Clinical Infectious Diseases最新文献

{"title":"Cutaneous Lesions at the Crossroads of Infection and Immunity.","authors":"Julyssa Renteria,Shivan Shah,Philippa Li,John Greene,Olga Klinkova","doi":"10.1093/cid/ciaf076","DOIUrl":"https://doi.org/10.1093/cid/ciaf076","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"26 1","pages":"213-215"},"PeriodicalIF":11.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real World Virologic Outcomes in Patients With Elevated Body Mass Index Receiving Long Acting Cabotegravir/Rilpivirine.","authors":"Christina Maguire, Kaitlyn Rueve, Eric Farmer, Emily Huesgen, Antoneta Karaj, Amanda Binkley, Karam Mounzer, Marisa Brizzi, Pallavi Chary, Peter Sung, Amy Graziani, Emily Hiserodt, Jillian Baron, Helen Koenig, William R Short","doi":"10.1093/cid/ciae579","DOIUrl":"10.1093/cid/ciae579","url":null,"abstract":"<p><strong>Background: </strong>The first long-acting injectable antiretroviral, cabotegravir/rilpivirine (LA-CAB/RPV), was approved by the Food and Drug Administration (FDA) in January 2021 for persons with human immunodeficiency virus (HIV) suppressed on their current regimen. Body mass index (BMI) ≥30 kg/m2 has been identified as a risk factor for virologic failure; however, data are limited due to small sample sizes. The aim of this study was to evaluate the impact of BMI on the efficacy of LA-CAB/RPV in a real-world setting.</p><p><strong>Methods: </strong>A retrospective, multicenter cohort study was conducted from 22 January 2021 to 15 February 2023 in individuals who received LA-CAB/RPV every 4 (Q4w) or 8 weeks (Q8w). Individuals included were virologically suppressed on their current regimen, received at least 1 dose of LA-CAB/RPV, and had a follow-up viral load post initiation.</p><p><strong>Results: </strong>A total of 374 individuals across 5 centers were included, with a BMI ≥30 kg/m2 in 148 (39.5%) individuals. Most individuals received a Q8w (68%) regimen, and the incidence of viral load ≥50 copies/mL was similar between those with BMI ≥30 kg/m2 (12%) as compared to those with BMI <30 kg/m2 (9%) (incidence rate ratio [IRR] 1.31; 95% confidence interval [CI]: .69-2.46, P = .4). Confirmed virologic failure occurred in 0.8% of individuals overall, with 2 of the 3 cases occurring in those with BMI ≥30 kg/m2.</p><p><strong>Conclusions: </strong>The data from this real-world cohort demonstrates no difference in virologic outcomes for individuals with BMI ≥30 kg/m2 as compared to those with BMI <30 kg/m2 suggesting that higher BMI alone should not preclude use of LA-CAB/RPV in eligible individuals.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"67-74"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Clear and Present Danger: Encephalitis Due to Infection With Normocellular Cerebrospinal Fluid.","authors":"Karen Bloch, Carol Glaser","doi":"10.1093/cid/ciae387","DOIUrl":"10.1093/cid/ciae387","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"188-189"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistently Higher Seroresponse to Benzathine Penicillin G (BPG) Combined With Doxycycline Versus BPG Alone for Early Syphilis.","authors":"Kai-Hsiang Chen, Kuan-Yin Lin, Chien-Ching Hung","doi":"10.1093/cid/ciae660","DOIUrl":"10.1093/cid/ciae660","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e13-e14"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV-1 Low-Level Viremia Predicts Viral Failure in Participants on Antiretroviral Therapy in the Swiss HIV Cohort Study.","authors":"Caroline Lanz, Jan Meier, Marcel Stöckle, Hansjakob Furrer, Alexandra Calmy, Matthias Cavassini, Enos Bernasconi, Patrick Schmid, Dominique L Braun, Roger D Kouyos, Tom Loosli, Katharina Kusejko, Huldrych F Günthard","doi":"10.1093/cid/ciae569","DOIUrl":"10.1093/cid/ciae569","url":null,"abstract":"<p><strong>Background: </strong>Most individuals receiving combination antiretroviral therapy (ART) have human immunodeficiency virus (HIV) plasma viral loads below the limit of detection. However, episodes of low-level viremia (LLV) are observed in subsets of individuals, the risk factors and clinical significance of which remain debated.</p><p><strong>Methods: </strong>We included participants enrolled in the Swiss HIV Cohort Study, starting ART between July 1999 and April 2023, with HIV RNA values <200 copies/mL 6 months after ART initiation. Using longitudinally collected data, we applied a time-updated Cox proportional hazards model to determine the association of LLV with the risk of subsequent viral failure, defined as ≥200 copies/mL. LLV was quantified by the time-updated area under the curve (AUC) of HIV RNA values, categorized as undetectable or, based on AUC tertiles, low, intermediate, or high.</p><p><strong>Results: </strong>We included 8132 participants with a total of 49 579 person-years of follow-up. The median follow-up time was 4.7 years, and the median number of HIV RNA measurements was 16. Participants had a median age of 38 years, 75.9% were male, 74.4% were white, and 45.9% had HIV-1 subtype B. LLV was associated with an increased risk of subsequent viral failure, with the highest LLV category showing the strongest association (hazard ratio, 3.3 [for comparison with undetectable viral load]) among all included variables, including race/ethnicity, age, and ART.</p><p><strong>Conclusions: </strong>LLV was strongly associated with risk of subsequent viral failure, even after adjustment for demographic and clinical characteristics, including adherence and treatment regimen. The detection of LLV should prompt appropriate measures to decrease the risk of subsequent viral failure.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"57-66"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefit of Early Oseltamivir Therapy for Adults Hospitalized With Influenza A: An Observational Study.","authors":"Nathaniel M Lewis, Elizabeth J Harker, Lauren B Grant, Yuwei Zhu, Carlos G Grijalva, James D Chappell, Jillian P Rhoads, Adrienne Baughman, Jonathan D Casey, Paul W Blair, Ian D Jones, Cassandra A Johnson, Adam S Lauring, Manju Gaglani, Shekhar Ghamande, Cristie Columbus, Jay S Steingrub, Nathan I Shapiro, Abhijit Duggal, Laurence W Busse, Jamie Felzer, Matthew E Prekker, Ithan D Peltan, Samuel M Brown, David N Hager, Michelle N Gong, Amira Mohamed, Matthew C Exline, Akram Khan, Catherine L Hough, Jennifer G Wilson, Jarrod Mosier, Nida Qadir, Steven Y Chang, Adit A Ginde, Amanda Martinez, Nicholas M Mohr, Christopher Mallow, Estelle S Harris, Nicholas J Johnson, Vasisht Srinivasan, Kevin W Gibbs, Jennie H Kwon, Ivana A Vaughn, Mayur Ramesh, Basmah Safdar, Anirudh Goyal, Lauren E DeLamielleure, Jennifer DeCuir, Diya Surie, Fatimah S Dawood, Mark W Tenforde, Timothy M Uyeki, Shikha Garg, Sascha Ellington, Wesley H Self","doi":"10.1093/cid/ciae584","DOIUrl":"10.1093/cid/ciae584","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.</p><p><strong>Methods: </strong>A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during 1 October 2022-21 July 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status. Multivariable logistic regression models were used to evaluate the odds of intensive care unit (ICU) admission, acute kidney replacement therapy or vasopressor use, and in-hospital death.</p><p><strong>Results: </strong>A total of 840 influenza-positive patients were analyzed, including 415 (49%) who started oseltamivir treatment on the day of admission, and 425 (51%) who did not. Compared with late or not treated patients, those treated early had lower peak pulmonary disease severity (proportional adjusted odds ratio [aOR]: 0.60, 95% confidence interval [CI]: .49-.72), and lower odds of intensive care unit admission (aOR: 0.24, 95% CI: .13-.47), acute kidney replacement therapy or vasopressor use (aOR: 0.40, 95% CI: .22-.67), and in-hospital death (aOR: 0.36, 95% CI: .18-.72).</p><p><strong>Conclusions: </strong>Among adults hospitalized with influenza, treatment with oseltamivir on day of hospital admission was associated reduced risk of disease progression, including pulmonary and extrapulmonary organ failure and death.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"190-197"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up Fungal Polymerase Chain Reaction Testing on Plasma and Bronchoalveolar Lavage Fluid Is Low Yield.","authors":"Niaz Banaei","doi":"10.1093/cid/ciae625","DOIUrl":"10.1093/cid/ciae625","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e8-e9"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Based Tuberculosis Isolation Decisions Require Individualization Based on Effectiveness and Duration of Treatment, Community Risks, and Patient Harms.","authors":"Maunank Shah, Ruvandhi Nathavitharana, Joseph Burzynski","doi":"10.1093/cid/ciae608","DOIUrl":"10.1093/cid/ciae608","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e2-e4"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV Is Associated With Subclinical Coronary Atherosclerosis: A Prospective Matched Cohort Study.","authors":"Andreas D Knudsen, Andreas Fuchs, Thomas Benfield, Lars Køber, Børge Grønne Nordestgaard, Shoaib Afzal, Jørgen Tobias Kuhl, Per Ejlstrup Sigvardsen, Moises Alberto Suarez-Zdunek, Marco Gelpi, Susanne D Nielsen, Klaus F Kofoed","doi":"10.1093/cid/ciae609","DOIUrl":"10.1093/cid/ciae609","url":null,"abstract":"<p><strong>Background: </strong>Persons with HIV (PWH) have an elevated risk of myocardial infarction compared to the general population. However, the underlying mechanisms linking HIV with this increased risk remain unclear. We aimed to compare the prevalence and characteristics of subclinical coronary atherosclerosis in PWH with population controls.</p><p><strong>Methods: </strong>Participants were included from the Copenhagen Comorbidity in HIV Infection study and the Copenhagen General Population Study. Presence of any and obstructive subclinical coronary atherosclerosis (≥50% stenosis) were assessed using coronary computed tomography angiography. Analyses were adjusted for cardiovascular risk factors including age, sex, hypertension, dyslipidemia, current smoking, overweight or obesity, and diabetes.</p><p><strong>Results: </strong>We included 519 PWH and 1114 age and sex-matched population controls. The median age was 52 years, and 89% of participants were men. The cardiovascular risk, evaluated by the Systematic COronary Risk Evaluation 2 prediction algorithm, was similar in PWH and population controls. PWH exhibited a higher prevalence of both any (54% vs 42%, P < .001) and obstructive coronary atherosclerosis (16% vs 8%, P < .001) than population controls. After adjusting for cardiovascular risk factors, HIV was associated with an odds ratio of 1.98 [95% confidence interval, 1.52-2.58] of any coronary atherosclerosis, and odds ratio of 3.21 [2.00-5.17] of obstructive atherosclerosis.</p><p><strong>Conclusions: </strong>HIV is independently associated with a three-fold higher risk of subclinical obstructive coronary atherosclerosis. Our results offer a possible explanation for the higher risk of myocardial infarction observed in PWH.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"84-91"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Nonsustained Viral Suppression With Long-Acting Cabotegravir and Rilpivirine Really Independent of Drug Levels?","authors":"Paul Thoueille, Catia Marzolini, Monia Guidi, Matthias Cavassini, Laurent A Decosterd","doi":"10.1093/cid/ciae616","DOIUrl":"10.1093/cid/ciae616","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e4-e5"},"PeriodicalIF":7.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}