{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:45:04Z","timestamp":1793040304403,"version":"4.5.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Babesiosis poses significant risks of adverse outcomes in individuals with immunocompromising conditions (IC) and asplenia\/hyposplenia (AH). This study compares clinical outcomes between these vulnerable groups and immunocompetent patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study included adult patients with laboratory-confirmed babesiosis from 2009 to 2023. Complications, management, and outcomes were compared between patients with IC\/AH (ICAH) and without ICAH (immune intact cohort).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 225 patients (mean age 66 years, 36% female), 112 were ICAH. ICAH patients had higher median peak parasitemia (2.8% vs 0.9%, P &amp;lt; .0001) and higher rates of complications, including acute kidney injury (24% vs 11%, P = .016) and acute respiratory distress syndrome (11% vs 4%, P = .041), and were more likely to undergo packed red blood cell transfusion (31% vs 17%, P = .023) and exchange transfusion (18% vs 6%, P = .008). Treatment duration was longer in the ICAH cohort (median 27 vs 10 days, P &amp;lt; .001), particularly in those with both IC and AH (median 43 days, P = .003). ICAH patients had higher 12-month all-cause mortality (7% vs 1%, P = .019) and recurrence rates (8% vs 0%, P = .001). Hematologic malignancy (odds ratio = 7.0, P = .023) and B-cell\u2013depleting therapies (odds ratio = 9.4, P = .015) were significant predictors of recurrence. Despite most patients undergoing follow-up testing with blood smears and polymerase chain reaction, these did not reliably predict recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with ICAH with babesiosis experience more severe disease and higher complication rates. Follow-up testing, including blood smear and polymerase chain reaction, did not reliably predict recurrence, highlighting the need for more effective monitoring strategies in these high-risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf034","type":"journal-article","created":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T23:18:12Z","timestamp":1737847092000},"page":"987-994","source":"Crossref","is-referenced-by-count":5,"title":["Comparative Outcomes of Babesiosis in Immunocompromised and Nonimmunocompromised Hosts: A Multicenter Cohort Study"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6245-1569","authenticated-orcid":false,"given":"Loukas","family":"Kakoullis","sequence":"first","affiliation":[{"name":"Department of Medicine, Mount Auburn Hospital , Cambridge, Massachusetts, USA"},{"name":"Harvard Medical School , Boston, Massachusetts, 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