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Antimicrobial Stewardship Standards: A Comparison of Centers for Medicare & Medicaid Services and Joint Commission Requirements

Along with a 1 reported case in Massachusetts, the

New Hampshire Department of Health and Human Services (DHHS) has confirmed a person infected with eastern equine encephalitis (EEE) has died. The public health agency said the person was hospitalized due to severe central nervous system disease. The last reported human EEEV infection in New Hampshire was in 2014, when DHHS identified 3 human infections, including 2 fatalities. In the same statement, DHHS mentions there has been 1 confirmed case in Vermont this summer.

On August 16, the Massachusetts Department of Public Health (MDPH) released a statement discussing the confirmation of the first human case of EEE in the state this year. The confirmed case was discovered in an 80 year old man who was exposed to the vector borne disease in Worcester County. As a result, the risk level in the local communities of Douglas, Oxford, Sutton, and Webster has been raised to critical, and in Dudley, Northbridge, and Uxbridge the risk is increased to high.

Additionally, the neighboring communities of Auburn, Charlton, Grafton, Leicester, Mendon, Millbury, Millville, Southbridge, and Upton are now considered at moderate risk according to MDPH.

“This is the first time we have seen a person infected with EEE in Massachusetts since 2020,” Public Health Commissioner Robbie Goldstein, MD, PhD, said in a statement. “EEE is a rare but serious disease and a public health concern. We want to remind residents of the need to protect themselves from mosquito bites, especially in areas of the state where we are seeing EEE activity.

Though very rare, EEE is serious and a potentially fatal disease that can affect people of all ages. EEE is generally spread to humans through the bite of an infected mosquito. There were 12 human cases of EEE in Massachusetts in 2019 with 6 deaths, and 5 human cases with 1 death in 2020. There were no human cases of EEE in Massachusetts in 2021, 2022, or 2023.

EEE has a fatality rate of 33% to 70%, with most deaths occurring 2–10 days after the onset of symptoms.

In addition to a high mortality rate, long-term physical and mental complications, including permanent neurological deficits have been identified in many people who survive EEE.

Plymouth is approximately 40 miles south of Boston along the coast, and Worcester County is in the middle of the state, so the 2 areas are not in close proximity, but due to the elevated risk locally, the town of Plymouth decided to take action in response to outdoor parks. As of last Friday, all town public parks and fields are close daily from dusk until dawn.

“As Mass DPH has now elevated Plymouth’s EEE risk status to high, it is important to take extra precautions when outdoors and follow state and local health guidelines to avoid unnecessary risk to exposure to EEE. The health and safety of our community, residents, and visitors remain our priority,” Plymouth’s Commissioner of Health and Human Services, Michelle Bratti, said in a statement.

According to the Centers for Disease Control and Prevention (CDC) most people who are infected with the virus do not develop symptoms; however, for those that do, the date from the bite to the onset of the illness is 4 to 10 days. EEE can also result in fever or neurologic disease. The type of illness will depend on the age of the person and other factors. Those who are infected can develop meningitis.

There are no FDA-approved treatments for EEE and for patients who develop severe cases, they can be hospitalized to receive supportive treatment.

Over the weekend, MDPH detailed plans of spraying for mosquitos including aerially in areas of Plymouth County, and truck-mounted spraying in parts of Worcester County. As of Saturday, 10 communities in Massachusetts were raised to high or critical risk for EEE virus.

“The risk from EEE is high in parts of Plymouth County and critical in parts of Worcester County,” State Epidemiologist Catherine M. Brown, DVM, said in a statement. “In addition to recommending that people use mosquito repellent with an EPA-registered active ingredient and clothing to reduce exposed skin, we also recommend that evening outdoor events be rescheduled to avoid the hours between dusk and dawn. The mosquitoes most likely to spread EEE are most active during the dusk to dawn hours.”

There are preventative strategies to avoid EEE, and the MDPH has listed such measures 

For those who live in Massachusetts and want more information on EEE, it can be found 

 or by calling the DPH Division of Epidemiology at 617-983-6800.

1.NH DHHS Identifies Person Infected with Eastern Equine Encephalitis Virus in New Hampshire.The New Hampshire Department of Health and Human Services. August 27, 2024. Accessed August 28, 2024.
https://www.dhhs.nh.gov/news-and-media/nh-dhhs-identifies-person-infected-eastern-equine-encephalitis-virus-new-hampshire
2. State health officials announce season’s first human case of Eastern Equine Encephalitis in Massachusetts. MDPH. August 16, 2024. Accessed August 27, 2024.
https://www.mass.gov/news/state-health-officials-announce-seasons-first-human-case-of-eastern-equine-encephalitis-in-massachusetts
3.Plymouth to Close all Public Parks and Fields from Dusk to Dawn. Town of Plymouth. August 23, 2024. Accessed August 27, 2024. PDF.
4. Eastern Equine Encephalitis: Symptoms, Diagnosis, and Treatment. CDC. May 15, 2024. Accessed August 27, 2024.
https://www.cdc.gov/eastern-equine-encephalitis/symptoms-diagnosis-treatment/index.html
5. State officials announce plans to spray for mosquitoes in sections of Worcester and Plymouth counties due to EEE. MDPH. August 24, 2024. Accessed August 27, 2024. 
https://www.mass.gov/news/state-officials-announce-plans-to-spray-for-mosquitoes-in-sections-of-worcester-and-plymouth-counties-due-to-eee



The town of Plymouth decided to prohibit people from using the parks from dusk to dawn due to concerns over eastern equine encephalitis after a man contracted the rare disease in the state.

Concerns Over Mosquito-Borne Illness Causes Massachusetts Town to Create Curfew for Parks, Spraying in Counties

In our latest podcast, Tim Gauthier, PharmD, BCPS, BCIDP, discusses his passion for all things pathogens and antibiotics.  He also details the opportunities for antimicrobial stewardship when it combines diagnostics and treatment duration. 

A Passion for Infectious Disease Education and Communication

Tim Gauthier PharmD, BCPS, BCIDP, began his career in academia, and although he has transitioned to working in a health system he has never left behind his passion about education around pathogens, antibiotics, and stewardship. He has 2 websites, 

, on these topics and it has really allowed him to continue communicating and educating people globally on these infectious disease subjects.

“I love this stuff so much, genuinely. I have a website called ID Stewardship, and many people are familiar with my work and my reach through that avenue where it's been just super cool to connect with people from all over the world and help people learn about antibiotics,” Gauthier said.

This website has reached millions of people since he first launched it in 2016, and he says it has allowed him to talk about his experiences in the field.

“It's really geared towards practical, real-life experience, and suggestions about how to go about navigating something. It could be anything in the field of clinical pharmacy or infectious diseases, antimicrobial stewardship, or pharmacy education. And the goal really is to provide quick information that is useful and practical for the reader,” Gautier explained.

He reminds people that everyone learns differently and having resources such as websites can be helpful for young learners as they begin to digest the voluminous amounts of educational materials they need to commit to memory.

For years, Gauthier has been communicating with the masses through social media, especially using Twitter/X and built a large audience through it. “I think it's been pretty neat to provide education in that forum too,” Gauthier said.

He sees the changes in social media today and as many people in the infectious disease community have steered away from the Twitter/X platform, Gauthier still uses it and acknowledges how it has evolved.

“I've been a content creator for infectious diseases education material for almost a decade, and it just changes,” Gauthier said. “So, Instagram becomes more popular as Facebook pages become less popular, or TikTok gains traction, and then TikTok loses traction. It's always changing and it's always evolving. You always have to— in my mind at least—go back to why am I here? What is my purpose? What am I doing? And if what you're engaging in aligns with what your purpose is, then you're probably fine…I don't feel great about X. I go on my profile and I just see content that I'm not interested in. It's super toxic, and I don't feel good about being part of that community right now. I’m keeping an eye on it and trying to maybe have a voice to some degree, because if we don't have a voice, someone will be happy to speak for us.” 

He also mentions the importance of staying professional on these platforms, and he values the importance of taking the time to reach out whether it is remotely through digital means or connecting in person with professionals in the infectious disease field or other fields at institutions including the lab.

“Respect for all individuals is something that we need to keep front of mind as we go through these very turbulent times and consider using social media or not,” Gauthier said. “That's one of my biggest things…as I'm looking around, the other thing is, we can get a lot of happiness out of working together. I really do believe that, and we should not hesitate to reach out and make connections with each other. If you haven't talked to your ID pharmacist, or if you haven't spoken to your microbiology lab folks, just go visit them.” 

Although Gauthier is excited to see some new antibiotics get FDA approved, he does acknowledge they will not likely replace the older, more established “workhorse” antibiotics. Resistance is always a concern and he is seeing extended-spectrum beta-lactamases (ESBL) 

, where he lives. Nonetheless, he sees a stewardship opportunity in these situations that combines shorter courses of antibiotics with help from the laboratory.

“When we look at the latest CDC [Centers for Disease Control and Prevention] report that they had put out, ESBLs are on the upward trend. And, locally in the Miami area, many of the hospitals here have considerable rates of ESBL 

,” he explained. “And you know what comes next? You probably use more carbapenems. Okay, use more carbapenems. What happens? You get more carbapenem resistance. That is the major issue right now that I'm seeing. I think people need to be aware of managing asymptomatic bacteria appropriately, picking shorter courses of antibiotics, and when reasonable, deescalating and narrowing within 48 to 72 hours, utilizing and leveraging the data that's coming out of the lab to make those decisions faster and smarter.”

, and much like other areas, Gauthier is seeing this mostly in long-term care patients with chronic conditions and comorbidities.

“There's definitely more patients with bloodstream infections with 

 than I would have liked to have seen in my life. And of course, the drug resistance that comes with 

 is particularly concerning,” he said. “Although I would say that hospitals that have highly complex patients that have histories of solid organ transplant, for example, or many days and months in the ICU are probably going to be battling this much more.”



Disclaimer: "The views and opinions expressed represent those of the speaker and do not necessarily reflect the official position or policy of any previous, current, or potential future employer."

In our latest podcast, Tim Gauthier, PharmD, BCPS, BCIDP, discusses all things pathogens and antibiotics.  He also details the opportunities presented for antimicrobial stewardship when it combines diagnostics and treatment duration. 

A Passion for Infectious Disease Education and Communication 

The 2023 CDC Hepatitis C Surveillance Report reveals important trends in hepatitis C-related mortality across the United States. Nationally, the hepatitis C-related death rate was 2.52 deaths per 100,000 population, marking a continuing decline from previous years. Although, this rate varied widely by state and demographic groups.

Among states, Oklahoma had the highest death rate, with 8.94 deaths per 100,000 population in 2023, significantly above the national average. Other states with notably elevated rates included Oregon (6.76), Alaska (6.02), and the District of Columbia (7.56). In contrast, states like New Hampshire (1.18) and Massachusetts (1.37) reported some of the lowest death rates. These regional differences underscore ongoing challenges in Hepatitis C prevention and care, particularly in areas with higher disease burden and limited healthcare access.

Death rates were highest among older adults, especially those aged 55 and older. The rate peaked in the 55–64 age group at 8.84 deaths per 100,000 and remained high in the 65–74 age group with 13.88 deaths per 100,000, highlighting the lasting impact of infections acquired decades earlier.

Men were disproportionately affected, with a death rate of 3.69 per 100,000 in 2023, compared to 1.45 per 100,000 among women, reflecting differences in exposure risk, healthcare access, or progression of disease.

The data also highlight significant racial and ethnic disparities. Non-Hispanic American Indian/Alaska Native populations had the highest death rates at 7.75 per 100,000, followed by non-Hispanic Black populations at 4.03 per 100,000. Conversely, non-Hispanic White populations had a death rate of 2.4 per 100,000, and Asian/Pacific Islanders reported the lowest rate at around 1.04 per 100,000.

These findings emphasize the need for targeted interventions to address Hepatitis C mortality, focusing on high-risk groups defined by geography, age, sex, and race/ethnicity. Efforts to expand screening, linkage to care, and antiviral treatment remain critical to further reduce Hepatitis C-related deaths in the US.

Recent staffing and operational disruptions at the 

have highlighted ongoing challenges in managing hepatitis B and C nationwide. The laboratory is essential for outbreak detection, prevalence estimation, and research supporting prevention and treatment strategies. Its temporary closure impaired the US ability to monitor hepatitis infections and respond promptly to outbreaks, potentially limiting public health effectiveness.

Emerging research suggests that statins may offer protective effects against chronic Hepatitis B, further underscoring the importance of robust laboratory capacity to validate new preventive approaches and manage hepatitis in high-risk populations.

The restoration of CDC hepatitis lab operations and sustained funding are necessary to strengthen surveillance, improve public health responses, and support hepatitis elimination goals.

1. CDC. Table 3.7 – Hepatitis C: Death Rates by Jurisdiction. CDC, National Center for Health Statistics (NCHS), Multiple Cause of Death on CDC WONDER Online Database. April 15, 2025. Accessed June 17, 2025. 

https://www.cdc.gov/hepatitis-surveillance-2023/hepatitis-c/table-3-7.html?utm_medium=email&utm_source=govdelivery

2. CDC. Table 3.8 – Hepatitis C: Death Rates by Demographics. CDC 2023 Hepatitis C Surveillance Report. CDC, National Center for Health Statistics (NCHS), Multiple Cause of Death on CDC WONDER Online Database. April 15, 2025. Accessed June 17, 2025. 

https://www.cdc.gov/hepatitis-surveillance-2023/hepatitis-c/table-3-8.html

3. Branswell H. CDC workers fired from prominent STI, hepatitis labs are rehired. STAT. Published June 16, 2025. Accessed June 17, 2025. 

https://www.statnews.com/2025/06/16/cdc-cuts-reversed-two-renowned-laboratories-targeted-by-doge-will-continue-work/

4. Branswell, H. Closure of CDC hepatitis lab imperils U.S. outbreak response, prevention. STAT. April 14, 2025. Accessed April 14, 2025. https://www.statnews.com/2025/04/14/cdc-hepatitis-lab-closes-rif-outbreak-response/ 

Data from the 2023 Centers for Disease Control and Prevention surveillance report highlight key differences in death rates across states and populations, informing targeted public health efforts.



Geographic and Demographic Variations in Hepatitis C Mortality

Part 3 with Robert C. Bransfield: on missed diagnoses, flawed tests, and the decades-long path from infection to mental health crisis

For over 50 years, psychiatrist Robert C Bransfield, MD, has focused on treating patients with some of the most difficult psychiatric conditions, those resistant to conventional therapies. Over time, his clinical work led him to a surprising pattern: many of these patients had a history of infectious disease, particularly Lyme and other tick-borne illnesses. What he found challenges assumptions in both psychiatry and infectious disease.

“I did a study of Lyme, tick-borne disease patients and the average patient, and these were well-confirmed CDC-positive cases. The average patient was nine years post-infection when they ended up in my office seeking treatment for psychiatric symptoms,” Bransfield explained.

Among the patients in his study, the progression from infection to psychiatric issues varied widely. “Now in that group, there would be some that would show rapid progression, and maybe in a year or two, and others that showed up 40 years after infection. So there was a big variability, and some patients had a rapid downhill course. Some patients did well, and then they had some traumatic event, car accident, sometimes delivery or something that was triggered. Maybe was a latent infection that then was reactivated.”

Bransfield added, “And sometimes it's a remitting course that they have, because there's such a long delay between the initial infection, or tick-borne infection, and then the manifestation of symptoms. And it may not be tick-borne, it may be some other way, vector-borne, or some other way the infection began.”

Because the delay between infection and symptoms can span years or decades, many patients go undiagnosed or misdiagnosed. “It can often be hard to connect the dots to show in a connection between infection and the mental illness or mental impairment,” he said.

“It usually follows a pattern where, when, let's say, for example, with tick borne infections, there may or may not be a rash, it may or may not be noticed that, just like with syphilis, the rash you see first and then you can have a some people, then they may get nor aligned with a rapid progression neurological symptoms.”

He added, “Those people usually do pretty well because it's obvious and they get aggressive treatment early. Problem is when people overlook it, they don't see the connection, or they get inadequate treatment early.”

Bransfield is critical of early treatment protocols that fail to consider long-term outcomes. “For example, they get one dose of doxycycline. And if you looked at that study, there wasn't a long follow-up to determine whether that was effective with long-term symptoms or not, it just reduced the rash. And rash isn't the problem the long-term impairments of the problem.”

Many patients also receive incomplete treatment for complex infections involving multiple pathogens. “Or they may have had a partial treatment, and they may have had an infection with more than one pathogen, an antibiotic that they got may be protected against one pathogen but not another.”

“Many of these infections that are more serious are a combination of Borrelia of different species, Bartonella of different species, Babesia of different species, and often not tested by the usual testing,” he said. “And the tests are of limited value.”

Bransfield emphasized that psychiatry, more than many other specialties, is uniquely equipped to recognize these patterns, if clinicians are looking for them. “A big thing in making the diagnosis is the clinical presentation. And in psychiatry, we rely particularly on the clinical presentation. If someone has depression or panic attacks, we look at the history, the symptoms, and that's how we make our diagnosis.”

“In other fields of medicine, sometimes there's more of an emphasis on blood work. If someone presents me with panic attacks, I don't say, I'll do blood work. And if it's positive, then you have it. If it's negative, you don't you have to look at all the evidence in making a diagnosis.”

Flawed Testing and the Need for Clinical Judgment

Bransfield warns against relying too heavily on lab tests, especially those designed around immune markers. “Right now, the lab tests are flawed. They're very limited. One basic problem is Lyme has evidence of being immunosuppressant and immunoevasive, and therefore there's a certain limitation of using an immune-based test with an infection that's immunosuppressant, and they were never standardized for late-stage disease begin with.”

“Therefore we have to look more at direct testing antigen or culture which or PCR, which usually isn't done. So a lot of times the diagnosis is missed.”

A Multi-System Illness with Lingering Effects

Tick-borne diseases don’t just affect one system of the body. “I think when it's like a Lyme case, often it's multi-system. You have the cognitive, the emotional, the general medical ,you may have the musculoskeletal symptoms, but those are easier to treat than a neuropsychiatric.”

“Partial treatment may eliminate the musculoskeletal treatments or significantly reduce it, but it may not be enough treatment to prevent later developing neuropsychiatric symptoms,” he said. “That's the problem is the later development of these symptoms, where there's often difficulty seeing the connection of how this evolves over time.”

Ultimately, Bransfield believes that understanding how these diseases affect patients over time requires physicians to rely on fundamentals. “You have to look at a timeline of how things evolved. What was a person's state of health before they had this initial infection, and how did that progress over time?”

His advice is simple but important: listen to patients, look beyond the labs, and don’t ignore the possibility that psychiatric symptoms may have infectious roots.

Bransfield RC. Aggressiveness, violence, homicidality, homicide, and Lyme disease. 

. 2018;14:693-713. Published 2018 Mar 9. Accessed June 18, 2025. doi:10.2147/NDT.S155143

Part 3 with Robert Bransfield, MD, explores treatment-resistant mental health issues linked to infection history and diverse progression patterns.

Psychiatric Symptoms Emerging Years After Infections Like Lyme and Tick-Borne Infections

Lenacapavir approved for twice-yearly HIV prevention based on Phase 3 PURPOSE trials, with global access plans underway, says Dr. Jared Baeten

Gilead Sciences, Inc announced today that the US Food and Drug Administration (FDA) has granted approval for yeztugo, the company’s first-in-class, long-acting HIV-1 capsid inhibitor, for use as a twice-yearly pre-exposure prophylaxis (PrEP) to prevent HIV infection. This approval marks the introduction of the first and only biannual injectable option for HIV prevention, representing a significant milestone in expanding and personalizing HIV prevention strategies.

Yeztugo’s approval is supported by compelling clinical data from Gilead’s phase 3 PURPOSE 1 and PURPOSE 2 trials, and comes as a major advance in overcoming long-standing challenges with daily oral PrEP adherence. To provide expert perspective on the impact and future of this therapy, Jared Baeten, MD, PhD, senior vice president of clinical development and virology at Gilead, shared insights on what this new option means for people at risk of HIV, and how it fits into the broader prevention landscape.

Clinical trial data highlight lenacapavir’s remarkable efficacy. PURPOSE 1 enrolled 2,134 sexually active, HIV-negative cisgender women in South Africa and Uganda, with zero HIV infections observed, equating to a 100% risk reduction compared to the background incidence rate of 2.41 per 100 person-years (95% CI, 1.82–3.19). By contrast, oral daily regimens like emtricitabine/tenofovir alafenamide (F/TAF) and emtricitabine/tenofovir disoproxil fumarate (F/TDF) showed incidences of 2.02 and 1.69 per 100 person-years, respectively.

PURPOSE 2, which enrolled a geographically diverse group of cisgender men and gender-diverse participants, reported only two HIV infections among those receiving yeztugo. This translated to a 96% risk reduction, with 99.9% of participants remaining HIV-free during the trial period, confirming the drug’s superiority over background incidence rates.

Discussing the potential of yeztugo to address adherence and stigma challenges,  Baeten emphasized, “This medicine, lenacapavir, offers a new option for people who need or want HIV prevention, and it's a medicine that, for many people, could meet them where they are. It's an injection just twice a year that can be discrete, private, and allows people to overcome many of the challenges of adherence—particularly the adherence to a pill every day—as well as challenges of stigma or privacy that people face when they, for example, have to bring home a bottle of HIV PrEP pills.”

“We built, over now nearly two decades since this research started, a medicine that—because it's given as an injection just twice a year—could really try to meet people where they are. This offers a new opportunity for people to make an empowered choice for what they might want for HIV prevention.”

Yeztugo was previously approved in December 2022 under the brand name Sunlenca for the treatment of multidrug-resistant HIV, based on the CAPELLA trial showing efficacy in heavily treatment-experienced patients receiving twice-yearly subcutaneous injections.

 As a novel HIV-1 capsid inhibitor, lenacapavir blocks multiple essential viral lifecycle stages, representing a new class of antiretroviral therapy.

Regarding the drug’s availability, Baeten explained, “Our intent is, within a couple of days of approval, we'll be able to provide lenacapavir within the channels of ways that medicines are provided within pharmacy systems in the United States. We anticipate that individual insurance plans—75% of them—will incorporate it within the first six months, and 90% within a year. It's really important to remember for PrEP that PrEP has been covered by insurance plans in the United States, and for individuals without insurance, medication assistance programs exist. So people should really be talking to their doctors about the PrEP options and what might work for them.”

Gilead has also submitted applications to the European Medicines Agency (EMA), including through the EU-Medicines for All (EU-M4all) program aimed at accelerating access in low- and middle-income countries.

Baeten highlighted the extensive preparation Gilead has undertaken to support clinicians and health systems in adopting this biannual injection, “PURPOSE included two very large clinical trials—8,000 people in total—where 99.9% of those who received lenacapavir remained HIV-free. The program touched across five continents and was the largest and most diverse in terms of geography, age, gender, race, and ethnicity ever conducted for HIV prevention. Our teams have been working for over a year on educational tools and clinician engagement to help integrate this twice-yearly injection into existing health systems and counseling workflows.”

Looking ahead to ongoing real-world monitoring, Baeten remarked, “The work in this field does not end with FDA approval. We have planned several initiatives over the next few years to understand how lenacapavir is used in real-world settings and to ensure it meets diverse community needs. This includes continued data collection from the PURPOSE trials, funding 16 investigator-sponsored studies in the US, and conducting implementation science research globally.”

While yeztugo offers unprecedented convenience and efficacy, challenges remain in ensuring equitable global access and affordability. Gilead has pledged to pursue voluntary licensing agreements and equitable pricing strategies, particularly to benefit low-income countries. With its twice-yearly injectable dosing, lenacapavir represents a potentially transformative step in HIV prevention, removing key barriers and enabling more people at risk to protect themselves effectively.

1. Gilead. Yeztugo® (Lenacapavir) Is Now the First and Only FDA-Approved HIV Prevention Option Offering 6 Months of Protection. June 18, 2025. Accessed June 18, 2025. https://www.gilead.com/news/news-details/2025/yeztugo-lenacapavir-is-now-the-first-and-only-fda-approved-hiv-prevention-option-offering-6-months-of-protection

2. Gilead Sciences. US FDA Accepts Gilead’s New Drug Applications for Twice-Yearly Lenacapavir for HIV Prevention Under Priority Review

 Press Release. February 18, 2025. Accessed June 18, 2025. https://www.gilead.com/news/news-details/2025/us-fda-accepts-gileads-new-drug-applications-for-twice-yearly-lenacapavir-for-hiv-prevention-under-priority-review

Sunlenca (lenacapavir) Receives FDA Approval as a First-in-Class, Twice-Yearly Treatment Option for People Living With Multi-Drug Resistant HIV.

 December 22, 2022. Accessed June 18, 2025. https://www.gilead.com/news/news-details/2022/sunlenca-lenacapavir-receives-fda-approval-as-a-first-in-class-twice-yearly-treatment-option-for-people-living-with-multi-drug-resistant-hiv

Gilead’s Yeztugo, a long-acting HIV capsid inhibitor, shows 96 to 100% efficacy in phase 3 trials and aims to expand access worldwide through regulatory filings and support programs.

 FDA Approves Gilead’s Twice-Yearly Injectable Lenacapavir (Yeztugo) for HIV Prevention

Presented at ASM Microbe 2025, a bioinformatics-driven study has identified nine human microRNAs (miRNAs) with strong complementary binding to both hepatitis C virus (HCV) and bovine viral diarrhea virus (BVDV), supporting their potential use as targeted antiviral therapeutics.

HCV, a positive-sense single-stranded RNA virus in the Flaviviridae family, is a major cause of liver cirrhosis and hepatocellular carcinoma. Despite the availability of direct-acting antivirals (DAAs), challenges persist due to drug resistance and lack of a prophylactic vaccine. BVDV, a related pestivirus, is an established model for studying HCV due to its similar genomic structure.

Researchers from Diné College used multiple computational tools, NCBI BLAST-n, miRBase, and miRDB, to conduct over 36,400 sequence alignments. The objective was to identify human miRNAs with high sequence complementarity to the BVDV nucleocapsid gene and the HCV capsid gene across all six major genotypes.

Nine miRNAs demonstrated strong dual-binding affinity:

Each candidate aligned to both viral targets with two complementary sequence locations, suggesting potential for simultaneous inhibition of viral replication pathways in both BVDV and HCV. This multi-target interaction highlights their potential utility in developing a dual-acting therapeutic strategy.

Presented at ASM Microbe 2025, a bioinformatics study highlights nine human miRNAs capable of binding and potentially inhibiting both hepatitis C and bovine viral diarrhea viruses.

Zahra Kassamali, PharmD, BCPS

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