging or reemerging infectious diseases. An approach to the pathogen-detection strategy is based on analyzing host immune response to the infection. This review focuses on a protein microarray approach for this purpose. Here we take a protein microarray approach to profile the humoral immune response to numerous infectious agents, and to identify the complete antibody repertoire associated with each disease. The results of these studies lead to the identification of diagnostic markers and potential subunit vaccine candidates. These results from over 30 different organisms can also provide information about common trends in the humoral immune response. This review describes the implications of the findings for clinical practice or research. A systems biology approach to identify the antibody repertoire associated with infectious diseases challenge using protein microarray has become a powerful method in identifying diagnostic markers and potential subunit vaccine candidates, and moreover, in providing information on proteomic feature (functional and physically properties) of seroreactive and serodiagnostic antigens. Combining the detection of the pathogen with a comprehensive assessment of the host immune response will provide a new understanding of the correlations between specific causative agents, the host response, and the clinical manifestations of the disease.
    Current Opinion in Infectious Diseases 07/2015; 28(5). DOI:10.1097/QCO.0000000000000193
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    ABSTRACT: A diverse array of microbes colonizes the human intestine. In this review, we seek to outline the current state of knowledge on what characterizes a 'healthy' or 'normal' intestinal microbiome, what factors modify the intestinal microbiome in the healthy state and how the intestinal microbiome affects normal host physiology. What constitutes a 'normal' or 'healthy' intestinal microbiome is an area of active research, but key characteristics may include diversity, richness and a microbial community's resilience and ability to resist change. A number of factors, including age, the host immune system, host genetics, diet and antibiotic use, appear to modify the intestinal microbiome in the normal state. New research shows that the microbiome likely plays a critical role in the healthy human immune system and metabolism. It is clear that there is a complicated bidirectional relationship between the intestinal microbiota and host which is vital to health. An enhanced understanding of this relationship will be critical not only to maximize and maintain human health but also to shape our understanding of disease and to foster new therapeutic approaches.
    Current Opinion in Infectious Diseases 07/2015; 28(5). DOI:10.1097/QCO.0000000000000196
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    ABSTRACT: Limitations of blood smear microscopy contributed to failure of the 1950-1960s WHO Global Programme to Eliminate Malaria. All diagnostic methods encounter limits of detection (LOD) beyond which it will not be possible to identify infected individuals. When this occurs, it becomes difficult to continue evaluating progress of malaria elimination. The purpose of this review is to compare available diagnostic technologies, factors that underlie their LOD, and their potential roles related to the goal of elimination. Parasite-containing cells, parasite proteins, hemozoin, nucleic acids, and parasite-specific human antibodies are targets of diagnosis. Many studies report advantages of technologies to detect these diagnostic targets. Nucleic acid amplification tests and strategies for enriching capture of malaria diagnostic targets have consistently identified a parasite reservoir not detected by methods focused on the other biological targets. Exploiting magnetic properties of hemozoin may open new strategies for noninvasive malaria diagnosis. Microscopy and rapid diagnostic tests provide effective surveillance for malaria control. Strategies that detect a reservoir of submicroscopic infection must be developed and standardized to guide malaria elimination.
    Current Opinion in Infectious Diseases 07/2015; 28(5). DOI:10.1097/QCO.0000000000000191
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    ABSTRACT: Previous treatments with pegylated interferon (PEG-IFN) and ribavirin for hepatitis C virus (HCV) infection resulted in significant adverse events and low cure rates, even with the addition of first-generation protease inhibitors. The standard of care for chronic HCV infection changed dramatically in 2013 with the approval of second-generation direct-acting antivirals, which led the way for IFN-free combination regimens. All-oral combinations of direct-acting antivirals, with or without ribavirin, have shown high efficacy and are well tolerated in patients with the predominant genotypes, advanced fibrosis stages, and HIV co-infection. New fixed-dose co-formulations of direct-acting antivirals have allowed simpler regimens with shorter treatment durations and low rates of discontinuation, but are associated with substantial costs. Since 2013, all-oral, IFN-free regimens with direct-acting antivirals have quickly become the mainstay of treatment for HCV infection as they provide high rates of sustained virologic response with a relatively short duration of treatment and low side-effect profile.
    Current Opinion in Infectious Diseases 07/2015; 28(5). DOI:10.1097/QCO.0000000000000190
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    ABSTRACT: There are over 100 serotypes of human enteroviruses, which cause a spectrum of illnesses, including meningitis, encephalitis, paralysis, myocarditis and rash. Increasing incidence of hand-foot-and-mouth disease in the Asia-Pacific region and recent outbreaks of enterovirus-associated disease, such as severe respiratory illness in the United States in 2014, highlight the threat of these viruses to human health. We describe recent outbreaks of human enteroviruses and summarize knowledge gaps regarding their burden, spectrum of diseases and epidemiology. Reported outbreaks of respiratory, neurological, skin and eye diseases associated with human enteroviruses have increased in frequency and size in recent years. Improved molecular diagnostics and genetic sequence analysis are beginning to reveal the complex dynamics of individual serotypes and genotypes, and their contribution to these outbreaks. However, the biological mechanisms underlying their emergence and transmission dynamics remain elusive. They are likely to involve changes in the virus, such as fitness, antigenicity, virulence or tropism, and in the human population, such as levels of sanitation and of homotypic and heterotypic immunity. Improvements in surveillance, serological surveys and detailed genetic and antigenic characterization of viral populations would help to elucidate these mechanisms. This will be important for the design of outbreak control and vaccine development strategies.
    Current Opinion in Infectious Diseases 07/2015; 28(5). DOI:10.1097/QCO.0000000000000187
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    ABSTRACT: Transmission of hepatitis A virus (HAV) infection is primarily fecal-oral. Symptomatic hepatitis, severe disease, and death are more likely to occur when infection occurs at an older age. Improvements in socioeconomic and hygienic conditions have led to a change in its epidemiology worldwide. In the last two decades, improved hygiene in several resource-poor countries has led to reduced transmission of HAV, an increase in average age at infection, and, consequently, a paradoxical increase in morbidity and mortality because of hepatitis A. In Argentina, introduction of one dose (instead of the conventional two doses, to reduce costs) of inactivated HAV vaccine at 12-month age in a universal childhood immunization program during such 'epidemiologic transition' has markedly reduced the incidence of symptomatic hepatitis A, and fulminant hepatitis and liver transplantation because of HAV infection. The monetary value of medical and nonmedical benefits of this strategy outweighed the expenditure on vaccination. These excellent results were possibly contingent upon a high vaccination coverage. Resource-poor countries should closely monitor the epidemiology of HAV infection and periodically undertake cost-effectiveness analyses of HAV immunization strategies. This should allow timely identification of epidemiologic transition and introduction of preventive strategies before HAV infection becomes a public health problem.
    Current Opinion in Infectious Diseases 07/2015; 28(5). DOI:10.1097/QCO.0000000000000188