Infectious Diseases and Therapy最新文献

{"title":"Time-Dependent Prognostic Value of the sCD25-to-Ferritin Ratio in Chronic Active Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis.","authors":"Yingxin Zhu, Tiankuo Gao, Xinyang Zhang, Chen Gong, Chun Yang, Xuefeng He, Yue Song","doi":"10.1007/s40121-026-01449-7","DOIUrl":"https://doi.org/10.1007/s40121-026-01449-7","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic active Epstein-Barr virus infection (CAEBV) is an EBV-positive T/NK-cell lymphoproliferative disease characterized by persistent EBV infection in T or NK cells. CAEBV-HLH refers to hemophagocytic lymphohistiocytosis secondary to CAEBV. As important markers of HLH activity, soluble CD25 (sCD25) and serum ferritin reflect lymphocyte activation and macrophage-mediated inflammation, respectively. The sCD25-to-ferritin ratio may therefore integrate information between the underlying EBV-driven T/NK-cell lymphoproliferative process and HLH-related hyperinflammation. Considering the heterogeneous clinical course varying over time, we evaluated the time-dependent prognostic value of baseline sCD25/ferritin in CAEBV-HLH.</p><p><strong>Methods: </strong>This multicenter retrospective study included 108 patients with CAEBV-HLH diagnosed between January 2015 and February 2026. Baseline sCD25/ferritin was calculated at diagnosis. All-cause mortality within the first year was assessed across cumulative monthly follow-up. Time-restricted Cox regression and time-dependent receiver operating characteristic (ROC) analysis were performed to evaluate prognostic association and discriminative performance over time. The optimal cutoff was determined using the Youden Index, and the AUC was validated by bootstrap resampling (1000 iterations) to correct for optimism bias. Survival was compared by Kaplan-Meier analysis. The discriminative performance of the sCD25/Fer ratio was further compared against the existing HScore using DeLong's test for paired ROC curves. Analyses were repeated in patients who did not undergo hematopoietic stem cell transplantation (HSCT).</p><p><strong>Results: </strong>During follow-up censored at 12 months, 43 (39.81%) deaths occurred. Baseline sCD25/ferritin was significantly higher in non-survivors than in survivors (P = 0.002). In the overall cohort, the sCD25/ferritin was significantly associated with mortality from month 3 onward (HR, 1.23; 95% CI, 1.02-1.47), with stable estimates through 12 months. The 4-month window was selected as an early clinically informative time point, with an AUC of 0.705 in conventional ROC analysis. A cutoff of 27.98 stratified the overall cohort into distinct survival groups (P < 0.001). In the non-HSCT subgroup, predictive performance became significant from month 4 onward, and the 4-month AUC increased to 0.766, with a cutoff of 22.80. Notably, sCD25/Ferritin ratio significantly outperformed the conventional HScore for 4-month mortality prediction (AUC 0.730 vs. 0.584; P = 0.022 by DeLong's test), with consistent superiority in the non-HSCT subgroup (AUC 0.768 vs. 0.597; P = 0.029).</p><p><strong>Conclusions: </strong>The baseline sCD25/ferritin ratio is a disease-relevant biomarker in CAEBV-HLH. Its prognostic value became statistically significant from month 3 onward and was more pronounced in patients without HSCT, indicating that this ratio may better reflect the","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169219","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":"Invasive Pneumococcal Disease in Children: A Retrospective Three-Center Study in Zhejiang Province, China (2010-2024).","authors":"Yan-Yan Zhu, Jin-Si Zhou, Jin-Hong Yang, Zhao-Jun Lu, Chao Fang, Ming-Ming Zhou, Kai-Hu Yao, Xiao-Yu Li, An-Li Sun, Julie Catusse, Eileen M Dunne, Chun-Zhen Hua","doi":"10.1007/s40121-026-01454-w","DOIUrl":"https://doi.org/10.1007/s40121-026-01454-w","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive pneumococcal diseases (IPD) are among the leading causes of global child mortality. Pneumococcal conjugate vaccines provide direct protection against IPD caused by serotypes included in the vaccine.</p><p><strong>Objective: </strong>To investigate the clinical characteristics, serotypes, and antibiotic resistance of Streptococcus pneumoniae (SP) causing IPD in children in China.</p><p><strong>Methods: </strong>Clinical data of IPD in children from three hospitals in Zhejiang Province, China, between January 2010 and September 2024 were retrospectively analyzed. Serotyping of SP was performed using the Quellung reaction, and antimicrobial susceptibility testing was conducted via the E-test method.</p><p><strong>Result: </strong>A total of 295 patients with IPD were identified, with ages ranging from 17 days to 13 years. Among them, 241 (81.7%) were children under 5 years old. The prevalent diagnoses included bacteremic pneumonia (33.2%), bacteremia without focus (27.1%), and meningitis (23.4%). Multiple organ damage or failure occurred in 73 patients (24.7%), pleural effusion/pyopneumothorax in 32 patients (10.8%), and septic shock in 22 patients (7.5%). There were 130 patients (44.1%) with underlying diseases, and leukemia was the most prevalent (41 patients). Sixteen patients (5.4%) died, including seven patients of purulent meningitis. Among 198 serotyped isolates, the ‌overall PCV13 serotype coverage rate‌ was 84.3%. The five most common serotypes were 19F (28.8%), 14 (13.6%), 6B (10.6%), 19A (9.6%), and 23F (9.1%). Forty-one (20.7%) isolates were resistant to penicillin, and 13.6% resistant to ceftriaxone. Serotypes 19F, 6B, and 19A exhibited significantly higher multidrug resistance rates than other serotypes (P < 0.001).</p><p><strong>Conclusion: </strong>IPD is most prevalent in children under 5 years of age and children with underlying medical conditions, with bacteremic pneumonia, bacteremia without focus, and meningitis as the main clinical manifestations. PCV13 serotypes remain the most common serotypes causing IPD in this region.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127457","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":"Clinical Experience with Omadacycline for the Treatment of Diabetic Foot Infections and Acute Osteomyelitis.","authors":"Matthew P Crotty, Ronda L Akins, Julie S Alexander, Nebu T Alexander, Edward A Dominguez","doi":"10.1007/s40121-026-01450-0","DOIUrl":"https://doi.org/10.1007/s40121-026-01450-0","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic foot infections (DFIs), frequently complicated by acute osteomyelitis (AOM), are associated with substantial morbidity and are increasingly difficult to manage due to antimicrobial resistance and treatment-related toxicities. Omadacycline is a broad-spectrum aminomethylcycline with favorable safety characteristics and oral bioavailability, but real-world data in DFI and AOM are limited.</p><p><strong>Methods: </strong>We conducted a prospective, open-label, two-center study evaluating omadacycline for hospitalized adults with moderate-to-severe DFI with or without AOM who were at high risk for adverse events from standard therapy. Outcomes were compared with a 2:1 matched historical cohort treated with standard of care. The primary endpoint was clinical success at end of therapy (EOT); secondary endpoints included clinical success at test-of-cure (TOC), safety outcomes, and healthcare utilization.</p><p><strong>Results: </strong>A TOTAL OF 14 patients received omadacycline and were matched to 28 historical controls. AOM was present in 64.3% of patients in both groups, while systemic inflammatory response syndrome was more common in the omadacycline group. Clinical success at EOT was achieved in 90% of omadacycline-treated patients versus 85.7% of controls (p = 0.999). TOC success rates were similar (60% vs. 64.3%, p = 0.999). All omadacycline patients transitioned to oral therapy and none required central venous catheter placement, compared with 71.4% of controls (p < 0.001). Serious adverse drug events occurred in no omadacycline patients versus 25% of controls.</p><p><strong>Conclusions: </strong>In this real-world analysis, there was no observed difference in efficacy between omadacycline and standard care for DFI, including cases complicated by AOM, with few adverse events observed. These findings support continued evaluation and potential use of omadacycline in treating select patients with DFIs.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT04714411.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109177","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":"Clinical Burden of Disease and Demographics in Older Adults Hospitalized with RSV Infection in England: A Retrospective Cohort Study.","authors":"Rebecca Butfield, Kiran K Rai, Thomas Jennison, Jack Said, Hannah Wright, Dheeraj Sethi, Jonathan Watkins, Antonia Geneidat, Isabel Jimenez, Dexter Wiseman","doi":"10.1007/s40121-026-01447-9","DOIUrl":"https://doi.org/10.1007/s40121-026-01447-9","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory syncytial virus (RSV) causes significant disease in older and comorbid adults. Current UK vaccination recommendations restrict eligibility to adults ≥ 75 years, 65-74 years with chronic respiratory disease or immunosuppression, and those in care homes, but evidence on clinical burden in adults < 75 years with comorbidities is limited. This study assessed patient characteristics, healthcare resource utilization (HCRU), and mortality in adults hospitalized with RSV in England.</p><p><strong>Methods: </strong>Population-based retrospective cohort study using linked Clinical Practice Research Datalink Aurum and Hospital Episode Statistics. Adults ≥ 60 years hospitalized with RSV between October 2014 and March 2019 were included. We defined RSV episodes as 90 days post-diagnosis. We defined cases using diagnosis codes for confirmed RSV (RSV-specific) or acute lower respiratory tract infection with exclusion of other causative pathogens (RSV-possible). All-cause HCRU (hospitalizations, critical care admissions, outpatient attendance, primary care consultations, and prescriptions) and case fatality rates were assessed. Results were stratified by age (60-74 and ≥ 75 years), case definitions (RSV-specific, RSV-possible), and comorbidity profiles (chronic respiratory disease, immunocompromised, cardiovascular disease).</p><p><strong>Results: </strong>A total of 97,712 hospitalized episodes in those aged ≥ 60 years were included in the analysis, of which 785 (0.8%) were RSV-specific cases (n = 338 aged 60-74 years, n = 447 aged ≥ 75 years). In RSV-specific cases, median (IQR) cumulative length of stay (LoS) for those ≥ 75 years was 10.00 (6.00-22.00) days, which was equivalent to or lower than each comorbidity subgroup in those aged 60-74 years, with the longest LoS in those immunocompromised (11.50 [7.00-26.00] days). Critical care admissions were more often observed across comorbidity stratifications (13.85-22.34%) compared to those ≥ 75 years (5.03%). All-cause and RSV-related case fatality rates for RSV-specific cases were highest among those ≥ 75 years (all-cause: 19.3%; RSV-related: 10.3%).</p><p><strong>Conclusions: </strong>HCRU within RSV episodes in those aged 60-74 years across comorbidity profiles was equal to or greater than that in those aged ≥ 75 years. These findings highlight the need to prioritize consideration of comorbidity groups that could benefit from RSV vaccination.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109212","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":"Clinical-Microbiological Discordance and Delayed Mortality in OXA-48/ESBL-Producing Proteus mirabilis Infections.","authors":"Isabel Machuca, Juan J Pineda, Juan A Marín-Sanz, Cristina Riazzo, Julia Guzmán-Puche, Ángela Cano, Raquel Moya-Riballo, Noelia De la Torre-Capitán, Carmen Bermúdez, Jorge Rodríguez, Juan J Castón, Elena Pérez-Nadales, Nicolas Kieffer, Irene Gracia-Ahufinger, Elisa Ruiz-Arabi, Isabel Carmona, Lorena Pozo, Patricia Cosano, Andrés Baumela, Carmen de la Fuente, Luis Martínez-Martínez, Julián Torre-Cisneros","doi":"10.1007/s40121-026-01453-x","DOIUrl":"https://doi.org/10.1007/s40121-026-01453-x","url":null,"abstract":"<p><strong>Introduction: </strong>OXA-48/extended-spectrum β-lactamase (ESBL)-producing Proteus mirabilis may appear susceptible to carbapenems in routine testing, potentially resulting in inappropriate therapeutic decisions. We aimed to evaluate clinical outcomes and the association between antimicrobial therapy and mortality.</p><p><strong>Methods: </strong>We conducted a single-center observational study including 1254 patients with P. mirabilis infections (2017-2024). Seventy-nine OXA-48/ESBL cases (6.3%) were matched 2:1 with non-OXA-48/ESBL controls based on age, comorbidity, infection source, and severity. OXA-48 production was detected using the NG-Test CARBA 5 immunochromatographic assay, while ESBL production was inferred phenotypically using cefotaxime, ceftazidime, and cefepime discs alone and in combination with clavulanic acid. Predictors of 30-day mortality were assessed using time-dependent Cox regression models.</p><p><strong>Results: </strong>OXA-48/ESBL-producing infections were associated with higher 30-day mortality (absolute difference 19.7%; population attributable fraction 18.2%). Differences in mortality emerged after day 8, suggesting delayed clinical deterioration. In time-dependent models, OXA-48/ESBL status was not associated with early mortality (days 0-7) but strongly predicted late mortality [hazard ratio (HR) 14.5; 95% confidence interval (CI) 3.19-65.93; p = 0.001]. Among patients with OXA-48/ESBL infections, carbapenem-based regimens were associated with higher mortality than alternative active therapies (50% vs. 20%; p = 0.04), remaining significant after adjustment (HR 3.37; 95% CI 1.27-8.9), although residual confounding by indication cannot be excluded.</p><p><strong>Conclusion: </strong>These observational findings support cautious interpretation of carbapenem susceptibility results and highlight the value of early carbapenemase detection to guide appropriate therapy. Graphical abstract available for this article.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109200","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":"Comparison of Five Assays for Rapid Antimicrobial Susceptibility Testing (RAST), Including Disk Diffusion, MIC-Based Systems, and Genotypic Methods: A Prospective Evaluation.","authors":"Christine Uitz, David Siebenhofer, Kristin Aurenhammer, Robert Krause, Michael Kroißenbrunner, Thomas Kuenzer, Ivo Steinmetz, Karl Dichtl","doi":"10.1007/s40121-026-01451-z","DOIUrl":"https://doi.org/10.1007/s40121-026-01451-z","url":null,"abstract":"<p><strong>Introduction: </strong>Early and targeted therapy is pivotal for the outcome of bloodstream infection, a life-threatening condition with high mortality. EUCAST developed a protocol for rapid antimicrobial susceptibility testing (RAST) that allows testing directly from positive blood cultures (BCs). Recently, fully automated minimum inhibitory concentration (MIC)-based systems were introduced. This is the first study to compare two of these systems with agar-based RAST and genotypic resistance testing.</p><p><strong>Methods: </strong>Ninety-seven Gram-negative BCs were prospectively analyzed using five different RAST assays. Agar-based RAST according to EUCAST was performed using conventional disk diffusion (DD) and a total laboratory automation solution (BD Kiestra), with reads at 4, 6, and 8 h. MIC-based, fully automated RAST was performed using VITEK Reveal (bioMérieux) and dRAST (Quantamatrix). Identification and genotypic resistance testing were additionally analyzed with the Biofire BCID2 multiplex PCR (bioMérieux).</p><p><strong>Results: </strong>A total of 6715 genotypic and phenotypic results were compared with reference methods. Biofire achieved 100% sensitivity and specificity for species identification and resistance gene detection; 0-28% of BCs were unanalyzable due to missing RAST breakpoints. Categorical agreement ranged from 82.2% (4 h DD) to 95.4% (Reveal). Agar-based RAST yielded significantly more results in the area of technical uncertainty than other methods. Kiestra-based DD outperformed conventional DD after short incubation. Reveal had the highest rate of false-susceptible results (2.4%), particularly for penicillin. dRAST tended to false-resistant results (3.4%), particularly with motile organisms like Proteus mirabilis.</p><p><strong>Conclusions: </strong>Automation of RAST provides more usable results than conventional DD, but each assay has specific weaknesses that users need to be aware of.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109210","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":"The Impact of Influenza on Health-Related Quality of Life, Work Productivity, and Activity Impairment Among Symptomatic US Patients with Influenza.","authors":"Tianyan Hu, Laura L Lupton, Alon Yehoshua, Joseph C Cappelleri, Meghan B Gavaghan, Verna L Welch, Santiago M C Lopez, Rachel Brathwaite, Manuela Di Fusco, Xiaowu Sun","doi":"10.1007/s40121-026-01407-3","DOIUrl":"10.1007/s40121-026-01407-3","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence on the impact of influenza on health-related quality of life (HRQoL) and work productivity and activity impairment (WPAI) remains limited. This study evaluated changes in the EuroQol Visual Analogue Scale (EQ-VAS), EuroQol Utility Index (EQ-UI), absenteeism, presenteeism, work productivity loss, and activity impairment over 1 month during the high-severity 2024-2025 influenza season in the USA.</p><p><strong>Methods: </strong>Symptomatic adults (≥ 18 years) with a positive influenza test at ambulatory care clinics within a national US retail pharmacy chain (10/24/2024-4/15/2025) and symptom onset ≤ 4 days of positive test were included. HRQoL was assessed on days 1-7, 10, 14, and week 4 and WPAI on days 1, 7, 14, and week 4. Mixed models for repeated measures estimated mean changes and standard error (SE) from baseline, adjusting for relevant covariates.</p><p><strong>Results: </strong>The analysis included 724 adults (mean [standard deviation (SD)] age: 42.0 [13.0] years; 74.2% female). HRQoL declined following infection: EQ-VAS decreased by 26.6 points (SE 0.9) on day 1 (p < 0.001) and 3.8 (0.8) on day 10 (p < 0.001), while EQ-UI scores decreased by 0.20 (0.01) on day 1 (p < 0.001) and 0.02 (0.01) on day 7 (p < 0.001). Compared with baseline, absenteeism rose by 58.3% (1.9) on day 1 and 34.9% (1.9) on day 7 (p < 0.001); presenteeism increased by 59.2% (2.0), 43.2% (2.0), and 8.8% (1.7) on days 1, 7, and 14 respectively (p < 0.001). Work productivity loss rose by 76.3% (1.7) on day 1, 55.5% (2.1) on day 7, and 8.1% (1.8) on day 14 (p < 0.001). Activity impairment increased by 62.6% (1.6) on Day 1, 43.6% (1.8) on day 7, and 6.6% (1.6) on day 14 (p < 0.001).</p><p><strong>Conclusions: </strong>Influenza was associated with marked declines in HRQoL, productivity, and daily functioning in symptomatic outpatients, highlighting the importance of patient-reported outcomes in capturing influenza's real-world burden.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier. Graphical Abstract available for this article.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2627-2643"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578485","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":"Long‑Term Effectiveness and Safety of Doravirine‑Based Antiretroviral Regimens in Virologically Suppressed People with HIV: The French Dat'AIDS Cohort.","authors":"Clotilde Allavena, Sean P Fleming, Colin Deschanvres, Philippe Mariot, Antoine Chaillon, Antoine Chéret, Pierre Dellamonica, André Cabié, Laurent Hocqueloux","doi":"10.1007/s40121-026-01422-4","DOIUrl":"10.1007/s40121-026-01422-4","url":null,"abstract":"<p><strong>Introduction: </strong>Doravirine (DOR)-based regimens are recommended as alternative options for virologically suppressed people with HIV (VS-PWH). However, data supporting their long-term use in real-world settings are scarce. This large study described the long-term effectiveness and safety of DOR-based regimens following treatment switch in routine clinical practice.</p><p><strong>Methods: </strong>Retrospective cohort study using data from Dat'AIDS, a French standardized database that collects real-world medical data from PWH across France. All treatment-experienced adults with confirmed plasma HIV-1 RNA < 50 copies/ml who initiated a DOR-based regimen for the first time between April 2019 and June 2024 were included. Baseline demographic and clinical characteristics, proportions of PWH receiving a DOR-based regimen and maintaining virologic suppression, and reasons for treatment discontinuation were collected. PWH were censored at the time of discontinuing DOR, death, or end of study (December 2024).</p><p><strong>Results: </strong>Data from 1666 VS-PWH (median age 56 years, interquartile range: 47-63; 65% male; 31% with obesity) were analyzed. Just before switching, 49% and 38% were receiving an integrase strand transfer inhibitor (INSTI) or non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen combined with at least one nucleo(t)side reverse transcriptase inhibitor (NRTI). Most (80%) switched to a triple therapy, mainly DOR/3TC/TDF (74%). Virologic suppression was maintained in 97% of PWH at 12 months (96% at 48 months). Only small changes in body weight, lipid parameters, and renal or hepatic function were observed during follow-up. Among the 45 discontinuations of DOR-based regimens, 11 were due to adverse events and two due to protocol-defined virologic failure, with no observed resistance to antiretroviral treatments.</p><p><strong>Conclusions: </strong>In this study, reporting the largest cohort of people receiving DOR-based regimens to date, DOR-based regimens demonstrated durable virologic effectiveness and a very favorable safety profile in treatment-experienced people with HIV and multiple comorbidities.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02898987.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2773-2791"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792555","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":"Long-Term Survival of Borna Disease Virus 1 (BoDV-1)-Encephalitis: An Exceptional Case with Valuable Insights for Pathophysiology and Disease Management.","authors":"Denis Grabova, Ida Wilkens, Matthias Klein, Suzette Heck, Viktoria Ruf, Sigrun Roeber, Michael Schmutzer-Sondergeld, Matthias Brendel, Robert Forbrig, Helena Klauss, Sabrina Katzdobler, Günter U Höglinger, Konstantin Dimitriadis, Andreas Straube, Markus Bauswein, Martina Kinzig, Fritz Sörgel, Dennis Tappe, Ilias Masouris, Florian Schöberl","doi":"10.1007/s40121-026-01425-1","DOIUrl":"10.1007/s40121-026-01425-1","url":null,"abstract":"<p><strong>Introduction: </strong>Borna disease virus 1 (BoDV-1) encephalitis has a (sub)acute and mostly fatal course. Initial flu-like symptoms are typically followed by rapid progressive panencephalitis and death within weeks. No curative therapy exists so far. We present a long-term survivor with distinctive clinical, imaging, and pathophysiological features.</p><p><strong>Case presentation: </strong>A previously healthy male in his fifties was admitted in summer 2023 with (sub)acute encephalitis (cerebrospinal fluid, CSF: 132 cells/µl, no pathogen detection). Brain magnetic resonance imaging (MRI) demonstrated vasogenic edema affecting basal ganglia, temporal and limbic regions bilaterally. Despite high-dose steroids, the clinical condition of the patient slowly worsened. Three months later, BoDV-1 reactive antibodies were detected by elevated titers in CSF (1:320) and serum (1:5120). Treatment with favipiravir, corticosteroids, and mycophenolate mofetil (MMF) was initiated. After recovery for months, the patient developed progressive bilateral optic atrophy, cognitive decline, and a sleep disorder resembling Kleine-Levin syndrome. Translocator protein (TSPO)-PET revealed widespread microglial activation, confirmed by targeted cortical biopsy. Immunosuppressive therapy was escalated with anakinra, cyclophosphamide, and intrathecal dexamethasone, achieving temporary stabilization. In the summer of 2025, a severe brainstem syndrome emerged, accompanied by increased TSPO uptake in the brainstem and detection of BoDV-1 RNA in CSF for the first time. Despite another treatment with favipiravir and high-dose corticosteroids, the patient remained in a minimally conscious state.</p><p><strong>Discussion: </strong>This exceptional case with long-term survival in BoDV-1 encephalitis gives important insights: BoDV1-associated neuroinflammation leading to a slowly progressive decline can be visualized by TSPO-PET. Late BoDV-1 RNA detection and subacute re-exacerbation after prolonged survival provides evidence that BoDV-1 persists in human brain tissue.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2817-2826"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721620","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 Letter to the Editor Regarding \"Antibiotic Pharmacokinetics and Prostate Penetration in Bacterial Prostatitis: Can We Draw Conclusions from Measured Prostatic Concentrations Reported in the Literature?\"","authors":"Antoine Hamon, Vincent Jullien, Aurélien Dinh, Maxime Vallée, Matthieu Lafaurie, Agnès Lefort","doi":"10.1007/s40121-026-01415-3","DOIUrl":"10.1007/s40121-026-01415-3","url":null,"abstract":"","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2835-2837"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724771","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}