Open Forum Infectious Diseases最新文献

{"title":"Utility of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography in Evaluating Disseminated Nontuberculous Mycobacterial Infection in Patients With Anti-interferon-γ Autoantibodies.","authors":"Pei-Ju Chuang, Wei-Cheng Lan, Mei-Fang Cheng, Chun-Kai Huang, Tzu-Chan Hong, Chi-Ying Lin, Yu-Shan Huang, Pao-Yu Chen, Un-In Wu, Jann-Tay Wang, Wang-Huei Sheng, Yee-Chun Chen, Shan-Chwen Chang","doi":"10.1093/ofid/ofae708","DOIUrl":"10.1093/ofid/ofae708","url":null,"abstract":"<p><strong>Background: </strong>Managing disseminated nontuberculous mycobacterial (NTM) infection in patients with neutralizing anti-interferon-γ autoantibodies (AIGAs) poses substantial challenges due to the lack of established treatment guidance and predictive tools for clinical outcomes. In this study, we investigated the utility of ¹⁸F-fluorodeoxyglucose (2-[¹⁸F]FDG) positron emission tomography (PET) in guiding treatment decisions, with a focus on its ability to predict rehospitalization outcomes.</p><p><strong>Methods: </strong>We conducted a post hoc analysis of the first available 2-[¹⁸F]FDG PET scans of patients with AIGAs and disseminated NTM infection from a prospective observational multicenter cohort. Cox proportional hazards regression was used to determine predictors for disease-related rehospitalization within 1 year of the examination.</p><p><strong>Results: </strong>Of the patients with AIGAs evaluated, 41.9% required rehospitalization within 1 year following the initial 2-[¹⁸F]FDG PET evaluation. Slowly growing mycobacteria were isolated in 64.5% of patients. Multivariable analysis identified splenic involvement (adjusted hazard ratio, 7.97; 95% CI, 2.34-27.16; <i>P</i> < .001) as a significant predictor of disease-related rehospitalization within 1 year following the examination. Moreover, mediastinal node involvement (adjusted odds ratio, 14.77; 95% CI, 1.01-216.76; <i>P</i> = .049) and axial skeleton involvement (adjusted odds ratio, 14.93; 95% CI, 1.11-201.43; <i>P</i> = .042) were significantly associated with the isolation of slowly growing mycobacteria.</p><p><strong>Conclusions: </strong>2-[¹⁸F]FDG PET appears useful in initial evaluation of disease extent and microbiology in patients with AIGAs and disseminated NTM infection. Identifying splenic involvement through this modality may help recognize patients at increased risk of disease-related rehospitalization within 1 year. These findings suggest that 2-[¹⁸F]FDG PET could inform management decisions in this challenging population.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae708"},"PeriodicalIF":3.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864993","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 Risk of Infection Among Patients Colonized With Antimicrobial-Resistant Pathogens: A Population-wide Cohort Study.","authors":"Christina Blagojevic, Kevin A Brown, Christina Diong, Daniel J Fridman, Jennie Johnstone, Bradley J Langford, Samantha M Lee, Derek R MacFadden, Kevin L Schwartz, Nick Daneman","doi":"10.1093/ofid/ofae712","DOIUrl":"10.1093/ofid/ofae712","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial-resistant (AMR) pathogens represent an ongoing global health burden. Colonization is often a prerequisite for infection, but the risk of infection after AMR colonization is not well understood. Using population-level health administrative data, we sought to investigate the risk of infection with the same AMR organism after detection of colonization.</p><p><strong>Methods: </strong>We conducted a retrospective population-wide cohort study among residents of Ontario, Canada, over a 5-year period to determine the risk of infection after detection of colonization with the following AMR pathogens: methicillin-resistant <i>Staphylococcus aureus</i>, vancomycin-resistant <i>Enterococcus</i>, extended-spectrum β-lactamase-producing Enterobacterales, and carbapenemase-producing Enterobacterales. We also examined the effects of age, sex, and health care setting of colonization detection on subsequent infection risk.</p><p><strong>Results: </strong>There were 69 998 individuals with a positive AMR pathogen surveillance test result during the study period, 15.6% of which subsequently developed a sterile or nonsterile site infection within a median 57 days (IQR, 11-228). Infection rates varied among organisms: 18.3% for methicillin-resistant <i>S aureus</i> within a median 57 days (IQR, 10-239), 2.8% for vancomycin-resistant <i>Enterococcus</i> within a median 37 days (IQR, 11-119), 21.5% for extended-spectrum β-lactamase-producing Enterobacterales within a median 71 days (IQR, 18-231), and 20.3% for carbapenemase-producing Enterobacterales within a median 10 days (IQR, 3-42). A positive surveillance test result detected in a hospital was associated with increased infection risk after colonization as compared with the community setting.</p><p><strong>Conclusions: </strong>The overall infection rate after colonization with an AMR pathogen was high for most organisms, highlighting the importance of detecting colonization from both an infection control and empiric antibiotic selection perspective.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae712"},"PeriodicalIF":3.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864992","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":"Herpesvirus Antibodies Are Correlated With Greater Expression of p16 in the T Cells of Humans.","authors":"Grace Noppert, Kathleen Wragg, Chihua Li, Kate Duchowny, Lona Mody, Allison E Aiello, Linda Nyquist, Martin O'Brien, Raymond Yung, Daniel Goldstein","doi":"10.1093/ofid/ofae693","DOIUrl":"10.1093/ofid/ofae693","url":null,"abstract":"<p><strong>Background: </strong>There is an increasing awareness that aging of the immune system, or immunosenescence, is a key biological process underlying many of the hallmark diseases of aging and age-related decline broadly. While immunosenescence can be in part due to normal age-related changes in the immune system, emerging evidence posits that viral infections may be biological stressors of the immune system that accelerate the pace of immunosenescence.</p><p><strong>Methods: </strong>We used a convenience sample of 42 individuals aged 65 years and older to examine correlations between antiviral immunoglobulin G (IgG) levels for 4 human herpesviruses (cytomegalovirus [CMV], herpes simplex virus [types 1 and 2], and Epstein-Barr virus) and multiple indicators of T-cell immunosenescence.</p><p><strong>Results: </strong>We found that most of the sample (n = 33) was antiviral IgG positive for 2 or more of the 4 herpesvirus infections. We also examined correlations between both the total number of viruses for which an individual had antiviral IgG and each individual virus and multiple indicators of T-cell immunosenescence, particularly p16 expression. The strongest correlations were observed between the total number of viruses for which an individual had detectable antiviral IgG and p16 mean fluorescent intensity (MFI) among CD27-CD28-CD57+ CD4+ cells (<i>r</i> = 0.60; <i>P</i> < .001) and between anti-CMV IgG and p16 MFI of CD27-CD57+ CD4+ cells (<i>r</i> = 0.59; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Broadly, our findings offer compelling preliminary evidence for future investigations to incorporate multiple indicators of persistent viral infections and a more comprehensive set of markers of T-cell immunosenescence in population-based studies of aging.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae693"},"PeriodicalIF":3.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864991","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":"Novel Dolutegravir and Lenacapavir Resistance Patterns in Human Immunodeficiency Virus Type 2 Infection: A Case Report.","authors":"Jeroen J A van Kampen, Els van Nood, Rizwan Mahmud, Zoë Krullaars, Tess Voskamp, Mike Voskamp, Tess Nijssen, Jolanda J C Voermans, Charlotte Charpentier, Quentin Le Hingrat, David A M C van de Vijver, Rob A Gruters, Thibault Mesplède","doi":"10.1093/ofid/ofae705","DOIUrl":"10.1093/ofid/ofae705","url":null,"abstract":"<p><strong>Background: </strong>The treatment management of human immunodeficiency virus (HIV)-2 infection presents greater challenges compared to HIV-1 infection, primarily because of inherent resistance against non-nucleoside reverse transcriptase inhibitors. Integrase strand transfer inhibitors, particularly dolutegravir, have improved treatment outcomes for people with HIV-2. Lenacapavir, a novel and potent antiretroviral capsid inhibitor, offers additional therapeutic options. However, limited knowledge exists regarding HIV-2 resistance against dolutegravir and lenacapavir.</p><p><strong>Methods: </strong>We report the case of a treatment-experienced individual who did not achieve virological suppression with regimens containing dolutegravir and lenacapavir. Clinical monitoring, genotypic and phenotypic resistance assays, and <i>in silico</i> structural modeling were performed.</p><p><strong>Results: </strong>Lenacapavir was added to a failing regimen of boosted darunavir, twice daily dolutegravir, and 2 nucleoside reverse transcriptase inhibitors. Initially, this addition led to a decline in the viral load and increase in CD4+ T-cell count, despite the identification of a previously unreported combination of integrase resistance mutations. However, virological suppression was not achieved and viral load, although reduced, resumed increasing. This rebound was associated with the development of an N73D capsid substitution in HIV-2, which conferred resistance against lenacapavir. Based on cell-based assays predicting hypersusceptibility to bictegravir, the regimen was adjusted to oral lenacapavir plus bictegravir/emtricitabine/tenofovir alafenamide, resulting in a resumption in viral load decline.</p><p><strong>Conclusions: </strong>Although lenacapavir demonstrated therapeutic potential, our case underscores the critical need to combine it with other fully active antiretroviral agents to prevent the rapid emergence of resistance and achieve long-term virological control in treatment-experienced individuals with HIV-2.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae705"},"PeriodicalIF":3.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915468","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":"Trajectories and Decline of Serum Hepatitis B Surface Antigen Predict Outcomes in Patients With Chronic Hepatitis B.","authors":"Wei-Fan Hsu, Chuen-Fei Chen, Hsueh-Chou Lai, Wen-Pang Su, Hung-Wei Wang, Sheng-Hung Chen, Guan-Tarn Huang, Cheng-Yuan Peng","doi":"10.1093/ofid/ofae699","DOIUrl":"10.1093/ofid/ofae699","url":null,"abstract":"<p><strong>Background: </strong>The kinetics of serum hepatitis B surface antigen (HBsAg) levels during long-term nucleos(t)ide analogue (NA) therapy remains unclear. We delineated the kinetics of HBsAg and analyzed its association with long-term treatment outcomes.</p><p><strong>Methods: </strong>We enrolled 912 treatment-naïve patients with chronic hepatitis B (CHB) who had received NA therapy for >12 months and analyzed the kinetic patterns through group-based trajectory models (GBTMs).</p><p><strong>Results: </strong>The median treatment duration for the entire cohort was 60.3 months. GBTMs revealed 4 patterns in patients achieving HBsAg loss (groups 1-4) in the study population and in patients achieving HBsAg <100 IU/mL among those with HBeAg-negative CHB with baseline HBsAg ≥100 IU/mL (groups A-D). Patients in groups 1 and A had the highest rates of HBsAg loss (22.2%, 6/27) and of achieving HBsAg <100 IU/mL (47.5%, 56/118), respectively. HBsAg <40 IU/mL and <400 IU/mL at 12 months of treatment predicted group 1 and group A membership among all patients and those with HBeAg-negative CHB, respectively. Multivariable Cox regression analysis identified HBsAg trajectory group (group 1 vs groups 3 and 4: hazard ratio [HR], 179.46; <i>P</i> < .001; group 2 vs groups 3 and 4: HR, 24.34; <i>P</i> < .001) and HBsAg decline (HR, 82.14; <i>P</i> < .001) as independent predictors of both HBsAg loss and achieving HBsAg <100 IU/mL.</p><p><strong>Conclusions: </strong>Serum HBsAg trajectories and decline can predict HBsAg loss and the achievement of HBsAg <100 IU/mL in patients with CHB receiving long-term NA therapy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae699"},"PeriodicalIF":3.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829464","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 Factors for Extrapulmonary Tuberculosis Among US Veterans, 1990-2022.","authors":"Gina Oda, Cynthia Lucero-Obusan, Patricia Schirmer, Joyce Chung, Mark Holodniy","doi":"10.1093/ofid/ofae698","DOIUrl":"10.1093/ofid/ofae698","url":null,"abstract":"<p><strong>Purpose: </strong>To determine factors that put US veterans with active tuberculosis at risk for extrapulmonary tuberculosis (EPTB) compared with pulmonary tuberculosis.</p><p><strong>Methods: </strong>We included veterans with laboratory-confirmed tuberculosis from 1990-2022 in our retrospective cohort study. Multivariable logistic regression was used to estimate the association of demographic and clinical risk factors with EPTB.</p><p><strong>Results: </strong>Of 7493 veterans aged 20-100 years (median, 58 years) with laboratory-confirmed tuberculosis, 1397 (19%) had EPTB. The most common EPTB infection among veterans was pleural (31.4%), while meningitis carried the highest mortality risk at 90 days. Factors independently associated with EPTB among veterans were non-Hispanic black race/ethnicity, diabetes mellitus, human immunodeficiency virus infection, severe kidney disease, and all-cause mortality within 90 days after tuberculosis diagnosis.</p><p><strong>Conclusions: </strong>Our study demonstrated several risk factors for EPTB among US veterans. Healthcare providers should be educated regarding patient populations at risk for EPTB, especially given the challenges in diagnosing this disease and the importance of instituting early treatment to prevent severe illness and death.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae698"},"PeriodicalIF":3.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829456","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":"Burden of Hospitalization for Coccidioidal Meningitis: An Analysis of the National Inpatient Sample, 2019-2021.","authors":"Craig I Coleman, Fariba Donovan, Lahar Miriyapalli, Ryan Shan, Belinda Lovelace","doi":"10.1093/ofid/ofae706","DOIUrl":"10.1093/ofid/ofae706","url":null,"abstract":"<p><p>Coccidioidal meningitis (CM) requires lifelong aggressive management, often necessitating hospitalization. In the National Inpatient Sample (2019-2021), CM hospitalizations (N = 2305) were associated with frequent CM-related procedures (63.6% [95% confidence interval {CI}, 59.3%-67.6%]), long stays (mean, 13.0 days [95% CI, 11.3-14.6 days]), substantial costs per stay (mean, $48 155 [95% CI, $42 382-$53 929]), and a 7.6% (95% CI, 5.6%-10.3%) mortality incidence. CM inflicts a substantial burden on hospital resources.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae706"},"PeriodicalIF":3.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807642","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":"Etiologies of Bloody Diarrhea in Children Presenting With Acute Gastroenteritis to US Emergency Departments.","authors":"Paola Fonseca-Romero, Ben J Brintz, D Matthew Vierkant, Jennifer Dien Bard, Daniel M Cohen, Ara Festekjian, Amy L Leber, Jami T Jackson, Neena Kanwar, Chari Larsen, Rangaraj Selvarangan, Kimberle C Chapin, Andrew T Pavia, Sharia M Ahmed, Daniel T Leung","doi":"10.1093/ofid/ofae692","DOIUrl":"10.1093/ofid/ofae692","url":null,"abstract":"<p><p>We used molecular testing to examine the causes of bloody diarrhea in a multicenter study of pediatric gastroenteritis. Pathogens typically associated with bloody diarrhea were detected in less than half of cases, and inappropriate antibiotic use was common, supporting the use of stool testing in patients with bloody diarrhea.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae692"},"PeriodicalIF":3.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847071","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 Comparison of Two DAAs Used in a Unique Model of Care to Treat Hepatitis C Infections in New Jersey.","authors":"Jihad Slim, Paul Bellafiore, Barbara Tempalski, Corey Rosmarin-DeStefano, Kevin Leyden, Juan Torres, Sheena Duprey, Emily Levaggi","doi":"10.1093/ofid/ofae645","DOIUrl":"10.1093/ofid/ofae645","url":null,"abstract":"<p><p>In this prospective observational study, we compare the efficacy of glecaprevir/pibrentasvir vs sofosbuvir/velpatasvir in treating hepatitis C within a unique model of care utilizing a combination of telehealth, an ambulatory van, case management, and a contracted pharmacy. Among 769 patients treated, 90.4% completed treatment, with 9.6% lost to follow-up. Both regimens demonstrated high completion rates and efficacy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae645"},"PeriodicalIF":3.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740002","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 and Outcomes of Direct-Acting Antiviral Experienced Patients with Hepatitis C Undergoing Retreatment at an Essential Hospital in the United States.","authors":"Alejandro De La Hoz, Amin Pooja, Anna Kancharla, Elissa M Schechter-Perkins, Glorimar Ruiz-Mercado, Marielle Baldwin, David Nunes, Jessica L Taylor","doi":"10.1093/ofid/ofae704","DOIUrl":"10.1093/ofid/ofae704","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) guidelines recommend direct-acting antiviral (DAA) rescue regimens in cases of treatment failure, and first-line regimens for reinfection. In patients with barriers to follow-up after treatment, it is difficult to determine if HCV viremia represents failure or reinfection. Patients are often retreated with rescue regimens despite higher costs. We compared the outcome of first-line vs rescue therapy in DAA experienced patients whose prior outcome was indeterminate.</p><p><strong>Methods: </strong>This retrospective cohort study included DAA experienced adults undergoing retreatment at a hospital in Massachusetts between January 2016 and May 2022. We used descriptive statistics to characterize the population. For patients with an indeterminate prior HCV treatment outcome, we compared the groups' characteristics and outcomes.</p><p><strong>Results: </strong>We included 112 patients. The mean age was 52 years (SD: 12.2), 80.4% were male, and 42.9% were White. Nearly 1 in 4 (25%) reported active substance use. Outcomes of prior DAA treatment included sustained virologic response at 12 weeks in 39.3% (n = 44) and treatment failure in 27.7% (n = 31). The prior treatment outcome was indeterminate in 33% (n = 37). We compared the outcomes of patients with an indeterminate treatment outcome retreated with first-line vs rescue therapy. Sustained virologic response at 12 weeks (66.7 vs 52.7%), treatment failure (0% vs 10.5%), and indeterminate outcome (33.3% vs 36.8%) were similar between the groups (<i>P</i> = .502).</p><p><strong>Conclusions: </strong>Outcomes with first-line DAAs were comparable to rescue medications for retreatment of patients with DAA experience and an indeterminate prior treatment outcome. Our findings can help decrease treatment-level barriers for HCV treatment.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae704"},"PeriodicalIF":3.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864990","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}