Therapeutic Advances in Infectious Disease最新文献

{"title":"Lymphomatous-type adult T-cell leukemia/lymphoma associated with HTLV-1 presenting as chronic respiratory illness in a young adult: a case report.","authors":"H A Nati-Castillo, M Ocampo-Posada, Jhan S Saavedra-Torres, Adriana Cecilia Correa Gomez, Marlon Arias-Intriago, Alice Gaibor-Pazmiño, Juan S Izquierdo-Condoy","doi":"10.1177/20499361261444136","DOIUrl":"https://doi.org/10.1177/20499361261444136","url":null,"abstract":"<p><p>Adult T-cell leukemia/lymphoma (ATLL) is a rare, human T-lymphotropic virus type 1 (HTLV-1)-driven neoplasm that is often underrecognized in low-endemic regions. We describe a 23-year-old man with an eight-year history of chronic dry cough who later developed weight loss, night sweats, odynophagia, and dyspnea. CT revealed cervical/supraclavicular lymphadenopathy with innumerable pulmonary micronodules, interlobular septal thickening, and ground-glass opacities; abdominal imaging showed hepatosplenomegaly, ascites, and extensive retroperitoneal/mesenteric adenopathy. HTLV-1 ELISA and confirmatory Western blot were positive. Excisional lymph node biopsy demonstrated diffuse architectural effacement by atypical T cells with a CD3+, CD4+, CD5+, CD25+, CD7-, granzyme B+ immunophenotype and a ~90% Ki-67 index, establishing lymphomatous-type ATLL with a cytotoxic profile. Despite rapid recognition, the patient deteriorated and died from respiratory failure 15 days after diagnosis, before chemotherapy could begin. This lung-predominant presentation in a young adult illustrates how ATLL can mimic chronic pulmonary disease and evade early detection outside endemic areas. Clinicians should prioritize early tissue acquisition and a minimal T-cell panel (CD3, CD4, CD25, CD7, Ki-67); a CD4+CD25+ phenotype with CD7 loss should prompt HTLV-1 testing irrespective of geography. Streamlined access to immunophenotyping and confirmatory HTLV-1 assays is essential to reduce diagnostic delays and improve outcomes.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261444136"},"PeriodicalIF":3.4,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay between chronic kidney disease and urinary tract infections: a comprehensive review on the pathophysiological insights, interconnected burdens, and prevention strategies.","authors":"Mohammad Khaled Iqbal Hamid, Aklima Khan Lima, Subeh Hasneen, Ramisa Anjum, Mohammad Shahriar, Mohiuddin Ahmed Bhuiyan","doi":"10.1177/20499361261441056","DOIUrl":"https://doi.org/10.1177/20499361261441056","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) and chronic kidney disease (CKD) contribute to a substantial global health issue that is closely intertwined. Research has demonstrated that CKD increases the likelihood of individuals experiencing frequent, severe, and often antibiotic-resistant UTIs, which can accelerate the diminution of kidney function and result in end-stage kidney disease. The inherent structural, metabolic, and immunological disruptions linked to CKD create a suitable environment for uropathogens to grow in the urinary tract. This risk is further heightened by ongoing exposure to antibiotics, which facilitates the emergence of multidrug-resistant (MDR) organisms, complicating treatment options. This review discusses the existing literature on the clinical and microbiological relationship between CKD and UTIs, particularly highlighting the increased vulnerability of CKD patients to MDR pathogens supported by recent studies. It also addresses the disparity in the burden of these conditions in lower-income countries where access to renal replacement therapies is limited, as illustrated by the ISN-Global Kidney Health Atlas analysis. This review emphasizes the bidirectional challenge presented by CKD, which increases the risk of significant UTIs, while UTIs can worsen kidney damage. This damaging cycle is further intensified by factors such as weakened immunity, microbiota, and rising antibiotic resistance, creating a substantial clinical issue. To effectively manage antibiotic treatment, it is necessary to transition toward a proactive, integrative strategy. Key components include early screening for CKD in high-risk populations, maintaining optimal urogenital hygiene, and implementing strong antibiotic stewardship to enhance treatment effectiveness. Additionally, this review explores promising non-antibiotic prophylactic methods, including vaccines, antimicrobial peptides, and lifestyle changes, which are critical for breaking the cycle of infection and renal decline. A comprehensive approach that incorporates preventive measures, judicious use of antimicrobials, and addressing underlying renal issues is essential for improving long-term outcomes in this vulnerable patient demographic.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261441056"},"PeriodicalIF":3.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing pneumonia severity using neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: a cross-sectional comparison with CURB-65 score.","authors":"Muhammad Osama, Ahmad Iftikhar, Mallahat Abdul Baseer, Nazim Khan, Abdul Majid, Akshay Amaraneni, Faiz Anwer, Pawan Kumar Thada","doi":"10.1177/20499361261441703","DOIUrl":"https://doi.org/10.1177/20499361261441703","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia continues to be a leading cause of morbidity and mortality worldwide. Several validated scoring systems are available for stratifying pneumonia severity, with the CURB-65 being well known. Recently, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been reported as reliable indicators of disease severity and adverse outcomes in patients with pneumonia, particularly when used alongside established scoring systems.</p><p><strong>Objectives: </strong>To evaluate the association of NLR and PLR with higher clinical severity classification (CURB-65 ⩾ 3), and to compare their discriminatory performance with C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in patients with community-acquired pneumonia.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>In this cross-sectional study conducted at a tertiary care hospital in Peshawar, Pakistan, we enrolled 121 adults with community-acquired pneumonia. Baseline demographic characteristics, comorbid conditions, clinical presentation, and laboratory measures were recorded. Pneumonia severity was assessed using the CURB-65 score. The discriminatory performance of NLR, PLR, CRP, and ESR was evaluated by receiver operating characteristic (ROC) curve analysis, with severe pneumonia defined as a CURB-65 score of 3 or higher. Multivariable logistic regression was performed to assess independent associations after adjustment for age and comorbidities.</p><p><strong>Results: </strong>The mean (±SD) age of the patients was 59.2 ± 20.6 years, and 69.4% were male. Common comorbidities included diabetes (31.4%), chronic obstructive pulmonary disease (28.1%), and chronic heart failure (19.8%). The mean CURB-65 score was 2.23 ± 1.20. NLR and PLR were significantly higher in severe pneumonia than in non-severe pneumonia (both <i>p</i> < 0.001), whereas CRP and ESR did not differ significantly (<i>p</i> = 0.083 and <i>p</i> = 0.197, respectively). In multivariable analysis, NLR remained independently associated with severe pneumonia (adjusted OR 1.91, 95% CI 1.46-2.51; <i>p</i> < 0.001). In ROC analysis, PLR showed the highest discriminative ability (area under the curve (AUC) 0.9935, 95% CI 0.9847-1.0000), followed by NLR (AUC 0.9436, 95% CI 0.8977-0.9895), CRP (AUC 0.6028, 95% CI 0.4878-0.7178), and ESR (AUC 0.5501, 95% CI 0.4258-0.6744).</p><p><strong>Conclusion: </strong>In this cohort, NLR and PLR demonstrated strong agreement with higher CURB-65 severity classification and superior discriminatory performance compared with CRP and ESR.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261441703"},"PeriodicalIF":3.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new multiplex molecular assay based on padlock probes and rolling circle amplification for MDR-TB detection in clinical specimens: a prospective diagnostic accuracy study.","authors":"Andrii Dudnyk, Nadiia Tytarenko, Oksana Lytvyniuk, Olena Tolstova, Joan-Pau Millet, Israel Molina, Adrián Antuori, Nelly Ciobanu, Valeriu Crudu, José Domínguez","doi":"10.1177/20499361261436542","DOIUrl":"https://doi.org/10.1177/20499361261436542","url":null,"abstract":"<p><strong>Background: </strong>Patients with multidrug-resistant tuberculosis (MDR-TB) receive treatment that is at least 20% less effective than drug-susceptible cases globally.</p><p><strong>Objectives: </strong>The study evaluated the diagnostic accuracy of mfloDx MDR-TB assay (EMPE Diagnostics AB, Solna, Sweden) for simultaneous detection of resistance to isoniazid (INH) and rifampicin (RIF) compared to culture-based drug susceptibility test (DST).</p><p><strong>Design: </strong>A prospective diagnostic accuracy study.</p><p><strong>Methods: </strong>Clinical samples from 287 patients (mean age 45.3 (95% CI 43.3-47.2) years; 50 (17.0%) were female) from TB facilities in Ukraine (<i>n</i> = 82, 28.6%), Moldova (<i>n</i> = 37, 12.9%) and Spain (168, 58.5%) with bacteriologically confirmed TB and persons evaluated for non-tuberculous mycobacteria (NTM) were consecutively tested. The results of the mfloDx MDR-TB assay were compared with culture-based DST.</p><p><strong>Results: </strong>A total of 186 out of 287 sputum specimens (64.8%) yielded conclusive results that allowed a definitive interpretation of resistance to at least one drug. The mfloDx MDR-TB assay demonstrated sensitivity at 86.9 (95% CI 80.6-91.7) and specificity at 100 (95% CI 79.4-100) correctly differentiating mycobacterium tuberculosis complex from NTM in smear positive sputum samples. Considering only conclusive results in sputum samples, the mfloDx MDR-TB assay simultaneously predicted resistance to INH and RIF in TB patients showing high sensitivity 100 (95% CI 93.0-100) and specificity 98.7 (95% CI 92.8-100) compared to MDR-TB detection by culture-based DST.</p><p><strong>Conclusion: </strong>While approximately one-third of tests yielded inconclusive results, the mfloDx™ MDR-TB assay demonstrated potential as a rapid screening tool for INH and RIF resistance, offering a time advantage over conventional culture-based DST.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261436542"},"PeriodicalIF":3.4,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enterovirus D68 and mycobacterial coinfection: case report.","authors":"Qiongling Bao, Xiaoqian Zhang, Jing Guo","doi":"10.1177/20499361261432918","DOIUrl":"https://doi.org/10.1177/20499361261432918","url":null,"abstract":"<p><p>The threat of viral epidemics to long-standing diseases, such as mycobacterial infection, is constantly evolving. Enterovirus D68 (EV-D68) is an emerging cause of respiratory infection and has raised great interest since its first outbreak in 2014. Very few studies have been done to describe the clinical aspects of the coinfection of EV-D68 and mycobacteria, so this study was conducted to help round out the understanding of this coinfection pattern. We observed three adult cases of EV-D68 and mycobacteria, who were admitted to the first affiliated hospital of Zhejiang University in August/September 2024. Only one case had a definite past history of immunodeficient disease and received long-term corticosteroid treatment, and the other two were previously healthy. The diagnoses of EV-D68 and mycobacterial infection were all simultaneously confirmed through the metagenomic Next-Generation Sequencing in bronchoalveolar lavage fluid specimens. All three patients were presented with severe respiratory symptoms, such as fever, cough, dyspnea and tachypnea, without any manifestations of central nervous system involvement. The radiological findings in chest CT scans varied from patchy opacity to massive consolidation. The individualized anti-mycobacterium treatment showed little therapeutic effect, while the improvement of symptoms and pulmonary lesions in chest CT was observed after starting or intensifying the administration of corticosteroid. All patients had a marked clinical improvement when discharged from hospital, and it took about 6-9 months for the lung lesions of mycobacterial infections to nearly resolve. These cases illustrate the potential for EV-D68 coinfection to exacerbate pulmonary inflammation in patients with mycobacterial disease, highlighting the need for vigilance regarding possible viral coinfections in settings with a high tuberculosis burden, such as China.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261432918"},"PeriodicalIF":3.4,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the epidemic curve: a critical systematic review of the structural, ecological, and viral determinants sustaining Chikungunya and Zika viruses in Latin America and the Caribbean.","authors":"Danladi C Husaini, Aneesah A Herbert, Marjorie Z Rivera, Jahaira Nunez, Arlen Coc, Joel H Chiroma, Orish E Orisakwe","doi":"10.1177/20499361261438240","DOIUrl":"https://doi.org/10.1177/20499361261438240","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The incursion of Chikungunya (CHIKV) and Zika (ZIKV) viruses into Latin America and the Caribbean (LAC) after 2013 created complex epidemics with high attack rates, severe complications, and persistent transmission. While individual aspects have been studied, a synthesized understanding of the interacting viral, ecological, and social drivers sustaining these arboviruses in the region remains lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To critically synthesize evidence on the incursion and establishment of CHIKV and ZIKV in LAC through an integrative framework examining the interaction between viral adaptation and structural vulnerabilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources and methods: &lt;/strong&gt;We systematically searched PubMed, EMBASE, Scopus, and LILACS, supplemented by gray literature from PAHO, WHO, and CDC, for studies published between January 2013 and December 2025. Eligible studies included observational studies, surveillance data analyses, outbreak reports, modeling studies, and genomic epidemiology focusing on CHIKV/ZIKV incursion, transmission dynamics, establishment, burden, or socio-ecological determinants in LAC populations. Two independent reviewers performed screening, data extraction, and quality assessment using Joanna Briggs Institute tools. A critical narrative synthesis was conducted using the novel &lt;i&gt;Structural Vulnerability and Pathogen Plasticity&lt;/i&gt; framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eighteen studies met inclusion criteria. Pathogen plasticity-evidenced by multiple independent introductions, genetic variability, and cryptic transmission (e.g., an unreported 2017 ZIKV outbreak in Cuba uncovered through travel-genomic surveillance)-exploited profound structural vulnerabilities. These included weak surveillance systems (detection rates as low as 1%-6% for ZIKV), inadequate water and sanitation infrastructure driving a knowledge-practice gap (75.2% knowledge vs 30.7% adequate practices), and socioeconomic inequities that concentrated disease burden. Severe impacts were disproportionately borne by marginalized groups, quantified by a 9.0-year disparity in average Years of Life Lost between Black (22.0 years) and White (13.0 years) Brazilians with Chikungunya. Despite the epidemic's waning, 58% of analyzed locations remain at high risk for future ZIKV outbreaks due to discrepancies between environmental suitability and population immunity. A critical geographical evidence bias was identified: 13 studies (72%) were conducted in Latin America (primarily Brazil and Colombia), while only 5 (28%) focused on the Caribbean region, limiting generalizability to smaller island states.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The establishment of CHIKV and ZIKV in LAC represents a biosocial process wherein adaptable pathogens exploit and reinforce structural i","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261438240"},"PeriodicalIF":3.4,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of microbial cell-free DNA next-generation sequencing for invasive mold infection-a single-center retrospective observational study.","authors":"Rebecca Berger, Nina Howard, Sarah Grant, Fernando Centeno, Todd Lasco, Mayar Al Mohajer","doi":"10.1177/20499361261437009","DOIUrl":"https://doi.org/10.1177/20499361261437009","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing invasive mold infections (IMI) is challenging because they typically occur as opportunistic infections in immunocompromised patients who often present with non-specific symptoms. Furthermore, no single test can definitively diagnose IMI, and a proven diagnosis often requires invasive sampling. This sampling can be unsafe and difficult to perform, especially in the immunocompromised population most at risk for these infections.</p><p><strong>Objectives: </strong>The objective of this study is to assess the clinical utility of plasma microbial cell-free DNA next-generation sequencing (mcfDNA-NGS) for diagnosing invasive mold infections in the context of conventional diagnostic methods.</p><p><strong>Design: </strong>Retrospective observational study at a quaternary care center (2017-2025).</p><p><strong>Methods: </strong>The charts of 30 patients with mold-positive mcfDNA-NGS (Karius™ Spectrum; Redwood City, CA, USA) were reviewed, with IMI adjudicated per 2020 EORTC/MSGERC criteria. Provider documentation, medication orders, and patient outcomes were used to assess clinician interpretation of mcfDNA-NGS result accuracy (true positive vs false positive) and its impact on diagnostic and therapeutic decision-making. Turnaround time (TAT) and molecules per microliter (MPM) were summarized.</p><p><strong>Results: </strong>IMI final classifications were proven (6), probable (8), possible (5), and unclassified (11). Overall, 23/30 (77%) results were true positives. Among these 23 patients with true positive results for mold, 5 (22%) received a new clinical adjudication of IMI that had been entirely missed by conventional diagnostic testing. Furthermore, mcfDNA NGS provided species-level pathogen identification in 9 of the 23 (39%) true positive cases where conventional testing detected fungal elements or elevated biomarkers but could not identify the specific organism. Median TAT was 102 h; median MPM 657. MPM did not differ between true and false positives (<i>p</i> = 0.86). mcfDNA-NGS changed diagnostic classification in 7/30 (23%) and antimicrobial management in 16/30 (53%).</p><p><strong>Conclusion: </strong>mcfDNA-NGS provided noninvasive, actionable information, informing diagnosis and therapy. Future studies should define optimal stewardship and cost-effectiveness.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261437009"},"PeriodicalIF":3.4,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haematological responses in children under 5 years with malaria and soil-transmitted helminth coinfections in Delta State, Nigeria: a cross-sectional study.","authors":"Ewomazino Oghenekome Odibo, Onyebiguwa Patrick Goddey Nmorsi, Ogochukwu Andy Egwunyenga, Osaro Mgbere","doi":"10.1177/20499361261425774","DOIUrl":"https://doi.org/10.1177/20499361261425774","url":null,"abstract":"<p><strong>Background: </strong>Malaria and soil-transmitted helminth (STH) infections often co-occur in Nigerian children under 5 years of age, affecting haematological functions. However, local data on their combined effect are limited.</p><p><strong>Objectives: </strong>To determine the prevalence and impact of malaria, STH and malaria-STH co-infection on haematological parameters in children under five in the Delta South Senatorial District in Nigeria.</p><p><strong>Design: </strong>Hospital-based cross-sectional study.</p><p><strong>Methods: </strong>A total of 269 children under 5 years of age attending selected health centres were recruited across the Delta South Senatorial District. Malaria was diagnosed by microscopy, STH by stool analysis and haematological parameters were measured using automated techniques. Associations between infection status, demographics, clinical characteristics and haematological indices were examined with descriptive statistics, <i>T</i>-test, ANOVA and correlation analyses.</p><p><strong>Results: </strong>Co-infection was most common in toddlers aged 1-2 years (40.9%) and was more frequent in males. Normal haemoglobin genotype (Hb AA) predominated (57.3%), followed by sickle cell trait (Hb AS) (36.3%) and sickle cell disease (Hb SS) (6.3%). Children with Hb SS had lower haemoglobin, packed cell volume (PCV) and red blood cell (RBC) counts, but higher white blood cell levels (<i>p</i> < 0.01). Children with malaria or STH, especially those with co-infection, showed a macrocytic hypochromic pattern with increased mean corpuscular volume and reduced mean corpuscular haemoglobin concentration (<i>p</i> < 0.001), despite only mild, non-significant reductions in haemoglobin and RBC counts. Parasitaemia varied with age (<i>p</i> = 0.033) but showed weak correlations with haemoglobin, RBC and PCV, suggesting that anaemia was influenced more by host factors than by parasite burden. Hb AS children had higher parasite loads but better red cell indices; Hb SS cases showed the greatest haematological derangement, particularly when coinfected.</p><p><strong>Conclusion: </strong>Malaria and STH infections remain a major cause of haematological abnormalities in children under five. Early red cell alterations, especially macrocytosis and hypochromia, preceded obvious anaemia and were more strongly influenced by host factors than by parasite density, underscoring the need for integrated control and careful haematological assessment in endemic settings.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261425774"},"PeriodicalIF":3.4,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of hepatitis B virus drug resistance and escape mutations in low- and middle-income countries.","authors":"Esther M E Asamoah, Anastasia A Asantewaa, Samuel N-A Yartey, Nicholas I Nii-Trebi, Eric S Donkor","doi":"10.1177/20499361261431606","DOIUrl":"10.1177/20499361261431606","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) remains highly endemic in many low- and middle-income countries (LMICs), where challenges such as antiviral resistance and immune/vaccine-escape mutations complicate disease management.</p><p><strong>Objective: </strong>This review synthesizes current data on HBV drug resistance, including the prevalence and distribution of resistance-associated mutations (RAMs), vaccine-escape mutations (VEMs), and immune-escape mutations (IEMs) in LMICs.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources: </strong>PubMed, Scopus, and Web of Science.</p><p><strong>Methods: </strong>A systematic search was conducted from 2014 to 2025 (last search date: August 04, 2025), and data were extracted from eligible studies. A random-effects meta-analysis was conducted to estimate pooled resistance rates and prevalences.</p><p><strong>Results: </strong>A total of 43,834 participants from 47 studies conducted in 28 LMICs were included. The overall antiviral resistance rate was 7.87% (95% CI (5.13-11.11)), with very high heterogeneity (<i>I</i> ² = 99.7%). Lamivudine (3TC) and telbivudine (LdT) had the highest resistance rates. Asia consistently reported the greatest resistance, with rates of 32.45% for 3TC and 51.92% for LdT. In a subgroup analysis on economic regions, Lower-middle-income countries showed the highest pooled resistance rate at 10.61% (95% CI (5.21-17.51); <i>I</i> ² = 96.9%). The most frequently detected RAMs were rtM204V/I, rtV173L, and rtL180M. The pooled prevalence of vaccine-escape mutations was 8.92% (95% CI (5.02-13.64); <i>I</i> ² = 78.4%). Immune-escape mutations were much more common, with a pooled prevalence of 55.66% (95% CI (28.10-81.53); <i>I</i> ² = 98.1%). The most prevalent mutations were sG145R/A/K, sQ129H/R, sD144E/A, sS143L/T, and sP120S/T. The pooled estimates in this study are reported and interpreted descriptively, given the substantial heterogeneity observed.</p><p><strong>Conclusion: </strong>The remarkably high drug resistance rates and prevalence of immune and vaccine-escape mutations suggest notable burdens of resistance, especially for drugs with low genetic barriers such as lamivudine and telbivudine, underscoring the growing challenges in achieving the WHO 2030 reduction goals, and highlighting the need for enhanced surveillance, adoption of potent antiviral regimens such as tenofovir disoproxil fumarate, and continuous vaccine efficacy monitoring. However, the results should be interpreted with caution due to the very high heterogeneity observed in the study.</p><p><strong>Trial registration: </strong>International prospective register of systematic reviews (PROSPERO) under the ID: CRD420251030302.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261431606"},"PeriodicalIF":3.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful use of isavuconazole as secondary prophylaxis of cryptococcal meningitis in a person living with HIV and AIDS: a case report.","authors":"Carmela Pinnetti, Alessandro Giacinta, Federico Cecilia, Francesco Baldini, Annalisa Mondi, Saba Gebremeskel Teklè, Susanna Grisetti, Marta Camici, Donatella Vincenti, Stefania Carrara, Carla Fontana, Andrea Antinori","doi":"10.1177/20499361251395903","DOIUrl":"10.1177/20499361251395903","url":null,"abstract":"<p><p>Cryptococcal meningitis (CM) is a severe opportunistic infection in people living with HIV (PLWH). We report a 54-year-old man with advanced HIV infection who presented with CM due to <i>Cryptococcus neoformans</i>. Induction therapy with liposomal amphotericin B (4 mg/kg/day) plus fluconazole (800 mg/day) was prolonged to 10 weeks because flucytosine was initially unavailable; intravenous flucytosine (25 mg/kg q6h) was introduced when accessible. Maintenance fluconazole (800 mg/day) was continued, and antiretroviral therapy (ART) with dolutegravir plus emtricitabine/tenofovir disoproxil was initiated after 8 weeks. One year later, despite virological suppression, he developed neurological deterioration compatible with recurrent CM in the absence of culture confirmation. He underwent re-induction with liposomal amphotericin B plus flucytosine, followed by off-label secondary prophylaxis with oral isavuconazole (200 mg/day). Over 6 months, he maintained HIV-RNA suppression, showed CD4+ T-cell recovery (from 94 to 165 cells/mm³), and experienced neurological stabilization without further CM episodes or drug-related toxicity. Isavuconazole's pharmacokinetic profile, oral availability, and limited antiretroviral drug-drug interactions supported its use as extended secondary prophylaxis in this setting, although limited access in low- and middle-income countries remains a concern. This case highlights isavuconazole as a potential alternative prophylactic strategy when fluconazole is ineffective or not tolerated.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361251395903"},"PeriodicalIF":3.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}