Open Forum Infectious Diseases最新文献

{"title":"Effect of Social Norm Messages on US Adults' Antibiotic Use Intentions.","authors":"Alistair Thorpe, Julia E Szymczak, Emely Luhan, Madeline C Farrell, William B Petty, Valerie M Vaughn, Angela Fagerlin, Rachael A Lee","doi":"10.1093/ofid/ofag664","DOIUrl":"10.1093/ofid/ofag664","url":null,"abstract":"<p><p>In this randomized survey of US adults (N = 972), public health messages explaining why antibiotics should be avoided for cold/flu symptoms reduced the desire for antibiotics for cold/flu symptoms. Social norm framing (62% do not vs 38% do) showed no significant effect on antibiotic intentions. Public communications should prioritize clear explanations.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag664"},"PeriodicalIF":3.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238959","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":"Humoral Immunogenicity of mRNA-1010, an mRNA-based Seasonal Influenza Vaccine, in Adults ≥50 Years.","authors":"Isabel Leroux-Roels, Elissa Malkin, HuiLing Chen, Andrei Avanesov, Ren Chen, Brianna Fidler, Rituparna Das, Eleanor Wilson","doi":"10.1093/ofid/ofag646","DOIUrl":"https://doi.org/10.1093/ofid/ofag646","url":null,"abstract":"<p><strong>Background: </strong>Seasonal influenza causes substantial morbidity and mortality worldwide. In a phase 3 study in adults ≥50 years, trivalent mRNA-1010 demonstrated superior efficacy vs a standard-dose (SD) seasonal influenza vaccine. This analysis reports humoral immunogenicity.</p><p><strong>Methods: </strong>Participants were randomized 1:1 to a single dose of mRNA-1010 (37.5-µg) or licensed SD influenza vaccine. Immunogenicity was assessed in a prespecified per-protocol subset. Antihemagglutinin antibody titers were measured by hemagglutination inhibition (HAI) and microneutralization (MN; subset) at baseline and day 29 against vaccine-matched strains. Outcomes included geometric mean titers (GMTs), geometric mean fold rises (GMFRs) from baseline, and seroconversion rates (SCRs; ≥4-fold rise).</p><p><strong>Results: </strong>The Per-Protocol Immunogenicity Subset included 2342 participants (mRNA-1010, n = 1167; SD influenza vaccine, n = 1175). mRNA-1010 induced higher levels of HAI antibodies relative to SD influenza vaccine. mRNA-1010 increased HAI GMTs, with day 29 GMFRs of 4.07 (A/H1N1), 4.70 (A/H3N2), and 3.14 (B/Victoria). Geometric mean ratio point estimates vs SD influenza vaccine exceeded 1.5 across all strains, with lower bounds (LBs) of 95% CIs all exceeding 1.4: 1.82 (95% confidence interval [CI], 1.69-1.97), 1.59 (1.48-1.71), and 1.67 (1.57-1.78), respectively. Similarly, SCR differences were positive; LBs >15: 27.95% (95% CI: 24.09-31.73), 19.99% (15.99-23.92), and 25.33% (21.65-28.95), respectively. mRNA-1010 elicited higher MN antibody responses vs SD influenza vaccine for all 3 strains.</p><p><strong>Conclusions: </strong>In adults ≥50 years, a single dose of mRNA-1010 induced higher humoral immune responses against vaccine-matched influenza strains than licensed SD influenza vaccine. Together with previously reported results, these findings support mRNA-1010 as a seasonal influenza vaccine option in adults ≥50 years.</p><p><strong>Clinical trials registration: </strong>NCT06602024.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag646"},"PeriodicalIF":3.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149271529","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":"What is in the Word \"Antibiotic?\" From Microbial Warfare to Microbial Signaling.","authors":"Carlos R V Kiffer","doi":"10.1093/ofid/ofag632","DOIUrl":"https://doi.org/10.1093/ofid/ofag632","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag632"},"PeriodicalIF":3.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183161","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":"High Initiation but Suboptimal Completion of Tuberculosis-Preventive Treatment Among People Living With HIV on Antiretroviral Therapy, Persistent Tuberculosis Incidence, and Programmatic Implications: Findings From a 2-Year Multicountry Cohort Study.","authors":"L Chimoyi, S Ginindza, B A S Nonyane, C Mulder, A Bedru, N Kawaza, J E Golub, K Shearer, A Kennar, L Mvusi, K Vilakazi-Nhlapo, T Apollo, M Ncube, C Gwanzura, G Bisa, D Gadissa, T Mabuto, L Tsope, I Rabothata, N Ntombela, K Sithole, S Sisay, M Makgabo, R E Chaisson, G Churchyard, C J Hoffmann, V Chihota","doi":"10.1093/ofid/ofag595","DOIUrl":"10.1093/ofid/ofag595","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis-preventive treatment (TPT) is recommended for those at risk of tuberculosis, but despite encouraging trial data, evidence of its effectiveness from routine settings with diverse TPT regimens is limited. We describe routine TPT implementation outcomes in people living with human immunodeficiency virus (HIV; PLWH) to identify bottlenecks and opportunities for improvement along the cascade of care.</p><p><strong>Methods: </strong>From 2021-2023, we conducted a 24-month prospective cohort study of PLWH facilities in Ethiopia, South Africa and Zimbabwe. Sociodemographic and clinical data were collected at enrollment. During follow-up, we collected TPT initiation, TPT-related adverse effects, and completion data. A subgroup was allocated digital boxes as a proxy measure for assessing treatment completion. Tuberculosis diagnoses were confirmed from clinic records or symptom agnostic sputum testing using Xpert MTB/RIF assay and mycobacteria growth indicator tube (MGIT) culture at 12- and 24 months after enrollment.</p><p><strong>Results: </strong>We enrolled 2095 participants, mostly female (n = 1489 [71.1%]), with a median age of 42 years (interquartile range, 35-50 years). Approximately 60% (n = 1312) were considered eligible for TPT, and 1110 (84.6%) initiated TPT within 60 days of antiretroviral therapy initiation or refill during follow-up (rifapentine and isoniazid [3HP] in 625 and 6 or 12 months of isoniazid [6H/12H] in 487). TPT was completed in 55.4% (406 of 733). Mild symptoms compatible with TPT adverse effects were commonly reported in 3HP versus 6H/12H (190 [31.0%] vs 51 [11.0%], respectively; <i>P</i> < .001]. The tuberculosis incidence rate was 1.27/100 person-years (95% confidence interval, .95-1.69) during study follow-up in a mostly long-term antiretroviral therapy population and was lower for PLWH who completed TPT (adjusted incidence rate ratio, 0.39 [.20-.78]; <i>P</i> = .01).</p><p><strong>Conclusions: </strong>There were losses along the cascade, particularly at completion. In programmatic settings, we observed more potential mild symptoms from 3HP compared to 6H/12H use. Interventions to support TPT completion are needed.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag595"},"PeriodicalIF":3.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183579","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":"Correction to: Prevalence of Endemic Respiratory Viruses During the COVID-19 Pandemic in Urban and Rural Malawi.","authors":"","doi":"10.1093/ofid/ofag682","DOIUrl":"https://doi.org/10.1093/ofid/ofag682","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofad643.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag682"},"PeriodicalIF":3.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183615","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":"The Utility of Microbial Cell-Free DNA in the Rapid Diagnosis of Chagas Disease: Chagas Disease Case Series.","authors":"Anissa Amilhamja, Adam Shaikh, Kristin Mondy, Michael Kron, Niki Viradia, Omer Beaird, Jaime Fergie","doi":"10.1093/ofid/ofag584","DOIUrl":"https://doi.org/10.1093/ofid/ofag584","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease (CD) is a leading tropical disease and the most prevalent parasitic infection in Latin America, affecting >7 million people globally and ∼240 000-350 000 individuals within the United States. Though known to be endemic to Latin America, prevalence in the United States is also increasing with improved recognition of locally acquired cases, especially in Texas. Autochthonous cases occur throughout the Southern United States, but the geographic range is anticipated to shift northwards as a result of climate change. Chagas disease is referred to as a \"silent and silenced disease\" by the World Health Organization as most people show no signs or symptoms for years following acute infection, and it primarily affects individuals who are socioeconomically disadvantaged. Historically, Chagas disease has been underrecognized. In the absence of treatment, infected individuals progress to a clinically silent or \"indeterminate form\" of infection that persists for life. While most patients with indeterminate Chagas disease do not have long-term sequelae, ∼30%-40% will develop end-organ cardiac or gastrointestinal disease decades after infection. Due to its protean clinical presentations, diagnosis requires a high clinical index of suspicion and knowledge of the epidemiology. Traditionally, the diagnosis is based on serology, visualization of the parasite in blood, and polymerase chain reaction (PCR), all of which require suspecting the infection. Microbial cell-free DNA (mcfDNA) of blood can serve as a useful tool for detection of <i>Trypanosoma cruzi</i> even when Chagas disease is not suspected.</p><p><strong>Results: </strong>Here we present 7 cases, 3 children and 4 adults, who presented with nonspecific manifestations; CD was not in the initial differential diagnosis in 5 of them. Chagas disease was ultimately diagnosed by Karius Spectrum test. In 1 case, the test was sent to expedite diagnosis in the setting of suspected Chagas reactivation.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag584"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183092","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":"Aligning Antimicrobial Stewardship and Infection Prevention Through Repeated Assessment and Feedback: A Multisite Quality Improvement Initiative in Viet Nam.","authors":"Quoc Phuong Nguyen, Van Giang Tran, Hai Yen Nguyen, Thi Phuong Oanh Pham, Trung Cap Nguyen, Minh Dien Vu, Anh Cuong Tran, Thi Ngoc Diep Nguyen, Van Minh Nguyen, Ba Hai Mai, Bao Dung Vo, Thanh Bao Nguyen, Dinh Phu Vu, Thi Thuy Van Pham, Thi Bich Ngoc Hoang, H Rogier van Doorn, Thomas Kesteman, Huong Thi Lan Vu","doi":"10.1093/ofid/ofag605","DOIUrl":"https://doi.org/10.1093/ofid/ofag605","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial stewardship (AMS) and infection prevention and control (IPC) are complementary strategies to improve patient safety and address antimicrobial resistance (AMR). In low- and middle-income countries (LMICs), they are often implemented separately, limiting potential impact.</p><p><strong>Objective: </strong>To evaluate the feasibility of an aligned AMS-IPC improvement approach and describe changes in implementation in Vietnamese hospitals.</p><p><strong>Methods: </strong>We conducted a quality improvement initiative in 4 hospitals within the national AMR surveillance network in Viet Nam (March-September 2025). We used US-CDC's tools to guide implementation, including the Global Antibiotic Stewardship Evaluation Tool (G-ASET) and the Infection Control Assessment and Response (ICAR) tool. Baseline assessments were followed by feedback, multidisciplinary action planning, and targeted capacity building. Follow-up occurred 2-5 months later. Changes were analyzed descriptively using quantitative scores and qualitative synthesis and reported following the SQUIRE 2.0 guidelines.</p><p><strong>Results: </strong>All hospitals had established IPC programs at baseline, while AMS maturity varied. G-ASET scores increased across all sites, with larger absolute gains in hospitals starting from lower baselines. Improvements were seen in leadership and governance, education and training, stewardship actions, and monitoring and reporting. Selected IPC activities aligned with AMS priorities also improved, particularly transmission-based precautions, environmental cleaning, and cross-team coordination. Infrastructure-dependent areas, such as water safety, showed limited short-term progress.</p><p><strong>Conclusions: </strong>This aligned AMS-IPC quality improvement strategy was feasible and associated with improvements in implementation capacity and program maturity over short follow-up. Further studies with longer follow-up, comparator designs, and outcome-level measures are needed to evaluate effectiveness, sustainability, and generalizability.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag605"},"PeriodicalIF":3.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167643","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 Rotarix Vaccine Effectiveness in Coastal Kenya, Estimated From Child Hospital Admissions Data From July 2014 to December 2022.","authors":"Zadock Kipkirui, Charity Wamwea, Esther N Katama, Robinson Cheruiyot, Martin Mutunga, Agustus Kea, Arnold W Lambisia, D James Nokes, Umesh D Parashar, Jacqueline E Tate, Eunice W Kagucia, Charles N Agoti","doi":"10.1093/ofid/ofag674","DOIUrl":"10.1093/ofid/ofag674","url":null,"abstract":"<p><strong>Background: </strong>Two doses of Rotarix demonstrated approximately 64% effectiveness against rotavirus hospitalization in Kenyan children 2.5 years postintroduction. We evaluated long-term Rotarix effectiveness and monitored circulating genotypes over its 8.5 years of use in Kenya.</p><p><strong>Methods: </strong>We conducted a test-negative case-control study in coastal Kenya among children admitted to Kilifi County Referral Hospital with diarrhea from July 2014 to December 2022. Eligible children had known Rotarix vaccination status, parent/guardian consent, and rotavirus testing via enzyme-linked immunosorbent assay. Positives were genotyped by sequencing. Rotarix effectiveness was estimated using unconditional logistic regression, adjusting for age, sex, calendar year, seasonality, and nutritional status.</p><p><strong>Results: </strong>Of the 1104 children (median age, 12 months [interquartile range, 8-18 months]) included in the effectiveness analysis, 87% (962/1104) had received 2 doses, 6% (70/1104) 1 dose, and 7% (72/1104) zero doses. Rotavirus was detected in stool specimens of 147 (13%) children. Overall, adjusted 2-dose Rotarix effectiveness was 68% (95% confidence interval [CI], 42%-82%). Effectiveness in children aged <12 months was 83% (95% CI, 62%-93%) compared to 38% (95% CI, -106% to 78%) in children aged ≥12 months. Genotyping of 147 positive samples revealed G3P[8] (66/147 [44.9%]), G1P[8] (32/147 [21.8%]), and G2P[4] (23/147 [15.6%]) to be the most common circulating rotavirus genotypes during the Rotarix vaccination era.</p><p><strong>Conclusions: </strong>Rotarix maintained modest effectiveness in coastal Kenya during its 8.5 years of use. Effectiveness declined in the second year of life onward, probably reflecting a combination of both waning immunity and accumulation of natural immunity among unvaccinated children. Emergence of vaccine heterologous strains emphasizes the need for continued effectiveness surveillance.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag674"},"PeriodicalIF":3.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238946","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":"Tuberculosis Risk in the Returning Traveler: Assessing Tuberculosis Test Conversion Among Routinely Tested Patients at an Asian American Health Center.","authors":"Nozomi Fukui, Zinnia Dong, Amy S Tang, Adam Readhead, Shereen S Katrak","doi":"10.1093/ofid/ofag606","DOIUrl":"https://doi.org/10.1093/ofid/ofag606","url":null,"abstract":"<p><strong>Background: </strong>In the United States, testing for latent tuberculosis (TB) infection is recommended for persons from higher-TB-prevalence countries, but guidelines do not address repeat testing for persons with international travel.</p><p><strong>Methods: </strong>Using 2010-2022 data from a Californian federally qualified health center serving an Asian American population, we measured the incidence of TB test conversion (negative to positive result) and proportion of test converters receiving treatment among routinely tested patients (ie, patients with no history of TB infection, at least one prior negative result, and annual or biennial TB testing). We performed a nested case-control study to measure the association between TB test conversion and travel outside the United States.</p><p><strong>Results: </strong>Of 5668 patients receiving routine TB testing at annual/biennial frequencies, conversions occurred in 117 patients with TB skin tests (2.9%) and 52 patients with interferon-gamma release assays (3.2%); the overall test conversion incidence rate was 2.1/100 person-years. Latent TB infection treatment was initiated in 57% of test converters. Two patients were diagnosed with TB disease after test conversion, representing a 2-year TB incidence rate of 0.35/100 person-years. Patients with documented international travel had a 1.95-fold increased odds of TB test conversion (95% confidence interval 1.07-3.57) compared to patients without documented travel, with most travel occurring in medium or high-TB-prevalence countries.</p><p><strong>Conclusions: </strong>Within a 13-year study period, among a routinely tested population at higher risk of TB infection due to race and nativity, risk of TB test conversion was low. However, recent travel to higher-TB-prevalence settings nearly doubled the odds of TB test conversion.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag606"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165730","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":"Projected Health and Economic Outcomes in People Who Inject Drugs in the United States, 2025-2034: A Modeling Study.","authors":"John J Chiosi, John Giardina, Sarah E Wakeman, Kenneth A Freedberg, Jagpreet Chhatwal, Andrea L Ciaranello","doi":"10.1093/ofid/ofag675","DOIUrl":"https://doi.org/10.1093/ofid/ofag675","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) face complications from injection drug use (IDU), including drug overdoses and infections (HIV, hepatitis C virus [HCV], and other serious injection-related infections). Decision makers need estimates of clinical outcomes and costs to plan health service programs and allocate resources.</p><p><strong>Method: </strong>We developed a microsimulation model, the Multimorbidity model to Reduce Infections Associated with Drug use (MYRIAD), with inputs derived from published data. We projected key clinical outcomes and costs in PWID in the United States from 2025 to 2034: new HIV and HCV cases, hospitalizations for severe injection-related infections (eg, endocarditis), and deaths from drug overdose and injection-related infections. We varied multiple parameters in deterministic sensitivity analyses and varied overdose death risk in scenario analyses.</p><p><strong>Results: </strong>For 3.3 million PWID over 10 years, we estimate that 29 715 new HIV infections, 218 186 new HCV infections or reinfections, and 1 714 773 hospitalizations from severe injection-related infections will occur. We project 487 249 deaths from IDU: 348 650 from drug overdose, 37 658 from severe injection-related infections, 90 486 from HCV, and 10 455 from HIV. Healthcare costs from IDU are projected to exceed $565 billion, with $431 billion from drug use and $135 billion from injection-related infections.</p><p><strong>Conclusions: </strong>The United States will face increasing IDU-related deaths and healthcare costs over the next decade with current levels of care. Although deaths are driven primarily by drug overdose, many are from injection-related infections. Interventions that concurrently prevent and treat drug overdose and injection-related infections are urgently needed to curb morbidity and mortality among PWID.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag675"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149271563","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}