BMC Infectious Diseases最新文献

{"title":"The incidence of radiologically verified community-acquired pneumonia requiring hospitalisation in adults living in southern Sweden, 2016-2018: a population-based study.","authors":"Elisabeth Rünow, Frida Valeur, Gustav Torisson, Karin Hansen, Christian Theilacker, Kristian Riesbeck, Jonas Ahl","doi":"10.1186/s12879-025-10468-7","DOIUrl":"https://doi.org/10.1186/s12879-025-10468-7","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) was one of the most common causes of death in the European Union in 2017. Severity and mortality of CAP increase with age and an aging European population will require increased planning for prevention, control, and management of CAP. The purpose of this study was to provide an updated population-based estimate of the incidence of CAP requiring hospitalization in Northern Europe.</p><p><strong>Method: </strong>We conducted a retrospective cohort study estimating the population-based incidence of CAP requiring hospitalization. Adults residing in Southern Sweden admitted between September 2016 and September 2018 with radiographically confirmed CAP and a primary discharge diagnosis consistent with pneumonia were identified by retrospective medical chart review. Incidence rates were stratified by age and sex.</p><p><strong>Results: </strong>We identified 1,575 episodes of CAP in 1,471 unique individuals, accounting for 45% of the total eligible patient population. The crude incidence rate of CAP requiring hospitalization was 259 (95% CI: 246-272) and age-standardized rate was 294 (95% CI: 280-309) per 100,000 person-years. Among those aged 80 years and older, hospitalization rate was 17 times higher vs those aged 18-64 years, yielding an IRR 17.4 (95% CI: 15.4-19.7). Males aged ≥ 80 years had a 57% increased risk of CAP requiring hospitalization compared to women ≥ 80 years, resulting in an IRR of 1.57 (95% CI: 1.33-1.85). The lowest in-hospital case-fatality risk was among the 18-64 years group 3.4% (n = 16), and highest among those ≥ 80 years 8.1% (n = 46).</p><p><strong>Conclusion: </strong>We found that the incidence and mortality of CAP requiring hospitalization in adults are considerable. Preventive measures are needed that target older adults and those at increased risk of CAP.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"80"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999593","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":"Tracking acute flaccid paralysis in Niger: a half-decade epidemiological portrait (2016-2021).","authors":"El Khalef Ishagh, Marc Talatou Ouédraogo, Batouré Oumarou, Mutenda Sheria Kaya, Gbaguidi Aichatou Diawara, Abdoulaye Macire Camara, Seyni Moussa, Kuyangisa Bienvenu, Joseph Toko, Hamidou Harouna, Haladou Moussa, N 'Zue Kofi, Jacques L Tamuzi, Patrick D M C Katoto, Charles S Wiysonge, Blanche-Philomene Melanga Anya, Manengu Casimir Tshikolasoni","doi":"10.1186/s12879-025-10457-w","DOIUrl":"https://doi.org/10.1186/s12879-025-10457-w","url":null,"abstract":"<p><strong>Background: </strong>Recently, a total of 74 circulating vaccine-derived poliovirus (cVDPV) outbreaks were detected in 39 countries, with 672 confirmed Acute Flaccid Paralysis (AFP) cases identified in 27 countries. Despite progress, Niger experienced cVDPV outbreaks in 2018, highlighting the importance of maintaining AFP surveillance as a tool for polio eradication. This analysis aims to comprehensively assess AFP surveillance trends, patterns, and challenges in Niger, offering insights for public health initiatives in conflict-affected contexts.</p><p><strong>Methods: </strong>We analyzed nationwide AFP surveillance data from 2016 to 2021. The data included information about the person's background, vaccinations, medical history, cVDPV, AFP cases, stool samples, how quickly AFP cases were reported, how complete weekly zero reporting (WZR) was, and non-polio enteroviruses (NPEV). Tables, graphs, and maps presented the study findings.</p><p><strong>Results: </strong>A total of 4,134 AFP cases under 15 years old were included, with a sex ratio of 1.3. Most cases (79.85%) were aged 1 to 4 years, and 79.44% received three or more doses of oral polio vaccine (OPV). Fever onset (90.13%), asymmetric paralysis (80.33%), and a 3-day AFP progression (80.48%) were common. cVDPV2 was found in 33 cases, predominantly in Zinder province. The annualized non-polio AFP rate per 100,000 population < 15 years fluctuated, with the lowest at 2.5 in 2016 and highest at 8.7 in 2018 (mean 5.93). Surveillance indicators, including faecal specimen collection, follow-up exams, NPEV detection, timeliness of AFP case notification, WZR, and timely laboratory results performed above the set target. However, stool specimen quality was suboptimal (69% in 2016), timeliness of AFP case investigation and contact sampling, and stool transportation times were below the set target. Five districts reported less than 80% stool adequacy.</p><p><strong>Conclusion: </strong>This study underscores the importance of continued AFP surveillance in Niger, with room for improvement in stool specimen quality and transportation times. Enhancing these aspects can improve public health efforts in conflict-affected areas and contribute to polio eradication in the region.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"79"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999594","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":"Prevalence of asymptomatic Leishmania donovani infection and associated factors in Ethiopia: a systematic review and meta-analysis.","authors":"Habtamu Belay, Adugna Abera, Esayas Aklilu, Tesfahun Bishaw, Ayinalem Alemu, Geremew Tasew, Berhanu Erko","doi":"10.1186/s12879-024-10275-6","DOIUrl":"10.1186/s12879-024-10275-6","url":null,"abstract":"<p><strong>Background: </strong>Visceral leishmaniasis is endemic in Ethiopia and caused by Leishmania donovani. Although the disease manifests with significant clinical variability, a substantial number of individuals are asymptomatic. These individuals can serve as reservoirs, complicating control efforts. However, comprehensive data on asymptomatic L. donovani infections in Ethiopia are lacking, highlighting the need for a systematic review and meta-analysis to consolidate evidence and understand the distribution and determinants of this infection.</p><p><strong>Methods: </strong>PRISMA guidelines followed and registered with PROSPERO (CRD42024531454). Systematically searched electronic databases and grey literature sources up to April 13, 2024. Original research articles in English considered. Statistical analyses performed using STATA version 16. Publication bias evaluated using funnel plots and Egger's regression tests. Pooled estimate of asymptomatic L. donovani infection derived using a random effects model. Study heterogeneity assessed using Chi-square (χ²)-based Q test (p < 0.1) and I² subgroup analysis and meta-regression conducted with significance set at p < 0.05.</p><p><strong>Result: </strong>A total of 1,288 articles were identified, with 11 studies met inclusion criteria. These studies, published between 2012 and 2024, reported data from 17 districts across six regions. Sample sizes ranged from 185 to 1,682, with a total of 7,288. Six types of laboratory testing methods were employed. Prevalence of asymptomatic L. donovani infection per individual study ranged from 0.9 to 15.8%, while district-level prevalence varied from 0 to 31.1%. The overall pooled estimate of asymptomatic L. donovani infection in Ethiopia was 9.0% (95% CI: 6.0-11.0%). The pooled estimate in the Amhara region was 9.0% (95% CI: 8.0-11.0%), compared to 7.0% (95% CI: 3.0-12.0%) in other regions. Living in a household with domestic animals (OR: 2.54; 95% CI: 1.43-3.64) and being male (OR: 2.22; 95% CI: 1.21-3.23) were significantly associated with higher asymptomatic L. donovani infection.</p><p><strong>Conclusion: </strong>A considerable number of asymptomatic L. donovani infections were reported in Ethiopia. Close contact with domestic animals and being male were identified as significant risk factors. Regular screening of people living in close contact with animals. This will minimize role of man as reservoir host of asymptomatic L. donovani infection VL and hence aid in disease control and management.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"78"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999542","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":"The CD4/CD8 ratio is associated with T lymphocyte functions in long-term virally suppressed patients with HIV.","authors":"Qing Xiao, Fengting Yu, Liting Yan, Xiaojie Lao, Xuelei Liang, Hongxin Zhao, Liuyue Zhai, Zailin Yang, Xiaomei Zhang, Yao Liu, Fujie Zhang","doi":"10.1186/s12879-025-10469-6","DOIUrl":"https://doi.org/10.1186/s12879-025-10469-6","url":null,"abstract":"<p><strong>Objective: </strong>Long-term management of people living with HIV (PLWHs) often relies on CD4⁺ T cell counts for assessing immune recovery, yet a single metric offers limited information. This study aimed to explore the association between the CD4/CD8 ratio and T lymphocyte activities in PLWHs.</p><p><strong>Methods: </strong>125 PLWHs and 31 HIV-uninfected controls (UCs) were enrolled and categorized into four groups based on their CD4/CD8 ratios: extremely low ratio (ELR) group: 0.4 < CD4/CD8; low ratio (LR) group: 0.4 ≤ CD4/CD8<0.7; medium ratio (MR) group: 0.7 ≤ CD4/CD8<1; high ratio (HR) group: CD4/CD8 ≥ 1. The activation and proliferation phenotypes, mitochondrial functions, and inflammatory indexes of CD4⁺ T cells and CD8⁺ T cells were measured, and correlations between the CD4/CD8 ratio and T cell functions were analyzed.</p><p><strong>Results: </strong>T cell activation and proliferation were significantly elevated in the ELR group compared to UCs. However, the ELR group had a larger proportion of T cells with lipid peroxidation, mitochondrial lipid reactive oxygen species (ROS), and mitochondrial membrane potential (MMP) abnormalities compared to the other groups. As the CD4/CD8 ratio increased, mitochondrial lipid peroxidation damage decreased and MMP was restored. Additionally, the ELR group had more inflammatory markers in CD4⁺ T cells. Correlation analysis revealed that the CD4/CD8 ratio was associated with multiple T cell functions, and its correlation coefficient with mitochondrial function was higher than that of CD4⁺ T cell count.</p><p><strong>Conclusion: </strong>The CD4/CD8 ratio is closely related to T lymphocyte functions and is significantly superior to the CD4⁺ T cell count in reflecting the mitochondrial lipid peroxidation level and mitochondrial functions within T lymphocytes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"76"},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999591","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":"Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya.","authors":"Victor Osoti, Kevin Wamae, Leonard Ndwiga, Paul M Gichuki, Collins Okoyo, Stella Kepha, Kibor Keitany, Regina Kandie, Stephen Aricha, Rosebella Kiplagat, Charles Mwandawiro, Philip Bejon, Robert W Snow, Lynette Isabella Ochola-Oyier","doi":"10.1186/s12879-025-10462-z","DOIUrl":"https://doi.org/10.1186/s12879-025-10462-z","url":null,"abstract":"<p><strong>Background: </strong>To understand the emergence and spread of drug-resistant parasites in malaria-endemic areas, accurate assessment and monitoring of antimalarial drug resistance markers is critical. Recent advances in next-generation sequencing (NGS) technologies have enabled the tracking of drug-resistant malaria parasites.</p><p><strong>Methods: </strong>In this study, we used Targeted Amplicon Deep Sequencing (TADS) to characterise the genetic diversity of the Pfk13, Pfdhfr, Pfdhps, and Pfmdr1 genes among primary school-going children in 15 counties in Kenya (Bungoma, Busia, Homa Bay, Migori, Kakamega, Kilifi, Kirinyaga, Kisii, Kisumu, Kwale, Siaya, Tana River, Turkana, Vihiga and West Pokot). A total of 920 dried blood spot (DBS) samples collected from 121 selected primary schools within the country were used to extract genomic DNA. A nested polymerase chain reaction (PCR) was used to generate amplicons that were sequenced to determine the prevalence of known and novel polymorphisms.</p><p><strong>Results: </strong>Pfk13 mutations associated with artemisinin resistance were present as mixed genotype infections for the C469Y mutation in 23 samples (4%), the A675V mutation in 2 samples (1.7%), and the P553L mutation in 7 samples (1.2%). The A578S mutation, was also identified in mixed infections, appearing in 15.2% of the 87 samples analysed. The Pfdhfr 51I and 108 N pyrimethamine-resistance mutations were at fixation (100% frequency), and the Pfmdr1 Y184F mutation, which is linked to reduced susceptibility to several antimalarial drugs, especially those used in combination therapies for malaria treatment, was detected in 97.5% of the samples as mixed-genotype infections.</p><p><strong>Conclusion: </strong>The genomic surveillance of asymptomatic school children in Kenya provides an early warning signal of at least 1 of the 3 validated artemisinin resistance mutations circulating in all regions in Western Kenya sampled except Homa Bay and Kisii Counties. These signals in asymptomatic and mixed infections would have been missed without deep sequencing.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"73"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999582","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":"Atypical conjunctival sporotrichosis secondary to Mooren's ulcer: a case report.","authors":"Qing Su, He Dong, Lin Cui, Lijun Zhang","doi":"10.1186/s12879-025-10467-8","DOIUrl":"https://doi.org/10.1186/s12879-025-10467-8","url":null,"abstract":"<p><strong>Background: </strong>Conjunctival sporotrichosis is a rare fungal infection, typically presenting as granulomatous lesions. Its manifestations can be atypical, particularly in immunosuppressed patients. Here, we present a rare case of a Mooren's ulcer patient with bulbar conjunctival Sporotrichosis presenting as a salmon-pink tumor.</p><p><strong>Case presentation: </strong>A 61-year-old with a history of Mooren's ulcer and corneal transplantation was diagnosed with conjunctival Sporotrichosis in the left eye. Slit-lamp examination showed conjunctival congestion and edema with a salmon-pink appearance, accompanied by nodules looking like \"bread crumbs\" scattered under the conjunctiva. After partial tumor resection, histopathology and immunofluorescence staining suggested fungal infection with squamous epithelial hyperplasia. Microbiological testing (DNA) confirmed Sporothrix schenckii as the pathogen. The conjunctival mass resolved without recurrence after local and systemic anti-fungal medicine treatment. Despite the progression of Mooren's ulcers, which further dissolved and perforated during treatment, aggressive management helped the patient retain some vision.</p><p><strong>Conclusion: </strong>Immunosuppression, such as steroids and tacrolimus eyedrops, may predispose patients to opportunistic infections like sporotrichosis. Oral itraconazole, combined with subconjunctival and topical antifungal therapy, effectively treat severe Sporothrix conjunctivitis. Future studies should explore the balance between antifungal and immunosuppressive therapies to manage coexisting conditions like Mooren's ulcer while curing fungal infections.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"71"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999418","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":"Risk factors for re-hospitalization within 90 days of discharge for severe influenza in children.","authors":"Shuo Yang, Sukun Lu, Can Qi, Yinghui Guo, Le Wang","doi":"10.1186/s12879-025-10492-7","DOIUrl":"https://doi.org/10.1186/s12879-025-10492-7","url":null,"abstract":"<p><strong>Background: </strong>Influenza virus is a contagious respiratory pathogen that can cause severe acute infections with long-term adverse outcomes. For paediatric patients at high risk of severe influenza, the readmission and the associated risk factors remain unclear.</p><p><strong>Methods: </strong>Children discharged with a diagnosis of severe or critical influenza from October 2021 to March 2022 were included. The disease severity was categorized according to the \"2020 edition of the Chinese expert consensus on the diagnosis and treatment of influenza in children\". Demographic data, clinical characteristics, underlying medical conditions, microbiology, treatment outcomes, and 90-day readmissions were retrieved and retrospectively analyzed. Those who tested positive for COVID-19 were excluded. Risk factors independently associated with readmission were identified using multiple logistic regression models.</p><p><strong>Results: </strong>During the study period, 225 children with severe influenza were hospitalized and 14.7% (33/225) of them were readmitted within 90 days. The median length of readmission was 62 (IQR, 31-76) days, and the most common cause of readmission was pneumonia. M. pneumoniae and influenza virus are the most common infections for readmission The children who were readmitted were more likely to have critical influenza and neurological comorbidities compared to patients without readmission. The readmitted children had a significantly higher proportion of natural killer cells and a shorter febrile duration and length of stay on their first admission, compared with those who were not readmitted. Rhinosinusitis (OR = 30.085, p = .008) and high level of natural killer cells (OR = 1.107, p = .012) were independent risk factors and febrile duration (OR, 0.748, p = .018) was a protective factor for 90-day readmission.</p><p><strong>Conclusions: </strong>Our findings suggest that, to reduce the potential readmission of children with severe influenza, a sustained focus on the risk factors including rhinosinusitis and over-activated host immune response during the index hospitalization is needed.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"75"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999500","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":"Safety and recommendation of voriconazole for invasive pulmonary aspergillosis in severe liver disease patients: a retrospective cohort study.","authors":"Xin Zhang, Caopei Zheng, Ling Zhang, Yuqing Sun, Ying Liang, Xue Chen, Lijun Pang, Yulin Zhang","doi":"10.1186/s12879-025-10459-8","DOIUrl":"https://doi.org/10.1186/s12879-025-10459-8","url":null,"abstract":"<p><strong>Background: </strong>Invasive pulmonary aspergillosis (IPA) is a common opportunistic infection in patients with severe liver disease (SLD), which increases the mortality of patients. The aim of this study was to evaluate the efficacy and safety of voriconazole for IPA in patients with SLD and explore an optimal antifungal regimen.</p><p><strong>Methods: </strong>This was a retrospective cohort study of SLD patients diagnosed with proven or probable IPA at Beijing Youan Hospital, Capital Medical University between January 1, 2012 to January 31, 2023. Univariate and multivariate logistic regression analysis were performed to identify the impact of voriconazole on outcomes of SLD patients with IPA.</p><p><strong>Results: </strong>A total of 142 patients were enrolled and categorized into voriconazole group (n = 92), echinocandins group (n = 26) and a combination of voriconazole and echinocandins group (n = 24). The 28-day all-cause mortality was lower in voriconazole group compared to the other groups (p = 0.033). Voriconazole monotherapy was associated with lower short-term mortality (OR 0.223, 95%CI 0.070-0.650, p = 0.008) and did not seem to exacerbate hepatic function deterioration in SLD patients with IPA (OR 0.259, 95%CI 0.094-0.674, p = 0.007) when compared to echinocandins monotherapy. Among the three subgroups of voriconazole monotherapy, no-loading dose regime demonstrated a superior response to IPA therapy compared to the standard-dose regimen (OR 0.264, 95%CI 0.068-0.845, p = 0.035).</p><p><strong>Conclusion: </strong>Voriconazole monotherapy demonstrated good tolerability with lower mortality in SLD patients with IPA. A no-loading dose voriconazole regimen is proposed for IPA treatment in SLD patients, yet pharmacokinetic studies combined with prospective studies are needed for further validation.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"70"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999516","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":"Effect of antiretroviral therapy on the mortality of HIV-1 infection long-term non-progressors: a cohort study.","authors":"Jinming Su, Jie Liu, Fengxiang Qin, Rongfeng Chen, Tongxue Qin, Xing Tao, Xiu Chen, Wen Hong, Bingyu Liang, Ping Cui, Li Ye, Junjun Jiang, Hao Liang","doi":"10.1186/s12879-025-10448-x","DOIUrl":"https://doi.org/10.1186/s12879-025-10448-x","url":null,"abstract":"<p><strong>Background: </strong>The study aims to investigate the demographic characteristics, the variations in their immune status, and mortality risk among HIV-1 infection long-term non-progressors (LTNP).</p><p><strong>Methods: </strong>Eligible LTNP and typical progressors (TP) were recruited in Guangxi by December 2018. Participants were followed up until December 2022, monitoring ART status, CD4⁺ T cell counts, and survival/death outcomes. Multivariate logistic, Cox regression, and Kaplan-Meier method were employed to scrutinize associated factors and mortality risk of LTNP.</p><p><strong>Results: </strong>A total of 212 LTNP and 390 TP were included. LTNP cohort predominantly comprised males (84.43%), those diagnosed with HIV at age ≤ 40 years (93.87%), and those infected through injection drug use (59.91%). The mortality rate of LTNP were lower than TP (12.74% vs. 27.18%). TP had a higher mortality risk compared to LTNP (adjusted hazard ratio [aHR] = 4.051, 95% CI: 2.284-7.186, P < 0.001). The mortality risk was also elevated in the ART-naïve group versus the ART-experienced ones (aHR = 3.943, 95%CI: 2.658-5.850, P < 0.001). Notably, the CD4/CD8 ratio in the LTNP group did not fully recover (< 1.0) despite ART. However, LTNP with ART-experienced had a significantly lower mortality risk compared to ART-naïve LTNP group (Log-rank: P = 0.003).</p><p><strong>Conclusions: </strong>ART effectively restores and maintains normal CD4⁺ T cell levels among LTNP, thereby decreasing mortality risk. Nonetheless, the CD4/CD8 ratio in LTNP exhibits incompletely recovered post-ART. These findings provide a scientific foundation for promoting ART in LTNP population.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"72"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998013","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":"Genotyped cluster investigations versus standard contact tracing: comparative impact on latent tuberculosis infection cascade of care in a low-incidence region.","authors":"Michael Asare-Baah, Marie Nancy Séraphin, LaTweika A T Salmon-Trejo, Lori Johnston, Lina Dominique, David Ashkin, Krishna Vaddiparti, Awewura Kwara, Anthony T Maurelli, Michael Lauzardo","doi":"10.1186/s12879-024-10358-4","DOIUrl":"https://doi.org/10.1186/s12879-024-10358-4","url":null,"abstract":"<p><strong>Background: </strong>Cluster and contact investigations aim to identify and treat individuals with tuberculosis (TB) and latent TB infection (LTBI). Although genotyped cluster investigations may be superior to contact investigations in generating additional epidemiological links, this may not necessarily translate into reducing infections. Here, we investigated the impact of genotyped cluster investigations compared to standard contact investigations on the LTBI care cascade in a low incidence setting.</p><p><strong>Methods: </strong>A matched case-control study nested within a cohort of 6,921 TB cases from Florida (2009-2023) was conducted. Cases (n = 670) underwent genotyped cluster investigations, while controls (n = 670) received standard contact investigations and were matched 1:1 by age. The LTBI care cascade outcomes were compared using Pearson's chi-square tests.</p><p><strong>Results: </strong>Of the 5,767 identified contacts, 3,230 (56.0%) were associated with the case group, while 2,537 (44.0%) were identified in the control group. A higher proportion of contacts were evaluated in the control group (85.5%) than in the case group (81.5%, p < 0.001). While the proportion of evaluated contacts diagnosed with LTBI did not significantly differ between the groups (case: 20.4%, control: 21.5%, p = 0.088), a higher percentage of LTBI-diagnosed contacts initiated TB preventive treatment (TPT) in the control group (95.9%) than the case group (92.9%, p = 0.029). TPT completion rates were similar, with 65.2% in the case group and 66.3% in the control group (p = 0.055). TB patients in the case group were more likely to be males, U.S.-born, Asians, residents of long-term care or correctional facilities, with past year histories of alcohol use, homelessness, and drug use.</p><p><strong>Conclusion: </strong>Despite the demographic and epidemiological differences between cases and controls, cluster investigations identified more contacts, with no significant difference in contacts diagnosed with LTBI, but were less effective than standard contact investigations in evaluating contacts, initiating LTBI treatment, and ensuring completion.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"74"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999231","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}