BMC Infectious Diseases最新文献

{"title":"Application of type-2 heptagonal fuzzy sets with multiple operators in multi-criteria decision-making for identifying risk factors of Zika virus.","authors":"M Sheela Rani, S Dhanasekar","doi":"10.1186/s12879-025-10741-9","DOIUrl":"10.1186/s12879-025-10741-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to identify and rank the key risk factors associated with the Zika virus by leveraging a novel multi-criteria decision-making (MCDM) framework based on type-2 heptagonal fuzzy sets. By integrating advanced aggregation operators, the framework effectively addresses uncertainties in expert assessments and enhances decision-making reliability.</p><p><strong>Methods: </strong>A robust MCDM approach was developed using type-2 heptagonal fuzzy sets, which provide a more nuanced representation of uncertainty compared to traditional fuzzy models. These sets were selected due to their superior ability to handle vague, imprecise, and subjective expert judgments, common challenges in epidemiological risk assessments. Arithmetic and geometric aggregation operators were employed to process fuzzy data effectively. To ensure comprehensive and reliable rankings, the framework incorporated both outranking methods and distance-based approaches, specifically TOPSIS and WASPAS. A sensitivity analysis was conducted to validate the stability of the rankings under varying conditions.</p><p><strong>Results: </strong>The proposed framework identified <math><msub><mi>Z</mi> <mn>3</mn></msub> </math> (unprotected sexual activity) as the most critical risk factor with a score of 0.6717, followed by <math><msub><mi>Z</mi> <mn>8</mn></msub> </math> (blood transfusions) at 0.5783, <math><msub><mi>Z</mi> <mn>10</mn></msub> </math> (pregnancy) at 0.5753, <math><msub><mi>Z</mi> <mn>9</mn></msub> </math> (mosquito bites) at 0.4917, and <math><msub><mi>Z</mi> <mn>7</mn></msub> </math> (travel to endemic areas) at 0.4726. The rankings remained consistent across different MCDM methods (TOPSIS and WASPAS), demonstrating the robustness of the proposed approach. Pearson correlation analysis confirmed a strong agreement between methods, with correlation coefficients, reinforcing the reliability of the model.</p><p><strong>Conclusion: </strong>This study introduces an advanced decision-support system for healthcare professionals to systematically identify and prioritize Zika virus risk factors. By leveraging type-2 heptagonal fuzzy sets, the framework effectively captures and processes uncertainty stemming from incomplete epidemiological data, imprecise expert assessments, and subjective linguistic evaluations. The consistency of rankings across multiple MCDM methods, along with sensitivity analysis confirming their stability, demonstrates the model's reliability. These findings provide a scientifically grounded tool for improving risk analysis and strategic public health interventions.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"450"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in systematic screening for tuberculosis among antiretroviral therapy naïve people with HIV in Kampala, Uganda.","authors":"Lelia H Chaisson, Fred C Semitala, Sandra Mwebe, Eileen P Scully, Jane Katende, Lucy Asege, Martha Nakaye, Alfred O Andama, Adithya Cattamanchi, Christina Yoon","doi":"10.1186/s12879-025-10835-4","DOIUrl":"10.1186/s12879-025-10835-4","url":null,"abstract":"<p><strong>Background: </strong>Systematic tuberculosis (TB) screening is recommended for all people with HIV (PWH) because of its potential to improve TB outcomes through earlier diagnosis and treatment initiation. As such, systematic screening may be particularly important for men, who experience excess TB prevalence and mortality compared to women. We assessed sex differences among PWH undergoing systematic TB screening, including TB prevalence and severity, diagnostic accuracy of screening tools, and TB outcomes.</p><p><strong>Methods: </strong>We enrolled and followed adults with HIV (CD4 ≤ 350 cells/µL) initiating antiretroviral therapy (ART) at two HIV/AIDS clinics in Uganda from July 2013 to December 2016. All participants underwent TB screening and sputum collection for TB testing (Xpert MTB/RIF [Xpert], culture). We evaluated diagnostic accuracy of four WHO-recommended TB screening strategies (symptom screen; C-reactive protiein [CRP]; symptom screen followed by CRP, if symptomatic [symptoms + CRP]; Xpert) for culture-positive TB and compared TB prevalence, days-to-treatment initiation, and 3-month mortality by sex.</p><p><strong>Results: </strong>Of 1,549 participants, 727 (46.9%) were male and 236 (15.2%) had culture-positive TB. Compared to females, males had lower pre-ART CD4 counts (median 139 vs. 183 cells/µL, p < 0.001), higher TB prevalence (20.5% vs. 10.6%, p < 0.001), and higher mycobacterial load as measured by Xpert semi-quantitative grade (p = 0.03). Sensitivity was high (≥ 89.8%) for all screening strategies except Xpert (Xpert sensitivity 57.2%) and did not differ by sex. Specificity varied widely from 13.9% for symptom screen to 99.2% for Xpert, and was 5-15% lower for males than females for symptom screen, CRP, and symptoms + CRP. Among PWH with culture-positive TB, median days-to-treatment initiation (2 vs. 4, p = 0.13) and 3-month mortality (9.4% vs. 9.2%, p = 0.96) were similar for males and females.</p><p><strong>Conclusions: </strong>Although ART-naïve males undergoing systematic screening had more advanced HIV and TB than females, days-to-TB treatment initiation and early TB mortality were similar, suggesting that systematic TB screening has the potential to reduce sex-based disparities in TB outcomes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"452"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Efficacy and safety of polymyxin B sulfate versus colistin sulfate in ICU patients with nosocomial pneumonia caused by carbapenem-resistant Acinetobacter baumannii: a multicenter, propensity score-matched, real-world cohort study.","authors":"Wei Bu, Chengyu Wang, Yuan Wu, Peng Zhang, Nengfang Zhang, Ying Han, Xiaona Xu, Sha Li, Yan Cai","doi":"10.1186/s12879-025-10859-w","DOIUrl":"10.1186/s12879-025-10859-w","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"451"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive care unit-based mortality risk model construction for severe fever with thrombocytopenia syndrome patients: a retrospective study.","authors":"Puhui Liu, Fangyuan Liu, Chunhui Wang, Aimin Mu, Chuanzhen Niu, Shihong Zhu, Ji Wang","doi":"10.1186/s12879-025-10828-3","DOIUrl":"10.1186/s12879-025-10828-3","url":null,"abstract":"<p><strong>Objective: </strong>This study develops a predictive model to evaluate mortality risk in severe fever with thrombocytopenia syndrome (SFTS) patients in intensive care units (ICU) to improve the accuracy of prognosis and guide the optimization of treatment strategies.</p><p><strong>Methods: </strong>In this study, a retrospective analysis was conducted on severe SFTS patients admitted to the ICU between July 2019 and October 2023. Patients were categorized into survival and mortality groups. Multivariate logistic regression was performed to determine independent risk factors (IRFs) for mortality. In addition, the nomogram model was constructed and its performance was assessed through ROC curves.</p><p><strong>Results: </strong>The study comprised 218 severe SFTS patients. The mortality group showed significantly lower Glasgow Coma Scale (GCS) scores, oxygenation indices, and higher levels of several serological markers, log10(virus loads), and lactic acid. Multivariate analysis identified GCS score [odds ratio (OR) = 0.66, P < 0.001], log10(virus loads) [OR = 2.24, P = 0.001], lactic acid [OR = 1.60, P = 0.01], and cystatin C [OR = 1.80, P = 0.049] as IRFs for mortality. A nomogram incorporating these IRFs demonstrated excellent predictive accuracy (AUC = 0.92, 95% CI: 0.88-0.96), with a sensitivity of 76% and a specificity of 91%. This model showed adequate fit and good clinical applicability.</p><p><strong>Conclusion: </strong>The nomogram model, based on GCS score, log10(virus loads), lactic acid, and cystatin C, offers clinical utility in predicting 28-day mortality for severe SFTS patients, though further validation is needed.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"449"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in gut microbiome following anti-tuberculosis treatment: a prospective cohort from eastern China.","authors":"Simin Zhang, Zhipeng Xu, Zhan Wang, Xinru Fei, Zhongqi Li, Limei Zhu, Leonardo Martinez, Jianming Wang, Qiao Liu","doi":"10.1186/s12879-025-10800-1","DOIUrl":"10.1186/s12879-025-10800-1","url":null,"abstract":"<p><strong>Background: </strong>The treatment of people with tuberculosis necessitates the administration of both broad-spectrum and narrow-spectrum antibiotics for a minimum duration of six months. Prolonged antibiotic therapy may result in dysregulation of the gut microbiota, potentially influencing the onset and progression of tuberculosis. There is a paucity of studies focus on the characteristics of gut microbiota changes at various time points during tuberculosis treatment. This study aims to elucidate the relationship between the composition of gut microbiota and their stage within anti-tuberculosis therapy.</p><p><strong>Methods: </strong>A multi-center, observational prospective cohort study was conducted at four designated hospitals in Jiangsu Province in eastern China. The Gastrointestinal Symptom Rating Scale was employed to evaluate the gastrointestinal discomfort experienced during anti-tuberculosis treatment. Fecal samples were collected at baseline before initiating anti-tuberculosis therapy and at the end of 2 months and 6 months during treatment. Total microbial genomic DNA was extracted and sequenced. Rarefaction curves and alpha diversity indices including observed operational taxonomic units, Chao1 richness and Shannon index were calculated.</p><p><strong>Results: </strong>From October 2020 to December 2022, a total of 204 people with tuberculosis were diagnosed. Among these, 85 people with tuberculosis provided baseline, 2-month, and 6-month fecal samples. The average age was 41.8 ± 15.193 years, with a gender ratio of 77 males to 8 females. Only 28.2% of the cohort reported being free of gastrointestinal symptoms during anti-tuberculosis treatment. Anti-tuberculosis treatment significantly reduced gut microbiota diversity, with a transient decrease in alpha diversity indices observed after two months. A higher alpha diversity in baseline (Shannon index with mean ± standard deviation (SD) 2.92 ± 0.93 vs. 2.50 ± 0.84, P = 0.0014, inverse Simpson's index with 11.9 ± 8.66 vs. 7.87 ± 6.42, P = 0.0012), compared with people with tuberculosis after 2 months of treatment. No significant differences were identified between 2 months of treatment and at the end of treatment microbiota diversity (Shannon index 2.50 ± 0.84 vs 2.58 ± 0.81, P = 0.55, inverse Simpson's index 7.87 ± 6.42 vs 11.90 ± 8.66, P = 0.43).</p><p><strong>Conclusions: </strong>Findings from our study show that anti-tuberculosis treatment has profound effects on people with tuberculosis gastrointestinal function and the gut microbiota, particularly during the intensive phase of therapy. After the intensive treatment phase, the gut microbiota has partially recovered, but it is an extremely slow process.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"453"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic and clinical perspectives of metagenome sequencing as a diagnostic tool for infectious disease: an interpretive phenomenological study.","authors":"Hannah Trivett, Alistair C Darby, Oyinlola Oyebode","doi":"10.1186/s12879-025-10820-x","DOIUrl":"10.1186/s12879-025-10820-x","url":null,"abstract":"<p><strong>Background: </strong>Effective infectious disease diagnostics (IDD) are vital for informing clinical decision-making regarding the treatment and patient management of disease and infections. In England, conventional clinical methods rely upon culture-dependent techniques, and there has been little shift in the acceptance and integration of culture-independent sequencing methods into routine clinical IDD. This study explored stakeholders' experiences within IDD, including those working in clinical settings and those conducting research at the forefront of microbial genomics. From the participants' experiences, the study aimed to identify barriers and facilitators driving the development and implementation of metagenome sequencing as a routine diagnostic.</p><p><strong>Methods: </strong>Virtual semi-structured interviews were conducted with purposively selected individuals involved in IDD. The interviews explored the experiences of implementing metagenome sequencing as a diagnostic tool and decisions about which diagnostics are used for identifying bacteria-causing infections. Thematic analysis was used to analyse the data, and an Interpretive Phenomenological approach was used throughout.</p><p><strong>Results: </strong>Ten individuals were interviewed between July 2021 and October 2021, including clinical scientists, consultants, and professors in academia. Their experience ranged from limited knowledge of metagenome sequencing to an expert understanding of the phenomenon. The thoughts and perspectives of participants of the study could be grouped into five themes: Availability of diagnostics for infectious diseases; Clinical laboratory infrastructure; Ethical Data Sharing: Enhancing metagenomics through Open Access; Case study in action: COVID-19; and The importance of communication to improve developments of new diagnostics. Participants recognised the need for new diagnostics to be implemented to overcome the limitations of current diagnostic approaches but highlighted the barriers to integrating new diagnostics into clinical settings, such as the impact on clinical decision-making, accreditation, and cost. Further, participants felt that lessons could be learnt from using metagenomics in COVID-19 and how other diagnostic platforms have been integrated into clinical settings over the last 20 years.</p><p><strong>Conclusions: </strong>The study provided insights into stakeholders' perspectives and opinions to address the knowledge gap in current literature and identified barriers and facilitators which drive the implementation of metagenome sequencing as a routine IDD in clinical settings. Knowledge of new and upcoming genomic diagnostic testing is not equally distributed throughout the UK, impacting the understanding and drive to integrate metagenome sequencing into routine clinical diagnostics. Improvements in access to new diagnostics could improve patient treatment and management and positively impact population health.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"448"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of non-hospitalized patients with COVID-19 versus seasonal influenza during the fall-winter 2022-2023 period.","authors":"Wan-Hsuan Hsu, Bo-Wen Shiau, Ya-Wen Tsai, Jheng-Yan Wu, Ting-Hui Liu, Po-Yu Huang, Min-Hsiang Chuang, Chih-Cheng Lai","doi":"10.1186/s12879-025-10833-6","DOIUrl":"10.1186/s12879-025-10833-6","url":null,"abstract":"<p><strong>Background: </strong>The comparability of outcomes for non-hospitalized COVID-19 outpatients during the Omicron wave to outpatients with influenza remains uncertain. This study aims to compare the outcomes of non-hospitalized outpatients with COVID-19 and seasonal influenza during the fall-winter of 2022-2023.</p><p><strong>Methods: </strong>This is a retrospective cohort study using TriNetX, a collaborative clinical research platform. Non-hospitalized outpatients with COVID-19 and seasonal influenza between 01 October 2022 and 31 January 2023 were selected from TriNetX. Propensity score matching (PSM) was used to compare patients receiving corresponding outpatient antiviral treatments. Hazard ratios (HRs) with 95% confidence intervals (CIs) for the primary outcome-a composite of all-cause emergency department (ED) visits, hospitalizations, or mortality during the 30-day follow-up period-were calculated and compared.</p><p><strong>Results: </strong>After PSM, two well-balanced groups of 9,030 patients each were identified. Non-hospitalized COVID-19 patients had a lower risk of primary composites outcomes including all-cause ED visits, hospitalization, or mortality (5.9% vs. 9.2%, HR, 0.661[95% CI, 0.593-0.737]) compared to the influenza group. In addition, the COVID-19 group demonstrated a reduced risk of all-cause ED visits (4.4% vs. 6.6%, HR 0.683[0.601-0.776]), hospitalization (1.7% vs. 2.9%, HR 0.605[0.495-0.739]) and mortality (0.1% vs. 0.2%, HR 0.176[0.052-0.597]), respectively.</p><p><strong>Conclusions: </strong>This study indicates a lower risk of all-cause ED visits, hospitalization, and mortality in the non-hospitalized COVID-19 patients compared to the seasonal influenza group, supporting the current public health strategy of adjusting COVID-19 management based on approaches used for seasonal influenza.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"442"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 QuantiFERON TB gold plus among TB household contacts in high incidence settings.","authors":"Sophie Nalukwago, Bonnie Thiel, Keith Chervenak, AnnaRitah Namuganga, LaShaunda L Malone, Mary Nsereko, W Henry Boom, Harriet Mayanja-Kizza","doi":"10.1186/s12879-025-10812-x","DOIUrl":"10.1186/s12879-025-10812-x","url":null,"abstract":"<p><strong>Background: </strong>Accurately identifying and categorizing individuals who are latently infected is critical for developing prevention strategies against tuberculosis (TB) disease. The QuantiFERON-TB Gold Plus (QFT-Plus), a set of two antigen tubes, was used to assess TB household contacts, aiming to induce CD4 + and CD8 + T cell responses.</p><p><strong>Methods: </strong>We examined fifty-six TB household contacts for TB infection using the QFT-Plus and QFT-Gold In-Tube (QFT-GIT) tests. In addition, we evaluated 616 samples from the parent study to determine whether there was any association between the QFT-Plus CD8 + T cell responses and variables that were clinically significant. This was done by analyzing the difference in interferon-gamma (IFNγ) levels between TB2 and TB1 tubes. We utilised a cut-off of 0.6 IU/mL.</p><p><strong>Results: </strong>To assess agreement between tests, a Cohen's kappa of 0.71 was observed across 56 TB contacts. Eight participants reported discordance: four reported positive QFT-Plus and negative QFT-GIT, and four reported negative QFT-Plus and positive QFT-GIT. The QFT-Plus CD8 + T cell responses did not show any significant correlation with the age, sex, history of BCG vaccination, HIV infection, TB risk score and baseline blood draw among adult TB household contacts.</p><p><strong>Conclusion: </strong>The QFT-Plus and QFT-GIT tests significantly agree with one another. No clinically significant variable was observed to be associated with CD8 + T cell responses in QFT-Plus.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"447"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low CD4 count was characterized in recent HIV CRF01_AE infection and it rapidly increased to reach a peak in the first year since ART initiation.","authors":"Xue-Ying Zhang, Li Wang, Yue Jiang, Si-Miao Huang, Hong-Rui Zhu, Wei Liu, Jia-Ye Wang, Xiang-Hui Wei, Yi-Lin Zhao, Wen-Juan Wei, Teng Fei, Xiao-Hong Chen, Dan Wang, Jin-Liang Li, Hong Ling, Min Zhuang","doi":"10.1186/s12879-025-10799-5","DOIUrl":"10.1186/s12879-025-10799-5","url":null,"abstract":"<p><strong>Background: </strong>Currently, most people living with HIV (PLWH) in China have a strong awareness of diagnosis and treatment in the early stage of HIV infection. Subtype-specific virological and immunological features of recently infected PLWH have not yet been elucidated.</p><p><strong>Methods: </strong>Data including CD4 count and viral load (VL) of 1508 anti-retroviral therapy (ART) -naïve PLWH were obtained from the HIV Database and comparatively analyzed among PLWH with different HIV subtypes. The infection status of 402 newly diagnosed and ART-naïve PLWH from a cohort of men who have sex with men (MSM) in China was evaluated using diagnosis records and LAg-Avidity EIA. Based on partial pol genes, HIV genotypes in 120 recent, 68 long-term, and 54 chronic infections were identified. The CD4 count, CD8 count, and VL, as well as trajectories of dynamic CD4 counts during ART of local PLWH with different HIV subtypes, were compared using non-parametric tests.</p><p><strong>Results: </strong>For the HIV database, the CD4 count in PLWH with CRF01_AE was lower than that in PLWH with CRF07_BC or subtype B. For the recently infected local PLWH, CRF01_AE was the dominant HIV subtype (65.83%), followed by CRF07_BC (18.33%) and subtype B (15.83%). Recent CRF01_AE infections showed a lower baseline CD4 count than CRF07_BC infections. During ART for recently infected PLWH, the CD4 count in the CRF01_AE group rapidly increased to reach a peak at the end of the first year post-ART, while the CD4 count in the CRF07_BC group increased slowly to reach a plateau at the end of the third year. The CD4 count in the subtype B group increased significantly to reach a plateau within the first two years and then its trajectory overlapped with that of the CRF07_BC group at the end of the third year post-ART.</p><p><strong>Conclusions: </strong>CRF01_AE rapidly reduced CD4 count during the recent HIV infection. The CD4 count of the recently infected individuals with CRF01_AE increased sharply and reached its highest level of recovery within the first year of ART initiation. This study revealed an important time point for estimating CD4 count recovery post-ART in individuals with different HIV subtypes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"443"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capillary lactate as a prognostic marker in sepsis: correlation with venous lactate and prediction of outcomes.","authors":"Philip A Joseph, Dinul Doluweera, Amalka Chandraratne, Branavan Balasubramaniam, Varuna Abeyratne, Saman P Hewa, Roshan Rambukwella, Kamani P Wanigasuriya, Jegarajah Indrakumar, Nilanka Perera","doi":"10.1186/s12879-025-10810-z","DOIUrl":"10.1186/s12879-025-10810-z","url":null,"abstract":"<p><strong>Introduction: </strong>Venous lactate (VL) measured by a blood‒gas analyser is not widely available despite its importance in the management of sepsis. Capillary lactate (CL) measured via a hand-held lactate analyser is a feasible and less expensive option. The aim of this study was to determine the correlation between CL and VL in sepsis patients at 0 h (t₀) and 6 h (t₆) and identify the best CL and lactate clearance cut-off values that predicts a poor outcome.</p><p><strong>Methods: </strong>A descriptive study was conducted recruiting all patients with suspected sepsis (qSOFA ≥ 2 with evidence of infection) admitted to a tertiary care hospital in Sri Lanka between March and June 2022. \"Lactate-plus\", a hand-held lactate analyser, was used to measure CL and VL at t₀ and t₆ of admission. The lactate analyser was tested for accuracy and calibrated in a pilot study of 30 patients by correlating to laboratory lactate values. Patient demographics, clinical data and outcomes during hospitalization and at 28 days were assessed.</p><p><strong>Results: </strong>There were 102 patients with suspected sepsis and a median age of 71.5 (interquartile range: 62-77) years were recruited. Majority were females (n = 52, 51%). Majority of the source of infection was pulmonary (n = 57, 55.9%) and urological (n = 19, 18.6%). Paired CL and VL values significantly correlated at both t₀ and t₆ (p < 0.001). CL at t₀ predicted 28-day mortality with a ROC curve AUC of 0.89 (95% CI: 0.82-0.95, p < 0.05) and 3.5 mmol/L was the best cut-off value with an 85% sensitivity and 78% specificity. CL ≥ 3.5 at t₀ was associated with increased intensive care unit (ICU) admission (p < 0.01), vasopressor requirement (p < 0.0001), and a higher mortality rate (p < 0.001) compared to CL < 3.5. Additionally, a capillary lactate clearance greater than 64% predicted a good outcome, with a 97% sensitivity and 91% specificity.</p><p><strong>Conclusions: </strong>CL measured by a lactate meter correlates well with VL and effectively predicts sepsis outcomes. A CL cut-off ≥ 3.5 mmol/L at admission increases the risk of mortality, vasopressor requirement and ICU admission, making CL a useful tool for risk assessment in sepsis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"438"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}