Infectious Disease Reports最新文献

{"title":"Mpox Surveillance and Laboratory Response in Portugal: Lessons Learned from Three Outbreak Waves (2022-2025).","authors":"Rita Cordeiro, Rafaela Francisco, Ana Pelerito, Isabel Lopes de Carvalho, Maria Sofia Núncio","doi":"10.3390/idr17040086","DOIUrl":"https://doi.org/10.3390/idr17040086","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Mpox re-emerged in 2022 as a global health concern. Between 2022 and 2025, Portugal experienced three distinct outbreak waves, highlighting the critical role of laboratory surveillance and public health interventions. This study describes the epidemiological trends, diagnostic performance, and key lessons learned to improve outbreak preparedness. <b>Methods:</b> A total of 5610 clinical samples from 2802 suspected cases were analyzed at the National Institute of Health Doutor Ricardo Jorge using real-time PCR methods. Positivity rates and viral loads (Ct values) were assessed across different clinical specimen types, including lesion, anal, oropharyngeal swabs, and urine samples. <b>Results:</b> Mpox was confirmed in 1202 patients. The first outbreak accounted for 79.3% of cases (n = 953), followed by a significant reduction in transmission during subsequent waves. Lesion and rectal swabs provided the highest diagnostic sensitivity (95.1% and 87.9%, respectively). Oropharyngeal swabs contributed to diagnosis in cases without visible lesions, while urine samples showed limited utility. <b>Conclusions:</b> This study underscores the importance of sustained laboratory surveillance and adaptive public health strategies in controlling mpox outbreaks. Optimizing specimen collection enhances diagnostic accuracy, supporting early detection. Continuous monitoring, combined with targeted vaccination and effective risk communication, is essential to prevent resurgence and ensure rapid response in non-endemic regions.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Rectal Syphilis in the Setting of Profound HIV Immunosuppression: A Case Report Highlighting ERG/CD38 Immunophenotyping and a Review of the Literature.","authors":"Diana Marcela Carmona Valencia, Juan Diego López, Shirley Vanessa Correa Forero, Diana Marcela Bonilla Bonilla, Jorge Karim Assis, Yamil Liscano","doi":"10.3390/idr17040085","DOIUrl":"https://doi.org/10.3390/idr17040085","url":null,"abstract":"<p><p><b>Background and Aim:</b> Syphilis, caused by <i>Treponema pallidum</i>, classically presents with genital or anal chancres; rectal involvement is rare and frequently misdiagnosed as inflammatory bowel disease or malignancy. We describe an unusually severe case of syphilitic proctitis in the setting of advanced HIV-related immunosuppression (CD4 39 cells/µL), in which targeted immunophenotyping (ERG and CD38) was a valuable adjunctive tool in the differential diagnosis. <b>Case Presentation:</b> A 46-year-old man with a recent history of erosive gastritis and esophageal candidiasis presented after six months of unintentional 20 kg weight loss, profound fatigue, intermittent fevers, profuse diarrhea, and two episodes of hematemesis. Workup revealed a new diagnosis of HIV infection (CD4: 39 cells/µL; viral load: 87,837 copies/mL). Contrast-enhanced CT demonstrated uniform, concentric rectal wall thickening (\"target sign\"). Colonoscopic biopsy showed exuberant granulation tissue and dense plasma cell infiltrates. Immunohistochemistry revealed a dense infiltrate of CD38-positive plasma cells and ERG-positive endothelial proliferation. These findings, in the context of positive serology, were highly supportive of a spirochetal etiology and helped differentiate it from potential mimics. Serology was positive for latent late syphilis (VDRL 1:64). The patient received three weekly doses of intramuscular benzathine penicillin; lumbar puncture excluded neurosyphilis. <b>Discussion:</b> This is among the first reported cases of syphilitic proctitis in a patient with CD4 < 50 cells/µL, where advanced immunophenotyping differentiated syphilitic inflammation from neoplastic or inflammatory mimics. Profound immunosuppression accelerates disease progression and yields atypical clinical features. <b>Conclusion:</b> In HIV-infected patients with chronic rectal symptoms, especially those with CD4 < 50 cells/µL, syphilitic proctitis must be considered. Integration of radiologic assessment, histopathology with ERG/CD38 staining, and serologic testing permits prompt diagnosis. Early benzathine penicillin therapy and rigorous clinical and serologic follow-up are essential to prevent complications, including neurosyphilis.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Hypertension Secondary to Fungal Infections: Underexplored Pathological Links.","authors":"Andrea Jazel Rodríguez-Herrera, Sabrina Setembre Batah, Maria Júlia Faci do Marco, Carlos Mario González-Zambrano, Luciane Alarcão Dias-Melicio, Alexandre Todorovic Fabro","doi":"10.3390/idr17040084","DOIUrl":"https://doi.org/10.3390/idr17040084","url":null,"abstract":"<p><strong>Background/objective: </strong>Pulmonary fungal infections are a significant diagnostic challenge, primarily affecting immunocompromised individuals, such as those with HIV, cancer, or organ transplants, and they often lead to substantial morbidity and mortality if untreated. These infections trigger acute inflammatory and immune responses, which may progress to chronic inflammation. This process involves myofibroblast recruitment, the deposition of extracellular matrix, and vascular remodeling, ultimately contributing to pulmonary hypertension. Despite its clinical relevance, pulmonary hypertension secondary to fungal infections remains under-recognized in practice and poorly studied in research.</p><p><strong>Results/conclusion: </strong>This narrative mini-review explores three key mechanisms underlying vascular remodeling in this context: (1) endothelial injury caused by fungal emboli or autoimmune reactions, (2) direct vascular remodeling during chronic infection driven by inflammation and fibrosis, and (3) distant vascular remodeling post-infection, as seen in granulomatous diseases like paracoccidioidomycosis. Further research and clinical screening for pulmonary hypertension in fungal infections are crucial to improving patient outcomes.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Mycobacterium bovis</i> Infection Frequently Requires Surgical Intervention in Individuals with HIV.","authors":"Sergio Zuñiga-Quiñonez, Pedro Martinez-Ayala, Monserrat Alvarez-Zavala, Andrea Torres-Rojas, Isaac D V Garcia-Govea, Luz A Gonzalez-Hernandez, Jaime F Andrade-Villanueva, Fernando Amador-Lara","doi":"10.3390/idr17040082","DOIUrl":"https://doi.org/10.3390/idr17040082","url":null,"abstract":"<p><strong>Background: </strong>Zoonotic infection with <i>Mycobacterium bovis</i> continues to occur, particularly in regions lacking bovine tuberculosis surveillance and where the consumption of unpasteurized dairy products, including artisanal cheeses, is common. We describe the clinical and microbiological characteristics, diagnostic procedures, and treatment outcomes of individuals with HIV with <i>M. bovis</i> infection.</p><p><strong>Methods: </strong>We conducted a retrospective study analyzing sociodemographic, clinical, microbiological, and computed tomography (CT) data, as well as treatment outcomes, in 12 patients with HIV with confirmed <i>M. bovis</i> infection. These findings were compared with those of 14 individuals with HIV diagnosed with <i>Mycobacterium tuberculosis</i> infection during the same period.</p><p><strong>Results: </strong>Consumption of unpasteurized dairy products was significantly associated with <i>M. bovis</i>. Patients with <i>M. bovis</i> infection had higher CD4+ T-cell counts compared to those with <i>M. tuberculosis</i> infection (<i>p</i> = 0.01, <i>r</i> = 0.45). All <i>M. bovis</i> cases presented with extrapulmonary disease. CT imaging in <i>M. bovis</i> infection more frequently demonstrated retroperitoneal lymphadenopathy, hepatosplenomegaly, and splenic abscesses compared to <i>M. tuberculosis</i> infection. Microbiological identification was exclusively from extrapulmonary sites in all <i>M. bovis</i> cases. Surgical interventions, including abscess drainage or splenectomy, were significantly more common among <i>M. bovis</i> patients.</p><p><strong>Conclusions: </strong><i>M. bovis</i> infection in individuals with HIV is characterized by consistent extrapulmonary, often abdominal, involvement. Surgical procedures are frequently required for both diagnosis and management. Targeted efforts to identify <i>M. bovis</i> are warranted, particularly in high-burden regions where unpasteurized dairy consumption remains prevalent.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erythema Nodosum Leprosum in a Patient with Borderline Lepromatous Leprosy: A Case Report.","authors":"Guido Chiriboga, Qianyu Guo, Eric Zuberi, Harry Ross Powers, Libardo Rueda Prada","doi":"10.3390/idr17040083","DOIUrl":"https://doi.org/10.3390/idr17040083","url":null,"abstract":"<p><strong>Background: </strong>Leprosy, caused by <i>Mycobacterium leprae</i>, presents on a spectrum ranging from tuberculoid to lepromatous disease. Borderline lepromatous leprosy represents an unstable immunological state that predisposes patients to immune-mediated reactions, including erythema nodosum leprosum (ENL), a severe inflammatory complication.</p><p><strong>Case presentation: </strong>We report a case of a 62-year-old female with borderline lepromatous leprosy who presented with recurrent facial cellulitis and later developed disseminated ENL. She was initially diagnosed following a series of facial infections and confirmatory skin biopsy. Months later, she developed systemic inflammatory lesions consistent with ENL, requiring hospitalization. She was treated with high-dose corticosteroids for ENL and methotrexate to treat type 1 reaction and continued multidrug therapy (MDT) with minocycline, rifampin, and clarithromycin for leprosy, which led to significant clinical improvement.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of leprosy in the United States and the importance of recognizing ENL as a severe immunologic complication requiring prompt intervention. A multidisciplinary approach is essential for optimal patient outcomes.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Type I Interferons in Tuberculosis and in Tuberculosis-Risk-Associated Comorbidities.","authors":"Florence Mutua, Ruey-Chyi Su, Terry Blake Ball, Sandra Kiazyk","doi":"10.3390/idr17040081","DOIUrl":"https://doi.org/10.3390/idr17040081","url":null,"abstract":"<p><p>The identification of a type I interferon-induced transcriptomic signature in active tuberculosis suggests a potential role for these interferons in the pathogenesis of tuberculosis. Comorbidities such as human immunodeficiency virus, diabetes, systemic lupus erythematosus, end-stage renal disease, and coronavirus disease are epidemiologically linked to an increased risk for reactivation of latent tuberculosis infection. Notably, type I interferons are also implicated in the pathogenesis of these conditions, with a recognizable type I interferon transcriptomic signature. The mechanisms by which type I interferons in tuberculosis-risk-associated comorbidities may drive the progression of tuberculosis or maintenance of latent infection however remain largely unknown. This review summarizes the existing literature on the increased association between type I interferons, focusing on interferon-α and -β, and the heightened risk of tuberculosis reactivation. It also underscores the similarities in the immunopathogenesis of these comorbidities. A better understanding of these mechanisms is essential to guide the development of host-directed interferon therapies and improving diagnostic biomarkers in <i>M. tuberculosis</i> infection.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Kidney Function in Predicting COVID-19 Severity and Clinical Outcomes: A Retrospective Analysis.","authors":"Victor Muniz de Freitas, Érika Bevilaqua Rangel","doi":"10.3390/idr17040079","DOIUrl":"https://doi.org/10.3390/idr17040079","url":null,"abstract":"<p><p><b>Background:</b> Coronavirus disease 2019 (COVID-19) involves a complex interplay of dysregulated immune responses, a pro-inflammatory cytokine storm, endothelial injury, and thrombotic complications. This study aimed to evaluate the impact of kidney function on clinical, laboratory, and outcome parameters in patients hospitalized with COVID-19. <b>Methods:</b> We conducted a retrospective analysis of 359 patients admitted during the first wave of COVID-19, stratified by estimated glomerular filtration rate (eGFR < 60 vs. ≥60 mL/min/1.73 m²). Data on demographics, vital signs, laboratory values, and clinical outcomes-including mortality, hemodialysis requirement, intensive care unit (ICU) admission, and mechanical ventilation (MV)-were collected. Univariate and multivariate linear regression, as well as area under the receiver operating characteristic curve (AUC-ROC) analyses, were performed. A <i>p</i>-value < 0.05 was considered statistically significant. <b>Results:</b> Patients with an eGFR < 60 were older and more likely to have systemic hypertension, chronic kidney disease, a history of solid organ transplantation, and immunosuppressive therapy. This group showed higher rates of mortality (41.6% vs. 19.2%), hemodialysis requirement (32.3% vs. 9.6%), ICU admission (50.9% vs. 37.9%), and MV (39.8% vs. 21.2%). Laboratory results revealed acidosis, anemia, lymphopenia, elevated inflammatory markers, and hyperkalemia. <b>Conclusions:</b> An admission eGFR < 60 mL/min/1.73 m² is associated with worse clinical outcomes in COVID-19 and may serve as a simple, early marker for risk stratification.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of CFTR Modulators on <i>Pseudomonas aeruginosa</i> Infections in Cystic Fibrosis.","authors":"Camelia Corina Pescaru, Alexandru Florian Crișan, Adelina Marițescu, Vlad Cărunta, Monica Marc, Ștefan Dumitrache-Rujinski, Sorina Laitin, Cristian Oancea","doi":"10.3390/idr17040080","DOIUrl":"https://doi.org/10.3390/idr17040080","url":null,"abstract":"<p><p><b>Background</b>: Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Modulator therapies have the ability to improve CFTR function in CF patients, but despite the clear evidence of benefits regarding CFTR modulator therapy, including improved lung function, the reduced rate of exacerbations, and an overall improved quality of life, studies focusing on the reduction rates of <i>P. aeruginosa</i> infections during modulator therapy expressed the need for future research on this topic. <b>Objective</b>: This study aimed to evaluate the impact of CFTR modulator therapies on the prevalence, density, and persistence of <i>P. aeruginosa</i> infection in CF patients and to explore the mechanisms involved. <b>Methods</b>: A systematic literature review was performed by searching five major databases (PubMed, Cochrane Library, Scopus, Google Scholar, and Web of Science), and 21 relevant articles investigating the link between CFTR therapy and <i>P. aeruginosa</i> infections were selected following the PRISMA guidelines. <b>Results</b>: The data indicated that Ivacaftor and the combination Elexacaftor/Tezacaftor/Ivacaftor (ETI) can reduce total bacterial load and markers of systemic inflammation. However, clonal lines of <i>P. aeruginosa</i> persist in most cases, and complete eradication is rare, mainly due to biofilm formation and antimicrobial resistance. <b>Conclusions</b>: Although CFTR-modulating therapies help to improve clinical condition and reduce inflammation, they do not consistently lead to the elimination of <i>P. aeruginosa</i>.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"This Is How I Give Back\": Long-Term Survivors on Legacy and HIV Cure Research at the End of Life-A Qualitative Inquiry in the United States.","authors":"Ali Ahmed, Jeff Taylor, Whitney Tran, Simran Swaitch, Samuel O Ndukwe, Rachel Lau, Kris H Oliveira, Stephanie Solso, Cheryl Dullano, Andy Kaytes, Patricia K Riggs, Robert Deiss, Sara Gianella, Karine Dubé","doi":"10.3390/idr17040078","DOIUrl":"10.3390/idr17040078","url":null,"abstract":"<p><p><b>Background/Objectives</b>: End-of-life (EOL) HIV cure research, which studies HIV persistence through pre- and post-mortem tissue collection, has focused primarily on people living with HIV (PLWH) with a prognosis of six months or less. However, the perspectives of long-term survivors (LTS) diagnosed before the advent of effective antiretroviral treatment (ART) remain underexplored. Understanding their motivations and concerns about EOL cure research is essential for creating inclusive and ethical research frameworks. <b>Methods</b>: Between 2023 and 2024, we conducted in-depth qualitative interviews with 16 PLWH aged 60 and older from diverse backgrounds across the United States, recruited through community-based organizations and HIV networks. We used inductive thematic analysis to explore LTS' perspectives on EOL HIV research. <b>Results</b>: Participants included cisgender men (56.25%) and women (43.75%) with diverse racial identities. While participants supported EOL HIV cure research, their willingness to participate varied, influenced by awareness, logistics, and ethical concerns. Altruism-motivated participation, but misconceptions about procedures and concerns over bodily integrity represented potential barriers. Some viewed blood draws and leukaphereses as routine, while others expressed hesitancy with biopsies and post-mortem tissue retrieval. HIV stigma, historical mistrust, and cultural beliefs also played a role in willingness to participate. LTS emphasized the need for decentralized research sites, travel support, and financial safeguards. <b>Conclusions</b>: To include LTS in EOL HIV cure research, a community-driven approach is needed, focusing on clear communication, ethical considerations, logistical support, and linkages to EOL care. Addressing misconceptions and building trust, particularly within groups traditionally underrepresented in research, is essential to expanding participation.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Centralized Sexual Assault Care Centers in HIV Post-Exposure Prophylaxis Treatment Adherence: A Retrospective Single Center Analysis.","authors":"Stefano Malinverni, Shirine Kargar Samani, Christine Gilles, Agnès Libois, Floriane Bédoret","doi":"10.3390/idr17040077","DOIUrl":"https://doi.org/10.3390/idr17040077","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sexual assault victims involving penetration are at risk of contracting human immunodeficiency virus (HIV). Post-exposure prophylaxis (PEP) can effectively prevent HIV infection if initiated promptly within 72 h following exposure and adhered to for 28 days. Nonetheless, therapeutic adherence amongst sexual assault victims is low. Victim-centered care, provided by specially trained forensic nurses and midwives, may increase adherence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective case-control study to evaluate the impact of sexual assault center (SAC)-centered care on adherence to PEP compared to care received in the emergency department (ED). Data from January 2011 to February 2022 were reviewed. Multivariable logistic regression analysis was employed to determine the association between centralized specific care for sexual assault victims and completion of the 28-day PEP regimen. The secondary outcome assessed was provision of psychological support within 5 days following the assault.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We analyzed 856 patients of whom 403 (47.1%) received care at a specialized center for sexual assault victims. Attendance at the SAC, relative to the ED, was not associated with greater probability of PEP completion both in the unadjusted (52% vs. 50.6%; odds ratio [OR]: 1.06, 95% CI: 0.81 to 1.39; &lt;i&gt;p&lt;/i&gt; = 0.666) and adjusted (OR: 0.81, 95%CI 0.58-1.11; &lt;i&gt;p&lt;/i&gt; = 0.193) analysis. The care provided at the SAC was associated with improved early (42.7% vs. 21.5%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and delayed (67.3% vs. 33.7%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) psychological support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;SAC-centered care is not associated with an increase in PEP completion rates in sexual assault victims beyond the increase associated with improved access to early and delayed psychological support. Other measures to improve PEP completion rates should be developed. &lt;b&gt;What is already known on this topic&lt;/b&gt;-Completion rates for HIV post-exposure prophylaxis (PEP) among victims of sexual assault are low. Specialized sexual assault centers, which provide comprehensive care and are distinct from emergency departments, have been suggested as a potential means of improving treatment adherence and completion rates. However, their actual impact on treatment completion remains unclear. &lt;b&gt;What this study adds&lt;/b&gt;-This study found that HIV PEP completion rates in sexual assault victims were not significantly improved by centralized care in a specialized sexual assault center when compared to care initiated in the emergency department and continued within a sexually transmitted infection clinic. However, linkage to urgent psychological and psychiatric care was better in the specialized sexual assault center. How this study might affect research, practice or policy-Healthcare providers in sexual assault centers should be more aware of their critical role in promoting PEP adherence and improving completion rates. P","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 4","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}