HIV Medicine最新文献

{"title":"Dual cross-sectional and longitudinal perspective on the continuum of HIV care to disentangle natural epidemic evolution from real progress, Belgium 2014-2022.","authors":"D Van Beckhoven, B Serrien, R Demeester, J Van Praet, P Messiaen, G Darcis, S Henrard, P De Munter, A Libois, J Deblonde","doi":"10.1111/hiv.70027","DOIUrl":"https://doi.org/10.1111/hiv.70027","url":null,"abstract":"<p><strong>Introduction: </strong>This study provides a comprehensive overview of HIV care by combining cross-sectional and longitudinal continuum of care (CoC) analyses.</p><p><strong>Methods: </strong>Using national surveillance data 2014-2022, a five-stage cross-sectional CoC was calculated among people living with HIV (incl. undiagnosed): diagnosed, linked to care, retained in care, on antiretroviral therapy (ART) and virally suppressed. For the longitudinal CoC, cumulative incidences (CI) were calculated for each transition.</p><p><strong>Results: </strong>The study included 26 191 people living with HIV. By the end of 2022, an estimated 18 302 persons were living with HIV in Belgium. Of these, 92.1% were diagnosed, 90.9% linked to care, 89.2% retained in care, 87.9% on ART and 85.6% virally suppressed. One-year post-infection diagnosis rates were 38% (2014-2016), 33% (2017-2019) and 31% (2020-2022), with differences disappearing after correction for immigration timing. Time from diagnosis to care entry remained stable at 82% within 3 months. Time to ART initiation and to viral load suppression reduced substantially, with 3-month CIs rising from 69% and 71%, respectively (2014-2016), to 91% and 77% (2020-2022). Transitions between all stages of care were the fastest among Belgian men who have sex with men. People who inject drugs had the lowest CI for care entry and viral suppression. Cumulative incidences of ART initiation increased substantially for all key populations, exceeding 90% within 3 months in 2020-2022, except for non-Belgian heterosexuals (87%).</p><p><strong>Conclusion: </strong>A steady improvement in the CoC places Belgium close to the joint united nations programme on HIV/AIDS 95-95-95 targets, although populations like people who inject drugs and migrants still face significant barriers to care. Timely diagnosis by supporting existing and innovative testing strategies should be prioritized.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and HIV-related stigma among Portuguese healthcare professionals: A cross-sectional analysis.","authors":"F Cota Medeiros, A Méndez-López, R Correia de Abreu, R Sarmento E Castro, F Maltez, F Antunes","doi":"10.1111/hiv.70039","DOIUrl":"https://doi.org/10.1111/hiv.70039","url":null,"abstract":"<p><strong>Introduction: </strong>Stigma and discrimination against people living with human immunodeficiency virus (PLHIV) within healthcare settings remain significant barriers to effective care. Stigmatizing attitudes persist among healthcare professionals, potentially undermining care quality. This study aimed to assess HIV-related knowledge and attitudes among healthcare professionals in Portugal, focusing on identifying factors associated with stigma.</p><p><strong>Methods: </strong>This study was part of a European survey by the European Centre for Disease Prevention and Control (ECDC) and the European AIDS Clinical Society (EACS). Data were collected via an online self-administered questionnaire between September and December 2023, targeting healthcare professionals in Portugal. Descriptive statistics, chi-square tests and multivariate logistic regression were used to assess associations between sociodemographic characteristics, HIV knowledge and stigma.</p><p><strong>Results: </strong>A total of 807 healthcare professionals participated in the study, with a majority being women (78%), and a mean age of 43.5 years. Most respondents were nurses (38%) and doctors (28%), worked in hospitals (54%) or primary healthcare centres (31%). The analysis showed that healthcare professionals working in HIV-dedicated departments, hospitals or community centres exhibited significantly higher levels of HIV-related knowledge. In contrast, female professionals, those over 40 years old and non-doctor professionals were less likely to demonstrate high HIV-related knowledge. Regarding stigma, professionals with limited HIV training and lower HIV knowledge were more likely to display higher levels of stigma.</p><p><strong>Conclusions: </strong>These findings highlight the need for targeted educational interventions to reduce stigma. Strengthening HIV-specific training, especially in stigma reduction, is crucial for improving care for PLHIV and fostering an inclusive healthcare environment.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What services, interventions and support are available for People with HIV in England to manage their overall health and wellbeing? A scoping review.","authors":"Howell T Jones, Lucy Lynch, Tristan J Barber, Meriel Rattue, Laura J Waters, David Asboe, Angeline Walker, Ian Williams","doi":"10.1111/hiv.70041","DOIUrl":"https://doi.org/10.1111/hiv.70041","url":null,"abstract":"<p><strong>Objectives: </strong>The average age of a person living with HIV in high-income countries is increasing, as are rates of multimorbidity and frailty. To meet these needs, existing services must adapt. This review aimed to identify the existing literature on what services are available to undertake long-term condition management (LTCM) for People with HIV in England.</p><p><strong>Methods: </strong>A scoping review employing the Arksey & O'Malley's methodological framework was performed. Seven databases were searched most recently in October 2024 for studies describing services, interventions, or support for People with HIV in England to manage their overall health and wellbeing. Study inclusion was not limited by year of publication. Narrative reviews were excluded. Two reviewers independently performed data extraction using predetermined criteria, followed by a descriptive analysis.</p><p><strong>Results: </strong>Forty publications were identified with six key areas where LTCM was addressed: HIV services, secondary care services, primary care, palliative care, peer support, self-management, and specialist services, suggesting that currently no service can undertake LTCM alone.</p><p><strong>Conclusions: </strong>If LTCM for People with HIV is to expand outside of HIV services, then additional HIV training is required for healthcare professionals with a focus on reducing stigma. Peer support should be at the forefront, and People with HIV should be involved in the assessment of need, design, and evaluation of services. There is a scarcity of high-level evidence, which justifies the need for further research and ongoing service evaluation to identify the optimal model(s) to ensure effective, equitable, and cost-effective care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV molecular network in Mexico City (2021-2022): Understanding transmission dynamics through the role of newly diagnosed cases.","authors":"Samuel E Schulz-Medina, Daniela Tapia-Trejo, Margarita Matías-Florentino, Dulce M López-Sánchez, Claudia García-Morales, Jessica Monreal-Flores, Ángeles Beristain-Barreda, Miroslava Cárdenas-Sandoval, Manuel Becerril-Rodríguez, Silvia Del Arenal-Sánchez, Verónica Quiroz-Morales, Steven Weaver, Joel O Wertheim, Raúl Adrián Cruz-Flores, Gustavo Reyes-Terán, Andrea González-Rodríguez, Santiago Ávila-Ríos, Vanessa Dávila-Conn","doi":"10.1111/hiv.70029","DOIUrl":"https://doi.org/10.1111/hiv.70029","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to infer and describe Mexico City's HIV genetic transmission network from 2021 through 2022 by characterizing its members based on time since HIV acquisition, as well as sociodemographic, clinical, and behavioural characteristics. Additionally, we assessed clustering potential according to time since HIV acquisition.</p><p><strong>Methods: </strong>Individuals with a recent HIV diagnosis at the largest HIV clinic in Mexico City were invited to participate, completing self-administered questionnaires on sociodemographic, clinical, and behavioural characteristics. Blood samples were collected for analysis of the HIV pol gene using next-generation sequencing. The stage of infection at diagnosis was determined using an algorithm that includes antibody avidity tests. Genetic transmission network analysis used the Seguro HIV-TRACE tool.</p><p><strong>Results: </strong>Of 6703 participants, 561 (8.4%) were identified as people newly living with HIV (PNLH). Transmission network analysis identified 896 clusters; 30.2% had at least one PNLH. Among all individuals, 43.5% formed clusters, with 11.8% being PNLH. PNLH added to a cluster showed higher odds for higher education, engaging in commercial sex, use of dating apps, annual HIV screening, and engaging in high-risk sexual practices (p < 0.05). Clusters with PNLH exhibited greater growth rates than those without PNLH (p < 0.05).</p><p><strong>Conclusions: </strong>The presence of PNLH in clusters was associated with a higher growth rate. Tailored prevention strategies are crucial, including using dating apps for risk communication, promoting PrEP use, and safe sexual practices in sex venues, and enhancing harm reduction related to drug use. PNLH could be key candidates for interventions aimed at breaking transmission chains, including contact tracing.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting treatment adherence in people with HIV - A single-Centre Descriptive Study from Turkey.","authors":"Sabri Atalay, Kamil Mert, Derya Caglayan, Ufuk Sonmez, Ilkay Akbulut","doi":"10.1111/hiv.70042","DOIUrl":"https://doi.org/10.1111/hiv.70042","url":null,"abstract":"<p><strong>Background: </strong>Treatment adherence is extremely important for virological suppression and a good clinical outcome in HIV. People with good adherence to treatment are less likely to experience treatment failure and have a better clinical course of the infection. In this study, we aimed to elucidate the factors affecting treatment adherence in people with HIV in a single centre from Turkey.</p><p><strong>Methods: </strong>The study was conducted at Tepecik Training and Research Hospital between September 2022 and December 2022. People with HIV over the age of 18 years who had been on ART for at least 6 months were included. Researchers designed a questionnaire by reviewing the literature to include factors that may affect treatment adherence.</p><p><strong>Results: </strong>A total of 306 people participated in the study (non-response rate: 30%), of which 86% were male. Among the individual factors, feeling depressed (19.5%), treatment fatigue (18.5%), and anxiety about not being able to have a healthy child (18.2%) were prominent. Major HIV/AIDS-related factors were the presence of AIDS-related opportunistic infection/cancer/comorbidity (20.9%) and lack of cure with current treatment (20.5%). Concern about side effects (14.6%) and drug-drug interaction (13.6%) were the most frequently mentioned ART-related factors. Main healthcare facility-related barriers for adherence were insufficient counselling (15.2%) and inability to reach the HIV physician (15.1%). Only a few patients stated factors related to the health system.</p><p><strong>Conclusion: </strong>In our study, the most significant factors affecting treatment adherence appeared to be individual and HIV/AIDS-related. It is important to be aware of these factors and to spend time on tailored counselling during initial diagnosis and follow-up visits.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of compliance with recommendations for HIV perinatal transmission prevention, timely diagnosis and early treatment of children living with HIV in Brazil.","authors":"Alexandre Alberto Cunha Mendes-Ferreira, Andrea Mônica Brandão Beber, Lino Neves da Silveira, Aranaí S D Guarabyra, Isabela Ornelas Pereira, Nazle Mendonça Collaço Véras, Rosana Elisa Gonçalves Gonçalves Pinho, Ana Roberta Pascom, Angelica Espinosa Miranda, Vivian I Avelino-Silva","doi":"10.1111/hiv.70038","DOIUrl":"https://doi.org/10.1111/hiv.70038","url":null,"abstract":"<p><strong>Introduction: </strong>Strategies for perinatally transmitted HIV (PTHIV) prevention are inconsistently adopted. Moreover, delays in diagnosis and treatment initiation for children living with HIV may aggravate outcomes.</p><p><strong>Methods: </strong>We used a survey study administered to Brazilian maternities to evaluate compliance with individual PTHIV prevention interventions as well as the overall compliance using a combined endpoint. We also investigated associations with the average number of births per month and municipal social vulnerability index (SVI) using regression models. Next, using data from Brazilian HIV monitoring systems, we obtained information on age at first HIV viral load (VL) testing and age at first antiretroviral dispensation to evaluate delayed diagnosis (first VL testing ≥6 months) and delayed antiretroviral initiation (first dispensation ≥12 months) among children living with HIV, investigating associations with race/ethnicity, sex and SVI.</p><p><strong>Results: </strong>Of 801 maternities, only 21% were compliant with the combined endpoint. Facilities located in cities with higher SVI and those with a lower number of births per month had lower odds of being compliant. Among 1152 children living with HIV, the median age at first HIV VL testing was 3 months (range 0-18) and 24% had a delayed diagnosis. Children living with HIV in cities with higher SVI had higher odds of delayed diagnosis. The median age at antiretroviral initiation was 6 months (range 1-120), and those with a delayed diagnosis had higher odds of delayed treatment initiation (aOR 4.9, 95% CI 3.5-9.9).</p><p><strong>Conclusion: </strong>Our study reveals significant challenges in access to PTHIV prevention, timely diagnosis and timely treatment initiation for children living with HIV, potentially related to social determinants.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported HIV viral load is reliable and not affected by adverse lived experiences of women living with HIV in British Columbia.","authors":"Tetiana Povshedna, Shayda A Swann, Marcela A P Silva, Shelly Tognazzini, Melanie Lee, Elizabeth M King, Zoë Osborne, Angela Kaida, Melanie C M Murray, Hélène C F Côté","doi":"10.1111/hiv.70035","DOIUrl":"https://doi.org/10.1111/hiv.70035","url":null,"abstract":"<p><strong>Introduction: </strong>HIV viral load (VL) is a key predictor of long-term health for women living with HIV. Here, we investigate how HIV VL self-reported by women living with HIV enrolled in the British Columbia CARMA-CHIWOS Collaboration Study relates to clinically measured HIV VL. Three HIV-related stigma scales and associations with selected socio-demographic characteristics, such as lifetime history of homelessness, history of substance use, ethnicity, and knowledge about 'Undetectable = Untransmittable', were also examined.</p><p><strong>Methods: </strong>For 219 women enrolled between December 2020 and August 2023, self-reported HIV VL status (classified as undetectable ≤40 copies/mL or detectable >40 copies/mL) was compared with HIV VL obtained from chart review closest to, but before the date of self-report (SR). Sensitivity, specificity, predictive values, and likelihood ratios were calculated for the study sample overall and for socio-demographically defined subgroups. Concordance between self-reported HIV VL and (CC) clinical chart-derived values was examined by Cohen's kappa. Three HIV-related stigma scores were compared between women stratified by the concordance of their self-reported and chart review-based HIV VL.</p><p><strong>Results: </strong>Ninety-five percent (208/219) of women were able to estimate their most recent HIV VL via self-report, and among them, 96% (200/208) were on antiretroviral therapy, 50% reported a history of homelessness, and 30% reported current substance use. Overall, the self-reported HIV VL was correctly estimated by 189 out of 219, and showed high overall concordance (86%) and moderate agreement (Cohen's kappa = 0.55) with HIV VL values derived from CCs. Correctly self-reported undetectable HIV VL showed high sensitivity (97.2%) and positive likelihood ratio (1.92), low negative likelihood ratio (0.06), moderate specificity (50%), and performed similarly across socio-demographic subgroups. HIV stigma scores did not differ between women who estimated their HIV VL correctly versus incorrectly. Of note, knowledge about 'Undetectable = Untransmittable' was lower (40%) among women who were not able to estimate their most recent VL than among those who did (74%).</p><p><strong>Conclusions: </strong>Our findings confirm previous reports of high awareness of HIV VL by women in British Columbia, Canada, despite a high prevalence of adverse socio-demographic experiences in this cohort. Our data further suggest that despite highly stigmatized life experiences, women living with HIV in British Columbia have a strong awareness of their VL status.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV disease hospitalizations and factors associated with in-hospital mortality in Ecuador: A nationwide analysis from 2015 to 2023.","authors":"German Josuet Lapo-Talledo, Ángel Luis Zamora Cevallos, Carlos Rafael Arteaga Reyes, José Daniel Sánchez Redrobán, Jhon Ernesto Delgado Pinargote, Ángela María Espinoza Guevara, Edgar Antonio Menéndez Cuadros","doi":"10.1111/hiv.70040","DOIUrl":"https://doi.org/10.1111/hiv.70040","url":null,"abstract":"<p><strong>Objective: </strong>Human immunodeficiency virus (HIV) remains a significant public health concern worldwide, contributing to notable rates of hospitalization and mortality. This study aimed to analyse HIV disease hospitalization trends and factors associated with in-hospital mortality in Ecuador during 2015-2023.</p><p><strong>Methods: </strong>Official national hospital discharge data were used. Hospitalization and in-hospital mortality rates were calculated. Multivariable logistic regression was performed to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to identify factors associated with in-hospital mortality.</p><p><strong>Results: </strong>Totally 28 408 HIV disease hospitalizations were analysed; the majority were males 61.19% (n = 17 383). Average hospitalization rate was 18.48 per 100 000 inhabitants. In-hospital deaths accounted for 11.31% (n = 3214). Older age (≥40 years) was significantly associated with a higher likelihood of death, particularly in 60-69 years (aOR 1.78, 95% CI 1.49-2.13) and ≥70 years (aOR 1.79, 95% CI 1.36-2.34). Patients with HIV-related Pneumocystis jirovecii pneumonia (aOR 2.74, 95% CI 2.28-3.29) and multiple malignant neoplasms (aOR 4.30, 95% CI 1.66-11.15) had the highest mortality likelihood. Although a declining trend in mortality rates was observed throughout 2015-2023, there was an increase in mortality probabilities in 2021 which may be linked to healthcare disruptions during the COVID-19 pandemic, while subsequent decline in 2022 and 2023 suggests improvements in HIV care access.</p><p><strong>Conclusions: </strong>While HIV-related hospitalizations and mortality have declined in Ecuador, older patients and those with severe opportunistic infections or malignancies remain at higher risk. These findings underscore the need for early diagnosis, enhanced management of HIV-related complications and sustained antiretroviral therapy (ART) coverage, particularly during public health crises.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiretroviral therapy use, self-reported adherence, and viral suppression among women living with HIV in Canada.","authors":"Maysaloun Mokaddam, Nadine Kronfli, Nancy L Sheehan, Araceli Gonzalez Reyes, Danièle Dubuc, Mona Loutfy, Angela Kaida, Alexandra de Pokomandy","doi":"10.1111/hiv.70034","DOIUrl":"https://doi.org/10.1111/hiv.70034","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, ≥95% adherence was recommended for viral suppression (VS). Newer antiretroviral therapy (ART) is now being increasingly prescribed and may be more forgiving of lower adherence. The lifelong nature of ART presents adherence challenges, particularly for women living with HIV. We aimed to describe ART use and examine the association between adherence and VS.</p><p><strong>Methods: </strong>The Canadian HIV Women's Sexual and Reproductive Health Cohort, which included 1422 participants, was used. Data was collected three times, at 18-month intervals, between 2013 and 2018. A Sankey diagram illustrated longitudinal ART trends among participants who reported their ART use. Cross-sectional analysis using 2017-2018 data included participants who self-reported their regimen, ART adherence, and viral load. Utilizing logistic regression models, self-reported adherence (percentage of ART taken in the past month) and self-reported VS (most recent <50 copies/mL) were investigated.</p><p><strong>Results: </strong>Among participants reporting ART use (n = 1187), integrase inhibitor use increased from 13.6% (n = 162) to 30.6% (n = 363), while other classes decreased. Among 617 participants assessed between 2017 and 2018, <70% adherence levels (adjusted odds ratio [aOR]: 0.06, 95% confidence interval [CI]: 0.01-0.27), 70%-79% adherence (aOR: 0.29, 95% CI: 0.05-1.77) and 80%-89% (aOR: 0.21, 95% CI: 0.05-0.86) were associated with lower odds of reporting VS compared with ≥95% adherence, although statistically not significant for 70%-79% adherence. No difference was found for 90%-94% adherence (aOR: 1.04, 95% CI: 0.20-5.32) compared with ≥95%.</p><p><strong>Conclusion: </strong>Our findings suggest that ART adherence levels lower than 90% are associated with a lower likelihood of VS among women living with HIV.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune profiles and HIV reservoir in people switching to long-acting cabotegravir/rilpivirine: Findings from a real-life prospective study.","authors":"Maria Mazzitelli, Maria Raffaella Petrara, Claudia Cozzolino, Lolita Sasset, Davide Leoni, Elena Ruffoni, Samuele Gardin, Beatrice Bragato, Angela Panese, Vincenzo Scaglione, Baldo Vincenzo, Anita De Rossi, Anna Maria Cattelan","doi":"10.1111/hiv.70030","DOIUrl":"https://doi.org/10.1111/hiv.70030","url":null,"abstract":"<p><strong>Introduction: </strong>Data on the dynamics of HIV-DNA and immune profiles under treatment with long-acting cabotegravir and rilpivirine (LACR) are limited.</p><p><strong>Methods: </strong>We prospectively enrolled people living with HIV who initiated LACR in our centre and assessed changes in HIV-DNA levels (measured by digital droplet PCR), as well as immune activated, senescent, exhausted, and regulatory T and B cells (analysed by flow cytometry), in peripheral blood mononuclear cells (PBMC) from baseline (T0) to 48 weeks of treatment (T5). Bivariate analyses, one-way repeated measures ANOVA and mixed ANOVA were conducted to assess differences in characteristics and biomarker changes over time between individuals switching to LACR from a dual (Group A) or triple (Group B) antiretroviral regimen.</p><p><strong>Results: </strong>A total of 71 persons were included (77.5% males, median age of 48 years). Overall, HIV-DNA levels exhibited a slight non-significant decrease, whereas activated CD8 cells decreased significantly (p < 0.001). Proportions of activated CD4 and regulatory T cells showed strong negative trends, but decreases did not reach statistical significance (p = 0.002 and 0.005). The dynamics of these markers within the two subgroups mirrored those of the entire cohort, with some differences. At baseline, Group A tended to exhibit higher levels of HIV-DNA (96 [31-160] vs. 41 [6-93] copies/10⁶ PBMC, p = 0.088), and activated CD4 (% activated CD4 cells: 2.3 [1-2.9] vs. 1 [0.7-2], p = 0.154) and CD8 cells (% activated CD8 cells: 4.9 [2.2-5.8] vs. 2.2 [1.2-3.5], p = 0.023) than Group B. Over the 48-week treatment period, HIV-DNA levels decreased slightly in both groups, remaining higher in Group A. At the end of the 48-week treatment period, the decrease of activated CD4 and CD8 cells was more pronounced in Group A than in Group B, ultimately reaching comparable levels between the two groups (% of activated CD4 cells: 0.9 [0.6-1.9] vs. 0.7 [0.6-1.1], p = 0.502): % of CD8 activated cells: (2 [1.3-2.5] vs. 1.6 [0.9-2.2], p = 0.278).</p><p><strong>Conclusion: </strong>During the first year of treatment, LACR does not significantly impact the HIV reservoir. However, it may reduce immune activation, particularly in persons switching from a dual therapy regimen.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}