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Long coronavirus disease-19 (COVID-19) is a complex, multifactorial condition characterized by persistent symptoms lasting more than 12 weeks following acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The underlying mechanisms remain incompletely understood, but chronic inflammation, immune dysregulation, autoimmunity, and viral persistence are increasingly being implicated. This study investigated the immunopathological drivers of long COVID-19 and their associations with clinical manifestations and organ damage. A prospective, longitudinal cohort study was conducted on 200 COVID-19 survivors aged 18-65 years, in which immune markers, autoantibody profiles, lymphocyte dysfunction, and imaging findings were assessed over a 12-month period. Persistent inflammation was observed, with elevated interleukin-6 and tumor necrosis factor α ± levels correlated with lung fibrosis and cognitive impairment. Autoantibodies were detected in 40% of the participants, particularly those with cardiovascular and neurological symptoms. A significant reduction in CD8+ T-cell counts was associated with severe fatigue and cognitive dysfunction, whereas persistent SARS-CoV-2 RNA was identified in 10% of cases, primarily in individuals with gastrointestinal symptoms. Imaging studies revealed multiorgan involvement, with structural abnormalities in the lungs, heart, and brain. These findings highlight the interplay of immune dysfunction, chronic inflammation, and autoimmunity in long-term COVID-19, underscoring the need for targeted therapeutic strategies to address its long-term health impacts.

The United Nations (UN) 2030 agenda is a developing program that aligns all human activities with the goodness and fullness of our planet. Sustainable development goals are grouped into categories, including planet, people, and partnership. Whereas ecology refers to caring for all elements of creation, human ecology points out that man specifically is part of it. It is at this point that medical ethics intersects with ecology. The responsibility of humans for the environment, living beings (animals and plants), and other men is needed for driving all creation to flourishing. Disregarding any of these elements would compromise the whole fulfillment by creatures on Earth, given their close interrelationship. Human abuse, instrumentalization, or exploitation of creatures-including one's own human being-would ultimately destroy our planet. Rather than empowering us with no limits, we should view creation as a gift and we, humans, as caregivers. Given the transformative power of human actions, concerns and regulations are required. This is why medical ethics should guide biotechnological advances, and the cautionary principle should prevail in human research. In this regard, ecology should be understood as the ethics of care. In a pyramidal way, caring should begin with human beings, followed by animals and plants, and finally consider the habitat we live in. In medicine, promoting "one health" underscores the need to expand caring beyond our own species, attending to the consequences of our actions on the environment and other living beings on our planet. The recent experience with the COVID-19 pandemic highlights the risk of zoonoses and the need for confronting human diseases globally.

Many non-infectious diseases have as a common complication the secondary development of infections, which are most likely to occur in immunocompromised individuals. Immunodeficiency (ID) is classified into primary and secondary ID (SID). Primary ID results from fundamental defects in proteins and cells that are critical for specific immune responses. Extrinsic factors, such as long-term use of immunosuppressive drugs and chronic diseases, can also affect immune responses, leading to a state of SID. In this review, we summarized the spectra of potential infectious pathogens in primary and SID, which are very different from those in immunocompetent individuals. We hope that this review will help clinicians with empirical management of infections in immunocompromised individuals caused by different etiologies and lead to better patient outcomes.

Globally, the 2025 prevention target, that is, 95% of people at risk of HIV infection having access to and using effective combination prevention options, is not within reach. Rapid, wider access to pre-exposure prophylaxis (PrEP) could quickly reduce the number of new infections, ultimately among people from key populations. In 2015, the World Health Organization recommended daily oral PrEP using tenofovir-based drugs; however, expanded access to PrEP is still limited. Key barriers to HIV PrEP uptake and persistence are daily adherence, fear of stigma and discrimination, and limited awareness of the acceptability of and access to PrEP services. Long-acting options could address these barriers. New prevention products such as long-acting injectable cabotegravir and, most recently, lenacapavir provide very high levels of protection against HIV when compared with daily oral PrEP.

Simian immunodeficiency viruses (SIV) infecting chimpanzees (SIVcpz) and sooty mangabeys (SIVsm) are, respectively, the biological precursors of human immunodeficiency viruses (HIV) Types 1 and 2. Former French colonies in West Africa are the regions where retroviruses first jumped from primates to humans. Ivory Coast is nowadays a country of over 29 million people, being 2% (580,000) persons living with HIV (PLWH). However, one-quarter remains undiagnosed. Heterosexual transmission is by far the most frequent mechanism of HIV acquisition and women exhibit higher rates of infection than men. Despite preventive measures, HIV infection in children throughout breastfeeding remains significant. The proportion of PLWH carrying HIV-1 is rising whereas conversely HIV-2 carriers are steadily declining. A nationwide survey conducted on earlier 2024 showed that a total of 188,880 PLWH were on follow-up. HIV-1 infection was found in 163,947, HIV-2 in 5,114, and coinfection in 3,182. HIV type was not reported for 7,500. Antiretroviral therapy with tenofovir, lamivudine, and dolutegravir is by far the most frequently prescribed regimen in Ivory Coast (n = 168,543). Viral suppression is recognized in 94.3% of treated PLWH, despite one-third acknowledging unwanted treatment interruptions after failure of stock supplies. Given shared transmission routes with HIV, coinfection with other human retroviruses such as Human T-lymphotropic virus type-1 (HTLV-1) and/or hepatitis viruses B, C, and delta are frequent in Ivory Coast. Coinfections remain largely undiagnosed and poorly managed. In summary, the HIV pandemic caused by both HIV-1 and HIV-2 is a major public health challenge in Ivory Coast, where strategies for expanding diagnosis, sustain antiretroviral treatment, and manage coinfections warrant further efforts.

On May 23-24, 2024, the 1^st Spanish Conference on Genomic Medicine convened in Madrid, Spain. An international and multidisciplinary group of experts gathered to discuss the current state and prospects of genomic medicine in the Spanish-speaking world. There were 278 attendees from Latin America, US, UK, Germany, and Spain, and the topics covered included rare diseases, genome medicine in national health systems (NHSs), artificial intelligence, and commercial development ventures. One particular area of attention was our still sketchy understanding of genome variants. This is evidenced by the fact that many diagnoses in rare diseases continue to yield odysseys that take years, with up to 50% of cases that may go undiagnosed. Since a lot of the genome remains to poorly understood, as new technologies such as long read sequencing become more ubiquitous and cheaper, it is expected that current gaps in genome references will improve. However, disparities within the NHSs suggest that advancements do not necessarily rely on resources but the appropriate regulation and pathways for education of professionals being properly implemented. This is where Genomics England can be a clinical genomic implementation example for routine health care. Ethical challenges, including privacy, informed consent, equity, representation, and genetic discrimination, also require the need for robust legal frameworks and culturally sensitive practices. The future of genomics in Spanish-speaking countries depends on addressing all of these issues. By navigating these challenges responsibly, Spanish-speaking countries can harness the power of genomics to improve health outcomes and advance scientific knowledge, ensuring that the benefits of personalized medicine are realized in an inclusive and equitable manner.