International Journal of Infectious Diseases最新文献

Objectives: Pneumococcal disease burden remains substantial in settings where pneumococcal conjugate vaccine (PCV) uptake is low. In China, PCV13 (Prevenar 13, Pfizer) has been available since 2016 on the private market, however no studies to date have evaluated its effectiveness against invasive pneumococcal disease (IPD). We aimed to evaluate the PCV13 vaccine effectiveness (VE) against vaccine-type IPD (VT-IPD) in Zhejiang, China in children aged ≤5 years.

Methods: We conducted a case-control study from 2018-2024 at three pediatric hospitals in Zhejiang, China. Eligible patients with laboratory-confirmed IPD due to serotypes included in PCV13 were enrolled as cases and matched 1:4 with community controls identified from the Zhejiang Provincial Smart Service Information System for Immunization Program, which also served as the source for vaccination history. PCV13 VE was calculated as (1 - odds ratio) × 100% using conditional logistic regression, adjusted for influenza vaccination status.

Results: A total of 47 cases and 188 controls were included in the study. Among VT-IPD cases, 22 (47%) were male, median age was 25 months, and serotypes 19F (n=11), 6B (n = 8), and 6A (n = 7) were most common. Adjusted VE for ≥3 doses of PCV13 against VT-IPD was 96·4% (95% confidence interval 60·9, 99·5).

Conclusions: PCV13 is highly effective at preventing VT- IPD in children in China. Findings underscore PCV13's public health value and provide local evidence that could support decision-making for routine childhood immunization programme.

Background: Lenacapavir is a first-in-class, long-acting HIV-1 capsid inhibitor enabling treatment and prevention with reduced reliance on daily oral adherence. Evidence from randomized trials across indications remains fragmented. We systematically synthesized trial data on its efficacy and safety in both treatment and pre-exposure prophylaxis (PrEP) settings.

Methods: Following PRISMA 2020 (protocol registered at OSF), we reviewed phase 2-3 randomized controlled trials evaluating lenacapavir for HIV treatment or prevention, with searches conducted from database inception through 15 January 2026. Comparators included placebo or active antiretroviral regimens. Primary outcomes were virologic efficacy and safety (injection-site reactions [ISRs], serious adverse events [SAEs]); secondary outcomes included resistance and treatment discontinuation.

Results: Five trials involving 9,986 participants from 20 countries were included. In treatment trials, lenacapavir administered with optimized background regimens achieved viral suppression (<50 copies/mL) in 83-100% of participants through weeks 24-54, comparable to standard oral therapy. In PrEP trials, HIV incidence was reduced to 0.00-0.10 per 100 person-years versus 0.93-2.37 in controls (incidence-rate ratio 0.00-0.11; p<0.001). ISRs were the most frequent adverse events (≤1.2% discontinuation), with no treatment-related SAEs. Capsid resistance mutations were rare and often transient.

Conclusions: Lenacapavir provides durable efficacy and favorable safety across treatment and prevention, supporting its role as a transformative biannual injectable strategy to advance global HIV control.

Background: The extended therapeutic duration required for pulmonary tuberculosis (PTB) treatment and current limitations in bacteriological gold standards for cure assessment may lead to premature discharge of incompletely cured patients, thereby elevating risks of disease transmission and drug resistance emergence. Host-directed biomarker research holds promise as a valuable adjunct to existing PTB cure evaluation standards, potentially enhancing diagnostic precision and therapeutic monitoring. Transcriptomic biomarkers represent a promising research direction and constitute the focal point of this study.

Methods: This study stratified participants into four groups: healthy controls(HC), PTB patients (TB0), 2-month PTB treatment patients (TB2), and cured PTB cases (TB6). Whole-transcriptome sequencing was systematically applied to peripheral blood mononuclear cells (PBMCs) to simultaneously profile mRNA, lncRNA, circRNA, and miRNA expression patterns, thereby constructing transcriptomic profiles characterizing PTB progression from disease to clinical resolution. Subsequently, the most significantly differentially expressed RNAs were prioritized as candidate biomarkers for therapeutic efficacy evaluation in PTB management.

Results: Comparative analysis between TB0 and TB6 groups revealed an intricate interaction network comprising 26 differentially expressed mRNAs, 19 lncRNAs, 1 circRNA, and 2 miRNAs. Three mRNAs (CD1B, CD247, and CCNB1) demonstrating significant differential expression between TB0 and TB6 groups were systematically identified. These biomarkers collectively captured two critical biological hallmarks of successful PTB treatment: CD1B and CD247 signatures reflected the establishment of T-cell-mediated host immunity, while CCNB1 downregulation indicated mitigation of cell cycle-associated pathological damage. Notably, the lncRNA FMNL2 emerged as a potential cell cycle regulator, potentially mediating its effects through targeted interaction with CCNB1.

Conclusion: This investigation elucidates two pivotal biological signatures associated with PTB resolution, providing novel insights into the pathological mechanisms underlying treatment success. These molecular candidates not only show significant potential as biomarkers for therapeutic efficacy monitoring but may also serve as promising therapeutic targets for PTB intervention strategies.

In a single-centre Italian study (201 6-2023), we analyzed all children and young people (n=53) with tuberculosis. All were born to foreign born parents. Those born in Italy were younger and mainly pulmonary, while those born abroad were more frequently malnourished and BCG vaccinated. These findings highlight the need for targeted screening, nutrition support, and vaccination strategies.

Background: Marginalized urban populations experience a high burden of HIV and HCV. We assessed the prevalence and risk factors for both infections and characterized the care cascades in a cohort of vulnerable individuals in Madrid, Spain.

Methods: We conducted a cross-sectional study (2019-2023) of 4,582 individuals via mobile units in high-risk hotspots, offering integrated rapid HIV/HCV testing with point-of-care HCV-RNA confirmation. Multivariable logistic regression identified independent HIV risk factors.

Results: HIV prevalence was 6.3% (95% CI 5.6-7.0). Among people with HIV (PWH), 17.0% of known cases were not receiving antiretroviral therapy; PrEP uptake was zero among HIV-negative individuals. A history of injecting drug use was the primary HIV risk factor (adjusted odds ratio[aOR] 6.6; 95% CI 4.6-9.5), followed by age >50 years, Spanish origin, and alcohol/benzodiazepine misuse (all p<0.05). Active HCV prevalence was 5.5% (95% CI 4.9-6.2); 15.7% in PWH vs. 4.8% in people without HIV (p<0.001). Among confirmed cases, HCV linkage (≥95.2%) and treatment (≥88.6%) were high; however, 16.8% of all antibody-positive individuals (23.2% among PWH) missed confirmatory RNA testing.

Conclusions: HIV and HCV remain prevalent, characterized by discontinuities in retention rather than diagnosis. Integrated, low-threshold strategies combining harm reduction with social support are required to address this syndemic.