Who actually clears HBsAg on peg-interferon add-on, and a quarter of seizure patients in endemic areas have neurocysticercosis

The edition in brief

Five findings and a pearl for the infectious diseases desk. PROSPER pooled individual participant data from eight trials of peg-interferon added to nucleos(t)ide analogue therapy in 581 patients with chronic hepatitis B. Overall HBsAg loss at end of follow-up was 8.6%, but that average conceals the only number that matters for selection: 37.7% in those starting with HBsAg below 100 IU/mL, 9.8% between 100 and 1000, and 2.3% above 1000, consistent across Caucasian and Asian patients. In patients above 1000 IU/mL, 48 weeks of peg-IFN brought 47.5% below 1000 and 16.3% below 100 - potentially useful as a lead-in to novel agents rather than as a cure attempt. A phase 3 trial in 7,677 adults aged 50 or over compared an MF59-adjuvanted, cell-derived, higher-dose quadrivalent influenza vaccine against the standard adjuvanted egg-derived vaccine and against recombinant vaccine: superior to the adjuvanted comparator on all four strains, but it failed non-inferiority against recombinant vaccine for A/H3N2, with a geometric mean titre ratio of 0.69. A Bayesian meta-analysis of 77 studies estimates that 25.2% of people presenting with epileptic seizures in Taenia solium endemic regions have neurocysticercosis, with the proportion falling since 2008. An FDA generic application supplement for nitrofurantoin is administrative, not a new indication. The practice-changer is a Cochrane review of thymosin-alpha-1 in chronic hepatitis B: ten trials, 1,349 participants, and evidence graded very low for every outcome except serious adverse events. Plus a pearl on when a positive urine culture should not be treated.