Clinical Infectious Diseases最新文献

{"title":"Pharmacokinetics of Twice-daily Tenofovir Alafenamide in Adults With HIV-associated Tuberculosis on Bictegravir/Emtricitabine/Tenofovir Alafenamide and Rifampicin.","authors":"Emmanuella Chinonso Osuala, Ivan Nicholas Nkuhairwe, Marothi Peter Letsoalo, Kogieleum Naidoo, Rubeshan Perumal, James F Rooney, Lubbe Wiesner, Roeland E Wasmann, Paolo Denti, Kelly E Dooley, Anushka Naidoo","doi":"10.1093/cid/ciaf732","DOIUrl":"10.1093/cid/ciaf732","url":null,"abstract":"<p><strong>Background: </strong>Tenofovir alafenamide (TAF) is a key component of many fixed-dose combinations used to treat HIV. There are limited data on the pharmacokinetics of plasma TAF, tenofovir (TFV), or intracellular tenofovir diphosphate (TFV-DP), among people with HIV (PWH) and tuberculosis (TB) who are taking rifampicin-based TB treatment.</p><p><strong>Methods: </strong>Participants in the intervention arm of the INSIGHT trial (NCT04734652) receiving bictegravir/emtricitabine/TAF (BIC/FTC/TAF 50/200/25 mg) were enrolled into the semi-intensive pharmacokinetic substudy. BIC/FTC/TAF was administered twice-daily during rifampicin-based TB treatment (∼24 weeks) and once-daily thereafter. Plasma (TAF/TFV) and dried blood spot samples (TFV-DP) were collected at weeks 4 and 12 (predose, 1, 2, 4, 6, and 8-12 hours postdose) during TB treatment and at week 32 (predose, 1, 2, 4, 6-8 and 24-25 hours postdose) post-TB treatment. Pharmacokinetic parameters were determined using noncompartmental analysis. Clinical and safety data were collected.</p><p><strong>Results: </strong>Among 43 participants enrolled; median (IQR) age and weight were 35 (30-39) years and 58 (52-65) kg; 77% were male. Geometric least square mean ratios (90% CI) at week 12 (twice-daily TAF) relative to week 32 (once-daily TAF) for TAF AUC0-4, TFV, and TFV-DP AUC0-24 were 1.55 (1.13-2.13), 1.24 (1.07-1.44), and 1.32 (1.13-1.53), respectively. At week 24, 95% of participants achieved viral suppression, with no treatment-related serious adverse events or drug discontinuations.</p><p><strong>Conclusions: </strong>Twice-daily TAF was safe and efficacious and achieved similar exposures of intracellular TFV-DP in PWH taking rifampicin for TB compared to once-daily TAF taken alone. These data support the use of TAF in a fixed-dose combination of BIC/FTC/TAF during rifampicin-containing TB treatment.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e720-e727"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854931","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":"Strong Real-World Evidence That a Single Dose of Benzathine Penicillin G or a 28-Day Course of Oral Doxycycline Is Not Inferior to 3 Doses of Benzathine Penicillin G for the Treatment of Late Latent or Unknown Duration Syphilis.","authors":"Noah Kojima, Jeffrey D Klausner","doi":"10.1093/cid/ciag101","DOIUrl":"10.1093/cid/ciag101","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e852-e854"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270042","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":"Regional Variations of Rates and Determinants of Drug Resistance Mutations in People Failing First-line Therapy for HIV-1: A Substudy from the D2EFT Phase 3b/4 Clinical Trial.","authors":"Billal Musah Obeng, Jolie Hutchinson, Ansari Shaik, Ploenchan Chetchotisakd, Iskandar Azwa, Wahyu Nawang Wulan, Nagalingeswaran Kumarasamy, Marcelo Wolff, José Bruguera, Marcelo Losso, Richard Kaplan, Mariama Sadjo Diallo, Nnakelu Eriobu, Godfrey Musoro, July Kumalawati, Abba Badamasi, Munawaroh Fitriah, Deshinta Putri Mulya, Matthew Law, Gail Matthews, Francesca Di Giallonardo, Anthony Dominic Kelleher","doi":"10.1093/cid/ciaf739","DOIUrl":"10.1093/cid/ciaf739","url":null,"abstract":"<p><strong>Background: </strong>D²EFT (Dolutegravir and Darunavir Evaluation in Adults Failing Therapy) was a phase 3b/4 randomized clinical trial designed to assess second-line treatment options systematically. This substudy evaluated the distribution of drug resistance mutations (DRMs) before treatment randomization in individuals failing first-line therapy.</p><p><strong>Methods: </strong>From a total of 826 participants across 14 countries, 727 sequences that covered the PR-RT-INT (700), PR-RT (24), and RT (3) regions were analyzed for drug resistance. Sequences were submitted to the Stanford HIV drug resistance database to detect DRMs and assign subtypes. By adjusting for country and antiretroviral therapy regimen, we assessed the association between DRMs and country and reported DRMs.</p><p><strong>Results: </strong>Subtype C of human immunodeficiency virus type 1 (HIV-1) accounted for most (59.3%) infections. There were extraordinarily high rates of high-level resistance to lamivudine and emtricitabine (both at 88.3%) and for efavirenz and nevirapine (92.8% and 96.8%, respectively). On average, nucleoside reverse transcriptase inhibitor mutations had the highest occurrence across countries with M184V/I detected in 86.2% of the samples, while the highest proportion of nonnucleoside reverse transcriptase inhibitor mutations was K103N at 57.8%. K103N had an increased likelihood of occurrence in African and South American countries (P < .05). Participants with prior exposure to a zidovudine-containing regimen had an increased likelihood of T215F/Y mutations (6.80 [2.59-17.86]), while those with nevirapine/rilpivirine exposure had a decreased likelihood of K103N mutations (0.29 [0.15-0.56]).</p><p><strong>Conclusions: </strong>The regional specificity of mutations underscores the dynamic nature of HIV-1 drug resistance patterns and the importance of monitoring and understanding local mutation profiles.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e693-e704"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892282","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 Virus Reactivation in People With HIV After Treatment With Non-hepatitis B Virus-Active Antiretroviral Therapy.","authors":"Amir M Mohareb, Anders Boyd","doi":"10.1093/cid/ciag002","DOIUrl":"10.1093/cid/ciag002","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e743-e745"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282523","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":"Respiratory Syncytial Virus After Chimeric Antigen Receptor T-cell Therapy: Risk Factors and Outcomes in a Multicenter Retrospective Cohort.","authors":"Maria Isabel Sotelo-Alva, Ofrat Beyar-Katz, Judy Yan, Silvia Escribano-Serrat, Alexander Boardman, Mika Geva, Marina Gomez-Llobell, Jabour Halloun, Hazim Khatib, Malin Hultcrantz, Jennifer Lue, Sham Mailankody, Genovefa Papanicolaou, Lia Palomba, Jae H Park, Kai Rejeski, Jaime Sanz, Michael Scordo, Susan K Seo, Gunjan Shah, Kayleen Shi, Niveen Shibli, Saad Usmani, Noriko Nishimura, Zainab Shahid, Miguel-Angel Perales, Roni Shouval, Mini Kamboj, Sigrun Einarsdottir","doi":"10.1093/cid/ciag052","DOIUrl":"10.1093/cid/ciag052","url":null,"abstract":"<p><p>Among 667 CAR-T recipients, the 2-year cumulative incidence of RSV was 7%, with 29% of diagnosed cases progressing to LRTI. Older age and lymphopenia were associated with severity. Most infections (74%) occurred beyond day +100 (median 8 months). No RSV-attributable deaths occurred. Clinical vigilance is warranted, especially during RSV season.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"618-621"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282586","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":"A 67-year-Old Immunocompromised Male Presenting With Right Upper-Quadrant Abdominal Pain and Hepatic Lesions.","authors":"Sara Yousef Zadeh Shoushtari, Janithra Muhandiram, Julianne Klein, Andrew Walkty, Signey Holmes, Philippe Lagacé-Wiens","doi":"10.1093/cid/ciaf729","DOIUrl":"https://doi.org/10.1093/cid/ciaf729","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"82 4","pages":"738-741"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811644","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":"Methodological Considerations in Evaluating Oral Antivirals for B-Cell-Depleted Patients.","authors":"Wenjing Chen, Ruixiang Li, Shi Huang","doi":"10.1093/cid/ciaf717","DOIUrl":"10.1093/cid/ciaf717","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e893-e894"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932494","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":"Uncertain Terrain.","authors":"Kap Sum Foong, Sara W Dong","doi":"10.1093/cid/ciaf283","DOIUrl":"10.1093/cid/ciaf283","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"558-561"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526711","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":"Preschool or Infant Human Papillomavirus Immunization?","authors":"Mark A Kane, Eduardo L Franco","doi":"10.1093/cid/ciaf678","DOIUrl":"10.1093/cid/ciaf678","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e884-e886"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741545","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":"Target Trial Emulation of Oral Antivirals for B-Cell-Depleted COVID-19 Patients-Reply to Chen et al.","authors":"Xiaofeng F Wang, Cassandra Calabrese, Leonard Calabrese","doi":"10.1093/cid/ciaf718","DOIUrl":"10.1093/cid/ciaf718","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e894-e895"},"PeriodicalIF":7.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932573","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}