Vincent Lo Re, Jennifer C Price, Steven Schmitt, Norah Terrault, Debika Bhattacharya, Andrew Arohnson
{"title":"The Obstacle is the Way: Finding a Path to Hepatitis C Elimination.","authors":"Vincent Lo Re, Jennifer C Price, Steven Schmitt, Norah Terrault, Debika Bhattacharya, Andrew Arohnson","doi":"10.1093/cid/ciae231","DOIUrl":"10.1093/cid/ciae231","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"i47-i50"},"PeriodicalIF":7.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"American Thoracic Society/Centers for Disease Control and Prevention/European Respiratory Society/Infectious Diseases Society of America (ATS/CDC/ERS/IDSA) Updated Guideline on the Treatment of Tuberculosis.","authors":"Sonal S Munsiff","doi":"10.1093/cid/ciaf066","DOIUrl":"10.1093/cid/ciaf066","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"i46"},"PeriodicalIF":7.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nandita Nadig, Adarsh Bhimraj, Kelly Cawcutt, Kathleen Chiotos, Amy L Dzierba, Arthur Y Kim, Greg S Martin, Jeffrey C Pearson, Amy Hirsch Shumaker, Lindsey R Baden, Roger Bedimo, Vincent Chi-Chung Cheng, Kara W Chew, Eric S Daar, David V Glidden, Erica J Hardy, Steven Johnson, Jonathan Z Li, Christine MacBrayne, Mari M Nakamura, Laura Riley, Robert W Shafer, Shmuel Shoham, Pablo Tebas, Phyllis C Tien, Jennifer Loveless, Yngve Falck-Ytter, Rebecca L Morgan, Rajesh T Gandhi
This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of infliximab in hospitalized adults with severe or critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.
{"title":"2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Infliximab.","authors":"Nandita Nadig, Adarsh Bhimraj, Kelly Cawcutt, Kathleen Chiotos, Amy L Dzierba, Arthur Y Kim, Greg S Martin, Jeffrey C Pearson, Amy Hirsch Shumaker, Lindsey R Baden, Roger Bedimo, Vincent Chi-Chung Cheng, Kara W Chew, Eric S Daar, David V Glidden, Erica J Hardy, Steven Johnson, Jonathan Z Li, Christine MacBrayne, Mari M Nakamura, Laura Riley, Robert W Shafer, Shmuel Shoham, Pablo Tebas, Phyllis C Tien, Jennifer Loveless, Yngve Falck-Ytter, Rebecca L Morgan, Rajesh T Gandhi","doi":"10.1093/cid/ciaf355","DOIUrl":"10.1093/cid/ciaf355","url":null,"abstract":"<p><p>This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of infliximab in hospitalized adults with severe or critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"i22-i26"},"PeriodicalIF":7.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12809853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adarsh Bhimraj, Yngve Falck-Ytter, Arthur Y Kim, Jonathan Z Li, Lindsey R Baden, Steven Johnson, Robert W Shafer, Shmuel Shoham, Pablo Tebas, Roger Bedimo, Vincent Chi-Chung Cheng, Kara W Chew, Kathleen Chiotos, Eric S Daar, Amy L Dzierba, David V Glidden, Erica J Hardy, Greg S Martin, Christine MacBrayne, Nandita Nadig, Mari M Nakamura, Amy Hirsch Shumaker, Phyllis Tien, Jennifer Loveless, Rebecca L Morgan, Rajesh T Gandhi
This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019, developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of the anti-severe acute respiratory syndrome coronavirus 2 neutralizing antibody pemivibart as pre-exposure prophylaxis. The recommendation is based on evidence derived from a systematic review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Information on pemivibart is included in the U.S. Food and Drug Administration Emergency Use Authorization for this agent.
{"title":"2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Management of COVID-19: Anti-SARS-CoV-2 Neutralizing Antibody Pemivibart for Pre-exposure Prophylaxis.","authors":"Adarsh Bhimraj, Yngve Falck-Ytter, Arthur Y Kim, Jonathan Z Li, Lindsey R Baden, Steven Johnson, Robert W Shafer, Shmuel Shoham, Pablo Tebas, Roger Bedimo, Vincent Chi-Chung Cheng, Kara W Chew, Kathleen Chiotos, Eric S Daar, Amy L Dzierba, David V Glidden, Erica J Hardy, Greg S Martin, Christine MacBrayne, Nandita Nadig, Mari M Nakamura, Amy Hirsch Shumaker, Phyllis Tien, Jennifer Loveless, Rebecca L Morgan, Rajesh T Gandhi","doi":"10.1093/cid/ciae435","DOIUrl":"10.1093/cid/ciae435","url":null,"abstract":"<p><p>This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019, developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of the anti-severe acute respiratory syndrome coronavirus 2 neutralizing antibody pemivibart as pre-exposure prophylaxis. The recommendation is based on evidence derived from a systematic review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Information on pemivibart is included in the U.S. Food and Drug Administration Emergency Use Authorization for this agent.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"i6-i12"},"PeriodicalIF":7.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nandita Nadig, Adarsh Bhimraj, Kelly Cawcutt, Kathleen Chiotos, Amy L Dzierba, Arthur Y Kim, Greg S Martin, Jeffrey C Pearson, Amy Hirsch Shumaker, Lindsey R Baden, Roger Bedimo, Vincent Chi-Chung Cheng, Kara W Chew, Eric S Daar, David V Glidden, Erica J Hardy, Steven Johnson, Jonathan Z Li, Christine MacBrayne, Mari M Nakamura, Laura Riley, Robert W Shafer, Shmuel Shoham, Pablo Tebas, Phyllis C Tien, Jennifer Loveless, Yngve Falck-Ytter, Rebecca L Morgan, Rajesh T Gandhi
This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of abatacept in hospitalized adults with severe or critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.
{"title":"2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Abatacept.","authors":"Nandita Nadig, Adarsh Bhimraj, Kelly Cawcutt, Kathleen Chiotos, Amy L Dzierba, Arthur Y Kim, Greg S Martin, Jeffrey C Pearson, Amy Hirsch Shumaker, Lindsey R Baden, Roger Bedimo, Vincent Chi-Chung Cheng, Kara W Chew, Eric S Daar, David V Glidden, Erica J Hardy, Steven Johnson, Jonathan Z Li, Christine MacBrayne, Mari M Nakamura, Laura Riley, Robert W Shafer, Shmuel Shoham, Pablo Tebas, Phyllis C Tien, Jennifer Loveless, Yngve Falck-Ytter, Rebecca L Morgan, Rajesh T Gandhi","doi":"10.1093/cid/ciaf354","DOIUrl":"10.1093/cid/ciaf354","url":null,"abstract":"<p><p>This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of abatacept in hospitalized adults with severe or critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"i17-i21"},"PeriodicalIF":7.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katarina Niward,Clara Braian,Gustav Svärdhagen,Daniel Augustinsson,Isabelle Öhrnberg,Rovina Ruslami,Stellah Mpagama,Elin M Svensson,Judith Bruchfeld,Jan-Willem Alffenaar,Thomas Schön
Developing shorter treatment regimens for tuberculosis requires careful characterization of the clinical phenotype, which is defined by patient characteristics, radiological extent of disease, mycobacterial burden, drug susceptibility, and host response. Advances in 'omics and model-informed precision dosing, as well as integrated algorithms using artificial intelligence, need to be adapted and validated in clinical trials to improve classification of patients for stratified treatment. When treatment is initiated based on the clinical phenotype, monitoring of treatment response can be improved by quantification of bacterial load, transcriptomic and epigenetic biosignatures for sputum-free monitoring, and assessing disease burden by radiological and symptom scoring tools. Many of these tools are suitable for high-endemic settings. Such integrated monitoring allows prompt drug adjustments for rapid reduction in bacterial load, which prevents development of drug resistance and achieves relapse-free cure even with shorter treatment.
{"title":"Future Prospects for Using Clinical Phenotypes in Tuberculosis Precision Medicine-An Approach for Clinical Management.","authors":"Katarina Niward,Clara Braian,Gustav Svärdhagen,Daniel Augustinsson,Isabelle Öhrnberg,Rovina Ruslami,Stellah Mpagama,Elin M Svensson,Judith Bruchfeld,Jan-Willem Alffenaar,Thomas Schön","doi":"10.1093/cid/ciaf663","DOIUrl":"https://doi.org/10.1093/cid/ciaf663","url":null,"abstract":"Developing shorter treatment regimens for tuberculosis requires careful characterization of the clinical phenotype, which is defined by patient characteristics, radiological extent of disease, mycobacterial burden, drug susceptibility, and host response. Advances in 'omics and model-informed precision dosing, as well as integrated algorithms using artificial intelligence, need to be adapted and validated in clinical trials to improve classification of patients for stratified treatment. When treatment is initiated based on the clinical phenotype, monitoring of treatment response can be improved by quantification of bacterial load, transcriptomic and epigenetic biosignatures for sputum-free monitoring, and assessing disease burden by radiological and symptom scoring tools. Many of these tools are suitable for high-endemic settings. Such integrated monitoring allows prompt drug adjustments for rapid reduction in bacterial load, which prevents development of drug resistance and achieves relapse-free cure even with shorter treatment.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"267 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David C Gaston,Romney M Humphries,Ariel A Lewis,Cheryl L Gatto,Li Wang,George E Nelson,Joanna L Stollings,Benjamin J Ereshefsky,Matthew A Christensen,Mary Lynn Dear,Ritu Banerjee,Matthew Rodgers,Alison Benton,Sharon Glover,Karen F Miller,Wesley H Self,Matthew W Semler,Edward T Qian,
BACKGROUNDFor hospitalized adults receiving empiric antibiotic therapy, antibiotic de-escalation prevents unnecessary exposure and adverse effects. Whether use of direct-from-blood bacterial testing facilitates earlier antibiotic de-escalation and improves clinical outcomes has never been evaluated in a randomized trial.METHODSBetween December 2023 and December 2024, this pragmatic randomized trial compared direct-from-blood bacterial testing with blood cultures (intervention group) to blood cultures alone (usual care group) in adults with suspected infection receiving empiric intravenous vancomycin in the emergency department of an academic medical center. The primary and secondary outcomes were time from randomization to last dose of intravenous vancomycin and systemic antipseudomonal beta-lactam antibiotics, respectively.RESULTSAmong 500 patients enrolled, the time from randomization to results of bacterial testing from blood (direct-from-blood test, gram stain, or negative culture) was a median of 5.2 days shorter (95% CI, 5.1-5.2) in the direct-from-blood test group (median 0.4 days; IQR, 0.3-0.5) than the usual care group (median, 5.5 days; IQR, 5.2-5.6). The time between randomization and the last dose of intravenous vancomycin did not differ between the direct-from-blood test group (median, 12.5 hours; IQR, 0.79-57.8) and the usual care group (median, 19.0 hours; IQR 0.9-64.8) (HR, 1.08; 95% CI, .90-1.28; P = .42), nor did the time to last dose of systemic antipseudomonal beta-lactam antibiotics (HR, 1.04; 95% CI .87-1.24). Clinical outcomes were also similar.CONCLUSIONSAmong adults with suspected infection receiving empiric intravenous vancomycin in the emergency department, use of direct-from-blood bacterial testing did not shorten the duration of intravenous vancomycin or antipseudomonal beta-lactam antibiotics.
{"title":"Effect of Direct-from-blood Bacterial Testing on Antibiotics Administration in Adults Presenting With Acute Infection: A Randomized Trial.","authors":"David C Gaston,Romney M Humphries,Ariel A Lewis,Cheryl L Gatto,Li Wang,George E Nelson,Joanna L Stollings,Benjamin J Ereshefsky,Matthew A Christensen,Mary Lynn Dear,Ritu Banerjee,Matthew Rodgers,Alison Benton,Sharon Glover,Karen F Miller,Wesley H Self,Matthew W Semler,Edward T Qian, ","doi":"10.1093/cid/ciaf677","DOIUrl":"https://doi.org/10.1093/cid/ciaf677","url":null,"abstract":"BACKGROUNDFor hospitalized adults receiving empiric antibiotic therapy, antibiotic de-escalation prevents unnecessary exposure and adverse effects. Whether use of direct-from-blood bacterial testing facilitates earlier antibiotic de-escalation and improves clinical outcomes has never been evaluated in a randomized trial.METHODSBetween December 2023 and December 2024, this pragmatic randomized trial compared direct-from-blood bacterial testing with blood cultures (intervention group) to blood cultures alone (usual care group) in adults with suspected infection receiving empiric intravenous vancomycin in the emergency department of an academic medical center. The primary and secondary outcomes were time from randomization to last dose of intravenous vancomycin and systemic antipseudomonal beta-lactam antibiotics, respectively.RESULTSAmong 500 patients enrolled, the time from randomization to results of bacterial testing from blood (direct-from-blood test, gram stain, or negative culture) was a median of 5.2 days shorter (95% CI, 5.1-5.2) in the direct-from-blood test group (median 0.4 days; IQR, 0.3-0.5) than the usual care group (median, 5.5 days; IQR, 5.2-5.6). The time between randomization and the last dose of intravenous vancomycin did not differ between the direct-from-blood test group (median, 12.5 hours; IQR, 0.79-57.8) and the usual care group (median, 19.0 hours; IQR 0.9-64.8) (HR, 1.08; 95% CI, .90-1.28; P = .42), nor did the time to last dose of systemic antipseudomonal beta-lactam antibiotics (HR, 1.04; 95% CI .87-1.24). Clinical outcomes were also similar.CONCLUSIONSAmong adults with suspected infection receiving empiric intravenous vancomycin in the emergency department, use of direct-from-blood bacterial testing did not shorten the duration of intravenous vancomycin or antipseudomonal beta-lactam antibiotics.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"29 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Tantalizing Pursuit for a Perfect Diagnostic Test: Balancing Innovation With Stewardship.","authors":"K C Coffey,Erica S Shenoy,Sarah E Turbett","doi":"10.1093/cid/ciaf674","DOIUrl":"https://doi.org/10.1093/cid/ciaf674","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"84 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Foncillas, Juan Ambrosioni, Abiu Sempere, Leire Berrocal, Julia Calvo, Iván Chivite, Lorena de la Mora, Alexy Inciarte, Berta Torres, María Martínez-Rebollar, José Luis Blanco, José M Miró, Elisa de Lazzari, Esteban Martínez, Josep Mallolas, Ana González-Cordón, Montserrat Laguno
Background To evaluate hepatitis B virus (HBV) serological profiles and risk of HBV reactivation (HBVr) or incident infection (HBVi) in people with HIV (PWH) switching to long-acting cabotegravir/rilpivirine (LA-CAB/RPV). Methods Prospective cohort study of PWH initiating LA-CAB/RPV at Hospital Clínic Barcelona between February 2023 and February 2025. HBV serology, vaccination status, and liver function tests (LFTs) were assessed at baseline. Follow-up LFTs were performed routinely (weeks 12, 28, and every 6 months), and HBV serology/DNA assessed if abnormal LFTs, acute hepatitis or clinical suspicion of reactivation. HBVr was defined as conversion from HBsAg negative to positive or detectable HBV DNA in anti-HBc-positive/HBsAg-negative individuals, or as HBV DNA ≥1 log increase or ≥100 IU/mL in chronic HBV (HBsAg-positive) participants. HBVi was defined as HBsAg seroconversion in HBV unexposed individuals. Results Among 741 participants—92% cis-gender male, median age 43 (IQR 35-52) —454 (61%) had vaccine-induced immunity and 25% had prior HBV exposure (anti-HBc-positive), with 3% showing isolated anti-HBc. Median follow-up was 54 weeks (IQR 28-77). No HBVr or HBVi were observed in people without chronic hepatitis at baseline. Four individuals (0.5%) with unnoticed chronic HBV infection (HBsAg-positive) started LA-CAB/RPV; two developed clinical HBVr and two remained stable after regimen switch, all four switched back to tenofovir-containing therapy. Transaminase elevations during follow-up occurred in 17% of the cohort, regardless of HBV serostatus. Conclusions LA-CAB/RPV appears safe in individuals with prior HBV exposure, including those with isolated anti-HBc. Comprehensive HBV screening, vaccination, and liver monitoring are essential.
{"title":"Hepatitis B Outcomes After Switching to Long-Acting Cabotegravir/Rilpivirine in People With HIV: Reactivation, Incident Infection, and Liver Safety Across Diverse Serological Profiles","authors":"Alberto Foncillas, Juan Ambrosioni, Abiu Sempere, Leire Berrocal, Julia Calvo, Iván Chivite, Lorena de la Mora, Alexy Inciarte, Berta Torres, María Martínez-Rebollar, José Luis Blanco, José M Miró, Elisa de Lazzari, Esteban Martínez, Josep Mallolas, Ana González-Cordón, Montserrat Laguno","doi":"10.1093/cid/ciag023","DOIUrl":"https://doi.org/10.1093/cid/ciag023","url":null,"abstract":"Background To evaluate hepatitis B virus (HBV) serological profiles and risk of HBV reactivation (HBVr) or incident infection (HBVi) in people with HIV (PWH) switching to long-acting cabotegravir/rilpivirine (LA-CAB/RPV). Methods Prospective cohort study of PWH initiating LA-CAB/RPV at Hospital Clínic Barcelona between February 2023 and February 2025. HBV serology, vaccination status, and liver function tests (LFTs) were assessed at baseline. Follow-up LFTs were performed routinely (weeks 12, 28, and every 6 months), and HBV serology/DNA assessed if abnormal LFTs, acute hepatitis or clinical suspicion of reactivation. HBVr was defined as conversion from HBsAg negative to positive or detectable HBV DNA in anti-HBc-positive/HBsAg-negative individuals, or as HBV DNA ≥1 log increase or ≥100 IU/mL in chronic HBV (HBsAg-positive) participants. HBVi was defined as HBsAg seroconversion in HBV unexposed individuals. Results Among 741 participants—92% cis-gender male, median age 43 (IQR 35-52) —454 (61%) had vaccine-induced immunity and 25% had prior HBV exposure (anti-HBc-positive), with 3% showing isolated anti-HBc. Median follow-up was 54 weeks (IQR 28-77). No HBVr or HBVi were observed in people without chronic hepatitis at baseline. Four individuals (0.5%) with unnoticed chronic HBV infection (HBsAg-positive) started LA-CAB/RPV; two developed clinical HBVr and two remained stable after regimen switch, all four switched back to tenofovir-containing therapy. Transaminase elevations during follow-up occurred in 17% of the cohort, regardless of HBV serostatus. Conclusions LA-CAB/RPV appears safe in individuals with prior HBV exposure, including those with isolated anti-HBc. Comprehensive HBV screening, vaccination, and liver monitoring are essential.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"50 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth C Arant,Thibaut Davy-Mendez,Tao Liang,Moreno Rodrigues,Cynthia L Gay,Meenakshi M Rana,Rachel Friedman-Moraco,Alexander Gilbert,Peter Stock,Sapna A Mehta,Shikha Mehta,Valentina Stosor,Marcus R Pereira,Michele I Morris,Jonathan Hand,Saima Aslam,Maricar Malinis,Ghady Haidar,Catherine B Small,Carlos A Q Santos,Joanna Schaenman,John W Baddley,David Wojciechowski,Emily A Blumberg,Karthik Ranganna,Oluwafisayo Adebiyi,Nahel Elias,Jose A Castillo-Lugo,Emmanouil Giorgakis,Senu Apewokin,Megan Morsheimer,Christian van Delden,Oriol Manuel,Nicolas J Mueller,Dionysios Neofyotos,Aaron A R Tobian,Allan Massie,Dorry L Segev,William Werbel,Christine M Durand
BACKGROUNDKidney transplantation (KT) from donors with human immunodeficiency virus (HIV-1) to recipients with HIV (HIV D+/R+) is noninferior to KT from donors without HIV (HIV D-/R+) with regard to safety. However, there may be differences in posttransplant infections.METHODSWe performed a secondary analysis of the HOPE in Action KT Study (NCT02602262) comparing the time to first clinically relevant infection within 24 months posttransplantation in 99 HIV D+/R+ versus 99 HIV D-/R+. Secondary outcomes included incidence rates, infection-related death, and timing of clinically relevant infection, each stratified by donor HIV status.RESULTSThe cumulative incidence of a clinically relevant infection at 24 months posttransplantation was 73.8% (95% confidence interval [CI]: 63.1%-81.2%) for HIV D+/R+ versus 64.7% (95% CI: 53.0%-73.4%) for HIV D-/R+. Comparing time to first clinically relevant infection in HIV D+/R+ versus HIV D-/R+, the adjusted hazard ratio (aHR) was 1.44 (95% CI: 1.01-2.04) at 24 months posttransplantation; for infections associated with hospitalization, the aHR was not significantly higher (1.21 [95% CI: .78-1.86). There were no significant differences in the number of infections, death from infection, duration, or site of infection between HIV D+/R+ versus HIV D-/R+, though viral infections were numerically more common in HIV D+/R+ (40% vs 35%).CONCLUSIONSAlthough there was a statistically significant association between receipt of a kidney from a donor with HIV and time to first clinically relevant infection in the 24 months posttransplantation, there were no differences in infections associated with hospitalization. These data are overall reassuring as this emerging practice expands into clinical care. Clinical Trials Registration. NCT02602262.
{"title":"Infections After Kidney Transplantation From Donors With Human Immunodeficiency Virus (HIV) to Recipients With HIV.","authors":"Elizabeth C Arant,Thibaut Davy-Mendez,Tao Liang,Moreno Rodrigues,Cynthia L Gay,Meenakshi M Rana,Rachel Friedman-Moraco,Alexander Gilbert,Peter Stock,Sapna A Mehta,Shikha Mehta,Valentina Stosor,Marcus R Pereira,Michele I Morris,Jonathan Hand,Saima Aslam,Maricar Malinis,Ghady Haidar,Catherine B Small,Carlos A Q Santos,Joanna Schaenman,John W Baddley,David Wojciechowski,Emily A Blumberg,Karthik Ranganna,Oluwafisayo Adebiyi,Nahel Elias,Jose A Castillo-Lugo,Emmanouil Giorgakis,Senu Apewokin,Megan Morsheimer,Christian van Delden,Oriol Manuel,Nicolas J Mueller,Dionysios Neofyotos,Aaron A R Tobian,Allan Massie,Dorry L Segev,William Werbel,Christine M Durand","doi":"10.1093/cid/ciaf656","DOIUrl":"https://doi.org/10.1093/cid/ciaf656","url":null,"abstract":"BACKGROUNDKidney transplantation (KT) from donors with human immunodeficiency virus (HIV-1) to recipients with HIV (HIV D+/R+) is noninferior to KT from donors without HIV (HIV D-/R+) with regard to safety. However, there may be differences in posttransplant infections.METHODSWe performed a secondary analysis of the HOPE in Action KT Study (NCT02602262) comparing the time to first clinically relevant infection within 24 months posttransplantation in 99 HIV D+/R+ versus 99 HIV D-/R+. Secondary outcomes included incidence rates, infection-related death, and timing of clinically relevant infection, each stratified by donor HIV status.RESULTSThe cumulative incidence of a clinically relevant infection at 24 months posttransplantation was 73.8% (95% confidence interval [CI]: 63.1%-81.2%) for HIV D+/R+ versus 64.7% (95% CI: 53.0%-73.4%) for HIV D-/R+. Comparing time to first clinically relevant infection in HIV D+/R+ versus HIV D-/R+, the adjusted hazard ratio (aHR) was 1.44 (95% CI: 1.01-2.04) at 24 months posttransplantation; for infections associated with hospitalization, the aHR was not significantly higher (1.21 [95% CI: .78-1.86). There were no significant differences in the number of infections, death from infection, duration, or site of infection between HIV D+/R+ versus HIV D-/R+, though viral infections were numerically more common in HIV D+/R+ (40% vs 35%).CONCLUSIONSAlthough there was a statistically significant association between receipt of a kidney from a donor with HIV and time to first clinically relevant infection in the 24 months posttransplantation, there were no differences in infections associated with hospitalization. These data are overall reassuring as this emerging practice expands into clinical care. Clinical Trials Registration. NCT02602262.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"20 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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