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Infectious Diseases
15th Jan, 2026
The Lancet
Fortunate Machingura and her siblings were raised by their mother in Victoria Falls, a town on the Zambezi river in north-western Zimbabwe. Like almost every family they knew, they had been tragically impacted by the HIV epidemic. In the early 2000s, they also had to contend with Zimbabwe's raging inflation and political instability. Attending an all-girl's school in Harare, Machingura did not know yet the role climate and health sciences would take in her life. “But I was already developing an interest in natural resource governance, and the social, structural, and environmental factors that shape people's access to health, food, land, education, and basic freedoms,” she tells The Lancet Infectious Diseases.
In the phase 2, open-label, SOLSTICE trial, adults aged 18–70 years with hepatitis D virus (HDV) infection for at least 6 months and a HDV RNA level of at least 500 IU/mL were randomly assigned to either 300 mg monotherapy with the monoclonal antibody tobevibart (subcutaneously every 2 weeks; n=33) or 300 mg tobevibart plus 200 mg elebsiran, a small-interfering RNA (subcutaneously every 4 weeks; n=32). Both drugs target HBsAg, which enables entry and propagation of HDV. At week 24, the combined primary endpoint of a virological response (either a HDV RNA level below the limit of detection or a decrease in the level of at least 2 log10 IU/mL from baseline) plus normalisation of alanine aminotransferase (ALT) levels was noted in 23 (70%) of 33 patients receiving tobevibart monotherapy and in 15 (47%) of 32 receiving tobevibart plus elebsiran; by week 48, proportions were 61% and 56%, respectively.
As of Nov 30, 2025, Ethiopia's Ministry of Health had reported 12 confirmed cases of Marburg virus disease since mid-November, including eight deaths. As of Nov 26, 349 contacts had been isolated, with 119 released after completing surveillance. This marks Ethiopia's first-ever outbreak of Marburg virus disease. WHO is working alongside Ethiopia's Ministry of Health to enhance surveillance, case management, infection prevention and control, laboratory capacity, and risk communication and community engagement.
Paton NI, Cousins C, Sari IP, et al. Efficacy and safety of 8-week regimens for the treatment of rifampicin-susceptible pulmonary tuberculosis (TRUNCATE-TB): a prespecified exploratory analysis of a multi-arm, multi-stage, open-label, randomised controlled trial. Lancet Infect Dis 2025; 25: 1084–96—In this Article, Professor Erlina Burhan's affiliation should have been as follows: “Faculty of Medicine, Universitas Indonesia and Persahabatan Hospital, Jakarta, Indonesia ”. This correction has been made to the online version as of Nov 17, 2025.
Symes R, Whitaker HJ, Ahmad S, et al. Vaccine effectiveness of a bivalent respiratory syncytial virus (RSV) pre-F vaccine against RSV-associated hospital admission among adults aged 75–79 years in England: a multicentre, test-negative, case–control study. Lancet Infect Dis 2025; published online Oct 27. https://doi.org/10.1016/S1473-3099(25)00546-8—In this Article in figure 1, “227 not admitted” should have read “227 excluded”. This correction has been made to the online version as of Nov 6, 2025, and will be made to the printed version.
Seruyange E, Nahayo E, Uwimana FX, et al. Safe delivery of intensive care for Marburg virus disease in Rwanda. Lancet Infect Dis 2025; published online Oct 29. https://doi.org/10.1016/S1473-3099(25)00466-9—In this Grand Round, Tsion Firew's degree should have been ‘MD MPH’ and affiliations should have been “Ministry of Health, Kigali, Rwanda”, “Accident and Emergency, King Faisal Hospital, Kigali, Rwanda”, and “Ronald O Perelman Department of Emergency Medicine, New York University, NY, USA”. These corrections have been made to the online version as of Nov 20, 2025.
In our recent Comment,1 we suggest that different artificial intelligence (AI) applications might improve our ability to predict hotspots for risk-based surveillance and improve prediction of novel pathogens in metagenomes from such surveillance, potentially including host range, disease profiles, and transmission efficacy. We also highlight that AI is unlikely to be the solution to all problems. In their Correspondence, Nader Ebrahimi and Amir Ghaemi argue that we overstate the current predictive capacities and underplay methodological challenges.
SARS-CoV-2 continues to evolve, with successive variants evading immunity established by previous infection or vaccination. In mid-2024, a vaccine tailored to the JN.1 variant was authorised by the European Medicines Agency (EMA), which boosted neutralising antibody responses and provided substantial protection against severe disease and hospitalisation.1–3 Around 6 months later, in January 2025, LP.8.1 (of the JN.1 lineage) was classified as a “variant under monitoring” by WHO, due to its epidemiological importance and enhanced transmission fitness relative to contemporaneous strains.
The constant emergence of novel SARS-CoV-2 variants has driven the COVID-19 pandemic and sustains the current endemic. Saltation variants, such as BA.2.86,1 encode highly mutated spike (S) proteins that efficiently evade neutralising antibodies. In November, 2024, a potential saltation variant, BA.3.2, was detected in South Africa but its spread remained uncertain. Early studies on BA.3.2 did not include comparisons among its subvariants or with dominant variants NB.1.8.1 and XFG.2,3 Moreover, the effect of the often overlooked S protein insertion of Ala-Ser-Asp-Thr at position 214 remained unexamined.
With the first issue of 2026, in The Lancet Infectious Diseases we do not only start a new year but also an exciting new collaboration with a cover artist who will create the cover images for our issues throughout the year. The winner of our annual competition, who will accompany us for all of 2026, is Daria Lada.
Arthropod-borne viruses (arboviruses), particularly those transmitted by Aedes aegypti and Aedes albopictus, are a growing global health threat. Approximately 70% of the world's population is at risk of infection from dengue, chikungunya, Zika, and yellow fever viruses,1 with the burden rising sharply in recent years. This increasing risk is driven by a confluence of factors, including rapid and often unplanned urbanisation, climate change, and increasing interconnectedness through global travel and trade.
Long COVID is an umbrella term for the heterogeneous long-term consequences of SARS-CoV-2 infection. It encompasses a wide spectrum of phenotypes (sometimes overlapping), and its underlying mechanisms might vary across and within phenotypes. Trials that do not account for this heterogeneity risk false-negative results. First, endotypic heterogeneity might produce heterogeneity in treatment response, and inadequate methodologies risk eclipsing responder subgroups. Second, and the focus herein, phenotypic heterogeneity constitutes a challenge for the choice of outcome measures.
Elevators are the circulatory systems of hospitals. Like corpuscles, we are carried where we need to go. But for me, like many other patients who are immunocompromised, entering a hospital elevator is an act of microscopic faith. In these crowded spaces, we share proximity with strangers and, in doing so, potential pathogens. Moments of such imprecision are part of the daily minutiae for people who are immunocompromised. We take stock and calculate a risk–benefit analysis. Is anyone coughing? Should I wait for the next elevator? Elevators are not inherently high risk but serve to show how many of us perceive the world—with uncertainty.
Helicobacter pylori infection is the primary cause of gastroduodenal diseases and current guidelines recommend eradication therapy for all patients regardless of symptom presentation.1,2 Over the past 30 years, promising advances in H pylori treatment have been achieved through continuous improvements in acid suppressants (eg, potassium-competitive acid blockers [P-CABs] and proton pump inhibitors) and optimisation of existing antibiotic combination regimens (eg, bismuth subcitrate potassium, metronidazole, plus tetracycline; and omeprazole, amoxicillin, plus rifabutin).
Malaria is a major global health challenge, especially in sub-Saharan Africa. In 2023 alone, malaria caused about 597 000 deaths worldwide, mostly in children.1 A safe and effective vaccine for children is therefore a top global health priority. In this issue of The Lancet Infectious Diseases, Selidji T Agnandji and colleagues2 report a randomised, double-blind, placebo-controlled, phase 2 trial evaluating the safety, tolerability, and efficacy of a radiation-attenuated Plasmodium falciparum sporozoite (PfSPZ) vaccine in children aged 1–12 years in Gabon.
What's New: Vaccines, Blood and Biologics
9th Apr, 2026
FDA
Center,
Research
What's New: Drugs
8th Apr, 2026
Oncology
Journal of the American Medical Association
