Clinical Infectious Diseases

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No abstract text is available yet for this article.

BACKGROUND: Using the results of a site assessment survey performed at clinics throughout Washington DC, we studied the impact of clinic-level factors on antiretroviral therapy (ART) initiation and viral suppression (VS) among people living with HIV (PLWH). METHODS: This was a retrospective analysis from the DC Cohort, an observational clinical cohort of PLWH from 2011-2018. We included data from PLWH not on ART and not virally suppressed at enrollment. Outcomes were ART initiation and VS (HIV RNA <200 copies/mL)...

BACKGROUND: In generalized epidemic settings, strategies are needed to prioritize individuals at higher risk of HIV acquisition for prevention services such as pre-exposure prophylaxis. We used population-level HIV testing data from rural Kenya and Uganda to construct HIV risk scores and assessed their ability to identify seroconversions. METHODS: Between 2013-2017, >75% of residents in 16 communities in the SEARCH Study tested annually for HIV. In this population, we evaluated three strategies for using demographic factors to predict the one-year risk of HIV seroconversion: (1) membership in ≥1 known "Risk Group" (e...

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BACKGROUND: Cohort studies have reported a high prevalence of musculoskeletal, neurologic, auditory, and visual complications among Ebola Virus Disease (EVD) survivors; however, little is known about the host- and disease-related predictors of these symptoms and their etiological mechanisms. METHODS: The presence and patterns of eight cardinal symptoms that are most commonly reported following EVD survival were assessed in the 326 EVD survivors participating in the ongoing longitudinal Liberian EVD Survivor Study...

BACKGROUND: Although chlamydia (CT) and gonorrhea (GC) infections are increasing in the United States, there are limited data on their incidence, testing rates and associated risk factors among persons with HIV (PWH), including by anatomic site among men who have sex with men (MSM). METHODS: We analyzed 2007-2017 medical record data from HIV Outpatient Study participants in care at nine HIV clinics. We calculated CT (and GC) incidence and testing rates and assessed associations with sociodemographic and clinical factors using log-linear regression...

BACKGROUND: Influenza infection is an important trigger of asthma attacks. Influenza vaccination has the potential to reduce the incidence of influenza in people with asthma, but uptake remains persistently low, partially reflecting concerns about vaccine effectiveness (VE). METHODS: We conducted a test-negative design case-control study to estimate the effectiveness of influenza vaccine in children and adults with asthma in Scotland over six influenza seasons (2010/11 to 2015/16)...

BACKGROUND: In the Netherlands the prevalence of intestinal Extended-spectrum Beta-lactamase producing Enterobacteriaceae (ESBL-E) carriage in community-dwelling subjects is ~5%. Little is known about the dynamics of ESBL-E carriage. METHODS: In a nation-wide population-based study (2014-2016) with 4,177 community-dwelling subjects, fecal samples from 656 subjects were also collected after one (T=1) and six (T=2) months. Growth of ESBL-E was quantified and whole genome sequence analysis performed...

BACKGROUND: Diarrhea is common and associated with substantial morbidity among hematopoietic cell transplant (HCT) recipients, but the etiology is often not identified. Multiplexed PCR assays increase the detection of diarrheal pathogens, but the impact of this technology in this population has not been evaluated. METHODS: Our center replaced stool cultures and other conventional microbiological methods with the FilmArray® Gastrointestinal Panel (GI PCR) in June 2016...

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No abstract text is available yet for this article.

Among prospectively enrolled adult patients with cancer receiving immune checkpoint inhibitors (ICIs, n=46) or cytotoxic agents (n=90), seroprotection and seroconversion rates after seasonal quadrivalent influenza vaccinations were higher with ICI than with cytotoxic chemotherapy. These results supports administration of annual influenza vaccinations for patients with cancer that receive ICIs.

Little is known about the effect of human migration on gut microbiome antibiotic resistance gene (ARG) carriage. Using deep shotgun stool metagenomics analysis, we found a rapid increase in gut microbiome ARG richness and abundance in women from two independent ethnic groups relocating from Thailand to the United States.

BACKGROUND: Detectable serum or plasma cryptococcal antigen (CrAg) precedes symptomatic cryptococcal meningitis. The World Health Organization (WHO) recommends CrAg screening for HIV infected people with CD4<100 cells/mcL initiating antiretroviral therapy (ART). However, an increasing proportion of cryptococcosis patients are now ART-experienced. Whether CrAg screening is cost-effective in those with virologic failure is unknown. METHODS: We retrospectively performed nationwide plasma CrAg testing among ART experienced Ugandan adults with virologic failure (≥1,000 copies/mL) using leftover plasma after viral load testing during September 2017-January 2018...

BACKGROUND: Bacille Calmette-Guérin (BCG) vaccination remains a cornerstone against tuberculosis. Randomized controlled trials (RCTs) has demonstrated that BCG-Denmark lowers all-cause mortality, but a recent RCT found no effect of BCG-Russia. Observational studies indicate that the genetically divergent BCG strains have different effects. METHODS: Parallel-group, open-label RCT conducted at the National Hospital in Guinea-Bissau. Healthy neonates were randomized 1:1 to BCG-Denmark (2,851 randomized, 2,840 analyzed) versus BCG-Russia (2,845 randomized, 2,837 analyzed)...

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BACKGROUND: Technology has changed the way men-who-have-sex-with-men (MSM) seek sex. Over 60% of MSM in the US use the internet and/or smartphone-based geospatial networking apps to find sex partners. We correlated use of the most popular app (Grindr™) with sexual risk and prevention behavior among MSM. METHODS: A nested cohort study was conducted between September 2018 and June 2019 among MSM receiving community-based HIV and STI screening in central San Diego...

BACKGROUND: The primary reported risk factors for herpes zoster (HZ) are increasing age and immunodeficiency yet estimates of HZ risk by immunocompromising condition have not been well characterized. We undertook a systematic review of the literature to estimate HZ risk in five categories of immunocompromised patients. METHODS: We systematically reviewed studies examining risk of HZ and its complications in adult patients with hematopoietic cell transplants (HCT), cancer (hematologic and solid tumor), HIV, and solid organ transplant (SOT; kidney and other)...

BACKGROUND: This study investigated treatment adherence and associated factors among people with recent injecting drug use or current opioid agonist therapy (OAT) and compared once-daily to twice-daily DAA therapy. METHODS: SIMPLIFY and D3FEAT are international, multicentre studies which recruited participants with recent injecting drug use (previous six months; SIMPLIFY, D3FEAT) or current OAT (D3FEAT) between March 2016 and February 2017 in eight countries. Participants received sofosbuvir/velpatasvir (once-daily; SIMPLIFY) or paritaprevir/ritonavir/ombitasvir, dasabuvir (twice-daily) ±ribavirin (D3FEAT) for 12 weeks administered in electronic blister-packs...