IDSA’s Journal of Infectious Diseases provides a monthly roundup of JID papers with direct relevance to clinicians. Read on to learn more about the poor antimalarial efficacy of IPTp-SP, how starting HIV treatment in early life can significantly reduce the size of the HIV reservoir and other research ready to inform clinical practice. (Titles and summaries are adapted from the June 2026 issue of JID.)
Frailty in People With HIV Is Linked to Inflammation, Bone Health and T-Cell Exhaustion
Companion editorial: Increasing Handgrip Strength to Combat Frailty in Human Immunodeficiency Virus: Linking Immune Exhaustion to a Bone Health Indicator
Little is known about the inflammatory networks and immune parameters that drive frailty outcomes in people with HIV. Measurement of plasma analytes and T-cell phenotypes from people with HIV without frailty (0 Fried score, n = 60) and with frailty (≥3 Fried score, n = 60) yielded a strong association of senescence-associated secretory phenotype and NF-κB related inflammation with frailty in people with HIV. Further, a low proportion of naive CD4 T-cells and increased TIGIT and PD-1 expression associated with both osteoprotegerin levels (inhibits osteoclasts to prevent bone resorption) and frailty, suggesting a link between inflammation, T-cell activation, bone health and frailty in people with HIV.
Companion editorial: Immune Checkpoint Inhibition Therapy Beyond the Tumor: Implications for Hepatitis B Virus in Hepatocellular Carcinoma
Limited research exists on immune checkpoint inhibitors’ antiviral efficacy in HBV-related hepatocellular carcinoma. This retrospective cohort study included 318 HBV-related HCC patients, including 268 who received ICIs (with/without targeted therapy; ICI group) and 50 who received targeted therapy alone (non-ICI group). Immune checkpoint inhibitors accelerated the decline of multiple HBV markers in HCC. This rapid viral suppression significantly correlated with improved patient survival, demonstrating a dual therapeutic benefit of immunotherapy in HBV-related HCC.
IPTp with monthly sulfadoxine-pyrimethamine (IPTp-SP) is recommended in malaria-endemic countries. But widespread resistance of Plasmodium falciparum to SP has compromised its efficacy, and the alternative dihydroartemisinin-piperaquine is under study. In this study, 1,377 samples collected from pregnant women with asymptomatic parasitemia enrolled in a trial comparing monthly SP, DP and DP+SP for IPTp in Uganda were sequenced. Risks of recurrent and recrudescent parasitemia, symptomatic malaria and selection of resistant parasites were greater in those treated with SP compared to DP or DP+SP, with risks greatest in primigravidae. IPTp-SP had poor antimalarial preventive efficacy and selected for increased drug resistance, questioning the value of this intervention.
Companion editorial: New Insights From Perinatal HIV: A Way Forward for HIV Cure Research
Under the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol, intact and defective HIV-1 proviruses were assessed in 201 peripheral blood mononuclear cell samples from participants ages 17.6 to 21.2 years; twenty-six participants (11 early-suppressed, <1 year of age at the time of virologic suppression and 15 late-suppressed, ages 1-5 years) were evaluated. Achieving viral suppression by 1 year of age in perinatal HIV-1 infection resulted in substantially smaller HIV-1 intact reservoirs by age 5, with effects sustained through young adulthood. Larger intact reservoirs and increases in defective proviruses occurred in females, underscoring both gender differences and the need for tailored ART-free remission and cure strategies for this population.
