HIV Medicine最新文献

{"title":"Late diagnosis of HIV among Ukrainian refugees in the Czech Republic: A retrospective, observational study.","authors":"Zofia Bartovská, Ricardo Massmann, David Jilich, Tomáš Groh, Lukáš Fleischhans, Milan Zlámal, Radek Svačinka, David Vydrář, Dalibor Sedláček, Miroslav Kubiska, Jaroslav Kapla, Lucie Nepovímová, Daniela Bartková, Lenka Olbrechtová, Zdeňka Jerhotová, Eva Novotná, Jakub Wnuk, Vratislav Němeček, Pavel Dlouhý, Štěpán Cimrman, Marek Malý","doi":"10.1111/hiv.70021","DOIUrl":"https://doi.org/10.1111/hiv.70021","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective, observational, non-interventional study describes the demographics, characteristics, immunological and virological status, coinfections, healthcare unit of HIV diagnosis and follow-up status of Ukrainian refugees with newly diagnosed HIV in the Czech Republic, with a special focus on those with a late HIV diagnosis.</p><p><strong>Methods: </strong>Ukrainian nationals with war refugee status, Ukrainian nationals with Czech Republic resident status and Czech Republic nationals who newly registered at HIV centres in the Czech Republic between March 2022 and June 2023 with a new diagnosis of HIV were included. Data were collected from medical records. The study was registered with the Czech State Institute for Drug Control (ID 2401240000).</p><p><strong>Results: </strong>In total, 298 patients with a new HIV diagnosis were included in the study. Of these, 58 patients were Ukrainian refugees who were retained in care. This cohort had a mean age of 37.0 years (min-max 13-60) and most (62.1%) were women. More than half of the Ukrainian refugees in this study (60.3%) had a late HIV diagnosis; these patients were older than those with a prompt diagnosis (mean age 40.7 vs. 31.5 years, p < 0.001). Ukrainian refugees were infrequently diagnosed in primary care and significantly more likely to have a late HIV diagnosis (60.3% vs. 37.8%, p = 0.005) and be diagnosed at a later HIV stage (p = 0.021) than Czech nationals.</p><p><strong>Conclusion: </strong>Ukrainian refugees were more likely to have a late HIV diagnosis than Czech nationals.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742768","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":"Rethinking HIV treatment: How non-integrase strand regimens may hold the key to better immune health.","authors":"Bogusz Aksak-Wąs, Karolina Skonieczna-Żydecka, Miłosz Parczewski, Rafał Hrynkiewicz, Filip Lewandowski, Karol Serwin, Kaja Mielczak, Franciszek Lenkiewicz, Paulina Niedźwiedzka-Rystwej","doi":"10.1111/hiv.70020","DOIUrl":"https://doi.org/10.1111/hiv.70020","url":null,"abstract":"<p><strong>Purpose: </strong>HIV outcome changed drastically with antiretroviral (ARV) therapy, especially after the introduction of second-generation integrase strand transfer inhibitors (INSTIs). Despite these advances, however, chronic immune activation and exhaustion, marked by programmed cell death 1 (PD-1) and programmed death ligand 1 (PD-L1) upregulation, persist in patients. This study investigates the impact of various ARV regimens on these immune exhaustion markers in newly diagnosed HIV patients over 12 months, taking into consideration cardiovascular risk.</p><p><strong>Methods: </strong>This study included 58 newly diagnosed patients with HIV at Pomeranian Medical University, Szczecin, Poland. Participants received ARV regimens classified as INSTI + tenofovir alafenamide, INSTI + tenofovir disoproxil fumarate, or non-INSTI-based (VARIA). Flow cytometry was used to assess PD-1 and PD-L1 expression on CD3+, CD3+CD4+, CD3+CD8+ and CD19+ lymphocytes. Statistical analyses included Wilcoxon paired tests, Kruskal-Wallis tests and multivariate regression, with validation through residual analysis and linear discriminant analysis (LDA).</p><p><strong>Results: </strong>INSTI-based regimens were linked to higher PD-1 expression on CD3+ and CD3+CD4+ lymphocytes, indicating increased immune exhaustion. Conversely, non-INSTI regimens were associated with lower PD-1 levels, suggesting better retention of immune function. A positive correlation between cardiovascular risk a prediction model to estimate 10-year fatal and non-fatal cardiovascular disease (SCORE2) and PD-1 expression was observed. However, the modest explanatory power of the models suggests variability in the effects of different ARV regimens.</p><p><strong>Conclusion: </strong>This study challenges the assumption that INSTI-based ARV regimens are universally superior, suggesting that non-INSTI therapies may better preserve immune function by reducing PD-1 expression. These findings highlight the potential benefits of non-INSTI regimens in improving long-term clinical outcomes in HIV treatment, warranting further research.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742770","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":"Trends of severe HIV disease and mortality among children in rural Tanzania.","authors":"L S Moshi, J Okuma, E Luoga, A V Kalinjuma, G J Mollel, G Sigalla, L Wilson, E Dotto, T Glass, F Vanobberghen, M Weisser","doi":"10.1111/hiv.70015","DOIUrl":"https://doi.org/10.1111/hiv.70015","url":null,"abstract":"<p><strong>Objective: </strong>To assess trends of severe HIV disease (SHD) and mortality/loss to follow-up (LTFU) among children living with HIV in rural Tanzania.</p><p><strong>Methods: </strong>Among children aged 0-14 years living with HIV enrolled in the prospective Kilombero & Ulanga Antiretroviral Cohort in January 2005-December 2023, we determined WHO-defined SHD prevalences at enrolment, mortality/LTFU incidence during follow-up using Kaplan-Meier methods, and associated factors using regression models.</p><p><strong>Results: </strong>At enrolment, among 1089 children [567 (52%) males, 587 (54%) aged <5 years and 530 (49%) with a HIV WHO stage III/IV], 112/332 (34%) had CD4 cell count <200 cells/μL among those aged 5-14 years. In children aged 5-14 years, SHD was diagnosed in 265/502 (53%) with a prevalence of 35-94% declining after 2013. Among children aged <5 years, 374/587 (64%) had SHD with no change over time. Male gender [adjusted odds ratio = 1.45; 95% confidence interval: 1.10-1.90], age <5 years versus older (1.64; 1.13-2.37), hospitalization versus outpatients (6.72; 3.35-13.5), antiretroviral treatment (ART) start within 30 days versus later (2.18; 1.52-3.13), and enrolment during 2013-2016 versus before (2.29; 1.54-3.41) were associated with SHD. After a median follow-up of 3.3 years [interquartile ratio: 0.8-7.8], 130 (12%) children died and 359 (35%) were LTFU. Predictors of mortality/LTFU were SHD [adjusted hazard ratio (aHR) = 1.54; 95% CI: 1.26-1.89], age <5 years versus older (1.28; 1.01-1.66), hospitalization versus outpatients (1.93; 1.42-2.63), living ≥50 km versus ≤1 km away (1.72; 1.37-2.16) and delayed ART initiation versus within 30 days (3.40; 2.70-4,27), while enrolment 2017-2023 versus before (0.51; 0.37-0.70) was protective.</p><p><strong>Conclusions: </strong>The persisting high prevalence of paediatric SHD and high mortality/LTFU underscores the need for early diagnosis and care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709674","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":"Biomarkers of inflammation and coagulation predict non-AIDS-defining events in a prospective cohort of virologically suppressed people living with HIV.","authors":"Maria Saumoy, Analuz Fernandez, Juan Tiraboschi, Judith Peñafiel, José Luis Sánchez-Quesada, Jaime Vega, Benito García, Irene Soriano, Daniel Podzamczer, Arkaitz Imaz","doi":"10.1111/hiv.70017","DOIUrl":"https://doi.org/10.1111/hiv.70017","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between biomarkers of inflammation, coagulation and immune activation and the incidence of non-AIDS-defining events in a contemporary, antiretroviral therapy (ART)-experienced and virologically suppressed cohort of people living with HIV (PLWH).</p><p><strong>Methods: </strong>Prospective, observational cohort study. PLWH aged 30-70 years, with undetectable HIV viral load and no history of cardiovascular disease, randomly selected from outpatients were included. At baseline, plasma biomarkers (high-sensitivity C-reactive protein [hs-CRP], sCD163, sCD14, D-dimer, interleukin-6, soluble vascular cell adhesion molecule [s-VCAM] and lipoprotein-associated phospholipase A2 [Lp-PLA2] activity) were measured. Non-AIDS-defining events (non-AIDS cancer and cardiovascular events) and non-AIDS death were recorded until November 2022. Cumulative incidence was analysed for each endpoint and adjusted Cox regression used to assess associations.</p><p><strong>Results: </strong>A total of 438 participants were included: 81.1% men, mean age 50.4 (SD 10.1) years. The median time on treatment was 15.5 (interquartile range [IQR] 8.69; 19.7) years and with undetectable viral load 7.05 (IQR 4.03; 11.6) years. A total of 77 non-AIDS-defining events were recorded in 70 patients (38 non-AIDS cancers, 21 cardiovascular events, 37 non-AIDS deaths) in a median follow-up of 6.72 (IQR 6.02; 7.36) years. The cumulative incidence for non-AIDS cancer, cardiovascular event and non-AIDS death was 8.7% (95% CI 6.2-11.7), 4.79% (95% CI 2.99-7.24) and 8.47% (95% CI 6-11.5), respectively. In adjusted models, sCD163 was associated with incident non-AIDS cancer (hazard ratio [HR] 1.23, 95% CI 1.08-1.39), hs-CRP with incident cardiovascular events (HR 1.61, 95% CI 1.05-2.47), sCD163 (HR 1.28, 95% CI 1.11-1.46) and D-dimer (HR 1.75, 95% CI 1.08-2.86) with non-AIDS death.</p><p><strong>Conclusions: </strong>Biomarkers of inflammation, monocyte activation and coagulation were associated with non-AIDS-defining events in a contemporary and long-term suppressed cohort of PLWH.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699645","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":"Pneumocystis jirovecii pneumonia-Immune reconstitution inflammatory syndrome: A review of published cases.","authors":"Natasha Marcella Vaselli, Kris Salaveria, James Winearls, Katherine Garnham","doi":"10.1111/hiv.70016","DOIUrl":"https://doi.org/10.1111/hiv.70016","url":null,"abstract":"<p><strong>Background: </strong>Immune reconstitution inflammatory syndrome (IRIS) can occur in patients with HIV after commencing antiretroviral therapy. Tuberculosis-IRIS is the most common, and Pneumocystis jirovecii pneumonia (PJP)-IRIS accounts for only 2.7%-4% of IRIS cases. The prognosis and management of IRIS is well studied in other opportunistic infections but is ill defined for PJP-IRIS, and no guidelines exist. We reviewed the literature to consolidate the available data for PJP-IRIS to formulate recommendations for the diagnosis and management of this condition.</p><p><strong>Methods: </strong>We performed a literature review of cases of PJP-IRIS and included cases in Australia that had not been previously published. We searched the Web of Science, MEDLINE, Embase, SCOPUS databases and grey literature sources for studies reporting cases of PJP-IRIS between January 1981 and August 2024. We provide a synthesis of published cases evaluating pathogenesis, mortality, and therapeutic options.</p><p><strong>Results: </strong>In total, 51 patients were identified from 25 data sources. Two mortalities were described. We found that 22% of PJP-IRIS cases required support in the intensive care unit. Antimicrobial treatment for PJP was given in 32 cases, and trimethoprim-sulfamethoxazole was the most prescribed. Extending the duration of PJP therapy beyond the usual 21 days did not appear to affect outcomes. Corticosteroids were given in 26 (52%) cases, not given in 12 cases (20%), and use was not stated in 13 cases (26%). The type and dose of steroid used varied and was described in 15 cases.</p><p><strong>Discussion: </strong>Mortality in PJP-IRIS appears lower than in IRIS secondary to other opportunistic infections. Prompt treatment with corticosteroids at a dose proportionate to disease severity is recommended. Extending antimicrobials for PJP beyond 21 days does not appear to offer clinical benefit in patients with PJP-IRIS. With the rise of immunotherapy, new treatments could be on the horizon for PJP-IRIS.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699548","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":"Efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide in Black and Hispanic/Latine adults with HIV-1 initiating first-line therapy: 5-year follow-up from two phase III studies.","authors":"C Martorell, M Ramgopal, D Hagins, O Osiyemi, J R Arribas, M Berhe, Y Yazdanpanah, C Orkin, L Santiago, C Rosero, N Unger, H Liu, R Rogers, J T Hindman, A Wurapa","doi":"10.1111/hiv.70018","DOIUrl":"https://doi.org/10.1111/hiv.70018","url":null,"abstract":"<p><strong>Introduction: </strong>Black and Hispanic/Latine people are disproportionately affected by HIV-1 and may have a greater risk of comorbidities than non-Black and non-Hispanic/Latine people with HIV. However, they have historically been underrepresented in HIV clinical studies. We aimed to assess the efficacy and safety of first-line antiretroviral therapy with bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) over 5 years in Black and Hispanic/Latine people with HIV.</p><p><strong>Methods: </strong>We present two post hoc pooled analyses of participants who received B/F/TAF up to week 240 in studies 1489 (NCT02607930) and 1490 (NCT02607956). Outcomes were compared between self-identified Black and non-Black participants and between Hispanic/Latine and non-Hispanic/Latine participants, including baseline characteristics, proportion with HIV-1 RNA <50 copies/mL, change in CD4 cell count, adherence, changes in metabolic parameters, and treatment-emergent adverse events.</p><p><strong>Results: </strong>Overall, 211 Black, 421 non-Black, 155 Hispanic/Latine, and 477 non-Hispanic/Latine participants received B/F/TAF up to week 240. At baseline, median ages were 30-34 years, and 84%-91% were male at birth. At week 240, high proportions of Black (97%), non-Black (99%), Hispanic/Latine (100%), and non-Hispanic/Latine (98%) participants had HIV-1 RNA <50 copies/mL. Black people with HIV were more likely than non-Black people with HIV to have low (<85%) adherence (11% vs. 5%; p = 0.0074). Changes in CD4 count, metabolic and renal parameters, and treatment-emergent hypertension and diabetes were generally similar between Black and non-Black and Hispanic/Latine and non-Hispanic/Latine participants. A smaller proportion of Black than non-Black people with HIV experienced study drug-related treatment-emergent adverse events (20% vs. 32%; p = 0.0026).</p><p><strong>Conclusions: </strong>These results demonstrate the durability and long-term safety of B/F/TAF in Black and Hispanic/Latine people with HIV.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673695","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":"Assessing weight change in adolescents and young adults with perinatally acquired HIV and integrase inhibitor use.","authors":"Kathleen J Pincus, Nabila Faridi, Patrick Amadeus Ryscavage, Hyunuk Seung, Kristine A Parbuoni, Matthew Grant, Neha Sheth Pandit","doi":"10.1111/hiv.70019","DOIUrl":"https://doi.org/10.1111/hiv.70019","url":null,"abstract":"<p><strong>Introduction: </strong>Integrase strand transfer inhibitors (INSTIs) are the mainstay of treatment in adults and children living with HIV. Weight gain has been associated with INSTI use in adults; however, less data exist on its effects on younger patients. This study aimed to characterize the impact of INSTIs on weight in patients living with perinatally acquired HIV (PAHIV).</p><p><strong>Methods: </strong>Retrospective cohort study of patients with PAHIV maintained on an INSTI for ≥6 months. Descriptive statistics were used to illustrate baseline characteristics. A linear mixed model with spline at the time of INSTI initiation was used to evaluate the primary outcome of the change in body mass index (BMI) slope pre- and post-INSTI use.</p><p><strong>Results: </strong>Ninety-three patients with PAHIV who initiated INSTIs between June 2010 and September 2021 were included. The median age of INSTI initiation was 19.3 (±5.9) years. Before INSTI initiation, BMI showed a positive trend of 0.11 kg/m² per 6 months (p = 0.2); after INSTI initiation, it increased by 0.26 kg/m² per 6 months (p = 0.002). Although similar post-INSTI BMI increases were seen regardless of age at initiation, a significant BMI change was seen post-INSTI initiation in females, those on concomitant tenofovir alafenamide or other medications that cause weight gain, with baseline BMIs of underweight or healthy weight, bictegravir or dolutegravir exposure and those virologically suppressed at initiation.</p><p><strong>Conclusion: </strong>In this US cohort of patients with PAHIV initiated on INSTI, a sustained increase in the rate of BMI change was observed. Specific patient variables resulted in a statistically significant increase in weight gain after INSTI initiation.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663574","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":"DÖAK 2025 German Austrian AIDS Conference","authors":"","doi":"10.1111/hiv.70004","DOIUrl":"10.1111/hiv.70004","url":null,"abstract":"<p><b>DÖAK 2025 | German Austrian AIDS Conference</b></p><p><b>Hofburg Vienna</b></p><p><b>20–22 March 2025</b></p><p>EPIDEMIOLOGY &amp; PREVENTIVE MEDICINE</p><p>BASIC SCIENCE</p><p>HIV THERAPY</p><p>COMORBIDITIES &amp; STIs</p><p>LIVING WITH HIV &amp; PSYCHOSOCIAL HEALTH</p><p>POPULATIONS OF SPECIAL INTEREST</p><p>PUBLIC HEALTH, PREVENTION &amp; CAREMODELS</p><p>EXPERT SESSION: INFECTIOLOGY CASE DISCUSSION</p><p>EXPERT SESSION: CONNECT HIV RESEARCH</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 S1","pages":"3-82"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taxonomic and functional profile of the anorectal microbiota in HIV-positive and HIV-negative men who have sex with men, using a metagenomic approach.","authors":"Paula Natalia Hernández-Trujillo, Camila Andrea Lopez-Barón, Gabriela Arévalo-Pinzón, Martha Liliana Trujillo-Güiza, Martha Isabel González-Duque, Adriana Matilde Flórez, Diego C Franco, Javier Vanegas","doi":"10.1111/hiv.70014","DOIUrl":"https://doi.org/10.1111/hiv.70014","url":null,"abstract":"<p><strong>Introduction: </strong>The study of bacterial diversity in human samples is crucial for developing biomarkers of health and disease. This research characterized the taxonomic and functional diversity of the anorectal bacterial microbiota in men who hae sex with men (MSM) with HIV compared to men from this group without HIV.</p><p><strong>Materials and methods: </strong>In July and August 2023, self-collected anorectal swabs were obtained. DNA was extracted from each sample, and metagenomic sequencing was performed. With the obtained data, alpha and beta diversity, bacterial abundance, differential operational taxonomic units, and functional diversity were determined.</p><p><strong>Results: </strong>Initially, 90 samples were collected, with 20 discarded due to having less than 200 ng of DNA and 15 due to incomplete sequencing, leaving 55 samples analysed (15 HIV-positive and 40 HIV-negative). No significant differences were found between groups in terms of alpha diversity (Shannon index p = 0.45) and beta diversity (PERMANOVA R = -0.03). Prevotella was identified as the most abundant genus in both groups. Twelve genes were found to be more abundant in the anorectal microbiota of the HIV group, which promote bacterial growth, colonization and survival.</p><p><strong>Conclusion: </strong>Alterations in the anorectal microbiota could influence the pathogenesis of HIV and its complications in this population, underscoring the need to investigate these mechanisms and explore interventions to improve health. Longitudinal studies are needed to analyse changes in the anorectal microbiota during HIV infection and its response to treatment, integrating metagenomic, clinical, and immunological data to better understand the interactions between HIV, the microbiota and host health.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648427","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":"Impact of mental health service use on the HIV care cascade among women.","authors":"Seerat Chawla, Angela Kaida, Marie-Josée Brouillette, Bluma Kleiner, Danièle Dubuc, Lashanda Skerritt, Ann N Burchell, Danielle Rouleau, Mona Loutfy, Alexandra de Pokomandy","doi":"10.1111/hiv.70008","DOIUrl":"https://doi.org/10.1111/hiv.70008","url":null,"abstract":"<p><strong>Background: </strong>While the negative effects of mental health issues on HIV clinical outcomes have been well-documented, the impact of mental health treatment on the HIV care cascade is largely uncharacterized. The objective of this study was to describe the engagement of women with mental health conditions and symptoms, who reported using mental health services, across the HIV care cascade and to assess the relationship between mental health service use and HIV care steps.</p><p><strong>Methods: </strong>Longitudinal data were analysed from participants enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) (2013-2018) who had clinically significant depressive symptoms or reported a mental health diagnosis at baseline. Among this subset, four states of HIV care were defined at baseline, 18 months and 36 months: (1) unengaged in care (did not visit an HIV provider in the past year), (2) not on antiretroviral therapy (ART) (visited an HIV provider in the past year but did not report current ART use), (3) detectable (reported current ART use but a detectable viral load) and (4) optimal (reported current ART use and an undetectable viral load). Sankey diagrams were used to illustrate the engagement of women across the HIV care cascade over 3 years based on their self-reported use of mental health services at baseline. The association between mental health service use and care state at baseline was analysed using multinomial logistic regression models.</p><p><strong>Results: </strong>Of the 898 women in the cohort with significant depressive symptoms or mental health conditions at baseline, 3.8% (n = 34) were unengaged in care, 10.9% (n = 98) were not on ART, 12.4% (n = 111) were detectable and 72.9% (n = 655) were optimal. Over the 36 months, 51.0% of women transitioned between states at least once. When stratified by service use, women who reported use of mental health services at baseline had better engagement across the care cascade and had fewer transitions between states over the 3 years, 37.2% of which were to better states of care. The use of mental health services at baseline was also significantly associated with greater odds of engagement in the optimal state compared with not on ART (adjusted odds ratio [aOR]: 1.72, 95% confidence interval [CI]: 1.07-2.77). A similar but statistically insignificant association was found with the detectable care state (aOR: 1.67, 95% CI: 0.92-3.03).</p><p><strong>Conclusions: </strong>Our findings demonstrate that linkage to mental health care has a positive impact on HIV care outcomes among women. Accessible mental health services may serve to improve both mental well-being and progression of these patients along the HIV care cascade, thereby achieving individual and public health goals.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556732","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}