Social precariousness hinders access to the cascade of care in people with HIV (PHIV). Its impact on the clinical presentation and outcome of critical illnesses in this patient population is unknown.

Tick-borne encephalitis virus (TBEV) is a flavivirus that causes a range of clinical presentations including severe neurological complications in humans. In Mongolia, TBEV is primarily transmitted by the tick, which serves as both a vector and reservoir. Historically, TBEV in Mongolian ticks has been predominantly described in the forested regions of the Bulgan and Selenge aimags (provinces).

Epstein-Barr virus (EBV) central nervous system (CNS) infection in immunocompromised hosts and among meningitis cohorts is well recognized. The clinical significance of EBV CNS infection, however, is poorly understood.

Given the melanocortin-4 receptor's (MC4R) importance in obesity, we examined associations between gene variants and weight following a switch to integrase inhibitor-containing antiretroviral therapy among participants in Advancing Clinical Therapeutics Globally studies. Among 529 persons with HIV (median age: 50 years, 29% non-Hispanic Black, 22% female), 62% were overweight or obese at integrase strand transfer inhibitor switch, and 62% switched to raltegravir. In adjusted linear models, three variants were associated ( < .05) with weight change after switch in all participants or in prespecified subgroups. These exploratory findings are consistent with the role of melanocortins in appetite and weight and suggest a neuroendocrine contribution to integrase inhibitor-related weight gain.

Ongoing high-risk behaviors continue to fuel HCV transmission among men who have sex with men (MSM), challenging elimination efforts. We studied HCV epidemiology in MSM with HIV (MSM-WH) and without HIV in the region of Madrid.

Zika virus (ZIKV) emergence in 2015-2016 was characterized by high attack rates and a wave of Congenital Zika Syndrome cases that affected several countries in the Americas. The sudden drop in virus transmission in the following years and the lack of a reliable correlate of protection have hampered the development of vaccines. ZIKV neutralizing antibodies (nAbs) responses to natural ZIKV infection provide insights into the potential efficacy of vaccine candidates.

Rural and critical access hospitals serve 15% of the United States population and utilize antibiotics at similar rates and spectrum as larger urban hospitals, making them a priority for antimicrobial stewardship. However, barriers such as insufficient personnel, limited electronic health record capabilities, and financial constraints limit stewardship initiatives. Telestewardship partnerships with urban hospitals offer a promising solution; however, a structured process to develop and implement such programs is not established. This perspective focuses on unmet needs in rural hospitals to provide future direction for improved patient care in these settings. In 2024, UW Health engaged leaders of small and rural hospitals to design a telestewardship program that meets regulatory requirements (ie, Joint Commission Standards). Despite these requested services, financial barriers hindered implementation of telestewardship partnerships. This work underscores the opportunities and challenges faced by rural hospitals and the ongoing need for state and national funding to support these communities.

Among 130 992 people with HIV (PWH) in South Africa, 60 anal cancers were diagnosed. Lower CD4 counts and, to a lesser extent, higher HIV RNA viral loads were associated with an increased anal cancer risk. Maintaining high CD4 counts may contribute to anal cancer prevention among PWH in South Africa.

Linezolid is recommended for the treatment of rifampin-resistant tuberculosis (TB), but its role in rifampin-susceptible TB (RS-TB) is less understood. In 45 RS-TB patients treated with linezolid, 8 stopped due to adverse events, most commonly cytopenias. Further research is needed on linezolid efficacy, dosing, and adverse event management in RS-TB.

Syphilis and hepatitis C virus (HCV) rates have increased among women of childbearing age. Given the potential for vertical transmission of both infections, we examined syphilis and HCV co-infection among pregnant women in West Virginia (2019-2023). Public health surveillance data for syphilis and HCV were cross-referenced to identify co-infections. Of the 161 pregnant women with syphilis, 42.9% had a past or present HCV infection. Compared with those without HCV, a greater proportion of women with past or present HCV self-reported incarceration (21.7% vs 5.4%) and drug use (50.7% vs 15.2%) during the past year. Notably, women with past or present HCV had lower adherence to syphilis treatment (56.5% vs 84.8%) and a higher frequency of reported congenital syphilis outcomes (59.4% vs 28.3%). Findings support the need for integrated care approaches to address overlapping infections and associated social vulnerabilities.

Few studies have investigated the diagnosis and management of pediatric visceral leishmaniasis (VL) in high-income countries.

In this ongoing, open-label, phase 3b/4 study, JN.1- and KP.2-encoding monovalent mRNA-1273 vaccines elicited robust neutralization of vaccine-matched variants (JN.1, KP.2) and cross-neutralized JN.1 subvariants circulating during the study (September 2024-November 2024; KP.3.1.1, XEC, LP.8.1) in vaccinated adults, showing reduced cross-neutralization against all subvariants tested. No safety concerns were identified.

Current evidence suggests that in young children with community-acquired alveolar pneumonia (CAAP), bacterial-viral coinfections (mostly respiratory syncytial virus [RSV]-pneumococcus coinfections) are more prevalent among hospitalized children than among outpatients and that RSV-pneumococcal coinfections are more frequently associated with non-PCV13 serotypes. Based on this background, we speculated that following pneumococcal conjugate vaccine [PCV] implementation, the decline of hospitalized CAAP episodes would be lower than that of outpatient episodes.

Bruton tyrosine kinase inhibitors (BTKis) have been associated with an increased risk of invasive fungal disease, with skin and soft tissue mucormycosis accounting for a minority of cases. We present a 72-year-old patient with chronic lymphocytic leukemia who developed necrotizing fasciitis and myositis due to spp after 4 months of therapy with the second-generation BTKi zanubrutinib, with a fatal outcome despite aggressive treatment. Our literature review identified 7 additional cases of BTKi-associated skin and soft tissue mucormycosis, revealing an all-cause mortality rate of 37.5%. Two-thirds of the patients had a previous trauma or skin lesion.

Advocacy has long been at the core of the infectious diseases (ID) field, with clinicians and researchers advocating to ensure patients can access the care they need on an individual and global scale. The Infectious Diseases Society of America Training Program Directors' (PD) Committee met in 2024 and discussed ways that advocacy is and should be incorporated into fellowship training, as well as highlighted the role PDs play in advocating for their trainees. Policies with a negative impact on ID clinical care, public health, and research underscore the importance of mobilizing the field of ID to advocate for the patients and communities we serve, as well as for ourselves. This paper presents ideas generated at this meeting and is meant to serve as a reference for ID PDs, as well as the wider ID community, as a call to action for teaching and participating in advocacy work.

Human adenovirus (HAdV) is a common cause of pediatric acute respiratory illness (ARI), contributing to 5-13% of cases worldwide. Clinical manifestations vary by HAdV species and type; therefore, delineating type-specific disease presentations and understanding severity of specific HAdV types' disease may help develop targeted interventions.

A deficient vitamin D status is linked to increased risk of community-acquired pneumonia (CAP) and both short- and long-term mortality. Given small sizes of previous studies and lack of adjustment for key confounders, we aimed to investigate the association between vitamin D status (sufficient, insufficiency, or deficiency) and mortality risk in adults hospitalized with CAP.

Hepatitis C continues to pose a significant global health burden, particularly in low- and middle-income countries, where access to diagnosis and treatment remains limited. This perspective explores how integrated care models, featuring decentralization, task-shifting, and simplified protocols, can accelerate hepatitis C elimination. Drawing on case studies from Egypt, Rwanda, Cambodia, Malaysia, and Nigeria, we highlight key enablers such as political commitment, infrastructure integration, and public engagement. These examples demonstrate that scalable, cost-effective strategies can achieve high treatment uptake and cure rates, even in resource-constrained settings. The paper underscores the importance of adapting successful models to local contexts and calls for broader adoption of World Health Organization-aligned policies to meet 2030 elimination targets.

Meningococcal urethritis is recognized as an emerging disease. However, its contemporary prevalence is unknown, and no molecular diagnostic tests are commercially available. With the widespread transition to molecular methods for sexually transmitted infection screening, high-throughput well-validated molecular methods for detection in urine may be useful for surveillance and diagnosis.