Top 5 Infectious Disease News Stories Week of July 5-12

Universal Hepatitis C Screening in EDs Detects More Infections, but Gaps in Care Remain

The DETECT Hep C trial, recently published in JAMA, demonstrates that universal (nontargeted) hepatitis C screening in emergency departments (EDs) identifies significantly more new HCV infections than traditional risk-based screening—154 vs. 115 cases among over 147,000 visits. However, despite the higher detection rate, linkage to care and treatment completion remain critically low, with fewer than 10% of diagnosed patients achieving a cure (SVR12). Barriers include homelessness, patient disengagement, and the passive nature of clinician referrals. The study, conducted across EDs in Denver, Baltimore, and Jackson, highlights the ED’s untapped potential as a key access point for underserved populations but also points to systemic failures in the HCV care continuum. Experts like Dr. Jason Haukoos call for innovative care models, such as “warm hand-offs” and integrated follow-up, to improve outcomes. These findings align with the CDC’s 2025 recommendations endorsing universal HCV screening for all adults and pregnant women, reinforcing the need for low-barrier, stigma-free approaches in high-volume clinical settings.

A Young Mother With C difficile Deals With Social Isolation, Concerns of Recurrence

In this deeply personal account, Sara Embry shares her traumatic experience contracting Clostridioides difficile (C diff) while newly pregnant, despite never taking antibiotics. Likely exposed via fecal spores at a restaurant, Embry describes the physical toll of rapid weight loss and extreme weakness, as well as the emotional isolation of being contagious around her family, particularly her two young children. She received little guidance from healthcare providers and struggled with the fear of recurrence long after her recovery. Her turning point came when she found the Peggy Lillis Foundation (PLF), which offered not only practical support but emotional connection. Inspired, she now works as a peer support volunteer, helping others navigate the disease. Embry emphasizes the need for greater public and provider awareness of C diff, which she argues is not rare and can affect healthy individuals. She calls for better education, responsible antibiotic prescribing, and patient-centered care, advocating through PLF to ensure no one faces the illness alone.

Carl Schmid on Supreme Court Ruling Upholding ACA Preventive Coverage and Its Impact on HIV Prevention

In a pivotal 6-3 ruling, the US Supreme Court upheld the Affordable Care Act’s (ACA) mandate requiring private insurers to cover preventive services recommended by the US Preventive Services Task Force (USPSTF) without cost-sharing. The decision in Kennedy v Braidwood Management safeguards access to critical services, including HIV testing, hepatitis screening, and pre-exposure prophylaxis (PrEP), for millions of Americans. Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, praised the ruling as a significant victory for public health, emphasizing that prevention has long been a bipartisan priority within the ACA. The lawsuit, rooted in ideological opposition to PrEP, threatened to unravel coverage protections, especially for those relying on employer-sponsored insurance. While the decision preserves the legal requirement, Schmid warned that compliance issues persist, particularly regarding insurers' handling of newer PrEP options like long-acting injectables. He stressed that enforcement and public awareness are now essential to ensure equitable access to the full range of preventive care benefits.

Structural Barriers Drive Racial Disparities in Outpatient COVID-19 Treatment

A new study published in JAMA Network Open finds that Black and Latino patients were significantly less likely than White patients to receive timely outpatient COVID-19 antiviral treatment, by 10.8 and 9.8 percentage points, respectively. Coauthored by Rebecca Bromley-Dulfano, MS, the research attributes over half of this disparity to structural and encounter-level factors, such as limited access to home testing, virtual care, and differences in clinic infrastructure. Black and Latino patients were less likely to use rapid antigen tests or engage in virtual visits, associated with faster treatment. The findings suggest these disparities are not solely due to individual clinical differences but reflect broader, modifiable system-level inequities. Bromley-Dulfano emphasized that expanding access to telehealth and rapid testing, particularly in underserved clinics, could significantly reduce racial gaps in treatment. The authors call for targeted health system investments to improve equitable access to COVID-19 care across diverse populations.

PREPARE Trial: Over Half of Middle-Aged Adults With HIV Experience Physical Function Decline

A new analysis from the PREPARE trial found that over half of middle-aged adults living with HIV experienced physical function decline, with key risk factors including older age, female sex, non-White race, higher BMI, prior depression treatment, and elevated inflammatory markers like IL-6 and hsCRP. Researchers linked this decline to chronic inflammation, co-infections such as cytomegalovirus, and side effects from certain antiretroviral therapies (ART). The study emphasizes the importance of routine screenings, such as gait speed and chair rise tests, to identify early signs of impairment, and highlights the vital role infectious disease specialists can play in preventing disability by recognizing risk factors and coordinating timely, multidisciplinary care.