Brazilian Journal of Infectious Diseases最新文献

{"title":"Racial disparities in HIV incidence and PrEP non-adherence among gay, bisexual and other Men who have Sex with Men (MSM) and transgender women using oral PrEP in Brazil: Results from the ImPrEP study","authors":"Lucilene Araujo Freitas ,&nbsp;Carolina Coutinho ,&nbsp;Debora Castanheira ,&nbsp;Ronaldo Ismerio ,&nbsp;Pedro Leite ,&nbsp;Iuri C. Leite ,&nbsp;Marcelo Cunha ,&nbsp;Josias Freitas ,&nbsp;Toni Araujo ,&nbsp;Laylla Monteiro ,&nbsp;Brenda Hoagland ,&nbsp;Mayara S.T. Silva ,&nbsp;Marcos Benedetti ,&nbsp;Cristina Pimenta ,&nbsp;Beatriz Grinsztejn ,&nbsp;Valdilea G. Veloso ,&nbsp;Thiago S. Torres","doi":"10.1016/j.bjid.2026.104614","DOIUrl":"10.1016/j.bjid.2026.104614","url":null,"abstract":"<div><h3>Introduction</h3><div>Access to health services may affect PrEP uptake, adherence, and persistance, especially among persons affected by structural inequities. We assessed the HIV incidence and factors associated with PrEP non-adherence among men who have sex with men (MSM) and transgender women in Brazil, focusing on potential racial disparities.</div></div><div><h3>Material and methods</h3><div>ImPrEP was a prospective, single-arm, open-label, PrEP implementation study that enrolled 9509 MSM and transgender women in Brazil, Mexico and Peru (February 2018 ‒ June 2021). Participants received oral PrEP with tenofovir disoproxil fumarate and emtricitabine at the enrollment visit and quarterly thereafter. This analysis was restricted to data from 14 HIV/STI clinics in 11 cities from Brazil. We calculated the HIV incidence per 100 person-years using the Poisson model according to race. We used adjusted logistic regression models to identify factors associated with PrEP non-adherence (medication possession rate &lt; 0.6) for White and Black/Pardo participants separately. Trial registration: UTN U1111-1217-6021</div></div><div><h3>Results</h3><div>Of 3928 participants, 1868 (47.6%) self-identified as White, 1410 (35.9%) <em>Pardo</em>, 595 (15.1%) Black, 42 (1.1%) Asian, and 12 (0.3%) Indigenous. PrEP non-adherence was higher among Black (26.2%) and <em>Pardo</em> (24.2%) compared to White (18.7%) participants (<em>p</em> &lt; 0.0001). Among participants with PrEP non-adherence, HIV incidence was higher among Black (2.16 [95% CI: 0.54‒8.63]) than <em>Pardo</em> (1.49 [95% CI: 0.48‒4.62]) and White (1.00 [95% CI 0.25‒4.01]). In multivariable models, participants aged 18‒30 years, self-identifying as transgender women, and reporting lower number of sex partners had increased odds of PrEP non-adherence among White and Black/<em>Pardo</em> participants. Lower education and transactional sex were associated with increased odds of PrEP non-adherence among Black/<em>Pardo</em>, but not among White participants.</div></div><div><h3>Conclusions</h3><div>Higher HIV incidence and PrEP non-adherence among racially and ethnically marginalized groups, such as Black and <em>Pardo</em> Brazilians, highlights the impact of structural racism on health outcomes. The implementation of public policies to reduce racial and social inequities in HIV prevention must be prioritized in Brazil.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 2","pages":"Article 104614"},"PeriodicalIF":2.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Pediatric Risk of Mortality-III, Phoenix Sepsis, and pediatric Sequential Organ Failure Assessment scores for predicting septic shock in Vietnamese children with sepsis","authors":"Khai Quang Tran,&nbsp;Ngan Tuong Thien Pham,&nbsp;Tri Duc Nguyen,&nbsp;Quan Minh Pham","doi":"10.1016/j.bjid.2026.104612","DOIUrl":"10.1016/j.bjid.2026.104612","url":null,"abstract":"<div><h3>Background</h3><div>Early recognition of septic shock is crucial for improving outcomes in children with sepsis. This study aimed to compare the predictive performance of the Pediatric Risk of Mortality-III (PRISM-III), Phoenix Sepsis Score (PSS), and pediatric Sequential Organ Failure Assessment (pSOFA) scores for septic shock in Vietnamese children.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on 86 children aged 2-months to 15-years with sepsis (including 23 with septic shock) admitted to a pediatric intensive care unit. Septic shock classification was performed independently and single ‒ blinded to score calculations to minimize assessment bias. The PSS and pSOFA were calculated using the worst parameters within the first 6-hours, and PRISM-III within the first 24 hours of admission. Discriminatory ability was assessed by the Area Under the Receiver Operating Characteristic Curve (AUROC). Multivariable logistic regression and calibration analyses were performed. Calibration results should be interpreted cautiously due to the small sample size.</div></div><div><h3>Results</h3><div>The PSS showed the highest AUROC (0.867, 95 % CI: 0.777–0.931), followed by PRISM-III (0.826, 95 % CI: 0.729–0.899) and pSOFA (0.791, 95 % CI: 0.690–0.871); pairwise comparisons were not statistically significant. The PSS demonstrated the highest sensitivity (95.7 %) and negative predictive value (97.6 %), while PRISM-III had the highest specificity (90.5 %) and positive predictive value (70.0 %). In multivariable analysis, both PSS (Odds Ratio, OR = 2.78) and PRISM-III (OR = 1.23) were independent predictors of septic shock.</div></div><div><h3>Conclusions</h3><div>The PSS and PRISM-III provide complementary value. A two-step approach using the sensitive PSS for initial screening and the specific PRISM III for confirmation may enhance early septic shock recognition in resource-limited settings.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104612"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracardiac mass in a 3-month-old boy revealing a congenital syphilis","authors":"Edouard Martinez Casado ,&nbsp;Ludovic Lemée ,&nbsp;Elise Barre ,&nbsp;Didier Pinquier ,&nbsp;Adnan Hassani ,&nbsp;Hortense Petat","doi":"10.1016/j.bjid.2026.104613","DOIUrl":"10.1016/j.bjid.2026.104613","url":null,"abstract":"<div><div>The rate of congenital syphilis remains low in developed countries, as most women with syphilis are routinely screened and treated during pregnancy. We report here the case of a 3-month-old boy, with fever that lasted 15-days referred to the emergency department of tertiary care paediatric center. He had no history and had never travelled. Examination showed severe pallor, slight forehead bulging and large isolated hepatomegaly. Blood tests found: anaemia, elevated C-reactive protein and hyperlymphocytosis. Echocardiography found an intracardiac mass on the posterior wall of the right atrium extending to the origin of the superior vena cava. Cardiac MRI confirmed that mass. The Treponemal Hemagglutination Assay (TPHA) and non-treponemal test (Venereal Disease Research Laboratory, VDRL) were highly positive. Prolonged antibiotic therapy with penicillin G resulted in good clinical evolution, disappearance of lymphocytosis and total disappearance of the mass at 20-months' follow-up.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104613"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroids as adjunctive therapy in patients with acute/subacute paracoccidioidomycosis presenting a severe paradoxical inflammatory reaction: Two case reports and literature review","authors":"Pedro Stringelli-Brandão,&nbsp;Marília Prior Fuga,&nbsp;Márcio Ketner Sguassábia,&nbsp;Ivonete Helena Rocha,&nbsp;Mario León Silva-Vergara","doi":"10.1016/j.bjid.2025.104608","DOIUrl":"10.1016/j.bjid.2025.104608","url":null,"abstract":"<div><div>Paradoxical inflammatory reactions, similar to Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV, have been occasionally reported in leprosy, tuberculosis, certain immunosuppressive conditions, and Paracoccidioidomycosis (PCM), among others. This report presents the clinical data and outcomes of two PCM cases in which the patients developed a severe inflammatory reaction following antifungal therapy, with subsequent improvement after adjunctive corticosteroid use. Both patients were adults with acute/subacute PCM who experienced clinical worsening after starting liposomal amphotericin B, with fever, anasarca, jaundice, and exacerbation of pre-existing symptoms. After excluding other infections, intravenous hydrocortisone was administered, resulting in rapid improvement. Corticosteroids were tapered after two to three weeks, and both patients continued outpatient follow-up while receiving itraconazole. Few similar PCM cases have been described in the literature, and they reported comparable outcomes. Its exact mechanism remains unclear, but may be immune-mediated. Reporting additional cases is essential to better establish the true incidence of this reaction and to strengthen the evidence supporting the benefit of corticosteroids as an adjunctive therapy.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104608"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Pacientes internados com tuberculose ativa e coinfecção por COVID-19: UM caso-controle pareado do registro brasileiro de Covid-19.” [The Brazilian Journal of Infectious Diseases 27 (2023) Supplement 1, October 2023, 102934]","authors":"Gabriella Genta Aguiar ,&nbsp;Jessica Fernandes Benavides Moreira ,&nbsp;Rafael Lima Rodrigues de Carvalho ,&nbsp;Daniella Nunes Pereira ,&nbsp;Danyelle Romana Alves Rios ,&nbsp;Felício Roberto Costa ,&nbsp;Fernando Anschau ,&nbsp;Genna Maira Santos Grizende ,&nbsp;José Miguel Chatkin ,&nbsp;Karen Brasil Ruschel ,&nbsp;Marcelo Carneiro ,&nbsp;Pedro Gibson Paraíso ,&nbsp;Milena Soriano Marcolino","doi":"10.1016/j.bjid.2025.104610","DOIUrl":"10.1016/j.bjid.2025.104610","url":null,"abstract":"","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104610"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BK and JC polyomavirus co-infection resulting in polyomavirus nephropathy and progressive multifocal leukoencephalopathy at the same time, a case report","authors":"Sébastien Briol ,&nbsp;Laura Labriola ,&nbsp;Arnaud Devresse ,&nbsp;Benoit Kabamba ,&nbsp;Valeria Onofrj ,&nbsp;Leïla Belkhir","doi":"10.1016/j.bjid.2025.104607","DOIUrl":"10.1016/j.bjid.2025.104607","url":null,"abstract":"<div><div>John Cunningham Virus (JCV) and BK Virus (BKV) are the most extensively studied Human Polyomaviruses (HPyVs), primarily associated with Progressive Multifocal Leukoencephalopathy (PML) and BKV Nephropathy (BKVN), respectively. While co-infection with these viruses has been documented in the same disease, simultaneous manifestation in distinct pathologies has not been previously reported. We present the first documented case of concurrent PML and Polyomavirus Nephropathy (PVN) due to reactivation of two different HPyVs, offering new insights into the clinical spectrum of HPyV-related diseases.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104607"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Forefront of Dengue Control","authors":"Luciano Z. Goldani","doi":"10.1016/j.bjid.2026.104611","DOIUrl":"10.1016/j.bjid.2026.104611","url":null,"abstract":"","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104611"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of maintenance immunosuppression regimen on anti-SARS-CoV-2 antibody and cellular kinetics in kidney transplant recipients receiving ChAdOx1 as primary vaccination","authors":"Julia Soares Reis ,&nbsp;Roberto Matias Souza ,&nbsp;Helio Tedesco-Silva ,&nbsp;Lúcio Requião-Moura ,&nbsp;José Medina Pestana ,&nbsp;Renato Demarchi Foresto","doi":"10.1016/j.bjid.2025.104604","DOIUrl":"10.1016/j.bjid.2025.104604","url":null,"abstract":"<div><h3>Background</h3><div>Kidney Transplant Recipients (KTRs) face increased COVID-19 risks due to immunosuppression, which may affect vaccine response. This study evaluates the impact of Mycophenolate Sodium (MPS) versus Azathioprine (AZA) on anti-SARS-CoV-2 humoral and cellular kinetics after ChAdOx1 vaccination.</div></div><div><h3>Methods</h3><div>In this prospective, observational study, 89 KTRs who seroconverted post-vaccination were grouped based on maintenance immunosuppression (MPS: <em>n</em> = 51; AZA: <em>n</em> = 38). Anti-SARS-CoV-2 IgG titers, neutralizing antibody activity, and cellular immunity assessed by the Interferon-Gamma (IFN-γ) release were measured at screening and 1-, 3-, 6-, and 12-months post-transplant. Linear regression and generalized estimating equations assessed group and time effects.</div></div><div><h3>Results</h3><div>At baseline, IgG titers were 12,059.2 AU/mL (MPS) and 14,369.3 AU/mL (AZA), with both groups experiencing a decline at month 1 (9483.9 AU/mL and 11,023.5 AU/mL, respectively). By month 12, titers stabilized at 11,626.8 AU/mL (MPS) and 13,851.4 AU/mL (AZA; <em>p</em> = 0.286). Neutralizing activity was initially higher with AZA (0.924 vs. 0.764 at baseline; <em>p</em> = 0.006) but converged by month 3 (0.937 vs. 0.871; <em>p</em> = 0.161). Booster doses significantly enhanced neutralizing activity by 0.175 over 12 months. Positive cellular immunity was inferior in the MPS group at screening (4.2% vs. 15.8 %; <em>p</em> = 0.171) and M1 (13.3% vs. 27.8 %; <em>p</em> = 0.266), but similar in the following visits.</div></div><div><h3>Conclusions</h3><div>AZA provided a transient early advantage in immunity responses against SARS-CoV-2, but long-term humoral and cellular kinetics were comparable. Booster doses are essential for sustaining immunity in KTRs, emphasizing the need for tailored vaccination strategies. These findings may inform clinical decisions during pandemics.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104604"},"PeriodicalIF":2.8,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculous brain abscess mimicking stroke in HIV-negative patient","authors":"Emerson dos Santos Hoffmann ,&nbsp;Cecilia Freire Lopes ,&nbsp;Giulia De Bastiani Graziottin ,&nbsp;Maíra Cristina Velho ,&nbsp;Mateus Swarovsky Helfer","doi":"10.1016/j.bjid.2025.104606","DOIUrl":"10.1016/j.bjid.2025.104606","url":null,"abstract":"","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104606"},"PeriodicalIF":2.8,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-clostridial gas gangrene due to Anaerococcus tetradius following a cesarean section: A case report","authors":"Takehiro Hashimoto ,&nbsp;Mamiko Okamoto ,&nbsp;Tomonori Yamada ,&nbsp;Eiji Kobayashi ,&nbsp;Kazufumi Hiramatsu","doi":"10.1016/j.bjid.2025.104609","DOIUrl":"10.1016/j.bjid.2025.104609","url":null,"abstract":"<div><div>A 25-year-old healthy woman was admitted to our hospital with fever and abdominal pain. Abdominal contrast-enhanced computed tomography revealed a fluid collection with foamy gas formation extending from both rectus abdominis muscles to the subcutaneous tissue. Antimicrobial therapy with meropenem (3 g/day), clindamycin (1800 mg/day), and daptomycin (300 mg/day) was initiated as empiric therapy. Subcutaneous abscess culture revealed gram-positive cocci, which was identified as <em>Anaerococcus tetradius</em>. Histopathological examination of the necrotic tissue showed skeletal muscle necrosis. On the basis of these findings, the patient was diagnosed with Non-Clostridial Gas Gangrene (NCGG) due to <em>A. tetradius</em>. We report a novel case of NCGG caused by <em>A. tetradius</em> following a cesarean section in an immunocompetent patient. Although <em>A. tetradius</em> has been detected in clinical specimens, cases of human infections are extremely rare. Clinicians should consider <em>A. tetradius</em> infection as a complication of a cesarean section.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"30 1","pages":"Article 104609"},"PeriodicalIF":2.8,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}