Open Forum Infectious Diseases最新文献

{"title":"Trends in Uropathogenic <i>Escherichia coli</i> Genotype and Antimicrobial Resistance From 2019 to 2022 in a San Francisco Public Hospital Network.","authors":"Sean Joyce, Cheyenne Belmont, Aaron Wolfe Scheffler, Kavitha Ravi, Hanna Kim, Noah Rubin-Saika, Matthew Elises, Abraham Soto, Padukudru Anand Mahesh, Henry Chambers, Eva Raphael","doi":"10.1093/ofid/ofaf579","DOIUrl":"10.1093/ofid/ofaf579","url":null,"abstract":"<p><strong>Background: </strong>Uropathogenic <i>Escherichia coli</i> (UPEC) is the predominant pathogen causing urinary tract infections and frequently exhibits antimicrobial resistance (AMR). Among urinary tract infections caused by UPEC, 4 genotypes-so-called pandemic sequence types (STs)-cause >50% of infections, with ST131 particularly prone to exhibiting AMR. To investigate the role of pandemic ST prevalence in driving AMR, we prospectively collected and genotyped UPEC isolated from patient urine samples.</p><p><strong>Methods: </strong>Over separate periods in 2019 and 2022, we collected and analyzed community-onset UPEC samples from patients with bacteriuria who received care in a public health care network (N = 997). Multiplex polymerase chain reaction was used to identify the presence of UPEC pandemic STs, including ST131, while patient characteristics and antibiotic susceptibilities of the UPEC samples were collected from electronic medical records. Differences in pandemic ST prevalence and AMR between years were assessed through χ² testing. Multivariable logistic regression modeling was performed for odds of AMR.</p><p><strong>Results: </strong>Pandemic ST prevalence remained stable between collection years, while resistance to any antimicrobial and trimethoprim-sulfamethoxazole generally decreased. However, within pandemic ST131, fluoroquinolone resistance increased significantly (45.6% to 76.8%, <i>P</i> < .001) even after controlling for confounding variables (adjusted odds ratio, 6.01; 95% CI, 2.41-15.01).</p><p><strong>Conclusions: </strong>Steady ST prevalence and stable or decreased AMR prevalence masked significant increased fluoroquinolone resistance with ST131, which may represent unmeasured patient characteristics, bacterial factors, or new exposure to resistant ST131 in the community. Antimicrobial surveillance of UPEC at the ST level may be important for monitoring otherwise unnoticed AMR trends.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf579"},"PeriodicalIF":3.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186312","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":"Effectiveness of the 2023 Southern Hemisphere Influenza Vaccine Against Outpatient Influenza-Like Illness: A Multi-Country Test-Negative Design Study.","authors":"Annette K Regan, Radhika Gharpure, Monique Chilver, Nigel Stocks, Siobhan St George, Sibongile Walaza, Anne von Gottberg, Nicole Wolter, Cheryl Cohen, Aaron M Samuels, Kriengkrai Prasert, Prabda Praphasiri, William W Davis, Chakrarat Pittayawonganon, Sheena G Sullivan, Eduardo Azziz-Baumgartner","doi":"10.1093/ofid/ofaf560","DOIUrl":"https://doi.org/10.1093/ofid/ofaf560","url":null,"abstract":"<p><strong>Background: </strong>Routine monitoring of seasonal influenza vaccine effectiveness (VE) across multiple countries is essential to understand the performance of seasonal vaccine programs.</p><p><strong>Methods: </strong>Using a test-negative study design, we estimated the effectiveness of the 2023 Southern Hemisphere formulation of the seasonal influenza vaccine in preventing outpatient medically attended influenza-like illness (ILI) in Australia, South Africa, and Thailand. Sentinel surveillance systems identified patients presenting with ILI who were tested by RT-PCR for influenza. VE was estimated as one minus the odds ratio comparing the vaccination status of test-positive cases and test-negative non-cases. Models adjusted for country, patients' age group, sex, underlying medical conditions, and calendar week of symptom onset. We assessed the duration of protection by modeling the effect of the interval between vaccination and symptom onset on influenza status.</p><p><strong>Results: </strong>About 2469 ILI outpatients were identified, including 966 (39%) test-positive cases and 1503 (61%) test-negative non-cases; 78% (<i>n</i> = 750/966) of viruses detected were influenza A; 8% (<i>n</i> = 72/966) of test-positive cases and 29% (<i>n</i> = 439/1503) of test-negative non-cases had received an influenza vaccine. Pooled VE was 68% (95% CI: 57%, 76%) against ILI with any influenza virus, 62% (95% CI: 39%, 76%) against influenza A(H1N1)pdm09, 60% (95% CI: 38%, 75%) against influenza A(H3N2), and 76% (95% CI: 59%, 86%) against influenza B. VE point estimates declined from 82% to 43% when the time from vaccination increased from 14 days to 150 days.</p><p><strong>Conclusions: </strong>The 2023 Southern Hemisphere formulation of seasonal influenza vaccines offered protection against ILI in three countries, underscoring the public health benefits of seasonal influenza vaccination programs.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 10","pages":"ofaf560"},"PeriodicalIF":3.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213369","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":"Vaccine Induced Seroreactivity Following Administration of ALVAC-HIV/AIDSVAX®B/E Identified by Common Anti-HIV Test Kits and Algorithms in Thailand.","authors":"Siriwat Akapirat, Elisavet Serti, Punnee Pitisutthithum, Sorachai Nitayaphan, Suwat Chariyalertsak, Chirapa Eamsila, Pornchanok Panjapornsuk, Anocha Kleebmontha, Somsak Chantakulkij, Bhubate Tongchanakarn, Hathairat Savadsuk, Jittima Dhitavat, Sanjay Gurunathan, Faruk Sinangil, Trevor A Crowell, Nelson L Michael, Merlin L Robb, Sandhya Vasan, Robert J O'Connell","doi":"10.1093/ofid/ofaf578","DOIUrl":"10.1093/ofid/ofaf578","url":null,"abstract":"<p><p>Vaccine-induced seroreactivity (VISR) was evaluated in RV306 and was shown to vary markedly (0-32.5%) among 6 HIV diagnostic tests and 84 algorithms. Our data show that selecting the SD Bioline HIV-1/2 assay and algorithms which exclude the ImmunoComb®II Bispot and Alere™ Determine HIV-1/2 assays would almost eliminate VISR in RV306.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 10","pages":"ofaf578"},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200531","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":"Intact and Defective HIV Provirus Changes During Antiretroviral Therapy in People Treated During Acute or Chronic HIV Infection or as HIV Controllers.","authors":"Rajesh T Gandhi, Joshua C Cyktor, Ronald J Bosch, Hanna Mar, Gregory M Laird, Albine Martin, Sharon A Riddler, Paul E Sax, Jonathan Z Li, Deborah K McMahon, John W Mellors, Joseph J Eron","doi":"10.1093/ofid/ofaf568","DOIUrl":"10.1093/ofid/ofaf568","url":null,"abstract":"<p><strong>Background: </strong>Intact proviral DNA (IPD) is a measure of the replication-competent HIV reservoir. Little is known about how IPD levels compare in people with HIV (PWH) who initiate antiretroviral therapy (ART) during acute HIV infection (AHI), chronic infection (CHI) or as HIV controllers (CON).</p><p><strong>Methods: </strong>Participants with sustained plasma HIV RNA < 50 copies/mL on ART had longitudinal measurements of intact, defective and total proviral DNA in blood samples.</p><p><strong>Results: </strong>Twenty-nine participants were evaluated: 14 CHI, 7 AHI and 8 CON. PWH-CON had lower IPD than PWH-AHI or PWH-CHI during ART. PWH-CON also had low intact and total provirus levels before initiating ART. During years 2-5 of ART, IPD decay half-life was 1.0 years in PWH-AHI, 1.6 years in PWH-CHI and 3.2 years in PWH-CON (<i>P</i> = .01 for PWH-CON vs PWH-AHI). Defective provirus levels did not decrease in PWH-AHI and PWH-CHI.</p><p><strong>Conclusions: </strong>During the initial years of ART, PWH treated during acute and chronic infection have decay in intact but not defective proviruses. PWH controllers have low intact and total provirus levels before and during ART, suggesting interactions between host and virus shape the proviral landscape. Variable proviral decay patterns in these populations provide insight into approaches to achieve ART-free HIV remission.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 10","pages":"ofaf568"},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207041","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":"Risk of Post-COVID-19 Conditions Among Adolescents and Adults Who Received Nirmatrelvir-Ritonavir for Acute COVID-19: A Retrospective Cohort Study.","authors":"Alexandra F Dalton, Sarah Baca, Julia Raykin, Cria O Gregory, Tegan Boehmer, Emilia H Koumans, Priti R Patel, Pragna Patel, Sharon Saydah","doi":"10.1093/ofid/ofaf567","DOIUrl":"10.1093/ofid/ofaf567","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID-19 Conditions (PCC) potentially affect millions of people, but it is unclear whether treating acute COVID-19 with nirmatrelvir-ritonavir may reduce the risk of PCC.</p><p><strong>Methods: </strong>This is a retrospective cohort study using real-world, closed claims data to assess the relationship between nirmatrelvir-ritonavir and PCC by age group (12-17, 18-49, 50-64, ≥65 years). Eligible patients had a COVID-19 index date (positive laboratory test, ICD-10 diagnosis code, or nirmatrelvir-ritonavir prescription) from 1 April to 31 August 2022, in the outpatient, telehealth, or emergency department setting, and had a higher risk of severe COVID-19 based on age (≥50 years) or underlying risk factors. Treated patients (ie, received a nirmatrelvir-ritonavir prescription within ±5 days of index date) were matched 1:2 on age, sex, month of index date, and HHS region with untreated patients. PCC was defined by the presence of ≥1 of 45 new-onset symptoms or conditions recorded ≥60 days after index date.</p><p><strong>Results: </strong>Of the treated patients, 291 433 were matched to 582 866 untreated patients. Treatment with nirmatrelvir-ritonavir reduced PCC risk in adults 50-64 years (adjusted hazard ratio [aHR] 0.93, 95% confidence interval [CI] 0.92-0.95) and ≥65 years (aHR 0.88, 95% CI 0.87-0.90). Treatment had minimal effect among high-risk adults 18-49 years (aHR 0.98, 95% CI 0.97-0.99) and no effect among high-risk adolescents 12-17 years (aHR 1.06, 95% CI 0.66-1.13).</p><p><strong>Conclusions: </strong>Results using real-world data suggest a protective relationship between nirmatrelvir-ritonavir during acute illness and PCC risk among older adults, but not among adolescents. Consideration may be given to outpatient treatment of mild to moderate COVID-19 with nirmatrelvir-ritonavir to reduce the risk of severe disease and PCC.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 10","pages":"ofaf567"},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200557","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":"Early versus deferred antiretroviral therapy initiation and long-term cardiovascular disease outcomes in people with HIV: The START study.","authors":"Nila J Dharan, Shweta Sharma, Alejandro Arenas-Pinto, Daniel Duprez, Vicente Estrada, Karen Ha, Mariana Angelica Kundro, Rosie Mngqibisa, Henry Mugerwa, David Munroe, Rakan Nasreddine, Tess E Peterson, Irini Sereti, Janine M Trevillyan, Jason V Baker, Gail V Matthews, Andrew N Phillips","doi":"10.1093/ofid/ofaf561","DOIUrl":"10.1093/ofid/ofaf561","url":null,"abstract":"<p><strong>Background: </strong>It is unknown whether delayed antiretroviral therapy (ART) initiation worsens CVD outcomes in people with HIV (PHIV). This study compared CVD event rates between PHIV who were randomized to receive immediate versus deferred ART.</p><p><strong>Methods: </strong>ART-naïve adult PHIV with CD4+ counts > 500 cells/µL were randomized to immediate versus deferred ART initiation. Event rates for the main composite CVD outcome (myocardial infarction, coronary artery disease requiring revascularization, stroke and CVD-related death) were estimated for: (i) pre-2016 (treatment arms as designed); (ii) post-1Jan2016 (ART use similar across arms); and (iii) entire study follow-up period. Subgroup analyses were performed according to baseline characteristics.</p><p><strong>Results: </strong>Among 4684 participants (median age 36 years, 27% female, 30% Black race), 32% were smokers and 17% had a BMI ≥ 30 kg/m². Comorbidities included hypertension (19%), dyslipidemia (8%), diabetes (3%); 0.8% had a history of CVD. The median time to ART initiation was 2.5 years (interquartile range [IQR] 1.6-3.5 years) in the deferred arm and 7 days (IQR 2-17 days) in the immediate arm. Over the entire study follow-up period (median follow-up of 9.3 years), 71 participants (35 immediate, 36 deferred) experienced a CVD event with no difference in CVD event rates between the immediate and deferred arms (0.17 vs 0.17 per 100 person-years, respectively); these findings were consistent across the pre-2016 and post-1Jan2016 periods. There were 58 CVD events among males (33 immediate; 25 deferred) and 13 among females (2 immediate; 11 deferred). A possible benefit of immediate ART was seen in females but not males (Hazard Ratio = 0.19 [95% confidence interval: 0.04-0.86] vs 1.33 [0.79-2.24]; interaction <i>P</i>-value = .014), though numbers of events were low.</p><p><strong>Conclusions: </strong>Early versus deferred ART initiation was not associated with reduced CVD events. The potential benefit associated with immediate ART in female participants warrants further evaluation.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf561"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186625","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":"Rezafungin Versus Caspofungin for the Treatment of Candidemia and Invasive Candidiasis: Results from the Double-blind, Randomized, Phase 3 ReSTORE Trial Including the China Extension Study.","authors":"George R Thompson, Haihui Huang, Sizhou Feng, Yunsong Yu, Alex Soriano, Oliver A Cornely, Bart Jan Kullberg, Peter G Pappas, Marin Kollef, Jose A Vazquez, Patrick M Honore, Laura Cox, Matteo Bassetti","doi":"10.1093/ofid/ofaf555","DOIUrl":"10.1093/ofid/ofaf555","url":null,"abstract":"<p><strong>Background: </strong>Rezafungin is approved for use in adults with candidemia and/or invasive candidiasis (IC) based on data from the ReSTORE trial (NCT03667690), which demonstrated noninferior efficacy to caspofungin. For regulatory purposes, an additional cohort of patients from China was recruited to ReSTORE. Here, we compared rezafungin and caspofungin in patients with candidemia and/or IC through analysis of the ReSTORE global data plus the China extension study.</p><p><strong>Methods: </strong>Adults with candidemia/IC were randomized (1:1) to receive weekly rezafungin (400/200 mg) or daily caspofungin (70/50 mg) for ≤28 days. Noninferiority was concluded for primary efficacy endpoints if the upper bound of the 95% confidence interval (CI) was below 20% for Day 30 all-cause mortality and if the weighted lower bound was above -20% for Day 14 global cure. Additional efficacy outcomes and safety were evaluated.</p><p><strong>Results: </strong>Overall, 246 patients were randomized (122 rezafungin and 124 caspofungin). Noninferiority was demonstrated for both primary endpoints. Day 30 all-cause mortality was 25.2% and 24.8% (treatment difference 0.4%; 95% CI -10.8, 11.6) and Day 14 global cure was 56.5% and 57.3% (weighted treatment difference -1.0%; 95% CI -13.5, 11.6) with rezafungin versus caspofungin, respectively. Day 5 mycological eradication was numerically higher (68.7% vs 63.2%) and time to negative blood culture was numerically shorter (median 26.5 vs 38.8 h). Safety was comparable between groups; 53.3% (64/120; rezafungin) and 53.7% (66/123; caspofungin) of patients experienced serious adverse events.</p><p><strong>Conclusions: </strong>This analysis confirmed the overall efficacy and safety of rezafungin demonstrated in ReSTORE, with early efficacy related to front-loaded exposure.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf555"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186270","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":"Changes in Bone Microarchitecture and Inflammatory Cytokines After Cure of Chronic Hepatitis C Infection With Direct-Acting Antiviral Therapy.","authors":"Vincent Lo Re, Dean M Carbonari, Craig W Newcomb, Jessie Torgersen, Erica J Weinstein, Shanae M Smith, Katherine L Brecker, X Sherry Liu, Jay R Kostman, Stacey Trooskin, Rebecca A Hubbard, Joshua F Baker, Babette S Zemel, Mary B Leonard","doi":"10.1093/ofid/ofaf571","DOIUrl":"10.1093/ofid/ofaf571","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear if cure of hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs) ameliorates HCV-related inflammation and bone deficits. We evaluated changes in cytokines and bone measurements by high-resolution peripheral quantitative computed tomography (HR-pQCT) prior to DAA treatment and 18 months following initiation and compared changes in uninfected controls over 18 months.</p><p><strong>Methods: </strong>We conducted a cohort study of 40 participants who initiated DAAs and achieved cure and 48 without HCV as controls. At enrollment and 18 months later, participants had measurements of volumetric bone mineral density, cortical dimensions, and mechanical properties of the radius and tibia by HR-pQCT; visceral fat area and appendicular lean mass by whole-body dual-energy X-ray absorptiometry; and serum tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and interleukin 18 (IL-18). Multivariable linear regression was used to estimate group differences in mean changes in bone measurements and cytokines.</p><p><strong>Results: </strong>We observed no significant differences in month 0-18 changes in HR-pQCT measurements between participants with cured HCV and controls in unadjusted models or after adjustment for age, sex, appendicular lean mass index, visceral fat area, and smoking. Participants with cured HCV had decreases in IL-18 (mean change, -0.085 vs +0.086 log pg/mL; <i>P</i> < .001) and TNF-α (mean change, -0.050 vs +0.084 log pg/mL; <i>P</i> < .001), but not IL-6 (mean change, +0.108 vs +0.009 log pg/mL; <i>P</i> = .214) versus controls.</p><p><strong>Conclusions: </strong>Participants with cured HCV had no significant changes in bone microarchitecture by HR-pQCT 18 months after DAA initiation compared with controls, but did have decreases in IL-18 and TNF-α versus controls.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf571"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186666","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":"Regional Mortality From Chronic Liver Diseases in African Countries Attributable to Hepatitis B Virus and Hepatitis C Virus Infections From 1990 to 2021 and Projections to 2030.","authors":"Tsong-Yih Ou, Le Duc Huy, Nguyen Ngoc Truong Giang, Nguyen Thi Thuy Dung, Jeffrey Mayne, Chung-Liang Shih, Yao-Mao Chang, Abdikani Ahmed Abdi, Shih-Chang Hsu, Hung-Jung Lin, Shiyng-Yu Lin, Chung-Chien Huang","doi":"10.1093/ofid/ofaf573","DOIUrl":"10.1093/ofid/ofaf573","url":null,"abstract":"<p><strong>Background: </strong>This study aims to explore the magnitude and temporal trend of the chronic liver disease (CLD) burden in Africa and examine the progress toward the global goal of eliminating CLD attributable to HBV and HCV by 2030.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease database were used to extract the mortality burden across 47 African countries between 1990 and 2021. The CLD burden from 2022 to 2030 was projected using the Bayesian age cohort model.</p><p><strong>Results: </strong>In 2021, the number of CLD-related deaths and age-standardized death rates (ASDR) due to HBV were higher (81 074 deaths and 14.2 per 100 000) compared to HCV (60 717 and 11.2 per 100 000). Western Africa had the highest number of deaths from CLD caused by HBV (33 603) and HCV (19 583), whereas Central Africa experienced the highest ASDR for both HCV (12.7) and HBV (16.1). An increase in CLD deaths is predicted to continue through 2030 across all regions, with the largest increases anticipated for CLD due to HBV (42.5%) in Eastern Africa and CLD due to HCV in Central Africa (45.5%).</p><p><strong>Conclusions: </strong>Despite a significant decline in ASDR for CLD, the mortality burden of CLD still increased considerably in Africa between 1990 and 2021. By 2030, most African regions are less likely to achieve the global target of CLD elimination, emphasizing the need for international support to reduce the burden of CLD caused by HBV and HCV in Africa.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 10","pages":"ofaf573"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200464","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":"Long-term Immunogenicity of Hepatitis A Vaccination in Adults Receiving Immunosuppressive Therapy and Adults Living With HIV: Three-year Follow-up of a Prospective Cohort Study.","authors":"Jenny L Schnyder, Hannah M Garcia Garrido, Irma Maurer, Agnes M Harskamp, Neeltje A Kootstra, Martin P Grobusch, Abraham Goorhuis","doi":"10.1093/ofid/ofaf457","DOIUrl":"10.1093/ofid/ofaf457","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis A (hepA) vaccination generates long-lasting protection against hepA in healthy adults. However, the duration of protection in immunocompromised patients (ICPs), such as people living with HIV (PLWH) and patients on immunosuppressive therapy, is uncertain.</p><p><strong>Methods: </strong>This 3-year follow-up study of a prospective cohort assessed hepA antibodies in PLWH, patients on immunosuppressive therapy, and controls after completing a full hepA vaccination series. Three years later (Y3), serum samples were collected in 88/150 (59%) of original participants. The primary outcome was the seroprotection rate (SPR) at Y3, defined as the proportion of participants with hepA antibodies ≥20 mIU/mL. Secondary outcomes included seroreversion rates, defined as the proportion of those unprotected at Y3, among those initially protected after the primary vaccination schedule, and geometric mean concentrations (GMCs) at Y3.</p><p><strong>Results: </strong>At Y3, SPRs were 87% (20/23) in PLWH, 90% (26/29) in patients on immunosuppressive monotherapy, 65% (13/20) in patients on immunosuppressive combination therapy, and 100% (16/16) in controls. Seroreversion rates were 13% (3/23) in PLWH, 10% (3/29) in patients on immunosuppressive monotherapy, 21% (4/19) in patients on immunosuppressive combination therapy, and 0% (0/16) in controls. GMCs in ICPs (41.13-70.75 mIU/mL) were significantly lower compared to controls (175.65 mIU/mL) (<i>P</i>-value = .001).</p><p><strong>Conclusions: </strong>Three years postvaccination, most ICPs remained seroprotected, but SPRs and GMCs were lower than in healthy controls, particularly in patients on combination immunosuppressive therapy. However, it remains uncertain if booster doses are necessary among those who seroreverted, as long-term protection may persist through formed cellular memory.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf457"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113888","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}