Although hepatitis C virus (HCV) infection is typically diagnosed by anti-HCV antibody testing, rare cases of seronegative HCV infection, defined by detectable HCV ribonucleic acid (RNA) in the absence of antibodies, have been reported in a small number of human immunodeficiency virus (HIV)-positive patients. We describe the case of an HIV-positive patient with persistently elevated alanine aminotransferase levels who was found to have a high HCV RNA viral load (1,140,000 IU/mL) despite a negative HCV antibody screening. The patient had been receiving combination antiretroviral therapy (cART) initially with efavirenz, TAF and 3TC, and was later switched to bictegravir/TAF/3TC. Following hepatological evaluation and initiation of sofosbuvir/velpatasvir therapy, plasma HCV RNA became undetectable. Remarkably, this patient, who maintained a stable immunological profile, also exhibited spontaneous HIV seroreversion, characterized by the loss of detectable HIV-specific antibodies. These observations illustrate the importance of a molecular-based diagnostic approach to complement serological testing in individuals at risk for HIV-related infections.

Evidence regarding infants with chronic hepatitis B virus (HBV) infection receiving antiviral therapy remains limited. In this case series, we describe four infants aged 7–10 months diagnosed with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB). CHB01, CHB03, and CHB04 demonstrated active HBV replication and elevated alanine aminotransferase (ALT) levels. CHB02 presented with a relatively low HBV DNA level (3.52 log₁₀ IU/mL), a low hepatitis B surface antigen (HBsAg) titer (4 IU/mL), and a normal ALT level. With parental informed consent, all four infants received lamivudine (LAM) monotherapy before one year of age. Ultimately, all achieved undetectable HBV DNA after a mean of 5.5 months, HBeAg seroconversion at 8.5 months, HBsAg loss at 7.0 months, and functional cure at 11 months on average. This suggests that early initiation of antiviral treatment may help achieve functional cure for infants with HBeAg-positive CHB.

Opportunistic infections (OIs) remain a major cause of morbidity and mortality among immunocompromised individuals, and delayed or inaccurate diagnosis can rapidly lead to adverse clinical outcomes. This narrative review critically evaluates the diagnostic performance, clinical utility, and evolving applications of quantitative real-time polymerase chain reaction (qPCR) for detecting opportunistic pathogens in vulnerable patient populations. Evidence across bacterial, fungal, viral, and parasitic infections demonstrates that qPCR consistently surpasses conventional culture- and serology-based methods in sensitivity, specificity, and turnaround time, particularly in cases of low pathogen burden or prior antimicrobial exposure. Its quantitative capability enables dynamic pathogen load monitoring and facilitates timely, targeted therapeutic interventions. However, limitations such as assay variability, incomplete standardization, and challenges in distinguishing colonization from active infection in polymicrobial contexts persist. Ongoing advances in multiplex technologies, digital PCR, and integrative data-driven diagnostics are expected to further refine clinical implementation. Collectively, qPCR has evolved from a supplemental assay to a cornerstone technology in precision diagnostics for OIs in immunocompromised patients.

Orthohantavirus infections constitute a significant global public health challenge, predominantly presenting as two distinct clinical syndromes: hemorrhagic fever with renal syndrome (HFRS) in Europe and Asia and hantavirus pulmonary syndrome (HPS) in the Americas. Epidemiological data indicate considerable geographic variability in disease incidence, influenced by intricate interactions among ecological, socioeconomic, and public health determinants. In Asia, a notable reduction in cases has been achieved through enhanced economic conditions, strategic public health initiatives, and effective management of rodent populations. Conversely, Nordic countries continue to report high HFRS incidence, which is attributed to ecological conditions conducive to sustaining reservoir rodent populations. South America has experienced an upward trend in cases, raising concerns about potential large-scale outbreaks, while emerging reports from Africa suggest a possible expansion of endemic regions. Notably, Australia remains one of the few regions without documented orthohantavirus infections and presents a unique epidemiological profile. This review comprehensively examines the global distribution of orthohantavirus infections, analyzes key epidemiological trends, and discusses the environmental and socioeconomic determinants influencing disease dynamics, providing critical insights for public health preparedness and intervention strategies.

The human immunodeficiency virus (HIV) epidemic poses a significant threat to global human health annually. Although antiretroviral therapy can control HIV viremia and delay disease progression, it cannot eliminate the viral reservoir. People living with HIV must rely on antiretroviral medication for their entire lifetime. HIV establishes a persistent viral latent reservoir, which remains an enormous challenge in eradicating HIV infection. With advancements in HIV research, many strategies have emerged to target cells harboring latent HIV. A functional cure for HIV has been proposed as a promising and pragmatic strategic objective. In this review, we provide an overview of current strategies and the latest research progress in the field of HIV cure development, highlighting the opportunities and challenges associated with finding a functional cure for HIV.