Open Forum Infectious Diseases最新文献

{"title":"Ethnic Disparities in Extrahepatic Manifestations Among People With HCV Infection: A Population-Based Study in British Columbia.","authors":"Dahn Jeong, Stanley Wong, Héctor A Velásquez García, Prince A Adu, Jean D Makuza, Sofia R Bartlett, Alnoor Ramji, Eric M Yoshida, Richard L Morrow, Amee R Manges, Mohammad E Karim, Amanda Yu, Georgine Cua, Mel Krajden, Naveed Z Janjua","doi":"10.1093/ofid/ofaf543","DOIUrl":"10.1093/ofid/ofaf543","url":null,"abstract":"<p><strong>Background: </strong>Ethnic disparities in extrahepatic manifestations (EHMs) among individuals with chronic hepatitis C virus (HCV) infection are poorly understood, especially in diverse populations. We aimed to examine ethnic disparities in EHMs among individuals diagnosed with HCV in British Columbia (BC), Canada.</p><p><strong>Methods: </strong>Using linked administrative health data from the BC Hepatitis Testers Cohort (1990-2015), we assessed EHMs incidence and risk by ethnicity (East Asian, South Asian, and Other) across 4 groups: individuals who remained untreated, pre-HCV treatment completion, post-HCV treatment completion, and those who spontaneously cleared HCV. EHMs included chronic kidney diseases (CKDs) and end-stage renal diseases (ESRDs), type 2 diabetes (T2DM), stroke, major adverse cardiac events (MACEs), and neurocognitive disorders. To assess the risk of EHMs by ethnicity, we used multivariable cause-specific proportional hazards models.</p><p><strong>Results: </strong>Among 41 874 individuals, South and East Asians had higher incidence rates of CKD and ESRD, T2DM, stroke, and MACE compared with other ethnicities, particularly among untreated individuals. Adjusted analyses showed that untreated South Asians had significantly higher risk of CKD and ESRD (adjusted hazard ratio [aHR] 1.27, 95% confidence interval [CI] 1.02-2.16) and T2DM (aHR 2.12, 95% CI 1.53-2.94). Following HCV treatment, these disparities largely disappeared except for diabetes.</p><p><strong>Conclusions: </strong>This study highlights the disproportionate burden of EHMs among Asians in BC and underscores the potential of HCV treatment to reduce ethnic disparities. Public health programming is needed to increase linkage to HCV treatment among those who remain untreated. Further research should focus on intra-ethnic differences and mechanisms underlying the impact of HCV treatment on mitigating these disparities.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf543"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186101","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":"Development of a Comprehensive Program for the Early Diagnosis and Treatment of Severe Infections in a Tertiary Hospital in Spain.","authors":"Guillermo Martín-Gutiérrez, José Molina, Carlos Martín-Pérez, Manuela Aguilar-Guisado, María Solla, Belén Ramos-Morán, Teresa Aldabó, Rosario Amaya-Villar, Adelina Gimeno, Pilar Egea, Rocío Álvarez-Marín, José Antonio Lepe, José Miguel Cisneros","doi":"10.1093/ofid/ofaf532","DOIUrl":"10.1093/ofid/ofaf532","url":null,"abstract":"<p><strong>Background: </strong>To assess the impact of the rapid diagnosis and treatment of severe infections (rDTSI) program on diagnostic and clinical outcomes in patients with severe infections.</p><p><strong>Method: </strong>We conducted a pre-post quasi-experimental study evaluating patients with severe pneumonia or sepsis before (October 2019-February 2020) and after (March 2022-March 2023) rDTSI implementation. The program integrated rapid molecular diagnostics, a 24/7 laboratory workflow, and multidisciplinary training. Primary outcomes included time from clinical diagnosis to pathogen-directed therapy and targeted therapy within 48 h. Secondary outcomes assessed antimicrobial appropriateness (DOOR-MAT), length of stay, and mortality.</p><p><strong>Results: </strong>The rDTSI program significantly reduced the median time to pathogen-directed therapy in pneumonia (48.8 vs 23.6 h, <i>P</i> < .001) and increased targeted therapy within 48 h (36.17% to 58.14%, <i>P</i> = .049). Hospital stays decreased (38.9 to 22.2 days, <i>P</i> < .001). In sepsis, diagnostic times (19.4 vs 18.1 h, <i>P</i> = .028) and DOOR-MAT scores (80.4 vs 88.0, <i>P</i> = .024) improved, while other clinical outcomes remained unchanged.</p><p><strong>Conclusions: </strong>The rDTSI program accelerated microbiological diagnosis, optimized antimicrobial therapy, and improved hospital efficiency in severe infections. These findings support integrating rapid diagnostics into antimicrobial stewardship programs to enhance severe infection management.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf532"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113765","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":"Anal Cancer Incidence Rates Among Men and Women With and Without HIV in South Africa.","authors":"Nathalie Verónica Fernández Villalobos, Yann Ruffieux, Chido Chinogurei, Andreas D Haas, Nicola Low, Matthias Egger, Jenni Noble, Gary Maartens, Naomi Folb, Eliane Rohner","doi":"10.1093/ofid/ofaf537","DOIUrl":"10.1093/ofid/ofaf537","url":null,"abstract":"<p><strong>Background: </strong>More than 7.5 million people in South Africa have HIV, but little is known about the association of HIV and anal cancer incidence. We examined anal cancer incidence in a large South African cohort of insured men and women.</p><p><strong>Methods: </strong>We conducted a cohort study using reimbursement claims data from a South African medical insurance scheme (01/2011-07/2020) to assess anal cancer rates among people with and without HIV aged ≥18 years. We estimated adjusted hazard ratios (aHRs) for the association of HIV and incident anal cancer using flexible parametric survival models. Covariates included sex, age, calendar year, a history of genital warts and other sexually transmitted infections, and in women, cervical precancer.</p><p><strong>Results: </strong>We included 1 068 915 people of whom 69 985 (7%) were living with HIV. Over 3 933 145 person-years, 122 anal cancers were diagnosed (crude rate: 3.1/100 000 person-years; 95% confidence intervals [CI] 2.6-3.7). People with HIV had a 4-fold higher anal cancer risk than people without HIV (aHR 4.43; 95% CI 2.44-8.04). While anal cancer rates were similar among men and women, older age (≥65 vs 45-54 years; aHR 5.01; 95% CI: 2.94-8.53), a history of genital warts (aHR 7.56; 95% CI: 2.28-25.07), and among women, a prior cervical precancer diagnosis (aHR 5.70; 95% CI 1.75-18.58) were associated with a higher anal cancer risk.</p><p><strong>Conclusions: </strong>In South Africa, men and women with HIV, older individuals, people with a history of genital warts, and women with a prior cervical precancer diagnosis might benefit from prioritized access to anal cancer screening.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf537"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113468","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":"Uptake and 24-month Outcomes of Dolutegravir- Versus Lopinavir-based Second-line Antiretroviral Therapy for People With HIV in South Africa: A Retrospective Cohort Study and Emulated Target Trial.","authors":"Jennifer Anne Brown, Lara Lewis, Yukteshwar Sookrajh, Lungile Hobe, Thulani Ngwenya, Johan van der Molen, Kwabena Asare, Kwena Tlhaku, Mlungisi Khanyile, Thokozani Khubone, Christian Bottomley, Nigel Garrett, Jienchi Dorward","doi":"10.1093/ofid/ofaf530","DOIUrl":"10.1093/ofid/ofaf530","url":null,"abstract":"<p><strong>Background: </strong>Aligning with the World Health Organization, South Africa has replaced ritonavir-boosted lopinavir (LPV/r) with dolutegravir (DTG) in second-line antiretroviral therapy (ART) after treatment failure with tenofovir disoproxil fumarate (TDF)/lamivudine or emtricitabine (XTC)/efavirenz (EFV). Initial guidance included special considerations for DTG use among women.</p><p><strong>Methods: </strong>We analyzed routine deidentified data of adults switched from TDF/XTC/EFV to second-line AZT/XTC/LPV/r, AZT/XTC/DTG, or TDF/XTC/DTG between December 2019 and December 2023 at 108 healthcare facilities in KwaZulu-Natal, South Africa. Among people switched before July 2021, we emulated a target trial comparing 24-month death or loss to follow-up (LTFU), and viremia (>50 copies/mL). We conducted intention-to-treat and per-protocol analyses using weighted logistic regression with bootstrapped CIs.</p><p><strong>Results: </strong>Overall, women were less likely than men to switch to DTG (RR: 0.92 [95% CI: .88, .96]; <i>N</i> = 3649). Of 2321 people switched before July 2021, 915 (39%) switched to AZT/XTC/LPV/r, 415 (18%) to zidovudine (AZT)/XTC/DTG, and 991 (43%) to TDF/XTC/DTG. Median age was 36 years (IQR: 30, 43) and 1364 (59%) were women. In intention-to-treat analyses, the standardized 24-month risk of death or LTFU was similar with AZT/XTC/LPV/r (31%), AZT/XTC/DTG (30%), and TDF/XTC/DTG (34%). The standardized risk of 24-month viremia among those retained in care with a viral load result (<i>N</i> = 1270) was higher with AZT/XTC/LPV/r (50%) than with AZT/XTC/DTG (40%; aRD: -10% [95% CI -19%, -2%]) or TDF/XTC/DTG (39%; aRD: -11% [95% CI -18%, -5%]). Per-protocol analyses gave similar results.</p><p><strong>Conclusions: </strong>While retention was similar across regimens, viremia was less common on DTG-based ART, supporting current guidelines.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf530"},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114005","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":"Antibody Responses are Sustained 2 Years Post-Mpox Infection but not Following Modified Vaccinia Ankara-Bavarian Nordic Vaccination.","authors":"Joanne Byrne, Alejandro Garcia-Leon, Aisling Murphy, Gurvin Saini, Ishan Banik, Alan Landay, Liem Binh Luong Nguyen, Stefano Savinelli, Cathal O'Broin, Mary Horgan, Christine Kelly, Carlos Mejia-Chew, Corinna Sadlier, Eoghan de Barra, Jane A O'Halloran, Virginie Gautier, Patrick W G Mallon, Eoin R Feeney","doi":"10.1093/ofid/ofaf536","DOIUrl":"10.1093/ofid/ofaf536","url":null,"abstract":"<p><strong>Background: </strong>Clade IIb mpox cases have declined globally, likely due to behavioral changes alongside vaccine- and infection-induced immunity. However, infections in vaccinated individuals raise concerns about immunity durability. We compared the longevity of antibody responses following mpox infection and modified vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccination.</p><p><strong>Methods: </strong>In a multicenter, prospective cohort, we measured plasma IgG titers to vaccinia virus (VACV) B5 antigen in adults with prior mpox, MVA-BN vaccination, and historical controls, sampled up to 2 years postexposure. Receiver operating characteristic analysis determined the seropositivity threshold. Generalized additive mixed models compared antibody kinetics, and logistic regression identified factors associated with seropositivity. The results are median (interquartile range) unless specified.</p><p><strong>Results: </strong>A total of 122 vaccinated participants (100% male, aged 36 [32.5-43.5], 25% people with HIV [PWH]) were sampled at 22.0 (20.0-23.5) months post-MVA-BN vaccination, 72 of whom had a paired sample 12.5 (8.0-15.5) months prior, alongside 13 participants post-mpox (100% male, aged 32.5 [30.5-40], 23% PWH) sampled 25.0 (22.5-29.0) months postinfection, 12 with a paired sample 12.5 (8.5-15.5) months prior. At follow-up, 85% (11/13) of the post-mpox group remained seropositive, versus 32% (39/122) of the vaccinated group. Predicted geometric-mean anti-VACV-B5 titers fell below the seropositivity threshold at 15.5 (95% confidence interval [CI]: 13.0-19.5) months postvaccine. PWH had significantly lower odds of retaining seropositivity (odds ratio: 0.18; 95% CI: .04-.60; <i>P</i> = .01).</p><p><strong>Conclusions: </strong>Antibody titers declined more rapidly postvaccination than post-mpox, with most vaccinated recipients, particularly PWH, losing seropositivity at 2 years. How these data relate to reinfection risk or the need for boosters remains to be determined.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf536"},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186653","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":"Outcomes in Military Blood Donors at Joint Base San Antonio With Reactive <i>Trypanosoma cruzi</i> Antibody Screening Results.","authors":"Michael J Wells, Brian G Casleton, Melita M Gella, Glorimar Z Rivera, Megan L Phelps, Theresa M Casey, Angela B Osuna, Ga On Jung, Erin L Winkler, Heather C Yun, Joseph E Marcus","doi":"10.1093/ofid/ofaf522","DOIUrl":"10.1093/ofid/ofaf522","url":null,"abstract":"<p><strong>Background: </strong>All blood donors in the United States are universally screened once for <i>Trypanosoma cruzi</i> antibodies to prevent transfusion-transmitted Chagas disease, but military donors are screened with every donation. Previous studies of military blood donors demonstrated that reactive <i>T cruzi</i> antibodies were a common reason for postdonation deferral, but follow-up is unclear. This study evaluated the diagnostic evaluation of blood donors with reactive <i>T cruzi</i> screening results.</p><p><strong>Methods: </strong>Medical records of all blood donors at the Armed Services Blood Bank Center at Joint Base San Antonio-Lackland with reactive screening results for <i>T cruzi</i> antibodies between January 2017 to December 2022 were evaluated after chemiluminescent immunoassay or chemiluminescent microparticle immunoassay screening and enzyme strip assay supplementary testing. Records were assessed to determine the diagnostic evaluation and final diagnosis of each case following initial reactive screening results.</p><p><strong>Results: </strong>Of 89,459 blood donors during the study period, 49 (0.055%) screened reactive for <i>T cruzi</i> antibodies on initial blood donation. Of those, 4 (8%) had positive and 18 (36%) had indeterminate supplementary test results. No donors met criteria for Chagas disease on clinical diagnostic testing. Of the 8 with repeated screening testing ordered in the weeks after their original reactive result, only 1 (13%) had a repeated reactive screening test result but negative confirmatory serologic results.</p><p><strong>Conclusions: </strong>While reactive <i>T cruzi</i> screening results occurred in this cohort, there were no cases of Chagas disease. This study demonstrates that some military blood donors have transient reactivity with screening assays, and future work should determine ways to safely bring these donors without Chagas disease back into the donor pool.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf522"},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113924","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":"Three-Year Outcomes After Programmatic Transitioning to Dolutegravir in the Context of Severe Civil Unrest in Haiti.","authors":"Bernard Liautaud, Ana Sanchez Chico, Youry Macius, Sosina Abuhay, Patrice Joseph, Harrison T Reeder, Theo Bolas, Adias Marcelin, Colette Guiteau Moïse, Alexandra Apollon, Pierre Cremieux, Jean W Pape, Serena P Koenig","doi":"10.1093/ofid/ofaf526","DOIUrl":"10.1093/ofid/ofaf526","url":null,"abstract":"<p><strong>Background: </strong>Tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) is widely prescribed in low and middle-income countries. Data on long-term outcomes are limited.</p><p><strong>Methods: </strong>We included all persons with HIV (PWH) ≥15 years of age who initiated or switched to TLD in Port-au-Prince, Haiti. We described treatment outcomes by pre-switch viral load and assessed predictors of virologic failure using multivariable logistic regression.</p><p><strong>Results: </strong>A total of 10 354 PWH initiated or switched to TLD from November 2018 to March 2021, and were included in the analyses. Of these, 2217 (21.4%) were ART-naïve and 8137 (78.6%) switched from an non-nucleoside reverse transcriptase inhibitor (NNTRI)-based regimen. Median follow-up time on TLD was 2.8 years (IQR: 2.3, 3.1). HIV-1 RNA <1000 copies/mL was achieved at the latest measurement in 92.7% of recipients of care (RoC) with pre-switch suppression, 88.5% without pre-switch viral load, 58.3% with pre-switch failure, and 81.8% of RoC ART-naïve at TLD initiation. Among treatment-experienced RoC, predictors of ≥1000 copies/mL at latest test included younger age (adjusted odds ratio [aOR]: 0.44; 95% CI: 0.34, 0.57 for age ≥50 vs <30 years), shorter time on ART (aOR: 0.91; 95% CI: 0.89, 0.93/year), lower education (aOR: 1.31; 95% CI: 1.13, 1.52), and higher pre-switch viral load: (aOR: 7.23; 95% CI: 6.06, 8.63 for ≥10 000 vs < 1000 copies/mL).</p><p><strong>Conclusions: </strong>Virologic outcomes on TLD are outstanding for PWH with pre-switch suppression. However, rates of virologic suppression are suboptimal among PWH who were ART-naïve at TLD initiation, and among those with a history of pre-switch failure, additional interventions are necessary, including access to long-acting treatment regimens.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf526"},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114029","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":"Re-emergence of Diphtheria in Guinea: An Outbreak Analysis of Vaccination and Disease Control Perspectives.","authors":"Alpha Kabiné Keita, Abdoul Karim Soumah, Thibaut Armel Chérif Gnimadi, Abass Kande, Kadio Jean Jacques Olivier Kadio, Haby Diallo, Mariama Cisse, Joel Ballè Koivogui, Djiba Kaba, Salifou Talassone Bangoura, Abdoulaye Toure, Florence Fenollar, Oleg Mediannikov, Alpha Kabinet Keita","doi":"10.1093/ofid/ofaf527","DOIUrl":"10.1093/ofid/ofaf527","url":null,"abstract":"<p><strong>Background: </strong>This study presented the key characteristics of patients who tested positive for diphtheria during the outbreak in the Republic of Guinea in 2023 and assessed the influence of some risk factors on disease development.</p><p><strong>Methods: </strong>The clinical diagnosis of diphtheria was confirmed by detecting diphtheria toxin genes in nasopharyngeal samples collected from suspected patients via 2 reverse transcription-quantitative polymerase chain reaction tests. Bivariate analyses with the χ² test and the Fisher's exact test were conducted to explore possible associations between diphtheria positivity and various sociodemographic, clinical, and exposure factors.</p><p><strong>Results: </strong>In total, 444 samples obtained from suspected cases were analyzed. In 90 (20.3%) cases, the condition was confirmed using quantitative polymerase chain reaction, with an overall fatality rate of 8.9% (<i>n</i> = 8). On average, deaths occurred 2 days after admission, with 6 (75.0%) of 8 (6 girls and 2 boys) deaths recorded within the first 3 months after the epidemic onset. The clinical characteristics included sore throat (91%), fever (90%), whitish throat membrane (83%), throat redness (81%), and dyspnea (28%). The risk factors were age <15 years, no prior vaccination, and contact with a patient with diphtheria. A whitish throat membrane and dyspnea were significantly associated with diphtheria positivity.</p><p><strong>Conclusions: </strong>This study emphasized that diphtheria remains a major and potentially fatal disease, despite vaccination and early symptom recognition. The identification of characteristic signs-particularly a whitish throat membrane and dyspnea-is important for reducing disease severity and mortality.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf527"},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131648","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":"Estimating Population Immunity and Impact of COVID-19 Vaccination in Washington State and Oregon.","authors":"Mia Moore, Larissa Anderson, Chloe Bracis, David A Swan, Ian Painter, Erik Everson, Holly Janes, Joshua T Schiffer, Laura Matrajt, Dobromir Dimitrov","doi":"10.1093/ofid/ofaf531","DOIUrl":"10.1093/ofid/ofaf531","url":null,"abstract":"<p><strong>Background: </strong>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine showed high clinical efficacy against the ancestral variant, but immunological waning, emergence of new variants, and the durability of infection-induced immunity complicate the estimation of population-level effectiveness. We used mathematical modeling to calculate the proportion of hospitalizations averted by vaccination in Washington and Oregon.</p><p><strong>Methods: </strong>We used an age- and region-structured compartmental model of vaccine-induced and infection-induced immunity from January 2020 until December 2022. We parameterized the strength and durability of immunity via a meta-regression of vaccine efficacy. We calibrated a time-varying contact matrix to weekly hospitalizations reported by the Washington Department of Health and Oregon Health Authority. We validated our model with Centers for Disease Control and Prevention serosurveillance data. To estimate vaccine effectiveness, we created counterfactual scenarios with no vaccination either in the entire population or in select age groups.</p><p><strong>Results: </strong>We found that total hospitalizations were reduced 74% (95% credible interval [CrI], 69%-78%) and 15% (95% CrI, 9%-19%) by primary vaccination and boosters, respectively. Vaccination effectiveness was highest during the Alpha wave, averting 90% (95% CrI, 88%-93%) of hospitalizations and in people aged 65+, averting 78% (95% CrI, 73%-81%). Relative to only vaccinating individuals aged 50+, vaccination of individuals aged 18-49 averted 52% (95% CrI, 44%-58%) of hospitalizations overall and 42% (95% CrI, 35%-48%) of hospitalizations among individuals 65+.</p><p><strong>Conclusions: </strong>The SARS-CoV-2 vaccination program in Washington and Oregon averted the majority of hospitalizations. Vaccinating individuals aged 18-49 significantly reduced hospitalization among individuals aged 65+.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf531"},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138184","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":"Global Prevalence of Long COVID, Its Subtypes, and Risk Factors: An Updated Systematic Review and Meta-analysis.","authors":"Yiren Hou, Tian Gu, Zhouchi Ni, Xu Shi, Megan L Ranney, Bhramar Mukherjee","doi":"10.1093/ofid/ofaf533","DOIUrl":"10.1093/ofid/ofaf533","url":null,"abstract":"<p><strong>Background: </strong>This mega-systematic review evaluated the global prevalence of long COVID and its subtypes and symptoms, and assessed the effects of risk factors for long COVID.</p><p><strong>Methods: </strong>Studies published from 5 July 2021 to 29 May 2024 were searched in PubMed, Embase, and Web of Science, with supplemental updates on 23 July 2024. Data were pooled using a random-effects framework with DerSimonian-Laird estimator. Risk of bias analysis was conducted.</p><p><strong>Results: </strong>A total of 429 studies were meta-analyzed. The global pooled long COVID prevalence was 36% (95% confidence interval [CI], 33%-40%) with 144 contributing studies. The highest prevalence rates were observed in South America (51% [95% CI, 35%-66%]). The prevalence of long COVID persisted over time, with 35% (95% CI, 31%-39%) at <1 year of follow-up and 46% (95% CI, 37%-57%) at 1-2 years. The most prevalent subtypes were respiratory (20% [95% CI, 14%-28%]) estimated from 31 studies, general fatigue (20% [95% CI, 18%-23%]) from 119 studies, psychological (18% [95% CI, 11%-28%]) from 10 studies, and neurological (16% [95% CI, 8%-30%]) from 23 studies. The 3 strongest risk factors were being unvaccinated for COVID-19 (pooled odds ratio [OR], 2.09 [95% CI, 1.55-2.81]) meta-analyzed from 7 studies, infections from pre-Omicron variants (OR, 1.74 [95% CI, 1.40-2.17]) from 6 studies, and female sex (OR, 1.56 [95% CI, 1.32-1.84]) from 33 studies.</p><p><strong>Conclusions: </strong>Long COVID is globally prevalent after a severe acute respiratory syndrome coronavirus 2 infection, highlighting a continuing health challenge. The heterogeneity of estimates across populations argues the need for well-designed follow-up studies that use consistent measures and are globally representative.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf533"},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186067","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}