首页 > 最新文献

Clinical Infectious Diseases最新文献

英文 中文
Preliminary Findings From the Dynamics of the Immune Responses to Repeat Influenza Vaccination Exposures (DRIVE I) Study: A Randomized Controlled Trial. 重复接种流感疫苗的免疫反应动态研究(DRIVE I)的初步结果:随机对照试验。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-15 DOI: 10.1093/cid/ciae380
Benjamin J Cowling, Sook-San Wong, Jefferson J S Santos, Lisa Touyon, Jordan T Ort, Naiqing Ye, Natalie K M Kwok, Faith Ho, Samuel M S Cheng, Dennis K M Ip, Malik Peiris, Richard J Webby, Patrick C Wilson, Sophie A Valkenburg, John S Tsang, Nancy H L Leung, Scott E Hensley, Sarah Cobey

Background: Studies have reported that repeated annual vaccination may influence influenza vaccination effectiveness in the current season.

Methods: We established a 5-year randomized placebo-controlled trial of repeated influenza vaccination (Flublok; Sanofi Pasteur) in adults 18-45 years of age. In the first 2 years, participants were randomized to receive vaccine or saline placebo as follows: placebo-placebo (P-P), placebo-vaccine (P-V), or vaccine-vaccine (V-V). Serum samples were collected each year just before vaccination and after 30 and 182 days. A subset of serum samples collected at 5 time points from 95 participants were tested for antibodies against vaccine strains.

Results: From 23 October 2020 through 11 March 2021 we enrolled and randomized 447 adults. Among vaccinated individuals, antibody titers increased between days 0 and 30 against each of the vaccine strains, with smaller increases for repeat vaccinees who on average had higher prevaccination titers in year 2. There were statistically significant differences in the proportions of participants achieving ≥4-fold rises in antibody titer for the repeat vaccinees for influenza A(H1N1), B/Victoria, and B/Yamagata, but not for A(H3N2). Among participants who received vaccination in year 2, there were no significant differences between the P-V and V-V groups in geometric mean titers at day 30 or the proportions of participants with antibody titers ≥40 at day 30 for any of the vaccine strains.

Conclusions: In the first 2 years, during which influenza did not circulate, repeat and first-time vaccinees had similar postvaccination geometric mean titers to all 4 vaccine strains, indicative of similar levels of clinical protection. Clinical Trials Registration. NCT04576377.

背景:有研究报告称,每年重复接种疫苗可能会影响当前季节的流感疫苗接种效果:我们在 18-45 岁的成年人中开展了一项为期 5 年的重复接种流感疫苗(Flublok,赛诺菲巴斯德公司)的随机安慰剂对照试验。在头两年,参与者按以下方式接种疫苗(V)或生理盐水安慰剂(P):P-P、P-V 或 V-V。每年在接种疫苗前以及接种疫苗 30 天和 182 天后采集血清样本。对 95 名参与者在 5 个时间点采集的血清子集进行了疫苗株抗体检测:从 2020 年 10 月 23 日至 2021 年 3 月 11 日,我们对 447 名成人进行了登记和随机分组。在接种者中,抗体滴度在第 0 天到第 30 天之间针对每种疫苗菌株都有所上升,重复接种者的抗体滴度上升幅度较小,他们在第 2 年的平均接种前滴度较高。在甲型 H1N1 流感、乙型 Victoria 流感和乙型 Yamagata 流感的重复接种者中,抗体滴度上升 >= 四倍的参与者比例在统计学上存在显著差异,但在甲型 H3N2 流感的重复接种者中则没有这种差异。在第 2 年接种疫苗的参与者中,P-V 组和 V-V 组之间在第 30 天的几何平均滴度或第 30 天抗体滴度≥40 的参与者比例方面没有统计学意义上的显著差异:在流感没有流行的头两年,重复接种者和首次接种者对所有四种疫苗株的接种后几何平均滴度相似,表明临床保护水平相似。
{"title":"Preliminary Findings From the Dynamics of the Immune Responses to Repeat Influenza Vaccination Exposures (DRIVE I) Study: A Randomized Controlled Trial.","authors":"Benjamin J Cowling, Sook-San Wong, Jefferson J S Santos, Lisa Touyon, Jordan T Ort, Naiqing Ye, Natalie K M Kwok, Faith Ho, Samuel M S Cheng, Dennis K M Ip, Malik Peiris, Richard J Webby, Patrick C Wilson, Sophie A Valkenburg, John S Tsang, Nancy H L Leung, Scott E Hensley, Sarah Cobey","doi":"10.1093/cid/ciae380","DOIUrl":"10.1093/cid/ciae380","url":null,"abstract":"<p><strong>Background: </strong>Studies have reported that repeated annual vaccination may influence influenza vaccination effectiveness in the current season.</p><p><strong>Methods: </strong>We established a 5-year randomized placebo-controlled trial of repeated influenza vaccination (Flublok; Sanofi Pasteur) in adults 18-45 years of age. In the first 2 years, participants were randomized to receive vaccine or saline placebo as follows: placebo-placebo (P-P), placebo-vaccine (P-V), or vaccine-vaccine (V-V). Serum samples were collected each year just before vaccination and after 30 and 182 days. A subset of serum samples collected at 5 time points from 95 participants were tested for antibodies against vaccine strains.</p><p><strong>Results: </strong>From 23 October 2020 through 11 March 2021 we enrolled and randomized 447 adults. Among vaccinated individuals, antibody titers increased between days 0 and 30 against each of the vaccine strains, with smaller increases for repeat vaccinees who on average had higher prevaccination titers in year 2. There were statistically significant differences in the proportions of participants achieving ≥4-fold rises in antibody titer for the repeat vaccinees for influenza A(H1N1), B/Victoria, and B/Yamagata, but not for A(H3N2). Among participants who received vaccination in year 2, there were no significant differences between the P-V and V-V groups in geometric mean titers at day 30 or the proportions of participants with antibody titers ≥40 at day 30 for any of the vaccine strains.</p><p><strong>Conclusions: </strong>In the first 2 years, during which influenza did not circulate, repeat and first-time vaccinees had similar postvaccination geometric mean titers to all 4 vaccine strains, indicative of similar levels of clinical protection. Clinical Trials Registration. NCT04576377.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11478574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747636","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}
引用次数: 0
How Immunocompromised Hosts Were Left Behind in the Quest to Control the COVID-19 Pandemic. 在寻求控制 Covid-19 大流行的过程中,免疫力低下的宿主是如何被抛在后面的?
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-15 DOI: 10.1093/cid/ciae308
Michael Boeckh, Steven A Pergam, Ajit P Limaye, Janet Englund, Lawrence Corey, Joshua A Hill

The immunocompromised population was disproportionately affected by the severe acute respiratory syndrome coronavirus 2 pandemic. However, these individuals were largely excluded from clinical trials of vaccines, monoclonal antibodies, and small molecule antivirals. Although the community of scientists, clinical researchers, and funding agencies have proven that these therapeutics can be made and tested in record time, extending this progress to vulnerable and medically complex individuals from the start has been a missed opportunity. Here, we advocate that it is paramount to plan for future pandemics by investing in specific clinical trial infrastructure for the immunocompromised population to be prepared when the need arises.

在 SARS-CoV-2 大流行中,免疫力低下的人群受到的影响尤为严重。然而,这些人在很大程度上被排除在疫苗、单克隆抗体和小分子抗病毒药物的临床试验之外。尽管科学家、临床研究人员和资助机构已经证明,这些疗法可以在创纪录的时间内完成和测试,但从一开始就将这一进展扩大到弱势和病情复杂的人群,却错失了良机。在此,我们主张必须为未来的流行病做好规划,为免疫力低下人群投资特定的临床试验基础设施,以便在需要时做好准备。
{"title":"How Immunocompromised Hosts Were Left Behind in the Quest to Control the COVID-19 Pandemic.","authors":"Michael Boeckh, Steven A Pergam, Ajit P Limaye, Janet Englund, Lawrence Corey, Joshua A Hill","doi":"10.1093/cid/ciae308","DOIUrl":"10.1093/cid/ciae308","url":null,"abstract":"<p><p>The immunocompromised population was disproportionately affected by the severe acute respiratory syndrome coronavirus 2 pandemic. However, these individuals were largely excluded from clinical trials of vaccines, monoclonal antibodies, and small molecule antivirals. Although the community of scientists, clinical researchers, and funding agencies have proven that these therapeutics can be made and tested in record time, extending this progress to vulnerable and medically complex individuals from the start has been a missed opportunity. Here, we advocate that it is paramount to plan for future pandemics by investing in specific clinical trial infrastructure for the immunocompromised population to be prepared when the need arises.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11478583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199644","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}
引用次数: 0
Tenofovir Alafenamide Versus Tenofovir Disoproxil Fumarate for Preventing Vertical Transmission in Chronic Hepatitis B Mothers: A Systematic Review and Meta-Analysis. 替诺福韦-阿拉非那胺与富马酸替诺福韦二吡呋酯在预防慢性乙型肝炎母亲垂直传播方面的比较:系统回顾和元分析》。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-15 DOI: 10.1093/cid/ciae288
Calvin Q Pan, Lin Zhu, Andy S Yu, Yuchan Zhao, Bo Zhu, Erhei Dai

Objective: International guidelines recommend maternal tenofovir disoproxil fumarate (TDF) therapy accompanied by infant immunoprophylaxis to prevent hepatitis B virus (HBV) mother-to-child transmission (MTCT) in highly viremic mothers. However, pooled analyses for tenofovir alafenamide (TAF) effects and comparisons between the 2 regimens are lacking.

Design: In this meta-analysis, pairs of independent reviewers performed multiple database searches from inception to 31 March 2024 and extracted data from cohort studies and randomized controlled trials (RCTs) in highly viremic mothers. The outcomes of interest were the reduction of MTCT and safety in the TDF-treated, TAF-treated, and control groups.

Results: We included 31 studies with 2588 highly viremic mothers receiving TDF, 280 receiving TAF, and 1600 receiving no treatment. Compared to the control, TDF therapy reduced the MTCT rate in infants aged 6-12 months (risk ratio: 0.10, 95% confidence interval [CI] .07-.16). Pairwise meta-analysis between TAF and TDF revealed similar effects on reducing MTCT (risk ratio: 1.09, 95% confidence interval .16-7.61). Network meta-analysis showed equal efficacy of the 2 regimens in reducing MTCT (risk ratio: 1.09, 95% CI .15-7.65). The surface under the cumulative ranking curve revealed TDF as the best regimen compared with TAF (probability ranking: .77 vs .72), while receiving a placebo during pregnancy had the lowest efficacy (probability ranking 0.01). There were no safety concerns for mothers and infants in all regimens.

Conclusions: Compared to placebo or no treatment, maternal TDF and TAF prophylaxis are equally effective and without safety concerns in reducing MTCT in highly viremic mothers.

目的:国际指南建议在对高病毒血症母亲进行母体富马酸替诺福韦二吡呋酯(TDF)治疗的同时进行婴儿免疫预防,以预防HBV母婴传播(MTCT)。然而,目前还缺乏对替诺福韦-阿拉非酰胺(TAF)效果的汇总分析以及两种治疗方案之间的比较:在这项荟萃分析中,一对独立审稿人对从开始到 2024 年 3 月 31 日的多个数据库进行了检索,并从针对高病毒血症母亲的队列研究和研究性临床试验中提取了数据。研究结果关注的是TDF治疗组、TAF治疗组和对照组的MTCT减少率和安全性:我们纳入了 31 项研究,其中有 2,588 名高病毒血症母亲接受了 TDF 治疗,280 名母亲接受了 TAF 治疗,1,600 名母亲未接受任何治疗。与对照组相比,TDF疗法降低了6-12个月婴儿的母婴传播率(风险比:0.10,95%置信区间为0.07-0.16)。TAF和TDF之间的配对荟萃分析显示,两者在减少母婴传播方面的效果相似(风险比:1.09,95%置信区间:0.16-7.61)。网络荟萃分析表明,两种方案在减少母婴传播方面的疗效相同(风险比:1.09,95% 置信区间:0.15-7.65)。累积排名曲线下表面显示,与 TAF 相比,TDF 是最佳方案(概率排名:0.77 vs. 0.72),而孕期服用安慰剂的疗效最低(概率排名 0.01)。所有治疗方案对母婴均无安全问题:结论:与安慰剂或不治疗相比,母体服用TDF和TAF预防性治疗在减少高病毒血症母亲的母婴传播方面同样有效,而且没有安全问题。
{"title":"Tenofovir Alafenamide Versus Tenofovir Disoproxil Fumarate for Preventing Vertical Transmission in Chronic Hepatitis B Mothers: A Systematic Review and Meta-Analysis.","authors":"Calvin Q Pan, Lin Zhu, Andy S Yu, Yuchan Zhao, Bo Zhu, Erhei Dai","doi":"10.1093/cid/ciae288","DOIUrl":"10.1093/cid/ciae288","url":null,"abstract":"<p><strong>Objective: </strong>International guidelines recommend maternal tenofovir disoproxil fumarate (TDF) therapy accompanied by infant immunoprophylaxis to prevent hepatitis B virus (HBV) mother-to-child transmission (MTCT) in highly viremic mothers. However, pooled analyses for tenofovir alafenamide (TAF) effects and comparisons between the 2 regimens are lacking.</p><p><strong>Design: </strong>In this meta-analysis, pairs of independent reviewers performed multiple database searches from inception to 31 March 2024 and extracted data from cohort studies and randomized controlled trials (RCTs) in highly viremic mothers. The outcomes of interest were the reduction of MTCT and safety in the TDF-treated, TAF-treated, and control groups.</p><p><strong>Results: </strong>We included 31 studies with 2588 highly viremic mothers receiving TDF, 280 receiving TAF, and 1600 receiving no treatment. Compared to the control, TDF therapy reduced the MTCT rate in infants aged 6-12 months (risk ratio: 0.10, 95% confidence interval [CI] .07-.16). Pairwise meta-analysis between TAF and TDF revealed similar effects on reducing MTCT (risk ratio: 1.09, 95% confidence interval .16-7.61). Network meta-analysis showed equal efficacy of the 2 regimens in reducing MTCT (risk ratio: 1.09, 95% CI .15-7.65). The surface under the cumulative ranking curve revealed TDF as the best regimen compared with TAF (probability ranking: .77 vs .72), while receiving a placebo during pregnancy had the lowest efficacy (probability ranking 0.01). There were no safety concerns for mothers and infants in all regimens.</p><p><strong>Conclusions: </strong>Compared to placebo or no treatment, maternal TDF and TAF prophylaxis are equally effective and without safety concerns in reducing MTCT in highly viremic mothers.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11478587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161186","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}
引用次数: 0
Effects of respiratory isolation for tuberculosis to reduce community-based transmission: a systematic review. 呼吸道隔离治疗肺结核对减少社区传播的影响:系统综述。
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-14 DOI: 10.1093/cid/ciae496
Ruvandhi R Nathavitharana,Abarna Pearl,Amanda Biewer,Laura Young,Leonard Mukasa,Naveed Delrooz,Advaith Subramanian,Sarah Miller,Sundari Mase,Sonal S Munsiff,Edward Nardell
BACKGROUNDRespiratory isolation of people with pulmonary tuberculosis (TB), including after treatment initiation, is used to prevent community-based transmission; yet guidelines on duration are limited and implementation is heterogeneous. This systematic review synthesized evidence on respiratory isolation for TB to inform National TB Coalition of America guidelines.METHODSAfter searching six databases, eight reviewers screened and extracted data in duplicate on effects of respiratory isolation compared to no isolation or masking. Studies were stratified by outcomes: TB infection or disease in contacts, mortality, hospitalization duration, patient and health system costs, and impact on mental health or stigma. We used a convergent integrated approach to synthesize quantitative and qualitative findings and assess limitations.RESULTSSeventeen studies were included. There were limited data directly comparing isolation to non-isolation interventions, including effects after treatment initiation. One randomized controlled trial suggested treatment in a sanatorium versus at home did not affect TB incidence in contacts. Modelling studies suggest isolation may reduce transmission, but relied on various assumptions, and isolation was implemented alongside other interventions. Descriptive, mixed-methods, and qualitative studies described adverse impacts of isolation on employment, education, food/housing security, and mental health due to transmission fears, stigma and social isolation. Impacts were compounded in marginalized groups including indigenous and incarcerated persons.CONCLUSIONData to support current isolation practices, particularly after effective treatment initiation, to reduce TB transmission in communities are limited. Public health guidance should weigh the negative impacts on people with TB against decreased community transmission to make evidence-based decisions about respiratory isolation.
背景对肺结核(TB)患者进行呼吸道隔离,包括在开始治疗后进行呼吸道隔离,可用于预防社区传播;但关于隔离持续时间的指南有限,且实施情况各不相同。本系统性综述综合了有关肺结核呼吸道隔离的证据,为美国国家结核病联盟的指导方针提供参考。方法在检索了六个数据库后,八位综述者筛选并提取了一式两份有关呼吸道隔离与不隔离或掩蔽相比效果的数据。研究按结果进行了分层:接触者的肺结核感染或疾病、死亡率、住院时间、患者和医疗系统成本以及对心理健康或耻辱感的影响。我们采用聚合综合方法来综合定量和定性研究结果并评估其局限性。直接比较隔离与非隔离干预的数据有限,包括治疗开始后的效果。一项随机对照试验表明,在疗养院治疗与在家中治疗并不影响接触者的肺结核发病率。模型研究表明,隔离可能会减少传播,但依赖于各种假设,而且隔离是与其他干预措施同时实施的。描述性研究、混合方法研究和定性研究描述了隔离对就业、教育、食品/住房安全和心理健康的不利影响,这些影响是由于对传播的恐惧、耻辱感和社会隔离造成的。结论 支持当前隔离做法(尤其是在开始有效治疗后)以减少社区结核病传播的数据有限。公共卫生指南应权衡对肺结核患者的负面影响与减少社区传播之间的关系,从而就呼吸道隔离做出循证决策。
{"title":"Effects of respiratory isolation for tuberculosis to reduce community-based transmission: a systematic review.","authors":"Ruvandhi R Nathavitharana,Abarna Pearl,Amanda Biewer,Laura Young,Leonard Mukasa,Naveed Delrooz,Advaith Subramanian,Sarah Miller,Sundari Mase,Sonal S Munsiff,Edward Nardell","doi":"10.1093/cid/ciae496","DOIUrl":"https://doi.org/10.1093/cid/ciae496","url":null,"abstract":"BACKGROUNDRespiratory isolation of people with pulmonary tuberculosis (TB), including after treatment initiation, is used to prevent community-based transmission; yet guidelines on duration are limited and implementation is heterogeneous. This systematic review synthesized evidence on respiratory isolation for TB to inform National TB Coalition of America guidelines.METHODSAfter searching six databases, eight reviewers screened and extracted data in duplicate on effects of respiratory isolation compared to no isolation or masking. Studies were stratified by outcomes: TB infection or disease in contacts, mortality, hospitalization duration, patient and health system costs, and impact on mental health or stigma. We used a convergent integrated approach to synthesize quantitative and qualitative findings and assess limitations.RESULTSSeventeen studies were included. There were limited data directly comparing isolation to non-isolation interventions, including effects after treatment initiation. One randomized controlled trial suggested treatment in a sanatorium versus at home did not affect TB incidence in contacts. Modelling studies suggest isolation may reduce transmission, but relied on various assumptions, and isolation was implemented alongside other interventions. Descriptive, mixed-methods, and qualitative studies described adverse impacts of isolation on employment, education, food/housing security, and mental health due to transmission fears, stigma and social isolation. Impacts were compounded in marginalized groups including indigenous and incarcerated persons.CONCLUSIONData to support current isolation practices, particularly after effective treatment initiation, to reduce TB transmission in communities are limited. Public health guidance should weigh the negative impacts on people with TB against decreased community transmission to make evidence-based decisions about respiratory isolation.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439223","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}
引用次数: 0
Linezolid Pharmacokinetic-Anemia Modeling in Children with Rifampicin-Resistant Tuberculosis 利奈唑胺在利福平耐药结核病患儿中的药代动力学-贫血模型
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-14 DOI: 10.1093/cid/ciae497
Jordan T Brooks, Belén P Solans, Agathe Béranger, H Simon Schaaf, Louvina van der Laan, Sangeeta Sharma, Jennifer Furin, Heather R Draper, Anneke C Hesseling, Anthony J Garcia-Prats, Radojka M Savic
Background Linezolid, an important component of rifampicin- and multidrug-resistant tuberculosis (RR/MDR-TB) treatment, is associated with treatment-limiting toxicities, including anemia. Patient-level and linezolid pharmacokinetic risk factors for anemia have not been well described in children treated for RR/MDR-TB. Methods We evaluated the pharmacokinetics of linezolid and longitudinal hemoglobin data to validate an existing population linezolid pharmacokinetic model. We assessed the impact of linezolid pharmacokinetics and the risk of developing anemia in a prospectively enrolled cohort of children. The validation of a previously published population pharmacokinetic linezolid model used nonlinear mixed effects modeling. A multivariable ordinal logistic regression model was built to predict the incidence of anemia. Results A total of 112 children, median age 7.2 (IQR: 2.2–16.3) years, were included from South Africa (n=87) and India (n=25). Of these, 24 children contributed new linezolid pharmacokinetic data. The population pharmacokinetic model which informs the currently recommended linezolid dosing in children (10-15 mg/kg) was validated with these additional new data. For every 1 g/dL lower baseline hemoglobin, the odds of developing grade 3 or 4 anemia increased by 2.64 (95% CI 1.98-3.62). For every 1 mg/L*h higher linezolid area under the concentration-time curve (AUC), the odds of developing a grade 3 or 4 anemia increased by 1.012 (95% CI 1.007-1.017). Conclusions These data taken together, confirm currently recommended linezolid doses in children. The risk of anemia in children should be carefully considered and monitored throughout. Initiating linezolid in children with low baseline hemoglobin increases the probability of experiencing grade 3 or 4 anemia.
背景利奈唑胺是利福平和耐多药结核病(RR/MDR-TB)治疗的重要组成部分,但它也会产生限制治疗的毒性反应,包括贫血。在接受 RR/MDR-TB 治疗的儿童中,患者水平和利奈唑胺药代动力学导致贫血的风险因素尚未得到很好的描述。方法 我们评估了利奈唑胺的药代动力学和纵向血红蛋白数据,以验证现有的人群利奈唑胺药代动力学模型。我们评估了利奈唑胺药代动力学的影响以及前瞻性入组儿童患贫血的风险。我们使用非线性混合效应模型对之前发表的利奈唑胺群体药代动力学模型进行了验证。建立了一个多变量序数逻辑回归模型来预测贫血的发生率。结果 南非(87 名)和印度(25 名)共纳入 112 名儿童,中位年龄为 7.2 岁(IQR:2.2-16.3 岁)。其中,24 名儿童提供了新的利奈唑胺药代动力学数据。目前推荐的利奈唑胺儿童用药剂量(10-15 毫克/千克)所依据的群体药代动力学模型已通过这些新增数据进行了验证。基线血红蛋白每降低 1 g/dL,发生 3 级或 4 级贫血的几率增加 2.64(95% CI 1.98-3.62)。利奈唑胺浓度曲线下面积(AUC)每增加 1 mg/L*h,发生 3 级或 4 级贫血的几率就增加 1.012(95% CI 1.007-1.017)。结论 综合这些数据,可以确认目前推荐的利奈唑胺儿童用药剂量。在整个治疗过程中,应仔细考虑并监测儿童贫血的风险。在基线血红蛋白较低的儿童中开始使用利奈唑胺,会增加出现 3 级或 4 级贫血的可能性。
{"title":"Linezolid Pharmacokinetic-Anemia Modeling in Children with Rifampicin-Resistant Tuberculosis","authors":"Jordan T Brooks, Belén P Solans, Agathe Béranger, H Simon Schaaf, Louvina van der Laan, Sangeeta Sharma, Jennifer Furin, Heather R Draper, Anneke C Hesseling, Anthony J Garcia-Prats, Radojka M Savic","doi":"10.1093/cid/ciae497","DOIUrl":"https://doi.org/10.1093/cid/ciae497","url":null,"abstract":"Background Linezolid, an important component of rifampicin- and multidrug-resistant tuberculosis (RR/MDR-TB) treatment, is associated with treatment-limiting toxicities, including anemia. Patient-level and linezolid pharmacokinetic risk factors for anemia have not been well described in children treated for RR/MDR-TB. Methods We evaluated the pharmacokinetics of linezolid and longitudinal hemoglobin data to validate an existing population linezolid pharmacokinetic model. We assessed the impact of linezolid pharmacokinetics and the risk of developing anemia in a prospectively enrolled cohort of children. The validation of a previously published population pharmacokinetic linezolid model used nonlinear mixed effects modeling. A multivariable ordinal logistic regression model was built to predict the incidence of anemia. Results A total of 112 children, median age 7.2 (IQR: 2.2–16.3) years, were included from South Africa (n=87) and India (n=25). Of these, 24 children contributed new linezolid pharmacokinetic data. The population pharmacokinetic model which informs the currently recommended linezolid dosing in children (10-15 mg/kg) was validated with these additional new data. For every 1 g/dL lower baseline hemoglobin, the odds of developing grade 3 or 4 anemia increased by 2.64 (95% CI 1.98-3.62). For every 1 mg/L*h higher linezolid area under the concentration-time curve (AUC), the odds of developing a grade 3 or 4 anemia increased by 1.012 (95% CI 1.007-1.017). Conclusions These data taken together, confirm currently recommended linezolid doses in children. The risk of anemia in children should be carefully considered and monitored throughout. Initiating linezolid in children with low baseline hemoglobin increases the probability of experiencing grade 3 or 4 anemia.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448678","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}
引用次数: 0
The heterogeneous syndrome of non-infectious causes of persistent fever in neutropenic patients with hematologic malignancy: another opportunity for stewardship? 血液系统恶性肿瘤中性粒细胞减少患者持续发热的非感染性病因异质性综合征:管理的又一次机会?
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-14 DOI: 10.1093/cid/ciae487
Abdullah Tarik Aslan, Murat Akova, Dimitrios P Kontoyiannis
Although occult fungal, viral and multidrug-resistant bacterial infections can cause persistent fever in neutropenic patients with hematologic cancer, a variety of non-infectious entities should be considered in case-by-case basis in the context of negative diagnostic workup for infection.
虽然隐性真菌、病毒和耐多药细菌感染可导致中性粒细胞减少的血液肿瘤患者持续发热,但在感染诊断阴性的情况下,也应根据具体情况考虑各种非感染因素。
{"title":"The heterogeneous syndrome of non-infectious causes of persistent fever in neutropenic patients with hematologic malignancy: another opportunity for stewardship?","authors":"Abdullah Tarik Aslan, Murat Akova, Dimitrios P Kontoyiannis","doi":"10.1093/cid/ciae487","DOIUrl":"https://doi.org/10.1093/cid/ciae487","url":null,"abstract":"Although occult fungal, viral and multidrug-resistant bacterial infections can cause persistent fever in neutropenic patients with hematologic cancer, a variety of non-infectious entities should be considered in case-by-case basis in the context of negative diagnostic workup for infection.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431443","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}
引用次数: 0
Primary Care Guidance for Providers of Care for Persons With Human Immunodeficiency Virus: 2024 Update by the HIV Medicine Association of the Infectious Diseases Society of America. 人类免疫缺陷病毒感染者初级保健指南》:美国传染病学会艾滋病医学协会 2024 年更新版。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-12 DOI: 10.1093/cid/ciae479
Michael Horberg, Melanie Thompson, Allison Agwu, Jonathan Colasanti, Marwan Haddad, Mamta Jain, Grace McComsey, Asa Radix, Natella Rakhmanina, William R Short, Tulika Singh, Hansel Tookes

Advances in antiretroviral therapy (ART) have made it possible for persons with human immunodeficiency virus (HIV) to live a lifespan approaching that of people without HIV, without progressing to AIDS or transmitting HIV to sexual partners or infants. There is, therefore, increasing emphasis on maintaining health throughout the lifespan. To receive optimal medical care and achieve desired outcomes, persons with HIV must be consistently engaged in care and able to access uninterrupted treatment, including ART. Comprehensive evidence-based HIV primary care guidance is, therefore, more important than ever. Creating a patient-centered, stigma-free care environment is essential for care engagement. Barriers to care must be decreased at the societal, health system, clinic, and individual levels. As the population ages and noncommunicable diseases arise, providing comprehensive health care for persons with HIV becomes increasingly complex, including management of multiple comorbidities and the associated challenges of polypharmacy, while also attending to HIV-specific health concerns. Clinicians must address issues specific to preventive health, including cancer screening, providing recommended vaccinations, as well as promoting sexual health, including sexually transmitted infection diagnosis, treatment, and prevention. Clinicians also must address issues for specific populations, including persons of childbearing potential, including during preconception and pregnancy; children; adolescents; and transgender and gender-diverse individuals. This guidance from an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America updates the previous 2020 HIV Primary Care Guidance.

抗逆转录病毒疗法(ART)的进步使人类免疫缺陷病毒(HIV)感染者的寿命接近未感染 HIV 的人,而不会发展为艾滋病或将 HIV 传播给性伴侣或婴儿。因此,人们越来越重视在整个生命周期内保持健康。为了获得最佳的医疗护理并达到预期的效果,艾滋病病毒感染者必须持续接受护理,并能够获得不间断的治疗,包括抗逆转录病毒疗法。因此,全面的循证艾滋病初级保健指导比以往任何时候都更加重要。营造以患者为中心、无污名化的护理环境对于参与护理至关重要。必须在社会、医疗系统、诊所和个人层面减少就医障碍。随着人口老龄化和非传染性疾病的出现,为艾滋病病毒感染者提供全面的医疗保健服务变得越来越复杂,包括管理多种合并症和相关的多重药物治疗挑战,同时还要关注艾滋病病毒特有的健康问题。临床医生必须解决预防保健方面的具体问题,包括癌症筛查、提供建议的疫苗接种,以及促进性健康,包括性传播感染的诊断、治疗和预防。临床医生还必须解决特定人群的问题,包括有生育能力的人群(包括孕前和孕期)、儿童、青少年、变性人和性别多样化人群。本指南由美国传染病学会艾滋病医学协会的专家小组制定,更新了之前的《2020 年艾滋病初级医疗指南》。
{"title":"Primary Care Guidance for Providers of Care for Persons With Human Immunodeficiency Virus: 2024 Update by the HIV Medicine Association of the Infectious Diseases Society of America.","authors":"Michael Horberg, Melanie Thompson, Allison Agwu, Jonathan Colasanti, Marwan Haddad, Mamta Jain, Grace McComsey, Asa Radix, Natella Rakhmanina, William R Short, Tulika Singh, Hansel Tookes","doi":"10.1093/cid/ciae479","DOIUrl":"https://doi.org/10.1093/cid/ciae479","url":null,"abstract":"<p><p>Advances in antiretroviral therapy (ART) have made it possible for persons with human immunodeficiency virus (HIV) to live a lifespan approaching that of people without HIV, without progressing to AIDS or transmitting HIV to sexual partners or infants. There is, therefore, increasing emphasis on maintaining health throughout the lifespan. To receive optimal medical care and achieve desired outcomes, persons with HIV must be consistently engaged in care and able to access uninterrupted treatment, including ART. Comprehensive evidence-based HIV primary care guidance is, therefore, more important than ever. Creating a patient-centered, stigma-free care environment is essential for care engagement. Barriers to care must be decreased at the societal, health system, clinic, and individual levels. As the population ages and noncommunicable diseases arise, providing comprehensive health care for persons with HIV becomes increasingly complex, including management of multiple comorbidities and the associated challenges of polypharmacy, while also attending to HIV-specific health concerns. Clinicians must address issues specific to preventive health, including cancer screening, providing recommended vaccinations, as well as promoting sexual health, including sexually transmitted infection diagnosis, treatment, and prevention. Clinicians also must address issues for specific populations, including persons of childbearing potential, including during preconception and pregnancy; children; adolescents; and transgender and gender-diverse individuals. This guidance from an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America updates the previous 2020 HIV Primary Care Guidance.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406200","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}
引用次数: 0
Cycles of susceptibility: Immunity debt explains altered infectious disease dynamics post -pandemic. 易感性循环:免疫债务解释了大流行后传染病动态的变化。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-11 DOI: 10.1093/cid/ciae493
Alasdair Ps Munro, Thomas House

The concept of immunity debt is a phenomenon resulting from the suppression of endemic pathogens during the COVID-19 pandemic due to non-pharmaceutical interventions (NPIs). The reduced circulation of various pathogens during the pandemic, particularly respiratory syncytial virus (RSV), altered typical infectious disease dynamics by reducing levels of population immunity usually acquired through exposure to infection. This concept is demonstrated through post-pandemic resurgence of diseases such as RSV and Group A Streptococcus, and highlights the interplay between reduced pathogen exposure and increased susceptibility in populations. The complexities and non-linear dynamics of seasonal transmission are observed in differences in pathogen resurgence across regions. These issues highlight the importance of comprehensive disease surveillance and public health strategies in mitigating these long-term epidemiological impacts.

免疫债务的概念是指在 COVID-19 大流行期间,由于非药物干预措施(NPI)抑制了地方性病原体而产生的一种现象。大流行期间,各种病原体(尤其是呼吸道合胞病毒(RSV))的循环减少,降低了通常通过接触感染获得的人群免疫力水平,从而改变了典型的传染病动态。大流行后,RSV 和 A 群链球菌等疾病的再次流行证明了这一概念,并强调了病原体暴露减少与人群易感性增加之间的相互作用。季节性传播的复杂性和非线性动态可从不同地区病原体复发的差异中观察到。这些问题凸显了全面疾病监测和公共卫生战略在减轻这些长期流行病学影响方面的重要性。
{"title":"Cycles of susceptibility: Immunity debt explains altered infectious disease dynamics post -pandemic.","authors":"Alasdair Ps Munro, Thomas House","doi":"10.1093/cid/ciae493","DOIUrl":"https://doi.org/10.1093/cid/ciae493","url":null,"abstract":"<p><p>The concept of immunity debt is a phenomenon resulting from the suppression of endemic pathogens during the COVID-19 pandemic due to non-pharmaceutical interventions (NPIs). The reduced circulation of various pathogens during the pandemic, particularly respiratory syncytial virus (RSV), altered typical infectious disease dynamics by reducing levels of population immunity usually acquired through exposure to infection. This concept is demonstrated through post-pandemic resurgence of diseases such as RSV and Group A Streptococcus, and highlights the interplay between reduced pathogen exposure and increased susceptibility in populations. The complexities and non-linear dynamics of seasonal transmission are observed in differences in pathogen resurgence across regions. These issues highlight the importance of comprehensive disease surveillance and public health strategies in mitigating these long-term epidemiological impacts.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399618","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}
引用次数: 0
Correction to: Prosthetic Joint Infections due to Candida Species: A Multicenter International Study. 更正:由念珠菌引起的人工关节感染:一项多中心国际研究。
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-10 DOI: 10.1093/cid/ciae492
{"title":"Correction to: Prosthetic Joint Infections due to Candida Species: A Multicenter International Study.","authors":"","doi":"10.1093/cid/ciae492","DOIUrl":"https://doi.org/10.1093/cid/ciae492","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142436166","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}
引用次数: 0
Mpox in People With Human Immunodeficiency Virus: Predictors of Diagnosis, Outcomes, and Vaccine Effectiveness in a Multisite Cohort 人类免疫缺陷病毒感染者中的麻疹病毒:多地点队列中的诊断、结果和疫苗有效性预测因素
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-08 DOI: 10.1093/cid/ciae464
Michalina Montaño, Adrienne E Shapiro, Bridget M Whitney, Laura Bamford, Greer Burkholder, Edward R Cachay, Katerina A Christopoulos, Heidi M Crane, Joseph A C Delaney, Joseph J Eron, Rob J Fredericksen, Peter W Hunt, Jeffrey M Jacobson, Jeanne C Keruly, H Nina Kim, Kenneth H Mayer, Richard D Moore, Sonia Napravnik, April Pettit, Michael S Saag, George A Yendewa, Mari M Kitahata, Rachel A Bender Ignacio
Introduction Since its global reemergence in 2022, monkeypox (mpox) has demonstrated increased incidence and severity among people with human immunodeficiency virus (HIV [PWH]). Predictors of mpox diagnosis, vaccination, and outcomes among PWH are limited. Methods We included PWH with primary care visits after 1 January 2022 at 9 US sites participating in the Centers for AIDS Research Network of Integrated Clinic Systems Network. We identified mpox diagnosed between 1 June 2022 and 31 May 2023, through a combination of polymerase chain reaction result, diagnosis code, and/or tecovirimat receipt. We examined validated clinical diagnoses, laboratory results, vaccine data, and patient reported outcomes. We evaluated relative risks (RR) of mpox diagnosis, hospitalization, tecovirimat treatment, and vaccine receipt. Findings Among 19 777 PWH in care, 413 mpox cases (all male sex at birth) occurred (2.2 cases/100 person-years). Age &lt;40 years, geographic region, Hispanic/Latine ethnicity, lack of antiretroviral therapy, detectable HIV viral load, and recent bacterial sexually transmitted infection predicted mpox diagnosis. PWH with CD4 200–349 cells/mm3 were most likely to be hospitalized (adjusted RR, 3.20; 95% confidence interval: 1.44–7.09) compared to CD4 ≥500, but half as likely as those with CD4 &lt;200 to receive tecovirimat. Overall, smallpox/mpox vaccine effectiveness of ≥1 vaccine was 71% (adjusted RR, 0.29; 95% confidence interval: .14–.47) at preventing mpox, and 86% or better with CD4 ≥350 or HIV viral suppression. Non-Hispanic Black PWH were less likely to be vaccinated than other racial/ethnic identities. Interpretation PWH not on antiretroviral therapy or with unsuppressed HIV were more likely to be diagnosed with, and hospitalized for, mpox. Mpox/smallpox vaccine effectiveness was high, inclusive of those with low CD4 count and HIV viremia.
导言:自 2022 年猴痘在全球重新出现以来,猴痘在人类免疫缺陷病毒(HIV [PWH])感染者中的发病率和严重程度都有所上升。在感染人类免疫缺陷病毒(HIV)的人群中,猴痘的诊断、疫苗接种和预后的预测因素非常有限。方法 我们纳入了 2022 年 1 月 1 日之后在参与艾滋病研究中心综合诊所系统网络的 9 个美国站点接受初级保健就诊的感染者。我们通过聚合酶链式反应结果、诊断代码和/或替考韦瑞(tecovirimat)收据的组合,确定了 2022 年 6 月 1 日至 2023 年 5 月 31 日期间确诊的麻风病人。我们检查了有效的临床诊断、实验室结果、疫苗数据和患者报告的结果。我们评估了麻风病诊断、住院治疗、替考韦瑞治疗和接种疫苗的相对风险系数(RR)。研究结果 在接受治疗的 19 777 名残疾人中,有 413 例水痘病例(出生时性别均为男性)(2.2 例/100 人-年)。年龄&lt;40岁、地理区域、西班牙裔/拉丁裔、缺乏抗逆转录病毒治疗、可检测到的HIV病毒载量以及近期细菌性性传播感染都预示着麻风病的诊断。与CD4≥500的人群相比,CD4为200-349 cells/mm3的人群最有可能住院治疗(调整后RR为3.20;95%置信区间:1.44-7.09),但与CD4为&lt;200的人群相比,接受替考韦酯治疗的可能性仅为后者的一半。总体而言,≥1 次接种天花/水痘疫苗对预防水痘的有效率为 71%(调整后 RR,0.29;95% 置信区间:.14-.47),CD4 ≥350或艾滋病毒病毒抑制者的有效率为 86%或更高。与其他种族/民族相比,非西班牙裔黑人公共卫生人员接种疫苗的可能性较低。解释 未接受抗逆转录病毒治疗或艾滋病毒未得到抑制的公共卫生人员更有可能被诊断出患有水痘并因此住院治疗。水痘/天花疫苗的有效性很高,包括那些 CD4 细胞计数低和艾滋病毒病毒血症患者。
{"title":"Mpox in People With Human Immunodeficiency Virus: Predictors of Diagnosis, Outcomes, and Vaccine Effectiveness in a Multisite Cohort","authors":"Michalina Montaño, Adrienne E Shapiro, Bridget M Whitney, Laura Bamford, Greer Burkholder, Edward R Cachay, Katerina A Christopoulos, Heidi M Crane, Joseph A C Delaney, Joseph J Eron, Rob J Fredericksen, Peter W Hunt, Jeffrey M Jacobson, Jeanne C Keruly, H Nina Kim, Kenneth H Mayer, Richard D Moore, Sonia Napravnik, April Pettit, Michael S Saag, George A Yendewa, Mari M Kitahata, Rachel A Bender Ignacio","doi":"10.1093/cid/ciae464","DOIUrl":"https://doi.org/10.1093/cid/ciae464","url":null,"abstract":"Introduction Since its global reemergence in 2022, monkeypox (mpox) has demonstrated increased incidence and severity among people with human immunodeficiency virus (HIV [PWH]). Predictors of mpox diagnosis, vaccination, and outcomes among PWH are limited. Methods We included PWH with primary care visits after 1 January 2022 at 9 US sites participating in the Centers for AIDS Research Network of Integrated Clinic Systems Network. We identified mpox diagnosed between 1 June 2022 and 31 May 2023, through a combination of polymerase chain reaction result, diagnosis code, and/or tecovirimat receipt. We examined validated clinical diagnoses, laboratory results, vaccine data, and patient reported outcomes. We evaluated relative risks (RR) of mpox diagnosis, hospitalization, tecovirimat treatment, and vaccine receipt. Findings Among 19 777 PWH in care, 413 mpox cases (all male sex at birth) occurred (2.2 cases/100 person-years). Age &amp;lt;40 years, geographic region, Hispanic/Latine ethnicity, lack of antiretroviral therapy, detectable HIV viral load, and recent bacterial sexually transmitted infection predicted mpox diagnosis. PWH with CD4 200–349 cells/mm3 were most likely to be hospitalized (adjusted RR, 3.20; 95% confidence interval: 1.44–7.09) compared to CD4 ≥500, but half as likely as those with CD4 &amp;lt;200 to receive tecovirimat. Overall, smallpox/mpox vaccine effectiveness of ≥1 vaccine was 71% (adjusted RR, 0.29; 95% confidence interval: .14–.47) at preventing mpox, and 86% or better with CD4 ≥350 or HIV viral suppression. Non-Hispanic Black PWH were less likely to be vaccinated than other racial/ethnic identities. Interpretation PWH not on antiretroviral therapy or with unsuppressed HIV were more likely to be diagnosed with, and hospitalized for, mpox. Mpox/smallpox vaccine effectiveness was high, inclusive of those with low CD4 count and HIV viremia.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385164","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}
引用次数: 0
期刊
Clinical Infectious Diseases
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1