HIV Medicine最新文献

{"title":"Sustained effect of Scotland's HIV pre-exposure prophylaxis programme on transmission among gay and bisexual men who have sex with men: Population-based retrospective cohort study.","authors":"Alan Yeung, Claudia Estcourt, Beth Cullen, Rebecca Metcalfe, Alison Rodger, Dan Clutterbuck, Nicola Steedman, Rak Nandwani, Duncan McCormick, Sharon Hutchinson","doi":"10.1111/hiv.70255","DOIUrl":"https://doi.org/10.1111/hiv.70255","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the population-level impact of seven years of Scotland's HIV pre-exposure prophylaxis (PrEP) programme among gay, bisexual and other men who have sex with men (GBMSM).</p><p><strong>Methods: </strong>National administrative data were used to estimate PrEP coverage and HIV incidence among 35 342 GBMSM attending specialist sexual health services between July 2015 and March 2024. Poisson regression was used to investigate the risk of HIV acquisition and its association with the extent of PrEP prescribing.</p><p><strong>Results: </strong>PrEP coverage increased from 21% in the initial PrEP period (July 2017 to March 2020) to 45% in the latter period (April 2022 to March 2024). HIV incidence reduced from 4.46 per 1000 person-years in the pre-PrEP period (July 2015 to June 2017) to 1.66 in the initial PrEP period (aIRR 0.37, 95% CI 0.25-0.54) and remained stable thereafter. During the entire PrEP period, the risk of HIV acquisition was reduced among those 'currently prescribed' (involving 4 HIV acquisitions among 11 720 person-years) compared to those never prescribed (60 HIV acquisitions among 34 328 person-years) (aIRR 0.19, 95% CI 0.07-0.51). Compared to those currently prescribed PrEP, risk was greatest in those prescribed 12+ months ago (11 HIV acquisitions among 3824 person-years) (aIRR 8.13, 95% CI 2.58-25.64).</p><p><strong>Conclusions: </strong>HIV incidence was sustained at a low level as PrEP coverage broadened among GBMSM, but did not reduce further. Efforts to support persistence and re-engagement with PrEP are warranted in those at ongoing risk of HIV.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836989","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":"Monitoring the HIV response for trans people in Europe and Central Asia.","authors":"S North, P A Calderon-Cifuentes, D Raben, S Bivol, A Rinder Stengaard, T Noori","doi":"10.1111/hiv.70250","DOIUrl":"https://doi.org/10.1111/hiv.70250","url":null,"abstract":"<p><strong>Objectives: </strong>This paper aims to present available data on national responses to HIV for trans populations related to national policies, legal environments and prevention programmes, as reported by European and Central Asian countries.</p><p><strong>Methods: </strong>Between February and April 2024, the European Centre for Disease Prevention and Control disseminated an online questionnaire to nominated National HIV Focal Points in Europe and Central Asia to monitor implementation of the Dublin Declaration on partnership to fight HIV/AIDS. This included questions on national HIV policies, legal environments, prevention programmes, the continuum of HIV care and avoidance of healthcare.</p><p><strong>Results: </strong>Twenty-three of 50 countries involve trans people in the content and development of national HIV strategies and policies related to their health. Two of 47 countries enact punitive legislation against trans people, and there is some evidence of healthcare seeking avoidance among trans people due to stigma in healthcare settings. In half of reporting countries (23/46), trans people have free (no cost) access to sexually transmitted infection testing and treatment. Limited availability and quality of national HIV data on the number of trans people diagnosed, treated and virally suppressed prevent the accurate measurement of progress towards global HIV targets for this key population.</p><p><strong>Conclusions: </strong>Trans people are to a lesser extent than other key populations addressed in national HIV policies and strategies, and the data available from countries suggest lower levels of access to services because of costs, unsupportive legal environments and avoidance of seeking healthcare services. Without comprehensive and trans-inclusive data collection, national and regional HIV responses may risk neglecting the specific needs of trans people in HIV prevention.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836658","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":"Preference for different PrEP formulations: A cross-sectional study in a PrEP cohort in Spain.","authors":"Alfredo Soler-Carracedo, Allison R Webel, Luis Ramos-Ruperto, Rafael Mican-Rivera, Rocio Montejano-Sanchez, Ana Milinkovic, Stephanie A Ruderman, Joseph P De Santis, Jose I Bernardino","doi":"10.1111/hiv.70252","DOIUrl":"https://doi.org/10.1111/hiv.70252","url":null,"abstract":"<p><strong>Objectives: </strong>To gain a better understanding of PrEP-users' preference for long-acting vs. oral PrEP formulation.</p><p><strong>Methods: </strong>From April 2023 to January 2024, participants who were prescribed PrEP completed an anonymous, structured, self-administered, cross-sectional survey as part of their routine PrEP care in a hospital setting in Madrid, Spain. Inclusion criteria were attendance at the clinic for PrEP care and the ability to understand the Spanish language. Eligibility was not restricted by age. A convenience sample of 200 participants was used. The ethics committee approved a waiver of written consent. Descriptive statistics and chi-square tests were used to analyse the data.</p><p><strong>Results: </strong>A sample of 201 participants completed the survey, of which 193 (96.5%) were male and most were 30-39 years old (48.8%). The response rate was estimated to be more than 90%. Among participants, 74.9% preferred LA-PrEP (53.9% preferred a subcutaneous (SC) injection every 6 months and 21.0% preferred an intramuscular (IM) injection every 2 months). Participants reported that LA-PrEP is more practical, indicating fewer visits to the clinic as a primary reason (67.4%). 29.4% of participants were aware of IM LA-PrEP, 10.0% of SC LA-PrEP and 10.4% were familiar with both. Respondents who selected LA-PrEP were more often under 40 years of age (p = 0.016) compared to those who preferred oral PrEP (73.7% vs. 61.2%, respectively). Limitations included the use of a cross-sectional design, a homogeneous sample and the use of one study location, among others.</p><p><strong>Conclusion: </strong>LA-PrEP is the preferred form of PrEP for the majority of respondents.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837037","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":"Prevalence of cardiometabolic diseases among ART-naïve people with HIV: A global systematic review and meta-analysis.","authors":"Peter Vanes Ebasone, Anastase Dzudie, Nasheeta Peer, Jerry Aseneh, Romain Ebene Mbende, Andre Pascal Kengne","doi":"10.1111/hiv.70254","DOIUrl":"https://doi.org/10.1111/hiv.70254","url":null,"abstract":"<p><strong>Introduction: </strong>The burden of cardiometabolic diseases (CMDs) is rising in people with HIV (PWH). While extensive data exist on CMD prevalence in PWH receiving antiretroviral therapy (ART), comprehensive data on ART-naïve PWH are scarce. We aimed to estimate the global prevalence of hypertension, diabetes, obesity and dyslipidaemia among ART-naïve PWH and compare estimates with those on ART and HIV-negative populations.</p><p><strong>Methods: </strong>This systematic review and meta-analysis included a search of PubMed-MEDLINE, CINAHL, SCOPUS, Academic Search Premier, Africa-Wide Information and Africa-Journals Online for original articles published up to June 2024. Cross-sectional, cohort and case-control studies providing baseline data on CMD prevalence were included. Studies had to include ART-naïve PWH aged ≥15 years. Two independent reviewers conducted studies screening, data extraction and methodological quality assessment. A random-effects meta-analysis with double arc-sine transformation was used for prevalence estimates. The study was registered with PROSPERO (CRD42021226001).</p><p><strong>Results: </strong>We included 184 studies published between 2000 and 2024, involving a total of 424 629 participants. The global pooled prevalence among ART-naïve PWH was 14.2% (95% CI: 12.4-16.1) for hypertension, 3.6% (2.9-4.3) for diabetes, 11.5% (10.3-12.9) for body mass index-based obesity, 18.3% (12.7-24.6) for waist circumference-based obesity, 14.8% (12.1-17.8) for elevated total cholesterol, 17.6% (11.3-24.8) for elevated low-density lipoprotein cholesterol, 22.9% (19.3-26.7) for elevated triglycerides and 54.6% (48.2-61.0) for low high-density lipoprotein cholesterol, all with high heterogeneity. Significant regional variations in the prevalence of diabetes, obesity and dyslipidaemia were observed according to UNAIDS regions.</p><p><strong>Discussion: </strong>We found a notable prevalence of CMDs in ART-naïve PWH, with significant regional variations in the prevalence of diabetes, obesity and dyslipidaemia. This highlights the need for targeted interventions and early screening to address the growing CMD burden among PWH.</p><p><strong>Conclusion: </strong>ART-naïve PWH face a considerable CMD burden, emphasizing the importance of early detection and management. Regional differences in CMD prevalence call for tailored public health strategies and integration of CMD prevention into HIV care protocols.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836991","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":"Real-world clinical and laboratory changes after switching to two-drug regimen in HIV-suppressed individuals: 48 weeks and beyond.","authors":"Tommy Hing-Cheung Tang, Ruby Tsz-Shan Kwong, Phillip Chan, Kwok-Wai Lam, Helen Shuk-Ying Chan, Man-Yee Chu, Wilson Lam, Tak-Chiu Wu, Wai-Shing Leung, Sai-Kwong Yung, Wan-Man Ting, Annabel Kai-Tung Choy, Joe Lok-Fung Tung, Jason Ka-Wah Fong, Daniel Kai-Yeung Yeung, Man-Po Lee","doi":"10.1111/hiv.70247","DOIUrl":"https://doi.org/10.1111/hiv.70247","url":null,"abstract":"<p><strong>Introduction: </strong>Two-drug regimens (2DRs) may reduce long-term drug toxicities and drug-drug interactions for people with HIV (PWH) on antiretroviral therapy (ART). This study evaluated clinical and laboratory outcomes in PWH who switched from standard ART to dolutegravir and lamivudine (DTG + 3TC) in real-world settings.</p><p><strong>Methods: </strong>We retrospectively identified virally suppressed PWH who switched from standard ART to DTG + 3TC at Queen Elizabeth Hospital, Hong Kong, China. They were grouped by age (PWH <50 years: PWH < 50; PWH > =50 years: PWH > =50). Their demographics, clinical and laboratory data before and 48 weeks after switch were compared.</p><p><strong>Results: </strong>Subjects included 352 PWH (84.7% male, 48.7% PWH > =50, median ART duration 8.3 years). At 48 weeks post-switch, 96.0% maintained DTG + 3TC with two (1.1%) in the PWH < 50 and three (1.7%) in the PWH > =50 experienced virological failure. There was no significant difference in virological failure (hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.11, 3.77, p = 0.613) or 2DR discontinuation (HR 0.95, 95% CI 0.33, 2.71, p = 0.926; restricted mean survival time (RMST) difference 0.23 weeks, 95% CI -0.64, 1.10, p = 0.600) between the groups. PWH > =50 exhibited a greater total cholesterol reduction than PWH < 50 post-switch (median change -4.8% (IQR -17.5%, 5.9%) versus 0.4% (IQR -8.1%, 8.2%), p = 0.005). Two sensitivity analyses excluding lipid-lowering drug users and restricting to INSTI-based ART users before switch yielded negative results.</p><p><strong>Conclusions: </strong>In this Chinese-majority cohort, switching from standard ART to DTG + 3TC was well tolerated at 48 weeks by both younger and older PWH. Despite more comorbidities in PWH > =50, their changes in laboratory outcomes post-switch were comparable to PWH < 50.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836999","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":"The effect of Biktarvy (B/F/TAF) on whole-body insulin sensitivity, lipid and endocrine profile in healthy volunteers.","authors":"Joseph Heskin, Roya Movahedi, Sujin Kang, Ruth Byrne, Krestine Elecito, Perrine Gridel, Paola Marchesani, Graeme Moyle, Ana Milinkovic, Marta Boffito","doi":"10.1111/hiv.70208","DOIUrl":"10.1111/hiv.70208","url":null,"abstract":"<p><strong>Background: </strong>Biktarvy is a single-tablet anti-retroviral regimen composed of a second-generation integrase-inhibitor (Bictegravir), in combination with tenofovir alafenamide and emtricitabine. Biktarvy has been shown to be highly effective in achieving and sustaining viral suppression. However, several studies have highlighted altered glycaemic control in individuals switching to Biktarvy from other regimens. The aim of this study was to quantify glucose disposal rates (GDR) in HIV-seronegative healthy volunteers following the administration of Biktarvy.</p><p><strong>Method: </strong>A 72 day, open-label, two-arm, crossover, single-centre study. Participants were randomized 1:1 to either start 28 days of Biktarvy followed by 44 days without treatment (Group 1), or no treatment for 43 days followed by Biktarvy treatment for 28 days (Group 2). A hyper-insulinaemic-euglycaemic clamp was carried out at days 1, 28 and 72 with a 14-day washout period following the second clamp. Statistical assessments of change in estimated GDR were carried out using Wilcoxon signed-rank test (within-group) and Two-sample Wilcoxon rank-sum (Mann-Whitney) test (between-group). The primary study outcome was change from baseline in total body glucose disposal by euglycaemic clamp method following 28 days treatment.</p><p><strong>Results: </strong>A total of 18 volunteers completed the study, with 11 in group 1 and seven in group 2. Within Group 1 the mean GDR was 7.52 mg/kg/min (SD 3.67) at baseline versus 8.50 mg/kg/min (SD 3.72) at day 28 (p = 0.32) and a mean percentage change of -13% (0.98). Within Group 2, the mean GDR was 6.54 mg/kg/min (SD 1.86) on day 28 versus 5.85 mg/kg/min (2.67) on day 72 (p-value = 0.38) mean percentage change -11% (-0.69). There was no statistically significant change between the groups at baseline (Mean 7.52 [SD 3.67] vs Mean 6.11 [SD 2.94], p-value = 0.31), at Day 28 (Mean 8.50 [SD 3.72] vs Mean 6.54 [SD 1.86], p-value = 0.27), or at Day 72 (Mean 9.65 [SD 5.07] vs Mean 5.85 [SD 2.67], p-value = 0.13). GDR on the final day of administration of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) was not significantly different (p = 0.104) between Group 1 Day 28 (6.64 [interquartile range (IQR) 5.83, 10.59] mg/kg/min) and Group 2 day 72 (0.28 [IQR 3.99, 8.79] mg/kg/min).</p><p><strong>Conclusion: </strong>Treatment with Biktarvy for 28 days was not associated with a statistically significant impact on total body insulin sensitivity as measured using a hyper-insulinaemic-euglycaemic clamp method. However, long-term data on the metabolic effects of Biktarvy are needed.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"809-814"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219085","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":"Perinatal and early infant outcomes after first-versus second-generation integrase strand transfer inhibitor use in pregnancy.","authors":"Rosa Balleny, Jeffrey Man Hay Wong, Terry Lee, Ari Bitnun, Isabelle Boucoiran, Jason Brophy, Jeannette Comeau, Fatima Kakkar, Athena McConnell, Laura Sauvé, Joel Singer, Alena Tse-Chang, Deborah Money","doi":"10.1111/hiv.70206","DOIUrl":"10.1111/hiv.70206","url":null,"abstract":"<p><strong>Introduction: </strong>Integrase strand transfer inhibitors (INSTIs) are first-line antiretroviral medications used in pregnancy. Pre-clinical research suggests adverse effects in human stem cells associated with second- versus first-generation INSTIs. We compared perinatal and early infant outcomes after exposure to first- versus second-generation INSTIs.</p><p><strong>Methods: </strong>Data were taken from the Canadian Perinatal HIV Surveillance Program. Infants born between January 1, 2010, and December 31, 2023, with in utero INSTI exposure were included. Univariate analysis compared perinatal and early infant outcomes between first- and second-generation INSTI exposures. Multivariable logistic regression was completed to identify independent associations between INSTI class and perinatal outcomes.</p><p><strong>Results: </strong>A total of 1160 infants were included: 433 exposed to first-generation INSTIs and 727 to second-generation. There was a non-significant finding of fewer small-for-gestational-age (SGA) infants with exposure to second-generation INSTIs (odds ratio [OR] = 0.75; 95% confidence interval [CI] = 0.55-1.01, p = 0.058), which remained non-significant in multivariable analysis (OR = 0.72, 95% CI = 0.49-1.07, p = 0.105). There was a non-significant finding of increased preterm births with exposure to second-generation INSTIs (OR = 1.40, 95% CI = 0.97-2.00, p = 0.070), which remained non-significant in multivariable analyses (OR = 1.01, 95% CI = 0.62-1.66, p = 0.962). There was a non-significant increase in infant deaths in the second-generation INSTI group compared to the first-generation group (6 vs. 0, p = 0.089). No differences were observed in HIV transmission (p = 0.208).</p><p><strong>Conclusions: </strong>There were no significant associations between second-generation INSTIs and adverse perinatal outcomes compared to first-generation INSTIs. These findings support the ongoing use of second-generation INSTIs in pregnancy with continued careful surveillance of perinatal outcomes.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"761-770"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157293","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":"Hypertriglyceridaemia and gender differences in the risk of major adverse cardiovascular events in people with HIV: A single-centre retrospective longitudinal study.","authors":"Alessia Siribelli, Nicolò Capra, Riccardo Lolatto, Costanza Bertoni, Rebecka Papaioannu Borjesson, Camilla Muccini, Vincenzo Spagnuolo, Giulia Morsica, Antonella Castagna, Hamid Hasson","doi":"10.1111/hiv.70203","DOIUrl":"10.1111/hiv.70203","url":null,"abstract":"<p><strong>Introduction: </strong>People with HIV (PWH) have an elevated risk of major adverse cardiovascular events (MACE) compared to the general population. The independent contribution of hypertriglyceridaemia (HTG) to cardiovascular risk remains unclear, and it is not accounted for in the standard used risk scores. The aim of this study was to evaluate whether HTG is independently associated with MACE, beyond factors included in the Atherosclerotic Cardiovascular Disease (ASCVD) risk score. Moreover, we assessed whether the association between MACE and cardiovascular risk factors, including HTG, is modified by sex.</p><p><strong>Methods: </strong>This was a retrospective longitudinal study including PWH followed at the San Raffaele Scientific Institute from January 2013 to January 2025. Baseline was defined as the first evaluation from 2013 onwards. A multivariate Cox regression model was used to assess the association between HTG and MACE, adjusting for ASCVD variables, statin use and HIV-related factors. Interaction terms were tested to explore sex-based modification of these associations.</p><p><strong>Results: </strong>Over a median follow-up of 11.4 years, 187 MACE occurred. HTG was independently associated with MACE [hazard ratio 1.53 (1.03; 2.30), p = 0.042], along with variables included in ASCVD risk score, statin use and unsuppressed HIV viraemia. No significant interactions were found between sex and any of the variables, although a marginal interaction was observed for diabetes.</p><p><strong>Conclusions: </strong>In this large cohort of PWH, HTG was independently associated with MACE, beyond traditional risk factors included in the ASCVD risk score. These findings suggest that triglycerides should be routinely considered in cardiovascular risk evaluation and targeted interventions-such as lifestyle changes and specific triglyceride-lowering therapies-may contribute to the reduction of residual cardiovascular risk.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"740-748"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105264","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":"Hierarchical analysis of unsuccessful tuberculosis treatment among people living with HIV in Brazil using nationwide surveillance data.","authors":"Lucas Vinícius de Lima, Gabriel Pavinati, Francisco Beraldi-Magalhães, Rubia Laine de Paula Andrade-Gonçalves, Aline Aparecida Monroe, Marcela Demitto Furtado, Rosana Rosseto de Oliveira, Daniele Maria Pelissari, Kleydson Bonfim Andrade Alves, Gabriela Tavares Magnabosco","doi":"10.1111/hiv.70200","DOIUrl":"10.1111/hiv.70200","url":null,"abstract":"<p><strong>Introduction: </strong>People with tuberculosis-HIV coinfection face multiple barriers to effective treatment, including social vulnerability, stigma and limited access to healthcare. This study examined factors associated with loss to follow-up and death among individuals with tuberculosis-HIV in Brazil.</p><p><strong>Methods: </strong>We conducted a longitudinal study using a nationally linked database from surveillance systems. Poisson regression models with robust variance were applied to identify factors associated with unfavourable outcomes, guided by a theoretical-conceptual hierarchical framework.</p><p><strong>Results: </strong>We analysed data from 54 516 individuals. The median time to loss to treatment follow-up was 115 days, with a cumulative proportion of 29.56%. Among the most consistent predictors of loss to follow-up were homelessness (relative risk, RR 1.18; 95% confidence interval, 95% CI 1.16-1.19), tuberculosis retreatment (RR 1.16; 95% CI 1.15-1.17) and drug use (RR 1.15; 95% CI 1.14-1.16), whereas antiretroviral therapy use (RR 0.95; 95% CI 0.95-0.96) showed a negative association. The median time to death during tuberculosis treatment was 27 days, with a cumulative proportion of 27.54%. Higher risk of death was observed among individuals with CD4 counts <350 cells/mm³ (RR 1.09; 95% CI 1.08-1.10), those experiencing homelessness (RR 1.08; 95% CI 1.06-1.10) and those with rifampicin resistance (RR 1.11; 95% CI 1.07-1.15).</p><p><strong>Conclusion: </strong>Key social, clinical and programmatic factors were associated with loss to follow-up and death during tuberculosis treatment among people with HIV. Addressing these vulnerabilities is essential to improving treatment outcomes and advancing progress towards the 2030 targets.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"710-726"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146062652","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":"Preferences for long-acting antiretroviral therapy among people with HIV: A systematic review of discrete choice experiments.","authors":"Ting Cao, Xinyu Chen, Huan Chen, Xianying Lu, Yuhang Li, Huiting Gao, Chaoming Hou, Jing Gao","doi":"10.1111/hiv.70198","DOIUrl":"10.1111/hiv.70198","url":null,"abstract":"<p><strong>Background: </strong>Long-acting antiretroviral therapy (LA-ART) is emerging as a promising strategy to enhance treatment satisfaction and improve the quality of life for people living with HIV (PLWH). A comprehensive understanding of treatment preferences is essential for effectively addressing the needs and expectations of PLWH.</p><p><strong>Objective: </strong>This review intends to delineate and assess the evidence gathered from discrete choice experiments, aiming to unravel the preferences of PLWHs towards LA-ART.</p><p><strong>Data source: </strong>PubMed, Web of Science, Cochrane Library, APA PsychInfo, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) are the data sources.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in six databases from inception to 4 January 2026. The PREFS (Purpose, Respondents, Explanation, Findings, Significance) and the International Society for Pharmacoeconomics and Outcomes Research checklist were used to evaluate the quality of the included studies. Data were synthesized narratively. Thematic analysis was applied to categorize attributes into groups. Frequency, significance, relative importance and willingness-to-pay were analysed.</p><p><strong>Results: </strong>Ten studies from six countries were included. In total, 62 individual attributes were extracted and grouped into three broad categories and eight sub-categories. Among the two studies that included cost, cost ranked highest. Preferences also vary among LA-ARTs at different stages of technical maturity and among PLWH with differing characteristics.</p><p><strong>Conclusion: </strong>In high-income country settings, cost and administration regimens are significant factors influencing PLWH preferences for LA-ART. However, the importance of cost depends on the specific context: it presents a direct barrier in systems with patient co-payments but is less pronounced in publicly funded treatment systems. Current evidence base originates exclusively from high-income countries, limiting the generalizability of these findings to low- and middle-income nations where diverse healthcare system constraints are more prevalent.</p><p><strong>Registration: </strong>The protocol for this study was registered with PROSPERO (registration number: CRD420251149075).</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"662-677"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046531","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}