Infectious Diseases and Therapy最新文献

{"title":"Prevalence of Macrolide-Resistant Mycoplasma pneumoniae Infections After the COVID-19 Pandemic in Southern Italy, 2023-2025.","authors":"Francesca Centrone, Marisa Accogli, Raffaella Melilli, Alfredo Marziani, Valentina A Orlando, Daniele Casulli, Vittoria Scolamacchia, Nicola Netti, Davide Sacco, Anna Sallustio, Maria Chironna","doi":"10.1007/s40121-025-01244-w","DOIUrl":"https://doi.org/10.1007/s40121-025-01244-w","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic and associated non-pharmaceutical interventions (NPIs) markedly reduced the circulation of respiratory pathogens. In late 2023, a resurgence of Mycoplasma pneumoniae (MP) infections, including macrolide-resistant strains (MRMP), was documented worldwide. This study aimed to determine MRMP prevalence and epidemiological characteristics in Southern Italy during the post-pandemic period.</p><p><strong>Methods: </strong>Between January 2023 and May 2025, 5362 respiratory specimens were tested for M. pneumoniae and other respiratory pathogens using multiplex real-time polymerase chain reaction (PCR). Macrolide resistance-associated mutations in the 23S rRNA gene were identified through PCR amplification and Sanger sequencing. Data were stratified by age group and clinical setting.</p><p><strong>Results: </strong>MP prevalence peaked at 15.8% in May 2025. Of 305 positive cases, the median age was 10 years, 52.1% were male, and 86.9% were hospitalized. Coinfections occurred in 23.3% of cases, particularly among children < 5 years. Macrolide resistance was detected in 7.5% of MP-positive samples, predominantly the A2063G mutation (96%), with the highest prevalence in patients aged 10-14 years (12.6%). No resistance was identified in ICU patients.</p><p><strong>Conclusion: </strong>The post-pandemic resurgence of M. pneumoniae in Southern Italy, coupled with sustained macrolide resistance, underscores the need for continuous molecular surveillance and targeted antimicrobial stewardship to optimize therapy and prevent further resistance spread.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Effectiveness and Estimated Public Health Impact of Cell- Versus Egg-Based Influenza Vaccines in Children and Adults During the US 2023-2024 Season.","authors":"Alicia N Stein, Anusorn Thanataveerat, Kimberly McDermott, Alex Dean, Stephanie Wall, Cory Pack, Ian McGovern, Sheena G Sullivan, Mendel Haag","doi":"10.1007/s40121-025-01230-2","DOIUrl":"https://doi.org/10.1007/s40121-025-01230-2","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the relative vaccine effectiveness (rVE) of cell-based versus egg-based quadrivalent influenza vaccines (QIVc versus QIVe) in preventing test-confirmed influenza during the 2023-2024 US influenza season.</p><p><strong>Methods: </strong>rVE was estimated using a test-negative design applied to a large, linked, real-world dataset. QIVc or QIVe recipients aged 6 months-64 years who were tested for influenza within ± 7 days of an acute respiratory or febrile illness were included. rVE was estimated using doubly robust logistic regression. Analyses were performed for the full, pediatric, adult, outpatient and high-risk populations and by influenza type. Public health impact was assessed using a compartmental influenza burden averted model.</p><p><strong>Results: </strong>The analysis included 2119 QIVc-cases, 14,750 QIVc-controls, 14,559 QIVe-cases, and 75,351 QIVe-controls. QIVc was superior to QIVe in preventing test-confirmed influenza with an rVE of 19.8% (95% CI 15.7-23.8%) in the full population, and with rVEs of 19.6% (13.6-25.3%) in the pediatric population aged 6 months-17 years and 18.5% (12.1-24.5%) in adults aged 18-64 years. Consistent results were observed for all sensitivity and subgroup analyses against any influenza. If all vaccinated individuals aged 6 months-64 years in the US received QIVc over QIVe, an estimated 2,379,395 additional symptomatic illnesses would have been prevented, with proportionate reductions in related complications.</p><p><strong>Conclusions: </strong>Our analysis showed superior effectiveness of QIVc over QIVe in preventing test-confirmed influenza among persons aged 6 months-64 years, and provided the first demonstration of superiority in pediatric populations from 6 months of age. A Graphical Abstract is availible for this article.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of the Respiratory Syncytial Virus Hospitalization Burden in Older Adults in the Veneto Region, Italy: A Modeling Study.","authors":"Claudia Cozzolino, Andrea Cozza, Laura Salmaso, Mario Saia, Davide Gentili, Michele Tonon, Francesca Russo, Silvia Cocchio, Vincenzo Baldo","doi":"10.1007/s40121-025-01241-z","DOIUrl":"https://doi.org/10.1007/s40121-025-01241-z","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory syncytial virus (RSV) in older adults can cause a variable spectrum of symptoms, ranging from mild manifestations to hospitalization and sometimes adverse outcomes. However, its true epidemiological burden is underestimated due to non-specific symptoms, lack of standardized diagnostic criteria, limited lab confirmation, and inadequate attribution in administrative datasets.</p><p><strong>Methods: </strong>We conducted a time-series analysis using hospital discharge data from the Veneto Region, Italy, between 2018 and 2024. Respiratory infections (RI) and RSV-related hospitalizations were identified using International Classification of Diseases codes. A generalized additive mixed model (GAMM) was applied to weekly RI admissions, incorporating circulating pathogen data from the RespiVirNet surveillance system. Seasonal patterns and age-stratified risk were modeled using smoothing terms.</p><p><strong>Results: </strong>Among individuals aged ≥ 65 years, RSV accounted for an estimated 3.0% to 4.6% of RI hospitalizations. Age-specific hospitalization rates attributable to RSV were 26.8, 109.4, and 317.4 per 100,000 person-years in the 65-74, 75-84, and ≥ 85 age groups, respectively. Explicit RSV coding underestimated the true burden by a factor of up to 7.6. Incidence rates and underreporting were highest in post-acute COVID-19 seasons.</p><p><strong>Conclusions: </strong>RSV-related hospitalizations in older adults are substantially underreported in administrative data. Improved surveillance and prospective clinical studies are needed to validate model estimates and assess diagnostic test performance. Statistical modeling represents a valid approach to estimate the burden of RSV hospitalizations in underdiagnosed populations, such as the elderly, when direct data are lacking.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Single Dose of Pneumococcal Conjugate Vaccine Against Invasive Pneumococcal Disease in Children: A Systematic Literature Review.","authors":"Eileen M Dunne, Linge Hong, Benjamin M Althouse, Kyla Hayford, Luis Jodar, Bradford D Gessner, Christian Theilacker","doi":"10.1007/s40121-025-01211-5","DOIUrl":"10.1007/s40121-025-01211-5","url":null,"abstract":"<p><strong>Introduction: </strong>While pneumococcal conjugate vaccines (PCVs) are typically administered to infants using a three- or four-dose regimen, children may receive less immunogenic regimens due to missed doses or alternative schedules. The level of direct protection in children vaccinated with a single dose of PCV remains unclear.</p><p><strong>Methods: </strong>We performed a systematic review of observational studies published during 2000-2024 on vaccine effectiveness (VE) of a single dose of PCV7, PCV10, or PCV13 against vaccine-type invasive pneumococcal disease (IPD) in children. Results were stratified by vaccine and age at administration, and meta-analysis performed to generate pooled VE estimates.</p><p><strong>Results: </strong>Twenty-seven studies met the inclusion criteria: nine reported VE for PCV7, four for PCV10, seven for PCV13, and seven reported VE separately for more than one PCV. For PCV7, pooled VE was 64.6% (95% CI 47.3, 76.2) when administered < 12 months or age unspecified and 81.6% (95% CI 72.5, 87.7) when given ≥ 12 months. For PCV10, pooled VE was 73.0% (95% CI - 29.4, 94.4) when age at vaccination was unspecified, and one study reported 68.0% (95% CI 17.6, 87.6) VE when administered ≥ 12 months. For PCV13, pooled VE was 56.8% (95% CI 44.1, 66.6) when administered < 12 months or age unspecified, and 79.2% (95% CI 65.5, 87.5) when given ≥ 12 months.</p><p><strong>Conclusions: </strong>Available evidence demonstrates that a single dose of PCV provides protection against vaccine-type IPD, especially when administered after age 12 months. While complete vaccination according to licensed schedules provides optimal protection, our findings support single-dose catch-up programs for toddlers. Potential single-dose strategies for infants in humanitarian emergencies warrant further exploration.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2189-2203"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Epidemiology and Clinical Burden in High-Risk and ≥ 50-Year-Old Adults in Low- to Middle-Income Countries: An Artificial-Intelligence-Enabled Systematic Literature Review.","authors":"Adriana Guzman-Holst, Digant Gupta, Amandeep Kaur, Vikas Verma, Arnas Berzanskis, Yolanda Penders, Désirée A M Van Oorschot","doi":"10.1007/s40121-025-01220-4","DOIUrl":"10.1007/s40121-025-01220-4","url":null,"abstract":"<p><strong>Introduction: </strong>Limited data are available on the epidemiology and clinical burden of respiratory syncytial virus (RSV) among adults with underlying medical or immunocompromising conditions (\"high-risk adults\") and ≥ 50-year-old adults in developing countries.</p><p><strong>Methods: </strong>To better understand the impact of RSV in these populations, a systematic literature review of articles published from the year 2000 onward reporting RSV data among high-risk 18-59-year-old adults and ≥ 50-year-old adults in low, lower-middle, upper-middle, and selected high-income countries was undertaken. Searches were run on Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica DataBASE (EMBASE), and were supplemented by additional searches (e.g., congress abstracts, gray literature). A combination of artificial intelligence models was used for title/abstract screening. After this, full-text screening of inclusions was conducted, followed by prioritization.</p><p><strong>Results: </strong>Overall, 77 citations were selected for final inclusion. Of these, 69 reported outcomes related to RSV epidemiology and clinical burden, and are reported in this article. There were limited data on RSV incidence, prevalence, disease severity, and subtype distribution. Adequate evidence was available for RSV positivity among patients with respiratory illnesses, seasonality, complications, and mortality. Incidence in ≥ 65-year-olds was in the range of ~10-178 episodes per 1000 person-years across studies. Ranges for RSV positivity among patients with different underlying respiratory conditions were 1.5-31.9% and 0-9.1%, in high-risk and ≥ 50-year-old adults, respectively. Case fatality rates of up to 15.2% and 27.0% were reported across studies for high-risk and > 60-year-old adults, respectively.</p><p><strong>Conclusions: </strong>Overall, there were considerable evidence gaps for RSV epidemiology among high-risk and ≥ 50-year-old adults in developing countries. However, available data indicate a substantial negative health impact of RSV on these populations, highlighting the need for further data generation.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2405-2427"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated Factors of Cognitive Frailty in People Living with HIV Aged 50 and Older: A Cross-Sectional Study.","authors":"Yali Xu, Mingdan Li, Chengde Su, Qianqian Zhu, Qian Liu, Ying Zhang, Xinyi Zhang, Qiuxiang Li, Huajun Wang, Ping Yang","doi":"10.1007/s40121-025-01218-y","DOIUrl":"10.1007/s40121-025-01218-y","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive frailty (CF), which typically precedes dementia and functional decline, serves as a more robust predictor of adverse health outcomes compared to physical frailty alone, representing a critical challenge in promoting healthy aging among older people living with HIV (PLWH) aged ≥ 50 years. This study aimed to investigate the prevalence of cognitive frailty and identify its associated factors among PLWH aged ≥ 50 years.</p><p><strong>Methods: </strong>A convenience sample of 344 PLWH ≥ 50 years was recruited from a tertiary Grade A hospital in Zunyi, China. Physical frailty: evaluated via the Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) Scale; Cognitive function: assessed via the Chinese version of the Montreal Cognitive Assessment (MoCA). Participants were divided into the cognitive frailty group (FRAIL score ≥ 3 and MoCA score < 26), the non-cognitive frailty group. Binary logistic regression analysis was conducted with SPSS 29.0 to identify factors associated with CF.</p><p><strong>Results: </strong>The prevalence of CF among the 344 PLWH aged ≥ 50 years was 37.5%. Regression analysis revealed that the following associated factors (p < 0.05) were independent risk factors for CF in PLWH aged ≥ 50 years: age, education level, weekly frequency of physical activity ≤ 2 sessions, depression, sleep disorders, and EFV-containing regimens.</p><p><strong>Conclusions: </strong>Cognitive frailty is highly prevalent among PLWH aged ≥ 50 years. Early screening and comprehensive healthcare interventions targeting modifiable risk factors are crucial for delaying or reversing CF progression in this population.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2429-2444"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Review of the Pharmacology of Dalbavancin and Oritavancin for Gram-Positive Infections: Birds of a Feather or Apples and Oranges?","authors":"Maytham Hussein, James Barclay, Mark Baker, Yuezhou Wu, Varsha J Thombare, Nitin Patil, Ananya B Murthy, Rajnikant Sharma, Gauri G Rao, Mark A T Blaskovich, Jian Li, Tony Velkov","doi":"10.1007/s40121-025-01215-1","DOIUrl":"10.1007/s40121-025-01215-1","url":null,"abstract":"<p><p>The clinical landscape of Gram-positive infections has been reshaped with the introduction of long-acting lipoglycopeptides, particularly dalbavancin and oritavancin. Both agents share broad-spectrum activity against multidrug-resistant pathogens, including methicillin-resistant Staphylococcus aureus and vancomycin-resistant strains, yet differ markedly in pharmacokinetics, pharmacodynamics, resistance profiles, and clinical adoption. This review presents a comprehensive comparative analysis of their structural innovations, distinct pharmacokinetic and pharmacodynamic characteristics, and dual mechanisms of action, supported by minimum inhibitory concentration data across key pathogens. Despite belonging to the same antimicrobial class, these agents exhibit important differences in real-world applications and clinical integration. We highlight real-world evidence supporting off-label use in osteomyelitis, endocarditis, and bloodstream infections, where traditional therapies fall short. Furthermore, we explore resistance development, drug-drug interaction profiles, and outpatient utility, providing actionable insights for optimizing treatment strategies. These findings underscore the need for tailored clinical integration of dalbavancin and oritavancin and spotlight their potential roles in future antimicrobial stewardship frameworks.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2221-2246"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Management of Carbapenem-Resistant Enterobacterales Bloodstream Infection with Organ Dissemination in Prolonged Severe Agranulocytosis Patients with Hematological Malignancy Through Combination Therapies Including Eravacycline.","authors":"Yuyuan Lv, Xin Zhang, Qingya Cui, Mengyun Li, Lian Bai, Yan Yu, XueKai Li, Xiaoqian Chen, Depei Wu, Xiaowen Tang","doi":"10.1007/s40121-025-01206-2","DOIUrl":"10.1007/s40121-025-01206-2","url":null,"abstract":"<p><p>This study reports three patients with hematologic malignancy patients and Carbapenem-resistant Enterobacterales (CRE) bloodstream infections and organ dissemination during neutropenia. After failed conventional therapy, a novel \"through Combination therapies including eravacycline\" regimen achieved fever control within 10 days and lesion resolution by 20 days approximately, demonstrating breakthrough efficacy for CRE bacteremia management.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2465-2476"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Colonisation to Infection: Assessing the BSI Potential in Patients with KPC, NDM, VRE and CRAB Rectal Colonisation.","authors":"Marta Colaneri, Paola Giordani, Simone Milanesi, Sonia Lerta, Elena M Tosca, Aurelia Sangani, Vincenzo A Villano, Marco Rettani, Alba Muzzi, Marta Corbella, Patrizia Cambieri, Andrea Gori, Giuseppe De Nicolao, Raffaele Bruno","doi":"10.1007/s40121-025-01222-2","DOIUrl":"10.1007/s40121-025-01222-2","url":null,"abstract":"<p><strong>Introduction: </strong>Multi-drug-resistant organisms (MDROs) that mostly contribute to nosocomial infections include carbapenem-resistant Enterobacterales that produce Klebsiella pneumoniae carbapenemase (KPC) and New Delhi metallo-β-lactamase (NDM), carbapenem-resistant Acinetobacter baumannii (CRAB) and vancomycin-resistant Enterococcus faecium (VRE). Patients colonised by these MDROs are at high risk for developing bloodstream infections (BSIs) by the same pathogen, emphasising the need for surveillance and intervention.</p><p><strong>Methods: </strong>This retrospective study included patients admitted to medical, surgical, and intensive care unit (ICU) wards in the IRCCS Policlinico San Matteo (Pavia, Italy) between January 2019 and October 2024 with rectal colonisation by KPC, NDM, VRE and CRAB. Demographic, clinical and microbiological data were extracted from electronic records. Logistic regression with stepwise model-building identified risk factors for BSI development.</p><p><strong>Results: </strong>A total of 1969 patients colonised with MDRO were identified: 79% of them were colonised by KPC, VRE, CRAB or NDM. Among the 1960 hospitalisations involving these specific rectal colonisations, the overall rate of BSIs was 9.4%, with CRAB and KPC showing the highest rates (20.0% and 12.6%, respectively). ICU hospitalisation was significantly associated with an increased risk of BSI in patients colonised with KPC, NDM and VRE. Haematological malignancies and bone marrow transplantation were independent risk factors for BSI in patients colonised with KPC (odds ratio [OR] = 3.22, p = 0.037) and VRE (OR = 4.07, p = 0.004) whereas solid organ transplantation increased BSI risk among patients colonised with CRAB (OR = 11.83, p = 0.034).</p><p><strong>Conclusions: </strong>Our findings show heterogeneous BSI risk among MDROs, with CRAB and KPC being the most dangerous, especially in patients in the ICU, followed by VRE in onco-haematological cases. These results support developing prevention strategies for critically ill and immunocompromised patients.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2359-2372"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular Carcinoma Recurrence in Patients with Chronic Hepatitis C Infection Treated with Direct-Acting Antivirals: A Systematic Review and Meta-Analysis.","authors":"Kristina Lindsley, Margaret Burroughs, Candido Hernandez-Lopez, Yi Wang, John Marcinak, Stephanie E Chiuve, Barbara A Haber, Jennifer Uyei, Soodabeh Navadeh, Giuseppe De Marco, Deanna D Hill","doi":"10.1007/s40121-025-01180-9","DOIUrl":"10.1007/s40121-025-01180-9","url":null,"abstract":"<p><strong>Introduction: </strong>Reports of direct-acting antivirals (DAA) use for chronic hepatitis C virus (HCV) infection after successful treatment of hepatocellular carcinoma (HCC) have suggested higher rates of HCC recurrence. However, other studies have indicated no increased risk of HCC recurrence.</p><p><strong>Methods: </strong>To estimate the comparative risk of early HCC recurrence in adults successfully treated for HCC and subsequently treated with interferon (IFN)-free DAAs versus not treated with DAAs for chronic HCV, we conducted a systematic literature review and meta-analysis following established guidelines.</p><p><strong>Results: </strong>Forty-one cohort studies (10,563 total participants) were identified. The following mutually exclusive comparisons to DAA therapy were determined: IFN-based therapy; no DAA; and no antiviral therapy. Random effects meta-analysis results indicated no increased risk of HCC recurrence with IFN-free DAA therapy when compared with IFN (combined risk ratio (RR) 1.29 [95% CI 0.69, 2.40] at 12 months, 0.88 [95% CI 0.56, 1.39] at 24 months, and 0.67 [95% CI 0.51, 0.88] at longest follow-up), no DAA (combined RR 0.55 [95% CI 0.25, 1.23] at 12 months, 0.67 [95% CI 0.51, 0.86] at 24 months and 0.72 [95% CI 0.61, 0.85] at longest follow-up), or no antiviral therapy (combined RR 0.95 [95% CI 0.76, 1.20] at 12 months, 0.48 [95% CI 0.11, 2.12] at 24 months, and 0.42 [95% CI 0.24, 0.73] at longest follow-up). Results were confirmed in sensitivity analyses.</p><p><strong>Conclusions: </strong>There is no evidence to suggest that DAA therapy has a higher risk of early HCC recurrence when compared with IFN, no DAA, or no antiviral therapy at any timepoint analyzed. Hence the benefit-risk profile of DAAs in HCV remains positive in relation to the risk of early HCC recurrence.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2247-2276"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}