Open Forum Infectious Diseases最新文献

{"title":"Influence of Access to Care on Decision-making About Antibiotic Duration at Discharge.","authors":"Guinn E Dunn, Andrea T White, Daniel L Giesler, Daraoun Mashrah, Adamo Brancaccio, Julia E Szymczak, Jennifer K Horowitz, Robert A Neetz, Valerie M Vaughn","doi":"10.1093/ofid/ofaf346","DOIUrl":"10.1093/ofid/ofaf346","url":null,"abstract":"<p><p>In a randomized vignette of an inpatient with pneumonia, hospitalists prescribed a longer antibiotic duration (>5 days) on discharge more often if the patient lived in a (A) rural versus (B) local community (37% [11/29] vs 10% [4/42], <i>P</i> = .004). Rurality and access to follow-up care may influence discharge medication prescribing.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 7","pages":"ofaf346"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554062","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":"Integrating Partner Services and Molecular Epidemiology Data to Enhance HIV Transmission Disruption in Rhode Island.","authors":"Aditya S Khanna, Vladimir Novitsky, August Guang, Mark Howison, Fizza S Gillani, Jon Steingrimsson, John Fulton, Thomas Bertrand, Meghan Macaskill, Joseph Hogan, Utpala Bandy, Rami Kantor","doi":"10.1093/ofid/ofaf341","DOIUrl":"10.1093/ofid/ofaf341","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate added value of integrating partner services and molecular epidemiology data to disrupt HIV transmission.</p><p><strong>Design: </strong>Integration of statewide partner services and molecular databases.</p><p><strong>Methods: </strong>We evaluated overlap of persons and their social/molecular links in contact tracing (Contact Tracing Database [CTDB], 2008-2022) and HIV-1 genomic (Genomic Database [GDB], 2004-2023) databases using Jaccard coefficient (JC); inferred molecular clustering using phylogeny; assessed care engagement gaps by developing a \"partner naming\" cascade; and explored associations of molecular clustering and partner naming using generalized estimating equations.</p><p><strong>Results: </strong>Among 2418 CTDB and 2527 GDB individuals, 894 (JC = 0.22) and 59 links (JC = 0.012) appeared in both databases, demonstrating low overlap. Molecular clustering occurred in 48% of all GDB persons, 65% of persons in both databases, 71% of persons providing partner data, and 88% of named partners in both databases. Of 1342 named partners, contacts were attempted for 66%, and 93% were reached; of those reached, 71% were newly HIV-tested, of whom 27% were newly diagnosed, and all newly diagnosed were sequenced. Men who have sex with men and people who inject drugs were more likely to cluster molecularly in the GDB if linked in the CTDB, while high-risk heterosexuals were less likely. Men who have sex with men and older individuals were more likely to be linked in the CTDB if they clustered molecularly, while people who inject drugs were less likely.</p><p><strong>Conclusions: </strong>Comprehensive, statewide integration of contact tracing and molecular data enables public health insights not available with one source alone, underscoring the added value of data integration in identifying gaps to improve HIV prevention services.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 7","pages":"ofaf341"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584461","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 Burden of Neonatal Invasive Candidiasis in Low- and Middle-income Countries: A Systematic Review and Meta-analysis.","authors":"Daniel Hsiang-Te Tsai, Ian Chang-Yen Wu, Ling-Fang Chang, Marie Jen-Huey Lu, Brishti Debnath, Nelesh P Govender, Mike Sharland, Adilia Warris, Yingfen Hsia, Laura Ferreras-Antolin","doi":"10.1093/ofid/ofaf329","DOIUrl":"10.1093/ofid/ofaf329","url":null,"abstract":"<p><strong>Background: </strong>Invasive <i>Candida</i> infection remains a significant threat to neonates worldwide. Most evidence on neonatal invasive candidiasis (NIC) comes from high-income countries, leaving the burden and characteristics of NIC in low- and middle-income countries (LMICs) poorly described. This study aimed to investigate the incidence, case-fatality rates (CFR), epidemiology, and etiology of NIC in LMICs.</p><p><strong>Methods: </strong>We conducted a systematic literature review and meta-analyses of all eligible studies in 17 databases published from inception until April 2022 focusing on microbiologically confirmed NIC in LMICs.</p><p><strong>Findings: </strong>A total of 257 articles were included, with 10 994 NIC cases from 27 LMICs. The overall incidence rate was 2.6% (95% confidence interval [CI], 2.2-3.0). Regional disparities were evident, with South-East Asia reporting the highest incidence rate (6.3%; 95% CI, 3.2-10.3). The mean gestational age and birth weight were 31.4 weeks (standard deviation, 3.3) and 1530 g (standard deviation, 644.6), respectively. Among 10 087 included isolates, the predominant species was <i>C albicans</i> (39.0%), followed by <i>C parapsilosis</i> (24.8%), with marked differences in species distribution across World Health Organization regions. Fluconazole was the most commonly used agent for NIC treatment (55.4%; 1567/2826). Overall, 24.8% (1128/6613) of isolates with available data were resistant to fluconazole. The pooled estimated CFR was 18.7% (95% CI, 15.5-22.1).</p><p><strong>Conclusions: </strong>A higher NIC incidence rate and CFR in LMICs is noted compared to high-income countries, although infected babies were less premature with a higher birth weight. The proportion of fluconazole-resistant isolates was high. Prevention and treatment strategies for NIC need to be targeted to LMIC settings.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 7","pages":"ofaf329"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591895","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":"Implementation of an Online Drug-Drug Interaction Screener for the STRIVE Ensitrelvir Trial for COVID-19.","authors":"Joshua P Havens, Nayon Kang, Lucy Chung, Courtney V Fletcher, Page Crew, Jacqueline Nordwall, Lianne Siegel, Katrina Harper, Birgit Grund, Marcelo Losso, Shikha Vasudeva, Kyle C Molina, Adit A Ginde, Ryosuke Shimizu, Ahmad Mourad, Alpha Diallo, Mina Pak, Anne Davis-Karim, Phiona Nabaggala, Alfredo J Mena Lora, Derek W Russell, Sho Saito, Jason V Baker","doi":"10.1093/ofid/ofaf327","DOIUrl":"10.1093/ofid/ofaf327","url":null,"abstract":"<p><strong>Background: </strong>Ensitrelvir is an antiviral agent against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with associated drug-drug interactions (DDIs) through CYP3A, <i>P</i>-glycoprotein (<i>P</i>-gp), breast cancer resistance protein (BCRP), and organic anion transporter-3 (OAT-3) inhibition. We present the development and implementation of an online DDI screener to assess interactions during the STRIVE ensitrelvir trial.</p><p><strong>Methods: </strong>The STRIVE Network is conducting a randomized, double-blind, placebo-controlled trial evaluating ensitrelvir's efficacy and safety in hospitalized adults with coronavirus disease 2019 (COVID-19) and lower respiratory tract involvement. DDI guidance was compiled into a database accessed via a web portal where a multidisciplinary team categorized medications as permitted, prohibited, or conditionally permitted. For prohibited medications, washout periods and start/restart criteria were provided with alternative medication suggestions. Sites could request new medications for addition. After 18 months, a survey was conducted to assess the tool's usefulness.</p><p><strong>Results: </strong>Version 1 of the DDI screener launched in December 2022 with 615 medications, expanding to 1182 through 6 updates by version 7. In 11 cases, prohibited medications were revised to conditionally permit enrollment after dosage adjustments (antihypertensives, anti-infectives, and psychiatric medications). Anticoagulants, immunosuppressants, and emergency use medications posed the greatest challenges due to trial blinding. With 334 participants enrolled across 150 sites in 13 countries, 117192 screener searches were completed by May 2024. The most searched medication classes were antihypertensive, antibiotics, corticosteroids, and anticoagulants. Sites found the DDI screener most helpful during screening/enrollment and valued the washout guidance.</p><p><strong>Conclusions: </strong>DDI resources for investigational medications like ensitrelvir, with high DDI potential, are crucial for safe conduct of clinical trials. Effective implementation requires a multidisciplinary, iterative approach that incorporates real-time feedback from trial sites.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 7","pages":"ofaf327"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541671","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":"HIV Viral Suppression With Unintentional Lenacapavir Monotherapy in Adherence-Challenged Patients: A Case Series.","authors":"Nicky J Mehtani, Janet Grochowski, Anthonia Chimezie, Alix Strough, Sarah Strieff, Monica Gandhi","doi":"10.1093/ofid/ofaf330","DOIUrl":"10.1093/ofid/ofaf330","url":null,"abstract":"<p><p>Lenacapavir, a long-acting human immunodeficiency virus (HIV) capsid inhibitor, is thought to have a low resistance barrier based on current, limited data. We describe 4 patients experiencing homelessness with severe mental illness who maintained HIV suppression (<30 copies/mL) despite unintentional receipt of lenacapavir monotherapy for 9-38 weeks, highlighting its potential among adherence-challenged populations.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf330"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497580","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":"Underdosed and Underappreciated: Why Japanese Community-Acquired Pneumonia Outcomes With Ampicillin-Sulbactam May Not Translate Globally.","authors":"Hayato Mitaka, Karrine Brade, Alyssa Y Castillo","doi":"10.1093/ofid/ofaf348","DOIUrl":"10.1093/ofid/ofaf348","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 7","pages":"ofaf348"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541675","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":"Social Vulnerability Modifies the Effects of Geographic Proximity on Engagement in Latent Tuberculosis Infection Care in a United States Safety Net Healthcare Network.","authors":"Jeffrey I Campbell, Ariane Garing, Dorine Lavache, Sophia Bahad, Melissa Hofman, Jessica E Haberer, Meredith B Brooks, Pranay Sinha, Laura F White, Vishakha Sabharwal, Cynthia A Tschampl, C Robert Horsburgh, Helen E Jenkins, Karen R Jacobson","doi":"10.1093/ofid/ofaf347","DOIUrl":"10.1093/ofid/ofaf347","url":null,"abstract":"<p><strong>Background: </strong>Latent tuberculosis (TB) infection care often requires engagement with multiple teams in several locations throughout the diagnostic and treatment steps of the TB infection care cascade. The intersecting effects of geographic proximity and social drivers on care cascade retention have not been well examined.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with a positive TB infection test between 2018-2019 within a health system in Boston, Massachusetts. The primary outcome was attendance at a TB clinic after a referral was placed. The primary exposure was geographic proximity, as measured by travel time by car. We assessed effect modification of proximity by Social Vulnerability Index (SVI), a composite measure of census tract social drivers.</p><p><strong>Results: </strong>We identified 1677 patients with positive TB infection tests; 1208 (72%) were referred to a TB clinic, of whom 748 (62%) completed referral. Longer travel times were associated with lower odds of referral completion (furthest vs nearest quartiles: adjusted odds ratio, 0.76 [95% confidence interval, .71-.82]). SVI significantly modified the effects of proximity: Increasing travel time was associated with decreasing probability of clinic attendance for patients in lower-vulnerability census tracts but had minimal effect on clinic attendance among patients in higher vulnerability census tracts.</p><p><strong>Conclusions: </strong>Additional support is needed for individuals referred to TB clinics that require long travel times to attend. Support should also account for other social drivers affecting care access for those living near TB clinics.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 7","pages":"ofaf347"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554063","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":"Spatiotemporal Association of Coronavirus Disease 2019 Cases and Deaths With Exposure to Wildfire Particulate Matter in 2020.","authors":"Thomas C McHale, David R Boulware, Kelly Searle, Leda Kobziar, Phinehas Lampman, Julio C Zuniga-Moya, Ben Papadopoulos, Andrej Spec, Naomi E Hauser, George R Thompson","doi":"10.1093/ofid/ofaf262","DOIUrl":"10.1093/ofid/ofaf262","url":null,"abstract":"<p><strong>Background: </strong>Climate change is anticipated to have profound effects on human health, including in infectious diseases. Wildfires have been increasing in frequency and intensity due to climate change and have been linked to worsening respiratory disease outcomes. We aimed to demonstrate whether there was an association between wildfire smoke and coronavirus disease 2019 (COVID-19) in California during 2020.</p><p><strong>Methods: </strong>We used an ecologic cohort study with a spatial autoregressive model to test for associations between wildfire smoke, measured as particulate matter <2.5 µg/m³ and COVID-19 cases and deaths at the county level in California in 2020. All data was downloaded from open sources that were freely available to the public. In our spatial autoregressive model, we adjusted for demographic, environmental factors and spatial autocorrelation that could be associated with the exposure and outcome.</p><p><strong>Results: </strong>In an adjusted analysis, we found a 1-month lag increase of 203 COVID-19 cases per 10 000 persons per 10 µg/m³ of smoke exposure (<i>P</i> < .001) at the county level. There was a 1-month lag increase of 2.75 COVID-19 deaths per 10 000 persons per 10 µg/m³ of smoke exposure (<i>P</i> < .001) at the county level. These findings were attenuated in the second month after smoke exposure, with a 2-month lag increase of 80.6 COVID-19 cases per 10 000 persons per 10 µg/m³ of smoke exposure (<i>P</i> = .002) and no 2-month lag association with COVID-19 deaths.</p><p><strong>Conclusions: </strong>The year 2020 was particularly strong for wildfires in California and a unique year for infectious diseases with the COVID-19 pandemic. Our findings demonstrate that wildfire smoke exposure likely increased the spread of COVID-19 and worsened the mortality rate.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf262"},"PeriodicalIF":3.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275455","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":"Association of SARS-CoV-2 With Health-related Quality of Life 1 Year After Illness Using Latent Transition Analysis.","authors":"Lauren E Wisk, Michael Gottlieb, Peizheng Chen, Huihui Yu, Kelli N O'Laughlin, Kari A Stephens, Graham Nichol, Juan Carlos C Montoy, Robert M Rodriguez, Michelle Santangelo, Kristyn Gatling, Erica S Spatz, Arjun K Venkatesh, Kristin L Rising, Mandy J Hill, Ryan Huebinger, Ahamed H Idris, Michael Willis, Efrat Kean, Samuel A McDonald, Joann G Elmore, Robert A Weinstein","doi":"10.1093/ofid/ofaf278","DOIUrl":"10.1093/ofid/ofaf278","url":null,"abstract":"<p><strong>Background: </strong>Long-term sequelae after SARS-CoV-2 infection may impact health-related quality-of-life (HRQoL), yet it is unknown how HRQoL changes during recovery. We compared patient-reported HRQoL among adults with COVID-19-like illness who tested SARS-CoV-2 positive (COVID+) with those who tested negative (COVID-).</p><p><strong>Methods: </strong>Participants in this prospective, multicenter, longitudinal registry study were enrolled from December 2020 through August 2022 and completed 3-month follow-up assessments until 12 months after enrollment. Participants were adults (≥18 years) with acute symptoms suggestive of COVID-19 who received a Food and Drug Administration-approved SARS-CoV-2 test. Participants received questions from PROMIS-29 (subscales: physical function, anxiety, depression, fatigue, social participation, sleep disturbance, and pain interference) and PROMIS SF-8a (cognitive function). Latent transition analysis was used to identify meaningful patterns in HRQoL scores over time; 4 HRQoL categories were compared descriptively and using multivariable regression. Inverse probability weighting was used to adjust for covariate imbalance.</p><p><strong>Results: </strong>There were 1096 (75%) COVID+ and 371 (25%) COVID-. Four distinct well-being classes emerged: optimal overall, poor mental, poor physical, and poor overall HRQoL. COVID+ participants were more likely to return to the optimal HRQoL class compared to COVID- participants. The most substantial transition from poor physical to optimal HRQoL occurred by 3 months, whereas movement from poor mental to optimal HRQoL occurred by 9 months.</p><p><strong>Conclusions: </strong>In adults with COVID-19-like illness, COVID+ participants demonstrated meaningful recovery in their physical HRQoL by 3 months after infection, but mental HRQoL took longer to improve. Suboptimal HRQoL at 3 to 12 months after infection remained in approximately 20%.</p><p><strong>Trial registration: </strong>NCT04610515.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf278"},"PeriodicalIF":3.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266867","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":"Evaluation of Insulin Resistance Markers for Diagnosing Moderate to Severe Hepatic Steatosis in Patients With Human Immunodeficiency Virus Using Transient Elastography.","authors":"Carlos Báguena, Cristina Tomás, Ángeles Muñoz, Antonia Alcaraz, Maria Isabel Martínez, Rodrigo Martínez-Rodríguez, Eva García-Villalba, Enrique Bernal","doi":"10.1093/ofid/ofaf324","DOIUrl":"10.1093/ofid/ofaf324","url":null,"abstract":"<p><strong>Background: </strong>Hepatic steatosis, commonly associated with metabolic dysfunction-associated steatotic liver disease, is a growing but underdiagnosed concern in people with human immunodeficiency virus (HIV). This study evaluates the diagnostic accuracy of insulin resistance markers (homeostatic model assessment for insulin resistance, triglyceride-glucose [TyG], triglyceride-glucose-body mass index [TyG-BMI], and triglyceride/high-density lipoprotein cholesterol indices) for identifying moderate to severe hepatic steatosis in people with HIV using transient elastography (FibroScan).</p><p><strong>Methods: </strong>We prospectively analyzed 235 people with HIV on antiretroviral therapy with suppressed viral loads (<50 RNA copies/mL). Moderate to severe hepatic steatosis was defined as a controlled attenuation parameter ≥269 dB/m. Insulin resistance markers were calculated and diagnostic performance was assessed using receiver operating characteristic curves.</p><p><strong>Results: </strong>Moderate to severe hepatic steatosis was detected in 48 patients (20.4%). These individuals had higher rates of diabetes, BMI, and waist circumference. Insulin resistance indices were significantly elevated in this group, with TyG-BMI demonstrating the highest diagnostic accuracy (area under the curve, 0.800 [95% confidence interval, .727-.873]), achieving 79.2% sensitivity and 61.3% specificity at a cutoff of 227.36.</p><p><strong>Conclusions: </strong>Insulin resistance markers, especially TyG-BMI, may serve as practical, noninvasive tools for identifying moderate to severe hepatic steatosis in people with HIV, particularly in resource-limited settings where transient elastography is unavailable.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf324"},"PeriodicalIF":3.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497578","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}