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 role of subtypes on perinatal transmission of HIV in the absence of antiretroviral therapy, the use of expired malaria rapid diagnostic tests in resource-limited settings and other research ready to inform clinical practice. (Titles and summaries are adapted from the August 2026 issue of JID.)
A previously reported global blood-based four-gene signature accurately discriminated bacterial from nonbacterial acute respiratory infection in 504 hospitalized adults (AUC = 0.90). This global signature was further tested in patient subgroups (e.g., lung disease, pneumonia) versus newly developed subgroup-specific signatures. The global gene signature strongly discriminated bacterial from nonbacterial ARI within every clinical subgroup (including pneumonia) and outperformed every subgroup-specific signature. This host response test may be broadly applicable in adults with ARI.
A two-dose hepatitis B vaccination schedule is highly immunogenic in children aged ≥1 year, but data for infants are scarce. In this study, 2-month-old infants were randomized to receive two dose homologous (Infanrix-hexa/Infanrix-hexa) or heterologous (Infanrix-hexa/Twinrix) vaccines at 2 and 12 months. Control children received a homologous three-dose schedule (Infanrix-hexa/Infanrix-hexa/Infanrix-hexa) at 2, 4 and 18 months. All groups received a challenge dose (Twinrix) three years later. Seroprotection (anti-HBs ≥10 mIU/mL) was similar in all three groups with local reactions significantly lower after the heterologous than homologous two-dose schedule. These data have clinical and public health implications.
This highly practical clinical study tested agreement of expired malaria rapid diagnostic tests with nonexpired mRDTs in western Uganda (200 enrollees). Expired mRDTs (SD Bioline Ag Pf/Pan and First Response Ag pLDH/HRP2) were administered to each participant in parallel with a nonexpired mRDT. All tests up to 9-months post-expiration were valid and consistent with reference mRDTs. All mRDTs 10- to 12-months post-expiration were invalid. In resource-limited settings, some expired malaria rapid diagnostic tests may retain accuracy. While encouraging, clinicians should interpret results cautiously and adhere to current guidelines until larger studies confirm safety and reliability.
Travelers who fly on commercial aircraft while infectious with measles are reported to the Centers for Disease Control and Prevention, which facilitates aircraft contact investigations through local health departments. In May 2025, an unvaccinated adult traveler infectious with measles flew from Europe to Colorado, transited through Denver International Airport, then flew from Colorado to North Dakota. Aircraft contact investigations identified 135 exposed domestic travelers. Seventeen people (~13%) were infected on two aircraft, in one airport and through community spread. Five secondary case-patients had >1 documented prior measles vaccination. Measles vaccination is recommended prior to international travel for all travelers aged 6 months or older. Travelers with fever and overt signs of transmissible illness should delay travel.
Perinatal transmission in a pre-ART Ugandan cohort was analyzed by maternal HIV-1 subtype and infant sex in 131 mother-child pairs. Subtype A infection in the mother was associated with a nearly three-fold increased risk of perinatal transmission as compared to subtype D (p = 0.008). When infants were stratified by both sex and maternal subtype, significantly more female (56.3%) than male (9.1%) infants born to mothers with subtype A were infected (p = 0.02), whereas among infants born to mothers with subtype D, transmission rates were comparable across sex. HIV subtype impacts maternal transmission to female versus male infants.
