International Journal of Infectious Diseases最新文献

{"title":"Tick-borne relapsing fever caused by Borrelia miyamotoi in Germany.","authors":"Gerrit Burger, Lene T Tscharntke, Diana J Vaca, Nadine Duschek, Theresa Alisch, Raja Idris, Sebastian Maffiold-Salas, Michael Hogardt, Thomas A Wichelhaus, Timo Wolf, Peter Kraiczy","doi":"10.1016/j.ijid.2026.109175","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109175","url":null,"abstract":"","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109175"},"PeriodicalIF":4.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building equitable epidemic response: the Interdisciplinary Consortium for Epidemics Research (ICER) position on Bundibugyo ebolavirus and regional preparedness in sub-Saharan Africa.","authors":"Misaki Wayengera, Patrick D M C Katoto, Wilber Sabiiti, Winters Muttamba, Bayode Romeo Adegbite, Samuel Lwamushi Makali, Elias N Nyanda, Placide K Mbala, Duncan Chanda, Willy Ssengooba, Haruna Muwonge, Hakim Sendagire, Bariki Mtafya, Denis Niyomwungere, Shema Hugor, Andrew Nsawotebba, Mudarshiru Bbuye, Jean Pierre Musabyimana, Barnabas Bakamutumaho, Henry Kyobe Bosa, Daniel Kiiza, Omu Anzala, David Lupande Mwenebitu, Archippe Muhandule Birindwa, Chiza Rogers, Gerard Jacques Mparanyi, Brenda Nakazibwe, Mosoka Papa Fallah, Pauline Byakika-Kibwika, Kariuki Njenga, Bruce Kirenga","doi":"10.1016/j.ijid.2026.109163","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109163","url":null,"abstract":"<p><p>The 2014-16 West African Ebola epidemic exposed consequences of weak regional preparedness and limited local scientific leadership. The Bundibugyo ebolavirus (BDBV) outbreak in the Democratic Republic of the Congo (DRC), with spill over into Uganda threatens to follow the same trend. Beyond the immediate response, this crisis is a defining moment for a question the region can no longer defer: who leads the science when Africa faces epidemics? As a scientific response, we argue for an immediate, regionally led research programme. To do this, ICER makes five priority positions: 1) Conduct of hypothesis-driven research as BDBV is understudied and yet is a high-risk and not a benign strain pathogen, 2) Rapid regional expansion is a realistic scenario, hence respective governments' preparedness frameworks must expedite to accommodate such an expansion, 3) African-led science is essential to an effective response, not merely an equity aspiration but a preparedness imperative, 4) Diagnostic, therapeutic, and vaccine development for BDBV cannot await commercial incentives and must be initiated proactively by public institutions, 5) An equitable partnership encompassing local leadership, fair authorship, capacity enhancement, and benefit sharing, is a prerequisite to be negotiated before research begins, and not an afterthought.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109163"},"PeriodicalIF":4.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inadequate empirical therapy and unnecessary broad-spectrum antibiotic use in community-onset bloodstream infection: A retrospective cohort study.","authors":"Celso Soares Pereira Batista, Laura Escolà-Vergé, Antoni Moliné Pareja, Jesús Ruiz-Ramos, Ivan Agra Montava, Raquel Arranz, Mireia Puig-Campmany, Ferran Navarro, Alba Rivera","doi":"10.1016/j.ijid.2026.109176","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109176","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate empirical antimicrobial therapy (EAT) adequacy, risk factors for inadequate EAT (IEAT) and multidrug-resistant (MDR) infection, and unnecessary broad-spectrum use in emergency department (ED) patients with bloodstream infection (BSI).</p><p><strong>Methods: </strong>Retrospective cohort study of adults with community-onset BSI at a tertiary-care ED (2022-2024). Adequate EAT (AEAT) was ≥1 administered agent with in vitro activity. Logistic regression identified factors associated with IEAT, unnecessary broad-spectrum therapy, and MDR infection. Cox regression assessed 7- and 30-day mortality.</p><p><strong>Results: </strong>Among 1,716 BSI episodes, 464 (27%) received IEAT or no EAT. MDR organisms accounted for 370 cases (21.6%) and were associated with IEAT (aOR 7.40, 95% CI 5.55-9.93). Of 606 patients receiving broad-spectrum EAT, 490 (80.9%) regimens were unnecessary. Community-acquired infection was associated with unnecessary broad-spectrum therapy (aOR 3.96, 95% CI 1.65-11.79), and healthcare-associated infection with MDR infection (aOR 2.02, 95% CI 1.31-3.14). Seven-day mortality was associated with polymicrobial infection (aHR 2.14, 95% CI 1.39-3.30), long-term care facility residence (aHR 1.72, 95% CI 1.20-2.46), and vasopressor requirement (aHR 3.20, 95% CI 2.21-4.62).</p><p><strong>Conclusions: </strong>IEAT was associated with MDR pathogens, and unnecessary broad-spectrum use was common. Improved MDR risk stratification may optimise EAT by reducing inadequate coverage and avoidable broad-spectrum exposure in the ED.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109176"},"PeriodicalIF":4.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and determinants of tuberculosis recurrence: a 12-year population-based cohort study.","authors":"Evelyn Lepka de Lima, Isadora Salles, Silvia Cohn, Ana Angélica Bulcão Portela Lindoso, Suely Fukasava, Jonathan Eric Golub, Samyra R Cox","doi":"10.1016/j.ijid.2026.109179","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109179","url":null,"abstract":"<p><strong>Objectives: </strong>Tuberculosis recurrence remains a challenge to elimination efforts in high-burden settings. We aimed to estimate the incidence and timing of tuberculosis recurrence and to identify its risk factors to inform post-treatment care.</p><p><strong>Methods: </strong>We conducted a population-based cohort study of tuberculosis survivors successfully treated for a first tuberculosis episode from 2013 through 2024 in São Paulo state, Brazil. Data were obtained from the state tuberculosis surveillance system (TBweb), and deaths were identified through linkage with the national mortality database. We applied competing risks survival analysis to estimate incidence and assess risk factors for recurrence. Covariates included demographic, clinical, behavioral, and social vulnerability indicators, measured at treatment initiation for the first tuberculosis episode. Risk factor models were stratified by age (<15 vs. ≥15 years).</p><p><strong>Results: </strong>Among 154,579 individuals who completed treatment for a first episode of tuberculosis, we identified 9,464 first recurrences over a median follow-up of 5.4 years (IQR 2.5-8.2). The overall recurrence incidence was 1,127.2 per 100,000 person-years. Rates were highest between 3-12 months after treatment completion, yet recurrence incidence remained over 1,000 per 100,000 person-years in the 2-5 years after treatment completion. In adults, hospitalization (adjusted subdistribution hazard ratio [aSHR] 2.53, 95%CI 2.36-2.71), and incarceration during the initial episode (aSHR 2.30, 2.13-2.48), together with pulmonary tuberculosis as initial diagnosis (aSHR 2.10, 1.87-2.35) were the strongest independent risk factors for recurrence. In children, HIV (aSHR 6.38, 2.64-15.40) was the strongest predictor.</p><p><strong>Conclusions: </strong>The high and persistent risk of tuberculosis recurrence reinforces the importance of post-treatment care with risk-based follow-up strategies.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109179"},"PeriodicalIF":4.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of a clinical prediction score for melioidosis among patients with community-acquired pneumonia: a substudy of the prospective multicentre MISSION cohort.","authors":"Nitin Gupta, Mohammed Ashiq, Praveen Kumar Tirlangi, Venkat Abhiram Earny, K E Vandana, Muralidhar Varma, Saurav Jyoti Patgiri, Ayush Gupta, Bijayini Behera, Chimanjita Phukan, Clarissa J Lyngdoh, Lalrempuii, Luna Adhikari, Mamta Devi, Margaret Yhome, Mika Umpo, Pradip Kumar Das, Rushika Saksena, Vibhor Tak, Anil Kumar, Pooja Kumari, Harpreet Kaur, Chiranjay Mukhopadhyay","doi":"10.1016/j.ijid.2026.109174","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109174","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pulmonary melioidosis may be clinically indistinguishable from other causes of community-acquired pneumonia (CAP), delaying appropriate microbiological investigation and antimicrobial therapy. A four-variable clinical prediction score incorporating monsoon-season presentation, diabetes mellitus, shock at presentation, and extrapulmonary focal abscesses was previously developed to identify melioidosis among patients with CAP. We aimed to externally validate this score in a prospective multicentre cohort and explore whether its performance could be improved by adding readily available predictors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a nested substudy of the prospective, multicentre, hospital-based MISSION study conducted across 15 tertiary-care centres in India between 1 January 2023 and 31 December 2025. Hospitalised adults with diabetes mellitus or chronic kidney disease who met predefined CAP criteria were eligible. Participants were excluded if one or more score variables could not be reliably ascertained at presentation, defined as clinical information available before microbiological confirmation. The original score was applied without refitting. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC), and sensitivity and specificity were calculated at prespecified cut-offs. An exploratory modified score was developed using independent predictors identified through multivariable logistic regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1,418 participants in the parent cohort who met the predefined CAP syndrome definition, 78 were excluded because one or more score variables could not be reliably ascertained at presentation. The final validation cohort included 1,340 participants, of whom 87 (6.5%) had culture-confirmed melioidosis CAP. The original score demonstrated moderate discrimination, with an AUC of 0.718 (95% CI 0.654-0.781). At a cut-off of ≥4, sensitivity was 72.4%, and specificity was 56.4%; at ≥5, sensitivity was 48.3%, and specificity was 86.4%. Extrapulmonary focal abscesses (adjusted odds ratio [aOR] 20.56, 95% CI 10.82-39.05), diabetes mellitus (aOR 2.94, 95% CI 1.36-6.37), male sex (aOR 2.39, 95% CI 1.32-4.33), high-risk occupation (aOR 2.37, 95% CI 1.43-3.93), and shock at presentation (aOR 2.30, 95% CI 1.31-4.05) were independently associated with melioidosis CAP. An exploratory modified score incorporating these variables had an apparent AUC of 0.770 (95% CI 0.711 to 0.828). At a cut-off of ≥3, sensitivity was 63.2% and specificity was 81.4%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The original four-variable score demonstrated moderate discrimination when externally validated among high-risk hospitalised adults with CAP. A cut-off of ≥4 may support screening, whereas ≥5 provides greater specificity but misses more than half of melioidosis cases. The exploratory modified score showed modestly higher apparent discrimination, and requires independent ext","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109174"},"PeriodicalIF":4.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sixteen Days Undetected: Growth Dynamics and the Case for Pre-Positioned Response Capacity in the 2026 Bundibugyo Virus Disease Outbreak, Democratic Republic of the Congo.","authors":"Johan G L Verheyden, Celestin Nzanzu Mudogo","doi":"10.1016/j.ijid.2026.109170","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109170","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate early growth rate, back-calculate transmission onset, and characterise the case-fatality trajectory of the 2026 Bundibugyo virus disease (BDBV) outbreak in the Democratic Republic of the Congo, the largest recorded BDBV outbreak to date.</p><p><strong>Design or methods: </strong>We analysed a corrected daily surveillance series (65 observations, 14 May-27 July 2026) using non-linear least-squares regression and a Bayesian Poisson growth model fitted by Markov chain Monte Carlo, with five sensitivity analyses.</p><p><strong>Results: </strong>Early confirmed cases grew at 0.1261 per day (95% CI 0.0885-0.1636), a doubling time of 5.50 days (4.24-7.83), three-fold faster than previous BDBV outbreaks (15-18 days). Bayesian back-calculation placed transmission onset on 19 April 2026 (95% highest-density interval 9-27 April), 16 days before the WHO alert and 25 days before laboratory confirmation. Confirmed case-fatality ratio rose from 12.1% to 44.3%; a higher ratio among suspected than confirmed cases on 21 May (23.6% vs 10.8%; p=0.0080) supported progressive reclassification rather than increasing virulence.</p><p><strong>Conclusions: </strong>Rapid BDBV growth leaves little time for outbreak-triggered mobilisation. Sentinel alerts based on unexplained deaths compatible with viral haemorrhagic fever, with healthcare-worker deaths as a high-priority special case, together with pre-positioned surveillance, diagnostic, and response capacity, could reduce avoidable amplification before confirmation.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109170"},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outbreak of Salmonella Agona linked to cross-contamination via doner kebab and electric knives in Hesse and Baden-Wuerttemberg, Germany, January 2022 - December 2024.","authors":"Syamend Saeed, Petra Heinmüller, Beatrice Ladewig, Claudia Eggert-Satzinger, Arthur Peter Schiffmann, Florian Burckhardt, Linda Falgenhauer, Ahmad Fawzy, Tilman Schultze, Anika Meinen, Sandra Simon, Michael Pietsch, Marina C Lamparter, Jennie Fischer, Laura Becker, Katharina Alpers, Ivo Foppa","doi":"10.1016/j.ijid.2026.109172","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109172","url":null,"abstract":"<p><strong>Objectives: </strong>Following an increase in Salmonella enterica spp. enterica (S.) serovar Agona notifications in Hesse and Baden-Wuerttemberg, Germany, 2022-2024, we investigated to identify the outbreak vehicle and source to implement control measures.</p><p><strong>Methods: </strong>Outbreak cases included laboratory-confirmed S. Agona cases defined as (1) probable (no isolate) or (2) confirmed cases (whole genome sequencing assigned outbreak strain, complex type 20182), residing in Hesse and Baden-Wuerttemberg. We analysed epidemiologic data, including food consumption histories, and compared isolates from clinical, food, and environmental samples.</p><p><strong>Results: </strong>Sixty S. Agona outbreak cases were identified (Hesse: 25 confirmed, 16 probable; Baden-Wuerttemberg: 15 confirmed, 4 probable), with 83% (40/48) of sequenced isolates closely linked genetically. The median age of cases was 21 years (range: 0-76 years) and 63% (38/60) were male. Cases were more likely to have consumed doner kebab compared to a population-based food survey (OR 6.7, CI 2.66-16.9). In three identified doner restaurants, the outbreak strain was detected in doner meat and on electric knives.</p><p><strong>Conclusion: </strong>Inadequate cleaning of knives due to improper disassembly may have contributed to sustained transmission over the three-year outbreak period. Improved hygiene measures, targeted sampling, and enhanced surveillance are essential to prevent similar foodborne outbreaks.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109172"},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident and Recurrent Sexually Transmitted Infections by Gender Identity Among Sex Workers on HIV Pre-Exposure Prophylaxis: A Prospective Cohort Study.","authors":"Jorge Valencia, Mariano Matarranz, Laia J Vázquez Guillamet, Guillermo Cuevas, Jesús Troya, Pedro Párbole, David Arroyo, Samuel Manzano, Felipe Pérez-García, Pablo Ryan, Salvador Resino","doi":"10.1016/j.ijid.2026.109169","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109169","url":null,"abstract":"<p><strong>Background: </strong>Sex workers on HIV pre-exposure prophylaxis (PrEP) experience high bacterial sexually transmitted infection (STI) rates. We assessed associations between gender identity and first/recurrent STI incidence to inform risk-stratified screening.</p><p><strong>Methods: </strong>This prospective cohort study (Madrid, 2022-2026) evaluated sex workers initiating PrEP. Participants underwent quarterly screening for Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum. We used Cox and Prentice-Williams-Peterson models to evaluate first and recurrent STIs, adjusting for confounders.</p><p><strong>Results: </strong>We included 147 sex workers (71 transgender women, 48 cisgender men, 28 cisgender women) with ≥3 months follow-up and ≥1 STI screening. First STI incidence was 5.14/100 person-months (cisgender men: 6.90; cisgender women: 2.13). Recurrent STI incidence was 3.26/100 person-months. Most incident STIs (93.1%) were asymptomatic. In multivariable analyses (reference: cisgender women), cisgender men had higher hazards for first (adjusted hazard ratio [aHR], 3.20; 95% CI, 1.47-6.99) and recurrent STIs (aHR, 4.04; 95% CI, 1.83-8.95). Transgender women also had higher hazards for first (aHR, 2.08; 95% CI, 1.02-4.22) and recurrent STIs (aHR, 2.25; 95% CI, 1.10-4.61).</p><p><strong>Conclusions: </strong>STI incidence during PrEP differs by gender identity, being highest in cisgender men and lowest in cisgender women. These findings support evaluating risk-stratified screening approaches over uniform quarterly guidelines.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109169"},"PeriodicalIF":4.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-based outcomes of antiretroviral therapy for people living with HIV in current follow-up: a comparative retrospective cohort study, Ganzhou, China, 2001-2021.","authors":"Chao-Xian Lian, Ya-Lan Wu, Yi-Lin Qin, Jia-Xin Wan, Chao-Ye Cao, Rong-Rong Yang, Xiao-Kang Liao, Li-Ling Yu, Gong-Wang Lan, Xin Chen","doi":"10.1016/j.ijid.2026.109173","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109173","url":null,"abstract":"<p><strong>Background: </strong>The increasing population of elderly people living with HIV (PLHIV) presents new challenges for HIV management, while few studies have explored antiretroviral therapy (ART) effects in this population. This study aimed to compare ART outcomes across multiple physiological systems between young and elderly PLHIV.</p><p><strong>Methods: </strong>A comparative retrospective cohort study was conducted among 2,178 young (18-49 years) and 1,495 elderly (≥50 years) PLHIV who received ART in Ganzhou, China, between 2001 and 2021. Temporal changes in multiple biomarkers related to virological, immunological, haematological, hepatic, renal, and metabolic functions were compared. Paired t tests and two-sample t tests were used for primary comparisons, and linear mixed-effects models were used for longitudinal analyses.</p><p><strong>Results: </strong>Baseline assessments revealed significantly lower white blood cells (WBC), platelets (PLT), haemoglobin (Hb), and alanine aminotransferase, alongside higher glucose (Glu), total cholesterol (TC), and serum creatinine (Scr) in elderly individuals (P<0.05). Both groups demonstrated comparable ART benefits including reduced viral load, decreased CD8⁺ T cells and aspartate aminotransferase, along with increased CD4⁺ T cells (CD4⁺), WBC, PLT, and Hb (P<0.05). Linear mixed-effects models confirmed significant longitudinal changes in most biomarkers. No significant age-group interactions were observed for CD8⁺ T cells, viral load, WBC, PLT, triglycerides, TC, Glu, and aspartate aminotransferase, indicating similar trends. However, compared with young PLHIV, elderly PLHIV had smaller increases in CD4⁺ and Hb, larger decreases in Scr and alanine aminotransferase, and a greater increase in total bilirubin. Moreover, both groups shared three notable temporal patterns: early-stage bilirubin decline, late-stage Scr rebound, and persistent Glu, TC, and triglyceride elevation throughout treatment.</p><p><strong>Conclusion: </strong>Despite baseline physiological disadvantages, elderly PLHIV attained virological suppression, immune reconstitution, and functional improvements across multiple organ systems that were comparable to those of young PLHIV. However, age-specific differences were observed, including smaller increases in CD4⁺ and Hb, and distinct renal, hepatic, and bilirubin trajectories in elderly PLHIV. These findings underscore the viability of ART in the elderly PLHIV and highlight the age-specific metabolic variations that demand clinical attention.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109173"},"PeriodicalIF":4.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of the updated FUJIFILM SILVAMP TB LAM II assay for pulmonary TB among HIV-negative outpatients at a primary-level clinic in rural China.","authors":"Gaoshun Xu, Yong Qiu, Mingcheng Guo, Rong Qu, Fajun Tian, Gengsheng Wang, Ya Wang, Meng Li, Peng Xu, Qian Gao","doi":"10.1016/j.ijid.2026.109168","DOIUrl":"https://doi.org/10.1016/j.ijid.2026.109168","url":null,"abstract":"<p><strong>Objectives: </strong>Non-sputum-based diagnostic tests are a priority for tuberculosis (TB) control. However, studies regarding urine lipoarabinomannan (LAM) tests in HIV-negative population remain limited. This study aimed to evaluate the accuracy of FujiLAM II for pulmonary TB among HIV-negative outpatients in primary-level healthcare settings.</p><p><strong>Methods: </strong>A prospective cohort study was conducted among outpatients with presumptive pulmonary TB and healthy controls in rural China. Urine samples from all participants were tested by FujiLAM II. Diagnostic accuracy was assessed against liquid culture, molecular test, microbiological reference standard (MRS) and composite reference standard (CRS).</p><p><strong>Results: </strong>408 presumptive pulmonary TB patients and 144 healthy controls were included, which were entirely HIV-negative. Among presumptive patients, 125 (30.6%) were MRS-positive and 149 (36.5%) were CRS-positive. All healthy controls were LAM-negative. Using liquid culture as the reference standard, FujiLAM II had a sensitivity of 35.8% (95% CI 26.4-46.3) and a specificity of 94.2% (95% CI 90.9-96.5). Against molecular assay, the sensitivity and specificity were 30.3% (95% CI 22.3-39.5) and 94.5% (95% CI 91.0-96.7). The sensitivities were 29.6% (95% CI 21.9-38.5) and 29.5% (95% CI 22.5-37.6) against MRS and CRS, respectively, with the corresponding specificities of 94.7% (95% CI 91.2-96.9) and 96.9% (95% CI 93.8-98.6). LAM-positive cases had a significantly shorter median liquid-culture time to positivity (9.5 vs 14.8 days, P = 0.002) and were more frequently smear-positive (35.3% vs 13.3%, P = 0.018) than LAM-negative cases, suggesting that bacillary burden may influenced FujiLAM II results.</p><p><strong>Conclusions: </strong>FujiLAM II could serve as a complementary tool with high specificity but limited sensitivity for pulmonary TB diagnosis among HIV-negative outpatients in primary healthcare settings.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"109168"},"PeriodicalIF":4.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}