Elise Pesonel, Cédric Laouénan, Laetitia Guiraud, Josephine Bourner, Isabelle Hoffmann, Diana Molino, Coralie Tardivon, Delphine Bachelet, France Mentré, Alain Amstutz, Laura Merson, Amanda Rojek, Minerva Cervantes Gonzalez, Andrea Antinori, Antonella Castagna, Silvia Nozza, Valérie Pourcher, Agnès Libois, Jake Dunning, Evelina Tacconelli, Maya Hites, Fernando De La Calle Prieto, Peter Horby, Yazdan Yazdanpanah, Alexandra Calmy, F-Xavier Lescure, Piero Olliaro
Background: The global mpox outbreak which started in May 2022 was caused by a novel clade IIb variant of the mpox virus (MPXV). It differed from the traditional Western and Central Africa disease in transmission patterns and clinical presentation.
Methods: To address the need for detailed clinical and virologic data, we conducted an observational cohort study (MOSAIC) during May 2022-July 2023 in individuals with confirmed MPXV infection enrolled in six European Countries. Case-management decisions were left to the attending physician. Participants were monitored for up to six months for clinical signs/symptoms and clinical and virologic outcomes through hospital visits, phone interviews, and self-administered questionnaires. Outcomes included time-to-lesion resolution, clinical status, and virus clearance.
Results: The 518 participants not receiving any specific treatment ("untreated") were diagnosed a median 5 days from symptom onset; 90% were managed as outpatients. Lesions were mostly cutaneous (88%) as and peri-genital (74%). By Day 14 from the first PCR-positive sample, 39% had resolved lesions. Time-to 95% unculturable virus was longest in cutaneous lesions (52 days). A putative systemic antiviral was available for 57 participants, 44% as in-patients, 34% and 58% had resolved lesions by D14 from the first PCR-positive sample and from treatment start, respectively. Time-to 95% unculturable virus was 60 days in skin and oropharynx. No death or recrudescence occurred by Day 180.
Conclusion: MOSAIC provides comprehensive insights into the clinical and virologic characteristics of mpox caused by the clade IIb variant. The study forms the basis of clinical characterisation for ongoing mpox outbreaks.
{"title":"Clinical characterisation and outcomes of human clade IIb mpox virus disease - a European multicentre observational cohort study (MOSAIC).","authors":"Elise Pesonel, Cédric Laouénan, Laetitia Guiraud, Josephine Bourner, Isabelle Hoffmann, Diana Molino, Coralie Tardivon, Delphine Bachelet, France Mentré, Alain Amstutz, Laura Merson, Amanda Rojek, Minerva Cervantes Gonzalez, Andrea Antinori, Antonella Castagna, Silvia Nozza, Valérie Pourcher, Agnès Libois, Jake Dunning, Evelina Tacconelli, Maya Hites, Fernando De La Calle Prieto, Peter Horby, Yazdan Yazdanpanah, Alexandra Calmy, F-Xavier Lescure, Piero Olliaro","doi":"10.1093/cid/ciae657","DOIUrl":"https://doi.org/10.1093/cid/ciae657","url":null,"abstract":"<p><strong>Background: </strong>The global mpox outbreak which started in May 2022 was caused by a novel clade IIb variant of the mpox virus (MPXV). It differed from the traditional Western and Central Africa disease in transmission patterns and clinical presentation.</p><p><strong>Methods: </strong>To address the need for detailed clinical and virologic data, we conducted an observational cohort study (MOSAIC) during May 2022-July 2023 in individuals with confirmed MPXV infection enrolled in six European Countries. Case-management decisions were left to the attending physician. Participants were monitored for up to six months for clinical signs/symptoms and clinical and virologic outcomes through hospital visits, phone interviews, and self-administered questionnaires. Outcomes included time-to-lesion resolution, clinical status, and virus clearance.</p><p><strong>Results: </strong>The 518 participants not receiving any specific treatment (\"untreated\") were diagnosed a median 5 days from symptom onset; 90% were managed as outpatients. Lesions were mostly cutaneous (88%) as and peri-genital (74%). By Day 14 from the first PCR-positive sample, 39% had resolved lesions. Time-to 95% unculturable virus was longest in cutaneous lesions (52 days). A putative systemic antiviral was available for 57 participants, 44% as in-patients, 34% and 58% had resolved lesions by D14 from the first PCR-positive sample and from treatment start, respectively. Time-to 95% unculturable virus was 60 days in skin and oropharynx. No death or recrudescence occurred by Day 180.</p><p><strong>Conclusion: </strong>MOSAIC provides comprehensive insights into the clinical and virologic characteristics of mpox caused by the clade IIb variant. The study forms the basis of clinical characterisation for ongoing mpox outbreaks.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920626","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}
Background Tenofovir-containing antiretroviral therapy (ART) improves survival in HBV-coinfected people with HIV (PWH). We investigated the incidence of HDV infection and its clinical impact in HBV-coinfected PWH in the era of tenofovir-containing ART. Methods Between 2011 and 2022, HBV-coinfected PWH were included and followed until December 2023. Anti-HDV antibody screening was performed using sequentially archived blood samples. The timing of incident HDV infection was estimated as the midpoint between the last time point of anti-HDV-negative samples and the first time point of anti-HDV-positive samples. Differences in survival and liver-related outcomes between HDV-infected and HDV-uninfected PWH were analyzed. Results 534 HBV-coinfected PWH were included and 36 (6.7%) tested HDV-seropositive at baseline. During 3987.78 person-years of follow-up (PYFU), 50 (10.0%) of 498 anti-HDV-negative PWH seroconverted for HDV, with an overall incidence rate of 12.54 per 1000 PYFU. 88.0% (44/50) of HDV seroconverters were men who have sex with men. After a median follow-up of 10.2 years (84.7% of the follow-up period covered by tenofovir-containing ART), the all-cause mortality was 4.7% (25/534). HDV-infected PWH had significantly higher rates of liver-related mortality (3.5% vs 0.4%, P=.032), cirrhosis (11.3% vs 3.6%, P=.008), and hepatitis flare (28.2% vs 14.2%, P=.001) than HDV-uninfected PWH. In multivariate Cox analysis, HDV infection was associated with liver-related mortality (adjusted HR, 9.696; 95% CI, 1.284-73.222, P=.028). The risk of hepatocellular carcinoma was similar for HDV-infected and HDV-uninfected PWH. Conclusions HBV-coinfected PWH remain at risk for HDV superinfection and HDV infection is associated with liver-related death in the era of tenofovir-containing ART.
{"title":"Incidence and outcome of hepatitis D virus infection in people with HIV in the era of tenofovir-containing antiretroviral therapy","authors":"Yu-Shan Huang, Hsin-Yun Sun, Shu-Yuan Ho, Kuan-Yin Lin, Wang-Da Liu, Wang-Huei Sheng, Szu-Min Hsieh, Yu-Chung Chuang, Li-Hsin Su, Yi-Ching Su, Wen-Chun Liu, Sui-Yuan Chang, Chien-Ching Hung","doi":"10.1093/cid/ciae655","DOIUrl":"https://doi.org/10.1093/cid/ciae655","url":null,"abstract":"Background Tenofovir-containing antiretroviral therapy (ART) improves survival in HBV-coinfected people with HIV (PWH). We investigated the incidence of HDV infection and its clinical impact in HBV-coinfected PWH in the era of tenofovir-containing ART. Methods Between 2011 and 2022, HBV-coinfected PWH were included and followed until December 2023. Anti-HDV antibody screening was performed using sequentially archived blood samples. The timing of incident HDV infection was estimated as the midpoint between the last time point of anti-HDV-negative samples and the first time point of anti-HDV-positive samples. Differences in survival and liver-related outcomes between HDV-infected and HDV-uninfected PWH were analyzed. Results 534 HBV-coinfected PWH were included and 36 (6.7%) tested HDV-seropositive at baseline. During 3987.78 person-years of follow-up (PYFU), 50 (10.0%) of 498 anti-HDV-negative PWH seroconverted for HDV, with an overall incidence rate of 12.54 per 1000 PYFU. 88.0% (44/50) of HDV seroconverters were men who have sex with men. After a median follow-up of 10.2 years (84.7% of the follow-up period covered by tenofovir-containing ART), the all-cause mortality was 4.7% (25/534). HDV-infected PWH had significantly higher rates of liver-related mortality (3.5% vs 0.4%, P=.032), cirrhosis (11.3% vs 3.6%, P=.008), and hepatitis flare (28.2% vs 14.2%, P=.001) than HDV-uninfected PWH. In multivariate Cox analysis, HDV infection was associated with liver-related mortality (adjusted HR, 9.696; 95% CI, 1.284-73.222, P=.028). The risk of hepatocellular carcinoma was similar for HDV-infected and HDV-uninfected PWH. Conclusions HBV-coinfected PWH remain at risk for HDV superinfection and HDV infection is associated with liver-related death in the era of tenofovir-containing ART.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"74 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142917500","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}
Background Most research on HIV-1 viremia and cancer risk is from high-income countries. We evaluated the association between HIV-1 viremia and the risk of various cancer types among people with HIV (PWH) in South Africa. Methods We analysed data from the South African HIV Cancer Match study, based on laboratory measurements from the National Health Laboratory Services and cancer records from the National Cancer Registry from 2004-2014. Using Cox proportional hazards models, we estimated hazard ratios (HR) for cancer incidence per unit increase in time-updated Log10 HIV-1 RNA viral load copies/mL. We created partially adjusted (sex, age, calendar year) and fully adjusted models (additionally including time-updated CD4 count). Results We included 2,770,200 PWH with 10,175 incident cancers; most common were cervical cancer (N=2,481), Kaposi sarcoma (N=1,902), breast cancer (N=1,063), and non-Hodgkin lymphoma (N=863). Hazard ratios for the association of HIV-1 viremia and cancer risk changed after partial and full adjustment and were generally attenuated for infection-related cancers but tended to increase for infection-unrelated cancers. In the fully adjusted model, HIV-1 viremia was associated with an increased risk of Kaposi sarcoma (HR per unit increase in Log10 HIV-1 RNA viral load: 1.38, 95% CI 1.35-1.42), leukemia (HR: 1.28, 95% CI 1.13-1.45), non-Hodgkin lymphoma (HR: 1.24, 95% CI 1.19-1.29), conjunctival cancer (HR: 1.19, 95% CI 1.11-1.25), and colorectal cancer (HR: 1.11, 95% CI 1.02-1.21). Associations with other cancer types were weaker or absent. Conclusions Our findings underline the importance of sustained viral suppression for cancer prevention among PWH in South Africa.
{"title":"HIV-1 Viremia and Cancer Risk in 2.8 Million People: the South African HIV Cancer Match Study","authors":"Yann Ruffieux, Judith Mwansa-Kambafwile, Carole Metekoua, Tinashe Tombe-Nyahuma, Julia Bohlius, Mazvita Muchengeti, Matthias Egger, Eliane Rohner","doi":"10.1093/cid/ciae652","DOIUrl":"https://doi.org/10.1093/cid/ciae652","url":null,"abstract":"Background Most research on HIV-1 viremia and cancer risk is from high-income countries. We evaluated the association between HIV-1 viremia and the risk of various cancer types among people with HIV (PWH) in South Africa. Methods We analysed data from the South African HIV Cancer Match study, based on laboratory measurements from the National Health Laboratory Services and cancer records from the National Cancer Registry from 2004-2014. Using Cox proportional hazards models, we estimated hazard ratios (HR) for cancer incidence per unit increase in time-updated Log10 HIV-1 RNA viral load copies/mL. We created partially adjusted (sex, age, calendar year) and fully adjusted models (additionally including time-updated CD4 count). Results We included 2,770,200 PWH with 10,175 incident cancers; most common were cervical cancer (N=2,481), Kaposi sarcoma (N=1,902), breast cancer (N=1,063), and non-Hodgkin lymphoma (N=863). Hazard ratios for the association of HIV-1 viremia and cancer risk changed after partial and full adjustment and were generally attenuated for infection-related cancers but tended to increase for infection-unrelated cancers. In the fully adjusted model, HIV-1 viremia was associated with an increased risk of Kaposi sarcoma (HR per unit increase in Log10 HIV-1 RNA viral load: 1.38, 95% CI 1.35-1.42), leukemia (HR: 1.28, 95% CI 1.13-1.45), non-Hodgkin lymphoma (HR: 1.24, 95% CI 1.19-1.29), conjunctival cancer (HR: 1.19, 95% CI 1.11-1.25), and colorectal cancer (HR: 1.11, 95% CI 1.02-1.21). Associations with other cancer types were weaker or absent. Conclusions Our findings underline the importance of sustained viral suppression for cancer prevention among PWH in South Africa.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"41 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902256","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}
Bradley J Langford, Kevin A Brown, Cindy Lau, Andrew Calzavara, Carsten Krueger, Valerie Leung, Nick Daneman, Kevin L Schwartz
Background Shorter courses of antibiotic therapy are increasingly recommended to reduce antibiotic exposure. However quantifying the real-world impact of duration of therapy is hindered by bias common in observational studies. We aimed to evaluate the harms and benefits of longer versus shorter duration of therapy in older adults. Methods This was a population-based cohort study using administrative health data from Ontario, Canada. We included outpatients aged 66 to 110 years who received a prescription for amoxicillin, cephalexin, and/or ciprofloxacin. Prescriptions were categorized as short (3-7 days) or long (8-14 days) duration. The primary outcome was a composite of antibiotic-related harms, including adverse reactions, Clostridioides difficile infection, and antibiotic resistance. The secondary outcome was a composite of safety measures including repeat antibiotic prescriptions, hospital visits and mortality. To reduce risk of bias, we used an instrumental variable analysis where the instrument was prescriber proportion of antibiotics that were long duration. Results Among 117,682 eligible patients, there was no difference in the primary harms outcome for patients receiving longer versus shorter courses of antibiotics (amoxicillin ORadj 0.99 (95%CI 0.84 to 1.15), cephalexin ORadj 1.11 (95%CI: 0.90 to 1.38), ciprofloxacin ORadj 0.94 (95%CI 0.74 to 1.20). Secondary safety outcomes were similar, with longer compared to shorter courses of antibiotic therapy (amoxicillin OR 1.01 (95%CI: 0.94 to 1.08), cephalexin OR 1.06 (95%CI 0.97 to 1.17), ciprofloxacin OR 0.99 (95%CI: 0.85 to 1.15)). Conclusion In this instrumental variable analysis of community-dwelling older adults, longer antibiotic courses were not associated with an increased benefit or harm compared to shorter courses.
{"title":"Evaluating Harms Associated with Prolonged Antibiotic Duration of Therapy in Community Dwelling Older Adults: A Cohort Study using Instrumental Variable Analysis","authors":"Bradley J Langford, Kevin A Brown, Cindy Lau, Andrew Calzavara, Carsten Krueger, Valerie Leung, Nick Daneman, Kevin L Schwartz","doi":"10.1093/cid/ciae629","DOIUrl":"https://doi.org/10.1093/cid/ciae629","url":null,"abstract":"Background Shorter courses of antibiotic therapy are increasingly recommended to reduce antibiotic exposure. However quantifying the real-world impact of duration of therapy is hindered by bias common in observational studies. We aimed to evaluate the harms and benefits of longer versus shorter duration of therapy in older adults. Methods This was a population-based cohort study using administrative health data from Ontario, Canada. We included outpatients aged 66 to 110 years who received a prescription for amoxicillin, cephalexin, and/or ciprofloxacin. Prescriptions were categorized as short (3-7 days) or long (8-14 days) duration. The primary outcome was a composite of antibiotic-related harms, including adverse reactions, Clostridioides difficile infection, and antibiotic resistance. The secondary outcome was a composite of safety measures including repeat antibiotic prescriptions, hospital visits and mortality. To reduce risk of bias, we used an instrumental variable analysis where the instrument was prescriber proportion of antibiotics that were long duration. Results Among 117,682 eligible patients, there was no difference in the primary harms outcome for patients receiving longer versus shorter courses of antibiotics (amoxicillin ORadj 0.99 (95%CI 0.84 to 1.15), cephalexin ORadj 1.11 (95%CI: 0.90 to 1.38), ciprofloxacin ORadj 0.94 (95%CI 0.74 to 1.20). Secondary safety outcomes were similar, with longer compared to shorter courses of antibiotic therapy (amoxicillin OR 1.01 (95%CI: 0.94 to 1.08), cephalexin OR 1.06 (95%CI 0.97 to 1.17), ciprofloxacin OR 0.99 (95%CI: 0.85 to 1.15)). Conclusion In this instrumental variable analysis of community-dwelling older adults, longer antibiotic courses were not associated with an increased benefit or harm compared to shorter courses.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"41 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901706","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}
Thomas Montrouge, Mélanie Bertine, Gilles Peytavin, Thibault Saint Joannis, Antoine Bachelard, Pierre De Truchis, Sylvie Lariven, Philippe Morlat, Cécile Pouderoux, Florence Damond, Naomi Sayre, Roland Tubiana, Nadia Valin, Charlotte Charpentier, Diane Descamps, Jade Ghosn, Quentin Le Hingrat
Lenacapavir is the first capsid inhibitor, its use is currently approved for multidrug resistant HIV-1 infection. We report that, despite an initial efficacy of a LEN-containing regimen in patients with multi-drug resistant HIV-2 viruses, virological suppression was not achieved after a year and most patients selected capsid drug-resistance associated mutations.
{"title":"Rapid Selection of HIV-2 Capsid Mutations in Salvage Therapy with Lenacapavir-Containing Regimen","authors":"Thomas Montrouge, Mélanie Bertine, Gilles Peytavin, Thibault Saint Joannis, Antoine Bachelard, Pierre De Truchis, Sylvie Lariven, Philippe Morlat, Cécile Pouderoux, Florence Damond, Naomi Sayre, Roland Tubiana, Nadia Valin, Charlotte Charpentier, Diane Descamps, Jade Ghosn, Quentin Le Hingrat","doi":"10.1093/cid/ciae650","DOIUrl":"https://doi.org/10.1093/cid/ciae650","url":null,"abstract":"Lenacapavir is the first capsid inhibitor, its use is currently approved for multidrug resistant HIV-1 infection. We report that, despite an initial efficacy of a LEN-containing regimen in patients with multi-drug resistant HIV-2 viruses, virological suppression was not achieved after a year and most patients selected capsid drug-resistance associated mutations.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"35 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142905161","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}
Lena van der Wekken-Pas, Fabian Weiss, Charlotte Simon-Zuber, Rena Sebisch, Carmen Wiese, Elisabeth van Leeuwen, David Burger, Angela Colbers
{"title":"Trial versus real world circumstances and how to interpret pharmacokinetic data.","authors":"Lena van der Wekken-Pas, Fabian Weiss, Charlotte Simon-Zuber, Rena Sebisch, Carmen Wiese, Elisabeth van Leeuwen, David Burger, Angela Colbers","doi":"10.1093/cid/ciae636","DOIUrl":"https://doi.org/10.1093/cid/ciae636","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945260","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}
Christina Gao, Shirajh Satheakeerthy, Carolyn Qian, Brittany Suann, Christina Guo, Andrew E C Booth, Sarah Howson, Shaun Evans, Brandon Stretton, Weng Onn Chan, Alyssa Pradhan, Stephen Bacchi
{"title":"A generalisable risk factor: Socioeconomic status and multi-resistant organism colonisation.","authors":"Christina Gao, Shirajh Satheakeerthy, Carolyn Qian, Brittany Suann, Christina Guo, Andrew E C Booth, Sarah Howson, Shaun Evans, Brandon Stretton, Weng Onn Chan, Alyssa Pradhan, Stephen Bacchi","doi":"10.1093/cid/ciae651","DOIUrl":"https://doi.org/10.1093/cid/ciae651","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945256","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":"Expanded Insights from a Case Study on Long-Acting Injectable Cabotegravir and Rilpivirine in Pregnancy.","authors":"Lauren Ziemba,Rachel Ketchum,Sean Brummel","doi":"10.1093/cid/ciae635","DOIUrl":"https://doi.org/10.1093/cid/ciae635","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"25 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887318","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}
Stefania Cheli, Alessandro Torre, Marco Schiuma, Cristina Montrasio, Aurora Civati, Miriam Galimberti, Vera Battini, Ilaria Mariani, Giulia Mosini, Carla Carnovale, Sonia Radice, Emilio Clementi, Andrea Gori, Spinello Antinori
Background Under standard therapies, the incidence of drug-induced liver injury (DILI) in patients with tuberculosis ranges from 2% to 28%. Numerous studies have identified the risk factors for antituberculosis DILI; however, none have been conducted in a multiethnic real-world setting. The primary outcome of the current study was to identify the risk factors that could be used as the best predictors of DILI in a multiethnic cohort. Methods A nested case-control study was conducted in patients at the tuberculosis clinic of Luigi Sacco Hospital in Milan. Results The study included 102 patients (mean age [SD], 45.6 [15.6] years). For each patient with hepatotoxicity, 2 controls were matched for sex, age, body mass index, tuberculosis/tuberculosis infection diagnosis, and index date. We found that N-acetyltransferase 2 gene (NAT2) slow acetylator status was the best independent predictor of DILI (odds ratio, 5.97 [95% confidence interval, 1.38–25.76]; P = .02]. Conclusions NAT2 genotype–guided dosing may help optimize antituberculosis drug treatment and prevent treatment failure. Clinical Trials Registration ClinicalTrials.gov NCT06539455
{"title":"NAT2 Slow Acetylator Phenotype as a Significant Risk Factor for Hepatotoxicity Caused by Antituberculosis Drugs: Results From a Multiethnic Nested Case-Control Study","authors":"Stefania Cheli, Alessandro Torre, Marco Schiuma, Cristina Montrasio, Aurora Civati, Miriam Galimberti, Vera Battini, Ilaria Mariani, Giulia Mosini, Carla Carnovale, Sonia Radice, Emilio Clementi, Andrea Gori, Spinello Antinori","doi":"10.1093/cid/ciae583","DOIUrl":"https://doi.org/10.1093/cid/ciae583","url":null,"abstract":"Background Under standard therapies, the incidence of drug-induced liver injury (DILI) in patients with tuberculosis ranges from 2% to 28%. Numerous studies have identified the risk factors for antituberculosis DILI; however, none have been conducted in a multiethnic real-world setting. The primary outcome of the current study was to identify the risk factors that could be used as the best predictors of DILI in a multiethnic cohort. Methods A nested case-control study was conducted in patients at the tuberculosis clinic of Luigi Sacco Hospital in Milan. Results The study included 102 patients (mean age [SD], 45.6 [15.6] years). For each patient with hepatotoxicity, 2 controls were matched for sex, age, body mass index, tuberculosis/tuberculosis infection diagnosis, and index date. We found that N-acetyltransferase 2 gene (NAT2) slow acetylator status was the best independent predictor of DILI (odds ratio, 5.97 [95% confidence interval, 1.38–25.76]; P = .02]. Conclusions NAT2 genotype–guided dosing may help optimize antituberculosis drug treatment and prevent treatment failure. Clinical Trials Registration ClinicalTrials.gov NCT06539455","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"308 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887773","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}
Morgan Birabaharan, Scott T Johns, David C Kaelber, Thomas C S Martin, Sanjay R Mehta
RSV vaccine clinical trials reported higher frequencies of atrial fibrillation in intervention groups compared to control. In this large, population-based, propensity-matched study, we found RSV vaccine was not associated with increased risk of new-onset or recurrent atrial fibrillation within 1-42 days compared to influenza or Tdap vaccines.
{"title":"Atrial Fibrillation after RSV Vaccination Among Older Adults","authors":"Morgan Birabaharan, Scott T Johns, David C Kaelber, Thomas C S Martin, Sanjay R Mehta","doi":"10.1093/cid/ciae649","DOIUrl":"https://doi.org/10.1093/cid/ciae649","url":null,"abstract":"RSV vaccine clinical trials reported higher frequencies of atrial fibrillation in intervention groups compared to control. In this large, population-based, propensity-matched study, we found RSV vaccine was not associated with increased risk of new-onset or recurrent atrial fibrillation within 1-42 days compared to influenza or Tdap vaccines.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"31 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887776","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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