Journal of Infectious Diseases最新文献

{"title":"Assessing Infectiousness and the Impact of Effective Treatment to Guide Isolation Recommendations for People With Pulmonary Tuberculosis.","authors":"Ruvandhi R Nathavitharana, Abarna Pearl, Amanda Biewer, Christie Tzelios, Sundari Mase, Sonal S Munsiff, Edward Nardell","doi":"10.1093/infdis/jiae482","DOIUrl":"10.1093/infdis/jiae482","url":null,"abstract":"<p><p>Determining the extent and duration of infectiousness of people with pulmonary tuberculosis (PWPTB) is critical for various aspects of tuberculosis care, including decisions regarding isolation. Studies suggest considerable heterogeneity in infectiousness of PWPTB. Pretreatment, measures of bacillary burden, including sputum smear microscopy, culture time to positivity, and Xpert MTB/RIF cycle threshold (Ct) value, predict the risk of transmission to contacts. Index patients with smear-negative disease pose lower infectious risk than those who have smear-positive disease, and household contact infection is more likely with index patients who have lower Xpert Ct values. Newer tools that enable detection of Mycobacterium tuberculosis complex from cough aerosol sampling and face mask sampling may be better predictors of contact infection risk. Clinical factors such as cough strength and frequency, and presence of cavitation on chest imaging, may also assist with risk prediction. Posttreatment, smear and culture status are poor predictors of infectiousness. While the exact duration of infectiousness post-treatment initiation remains uncertain, data from human-to-guinea pig transmission studies and clinical studies suggest that effective treatment results in a rapid decline in infectiousness, irrespective of smear or culture conversion. This is largely supported by early bactericidal activity and transcriptomic studies, as well as cough aerosol sampling studies, although a subset of patients may have persistent cough aerosol positivity. These findings can enable a more nuanced approach to isolation decision making while further research studies are awaited.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"10-22"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-C Motif Ligand 7 and C-C Motif Chemokine Receptor 3 Dysregulation in Patients With Scrub Typhus and Association With Mortality.","authors":"Thor Ueland, Elisabeth Astrup, Kari Otterdal, Tove Lekva, Jeshina Janardhanan, Annika E Michelsen, Pål Aukrust, George M Varghese, Jan K Damås","doi":"10.1093/infdis/jiae401","DOIUrl":"10.1093/infdis/jiae401","url":null,"abstract":"<p><strong>Background: </strong>Scrub typhus, caused by Orientia tsutsugamushi, involves infiltration of a mixture of perivascular lymphocytes and macrophages into affected organs. We investigated if this is characterized by chemokine dysregulation.</p><p><strong>Methods: </strong>mRNA expression of chemokines and receptors was screened in whole blood by cDNA microarray in a subgroup of patients and controls. Regulated transcripts were analyzed in plasma by enzyme immunoassays (chemokines) and in whole blood by quantitative polymerase chain reaction (receptors) from patients with scrub typhus (n = 129), patients with similar febrile illness without O tsutsugamushi infection (n = 31), and healthy controls (n = 31).</p><p><strong>Results: </strong>cDNA microarray identified dysregulation of the chemokines CCL18 and CCL23 and the receptor CCR3 in severe scrub typhus. Plasma CCL7 (a ligand for CCR3), CCL18, and CCL23 were higher in patients with scrub typhus, with a decline during follow-up. Conversely, mRNA levels of CCR3 and CCR8 (the receptor for CCL18) were decreased in whole blood at hospital admission, followed by an increase during follow-up. CCL7 was independently associated with disease severity. Admission CCL7 levels were associated with short-time mortality.</p><p><strong>Conclusions: </strong>Our findings suggest that CCL7 could represent a hitherto unknown pathogenic mediator in O tsutsugamushi infection, contributing to local and systemic inflammation.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e59-e67"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Artemether-Lumefantrine Against Uncomplicated Falciparum Malaria Infection in Tanzania, 2022: A Single-Arm Clinical Trial.","authors":"Jessica E Laury, Kefas Mugittu, Debora C Kajeguka, Erasmus Kamugisha, Deus S Ishengoma, Celine I Mandara, Billy Ngasala, Mercy G Chiduo, Muhidin K Mahende, Jovin Kitau, Maimuna M Ahmed, Sixbert I Mkumbaye, Filbert Francis, Frank Chacky, Marian Warsame, Naomi Serbantez, Chonge Kitojo, Erik J Reaves, Dunstan R Bishanga, Marko Bajic, Bilali I Kabula, Florida Muro, Reginald A Kavishe","doi":"10.1093/infdis/jiae425","DOIUrl":"10.1093/infdis/jiae425","url":null,"abstract":"<p><strong>Background: </strong>Artemether-lumefantrine (AL) is the first-line antimalarial drug for the treatment of uncomplicated malaria in Tanzania. The World Health Organization (WHO) recommends regular efficacy monitoring of antimalarial drugs to inform case management policy decisions. This study assessed the safety and efficacy of AL for treating uncomplicated Plasmodium falciparum malaria in Tanzania in 2022.</p><p><strong>Methods: </strong>Children aged 6 months to 10 years with uncomplicated P falciparum malaria were recruited from 4 sentinel sites and treated with the standard 6-dose, 3-day regimen for AL. Clinical and parasitological responses were monitored for 28 days using the WHO standard protocol. Genotyping based on msp1, msp2, and glurp was used to distinguish recrudescence from reinfection. Sanger sequencing was used to detect K13 mutations.</p><p><strong>Results: </strong>Three hundred fifty-two participants, 88 per site, were enrolled. Four withdrew and 55 experienced parasite recurrence. The polymerase chain reaction (PCR)-corrected Kaplan-Meier efficacies were 89.9% in Pwani, 95.0% in Kigoma, 94.4% in Tanga, and 98.9% in Morogoro. No K13 mutations were found.</p><p><strong>Conclusions: </strong>Artemether-lumefantrine remains highly efficacious in 3 regions of Tanzania, but the PCR-corrected efficacy in Pwani fell below the WHO-defined 90% threshold at which policy change is recommended. Implementing strategies to diversify artemisinin-based combination therapies to ensure effective case management in Tanzania is critical.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"251-259"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Resistance and Epidemiological Success of Modern Mycobacterium tuberculosis Lineages in Western India.","authors":"Avika Dixit, Yasha Ektefaie, Anju Kagal, Luca Freschi, Rajesh Karyakarte, Rahul Lokhande, Matthias Groschel, Jeffrey A Tornheim, Nikhil Gupte, Neeta N Pradhan, Mandar S Paradkar, Sona Deshmukh, Dileep Kadam, Marco Schito, David M Engelthaler, Amita Gupta, Jonathan Golub, Vidya Mave, Maha Farhat","doi":"10.1093/infdis/jiae240","DOIUrl":"10.1093/infdis/jiae240","url":null,"abstract":"<p><strong>Background: </strong>Drivers of tuberculosis (TB) transmission in India, the country estimated to carry a quarter of the world's burden, are not well studied. We conducted a genomic epidemiology study to compare epidemiological success, host factors, and drug resistance among the 4 major Mycobacterium tuberculosis (Mtb) lineages (L1-L4) circulating in Pune, India.</p><p><strong>Methods: </strong>We performed whole-genome sequencing (WGS) of Mtb sputum culture-positive isolates from participants in two prospective cohort studies and predicted genotypic susceptibility using a validated random forest model. We compared lineage-specific phylogenetic and time-scaled metrics to assess epidemiological success.</p><p><strong>Results: </strong>Of the 612 isolates that met sequence quality criteria, Most were L3 (44.6%). The majority (61.1%) of multidrug-resistant isolates were L2 (P < .001) and L2 demonstrated a higher rate and more recent resistance acquisition. L4 and/or L2 demonstrated higher clustering and time-scaled haplotypic density (THD) compared to L3 and/or L1, suggesting higher epidemiological success. L4 demonstrated higher THD and clustering (odds ratio, 5.1 [95% confidence interval, 2.3-12.3]) in multivariate models controlling for host factors and resistance.</p><p><strong>Conclusions: </strong>L2 shows a higher frequency of resistance, and both L2 and L4 demonstrate evidence of higher epidemiological success than L3 or L1 in Pune. Contact tracing around TB cases and heightened surveillance of TB DR in India is a public health priority.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"84-93"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Smoking on Longitudinal Interferon γ Release Assay Results Among Close Contacts of People with Pulmonary Tuberculosis.","authors":"María B Arriaga, Gustavo Amorim, Marina C Figueiredo, Cody Staats, Afrânio L Kritski, Marcelo Cordeiro-Santos, Valeria C Rolla, Bruno B Andrade, Timothy R Sterling","doi":"10.1093/infdis/jiae285","DOIUrl":"10.1093/infdis/jiae285","url":null,"abstract":"<p><p>Diagnosis of Mycobacterium tuberculosis infection in close contacts is critical for tuberculosis control. Smoking is a risk factor for M. tuberculosis infection and tuberculosis disease but its effect on longitudinal interferon γ release assay (IGRA) results remains unknown. We conducted a multisite prospective study in Brazil between 2015 and 2019, among close contacts of adults with culture-confirmed pulmonary tuberculosis. IGRA was performed at baseline, at month 6 if results were negative at baseline, and at months 24-30 after enrollment. IGRA results were categorized as IGRA positive (maintained from baseline to the last visit), IGRA conversion (from negative to positive at any time), IGRA reversion (from positive to negative at any time), and IGRA negative (maintained from baseline to the last visit). Associations between IGRA results and smoking status at baseline (current/former vs never) in contacts were evaluated using propensity score-adjusted logistic regression models. Estimated propensity score was used as a covariate in models, which regressed the outcome (IGRA positive, IGRA conversion, IGRA reversion) on smoking status. Of 430 close contacts, 89 (21%) were IGRA positive, 30 (7%) were converters, 30 (7%) were reverters and 22 were indeterminate. Smoking frequency was 26 (29%) among IGRA-positive contacts, 7 (23%) in converters, and 3 (10%) in reverters. Smoking in contacts was associated with lower odds of IGRA reversion (adjusted odds ratio, 0.16 [95% confidence interval, .03-.70]). We did not detect associations between smoking and IGRA positive or IGRA conversion. Our findings highlight the importance of smoking on longitudinal IGRA results. This has implications for clinical care and clinical trials in which IGRA status is monitored or used as an outcome.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"103-108"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Plasma Matrix Metalloproteinases Are Associated With Mycobacterium tuberculosis Bloodstream Infection and Mortality in Human Immunodeficiency Virus-Associated Tuberculosis.","authors":"Naomi F Walker, Charlotte Schutz, Amy Ward, David Barr, Charles Opondo, Muki Shey, Paul T Elkington, Katalin A Wilkinson, Robert J Wilkinson, Graeme Meintjes","doi":"10.1093/infdis/jiae296","DOIUrl":"10.1093/infdis/jiae296","url":null,"abstract":"<p><p>Mortality from human immunodeficiency virus (HIV)-associated tuberculosis (TB) is high, particularly among hospitalized patients. In 433 people with HIV hospitalized with symptoms of TB, we investigated plasma matrix metalloproteinases (MMP) and matrix-derived biomarkers in relation to TB diagnosis, mortality, and Mycobacterium tuberculosis (Mtb) bloodstream infection (BSI). Compared to other diagnoses, MMP-8 was elevated in confirmed TB and in Mtb-BSI, positively correlating with extracellular matrix breakdown products. Baseline MMP-3, -7, -8, -10, and PIIINP were associated with Mtb-BSI and 12-week mortality. These findings implicate MMP dysregulation in pathophysiology of advanced HIV-TB and support MMP inhibition as a host-directed therapeutic strategy for HIV-TB.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"109-114"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Evaluation of the Diagnostic Accuracy of the Point-of-Care VISITECT CD4 Advanced Disease Test in 7 Countries.","authors":"Tinne Gils, Jerry Hella, Bart K M Jacobs, Bianca Sossen, Madalo Mukoka, Monde Muyoyeta, Elizabeth Nakabugo, Hung Van Nguyen, Sasiwimol Ubolyam, Aurélien Macé, Marcia Vermeulen, Sarah Nyangu, Nsala Sanjase, Mohamed Sasamalo, Huong Thi Dinh, The Anh Ngo, Weerawat Manosuthi, Supunnee Jirajariyavej, Claudia M Denkinger, Nhung Viet Nguyen, Anchalee Avihingsanon, Lydia Nakiyingi, Rita Székely, Andrew D Kerkhoff, Peter MacPherson, Graeme Meintjes, Klaus Reither, Morten Ruhwald","doi":"10.1093/infdis/jiae374","DOIUrl":"10.1093/infdis/jiae374","url":null,"abstract":"<p><strong>Background: </strong>CD4 measurement is pivotal in the management of advanced human immunodeficiency virus (HIV) disease. VISITECT CD4 Advanced Disease (VISITECT; AccuBio, Ltd) is an instrument-free, point-of-care, semiquantitative test allowing visual identification of CD4 ≤ 200 cells/µL or >200 cells/ µL from finger-prick or venous blood.</p><p><strong>Methods: </strong>As part of a diagnostic accuracy study of FUJIFILM SILVAMP TB LAM, people with HIV ≥18 years old were prospectively recruited in 7 countries from outpatient departments if a tuberculosis symptom was present, and from inpatient departments. Participants provided venous blood for CD4 measurement using flow cytometry (reference standard) and finger-prick blood for VISITECT (index text), performed at point-of-care. Sensitivity, specificity, and positive and negative predictive values of VISITECT to determine CD4 ≤ 200 cells/ µL were evaluated.</p><p><strong>Results: </strong>Among 1604 participants, the median flow cytometry CD4 was 367 cells/µL (interquartile range, 128-626 cells/µL) and 521 (32.5%) had CD4 ≤ 200 cells/µL. VISITECT sensitivity was 92.7% (483/521; 95% confidence interval [CI], 90.1%-94.7%) and specificity was 61.4% (665/1083; 95% CI, 58.4%-64.3%). For participants with CD4 0-100, 101-200, 201-300, 301-500, and >500 cells/µL, VISITECT misclassified 4.5% (95% CI, 2.5%-7.2%), 12.5 (95% CI, 8.0%-18.2%), 74.1% (95% CI, 67.0%-80.5%), 48.0% (95% CI, 42.5%-53.6%), and 22.6% (95% CI, 19.3%-26.3%), respectively.</p><p><strong>Conclusions: </strong>VISITECT's sensitivity, but not specificity, met the World Health Organization's minimal sensitivity and specificity threshold of 80% for point-of-care CD4 tests. VISITECT's quality needs to be assessed and its accuracy optimized. VISITECT's utility as CD4 triage test should be investigated. Clinical Trials Registration. NCT04089423.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e82-e90"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Ethics in Public Health Guideline Development: Case Study of Guidelines on Respiratory Isolation for Persons With Tuberculosis in Community Settings.","authors":"Olivia S Kates, Maunank Shah","doi":"10.1093/infdis/jiae478","DOIUrl":"10.1093/infdis/jiae478","url":null,"abstract":"<p><p>Public health interventions often involve explicit trade-offs in which the health of the many must be weighed against burdens imposed on individuals. We describe development of public health guidelines for respiratory isolation in community settings for persons with tuberculosis. While stopping the spread of disease is a core moral imperative in public health, the duty to prevent disease transmission does not supersede all other considerations. Community well-being must be balanced with individual well-being, liberty, and social justice. In response to these challenges, the National Tuberculosis Coalition of America's 2024 guidelines for persons with tuberculosis in community settings were developed using a modified GRADE approach supported by a complementary, comprehensive, and context-specific ethical framework. By addressing the distinct roles that evidence (subject to uncertainty), values, justificatory conditions, and procedural legitimacy all play in ethical guideline development, we promote rigor and transparency in the integration of ethics in public health guidelines.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"23-30"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombocytopenia in Severe Fever with Thrombocytopenia Syndrome Due to Platelets With Altered Function Undergoing Cell Death Pathways.","authors":"Yaohui Fang, Shu Shen, Jingyuan Zhang, Ling Xu, Tong Wang, Lei Fan, Qiong Zhu, Jian Xiao, Xiaoli Wu, Jiayin Jin, Qiaoli Wu, Yanfang Zhang, Shuang Tang, Xin Zheng, Fei Deng","doi":"10.1093/infdis/jiae355","DOIUrl":"10.1093/infdis/jiae355","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia is the major clinical feature of severe fever with thrombocytopenia syndrome (SFTS), but the mechanism by which it occurs remains unclear.</p><p><strong>Methods: </strong>RNA transcriptome analyses were performed on platelets purified from patients with SFTS and mice infected with SFTS virus (SFTSV). The functions of differentially expressed genes (DEGs) in the platelets were characterized. Enzyme-linked immunosorbent assay, flow cytometry, and quantitative reverse-transcription polymerase chain reaction were used to measure the levels of platelet activation, SFTSV infection in platelets, formation of neutrophil extracellular traps, transcription of DEGs, and the percentage of platelets undergoing cell death.</p><p><strong>Results: </strong>Enhanced neutrophil activation and interferon signaling involved in the viral life cycle were common platelet responses in SFTS, which may consume increasing numbers of platelets. Other functional changes may be associated with different outcomes of SFTS. SFTSV infection led to platelet destruction by pyroptosis, apoptosis, necroptosis, and autophagy. Platelets in SFTSV-infected mice mainly play a role in adaptive immunity, and platelet death was not as severe as in humans.</p><p><strong>Conclusions: </strong>The altered functions of platelets, including mediating leukocyte activation and undergoing cell death, contribute to thrombocytopenia in patients with SFTS. The different mechanisms of thrombocytopenia in mice suggest that platelet functions should be considered in experimental animal models.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e183-e194"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Spread of HIV-1 CRF55_01B in its Place of Origin: Dynamics and Hotspots.","authors":"Minghui An, Chenli Zheng, Lin Chen, Hao Li, Yan Zhang, Yongxia Gan, Bin Zhao, Hui Zhang, Xiaoxu Han, Jin Zhao, Hong Shang","doi":"10.1093/infdis/jiae428","DOIUrl":"10.1093/infdis/jiae428","url":null,"abstract":"<p><strong>Background: </strong>Shenzhen, a city with a substantial mobile population, was identified as the first discovered region of human immunodeficiency virus-1 (HIV-1) CRF55_01B and epicenter of its severe epidemic. During the implementation of venue-based behavioral interventions and the \"treat-all\" policy, identifying the patterns of spread and transmission hotspots of CRF55_01B is imperative.</p><p><strong>Methods: </strong>In this study, 1450 partial pol sequences, with demographic information, were collected from all newly diagnosed CRF55_01B infections in Shenzhen from 2008 to 2020. Molecular networks were constructed using the maximum likelihood and time-resolve phylogenies. Transmission rates, effective reproduction numbers (Re) of clusters, and viral dispersal were evaluated using Bayesian inference.</p><p><strong>Results: </strong>In total, 526 sequences formed 114 clusters, including 7 large clusters. The status and size of clusters were strongly correlated with age, ethnicity, occupation, and CD4+ T-cell counts. The transmission rates of clusters were significantly higher than the national epidemic estimate. Four large clusters had Re exceeding 1 at the end of the sampling period. Immigrants from Guangdong and Hunan, along with local residents, were identified as the transmission hubs, with heterosexual men being the main source and MSM being the main destination. The virus exhibited a high movement frequency from individuals aged 30-49 years toward diverse age groups.</p><p><strong>Conclusions: </strong>This study demonstrated that the hidden CRF55_01B transmissions continued despite current combined interventions in Shenzhen, and at-risk individuals susceptible to infection or transmission were identified, potentially serving as targets for more effective prevention and control of the local epidemic, thereby mitigating cross-regional spread nationwide due to population migration.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"137-146"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}