Open Forum Infectious Diseases最新文献

{"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}

{"title":"A Randomized, Observer-Blinded, Active-Controlled, Phase IIIb Study to Compare IV/Oral Delafloxacin Fixed-Dose Monotherapy With Best Available Treatments in a Microbiologically Enriched Population With Surgical Site Infections: The DRESS Study.","authors":"Nikolay Belev, Andres Tein, Giuseppe Mangialardi, Alessandra Nuti, Giovanni Marino Merlo, Simona Scartoni, Monica Bertolotti, Margherita Lerro, Stefano Margaritora","doi":"10.1093/ofid/ofaf476","DOIUrl":"10.1093/ofid/ofaf476","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are the most common skin and skin structure infections and are mostly polymicrobial, requiring hospitalization and broad-spectrum antibiotics. This clinical trial evaluated the noninferiority of delafloxacin vs best available therapy (BAT) for the treatment of superficial or deep incisional SSI following a cardiothoracic/related leg or abdominal surgical procedure.</p><p><strong>Methods: </strong>In this randomized, observer-blinded, active-controlled, parallel-group, multicenter, phase IIIb study, patients with SSI were randomized 1:1 to receive delafloxacin 300 mg intravenous (IV)/450 mg oral (OS) or BAT IV/OS (vancomycin or linezolid for cardiothoracic SSI, piperacillin/tazobactam or tigecycline for abdominal SSI). The primary end point was clinical success, defined as the clinical response (cure or improved) at test of cure (TOC), performed 7-14 days after end of treatment (EOT) visit. Secondary end points were clinical success at EOT, sustained clinical response at last follow-up (LFU), microbiological response, and safety.</p><p><strong>Results: </strong>Thi study enrolled 266 patients (delafloxacin = 134; BAT = 132) with comparable baseline characteristics between the 2 treatment arms. Delafloxacin clinical success was noninferior vs BAT at TOC visit (91.8% vs 90.2%, respectively). Similar efficacy was confirmed at LFU (91.8% delafloxacin; 87.9% BAT). Comparable microbiological response was obtained with delafloxacin (89.5%) and BAT (79.4%). Delafloxacin and BAT demonstrated comparable treatment adverse event rates (23.9% and 19.7%, respectively), mostly mild-to-moderate gastrointestinal reactions.</p><p><strong>Conclusions: </strong>This study provided new data on delafloxacin in SSIs, covering the need for effective empiric treatment against the wide spectrum of pathogens involved in these infections.</p><p><strong>Clinical trials registration: </strong>NCT04042077; 2018-001082-17 (EudraCT).</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf476"},"PeriodicalIF":3.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001056","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 Case of Measles Virus-caused Subacute Sclerosing Panencephalitis Diagnosed by Molecular and Clinical Analysis.","authors":"Tingyan Liu, Caiyan Zhang, Meixiu Ming, Lian Chen, Weiming Chen, Yang Xu, Meili Shen, Jia Liu, Qiuxiang Ou, Hua Bao, Xiangjun Chen, Guoping Lu, Gangfeng Yan","doi":"10.1093/ofid/ofaf453","DOIUrl":"10.1093/ofid/ofaf453","url":null,"abstract":"<p><p>Subacute sclerosing panencephalitis (SSPE) is a rare and lethal neurodegenerative encephalitis caused by persistent measles virus infection. We report an SSPE case in a patient infected at 6 months old, diagnosed using clinical methods and metagenomic sequencing, highlighting the benefits of combining clinical and molecular techniques for improved diagnosis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 8","pages":"ofaf453"},"PeriodicalIF":3.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963615","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":"Linezolid-related Optic Nerve Disorders: Insight From a Pharmacovigilance Analysis of the US FDA Adverse Event Reporting System.","authors":"Yuki Nakano, Motoyasu Miyazaki, Arisa Fukuyama, Hirotsugu Hasuwa, Osamu Imakyure","doi":"10.1093/ofid/ofaf520","DOIUrl":"10.1093/ofid/ofaf520","url":null,"abstract":"<p><strong>Background: </strong>Linezolid is a crucial oxazolidinone used to treat multidrug-resistant gram-positive infections; however, it is associated with optic neuropathy and other adverse events. Data regarding the usage and toxicity features of linezolid and those of tedizolid, a related agent with a potentially improved safety profile, are limited. Therefore, this study aimed to investigate the signals and characterize the clinical features of optic nerve disorders related to oxazolidinones using the Food and Drug Administration Adverse Event Reporting System (FAERS) database.</p><p><strong>Methods: </strong>This retrospective pharmacovigilance study examined FAERS data from July 2014 to April 2024. Disproportionality analyses (reporting odds ratio [ROR] and information component [IC]) were conducted to detect signals of oxazolidinone-related optic nerve disorders. Firth-type penalized logistic regression was used to further characterize the features of optic nerve disorders by comparing them with other adverse events (AEs).</p><p><strong>Results: </strong>In total, 15 350 730 reports were retrieved from the FAERS database, from which signals (defined as ROR > 1 and IC > 0) were detected only for linezolid, consistent with sensitivity analyses. Compared with other linezolid-related AEs, linezolid-related optic nerve disorders were characterized by younger age (<60 years; adjusted odds ratio [OR]: 6.86, 95% confidence interval [CI]: 2.36-26.51, <i>P</i> < .001) and high cumulative doses (≥720 mg/kg; adjusted OR: 7.96, 95% CI: 2.93-20.62, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Among oxazolidinones, a signal for optic nerve disorders was detected exclusively for linezolid. Clinicians should ensure regular ophthalmologic monitoring during linezolid treatment, particularly in younger patients and those receiving high cumulative doses.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf520"},"PeriodicalIF":3.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113876","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":"Single-Cell and Plasma Proteomics Do Not Differentiate Patients With and Without SARS-CoV-2 Antigenemia in Convalescence in a Cohort of 100 Patients.","authors":"Shaun Pienkos, Zoe Swank, Rebecca E Hamlin, Mallika Rao, Phillip Grant, Hector Bonilla, Karen Jacobson, Prasanna Jagannathan, Upinder Singh, David R Walt, Aruna Subramanian, Catherine Blish","doi":"10.1093/ofid/ofaf515","DOIUrl":"10.1093/ofid/ofaf515","url":null,"abstract":"<p><p>Plasma samples obtained approximately 3 (<i>n</i> = 100) and 12 months (<i>n</i> = 78) after acute SARS-CoV-2 infection were tested for S1, spike, and N antigens. There were no significant differences in plasma proteins or single-cell protein expression levels on immune cells between those with and without plasma antigen detected.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf515"},"PeriodicalIF":3.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030440","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":"Frequent Missed Opportunities for Earlier HIV Diagnosis in a Routine Opt-out Testing Environment in Atlanta.","authors":"Sarah F Gruber, Megan Schwinne, Rishika Iytha, Emma J Hollenberg, Chad Robichaux, Valeria D Cantos, Jonathan A Colasanti, Anna Q Yaffee, Sara Turbow, Eric Leue, Andrés Camacho-González, Yun F Wang, Meredith H Lora","doi":"10.1093/ofid/ofaf423","DOIUrl":"10.1093/ofid/ofaf423","url":null,"abstract":"<p><strong>Background: </strong>Routine, opt-out HIV testing strategies aim to diagnose HIV earlier and decrease ongoing transmission. We report missed opportunities (MO) and missed testing opportunities (MTO) for earlier HIV diagnosis in a safety-net healthcare system using routine opt-out testing.</p><p><strong>Methods: </strong>This retrospective study analyzed adults diagnosed with HIV between 2015 and 2022 with eligible encounters 30-365 days before diagnosis. MO is defined as no HIV testing in the year before diagnosis. MTOs are encounters where testing was indicated but not performed. Logistic regression identified factors associated with MO and MTO. To evaluate the opt-out testing program, we measured the number of individuals eligible for testing, tests completed, reactive results, and new HIV diagnoses.</p><p><strong>Results: </strong>Of 713 newly diagnosed individuals, 499 (70%) had MO. Among 1845 encounters, 1235 (67%) were MTO. Sexual health-related encounters and STI testing had lower MO odds (adjusted odds ratio [aOR] 0.62; 95% confidence interval [CI], 0.42-0.90; <i>P</i> = .013) and (aOR 0.36; 95% CI, 0.28-0.48; <i>P</i> < .0001), respectively. MO was associated with higher odds of CD4 < 350 cells/mm³ at diagnosis (aOR 1.8; 95% CI, 1.2-2.9; <i>P</i> = .011). Outpatient encounters, particularly primary care, had higher MTO odds than emergency department (OR 0.67; 95% CI, 0.54-0.82; <i>P</i> < .0001). Among 531,848 eligible individuals, 357,771 tests were conducted in 199,004 individuals (37.4%); 4719 (1.3%) tests were reactive, resulting in 861 (0.4%) new HIV diagnoses.</p><p><strong>Conclusions: </strong>Despite routine opt-out HIV testing, most individuals newly diagnosed with HIV had no testing in the prior year, highlighting the need to optimize opt-out testing procedures, particularly in primary care and nonsexual health visits.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 8","pages":"ofaf423"},"PeriodicalIF":3.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963563","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":"Cost-effectiveness of Alternative Approaches to Hepatitis C Diagnosis and Treatment Initiation for Treatment-naive People Who Inject Drugs in Australia: A Model-based Economic Evaluation.","authors":"Christopher R Bailie, Nick Scott, Alisa E Pedrana, Margaret E Hellard, Joseph S Doyle","doi":"10.1093/ofid/ofaf514","DOIUrl":"10.1093/ofid/ofaf514","url":null,"abstract":"<p><strong>Background: </strong>Eliminating hepatitis C virus requires efficient testing and treatment strategies. We evaluated cost-effectiveness of alternative hepatitis C virus diagnosis and treatment initiation approaches for treatment-naive people who inject drugs attending Australian community settings.</p><p><strong>Methods: </strong>We compared 7 strategies differing by use of antibody screening, laboratory, and/or point-of-care tests, and point of treatment commencement. Outcomes were treatment initiation and completion. We considered costs from a healthcare sector perspective at a 1-year time horizon. We used decision analytical models parameterized with publicly available estimates.</p><p><strong>Results: </strong>Standard of care laboratory antibody then RNA testing on separate samples was cheapest but least effective. Laboratory antibody then reflex RNA testing on 1 sample provided higher effectiveness and was the only strategy to reduce average cost per completion ($6141 2023AUD; 95% confidence interval, $3924-$10,382). Combined point-of-care antibody and RNA testing, point-of-care RNA alone, and point-of-care antibody with immediate treatment initiation in turn provided incremental improvements in completion at higher average costs per completion (point estimates: $6976-$11 707AUD). Changes in treatment uptake of at least 16 points were required to achieve equivalence between reflex laboratory and point-of-care strategies. Although treatment of nonviremic individuals contributed to higher costs of point-of-care strategies, reflex laboratory testing remained less costly per completion at generic medication costs.</p><p><strong>Conclusions: </strong>Reflex RNA testing was the most efficient strategy and can be implemented within the existing Australian laboratory framework. Point-of-care approaches may provide additional benefit at higher near-term costs. Studies accounting for transmission and disease sequelae are needed to understand cost-effectiveness in the longer term.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf514"},"PeriodicalIF":3.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113682","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":"Evaluating Blood Culture Parameters to Identify Patients at Low Risk of Infective Endocarditis Among Those With Bacteremia by Gram-positive Cocci.","authors":"Nicolas Fourré, Virgile Zimmermann, Nicoleta Ianculescu, Thomas Brahier, Zélie Dennebouy, André Teixeira-Antunes, Pierre Monney, Georgios Tzimas, Laurence Senn, Lars Niclauss, Matthias Kirsch, Benoit Guery, Matthaios Papadimitriou-Olivgeris","doi":"10.1093/ofid/ofaf518","DOIUrl":"10.1093/ofid/ofaf518","url":null,"abstract":"<p><strong>Background: </strong>Identifying patients at low risk for infective endocarditis (IE) among those with bacteremia by Gram-positive cocci is critical to optimize cardiac imaging use. The aim was to assess the diagnostic performance of blood culture parameters in identifying patients at low risk for IE.</p><p><strong>Methods: </strong>Adult patients with bacteremia due to <i>Staphylococcus aureus</i>, streptococci, or <i>Enterococcus faecalis</i> at the Lausanne University Hospital were included. Low-risk criteria were defined as: only one positive out of four initial blood culture bottles and bacteremia clearance within 48 hours. The primary outcome was the diagnosis of IE, determined by the Endocarditis Team. Negative likelihood ratios (NLRs) were calculated.</p><p><strong>Results: </strong>Among 2165 episodes of bacteremia, 1165 (54%) were due to <i>S. aureus</i>, 726 (34%) to streptococci, and 326 (15%) to <i>E. faecalis</i>. IE was diagnosed in 561 (26%) episodes. Among all episodes, 1767 (82%) had >1 positive out of the initial 4 blood culture bottles collected, and 1783 (82%) had either >1 positive out of the initial 4 blood culture bottles or persistent bacteremia for ≥48 hours. Having only 1 positive out of 4 initial blood culture bottles was associated with a NLR of 0.10 (95% CI, .06-.18). When combining both criteria, 1 positive out of 4 blood culture bottles and bacteremia clearance before 48 hours, the NLR was 0.08 (0.05-0.15).</p><p><strong>Conclusions: </strong>Simple blood culture parameters may help identify patients at low risk for IE. However, the approach classifies most patients as high-risk and may have limited impact on reducing echocardiography use.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf518"},"PeriodicalIF":3.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001088","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":"Opsoclonus-myoclonus-ataxia Syndrome in an ART-naïve Patient With CSF/Plasma HIV-1 RNA Discordance.","authors":"Hiroo Matsuo, Kairi Yonekura, Satoshi Kutsuna","doi":"10.1093/ofid/ofaf517","DOIUrl":"10.1093/ofid/ofaf517","url":null,"abstract":"<p><p>Opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare neuroimmunological disorder with diverse etiologies, including infection-associated triggers such as human immunodeficiency virus (HIV) infection. Herein, we report a case of HIV-associated OMAS in an antiretroviral therapy (ART)-naïve patient who presented with cerebrospinal fluid (CSF)/plasma HIV-1 RNA discordance. A 16-year-old female was diagnosed with HIV following the onset of OMAS. The CSF HIV-1 RNA level was higher than that in the plasma. After ART initiation, both the CSF HIV viral load and OMAS symptoms improved simultaneously. This case demonstrates that CSF/plasma HIV-1 RNA discordance can occur in ART-naïve patients with HIV-associated OMAS. Moreover, our findings suggest that, in such cases, viral suppression through ART alone may be sufficient to achieve clinical resolution without the need for adjunctive immunosuppressive therapy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf517"},"PeriodicalIF":3.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113928","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}