BACKGROUNDHigh-dose dual therapy (HDDT) is a promising first-line treatment option for Helicobacter pylori infection. In this study, we aimed to compare the efficacy and safety of different HDDT regimens.METHODSThis multicenter retrospective study included data from 10 centers between January 2022 and January 2025. Inverse probability of treatment-weighted (IPTW) adjustment was used to address the imbalance in variables across groups. The outcomes included the eradication rate, adverse events and adherence.RESULTSA total of 1,665 patients were included, with a full analysis set (FAS) eradication rate of 88.6% and a per-protocol (PP) eradication rate of 89.5% for HDDT. After IPTW adjustment, the eradication rate of vonoprazan-amoxicillin (VA) 14-day based on FAS analysis was 95.1%, which was significantly higher than VA-10 day (88.7%) (P = 0.001), esomeprazole-amoxicillin (EA) (85.1%) (P < 0.001), and tegoprazan-amoxicillin (TA) (87.3%) (P < 0.001). The incidence of adverse events for VA-14 was 8.1%, which was comparable to VA-10 (11.1%) but lower than TA (14.4%) and EA (15.3%) (P = 0.002). Adherence showed no significant difference across groups. High body surface area (BSA) (≥1.80 m²) (OR 1.594, 95% confidence interval [CI], 1.018-2.495, P = 0.041), poor adherence (OR 4.975, 95% CI, 2.753-8.992, P < 0.001), and non-VA-14 treatment regimen were independent risk factors for eradication failure. Factors varied across regimens.CONCLUSIONSHDDT, particularly VA-14, is a competitive first-line option for H. pylori eradication. High BSA and low adherence were risk factors for eradication failure but varied across regimens, highlighting the necessity of personalized adjustment.
{"title":"Comparative Analysis of High-Dose Dual Therapies in First-Line Helicobacter pylori Eradication: An Inverse Probability of Treatment-Weighted Multicenter Study.","authors":"Qingzhou Kong,Baobao Wang,Bengang Zhou,Hong Lu,Tianlian Yan,Yingying Han,Yanbing Ding,Peiyuan Li,Miao Duan,Kunping Ju,Wenrong Geng,Yuting Guo,Hongyu Zhao,Xiaohui Song,Xiaowei Li,Xin Long,Xiuli Zuo,Yanqing Li,Yueyue Li","doi":"10.1093/infdis/jiag059","DOIUrl":"https://doi.org/10.1093/infdis/jiag059","url":null,"abstract":"BACKGROUNDHigh-dose dual therapy (HDDT) is a promising first-line treatment option for Helicobacter pylori infection. In this study, we aimed to compare the efficacy and safety of different HDDT regimens.METHODSThis multicenter retrospective study included data from 10 centers between January 2022 and January 2025. Inverse probability of treatment-weighted (IPTW) adjustment was used to address the imbalance in variables across groups. The outcomes included the eradication rate, adverse events and adherence.RESULTSA total of 1,665 patients were included, with a full analysis set (FAS) eradication rate of 88.6% and a per-protocol (PP) eradication rate of 89.5% for HDDT. After IPTW adjustment, the eradication rate of vonoprazan-amoxicillin (VA) 14-day based on FAS analysis was 95.1%, which was significantly higher than VA-10 day (88.7%) (P = 0.001), esomeprazole-amoxicillin (EA) (85.1%) (P < 0.001), and tegoprazan-amoxicillin (TA) (87.3%) (P < 0.001). The incidence of adverse events for VA-14 was 8.1%, which was comparable to VA-10 (11.1%) but lower than TA (14.4%) and EA (15.3%) (P = 0.002). Adherence showed no significant difference across groups. High body surface area (BSA) (≥1.80 m²) (OR 1.594, 95% confidence interval [CI], 1.018-2.495, P = 0.041), poor adherence (OR 4.975, 95% CI, 2.753-8.992, P < 0.001), and non-VA-14 treatment regimen were independent risk factors for eradication failure. Factors varied across regimens.CONCLUSIONSHDDT, particularly VA-14, is a competitive first-line option for H. pylori eradication. High BSA and low adherence were risk factors for eradication failure but varied across regimens, highlighting the necessity of personalized adjustment.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146089164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Priya Khetan,Kunjal Patel,Wendy Yu,Joseph Szewczyk,Adit Dhummakupt,Sandra Burchett,Russell B Van Dyke,Deborah Persaud
BACKGROUNDUnderstanding HIV-1 reservoir dynamics during long-term antiretroviral therapy (ART) in youth with perinatal HIV-1 is essential for ART-free remission strategies.METHODSWe quantified intact and defective HIV-1 proviruses in 201 peripheral blood mononuclear cell samples (PBMCs) from participants ages 17.6-21.2 years in the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol. Participants were classified as early-suppressed (ES, <1 year of age at virologic suppression (VS)) or late-suppressed (LS, 1-5 years of age at VS) and had maintained VS for up to 20 years. We compared proviral dynamics based on age at and duration of suppression, and sex.RESULTSTwenty-six participants (11 ES and 15 LS) were evaluated. ES participants exhibited significantly lower intact HIV-1 reservoirs compared with LS participants, with 67% of ES samples below detection limits (2.0 copies/106 PBMCs), By 5 years of VS, the ES participants had significantly lower mean intact proviral load (2.0 vs 6.6 copies/106 PBMCs) than LS participants, largely driven by faster clearance of intact proviruses in the first 5 years of VS. Among LS- participants, females had larger intact reservoirs than males (mean: 12.5 vs 4.1 intact copies/106 PBMCs) and exhibited greater increases in defective proviruses over time.CONCLUSIONSAchieving VS by 1 year of age in perinatal HIV-1 infection results in substantially smaller HIV-1 intact reservoirs by age 5, with effects sustained through young adulthood. Additionally, sex-based differences, larger intact reservoirs and increases in defective proviruses in females, underscore the need for tailored ART-free remission and cure strategies for this population.
背景：了解围产期HIV-1青少年长期抗逆转录病毒治疗（ART）期间HIV-1病毒库的动态对于制定无ART缓解策略至关重要。方法：我们对来自儿童HIV/AIDS队列研究（PHACS）青少年主方案中17.6-21.2岁参与者的201个外周血单个核细胞样本（PBMCs）中的完整和缺陷HIV-1前病毒进行了定量分析。参与者被分为早期抑制（ES，病毒学抑制时<1岁）或晚期抑制（LS，病毒学抑制时1-5岁），并维持了长达20年的VS。我们比较了基于年龄和抑制持续时间以及性别的前病毒动态。结果共对26例患者进行了评估，其中11例为中西医结合，15例为中西医结合。与LS参与者相比，ES参与者表现出更低的完整HIV-1库，67%的ES样本低于检测限（2.0拷贝/106 PBMCs），到VS的5年，ES参与者的平均完整前病毒载量（2.0拷贝/106 PBMCs）显著低于LS参与者，这主要是由于在VS的前5年，完整前病毒的清除速度更快。12.5 vs 4.1完整拷贝/106 pbmc)，并且随着时间的推移，缺陷原病毒的增加幅度更大。结论围产期HIV-1感染在1岁时达到VS，可导致5岁时HIV-1完整库的显著缩小，其影响持续到青年期。此外，基于性别的差异，更大的完整储存库和女性中缺陷原病毒的增加，强调了针对这一人群量身定制的无art缓解和治愈策略的必要性。
{"title":"Dynamics of Intact and Defective HIV-1 Proviruses during Decades of Suppressive Antiretroviral Treatment in Young Adults with Perinatal HIV-1.","authors":"Priya Khetan,Kunjal Patel,Wendy Yu,Joseph Szewczyk,Adit Dhummakupt,Sandra Burchett,Russell B Van Dyke,Deborah Persaud","doi":"10.1093/infdis/jiag045","DOIUrl":"https://doi.org/10.1093/infdis/jiag045","url":null,"abstract":"BACKGROUNDUnderstanding HIV-1 reservoir dynamics during long-term antiretroviral therapy (ART) in youth with perinatal HIV-1 is essential for ART-free remission strategies.METHODSWe quantified intact and defective HIV-1 proviruses in 201 peripheral blood mononuclear cell samples (PBMCs) from participants ages 17.6-21.2 years in the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol. Participants were classified as early-suppressed (ES, <1 year of age at virologic suppression (VS)) or late-suppressed (LS, 1-5 years of age at VS) and had maintained VS for up to 20 years. We compared proviral dynamics based on age at and duration of suppression, and sex.RESULTSTwenty-six participants (11 ES and 15 LS) were evaluated. ES participants exhibited significantly lower intact HIV-1 reservoirs compared with LS participants, with 67% of ES samples below detection limits (2.0 copies/106 PBMCs), By 5 years of VS, the ES participants had significantly lower mean intact proviral load (2.0 vs 6.6 copies/106 PBMCs) than LS participants, largely driven by faster clearance of intact proviruses in the first 5 years of VS. Among LS- participants, females had larger intact reservoirs than males (mean: 12.5 vs 4.1 intact copies/106 PBMCs) and exhibited greater increases in defective proviruses over time.CONCLUSIONSAchieving VS by 1 year of age in perinatal HIV-1 infection results in substantially smaller HIV-1 intact reservoirs by age 5, with effects sustained through young adulthood. Additionally, sex-based differences, larger intact reservoirs and increases in defective proviruses in females, underscore the need for tailored ART-free remission and cure strategies for this population.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146089165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Gianella, Adam Lauring, Roger Paredes, Julio Croda, David Andes, Anne-Catrin Uhlemann, Kara Chew, Kathryn E Stephenson, Joseph A Lewnard, Audrey R Odom John, Daniel T Leung, Cornelius J Clancy, Helen Y Chu, Cynthia L Sears, Jonathan Z Li
Despite transformative advances in antiretroviral therapy, HIV remains a lifelong condition driven by durable viral reservoirs, chronic immune dysfunction, and complex interactions with host biology, co-infections, and aging. While implementation science is essential to ensure that effective interventions reach populations most affected by HIV, implementation cannot succeed in isolation from continued discovery or from the political and social contexts in which care is delivered. This editorial highlights critical gaps in our understanding of sex-based immunologic differences, tissue-specific viral persistence, resistance evolution, and the long-term inflammatory and metabolic consequences of treated HIV—gaps that directly constrain the durability, equity, and scalability of prevention, treatment, and cure strategies. We further emphasize that successful translation depends on stable policy environments, sustained public investment, and trust-based partnerships with affected communities, without which even highly effective biomedical advances fail to achieve impact. Sustained investment across the full translational spectrum—from basic and mechanistic science through clinical, behavioral, and implementation research—is therefore essential. HIV research has repeatedly served as a model system driving advances across immunology, vaccinology, oncology, aging, and pandemic preparedness, underscoring its broader relevance to human infectious diseases.
{"title":"Implementation Does Not Occur in a Vacuum: Sustaining a Comprehensive and Global Vision for HIV Research","authors":"Sara Gianella, Adam Lauring, Roger Paredes, Julio Croda, David Andes, Anne-Catrin Uhlemann, Kara Chew, Kathryn E Stephenson, Joseph A Lewnard, Audrey R Odom John, Daniel T Leung, Cornelius J Clancy, Helen Y Chu, Cynthia L Sears, Jonathan Z Li","doi":"10.1093/infdis/jiag063","DOIUrl":"https://doi.org/10.1093/infdis/jiag063","url":null,"abstract":"Despite transformative advances in antiretroviral therapy, HIV remains a lifelong condition driven by durable viral reservoirs, chronic immune dysfunction, and complex interactions with host biology, co-infections, and aging. While implementation science is essential to ensure that effective interventions reach populations most affected by HIV, implementation cannot succeed in isolation from continued discovery or from the political and social contexts in which care is delivered. This editorial highlights critical gaps in our understanding of sex-based immunologic differences, tissue-specific viral persistence, resistance evolution, and the long-term inflammatory and metabolic consequences of treated HIV—gaps that directly constrain the durability, equity, and scalability of prevention, treatment, and cure strategies. We further emphasize that successful translation depends on stable policy environments, sustained public investment, and trust-based partnerships with affected communities, without which even highly effective biomedical advances fail to achieve impact. Sustained investment across the full translational spectrum—from basic and mechanistic science through clinical, behavioral, and implementation research—is therefore essential. HIV research has repeatedly served as a model system driving advances across immunology, vaccinology, oncology, aging, and pandemic preparedness, underscoring its broader relevance to human infectious diseases.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The National Institutes of Health remain committed to ending HIV in the United States by 2030 through a combination of implementation science, public and private partnerships, community engagement, federal agency collaborations, and a comprehensive research portfolio that includes basic science.
{"title":"Future Directions for NIH HIV Research: A Look Ahead to 2026","authors":"Geri R Donenberg, Robert W Eisinger","doi":"10.1093/infdis/jiag062","DOIUrl":"https://doi.org/10.1093/infdis/jiag062","url":null,"abstract":"The National Institutes of Health remain committed to ending HIV in the United States by 2030 through a combination of implementation science, public and private partnerships, community engagement, federal agency collaborations, and a comprehensive research portfolio that includes basic science.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guiding Lines: Practical and Accessible Approaches For Analyzing Serological Data for Infectious Disease Surveillance.","authors":"Laura C Steinhardt","doi":"10.1093/infdis/jiag054","DOIUrl":"https://doi.org/10.1093/infdis/jiag054","url":null,"abstract":"","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"282 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146089166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New Insights from Perinatal HIV: A Way Forward for HIV Cure Research.","authors":"Rajesh T Gandhi,Ronald J Bosch,Ann Chahroudi","doi":"10.1093/infdis/jiag057","DOIUrl":"https://doi.org/10.1093/infdis/jiag057","url":null,"abstract":"","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146072951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kedan Endrias, Soham Sonawane, Kirk A Easley, Benedicth Ukhueduan, Michelle Lee, Vijayakumar Velu, Rama R Amara, Steven E Bosinger, Mirko Paiardini, Guido Silvestri, Maud Mavigner, Vidisha Singh, Ann Chahroudi
Lentiviral infection of rhesus macaques represents a robust model for HIV persistence and a key system to evaluate HIV cure-directed interventions. How sex impacts viral reservoirs in macaques is unknown. We sought to uncover potential sex differences in viral measurements during antiretroviral therapy (ART) using data from 19 studies conducted at Emory Primate Center. Sex differences in total and intact SIV/SHIV-DNA levels in blood and lymph node CD4+ T-cells were not observed, although subgroup analysis of SIV-infected adult macaques revealed higher reservoir levels in females. Age (adult versus infant) was a significant effect for all viral outcomes studied.
{"title":"Limited sex-based differences in viral outcomes of ART-treated SIV/SHIV infection","authors":"Kedan Endrias, Soham Sonawane, Kirk A Easley, Benedicth Ukhueduan, Michelle Lee, Vijayakumar Velu, Rama R Amara, Steven E Bosinger, Mirko Paiardini, Guido Silvestri, Maud Mavigner, Vidisha Singh, Ann Chahroudi","doi":"10.1093/infdis/jiag064","DOIUrl":"https://doi.org/10.1093/infdis/jiag064","url":null,"abstract":"Lentiviral infection of rhesus macaques represents a robust model for HIV persistence and a key system to evaluate HIV cure-directed interventions. How sex impacts viral reservoirs in macaques is unknown. We sought to uncover potential sex differences in viral measurements during antiretroviral therapy (ART) using data from 19 studies conducted at Emory Primate Center. Sex differences in total and intact SIV/SHIV-DNA levels in blood and lymph node CD4+ T-cells were not observed, although subgroup analysis of SIV-infected adult macaques revealed higher reservoir levels in females. Age (adult versus infant) was a significant effect for all viral outcomes studied.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146110020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Smritee Dabee,Shaun Barnabas,Bart Versteeg,Brian Kullin,Shameem Z Jaumdally,Hoyam Gamieldien,Nonhlanhla Mkhize,Etienne Muller,Venessa Maseko,Katherine Gill,Darren P Martin,Glenda Gray,Linda-Gail Bekker,David A Lewis,Heather B Jaspan,Sylvia M Bruisten,Jo-Ann S Passmore
Chlamydia trachomatis (CT) is the most common sexually transmitted bacterial infection globally, significantly affecting adolescent girls and young women (AGYW) in South Africa. This study investigated CT prevalence and genotypic diversity among 298 AGYW from Cape Town and Johannesburg, revealing an overall prevalence of 29.5%. Prevalence was higher in Cape Town (41.6%) compared to Johannesburg (17.4%; P < .0001). Genetic analysis identified 34 sequence types, including 15 novel variants. Longitudinal data highlighted frequent reinfections or persistent infections despite treatment. These findings underscore the importance of addressing CT's genetic diversity for improved reproductive health strategies and vaccine development.
{"title":"High Prevalence and Genotypic Diversity of Persistent Chlamydia Trachomatis Infections Among South African Adolescent Girls and Young Women: A Tale of Two Cities.","authors":"Smritee Dabee,Shaun Barnabas,Bart Versteeg,Brian Kullin,Shameem Z Jaumdally,Hoyam Gamieldien,Nonhlanhla Mkhize,Etienne Muller,Venessa Maseko,Katherine Gill,Darren P Martin,Glenda Gray,Linda-Gail Bekker,David A Lewis,Heather B Jaspan,Sylvia M Bruisten,Jo-Ann S Passmore","doi":"10.1093/infdis/jiag023","DOIUrl":"https://doi.org/10.1093/infdis/jiag023","url":null,"abstract":"Chlamydia trachomatis (CT) is the most common sexually transmitted bacterial infection globally, significantly affecting adolescent girls and young women (AGYW) in South Africa. This study investigated CT prevalence and genotypic diversity among 298 AGYW from Cape Town and Johannesburg, revealing an overall prevalence of 29.5%. Prevalence was higher in Cape Town (41.6%) compared to Johannesburg (17.4%; P < .0001). Genetic analysis identified 34 sequence types, including 15 novel variants. Longitudinal data highlighted frequent reinfections or persistent infections despite treatment. These findings underscore the importance of addressing CT's genetic diversity for improved reproductive health strategies and vaccine development.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146072952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anabella Clara Fantilli,María Belén Pisano,Maribel Martínez Wassaf,Guadalupe Di Cola,Domingo Balderramo,Pablo Romagnoli,Jhon Prieto,Marco Arrese,Enrique Carrera,Javier Díaz Ferrer,Angelo Z Mattos,Marina Fernández,Grisel Maribel Britos,María Eugenia Bernaschini,Santiago A Sepúlveda,Juan Carlos Roa,Sergio Grutadauria,Alina Zerega,Melina Ferreiro,Esteban González Ballerga,Jonathan Salmon,Andre Boonstra,José Daniel Debes,Viviana Elizabeth Ré
BACKGROUNDHepatitis E virus (HEV) is a major cause of acute hepatitis worldwide, yet its impact in Latin America remains underexplored. Evidence suggests that chronic liver disease (CLD) patients infected with HEV face increased risks of disease progression and mortality. The PROGINS haplotype has been proposed to influence susceptibility to HEV. This study assessed HEV infection in CLD patients from Latin America and potential associated factors, including the PROGINS haplotype.METHODSA total of 971 individuals-784 with CLD and 187 healthy controls (HC)-from six countries (Argentina, Brazil, Chile, Colombia, Ecuador, and Peru) were analyzed for anti-HEV IgG and IgM (ELISA), HEV-RNA (RT-qPCR and nested PCR with Sanger sequencing and phylogenetic analysis), and the PROGINS haplotype (PCR).RESULTSThe overall anti-HEV IgG seroprevalence was 15.2%: 15.4% in CLD and 14.4% in HC, with no statistical difference. Marked geographical disparities were observed, with Chile showing the highest (45.1%) and Argentina the lowest (4.2%) anti-HEV IgG detection rates. Cirrhosis and alcohol-related liver disease (ALD) were significantly associated with higher detection rates, while neither age nor sex influenced HEV seroprevalences. PROGINS haplotype showed no significant association with HEV infection. Anti-HEV IgM and HEV-RNA were detected in 11.2% and 0.4% of participants, respectively. Phylogenetic analysis confirmed zoonotic HEV-3 circulation in the region.CONCLUSIONSThis first multinational assessment of HEV in Latin America reveals heterogeneous seroprevalence across countries. Findings support considering HEV testing in diagnostic protocols for CLD patients particularly those with cirrhosis or ALD- when presenting with unexplained hepatic decompensation or acute hepatitis.
{"title":"Hepatitis E Virus Infection in Patients With Chronic Liver Diseases: A Latin American Multicenter Study.","authors":"Anabella Clara Fantilli,María Belén Pisano,Maribel Martínez Wassaf,Guadalupe Di Cola,Domingo Balderramo,Pablo Romagnoli,Jhon Prieto,Marco Arrese,Enrique Carrera,Javier Díaz Ferrer,Angelo Z Mattos,Marina Fernández,Grisel Maribel Britos,María Eugenia Bernaschini,Santiago A Sepúlveda,Juan Carlos Roa,Sergio Grutadauria,Alina Zerega,Melina Ferreiro,Esteban González Ballerga,Jonathan Salmon,Andre Boonstra,José Daniel Debes,Viviana Elizabeth Ré","doi":"10.1093/infdis/jiaf615","DOIUrl":"https://doi.org/10.1093/infdis/jiaf615","url":null,"abstract":"BACKGROUNDHepatitis E virus (HEV) is a major cause of acute hepatitis worldwide, yet its impact in Latin America remains underexplored. Evidence suggests that chronic liver disease (CLD) patients infected with HEV face increased risks of disease progression and mortality. The PROGINS haplotype has been proposed to influence susceptibility to HEV. This study assessed HEV infection in CLD patients from Latin America and potential associated factors, including the PROGINS haplotype.METHODSA total of 971 individuals-784 with CLD and 187 healthy controls (HC)-from six countries (Argentina, Brazil, Chile, Colombia, Ecuador, and Peru) were analyzed for anti-HEV IgG and IgM (ELISA), HEV-RNA (RT-qPCR and nested PCR with Sanger sequencing and phylogenetic analysis), and the PROGINS haplotype (PCR).RESULTSThe overall anti-HEV IgG seroprevalence was 15.2%: 15.4% in CLD and 14.4% in HC, with no statistical difference. Marked geographical disparities were observed, with Chile showing the highest (45.1%) and Argentina the lowest (4.2%) anti-HEV IgG detection rates. Cirrhosis and alcohol-related liver disease (ALD) were significantly associated with higher detection rates, while neither age nor sex influenced HEV seroprevalences. PROGINS haplotype showed no significant association with HEV infection. Anti-HEV IgM and HEV-RNA were detected in 11.2% and 0.4% of participants, respectively. Phylogenetic analysis confirmed zoonotic HEV-3 circulation in the region.CONCLUSIONSThis first multinational assessment of HEV in Latin America reveals heterogeneous seroprevalence across countries. Findings support considering HEV testing in diagnostic protocols for CLD patients particularly those with cirrhosis or ALD- when presenting with unexplained hepatic decompensation or acute hepatitis.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aapo Knuutila,Lauri Ivaska,Alex-Mikael Barkoff,Pieter van Gageldonk,Annemarie Buisman,Jussi Mertsola,Qiushui He
BACKGROUNDImmunization during pregnancy (IP) against pertussis protects young infants, but the maternally derived antibodies blunt the quantity of infants' antibody responses to their primary vaccination. While the blunting effect has been well studied for antibody quantity, potential blunting that would affect functional characteristics of these antibodies is less studied. This study evaluated the effect of IP on the epitopes and avidity of anti-pertussis toxin (PT) IgG antibodies in infants and their mothers.METHODSIn this prospective open-label controlled clinical trial, 47 pregnant women received diphtheria-tetanus-acellular pertussis (DTaP) vaccine booster, and 22 pregnant women who were not vaccinated served as controls. Sixty-nine infants received hexavalent DTaP vaccine at three and five months of age. Anti-PT IgG antibodies' binding strength and their ability to inhibit epitope-specific binding of mouse monoclonal antibodies were measured with ELISA in both maternal and infant samples.RESULTSIn both study groups antibodies in cord blood showed higher epitope-specific inhibition and avidity than what was induced in infants after two primary vaccine doses, at six months. Higher anti-PT IgG concentrations (p<0.001) and epitope-specific inhibition targeting 1B7 (p=0.049) and 11E6 (p=0.024) were noted at six months in control group infants, suggesting epitope-specific blunting in IP group. No difference was observed in the avidity of anti-PT IgG at six months between two study groups. The increase in avidity after vaccination was the highest in those mothers and infants with lower baseline avidity.CONCLUSIONSImmunization during pregnancy decreased primary vaccination-induced antibody responses disproportionately against different PT epitopes in infants.The trial was registered in the EU Clinical Trial database (EudraCT number 2019-001986-34, https://www.clinicaltrialsregister.eu).
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