Clinical Infectious Diseases最新文献

{"title":"Association of Schistosoma haematobium Infection With Decreased Pregnancy: A Prospective Cohort Study.","authors":"Sheridan F Bowers, Jane K Maganga, Loyce Mhango, Peter Shigella, Crispin Mukerebe, Humphrey D Mazigo, Govert J van Dam, Danielle de Jong, Pytsje T Hoekstra, Paul L Corstjens, Saidi H Kapiga, W Evan Secor, Myung Hee Lee, Jennifer A Downs, John M Changalucha","doi":"10.1093/cid/ciag215","DOIUrl":"https://doi.org/10.1093/cid/ciag215","url":null,"abstract":"<p><p>We quantified incident pregnancies among reproductive-aged women with and without Schistosoma haematobium infection. Among 245 women, 59 (24.1%) became pregnant during a median follow-up of 370 days. Women with S. haematobium infection had a 52% lower rate of pregnancy within the study period compared with uninfected women (hazard ratio = 0.48 [0.29-0.80], P = .005).</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811712","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 Resistance to Dolutegravir Varies With Coadministered Agents.","authors":"Ingrid A Beck, Ceejay L Boyce, Marley D Bishop, Alyssa R Oldroyd, Louise du Toit, Amashnee Saimen, Kholofelo Mn Ramarope, Sonia Hitchcock, Nicolette M du Plessis, Loice Mbogo, Bhavna H Chohan, Pooja Maheria, Patrick Oyaro, Kevin Knowles, Zhongli Zhang, Sean S Brummel, Paul K Drain, Robert A Smith, Geoffrey S Gottlieb, Lisa Abuogi, Rena C Patel, Carey Farquhar, Andrew Wiznia, Theodore D Ruel, Theresa M Rossouw, Stephen E Hawes, Lisa M Frenkel","doi":"10.1093/cid/ciaf481","DOIUrl":"10.1093/cid/ciaf481","url":null,"abstract":"<p><p>We hypothesized that HIV-dolutegravir resistance is more frequent when coadministered with nucleos(t)ides with shorter intracellular half-lives. Multivariable analysis of 183 viremic (≥200 c/mL) participants from 4 cohorts (N = 660 participants) found dolutegravir resistance in 21 (11.5%). Dolutegravir resistance was greater with dolutegravir + lamivudine + zidovudine/(1 on stavudine) (odds ratio [OR] = 19.4, 95% confidence interval [CI]: 5.1-74.3) or dolutegravir + lamivudine +abacavir (OR = 5.4, 95% CI: 1.1-25.8), compared with dolutegravir + lamivudine + tenofovir.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"592-596"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection Control in Carceral Facilities.","authors":"Amadin A Olotu, Joseph A Bick, B Sue Medley-Lane, Anne C Spaulding","doi":"10.1093/cid/ciaf479","DOIUrl":"10.1093/cid/ciaf479","url":null,"abstract":"<p><p>At the end of 2022, 5.4 million people (1 of every 48 adults) were either in jail, in prison, or on probation/parole in the United States. One in 20 persons in the United States (5%) will be incarcerated during their lifetime. Among those newly admitted to carceral settings, the prevalence of active tuberculosis disease and infections from blood-borne viruses and sexually transmitted pathogens is substantially higher than in community counterparts. Exposure to the carceral setting places residents, employees, and visitors at risk for acquiring communicable diseases, predominately those transmitted via airborne routes. Efforts to prevent, mitigate, or control infectious diseases benefit those within carceral facilities and also surrounding communities. This review briefly explores some of the changes, challenges, and opportunities relevant to the prevention and control of infectious diseases in jails, prisons, and juvenile residential facilities. It also emphasizes the need for adequate education and training when planning and implementing interventions.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e781-e790"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Effect of Ending Centers for Disease Control and Prevention Funding for HIV Tests: A Modeling Study in 18 States.","authors":"Ruchita Balasubramanian, Melissa Schnure, Ryan Forster, William P Hanage, D Scott Batey, Keri N Althoff, Kelly A Gebo, David W Dowdy, Maunank Shah, Parastu Kasaie, Anthony T Fojo","doi":"10.1093/cid/ciag038","DOIUrl":"10.1093/cid/ciag038","url":null,"abstract":"<p><strong>Background: </strong>Timely HIV diagnosis and treatment is critical to preventing transmission. The US Centers for Disease Control and Prevention (CDC) provides funding for HIV testing to local health departments and community organizations. We sought to estimate the number of additional HIV infections that would result from ending or interrupting CDC funding for HIV tests in US states.</p><p><strong>Methods: </strong>We used a validated model of HIV transmission to simulate HIV epidemics in 18 US states. We projected incidence forward under 3 scenarios where all CDC-funded HIV testing ends in October 2025 and (1) never resumes, (2) returns to previous levels between January and December 2027, and (3) returns from January to December 2029. We calculated the excess incident HIV infections compared to a scenario where CDC-funded testing continues uninterrupted.</p><p><strong>Results: </strong>If CDC funding for HIV tests were to end on 1 October 2025, we project 12 719 additional HIV infections across 18 states by 2030 (95% credible interval, 4547-21 896)-an increase of 10%. The projected effects varied by state, ranging from a 2.7% increase in Washington (1.0%-4.7%) to a 29.9 increase in Louisiana (9.4%-59.9%). States that perform more CDC-funded tests and states with more rural HIV epidemics were projected to see greater rises in incidence.</p><p><strong>Conclusions: </strong>Disruptions to CDC-funded HIV testing would substantially increase new infections, particularly in states with more rural epidemics. These findings demonstrate the value of the CDC's HIV testing activities in curbing the spread of HIV in the United States.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e746-e754"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Reactivation in a US Cohort of People With HIV and Hepatitis B Core Antibody After Switch to Antiretroviral Therapy Without Hepatitis B Activity.","authors":"Rachel V Denyer, Janet P Tate, Debra A Benator, Joseph K Lim, Amy Weintrob","doi":"10.1093/cid/ciag001","DOIUrl":"10.1093/cid/ciag001","url":null,"abstract":"<p><strong>Background: </strong>One in 3 people with human immunodeficiency virus (HIV-1; PWH) are hepatitis B (HBV) core antibody positive (anti-HBc+) and surface antigen negative (HBsAg-) suggesting prior exposure. HBV reactivation can occur in this group if nucleos(t)ide reverse transcriptase inhibitor antiretrovirals (ARV) active against both HIV and HBV are stopped. We describe HBV reactivation in anti-HBc+/HBsAg- PWH following switch from ARV with HBV activity to ARV without HBV activity.</p><p><strong>Methods: </strong>We identified an at-risk cohort of 5986 anti-HBc+ participants switched from HBV-active to non-HBV-active ARV on or before 31 December 2023 and HBsAg- on the most recent result preceding switch from 63 153 PWH in the Veterans Aging Cohort Study. We defined HBV reactivation as HBV DNA detection or HBsAg+ result at any time following switch. HBV-active ARV included lamivudine, emtricitabine, or tenofovir.</p><p><strong>Results: </strong>Forty (0.67%) anti-HBc+/HBsAg- PWH experienced HBV reactivation after switch to non-HBV-active ARV, with median time to reactivation 8.9 months (interquartile range 5.5-26.7). The rate of HBV reactivation was 25.1 per 10 000 person-years (95% confidence interval [CI], 18.4-34.3). Prespecified subgroup analyses revealed higher rates per 10 000 person-years of HBV reactivation in those HBsAg+ in the remote past with no hepatitis B surface antibody positive (anti-HBs+) result (321; 95% CI, 120-855) versus subgroups never previously HBsAg+ or anti-HBs+ (38.0; 95% CI, 22.9-63.0), or anti-HBs+ but never HBsAg+ (17.4; 95% CI, 11.2-27.0).</p><p><strong>Conclusions: </strong>Overall risk of HBV reactivation appears low after switch from HBV-active to non-HBV-active ARV among anti-HBc+ PWH with no prior HBsAg+. Our results inform provider-patient discussion about HBV reactivation risk when considering ARV switching.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e735-e742"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Yield of Tongue Swab- Compared to Sputum-Based Molecular Testing for Tuberculosis in Four High-Burden Countries.","authors":"Caitlin A Moe, Rita Kabuleta Luswata, Armen Jheannie Barrameda, Hien Le, Seke Muzazu, Rebecca Crowder, Alfred O Andama, Claudia M Denkinger, Monde Muyoyeta, Ha Phan, Adithya Cattamanchi, Charles Yu","doi":"10.1093/cid/ciag077","DOIUrl":"10.1093/cid/ciag077","url":null,"abstract":"<p><strong>Background: </strong>Tongue swabs are a promising alternative specimen for tuberculosis (TB) diagnosis. Although test specificity exceeds 98%, sensitivity is lower than sputum-based molecular testing. We investigated whether the use of tongue swabs could increase sample availability, resulting in similar diagnostic yield.</p><p><strong>Methods: </strong>In this cross-sectional study (July 2024-January 2025), we screened consecutive people with presumptive TB at health centers in the Philippines, Vietnam, Uganda, and Zambia. Participants were asked to provide tongue swabs and referred for routine sputum collection. Tongue swabs were tested in research laboratories using the MiniDock MTB Test (Guangzhou Pluslife Biotech Co., Ltd., China); sputum was tested using WHO-recommended molecular testing per national guidelines. We compared diagnostic yield, defined as proportion of positive test results among all participants, between tongue swab- and sputum-based molecular testing with a prespecified 3.0% non-inferiority margin.</p><p><strong>Results: </strong>Of 1639 participants, 851 (51.9%) were female, 415 (25.3%) were diagnosed with HIV, and 132 (8.1%) were children <5 years. All provided tongue swabs, but only 1389 (84.7%) produced sputum. Diagnostic yield was 3.8% (63/1639) for tongue swabs and 4.1% (68/1639) for sputum-based (68/1639, 4.1%) molecular testing. The difference (0.3%, 95% CI -0.6 to +1.2) was within the prespecified non-inferiority margin. Results were consistent across countries and key subgroups (age, sex, and HIV status).</p><p><strong>Conclusions: </strong>Tongue swab-based molecular testing with MiniDock MTB achieved non-inferior diagnostic yield compared with sputum-based molecular testing. These findings support scale-up of swab-based platforms as a cost-efficient alternative, particularly where sputum collection is challenging or smear microscopy remains the primary diagnostic method.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e816-e823"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent Testing to Accelerate the Development of Lateral Flow Assays for Influenza A, Influenza B and SARS-COV-2.","authors":"Anuradha Rao, Laura Johnson, Leda Bassit, Julie Sullivan, Heather B Bowers, Courtney Sabino, Seegar Swanson, Mark Griffiths, Cheryl Stone, Kaleb B McLendon, Kathy Bifulco, Chelsea Rock, Julia Tisheh, Emily B Kennedy, Eric Lai, Pamela Miller, Raymond F Schinazi, Jennifer K Frediani, Annette Esper, Greg S Martin, Wilbur A Lam, Gregory L Damhorst","doi":"10.1093/cid/ciaf660","DOIUrl":"10.1093/cid/ciaf660","url":null,"abstract":"<p><strong>Background: </strong>As the test verification core for the Rapid Acceleration of Diagnostics (RADx) Independent Test Assessment Program (ITAP), we conducted independent bench- and field-based performance testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A&B lateral flow assays (LFAs) prior to formal clinical studies for Food and Drug Administration (FDA) submission.</p><p><strong>Methods: </strong>During bench testing, the limit of detection (LOD) was approximated using serially diluted panels of laboratory-propagated virus. In field studies, LFA results were interpreted by study participants, and sensitivity and specificity were determined using reverse transcription polymerase chain reaction (RT-PCR) (Xpert CoV-2/Flu/RSV plus) from a concurrent nasal swab as the reference standard.</p><p><strong>Results: </strong>Between February 2023 and February 2025, we tested 30 iterations of 14 LFAs. LODs were 53 277-1 393 314 genome equivalents (GE)/mL for SARS-CoV-2, 85 027-1 731 676 for influenza A, and 11 688-2 960 941 for influenza B. Field studies enrolled 27 to 126 participants per LFA with most enrolling at least 50 participants. When minimum 5 positive cases were enrolled, sensitivity ranged from 0.57-1.00 for SARS-CoV-2 and 0.64-0.85 for influenza A. Influenza B case enrollment was low. Specificity ranged from 0.91-1.00 across all targets. Eleven of 14 devices underwent at least two iterations of testing. Following ITAP assessment, 7 devices received FDA emergency use authorization, and 3 ultimately received de novo marketing approval or 510 (k) clearance.</p><p><strong>Conclusions: </strong>The ITAP enabled rapid feedback to federal agencies and manufacturers on the analytical and clinical performance of over-the-counter LFAs for SARS-CoV-2 and influenza, ultimately contributing to success in regulatory authorization or clearance.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e807-e815"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Soil to Skin: An Unexpected Cause of Necrotizing Cellulitis.","authors":"Erica Peak, Aldo Barajas-Ochoa, Nathaniel C Warner","doi":"10.1093/cid/ciaf555","DOIUrl":"https://doi.org/10.1093/cid/ciaf555","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"82 4","pages":"734-737"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811733","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":"Protocols for Randomized Controlled Trials: Advancing Transparency in Infectious Diseases.","authors":"Jean-Jacques Parienti, Roger Bedimo, Cynthia L Sears, Paul E Sax","doi":"10.1093/cid/ciag198","DOIUrl":"https://doi.org/10.1093/cid/ciag198","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"82 4","pages":"557"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811715","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":"The Fate of Oral Meds.","authors":"Monica V Mahoney","doi":"10.1093/cid/ciaf708","DOIUrl":"10.1093/cid/ciaf708","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e682-e683"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793620","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}