The National HIV/AIDS Strategy for 2022-2025 and the federal Ending the HIV Epidemic (EHE) initiative1,2 have an ambitious goal of dramatically reducing new HIV infections in the United States. by 90% by 2030. While we have the tools to achieve that, the persistent barriers to healthcare services experienced by too many individuals will need to be addressed to make significant progress and improve

Background The impact of chemoprophylaxis targeting Plasmodium falciparum on Plasmodium vivax and Plasmodium ovale, which may remain quiescent as hypnozoites in the liver, is debated. Methods We conducted a nested case-control analysis of the outcomes of P. vivax and P. ovale infections in imported malaria cases in France among civilian travellers from January 1st, 2006, to December 31st, 2017. Using

In a population-based survey of NYC adults, we assessed positive SARS-CoV-2 tests (including via exclusive at-home testing) and possible cases among untested respondents. An estimated 27.4% (95%CI: 22.8%-32.0%) or 1.8 million adults (95%CI: 1.6-2.1 million) had SARS-CoV-2 infection between January 1 and March 16, 2022.

Background Identifying SARS-CoV-2 infections during peripartum hospitalizations is important to guide care, implement prevention measures, and understand infection burden. Methods This cross-sectional analysis used electronic health record data from hospitalizations during which pregnancies ended (peripartum hospitalizations) among a cohort of pregnant persons at 3 U.S. integrated healthcare networks

Background Influenza circulated at historically-low levels during 2020 and 2021 due to COVID-19 pandemic travel restrictions. In Australia, international arrivals to Australia were required to undertake 14 days hotel quarantine to limit new introduction of SARS-CoV-2 virus. Methods We used routine testing data for travellers arriving on repatriation flights to Darwin, Australia from 3 January to 11

BACKGROUND The burden and duration of persistent symptoms after non-severe COVID-19 remains uncertain. This study aimed to assess post-infection symptom trajectories in home-isolated COVID-19 cases compared to age- and time-period matched seronegative controls, and investigate immunological correlates of long COVID. METHODS A prospective case-control study conducted between February 28th and April

Background England’s third trimester maternal pertussis vaccination, introduced in October 2012, was extended to the second trimester in 2016. Maternal vaccination provides high protection against infant disease but routine second trimester vaccination has not previously been assessed. Methods National laboratory-confirmed pertussis case-surveillance determined vaccination history, maternal vaccination

Antibody responses to SARS-CoV-2 vaccination are reduced in solid organ transplant recipients (SOTRs). We report that increased levels of pre-existing antibodies to seasonal coronaviruses are associated with decreased antibody response to SARS-CoV-2 vaccination in SOTRs, supporting that antigenic imprinting modulates vaccine responses in this immunosuppressed population.

Background Mumps is a highly contagious disease spread by airborne droplets, making control especially difficult in congregate, crowded settings such as shelters and jails. A mumps outbreak in Honduras, starting in 2018 among adults who were unvaccinated, spread northward with Central Americans migrating to the USA. We describe two mumps outbreaks in Houston during 2019 among migrants at the Houston

Background Next-generation sequencing (NGS) is increasingly used for periprosthetic joint infection (PJI) diagnosis, but its clinical utility is poorly defined. Shotgun metagenomic sequencing (sNGS) has been reported to identify PJI pathogens undetected by culture in sonicate fluid. However, sNGS is complex and costly. Here, 16S ribosomal RNA (rRNA) gene-based targeted metagenomic sequencing (tNGS)

Background Toxoplasmic encephalitis (TE) is an opportunistic infection of people living with HIV or other causes of immunosuppression. For decades, the standard of care has been combination therapy with pyrimethamine and sulfadiazine (P-S) or pyrimethamine and clindamycin (P-C). However, a substantial price increase has starkly limited access to pyrimethamine. Consequently, some centers have transitioned

Background Cervicovaginal CD4+ T cells are preferential targets for human immunodeficiency virus (HIV) infection and have consequently been used as a proxy measure for HIV susceptibility. The ECHO randomized trial offered a unique opportunity to consider the association between contraceptives and Th17-like cells within a trial designed to evaluate HIV risk. In a mucosal substudy of the ECHO trial,

Background Many interventional in-patient COVID-19 trials assess primary outcomes through day 28 post-randomization. Since a proportion of patients experience protracted disease or relapse, such follow-up period may not fully capture the course of the disease, even when randomization occurs a few days after hospitalization. Methods Among adults hospitalized with COVID-19 in Eastern Denmark from March

Background Prior to the COVID-19 pandemic, crowded and unsanitary living conditions lacking medical expertise made U.S. detention centers hotbeds for infectious disease outbreaks. There have been 30,000 COVID-19 cases, positivity rates exceeding 50%, and nine deaths in Immigration and Customs Enforcement (ICE) custody, but the extent of disease among children under the care of the Office of Refugee

Background The causes and clinical characteristics of recurrent gram-negative bacterial bloodstream infections (GNB-BSI) are poorly understood. Methods We used a prospectively ascertained cohort of patients with GNB-BSI to identify clinical characteristics, microbiology, and risk factors associated with recurrent GNB-BSI. Bacterial genotyping (both pulsed field gel electrophoresis [PFGE] and whole

BACKGROUND Multisystem inflammatory syndrome in children (MIS-C), linked to antecedent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with considerable morbidity. Prevention of SARS-CoV-2 infection or coronavirus disease 2019 (COVID-19) by vaccination might also decrease MIS-C likelihood. METHODS In a multicenter case-control public health investigation of children

Background In South Africa, 19% of the adult population are living with HIV (LWH). Few data on the influence of HIV on SARS-CoV-2 household transmission are available. Methods We performed a case-ascertained, prospective household transmission study of symptomatic index SARS-CoV-2 cases LWH and HIV-uninfected adults and their contacts in South Africa, October 2020 to September 2021. Households were

Our study demonstrates that neither 2020-convalescent plasma (CP) nor 2019/2020-immunoglobulin (IVIG) neutralize Omicron subvariants BA.1 to BA.5. In contrast, hyperimmune 2020-hCoV-2IG lots neutralized Omicron VOCs, similar to 2022-CP from BA.1 breakthrough infections. Therefore, high-titer hCoV-2IG and CP could be evaluated for treatment of high-risk individuals infected with circulating Omicron

Background Chagas disease (CD) has significant global health impact, but safe and effective treatments remain elusive. The nitroimidazole fexinidazole is a potential treatment. Methods This double-blind, randomised, placebo-controlled, dose-finding, proof-of-concept study was conducted in Bolivia. Adults with serologically-confirmed chronic indeterminate CD and positive PCR were randomly assigned to

Background Work-related exposures play an important role in SARS-CoV-2 transmission, yet few studies have measured the risk of COVID-19 across occupations and industries. Methods During September 2020 – May 2021, the Wisconsin Department of Health Services collected occupation and industry data as part of routine COVID-19 case investigations. Adults aged 18-64 years with confirmed or probable COVID-19

Background Although several COVID-19 vaccines initially showed high efficacy, there have been concerns due to waning immunity and the emergence of variants with immune escape capacity. Methods A test-negative design case-control study was conducted in 16 healthcare facilities in Japan during the Delta-dominant period (August-September 2021) and the Omicron-dominant period (January-March 2022). Vaccine

Background Asymptomatic cryptococcal antigenemia (positive blood cryptococcal antigen [CrAg]) is associated with increased mortality in HIV-positive individuals even after adjusting for CD4 count and despite receiving antifungal treatment. The association of antibody immunity with mortality in HIV-positive adults with cryptococcal antigenemia is unknown. Methods Cryptococcus spp. capsular glucuronoxylomannan

Long COVID (LC) constitutes a potential health emergency as millions of SARS-CoV-2 infections lead to chronic symptoms. We must understand whether vaccines reduce LC as this has major implications for health policy. We report a 79% reduction in LC referrals correlating with reinfections and vaccination in the UK.

Background Globally, noroviruses cause infections year-round but have recognized winter seasonality in the northern hemisphere and yearly variations in incidence. With candidate norovirus vaccines in development, understanding temporal and geographic trends in norovirus disease is important to inform potential vaccination strategies and evaluate vaccine impact. Methods We analyzed data from the National

Background Long-acting injectable antiretroviral therapy (LAI-ART) is approved for treatment-naïve or experienced people living with HIV (PLWH) based on trials that only included participants with viral suppression. We performed the first LAI-ART demonstration project to include PLWH unable to achieve or maintain viral suppression due to challenges adhering to oral ART. Methods Ward 86 is a large HIV

Background We explore SARS-CoV-2 antibody lateral flow immunoassay (LFIA) performance under field conditions compared to laboratory-based electrochemiluminescence immunoassay (ECLIA) and live virus neutralisation. Methods In July 2021, 3758 participants performed, at home, a self-administered Fortress LFIA on finger-prick blood, reported and submitted a photograph of the result, and provided a self-collected

BACKGROUND Empiric antifungal therapy is considered the standard-of-care for high-risk neutropenic patients with persistent fever. The impact of a pre-emptive, diagnostic-driven approach based on galactomannan (GM) screening and chest CT-scan on demand on survival and on the risk of invasive fungal disease (IFD) during the first weeks of high-risk neutropenia is unknown. METHODS Patients with acute

Background This study was designed to evaluate if patients with high risk for severe COVID-19 would benefit from treatment with TDF/FTC followed by baricitinib in case of hypoxemia and systemic inflammation. Methods PANCOVID is an open-label, double-randomized, phase 3 pragmatic clinical trial including adults with symptomatic COVID-19 with ≥ 2 comorbidities or older than 60 years conducted between

Antibiotic resistance is a global public health threat. The use of telehealth in primary care presents unique barriers to antimicrobial stewardship, including limited physical examination and changes to the patient-provider relationship. Since the COVID-19 pandemic, there is a need to identify novel antimicrobial stewardship strategies with an explosion in the use of telehealth within primary care

Background Despite advances in the understanding and diagnosis of Clostridioides difficile Infection (CDI), clinical distinction within the colonization-infection continuum remains an unmet need. Methods By measuring stool cytokines and anti-toxin antibodies in well-characterized cohorts of CDI (diarrhea, Nucleic Acid Amplification Test [NAAT]+), Non-CDI diarrhea (NCD; diarrhea, NAAT-), asymptomatic

Background Doxycycline has been recommended as a treatment option for non-severe community-acquired pneumonia (CAP) in adults. We sought to review the evidence for the efficacy of doxycycline in adult patients with mild-to-moderate CAP. Methods We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) of doxycycline versus comparator to assess the clinical efficacy.

Background Intramuscular AZD7442 (Tixagevimab–Cilgavimab, (Evusheld)) has been found effective among immunocompromised individuals (ICI) in reducing Sars-Cov-2 infection and severe disease in ICIs. We evaluated the association between AZD7442 administration and SARS-CoV-2 infection and severe disease (COVID-19 hospitalization and all-cause mortality) among selected ICIs, during a fifth Omicron-dominated

Background Estrogen-based hormone therapy (HT) may have beneficial cardiovascular effects when initiated in early menopause. This has not been examined in women with HIV who have heightened immune activation and cardiovascular risks. Methods Among 609 post-menopausal women (1,234 person-visits) in the Women’s Interagency HIV Study, we examined the relationship of ever HT use (oral, patch, or vaginal)

Background Representative data describing serious infections in over five-year-old children and adults in Africa are limited. Methods We conducted population-based surveillance for pneumonia, meningitis, and septicaemia in a demographic surveillance area in The Gambia between May 12, 2008 and December 31, 2015. We used standardised criteria to identify, diagnose, and investigate patients aged ≥5 years

Of 65 cases during an HIV outbreak among persons who inject drugs (PWID) in Kanawha County, West Virginia during 2019-2021, 61 (94%) had hepatitis C diagnosed at a median of 46 months prior to HIV diagnosis. Hepatitis C diagnosis among PWID should trigger improved access to prevention and treatment services.

Background Tenofovir alafenamide (TAF) has replaced tenofovir disoproxil fumarate (TDF) in many clinical settings. However, concerns remain about potential metabolic complications of TAF. We aimed to evaluate changes in weight, laboratory markers, and metabolic-related clinical events after replacing TDF with TAF. Methods Multicenter prospective cohort study in the Spanish CoRIS cohort. We included

Monkeypox virus is an emergent human pathogen. While it is less lethal than smallpox, it can still cause significant morbidity and mortality. In this review, we explore three antiviral agents with activity against monkeypox and other orthopoxviruses: cidofovir, brincidofovir, and tecovirimat. Cidofovir, and its prodrug brincidofovir, are inhibitors of DNA replication with a broad spectrum of activity

Background A link between chronic inflammation and several non-communicable diseases (NCD) has been established. Although chronic infection with the human T-cell leukaemia virus type 1 (HTLV-1) is the recognised cause of several inflammatory diseases and these are associated with a high number of HTLV-1 infected cells in peripheral blood (proviral load, PVL), possible interactions between PVL and NCDs

Our study in 21 pediatric cancer patients demonstrates that 3 doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA vaccine (BioNTech/Pfizer) elicited both humoral and cellular immunity in most patients during chemotherapy. Immunity was stronger in children with solid tumors and during maintenance therapy compared to those with hematological malignancies or during intensive

Background Statins are competitive inhibitors of 3-hydroxy-3methylglutaryl coenzyme A reductase (HMG-CoA reductase) that catalyses HMG-CoA conversion to mevalonate, a process involved in synthesizing cholesterol in humans and ergosterol in fungi. The effect of statin use on the risk of development of invasive aspergillosis (IA) in lung transplant recipients (LTRs) is not well documented. Methods This

BACKGROUND Suspected pneumonia is the most common indication for antibiotics in hospitalized patients but frequently overdiagnosed. We explored whether normal oxygenation could be used as an indicator to support early discontinuation of antibiotics. METHODS We retrospectively identified all patients started on antibiotics for pneumonia in 4 hospitals with oxygen saturations ≥95% on ambient air, May

Background Cache Valley virus (CVV) is a mosquito-borne virus that is a rare cause of disease in humans. In the Fall of 2020, a patient developed encephalitis six weeks following kidney transplantation and receipt of multiple blood transfusions. Methods After ruling out more common etiologies, metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) was performed. We reviewed the

Background Lassa fever is endemic in large parts of West Africa. The recommended antiviral treatment is ribavirin. Two treatment regimens are currently endorsed in Nigeria: the “McCormick regimen” based on a study published in 1986 and the “Irrua regimen” constituting a simplified schedule developed at the Irrua Specialist Teaching Hospital (ISTH), Nigeria. Evidence for the safety and efficacy of ribavirin

Background Risk factors for nontuberculous mycobacteria (NTM) infections after solid organ transplant (SOT) are not well characterized. Here we aimed to describe these factors. Methods Retrospective, multinational, 1:2 matched case-control study that included SOT recipients ≥12 years old diagnosed with NTM infection from January 1, 2008, to December 31, 2018. Controls were matched on transplanted organ

Background HIV viral load (VL) monitoring is critical for antiretroviral therapy (ART) management. Point-of-care (POC) VL testing has been reported to be feasible and preferred over standard of care (SOC) testing in many low- and middle-income country (LMIC) settings, where rapid results could improve patient outcomes. Methods The timeliness of receipt of VL results was evaluated as part of an open

Background This study evaluated the distribution of macrolide-resistant Mycoplasma genitalium in multiple urogenital specimens collected from women enrolled in a prospective multi-center US clinical study. Methods Four female urogenital specimens (vaginal swab, urine, endocervical swab, ectocervical brush/spatula) collected from each subject were tested using a transcription-mediated amplification

Background Acceleration of negative respiratory conversion of SARS-CoV-2 in patients with coronavirus disease 2019 (COVID-19) might reduce viral transmission. Nirmatrelvir/ritonavir is a new antiviral agent recently approved for treatment of COVID-19 that has the potential to facilitate negative conversion. Methods A cohort of hospitalized adult patients with mild-to-moderate COVID-19 who had a high-risk

Background Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programmes but has not been systematically characterised. Methods We reanalysed data from 34 studies with 16 164 individuals in six risk groups defined by HIV status, gender, and male sexuality: men who have sex with men (MSM) living with HIV (LWH) [MSMLWH]

Background Immune dysregulation in individuals with Down syndrome (DS) leads to an increased risk for hospitalization and death due to COVID-19 and may impair the generation of protective immunity after vaccine administration. Methods The cellular and humoral responses of 55 DS patients who received a complete SARS-CoV-2 vaccination regime at one to three (V1) and six (V2) months were characterized

Background In the general population, illness after infection with the SARS-CoV-2 Omicron variant is less severe compared with previous variants. Data on the disease burden of Omicron in immunocompromised patients are lacking. We investigated the clinical characteristics and outcome of a cohort of immunocompromised patients with COVID-19 caused by Omicron. Methods Solid organ transplant recipients

Background Point-of-care (POC) viral load (VL) tests provide results within hours, enabling same-day treatment interventions. We assessed treatment outcomes with POC versus standard-of-care (SOC) VL monitoring. Methods We implemented a randomized controlled trial at an urban and rural hospital in Nigeria. Participants initiating antiretroviral therapy (ART) were randomized 1:1 for monitoring via the

Viral evolution was evaluated in 47 immunocompromised patients treated with sotrovimab. Sequencing of SARS-CoV-2 following therapy was successful in 16. Mutations associated with sotrovimab resistance were documented in 6, viral replication continued after 30 days in 5. Combination antibody therapy may be required to avoid acquired resistance in immunocompromised patients.

BACKGROUND National guidelines recommend antiviral treatment for children with influenza at high-risk for complications regardless of symptom duration. Little is known about concordance of clinical practice with this recommendation. METHODS We performed a cross-sectional study of outpatient children (1-18 years) at high-risk for complications who were diagnosed with influenza during the 2016-2019 influenza

Background Adult studies have demonstrated within-season declines in influenza vaccine effectiveness (VE); data in children are limited. Methods We conducted a prospective, test-negative study of children 6 months–17 years hospitalized with acute respiratory illness at 7 pediatric medical centers during the 2015-2016 through 2019-2020 influenza seasons. Case-patients were children with an influenza-positive

Background Previous infection with SARS-CoV-2 provides strong protection against future infection. There is limited evidence on whether such protection extends to the Omicron variant. Methods This retrospective cohort study included 635,341 patients tested for SARS-CoV-2 via polymerase chain reaction (PCR) from 09 March 2020 to 01 March 2022. Patients were analyzed according to the wave in which they