The human virome represents a fundamental yet understudied component of the microbiome, influencing immune regulation and disease. Given the profound immune dysregulation and microbial imbalance associated with HIV infection, understanding virome alterations during HIV and antiretroviral therapy is essential. This narrative review seeks to integrate and discuss the latest evidence regarding the structure and behavior of the human virome in healthy individuals, in the context of HIV infection, and under antiretroviral therapy. A comprehensive literature search was performed in MEDLINE and Google Scholar for peer-reviewed English-language articles published up to November 2025. Studies describing virome composition, diversity, and interactions in people living with HIV, as well as antiretroviral-induced changes, were included. Reference lists of relevant papers were screened to identify additional sources. Data were extracted and synthesized narratively, emphasizing human studies and supported by evidence from primate models where applicable. HIV infection induces profound alterations in the human virome, notably an expansion of eukaryotic viruses such as Anelloviridae, Adenoviridae, and Parvoviridae, accompanied by reduced bacteriophage diversity. Antiretroviral therapy partially restores virome balance but fails to fully re-establish pre-infection diversity, with persistent enrichment of Anelloviridae reflecting incomplete immune reconstitution. Virome perturbations correlate with immune activation, microbial translocation, and inflammation, contributing to comorbidities despite virological suppression. Emerging evidence suggests regimen-specific effects, with integrase inhibitor-based therapies showing more favorable viromic recovery. HIV and antiretroviral therapy profoundly remodel the human virome, with lasting implications for immune homeostasis and chronic inflammation. The ongoing disruption of the virome highlights its promise as both a biomarker and a potential therapeutic target in the management of HIV. Longitudinal, multi-omic studies are needed to clarify the causal role of virome alterations and guide future interventions.

Background: Influenza A(H3N2) viruses remain a major public health concern due to their rapid antigenic evolution and association with severe disease, particularly among high-risk populations. During the 2025–2026 influenza season, a marked epidemiological shift was observed in Europe, with the emergence and predominance of the A(H3N2) subclade K (J.2.4.1). Objectives: This narrative review aims to provide an integrated overview of the epidemiology, evolutionary dynamics, and public health implications of subclade K, with a particular focus on its impact on vaccine effectiveness, in comparison with the 2024–2025 influenza season. Methods: A non-systematic literature review was conducted using major scientific databases and official public health sources, including WHO and ECDC reports. Recent surveillance data, genomic analyses, and epidemiological updates were included. Given the rapidly evolving evidence base, selected preprint studies were also considered and interpreted with caution. Results: The 2025–2026 influenza season in Europe was characterized by a relative genetic convergence, with subclade K accounting for the majority of A(H3N2) sequences. This variant demonstrated a clear selective advantage and was associated with an earlier and more intense epidemic peak. Molecular analyses indicate the accumulation of multiple mutations in the hemagglutinin protein, particularly within key antigenic sites, contributing to immune escape. These evolutionary changes have important implications for vaccine effectiveness, with current estimates suggesting moderate protection against infection but preserved effectiveness against severe outcomes. Antigenic mismatch, manufacturing constraints, and host-related factors further contribute to reduced vaccine performance. Conclusions: The emergence and rapid spread of subclade K highlight the dynamic nature of influenza virus evolution and its impact on public health. Continuous genomic surveillance and timely vaccine updates remain essential. Despite suboptimal effectiveness against infection, influenza vaccination continues to provide significant protection against severe disease and should remain a cornerstone of prevention strategies.

Background: Erectile dysfunction (ED) is a multidimensional condition commonly affecting men living with HIV. The structured interview of erectile dysfunction (SIEDY) is the only validated tool assessing organic, relational, and psychological factors contributing to ED, while dynamic penile color Doppler ultrasound (dPCDU) is a reliable method for evaluating vascular causes of ED. Objectives: This monocentric cross‐sectional study aims to assess the reliability of the SIEDY questionnaire in determining the underlying causes of ED in young men living with HIV. Materials and Methods: Young men (<50 years) living with HIV, on antiretroviral therapy for at least the last 12 months, and reporting symptoms of ED were enrolled. The degree of sexual dysfunction was assessed with the International Index of Erectile Function‐5 (IIEF‐5), while SIEDY was used to explore the pathogenetic components of ED. dPCDU was performed to assess vascular damage in the penile district. Univariate binomial logistic regression models were used to evaluate the association between ultrasound parameters and SIEDY results. Results: A total of 50 young men living with HIV were enrolled, of whom 40 (80%) had at least one altered SIEDY scale, most frequently Scale 3 (70%). Forty‐five (90%) participants presented with at least one abnormal ultrasound parameter, with intima‐media thickness being the most common (76%). No correlation was found between ultrasound parameters and the SIEDY Scale 1, while logistic regression identified IMT as the only variable significantly associated with SIEDY Scales 2 (relational) and 3 (psychological). Discussion and Conclusions: SIEDY may have limited reliability in detecting vascular causes of ED in this population, particularly underestimating organic causes. The lack of correlation with objective vascular findings highlights the importance of including tools like dPCDU for vascular assessment in routine clinical evaluations of the ED.

To study the epidemiology of Coeliac Disease (CD) in the general paediatric population and among children with Type 1 Diabetes (T1D) in a population of Central Italy, and to assess the temporal trends of these two chronic conditions. A population-based longitudinal study on children aged < 15 was conducted using Healthcare Utilization Databases of the Marche Region, 2011-2023. Prevalent and incident cohorts of T1D and CD were identified using hospital discharges, drug prescriptions, and healthcare exemption databases. Prevalence ratios (PR), incidence rate ratios (IRR), temporal trends, and cumulative CD risk after T1D diagnosis were assessed with 95% confidence intervals (CI). Overall 13-year period prevalences of T1D and CD were 1.65‰ and 5.28‰, respectively. CD prevalence among children with T1D was 97.7‰, 18-fold higher than in the general population (PR 18.6; 95%CI 14.3-24.0). CD incidence was 65 per 100,000 person-years in the general population and 2,410 per 100,000 person-years among children with newly diagnosed T1D (IRR 37.0; 95%CI 24.7-55.4). The six-year cumulative probability of developing CD in the T1D cohort was 10.3% (95%CI: 6.2%-14.3%). Children with T1D have a markedly increased risk of CD, particularly in the first years after diagnosis, supporting systematic CD screening in this high-risk population.

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Background: Dalbavancin (DBV) is a long-acting lipoglycopeptide with activity against Gram-positive pathogens approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI). Its pharmacological profile supports use in infections requiring prolonged therapy, yet its role in osteomyelitis without implantable devices (OM-WoID) remains off-label. This study aims to describe real-world DBV use in a large tertiary care hospital, focusing on its effectiveness in OM-WoID. Methods: This is a monocentric, retrospective analysis including all patients receiving DBV at ASST Spedali Civili di Brescia, Italy, from April 2017 to July 2023. The statistical analysis focused on patients who received DBV for either ABSSSI or OM-WoID, with the latter transitioning to DBV after traditional daily intravenous therapy. Clinical, microbiological, and treatment data were extracted from electronic records and stored in REDCap. Effectiveness was defined as infection resolution or improvement; treatment failure encompassed clinical worsening, recurrence or suppressive therapy. Predictors of failure were identified through univariate and stepwise multivariate logistic regression. Results: During the study period, 157 patients (63.0% male; mean age 62.5 ± 20 years) received at least one dose of DBV, predominantly for off-label indications (66.2%). Early discharge was the most common reason for switching to DBV (66.3%). Focusing specifically on patients treated for ABSSSI (53) and OM-WoID (43), treatment success was achieved in 81.1% of ABSSSI and 90.7% of OM-WoID cases. In the stepwise multivariate logistic regression, older age was independently associated with an increased risk of treatment failure (OR 1.07, 95% CI 1.01–1.13; p = 0.028), while the presence of multimorbidity significantly reduced the risk (OR 0.07, 95% CI 0.01–0.77; p = 0.029). Discussion: Our study offers a comprehensive real-world analysis of DBV use in both approved and off-label indications. Although current clinical experience with DBV remains limited, DBV emerges as a valuable step-down option for the management of invasive Gram-positive infections in our setting. Consistent with previous evidence, older age independently increased the risk of treatment failure, whereas multimorbidity appeared protective, likely due to selection bias and the more intensive monitoring, earlier interventions, and tailored management such patients often receive. Our results support a broader range of approved indications for DBV to allow earlier discharge and more efficient use of healthcare resources.