Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection - Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug Resistance.

In April 1984, 40 years ago, the Secretary of the US Department of Health and Human Services announced that Dr. Robert Gallo and his colleagues at the National Cancer Institute (NCI) had confirmed the cause of acquired immunodeficiency syndrome (AIDS) as a retrovirus, which became known as human immunodeficiency virus (HIV) in 1986. For the past 40 years, prevention and cure of HIV infection have been the dual 'holy grail' sought but still not achieved. By the beginning of 2024, the World Health Organization (WHO) estimated that in the past 40 years, between 65.0 million and 113.0 million people have been infected with HIV, and between 32.9 million and 51.3 million people have died from HIV infection. On 29 February 2024, the WHO published an updated report in response to increasing reports of HIV drug resistance (HIVDR). Currently, HIV vaccines in development are in early-stage clinical trials. People with HIV are more likely to develop tuberculosis, with increasing rates of antimicrobial resistance. MTBVAC is the first live attenuated vaccine to prevent Mycobacterium tuberculosis infection, with phase 2a safety and efficacy clinical trial data expected at the end of 2024. This editorial aims to summarize the current challenges and hopes for developing vaccines to prevent HIV infection and approaches to overcome antiretroviral drug resistance as a cure for HIV/AIDS.

Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent ß-Thalassemia.

In 2020, Emmanuelle Charpentier and Jennifer Doudna were awarded the Nobel Prize in Chemistry for their research on the endonuclease, clustered regularly interspaced short palindromic repeats (CRISPR) and the CRISPR-associated protein 9 (CRISPR-Cas9) method for DNA editing. On 16 November 2023, the UK Medicines and Healthcare Products Regulatory Agency (MHRA) was the first to approve the CRISPR-Cas9 gene editing therapy, Casgevy (exagamglogene autotemcel), for the treatment of patients with transfusion-dependent b-thalassemia and the treatment of sickle cell disease in patients aged ≥12 years with recurrent vaso-occlusive crises. On 8 December 2023, the US Food and Drug Administration (FDA) approved both Casgevy and Lyfgenia (lovotibeglogene autotemcel) for patients with sickle cell disease. On 15 December 2023, the European Medicines Agency (EMA) approved Casgevy for sickle cell disease and transfusion-dependent ß-thalassemia. This Editorial aims to present an update on the landmark first regulatory approvals of CRISPR-Cas9 for patients with sickle cell disease and transfusion-dependent b-thalassemia and the potential challenges for therapeutic gene (DNA) editing.

A Review of the Resurgence of Measles, a Vaccine-Preventable Disease, as Current Concerns Contrast with Past Hopes for Measles Elimination.

On 22 February 2024, the World Health Organization (WHO) stated that, following the recent resurgence of measles cases in Europe, more than half the world's countries could expect significant measles outbreaks this year. Measles is a highly infectious virus with a primary case reproduction number (R0) of 12-18. Measles infection can be severe, resulting in pneumonia, and also more rarely in subacute sclerosing panencephalitis (SSPE), which occurs in 1 child out of every 1,000 and can be fatal. Until the 1990s, the hope of eliminating measles seemed possible following the successful development of effective vaccines, given individually or in the combined measles, mumps, and rubella (MMR) vaccine. Vaccine hesitancy due to misinformation about possible vaccine side effects, reduced vaccine uptake during and after the COVID-19 pandemic, and lack of awareness of the severe consequences of measles infection have contributed to low vaccine uptake, resulting in vulnerable communities. This article aims to review the recent resurgence of measles cases in the US, Europe, and the UK, to provide a reminder of the potential severity of measles, and to consider the causes of the failure to eliminate this vaccine-preventable viral infection.

Editorial: Global Health Concerns as Vaccine-Preventable Infections Including SARS-CoV-2 (JN.1), Influenza, Respiratory Syncytial Virus (RSV), and Measles Continue to Rise.

In December 2023, the US Centers for Disease Control and Prevention (CDC) published the updated 2024 Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule, which is available online for access by the public and healthcare professionals. These new guidelines come at a time when the incidence of vaccine-preventable viral infections from SARS-CoV-2 (JN.1), respiratory syncytial virus (RSV), influenza, and measles are increasing in adults and children due to vaccine hesitancy, or non-compliance. This editorial aims to highlight the ongoing global health concerns for the consequences of increasing reports of vaccine-preventable infections, including SARS-CoV-2 (JN.1), influenza, RSV, and measles, to understand the causes of vaccine hesitancy, and introduce some public health measures that could improve vaccine uptake.

A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and Future.

The clinical association of purpura, arthralgia, and arthritis was first described in 1837 in a publication by Johann Lukas Schönlein, a German physician. In 1874, Eduard Henoch, a student of Schönlein, reported cases of children with purpura, abdominal pain, bloody diarrhea, and joint pain. IgA vasculitis, or Henoch-Schönlein purpura, is a systemic hypersensitivity vasculitis caused by the deposition of immune complexes in small blood vessels, including the renal glomeruli and mesangium. In the skin, the presentation is with non-thrombocytopenic purpura or urticaria. Worldwide, IgA nephropathy is the most common cause of primary glomerulonephritis. Detection of IgA deposition in small blood vessels and the renal glomeruli is diagnostic in most cases. This article aims to review the history, current classification, epidemiology, presentation, and diagnosis of IgA vasculitis and nephropathy, disease associations or trigger factors, including infections, vaccines, and therapeutic agents, and highlights some future approaches to improve diagnosis and clinical management.

Editorial: Climate Change and the Spread of Vector-Borne Diseases, Including Dengue, Malaria, Lyme Disease, and West Nile Virus Infection.

The major health threats from climate change include increasing temperatures, air pollution, extreme weather events, changes in the spread of infectious diseases, antimicrobial resistance, emerging pathogens, and an increase in vector-borne disease. Between October and December 2023, in 200 medical journal, epidemiologists, clinicians, healthcare policymakers, and journal editors published an emergency call to action to health professionals, the United Nations, and political leaders on climate change and its effects on the ecosystem and human health. Also, in December 2023, the Intergovernmental Panel on Climate Change (IPCC) published its sixth Assessment Report (AR6) that summarizes current knowledge, impacts, and health risks from climate change, as well as suggestions for mitigation and adaptation. For over a decade, the IPCC has reported that the prevalence of vector-borne diseases has increased and highlighted the importance of monitoring dengue, malaria, Lyme disease, West Nile virus infection, and other vector-borne diseases. This editorial aims to provide an update on the association between climate change and the spread of vector-borne diseases and highlights the urgent need for public health and disease prevention and treatment strategies to control the rise in vector-borne diseases.

Editorial: Outbreaks of Post-Pandemic Childhood Pneumonia and the Re-Emergence of Endemic Respiratory Infections.

In October and November 2023, hospitals in the major cities of Beijing and Liaoning in northern China reported a surge in cases of pneumonia in children, with some hospitals being overwhelmed by pediatric emergency admissions. Similar outbreaks of childhood pneumonia had been reported in the autumn of 2022 in Europe and North America. Therefore, increased reports of childhood pneumonia could be driven by post-pandemic changes in the pathogenesis of endemic respiratory infections other than COVID-19, including Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and influenza, rather than emerging novel pathogens. However, the recent reports of increased hospitalizations for children with pneumonia warrant continued infection surveillance and monitoring to exclude new respiratory pathogens or more virulent variants of known pathogens, including SARS-CoV-2. This editorial aims to present what is known about the re-emergence of endemic respiratory infections, which may be the cause of the recently reported outbreaks of childhood pneumonia.

Editorial: Factors Driving New Variants of SARS-CoV-2, Immune Escape, and Resistance to Antiviral Treatments as the End of the COVID-19 Pandemic is Declared.

On May 5, 2023, the Director-General of the World Health Organization (WHO) advised the transition to long-term management of the COVID-19 pandemic and that COVID-19 is now an established and ongoing health issue that is no longer a public health emergency of international concern (PHEIC). The WHO decision was based on an analysis of the decreasing trend in mortality, the decline in hospital admissions and Intensive Care Unit (ICU) admissions from COVID-19, and the increasing levels of population immunity to SARS-CoV-2. This Editorial aims to highlight what is known of the factors that drive new variants, subvariants, and lineages of SARS-CoV-2 associated with immune escape to previous infection or vaccines and resistance to antiviral treatments as the end of the COVID-19 pandemic is declared.

Editorial: Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 Guidelines for COPD, Including COVID-19, Climate Change, and Air Pollution.

The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report includes relevant topics from the clinician's perspective and evidence published on chronic obstructive pulmonary disease (COPD) since GOLD 2017. The World Health Organization (WHO) and GOLD 2023 have developed an updated definition of COPD as, "a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, expectoration, exacerbations) due to abnormalities of the airway (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction." GOLD 2023 includes recommendations for COPD patients diagnosed with COVID-19 and acknowledges the role of reduced air quality in the etiology and progression of COPD. In May 2023, the GOLD Scientific Committee on Air Pollution and COPD reported that air pollution increasingly contributes to the pathogenesis of COPD. This Editorial aims to introduce the updated GOLD 2023 report in the context of climate change and the aftermath of the COVID-19 pandemic.

Editorial: The Increasing Relevance of Case Reports in Medical Education and Clinical Practice - and How to Write Them.

Between 2012 and 2022, the American Journal of Case Reports published over 3,500 case reports and case series. In 2022-23, this journal achieved an impact factor (IF) of 1.2. The significant merits of published case reports include identifying rare diseases and syndromes, treatment complications or side effects, pharmacovigilance, and medical education. The limitations or cautions of the case report include the inability to generalize, the lack of establishment of a cause-effect relationship, and over-interpretation. Historically, new clinical conditions and syndromes have been identified. Since 2020, the COVID-19 pandemic has significantly impacted manuscript submissions and publications, as illustrated for this journal. This editorial aims to highlight the importance of case reports and series, recent publication trends and includes recommendations on what to do and what not to do when preparing and writing the manuscript for a case report.

Editorial: A Rapid Global Increase in COVID-19 is Due to the Emergence of the EG.5 (Eris) Subvariant of Omicron SARS-CoV-2.

A new variant of SARS-CoV-2 has currently achieved global domination. EG.5 (Eris) was first reported by the World Health Organization (WHO) on February 17, 2023, and designated as a variant under monitoring (VUM) on July 19, 2023. EG.5 (Eris), and its sublineages, EG.5.1, EG.5.1.1, and EG.5.2, is a descendent lineage of XBB.1.9.2, which has the same spike amino acid profile as XBB.1.5 (Kraken). However, EG.5 (Eris) has an additional F456L amino acid mutation in the spike protein compared to these parent subvariants, and the subvariant EG.5.1 has another spike mutation, Q52H. Following risk evaluation by the WHO, EG.5 (Eris) and its sublineages were designated as a variant of interest (VOI) on August 8, 2023. In the US, the Centers for Disease Control and Prevention (CDC) provides two-weekly monitoring data on the incidence and mortality from COVID-19 and SARS-CoV-2 variants. The most recent CDC data for August 19, 2023, showed an increase in cases in the past two weeks, with hospitalizations for COVID-19 increasing by 14.3% and mortality from COVID-19 rising by 8.3%. In the US, the most common COVID-19 cases have been due to three new SARS-CoV-2 Omicron variants: EG.5 (Eris) (20.6%); FL.1.5.1 (Fornax) (13.3%); and XBB.1.16 (Arcturus) (10.7%). This Editorial aims to highlight the importance of rapid virus genomic sequencing and continued global SARS-CoV-2 surveillance to identify rapidly emerging SARS-CoV-2 Omicron variants, such as EG.5 (Eris).

Editorial: First Regulatory Approval for Allogeneic Pancreatic Islet Beta Cell Infusion for Adult Patients with Type 1 Diabetes Mellitus.

Type 1 diabetes mellitus affects adults and children, with an increasing number of newly-diagnosed cases each year. Type 1 diabetes involves a primary functional defect in pancreatic islet beta cells, resulting in secondary autoimmunity that results in T-cell-mediated beta cell death. However, pancreatic transplantation is a complex procedure, with complications that include transplant organ failure due to rejection or ischemia-reperfusion injury, safety issues of the duodenal-duodenal anastomosis technique, and the availability of segmental or whole organs. On June 28, 2023, the FDA Center for Biologics Evaluation and Research (CBER) approved Lantidra (donislecel), the first allogeneic (deceased donor) pancreatic islet cell therapy for the treatment of adults with type 1 diabetes who do not achieve target glycated hemoglobin levels because of repeated episodes of severe hypoglycemia, despite current management. This Editorial aims to highlight the increasing global health burden of type 1 diabetes, previous approaches to pancreatic transplant methods and introduces the first regulatory approval for allogeneic pancreatic islet beta cell infusion, a novel approach to transplantation.

Editorial: Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). Updated Terminology for the Long-Term Effects of COVID-19.

Most studies on the long-term effects of SARS-CoV-2 infection have been retrospective, have lacked an uninfected comparison group, and have focussed on the prevalence of individual symptoms, resulting in different estimates of prevalence. Recognizing the range and complex interactions between the many long-term effects of COVID-19 is essential before effective prevention or management strategies can be investigated and implemented. Therefore, the term, long COVID, is too simplistic, and there are reasons to replace it with the term, post-acute sequelae of SARS-CoV-2 infection (PASC). The National Institutes of Health (NIH) have established the Researching COVID to Enhance Recovery (RECOVER) Consortium, a prospective longitudinal cohort initiative to learn about the long-term effects of COVID-19. Analysis of the RECOVER data identified 37 symptoms involving multiple systems at 6 months. This Editorial aims to present the range and complex interactions between the many long-term effects of COVID-19 that support the updated terminology of PASC.

Editorial: Infectious Disease Surveillance Using Artificial Intelligence (AI) and its Role in Epidemic and Pandemic Preparedness.

Artificial intelligence (AI), or machine learning, is an ancient concept based on the assumption that human thought and reasoning can be mechanized. AI techniques have been used in diagnostic medicine for several decades, particularly in image analysis and clinical diagnosis. During the COVID-19 pandemic, AI was critical in genome sequencing, drug and vaccine development, identifying disease outbreaks, monitoring disease spread, and tracking viral variants. AI-driven approaches complement human-curated ones, including traditional public health surveillance. Preparation for future pandemics will require the combined efforts of collaborative surveillance networks, which currently include the US Centers for Disease Control and Prevention (CDC) Center for Forecasting and Outbreak Analytics and the World Health Organization (WHO) Hub for Pandemic and Epidemic Intelligence, which will use AI combined with international cooperation to implement AI in surveillance programs. This Editorial aims to provide an update on the uses and limitations of AI in infectious disease surveillance and pandemic preparedness.

Editorial: Twenty Years On from Sequencing the Human Genome, Personalized/Precision Oncology Prepares to Meet the Challenges of Checkpoint Inhibitor Therapy.

On April 14, 2003, the International Human Genome Project was declared complete after identifying, mapping, and sequencing approximately 92% of the human genome. Significant genetic alterations have now been identified in most human cancers. Personalized, or precision, oncology involves molecular profiling of tumors to identify targetable alterations for drug treatments. T-cell responses to antigens, including tumor-associated antigens, are mediated by the interaction between stimulatory and inhibitory signaling molecules, known as immune checkpoints. Targets of inhibitory checkpoints include programmed death 1 (PD-1), its ligand PD-L1, and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). Challenges of checkpoint inhibition therapy include the prevalence and severity of immune-related adverse events (irAEs) and the short duration of response. Also, the beneficial effects in patients with hematologic malignancies other than Hodgkin's lymphoma remain limited. Checkpoint inhibitors are now integrated into standard-of-care for patients with several types of cancer. This Editorial aims to highlight the impact and challenges of checkpoint inhibitors in personalized/precision oncology and how molecular technologies may begin to address these challenges.

Editorial: Effective Direct-Acting Antiviral Treatments Support Global and National Programs to Eliminate Hepatitis C.

Eliminating an infectious disease aims to result in no residual disease in a specific geographic area due to deliberate efforts, which may require ongoing control measures to prevent the re-establishment of infection transmission. Currently, no effective vaccines prevent hepatitis C virus (HCV) infection. However, during the past decade, oral direct-acting antivirals (DAAs) have been developed and approved for the treatment of HCV that result in a 'cure' in more than 95% of people infected. Morbidity and mortality from untreated hepatitis C result from liver failure, cirrhosis, and HCC and can be prevented by curative treatment with DAAs, which also prevents HCV transmission. Morbidity and mortality from untreated hepatitis C result from liver failure, cirrhosis, and HCC and can be prevented by curative treatment with DAAs, which also prevents HCV transmission. In May 2016, the World Health Assembly of the World Health Organization (WHO) proposed the first global health initiative on viral hepatitis, which proposed the elimination of hepatitis B and C by 2030. In March 2023, the US President announced that in the 2024 fiscal year budget proposal, a 5-year program was approved to eliminate hepatitis C in the US, using a screening and treatment approach. This Editorial aims to present the development of effective and curative DAA treatments for hepatitis C that support the WHO and US Federal programs for disease elimination.

Editorial: Global Surveillance of Highly Pathogenic Avian Influenza Viruses in Poultry, Wild Birds, and Mammals to Prevent a Human Influenza Pandemic.

Strains of avian influenza A, believed to have originated in poultry with transmission to wild birds, have been associated with epidemics and four major pandemics in humans in the past century. The 1918 influenza pandemic was caused by an avian strain of the influenza A(H1N1) virus that initially adapted to infect humans and then rapidly spread between humans. Since 2021, highly pathogenic avian influenza (HPAI) virus subtypes have been identified in poultry and wild birds. In October 2022, the HPAI virus variant A(H5N1) was isolated from intensively farmed American mink. The World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and the European Union Reference Laboratory for Avian Influenza (EURL) have stated that the risk of human infection from birds and mammals and human-to-human transmission from known HPAI viruses is currently low. However, they recommend increased infection surveillance and preparedness. This editorial aims to present the status of HPAI virus transmission in poultry, wild birds, and mammals to highlight the importance of international infection surveillance, control, and preparedness to prevent the next human influenza pandemic.

Editorial: The XBB.1.5 ('Kraken') Subvariant of Omicron SARS-CoV-2 and its Rapid Global Spread.

In November 2021, the World Health Organization (WHO) first identified the Omicron variant of SARS-CoV-2, B.1.1.529, as a variant of concern (VOC). By early 2022, the Omicron variant and its five lineages, BA.1, BA.2, BA.3, BA.4. and BA.5, had become the predominant cause of COVID-19 in most countries. The Omicron XBB.1.5 subvariant is a sublineage of the XBB variant, a recombinant of two BA.2 sublineages, with the F486P mutation in the spike protein that increases infectivity due to increased binding affinity to the angiotensin-converting enzyme 2 (ACE2) receptor. On the week ending 21 January 2023, the XBB.1.5 subvariant caused 49.1% of cases of COVID-19 in the US. The rapid rise in the prevalence of this subvariant may be explained by immune escape to previous infection or vaccines, spike mutations in F486P, and increased affinity for the ACE2 receptor. Also, current booster vaccines may not provide adequate protection from infection from this subvariant, which has been named by the media as the 'Kraken' subvariant. This Editorial aims to present the current status of the XBB.1.5 subvariant of Omicron SARS-CoV-2 and the reasons for, and implications of, its rapid global spread.

Editorial: Current Status of Two Adjuvanted Malaria Vaccines and the World Health Organization (WHO) Strategy to Eradicate Malaria by 2030.

There is hope that 2023 could bring regulatory approval, licensing, and implementation programs for safe and effective adjuvanted vaccines to prevent malaria. Clinical trials involving the two leading adjuvanted malaria vaccines directed to the Plasmodium falciparum circumsporozoite protein (PfCSP) are ongoing. These vaccines are RTS,S/ASO1 (Mosquirix®) and R21/Matrix-M™ (R21/MM). This year, the World Health Organization (WHO) updated its strategy to eradicate malaria by 2030. The hope is that major advances in global health security from effective malarial vaccines could reduce morbidity and save the lives of millions of people living in malaria-endemic countries to achieve the goals recommended by the WHO. This Editorial aims to give an update on recent findings from key clinical trials on the safety and efficacy of RTS,S/ASO1 and R21/MM malaria vaccines and to provide an insight into the importance of key ongoing clinical trials that will report in early 2023.

Editorial: The World Health Organization (WHO) Fungal Priority Pathogens List in Response to Emerging Fungal Pathogens During the COVID-19 Pandemic.

The COVID-19 pandemic, climate change, increased resistance to antifungal drugs, and an increased number of immunocompromised patients have driven a recent global surge in pathogenic fungal infections, including aspergillosis, candidiasis, and mucormycosis. On 25 October 2022, the World Health Organization (WHO) released a list of 19 fungal priority pathogens identified as having the greatest threat to public health. The WHO Fungal Priority Pathogens List represents the first global response to identify and prioritize fungal pathogens and their impact on global public health and to consider the unmet research and development needs. The WHO has grouped the priority fungal pathogens into those of critical, high, and medium priority. This Editorial aims to highlight the importance of identifying and prioritizing fungal pathogens and identifying emerging fungal pathogens and the global factors driving changing patterns of infection.