This Week in Infectious Disease: HIV Management Strategies and Antimicrobial Stewardship

Research this week highlighted various approaches to managing chronic infections, particularly regarding HIV. In the journal HIV medicine, a pooled analysis of Phase 3/3b trials reported that dolutegravir/lamivudine achieved 78% HIV-1 RNA suppression in adults with HIV-1 and isolated reactive hepatitis B core antibody ^[1].

The authors noted these findings suggest high rates of viral suppression and no HBV reactivation in this specific patient population ^[1].

Regarding public health interventions for HIV, a cluster randomized controlled trial published in JMIR medical education explored training methods for lay health care workers in Malawi. The study found that tablet-guided training improved knowledge, attitudes, and counseling fidelity by 30.5 percentage points compared to standard in-person training ^[5].

These findings suggest that digital tools may be an effective method to improve counselor fidelity and knowledge during index case testing ^[5].

Elsewhere this week, research focused on antimicrobial stewardship and malaria prevention. A randomized trial in JAMA internal medicine evaluated the impact of rapid multiplex point of care testing (RM-POCT) on antibiotic prescribing for respiratory infections. The study reported that RM-POCT significantly reduced same-day antibiotic prescriptions for patients with confirmed viral infections or chronic lung disease ^[2].

In a separate study, a meta-analysis published in medRxiv analyzed 32 sites across 13 African countries and found that sulfadoxine-pyrimethamine plus amodiaquine (SP+AQ) reduced malaria incidence by 54.6% compared with SP alone in children ^[3].

Finally, research regarding tuberculosis highlighted regional prevalence and risk factors. A meta-analysis published in medRxiv involving 9,931 patients identified a 5.2% pooled prevalence of multidrug-resistant tuberculosis (MDR-TB) among bacteriologically confirmed cases in Cameroon ^[4].

The analysis also reported that alcohol consumption and incarceration were associated with an increased risk of drug resistance in these patients ^[4].