HIV Research & Clinical Practice最新文献

{"title":"QuantiFERON-TB gold plus in people living with HIV: independence from CD4+ T-cell counts in a low TB-burden setting.","authors":"Erika Asperges, Roberto Gulminetti, Laura Maiocchi, Stefano Novati, Layla Pagnucco, Paolo Sacchi, Valentina Zuccaro, Angelo Tavano, Francesco Siviero, Pietro Guidicini, Enrica Bono, Giuseppe Albi, Patrizia Cambieri, Bianca V Mariani, Raffaele Bruno","doi":"10.1080/25787489.2026.2624947","DOIUrl":"10.1080/25787489.2026.2624947","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis screening is recommended for people living with HIV. The QuantiFERON-TB test measures the cell-mediated response against <i>M. Tuberculosis</i>. The Gold-In-Tube measures the response of CD4+ T-cells, often leading to indeterminate results. The new Gold-Plus (QFT-GP) also measures CD8+ T-cells response, thus reducing uncertainties. However, studies on people living with HIV, that would benefit from a test independent from CD4+ T-cells, are scarce.</p><p><strong>Objective: </strong>This study addresses this gap by evaluating the performance of QFT-GP specifically in a large cohort of people living with HIV in a low TB-endemic setting.</p><p><strong>Methods: </strong>We retrospectively evaluated the frequency of indeterminate QFT-GP tests in a cohort of people living with HIV with at least one test. We collected demographic data, CD4+ and CD8+ T-cell count at nadir and at the time of testing, and history of prior TB infection or treatment. We correlated the QFT-GP results to the CD4+ T-cell count.</p><p><strong>Results: </strong>Six hundred and ninety five patients were included (males/females 72.5/27.5%), median age was 51 ± 14 years. Only 1,2% of tests were indeterminate, and there was no association with the CD4+ or CD8+ T-cell count at the moment of the test or at the nadir.</p><p><strong>Conclusions: </strong>QFT-GP has few indeterminate results, even in patients with a low CD4+ T-cell count.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2624947"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of doravirine/islatravir for HIV-1: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.","authors":"Hamzah M Alghzawi, Syed Zohad Shah, Zain Ul Abideen, Muhammad Farhan Ashraf","doi":"10.1080/25787489.2026.2698230","DOIUrl":"10.1080/25787489.2026.2698230","url":null,"abstract":"<p><strong>Background: </strong>The combination of doravirine and islatravir (DOR/ISL) is a novel two-drug regimen for HIV-1. Early development faced challenges due to dose-dependent immunological signals. We aimed to synthesize the evidence on the efficacy and safety of DOR/ISL across all treatment-experience categories, specifically evaluating the impact of islatravir dosage (0.25 mg vs 0.75 mg) on clinical and immunological outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) following PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, and Google Scholar from inception through April 2026. Primary outcomes were virological suppression (<50 copies/mL) and mean change in CD4+ T-cell count at week 48. Data were pooled using random-effects models. Islatravir dose was evaluated as a pre-specified moderator. Quality was assessed using Cochrane RoB 2.0 and certainty of evidence was graded using the GRADE approach.</p><p><strong>Results: </strong>Seven RCTs (<i>n</i> = 3,600 participants) were included. At Week 48, DOR/ISL showed non-inferior suppression rates (RR 1.01 [95% CI 0.99-1.02]; <i>p</i> = 0.516; moderate-certainty evidence) and a statistically significant reduction in virological failure risk (RR 0.55 [0.33-0.92]; <i>p</i> = 0.022) compared to active control. Overall CD4+ gain was lower with DOR/ISL (MD -34.55 cells/μL; low-certainty evidence); however, a profound moderator effect of dose was observed (<i>p</i> < 0.0001). The 0.75 mg dose was associated with significant CD4+ and lymphocyte declines, whereas the approved 0.25 mg dose was immunologically neutral. DOR/ISL was weight-neutral compared to bictegravir/emtricitabine/tenofovir alafenamide (MD -0.25 kg [-0.66 to 0.16]; low-certainty evidence).</p><p><strong>Conclusion: </strong>DOR/ISL 100/0.25 mg once daily achieved virological suppression comparable to standard-of-care ART regimens and was associated with lower rates of virological failure compared with active comparators. The immunological safety concerns observed in early trials were successfully resolved by dose optimization. These findings support the use of DOR/ISL (IDVYNSO) as a potential treatment option for both treatment-naïve and virologically suppressed adults while emphasizing long-term safety surveillance.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2698230"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure among people with HIV: prescription of guideline-directed medical therapy.","authors":"Melissa Klein Cutshaw, Robert Clare, Karen Chiswell, Paul Hofmann, April C Pettit, Eric Meissner, Matthew S Durstenfeld, Christopher T Longenecker, Gerald S Bloomfield, Nwora Lance Okeke","doi":"10.1080/25787489.2026.2728496","DOIUrl":"10.1080/25787489.2026.2728496","url":null,"abstract":"<p><strong>Background: </strong>People with HIV have an increased risk of heart failure (HF) compared to people without HIV. Guideline-directed medical therapy (GDMT) is the cornerstone of HF management, but little is known about GDMT prescription in this high-risk population.</p><p><strong>Objective: </strong>To evaluate GDMT intensity and identify patient factors associated with optimal HF therapy among people with HIV and systolic HF.</p><p><strong>Methods: </strong>We conducted retrospective analyses of the PATHWAYS study, a multi-institutional study of underrepresented racial and ethnic minorities with HIV. Adult patients with systolic HF (by ICD code) were included. A composite GDMT score was constructed using dosage-weighted prescription of GDMT drugs, ranging from 0% to 100% (with 100% indicating optimal therapy).</p><p><strong>Results: </strong>Among 451 PWH with systolic HF, the median age was 54 years (IQR = 47-62), 34.6% were female, and 96.6% were Black. In the year after HF diagnosis, 85.8% of patients were prescribed any GDMT, and 45.5% of patients attended a cardiology clinic visit. The mean GDMT score was 30% (SD = 22%). In multivariable analyses, lower GDMT scores occurred among patients with older age (adjusted mean ratio [AMR] = 0.96, 95% CI: 0.93-0.99) and severe renal disease (AMR = 0.84, 95% CI: 0.71-0.99). Higher GDMT scores occurred among patients with diabetes mellitus (AMR = 1.33, 95% CI: 1.16-1.53), prior myocardial infarction (AMR = 1.17, 95% CI: 1.02-1.35), and those who attended a cardiology clinic visit (AMR = 1.29, 95% CI: 1.13-1.47).</p><p><strong>Conclusions: </strong>People with HIV and HF had low GDMT scores, suggesting suboptimal intensity of HF care. Cardiology clinic attendance was associated with higher GDMT scores.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2728496"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional distributions of chemsex, broader sexualised substance use and individual-level substance use patterns and their associations with HIV among men who have sex with men in the Netherlands: a Bayesian spatial ecological modelling and a latent class analysis.","authors":"Haoyi Wang, Liana Aphami, Jules Casalini, Hanne M L Zimmermann, Kai J Jonas","doi":"10.1080/25787489.2026.2728499","DOIUrl":"https://doi.org/10.1080/25787489.2026.2728499","url":null,"abstract":"<p><strong>Background: </strong>Chemsex increases HIV risk, but the Dutch substance landscape is evolving beyond traditional drugs (e.g. GHB/GBL, methamphetamine) to include novel synthetic cathinones. This study mapped the spatial distribution of sexualised substance use and identified distinct chemsex-user profiles among men who have sex with men (MSM) in the Netherlands.</p><p><strong>Methods: </strong>Data from 1413 Dutch MSM in the EMIS-2024 survey (December 2023-July 2024) were analysed. Bayesian spatial ecological regression estimated the regional posterior prevalence and relative risk (RR) of chemsex engagement and its association with regional self-reported HIV prevalence. Latent-class analysis (LCA) identified substance-use patterns. Logistic regression assessed associations between HIV, chemsex engagement, and user patterns.</p><p><strong>Results: </strong>Overall, 19.8% of MSM reported chemsex. Regional prevalence was highly heterogeneous, ranging from 25.2% (RR = 1.27) in GGD-Amsterdam to 16.4% (RR = 0.83) in GGD IJsselland. Amsterdam and unexpected border regions (e.g. GGD-Drenthe) showed significantly higher RRs for chemsex engagement and the broader sexualised substance use. Substance use varied widely, with a notable presence of novel synthetic stimulants (13.9%) and ecstasy (21.4%). LCA revealed two distinct profiles: a 'Traditional Substance-Moderate use' class and a 'Broader-Polysubstance' class using a broader range of sexualised substances. Both individual and ecological analyses confirmed a strong association between chemsex engagement and higher self-reported HIV prevalence.</p><p><strong>Conclusion: </strong>Chemsex among Dutch MSM is geographically heterogeneous and increasingly features broad polysubstance use. Its consistent link to higher self-reported HIV prevalence at individual and regional levels highlights the need for geographically tailored harm-reduction strategies.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2728499"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal analysis of viral suppression before, during, and after pregnancy among women on antiretroviral therapy in Uganda: six-year real-world experience.","authors":"Collins Ankunda, Jude Emunyu, Sharon Namasambi, Brendah Kyomuhangi, Conrad Sserunjogi, Iving Mumbere, Jane Nakawesi","doi":"10.1080/25787489.2026.2637206","DOIUrl":"10.1080/25787489.2026.2637206","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the effectiveness of antiretroviral therapy (ART) and associated factors on viral suppression before, during, and after pregnancy (maternal timeline).</p><p><strong>Methods: </strong>We conducted a cohort study, retrospectively reviewing records of 1291 pregnant and breastfeeding women on ART. Descriptive statistics summarised the demographics and clinical characteristics. Chi-square, Fisher's exact, and generalised estimating equations were used to assess variations in viral suppression across the maternal timeline.</p><p><strong>Results: </strong>ART regimens comprised 62.5% dolutegravir (DTG)-, 28.8% efavirenz (EFV)-, 4.5% nevirapine (NVP)-, and 4.2% protease inhibitor (PI)-based therapy. Viral suppression rates before, during, and after pregnancy were DTG- (95.0%, 94.6%, 95.7%), EFV- (94.9%, 94.2%, 93.6%), NVP- (93.1%, 94.7%, 93.5%), and PI-based (79.6%, 88.0%, 85.7%). ART regimens varied in effectiveness, with statistical significance observed before (<i>p</i> < 0.001) and after (<i>p </i>= 0.018), but not during pregnancy (<i>p</i> = 0.678). PI-based regimens showed higher risk of non-suppression in the non-adjusted model (IRR = 3.20, 95% CI: 1.63-6.30, p = 0.001). In the adjusted model, poor adherence (aIRR = 7.80, 95% CI: 2.54-23.90, <i>p</i> < 0.001), fair adherence (aIRR = 5.03, 95% CI: 1.11-22.86, <i>p</i> =  0.036), second-line ART (aIRR = 3.14, 95% CI: 1.75-5.62, <i>p</i> < 0.001), and third-line ART (aIRR = 8.48, 95% CI: 1.82-39.43, <i>p</i> = 0.006) remained significant.</p><p><strong>Conclusion: </strong>ART effectiveness showed variation before and after, but not during pregnancy. EFV- and NVP-based regimens achieved suppression rates comparable to DTG across maternal timelines, with the exception of PI-based regimens. Adherence and ART drugs influence outcomes more than regimen choice alone, with good adherence essential for optimal maternal outcomes.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2637206"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life trajectories during analytical treatment interruptions in HIV cure-related studies and the influence of depression, anxiety, and resilience.","authors":"Steven Meanley, Ali Ahmed, Nadra E Lisha, Michael J Peluso, Meghann C Williams, Tony Figueroa, Steven G Deeks, Lillian B Cohn, Karine Dubé, John Sauceda","doi":"10.1080/25787489.2026.2715800","DOIUrl":"10.1080/25787489.2026.2715800","url":null,"abstract":"<p><strong>Background: </strong>Although analytical treatment interruptions (ATIs) protocols are essential for evaluating the efficacy of HIV cure-related interventions, little is known about how their health-related quality of life (HRQOL) changes when undergoing these trial requirements.</p><p><strong>Objective: </strong>This study evaluated how HRQOL evolved over time among people with HIV (PWH) participating in HIV cure-related studies requiring ATIs and examined the role of baseline depressive symptoms, anxiety, and resilience in shaping these trajectories.</p><p><strong>Methods: </strong>Seventeen PWH were included. Our analysis included data from two HIV cure-related studies involving ATIs: the UCSF SCOPE-ATI Study and the UCSF-amfAR Combination Trial. HRQOL was measured at baseline, pre-ATI, medication restart, and study completion. Baseline depressive symptoms, trait-based anxiety, and resilience were assessed using validated scales. Frequentist and Bayesian Linear mixed-effects models evaluated changes in HRQOL, the influence of baseline psychosocial factors, and potential moderating effects.</p><p><strong>Results: </strong>In frequentist models, HRQOL significantly improved over time (<i>β</i> = 0.63, <i>p</i> = .016). Baseline depressive symptoms (<i>β</i> = -1.00, <i>p</i> = .048) and anxiety (<i>β</i> = -1.18, <i>p</i> = .001) were negatively associated with HRQOL, indicating that higher levels of these factors were linked to lower HRQOL. Resilience moderated improvements in HRQOL over time (time*resilience <i>β</i> = 0.36, <i>p</i> = .040), with higher baseline resilience associated with steeper increases in HRQOL.</p><p><strong>Conclusions: </strong>HRQOL improved over time in this sample despite ATI participation requirements. Findings underscore the need to address psychosocial factors, particularly depressive symptoms and anxiety, in HIV cure-related studies to optimize participant well-being and enhance the overall study experience.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2715800"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to linkage to HIV care after hospital discharge among adults living with advanced HIV disease in Uganda: a COM-B-guided qualitative study.","authors":"Richard Katuramu, Fred C Semitala, Irene Mildred Neumbe, Rebecca Nekaka, Joan Nangendo, Proscovia M Namuwenge, Anne R Katahoire, Pauline Byakika-Kibwika, Moses R Kamya, Joseph K B Matovu","doi":"10.1080/25787489.2026.2707013","DOIUrl":"https://doi.org/10.1080/25787489.2026.2707013","url":null,"abstract":"<p><strong>Background: </strong>Hospital discharge represents a high-risk transition period for people living with HIV, particularly those with advanced HIV disease. In low-resource settings, substantial gaps persist in linking these individuals to outpatient HIV care following hospitalisation. This study explored barriers and facilitators to post-discharge linkage to care from the perspectives of patients and healthcare workers (HCWs) in Eastern Uganda.</p><p><strong>Methods: </strong>We conducted a descriptive qualitative study at Mbale Regional Referral Hospital between May and October 2025. Guided by the capability, opportunity, motivation, and behaviour (COM-B) model, we conducted 20 in-depth interviews with adults with advanced HIV disease who had recently been discharged from the medical ward (10 who successfully linked to care and 10 who did not), alongside 10 key informant interviews with HCWs involved in their care. Data were analysed using a thematic framework approach aligned with the COM-B constructs.</p><p><strong>Results: </strong>Patient-reported barriers included physical weakness (physical capability), limited knowledge of the linkage process (psychological capability), high transport costs and long travel distances (physical opportunity), and stigma or non-disclosure of HIV status (social opportunity). HCWs identified the absence of standardised linkage protocols, post-discharge follow-up mechanisms, and incentive structures as key systemic barriers (physical opportunity). Facilitators reported by patients included initiation or resumption of antiretroviral therapy (ART) before discharge (physical opportunity), support from peer supporters and disclosure to caregivers (social opportunity), and fear of clinical deterioration (reflective motivation). HCWs identified the existing TB-HIV linkage system (reflective motivation) and the presence of ward-based linkage counsellors (physical opportunity) as enabling factors.</p><p><strong>Conclusion: </strong>People living with advanced HIV disease face multiple, interrelated barriers to linkage with HIV care following hospital discharge, including physical debility, limited knowledge of the linkage process, financial and geographic constraints, and stigma. Conversely, pre-discharge ART initiation, peer support, and disclosure facilitate successful linkage. Strengthening post-discharge care will require standardised linkage protocols, structured follow-up mechanisms, and expanded use of peer supporters within health systems.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2707013"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypocoagulability among people living with HIV at Hoima Regional Referral Hospital, Western Uganda: a cross-sectional study.","authors":"Abdisalam Ahmed Sandeyl, Mohamed Jayte, Farah Dubad Abdi, Hassan Omar Ali, Abdisamad Guled Hersi, Zakarie Abdullahi Hussein, Venance Emmanuel Mswelo, Abdalla Ahmed Deifa, Abishir Mohamud Hirsi, Jacinto Amandua","doi":"10.1080/25787489.2026.2649042","DOIUrl":"10.1080/25787489.2026.2649042","url":null,"abstract":"<p><strong>Background: </strong>Coagulation abnormalities are an under-recognized complication among people living with HIV. Despite widespread antiretroviral therapy (ART), hematologic dysfunction, including coagulation and platelet abnormalities, continues to contribute to morbidity in sub-Saharan Africa.</p><p><strong>Objective: </strong>This study aimed to determine the prevalence, associated factors, and clinical features of hypocoagulability among people with HIV at Hoima Regional Referral Hospital (HRRH).</p><p><strong>Methods: </strong>We conducted a cross-sectional study at HRRH, Western Uganda, from May to July 2025. Sociodemographic, clinical, and behavioral data were collected via questionnaires and chart review. Laboratory evaluation included platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR). Hypocoagulability was defined as ≥ 1 abnormal parameter: PT > 13.5 s, aPTT > 35 s, INR > 1.2, or platelet count <150,000/µL. Multivariable logistic regression identified independent factors associated with hypocoagulability.</p><p><strong>Results: </strong>The study enrolled 389 HIV-positive adults. Hypocoagulability was detected in 121 participants (31.1%). The most frequent abnormalities were prolonged PT (14.1%), elevated INR (11.8%), prolonged aPTT (11.1%), and thrombocytopenia (9.3%). Independent factors associated with hypocoagulability included older age (aOR: 2.012, 95% CI = 1.165-4.813), alcohol use (aOR: 2.177, 95% CI = 1.250-3.792), ART-naïve status (aOR: 3.159, 95% CI 1.057-9.364), and unsuppressed viral load (aOR: 2.235, 95% CI = 1.297-3.851). Clinically, affected participants more commonly reported easy bruising (33.1%), frequent nose bleeds (29.8%), and heavy menstrual bleeding among women (39.2%) compared to participants without hypocoagulability.</p><p><strong>Conclusion: </strong>These findings highlight the importance of early detection, promotion of ART adherence, targeted screening of high-risk groups, and integrated management strategies to reduce bleeding-related morbidity in HIV care.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2649042"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported quality of life in people living with HIV in Romania: a cross-sectional PROM-based study.","authors":"Anca Streinu-Cercel, Victor Daniel Miron, Irina Magdalena Dumitru, Adriana Topan, Violeta Briciu, Manuela Arbune, Voichița Lăzureanu, Carmen Dorobăț, Adrian Streinu-Cercel, Oana Săndulescu","doi":"10.1080/25787489.2026.2672255","DOIUrl":"10.1080/25787489.2026.2672255","url":null,"abstract":"<p><strong>Background: </strong>In Romania, people living with HIV represent heterogeneous cohorts shaped by distinct epidemiological and social contexts. While antiretroviral therapy (ART) has markedly improved survival, quality-of-life (QoL) encompasses broader dimensions not fully captured by clinical indicators. Patient-reported outcome measures (PROMs) offer a valuable approach to understanding these dimensions in routine care.</p><p><strong>Methods: </strong>We conducted a multicenter, cross-sectional study using the OCTAVE PROM to assess patient-reported health-related QoL among people with HIV in Romania. The self-completed questionnaire evaluates eight domains: ART, physical health, mental health, sleep quality, sexuality, emotional wellbeing, non-HIV-related health, social and professional life. Adults attending routine follow-up visits in HIV centers across Romania were consecutively enrolled between August 2024 and July 2025.</p><p><strong>Results: </strong>In total, 1042 people with HIV completed the questionnaire (median age 36 years; 66.9% male). Over 95% of respondents reported being happy or very happy with treatment ease, adherence, tolerability, and information about ART. Lower levels of wellbeing were observed in the domains of sexuality (63.1%), sleep quality (74.8%), and social and professional life (77.0%). Sexuality was the most vulnerable domain and the only one showing consistent age-related differences, with progressively lower wellbeing reported in older age groups (all <i>p</i> < 0.001). Higher education was linked to better self-perceived physical functioning, emotional wellbeing, social integration, and financial security.</p><p><strong>Conclusions: </strong>This large, multicenter PROM-based study demonstrates that while treatment-related QoL among people with HIV in Romania is high, challenges persist in sexuality, sleep, and social wellbeing. Educational level emerged as key determinant of patient-reported outcomes. Integrating PROMs into routine HIV care can enhance patient-centered approaches by identifying unmet needs beyond virological control and informing targeted, individualized interventions.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2672255"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking the impact of cytomegalovirus reactivation in people with advanced HIV disease with <i>Pneumocystis Jirovecii</i> pneumonia: does antiviral therapy change outcomes?","authors":"Krystof Sram, David Jilich, Dan Vesely, Marek Duricek, Dita Smiskova, Hanus Rozsypal","doi":"10.1080/25787489.2026.2621466","DOIUrl":"10.1080/25787489.2026.2621466","url":null,"abstract":"<p><strong>Background: </strong><i>Pneumocystis jirovecii</i> pneumonia (PJP) remains a leading opportunistic infection in people with HIV and severe immunodeficiency. While PJP treatment has been well studied, the clinical significance of cytomegalovirus (CMV) DNA detection during PJP and the role of specific anti-CMV therapy remain uncertain.</p><p><strong>Objectives: </strong>To examine associations between CMV DNA detection, anti-CMV therapy, and clinical outcomes in people with HIV hospitalized with PJP.</p><p><strong>Methods: </strong>This retrospective cohort study examined people with HIV hospitalized with PJP between 2008 and 2022 at University Hospital Bulovka. A customized severity index was developed for this cohort. In-hospital mortality, one-year survival, and disease severity were assessed, focusing on CMV DNA detection and its treatment. Data were analyzed using Firth penalized logistic regression to identify associations with clinical outcomes, and ordinal logistic regression to assess predictors of severity scores in this observational cohort.</p><p><strong>Results: </strong>One hundred and one patients were included. In unadjusted analyses, CMV DNA detection was associated with higher odds of both in-hospital and one-year mortality, and anti-CMV therapy was associated with increased in-hospital mortality. In multivariable analyses, CMV DNA detection was not independently associated with in-hospital or one-year mortality, although point estimates consistently suggested higher odds of death. Receipt of anti-CMV therapy was not independently associated with mortality after adjustment. The severity index was independently associated with both in-hospital and one-year mortality. CMV DNA detection and anti-CMV therapy were independently associated with greater disease severity in ordinal regression analyses. Anti-CMV therapy was more frequently administered to patients with more severe disease and was also associated with in-hospital mortality.</p><p><strong>Conclusions: </strong>CMV DNA detection in people with HIV hospitalized with PJP was associated with worse outcomes. Anti-CMV therapy was more often used in severe cases and showed an association with in-hospital mortality in unadjusted analyses. The observational design precludes determination of causality.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2621466"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}