A better understanding of lung microorganisms is conducive to early diagnosis and treatment and will improve the prognosis of HIV-infected patients with pulmonary infection. Currently, few studies have systematically described the spectrum of pulmonary infection among HIV-infected patients.

Accurate and rapid differentiation of Mycobacterium tuberculosis ( M. tuberculosis ) and nontuberculous mycobacteria (NTM) remains challenging, especially in smear-negative samples. Routine diagnostic methods often lack specificity and rapidity, highlighting the urgency of developing applicative molecular diagnostics to guide clinical management and improve patient outcomes. We developed and validated a multiplex PCR assay employing TaqMan probes targeting the IS6110 and rpoB genes to simultaneously detect M. tuberculosis and 23 NTM species in a single reaction, while avoiding cross-reactivity. Analytical performance was assessed using reference strains, and clinical feasibility was evaluated in a prospective, single-center pilot study involving 96 smear-negative presumptive tuberculosis patients. The assay’s diagnostic performance was compared to mycobacterial culture, DNA sequencing, and the Xpert MTB/RIF assay. The multiplex PCR assay demonstrated a wide linear dynamic range (10 ⁸ –10 ³ copies/mL), low limit of detection (10 ³ copies/mL), high precision (intra-assay CV 0.05–1.18%, inter-assay CV 0.08–2.57%), and complete specificity for both M. tuberculosis and NTM. In the clinical feasibility study, using a combination of clinical diagnosis and mycobacterial culture as reference standards, it achieved sensitivities of 73.33% ( M. tuberculosis ) and 100% (NTM), and specificities of 100% ( M. tuberculosis ) and 94.33% (NTM). Notably, it reliably identified M. tuberculosis /NTM co-infections. The Multiplex PCR assay fills a critical gap in the rapid, accurate diagnosis of M. tuberculosis and NTM in challenging clinical specimens. With a cost of $5 per test and a turnaround time of 3 h, our assay has the potential to improve patient care and optimize mycobacterial infection treatment strategies in resource-limited settings. IMPORTANCE: Rapid and accurate differentiation between Mycobacterium tuberculosis ( M. tuberculosis ) and nontuberculous mycobacteria (NTM) is essential for ensuring timely and appropriate treatment, especially in high tuberculosis (TB) burden regions. Conventional diagnostic methods, such as smear microscopy and culture, often lack the sensitivity or speed needed for reliable results in smear-negative cases, risking misdiagnosis and delayed care. In this study, we developed a novel multiplex real-time PCR assay capable of simultaneously detecting M. tuberculosis and up to 23 clinically relevant NTM species with high specificity and sensitivity. By targeting distinct genetic markers for M. tuberculosis and NTM, our assay provides a cost-effective, 3-h diagnostic solution that enhances diagnostic accuracy in challenging samples. This innovation addresses a critical gap in mycobacterial diagnostics, supporting improved patient outcomes and aligning with global health priorities for the control and elimination of TB.

Background: This cross-sectional study investigates the relationship between social support, psychological resilience, and HIV-related stress in older adults living with HIV in China. It further explores whether psychological resilience mediates the link between social support and stress and whether living arrangements moderate this relationship. Methods: From January to February 2024, 405 older adults aged 50 and above were selected from the outpatient Department of Infection and Immunology at Changsha Infectious Disease Hospital. Participants filled out a structured on-site questionnaire survey measuring the Chinese HIV/AIDS Stress Scale (CSS-HIV), the Connor-Davidson Resilience Scale (CD-RISC-10), and the Social Support Rating Scale (SSRS). Data were analyzed using SPSS 26.0, GraphPad Prism 10, and the PROCESS macro to test for mediation and moderation effects. Results: The mean HIV-related stress score was 24.84 ± 14.01, comprising instrumental (4.71 ± 4.74), social (14.23 ± 6.21), and emotional (5.91 ± 5.98) stress components. Social support had a significant total effect on HIV-related stress (β = -0.462, p < 0.001). The indirect effect via psychological resilience was statistically significant (β = -0.216, 95% CI [-1.044, -0.339], p < 0.001), and the direct effect remained significant (β = -0.246, p = 0.025), indicating partial mediation. Living with others showed a stronger moderating effect on psychological resilience against stress (β = -1.004, p < 0.001) than living alone (β = -0.586, p < 0.001). Conclusion: In this study, we found that psychological resilience and social support play critical roles in reducing HIV-related stress among older adults living with HIV in China. Our findings suggest that interventions designed to strengthen resilience and promote a supportive social environment have the potential to significantly improve mental health outcomes for this population. Future programs should consider the role of living arrangements by addressing privacy challenges and the dynamics of shared living, and by recognizing how these factors shape stress experiences and support needs in this vulnerable population. Trial registration: Not applicable. This study is a cross-sectional observation study and was therefore not registered as a clinical trial.

Human immunodeficiency virus type 1 (HIV-1) drug resistance remains a major challenge in HIV/AIDS management, particularly in individuals with low-level viremia (LLV) where RNA-based drug resistance testing (DRT) often fails. Although HIV-1 DNA DRT represents a promising alternative, its clinical utility has been constrained by insufficient evidence. This nationwide study in China enrolled 9,428 people living with HIV (PLWH), analyzing 10,903 samples spanning a wide viral load (VL) spectrum. To improve RNA detection, an optimized primer design combined with an extracellular particle (EP)-HIV co-isolation technique was developed. We then evaluated the reproducibility of drug resistance mutation (DRM) profiles between paired RNA and DNA DRTs using Sanger sequencing (SS), with single-molecule sequencing employed to establish a dominant sequence threshold. Our findings demonstrated that primer optimization and EP-co-isolation significantly enhanced RNA amplification success. DRMs were prevalent across all VL strata. The combined concordance and degeneracy rates (C/D rates) (where multiple DNA DRMs included all RNA-derived DRMs) between RNA and DNA DRTs ranged from 90.4% to 100% in different gene regions, with higher discordance rates observed in the nucleoside reverse transcriptase inhibitor (NRTI) and non-NRTI (NNRTI) regions. Based on Stanford penalty scores across 25 antiretroviral drugs, the degeneracy group showed a 98.3% ± 1.7% interpretation agreement. Even within the discordance group, mean agreement remained high (89.5% ± 5.0%), with only four NNRTIs exhibiting agreement below 85%. The dominant sequence proportion threshold for HIV-1 DNA was determined to be 24.6%. This study provides strong evidence supporting the integration of HIV-1 DNA DRT into clinical practice for reliable drug resistance surveillance and treatment monitoring.

Sparganosis, especially cerebral sparganosis, is a rare comorbidity of HIV/AIDS. Owing to nonspecific symptoms of sparganosis, diagnosis and treatment of the disease are challenging with a very high rate of misdiagnosis. This case report summarizes the clinical data of a case of cerebral sparganosis in a patient with HIV/AIDS. It provides a reference for the treatment of HIV/AIDS coexisting with parasitic encephalopathy (cerebral sparganosis). Cerebral sparganosis has been reported worldwide, especially in Asian countries. To our knowledge, this is the first case report of cerebral sparganosis associated with HIV/AIDS.