Volume 67, Issue 10, 15 November 2018

Currently, risk-based hepatitis C virus (HCV) screening is recommended for women of childbearing age and pregnant women despite a high HCV prevalence. For many reasons outlined here, the time has come for universal screening for HCV for all pregnant women.

Our study demonstrated real-world, direct effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-type community-acquired pneumonia following introduction into a routine immunization program among adults aged ≥65 years, many of whom had immunocompromising and chronic medical conditions.

Human coronaviruses (HCoVs) are associated with respiratory illnesses in infants aged 0–6 months in a rural South Asian setting. HCoV incidence increases beyond the first month of life. Four tested species (229E, OC43, NL63, HKU1) were present.

The trial found that individual handwashing and sanitation interventions significantly reduced childhood Giardia infections. Combined interventions provided no additional benefit. To reduce Giardia infection, individual interventions may be more feasible and cost-effective than combined interventions in similar rural, low-income settings.

Influenza antibodies from hosts with preexisting immunity showed broader cross-reactivity than those without preexisting immunity. Repeated influenza exposures imprinted both antibody quantity and antibody quality. To improve vaccine effectiveness, vaccine strain selection needs to consider the preexisting immunity in humans.

Herpes simplex virus type 1/2 (HSV-1/2) seroprevalence was stable among pregnant women between 1999–2006 and 2007–2014. HSV-1/-2 seronegativity increased among those with ≤3 sex partners highlighting vulnerability to primary HSV infection and increased risk of neonatal herpes.

Vivax malaria relapses frequently even in low-transmission settings. Chloroquine delays but does not prevent recurrences. Adding primaquine to a slowly eliminated schizonticide significantly reduces recurrences and improves hematocrit, but this advantage is offset by hemolysis in G6PD-deficient females.

Twenty-six hospitals participated in a statewide collaborative to improve the diagnosis and treatment of inpatient urinary tract and skin infections. Overall performance targets for the collaborative were partially met; however, a number of hospitals achieved substantial changes in prescribing.

This is the first household study of multiple respiratory viruses in a low-income setting that used intensive sampling regardless of symptoms. There was a remarkably high frequency of virus infection and illness, demonstrating the opportunity for complex interactions.

In a retrospective cohort analysis of claims data, patients receiving antibiotic/immunomodulatory pharmacotherapy for post–Lyme disease syndrome (PLDS) had greater 90-day incidence of all-cause hospitalizations, all-cause emergency department visits, infections, and electrolyte abnormalities, compared with PLDS patients not receiving such therapies.

We observed a dose–response relationship between the cumulative burden of depression and all-cause mortality among women living with human immunodeficiency virus (HIV). Shortening the duration of depressive episodes through enhanced treatment protocols in HIV primary care settings may interrupt accumulation of mortality risk.

Similar factors affect career choice among military internal medicine residents and their civilian counterparts, including mentorship, learning style, and salary. Recruitment strategies for infectious (ID) diseases physicians should focus on residency opportunities, considering reasons for continued interest in military ID.

Our trial of a single-tablet regimen containing elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate in antiretroviral therapy–naive HIV-2–infected individuals for 48 weeks, in a resource-limited setting, demonstrated favorable immunovirologic outcomes and was well tolerated.

During an AHA outbreak, we found that HIV-infected patients had a lower severity, but delayed resolution, of AHA than HIV-uninfected patients. Better viral suppression by cART alleviated the impact of HIV infection on the disease course of AHA in HIV-infected patients.

This study describes the burden of respiratory virus infections (RVIs) among preterm infants in the tropics. RVIs affected >1 of 10 infants born at ≤32 weeks’ gestation before age 2 years, with respiratory syncytial virus being the main causative pathogen.

Plasma concentrations of chloroquine and desethyl-chloroquine did not differ among individuals receiving protease inhibitor-based antiretroviral therapy (ART) (n = 9), efavirenz-based ART (n = 15), other ART (n = 8), or no ART (n = 31). Efavirenz appeared to inhibit chloroquine desethylation.

Despite the effectiveness of mold-active prophylaxis, breakthrough invasive mold infections (bIMIs) are encountered in high risk hematology patients. This viewpoint outlines different clinical scenarios and presents the diagnostic and treatment challenges of bIMIs in that patient population.