Open Forum Infectious Diseases最新文献

{"title":"Breakthrough Invasive Mold Infections in Hematologic Cases: Relevance of the Host's Factors.","authors":"Isabel Rodríguez-Goncer, Jorge Boán, Riansares Carrero-Arribas, José María Sanchez-Pina, Manuel Lizasoaín, Mario Fernández-Ruiz, Rafael San-Juan, Francisco López-Medrano, Ana Pérez-Ayala, José Manuel Caro-Teller, Joaquín Martínez-López, José María Aguado, María Calbacho","doi":"10.1093/ofid/ofaf025","DOIUrl":"10.1093/ofid/ofaf025","url":null,"abstract":"<p><strong>Background: </strong>Breakthrough invasive mold infections (bIMIs) are life-threatening complications in hematologic cases. Most previous studies in this field covered the whole spectrum of fungal pathogens, including yeasts, and antifungal agents.</p><p><strong>Methods: </strong>We conducted a retrospective study including all hematologic cases of patients diagnosed with a bIMI while receiving a mold-active antifungal agent at our center between January 2017 and June 2022.</p><p><strong>Results: </strong>Overall 37 patients were diagnosed with bIMI: 6 (16.2%) proven, 18 (48.6%) probable, and 13 (35.1%) possible. The highest incidence rate was found for micafungin (1.31 bIMI episodes per 1000 treatment-days), although with no significant differences across antifungal agents. Most patients (90.9%) for whom therapeutic drug monitoring was performed exhibited adequate through levels. Ten (27.0%) patients had undergone allogeneic hematopoietic stem cell transplantation. <i>Aspergillus</i> species was the most common pathogen in cases with microbiological identification. Regarding risk factors, 67.6% had severe neutropenia at diagnosis and 40.5% had received high-intensity chemotherapy. Rates of clinical response and attributable mortality by day +30 were 64.9% and 23.3%, respectively. Poorer performance status, higher Charlson Comorbidity index, older age, and higher C-reactive protein by day +7 were associated with 30-day attributable mortality.</p><p><strong>Conclusions: </strong><i>Aspergillus</i> was the predominant pathogen in our cohort of bIMIs, with a significant proportion of episodes occurring despite adequate triazole levels. Thirty-day attributable mortality was lower than previously reported. Poorer performance status, higher comorbidity burden, and older age had a relevant role in the outcome of bIMI.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf025"},"PeriodicalIF":3.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BCG-Induced DNA Methylation Changes Improve Coronavirus Disease 2019 Vaccine Immunity Without Decreasing the Risk for Severe Acute Respiratory Syndrome Coronavirus 2 Infection.","authors":"Santiago Carrero Longlax, Kent J Koster, Ashish M Kamat, Marisa Lozano, Seth P Lerner, Rebecca Hannigan, Tomoki Nishiguchi, Abhimanyu, Daanish Sheikh, Malik Ladki, Alexandra Portillo, Amrit Koirala, Tajhal D Patel, Zoe Spieler, Aaron B Benjamin, Maxim Lebedev, Theresa U Ofili, Robert W Hutchison, George Udeani, Lynne A Opperman, Gabriel Neal, Anna M Mandalakas, Mihai G Netea, Moshe Arditi, Pablo Avalos, Sandra L Grimm, Cristian Coarfa, Jeffrey D Cirillo, Andrew R DiNardo","doi":"10.1093/ofid/ofaf007","DOIUrl":"10.1093/ofid/ofaf007","url":null,"abstract":"<p><strong>Background: </strong>The BCG vaccine induces trained immunity, an epigenetic-mediated increase in innate immune responsiveness. Therefore, this clinical trial evaluated if BCG-induced trained immunity could decrease coronavirus disease 2019 (COVID-19)-related frequency or severity.</p><p><strong>Methods: </strong>A double-blind, placebo-controlled clinical trial of healthcare workers randomized participants to vaccination with BCG TICE or placebo (saline). Enrollment included 529 healthcare workers randomized to receive BCG or placebo. Primary analysis evaluated COVID-19 disease frequency, while secondary analysis evaluated coronavirus immunity in a subset of participants. Study enrollment ceased early in December 2020 following introduction of COVID-19-specific vaccines.</p><p><strong>Results: </strong>Study enrollment was halted early, prior to reaching the targeted recruitment, and was not powered to detect a decrease in COVID-19 frequency. Symptomatic COVID-19 occurred in 21 of 263 and 10 of 266 participants in the BCG and placebo arms, respectively (<i>P</i> = .50, Fisher exact test). Participants vaccinated with BCG, but uninfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrated increased coronavirus vaccine immunity (increase spike-inducible levels of tumor necrosis factor, interleukin 6, and interleukin 1β) 12 months after BCG vaccination compared to participants receiving placebo. Immune responsiveness to SARS-CoV-2 antigens correlated with BCG-induced DNA methylation changes.</p><p><strong>Conclusions: </strong>Due to early study closure, the study was not powered to evaluate COVID-19 frequency. Secondary analysis demonstrated that 12 months following vaccination, BCG increased coronavirus vaccine immunity compared to those who did not receive BCG. This increase in COVID-19 vaccine immunity correlated with BCG-induced DNA methylation changes.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofaf007"},"PeriodicalIF":3.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ratio of Infections to COVID-19 Cases and Hospitalizations in the United States based on SARS-CoV-2 Seroprevalence Data, September 2021-February 2022.","authors":"Yangyang Deng, Yun Kim, Anna Bratcher, Jefferson M Jones, Muloongo Simuzingili, Adi V Gundlapalli, Melissa Briggs Hagen, Ronaldo Iachan, Kristie E N Clarke","doi":"10.1093/ofid/ofae719","DOIUrl":"10.1093/ofid/ofae719","url":null,"abstract":"<p><strong>Background: </strong>Understanding the risk of hospitalization from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can guide effective public health interventions and severity assessments. This study calculated infection-hospitalization ratios (IHRs) and infection-case ratios (ICRs) to understand the relationship between SARS-CoV-2 infections, cases, and hospitalizations among different age groups during periods of Delta and Omicron variant predominance.</p><p><strong>Methods: </strong>After calculating antinucleocapsid SARS-CoV-2 antibody seroprevalence using residual commercial laboratory serum specimens, 2 ratios were computed: (1) IHRs using coronavirus disease 2019 hospitalization data and (2) ICRs using Centers for Disease Control and Prevention surveillance data. Ratios were calculated across age groups (0-17, 18-49, 50-69, and ≥70 years) for 2 time periods (September-December 2021 [Delta] and December 2021-February 2022 [Omicron]).</p><p><strong>Results: </strong>Pediatric IHRs increased from 76.7 during Delta to 258.4 during Omicron. Adult IHRs ranged from 3.0 (≥70 years) to 21.6 (18-49 years) during Delta and from 10.0 (≥70 years) to 119.1 (18-49 years) during Omicron. The pediatric ICR was lower during the Delta period (2.7) compared with the Omicron period (3.7). Adult ICRs (Delta: 1.1 [18-49 years] to 2.1 [70+ years]; Omicron: 2.2 [>70+ years] to 2.9 [50-69 years]) were lower than pediatric ICRs during both time periods.</p><p><strong>Conclusions: </strong>All age groups exhibited a lower proportion of infections associated with hospitalization in the Omicron period than the Delta period; the proportion of infections associated with hospitalization increased with each older age group. A lower proportion of SARS-CoV-2 infections were associated with reported cases in the Omicron period than in the Delta period among all age groups.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae719"},"PeriodicalIF":3.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quantitative Polymerase Chain Reaction (qPCR) Protocol Predictive of Treatment Outcome in Cutaneous Leishmaniasis Caused by <i>Leishmania braziliensis</i>.","authors":"Bianca Lordêlo, Andréa Magalhães, Almério Noronha, Livia Oliveira, Daniel Beiting, Phillip Scott, Edgar M Carvalho, Lucas P Carvalho","doi":"10.1093/ofid/ofae749","DOIUrl":"10.1093/ofid/ofae749","url":null,"abstract":"<p><p><i>Leishmania braziliensis</i> is the most prevalent agent causing cutaneous leishmaniasis (CL) in Brazil. While inflammation is a hallmark of CL, few parasites are found at the lesion site, leading to challenges regarding diagnosis. Using <i>L braziliensis</i> kDNA and human 18S rRNA as targets, the present study developed a quantitative polymerase chain reaction assay to determine parasite load in biopsies from patients with CL who were residing in an endemic area in northeastern Brazil. In addition, we investigated whether parasite load correlated with clinical outcome, and we observed that patients with higher parasite load were more likely to experience therapy failure. Moreover, patients with CL in the early phase of infection presented higher levels of parasite transcripts than individuals in later phases. Thus, our results suggest that parasite load as determined by quantitative polymerase chain reaction may constitute a valuable prognostic tool to aid in the determination of disease severity and treatment outcome.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofae749"},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Pneumococcal Carriage in Asymptomatic Healthcare Workers.","authors":"Pari Waghela, Raechel Davis, Melissa Campbell, Rupak Datta, Maikel S Hislop, Noel J Vega, Loren Wurst, Devyn Yolda-Carr, Luke Couch, Michael Hernandez, Lindsay R Grant, Ronika Alexander-Parrish, Adriano Arguedas, Bradford D Gessner, Richard A Martinello, Daniel M Weinberger, Anne L Wyllie","doi":"10.1093/ofid/ofaf008","DOIUrl":"10.1093/ofid/ofaf008","url":null,"abstract":"<p><strong>Background: </strong>Healthcare workers are at increased risk of exposure to respiratory pathogens including <i>Streptococcus pneumoniae</i> (pneumococcus). While little asymptomatic carriage has been reported in young-to-middle-aged adults, this may be due to nonsensitive diagnostic methods. The aim of the current study was to investigate the rates of pneumococcal carriage in a large cohort of healthcare workers, using saliva as a respiratory specimen.</p><p><strong>Methods: </strong>We evaluated pneumococcal carriage in convenience samples of saliva, self-collected from asymptomatic healthcare workers (Connecticut, USA) who were testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 30 March to 11 June 2020. DNA extracted from the culture-enriched saliva was later tested using quantitative polymerase chain reaction for <i>piaB</i>, <i>lytA</i>, and serotype. Saliva samples were considered positive for pneumococcus when the <i>piaB</i> cycle threshold value was <40.</p><p><strong>Results: </strong>Study participants were 22-74 years old (mean age, 38.5 years), 75% female, 75% white, and with occupations including registered nurses (48%), medical doctors (23%), and patient care assistants (5%). Overall, 138 of 1241 samples (11%) from 86 of 392 individuals (21%) tested <i>piaB</i> positive at some point during the 4-month study period, with 28 (33%) colonized individuals positive at multiple time points. Carriers reflected the overall study population. No significant demographic characteristics were associated with detection of pneumococcus. Colonized individuals primarily carried serotypes 19F (25.6%) and 3 (12.8%).</p><p><strong>Conclusions: </strong>During a period of mandatory masking, we identified a cumulative pneumococcal carriage prevalence of 21% among healthcare workers. This study highlights that healthcare workers may act as unrecognized reservoirs of pneumococcus in the population. Despite long-standing pediatric immunization programs, vaccine-targeted serotypes continue to be prevalent among the adult population.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf008"},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Clinics Offering Nontraditional Lyme Disease Therapies in Lyme Endemic States of the United States.","authors":"Jason R Sakizadeh, Meghan K Rothenberger, Jonathan D Alpern","doi":"10.1093/ofid/ofaf017","DOIUrl":"https://doi.org/10.1093/ofid/ofaf017","url":null,"abstract":"<p><p>In this cross-sectional analysis, we analyzed 117 US clinics in Lyme endemic states that provide nontraditional care for Lyme disease. We found that unproven therapies are routinely offered, and some therapies raise safety concerns. The cost of care can be high, which may lead to significant out-of-pocket expenditures for patients.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf017"},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory Confirmation of Respiratory Syncytial Virus Infection Is Not Associated With an Increased Risk of Death in Adults With Acute Respiratory Illness.","authors":"Jeffrey A Kline, Robert D Welch, Christopher Kabrhel, Daniel Mark Courtney, Carlos A Camargo","doi":"10.1093/ofid/ofaf004","DOIUrl":"10.1093/ofid/ofaf004","url":null,"abstract":"<p><strong>Background: </strong>Limited data have described the testing patterns and outcomes of adults (≥18 years) with acute respiratory illness (ARI) in the emergency department setting.</p><p><strong>Methods: </strong>This prospective cohort study includes patients with ARI from a program sponsored by the Centers for Disease Control and Prevention entitled Respiratory Virus Laboratory Emergency Department Network Surveillance (RESP-LENS) from August 2021 until March 2024 (91 hospitals). Patients with ARIs were identified weekly by electronic surveillance for 1 or more of 130 <i>ICD-10</i> codes that defined ARI. Patients were followed for 30 days for the primary outcomes of hospitalization and mortality. Testing for RSV with nasopharyngeal swabbing followed by reverse transcription polymerase chain reaction was done as part of usual care. Risk of 30-day mortality and RSV positivity was tested in a generalized estimating equation.</p><p><strong>Results: </strong>From 1 210 394 patients with ARI, 345 185 (28.5%) adults underwent RSV testing, which was positive in 2.4%. In adults who were RSV+, the overall mortality rate was 1.9% as compared with 2.9% in adults who were RSV-. Mortality with RSV+ status increased with age ≥65 years to 3.8% (95% CI, 3.1%-4.5%). However, in the generalized estimating equation, RSV+ status was not associated with a higher rate of hospitalization (adjusted odds, 0.79; 95% CI, .75-.84) or 30-day mortality (odds, 0.62; 95% CI, .53-.74) relative to those who were RSV-. Age ≥65 years, incremental worsening of vital signs, male sex, and heart failure were independently associated with death.</p><p><strong>Conclusions: </strong>Among adults with ARI presenting to an emergency department who were tested for RSV as part of their usual care, laboratory-confirmed RSV positivity was not associated with increased risk, including hospitalization, intensive care unit requirement, or death.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf004"},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programmatic Diagnostic Accuracy and Clinical Utility of Xpert MTB/XDR in Patients With Rifampicin-Resistant Tuberculosis in Georgia.","authors":"Theresa Pfurtscheller, Ana Tsutsunava, Nino Maghradze, Mariam Gujabidze, Nino Bablishvili, Seda Yerlikaya, Claudia M Denkinger, Nestani Tukvadze, Ankur Gupta-Wright","doi":"10.1093/ofid/ofaf022","DOIUrl":"10.1093/ofid/ofaf022","url":null,"abstract":"<p><strong>Background: </strong>Xpert MTB/XDR (Cepheid) is recommended by the World Health Organization for drug susceptibility testing in patients with tuberculosis, with potential for rapid detection of isoniazid and fluoroquinolone resistance. However, diagnostic accuracy and clinical utility in a programmatic setting are unknown.</p><p><strong>Methods: </strong>We evaluated the accuracy and clinical utility of Xpert MTB/XDR in patients with rifampicin-resistant pulmonary tuberculosis during programmatic implementation in Georgia between July 2022 and August 2024, using phenotypic drug susceptibility testing (DST) as a reference standard.</p><p><strong>Results: </strong>An overall 140 patients were tested with Xpert MTB/XDR and phenotypic DST, and 94.9% and 33.8% had isoniazid and fluoroquinolone resistance by phenotypic DST, respectively. Xpert MTB/XDR showed 99.2% sensitivity (95% CI, 95.5%-100%) and 100% specificity (95% CI, 54.1%-100%) for isoniazid resistance. Sensitivity and specificity for fluoroquinolone resistance were 88.4% (95% CI, 74.9%-96.1%) and 100% (95% CI, 95.6%-100%). When indeterminate/invalid Xpert MTB/XDR results were included, 17.4% (8/46) and 6.2% (8/129) of patients with phenotypic fluoroquinolone and isoniazid resistance were missed. Median turnaround time for Xpert MTB/XDR was 1 day (IQR, 1-3) and median time to treatment was 4 days (IQR, 1-7). Phenotypic DST results took a median 43 days (IQR, 29-63) longer than Xpert MTB/XDR results. Finally, 95% (115/121; 95% CI, 89.5%-98.2%) of patients had fluoroquinolones appropriately prescribed based on Xpert MTB/XDR results.</p><p><strong>Conclusions: </strong>Programmatic data confirm the high accuracy of Xpert MTB/XDR, despite being below the World Health Organization target product profile targets for fluoroquinolones, with significantly faster time to results than phenotypic DST.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf022"},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis C Virus Seroprevalence, Incidence, and Screening Patterns in Ontario Preexposure Prophylaxis Users.","authors":"Matthew W McGarrity, Ryan Lisk, Paul MacPherson, David Knox, Kevin S Woodward, Jeff Reinhart, John MacLeod, Isaac I Bogoch, Deanna Clatworthy, Mia J Biondi, Sean T Sullivan, Alan T W Li, Ann N Burchell, Darrell H S Tan","doi":"10.1093/ofid/ofaf014","DOIUrl":"10.1093/ofid/ofaf014","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) has emerged as a sexually transmitted infection in gay, bisexual, and other men who have sex with men (GBM). We estimated the seroprevalence and incidence of HCV infection and examined patterns of HCV testing among GBM using human immunodeficiency virus preexposure prophylaxis (PrEP) in Ontario, Canada.</p><p><strong>Methods: </strong>We analyzed data from the Ontario PrEP Cohort Study (ON-PrEP), a prospective cohort of PrEP users from 10 Ontario clinics. Participants completed an online questionnaire and study staff collected clinical information into a study database biannually for 2 years. We estimated the baseline seroprevalence and incidence of HCV infection and examined patterns of HCV testing during follow-up. We further explored differences in sociodemographic/clinical variables between those with and without prevalent/incident HCV infection through bivariate analysis.</p><p><strong>Results: </strong>Among 557 eligible PrEP users, 382 (68.6%) underwent baseline HCV antibody testing, of whom 5 tested HCV seropositive, giving a seroprevalence of 1.3% (95% confidence interval [CI], .43%-3.03%). Only 245 (43.9%) participants underwent HCV antibody testing after baseline, and median time to participants' first follow-up test was 245 days. During follow-up, 2 participants tested newly HCV seropositive, giving an incidence of 0.47/100 person-years (95% CI, .06-1.69) over 428.9 years of follow-up. Participants with prevalent/incident HCV infection during the study appeared more likely to report giving money, drugs, gifts, or services for sex in the 3 months preceding enrollment compared to those who never tested HCV seropositive (<i>P</i> = .02).</p><p><strong>Conclusions: </strong>HCV seroprevalence and incidence were low but not negligible among Ontario PrEP users. HCV antibody and RNA testing were suboptimal.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofaf014"},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Clinician Reporting to the Antiretroviral Pregnancy Registry From Within and Outside the United States.","authors":"Stavroula Mantas, Jessica O'Bryan, Michelle L Giles, William R Short, Erin Logue-Chamberlain, Sushena Krishnaswamy","doi":"10.1093/ofid/ofaf023","DOIUrl":"10.1093/ofid/ofaf023","url":null,"abstract":"<p><strong>Background: </strong>Excluding pregnant women with human immunodeficiency virus (HIV) from clinical trials results in inadequate pregnancy safety data for new antiretroviral therapies (ART). More rapid accumulation of ART pregnancy safety data is required. The Antiretroviral Pregnancy Registry (APR) collects teratogenicity data on ART exposures during conception and pregnancy, yet reporting to the registry is suboptimal, impacting ART choices for women with HIV globally. This research assesses awareness of the APR and barriers to reporting among HIV providers in the United States (US) and Australia.</p><p><strong>Methods: </strong>Anonymous, online surveys were conceived independently by researchers in the US and Australia. The surveys were distributed through national email distribution lists to healthcare providers for pregnant women with HIV and their newborns or women of reproductive potential with HIV, to assess their awareness of the APR and barriers to reporting.</p><p><strong>Results: </strong>In total, 146 healthcare providers (66 US, 80 Australia) completed the survey. Respondents from the US had greater awareness of the registry and more reporting experience, describing the process as complex and laborious. Providers from Australia were largely unaware that the APR accepts reports from outside the US. Key barriers to reporting were uncertainty about how to report and incomplete access to all relevant maternal and pediatric data.</p><p><strong>Conclusions: </strong>Barriers to reporting to the APR are context specific. There is scope to raise the global profile of the APR to expedite data collection, reducing time between antiretroviral licensure and accumulation of sufficient pregnancy safety data.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf023"},"PeriodicalIF":3.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}