HIV Medicine最新文献

{"title":"Transitions in treatment: A systematic review and meta-aggregation of preferences and barriers in switching from oral to long-acting injectable antiretroviral therapy among people living with HIV and stakeholders.","authors":"Tiantian Hu, Shuqi Yang, Junwen Yu, Zhongfang Yang, Yilin Jin, Zheng Zhu","doi":"10.1111/hiv.13756","DOIUrl":"https://doi.org/10.1111/hiv.13756","url":null,"abstract":"<p><strong>Introduction: </strong>Antiretroviral treatment (ART) has significantly enhanced health outcomes for people living with HIV (PLWH). With the evolution of treatment options, there is an increasing interest in the development of long-acting injectable formulations of antiretroviral drugs. These formulations present a promising alternative to oral ART.</p><p><strong>Methods: </strong>The methodology and reporting of this systematic review followed the guidance of the Joanna Briggs Institute Reviewer's Manual and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). The comprehensive searches involved multiple databases, including PubMed, MEDLINE (Ovid), Embase (Ovid), CINHAL (EBSCO), ProQuest Dissertations and Theses, Web of Science, Wanfang (Chinese), CNKI (Chinese), Google Scholar and Baidu Scholar (Chinese).</p><p><strong>Results: </strong>In all, 142 studies were identified and 20 eligible studies were included in the meta-aggregation. A total of 141 findings, 20 categories and nine synthesized findings were extracted from 20 studies. The nine synthesized findings identified from the 20 studies focused on the following topics: benefits, flexibility and practicality of long-acting injectable (LAI) treatment; scepticism about the use of LAI treatment; management challenges; logistical challenges; potential for protecting marginalized populations; concerns about side effects; financial issue; suggestions for improvement. PLWH's geographical distribution, backgrounds, demographics and clinical characteristics were limited.</p><p><strong>Conclusion: </strong>We recommend considering the needs and experiences of PLWH in the transition from oral ART to LAI treatment. For marginalized populations, it is crucial to maintain regular communication with healthcare providers and institutions. Additionally, at the community level, engaging diverse stakeholders with valuable insights is vital, as is enhancing health education programmes and intensifying efforts to combat discrimination. These measures will play a key role in addressing the needs of PLWH, enhancing public awareness and promoting better understanding of LAI treatment.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921544","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":"Commentary on 'DORA: 48-week weight and metabolic changes in black women with HIV, in a phase IIIb switch study from dolutegravir- or efavirenz- to doravirine-based first-line antiretroviral therapy'.","authors":"Amit Varma, Mahendra Pratap Singh, Sanjit Sah, Amogh Verma","doi":"10.1111/hiv.13755","DOIUrl":"https://doi.org/10.1111/hiv.13755","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894164","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":"Editorial comment on: \"It's like it's the old boys Club: The age-related experiences of diverse older women living with HIV: A scoping review and consultative exercise\".","authors":"Oana Săndulescu, Ellen Moseholm","doi":"10.1111/hiv.13750","DOIUrl":"https://doi.org/10.1111/hiv.13750","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876864","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":"Exploring the cascade of mental healthcare among people with HIV experiencing depressive symptoms in the UK and Ireland: The POPPY study.","authors":"Hajra Okhai, Alan Winston, Frank Post, Marta Boffito, Patrick Mallon, Jaime Vera, Ian Williams, Memory Sachikonye, Margaret Johnson, Jane Anderson, Christina Prechtl, Caroline Sabin","doi":"10.1111/hiv.13753","DOIUrl":"https://doi.org/10.1111/hiv.13753","url":null,"abstract":"<p><strong>Introduction: </strong>Depressive symptoms are highly prevalent among people with HIV, which can negatively impact HIV-related outcomes. We explore the cascade of mental healthcare for people with HIV experiencing depressive symptoms.</p><p><strong>Methods: </strong>People with HIV who were part of the Pharmacokinetic and clinical Observations in PeoPle over fiftY (POPPY) study (2013-2016) were included. A Patient Health Questionnaire-9 (PHQ-9) score ≥10 or Center for Epidemiologic Studies Depression Scale (CES-D) ≥16 was defined as moderate/severe depressive symptoms. Diagnosed depression and access to mental healthcare were self-reported. A cascade of mental healthcare was explored, defining individuals experiencing depressive symptoms; those among them reporting a diagnosis of depression; and of this latter group, the proportion reporting accessing mental healthcare. Demographic, social and clinical characteristics were assessed at each step using logistic regression.</p><p><strong>Results: </strong>Of the 1009 participants (65.5% ≥50 years, 85.8% male, 85.1% white), 387 (38.4%) individuals were experiencing depressive symptoms, over half of whom (54.3%) reported a diagnosis of depression. Only 43.3% of individuals with diagnosed depression reported accessing mental healthcare. Men [odds ratio = 0.62, 95% confidence interval (CI): 0.42-0.92], people in a relationship (0.44, 0.33-0.59), those who were employed (0.28, 0.21-0.38) and those with university qualifications (0.54, 0.40-0.72) were less likely to experience depressive symptoms. Heterosexuals (0.30, 0.14-0.64) were less likely to report a diagnosed depression, whereas smokers were more likely to have a diagnosed depression (1.75, 1.10-2.77). Older individuals (2.36, 1.31-4.28) were less likely to have accessed mental healthcare.</p><p><strong>Conclusions: </strong>Our findings suggest the presence of unmet mental healthcare needs for people with HIV. We hope these findings will inform policies to streamline mental health services for people with HIV.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864116","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":"Perception of medical care among women living with HIV aged 40 years or older-A European-wide survey.","authors":"Victor Daniel Miron, Caroline A Sabin, Oana Săndulescu, Giota Lourida, Tetiana Kyrychenko, Gordana Dragovic, Justyna Kowalska, Åsa Mellgren, M José Galindo, Jo Josh, Ellen Moseholm","doi":"10.1111/hiv.13749","DOIUrl":"https://doi.org/10.1111/hiv.13749","url":null,"abstract":"<p><strong>Objectives: </strong>Our objective was to explore how women living with HIV aged ≥40 years perceive their care in relation to their HIV infection, comorbidities, and menopausal health and to evaluate the extent to which the care they receive meets their expectations, comparatively across World Health Organization (WHO) European regions.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey (May-December 2023) among women living with HIV aged ≥40 years from the WHO European region. Five dimensions of care were assessed: content of care, information, relationship with caregiver, organization of care, and patients' rights and privacy, in addition to management of non-HIV comorbidities and menopause.</p><p><strong>Results: </strong>In total, 600 women completed the survey; they were predominantly from the Western European region (70.2%), followed by the Eastern (20.2%) and Central (9.6%) regions. The majority of women (46.5%-95.1%) described positive experiences, responding that they were 'always' or 'usually' satisfied with the five dimensions of HIV care. The concordance between perceptions and experiences of HIV care ranged from 49.4% to 96.1% and was lower in the Eastern region. Among menopausal women, 58.5% were 'very satisfied' or 'satisfied' with the care they received; satisfaction was significantly lower in Eastern European countries than in Western countries.</p><p><strong>Conclusions: </strong>Our results highlighted a generally high concordance between respondents' expectations and the services provided, including both HIV and non-HIV care. Women aged ≥40 years living with HIV face several challenges that should be addressed. These findings inform stakeholders and decision-makers about the need to adopt a more inclusive and sensitive approach in healthcare systems.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828399","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":"\"It's like it's the old boys club\"-the age-related experiences of diverse older women living with HIV: A scoping review and consultative exercise.","authors":"Kristina M Kokorelias, Esther Su, Paige Brown, Stuart McKinlay, Ashley Flanagan, Sharon Walmsley, Alice Zhabokritsky, Katie Lee, Luxey Sirisegaram","doi":"10.1111/hiv.13751","DOIUrl":"https://doi.org/10.1111/hiv.13751","url":null,"abstract":"<p><strong>Objectives: </strong>HIV is often under-recognized in older individuals, particularly women, despite a significant number of new cases being diagnosed in those aged >50 years. This review aimed to understand the age-related experiences and challenges faced by women aged ≥50 years living with HIV through an intersectional perspective.</p><p><strong>Methods: </strong>We conducted a systematic scoping review using the framework by Arksey and O'Malley, refined by Levac, Colquhoun, and Peters, and informed by a Sex- and Gender-Based Analysis Plus (SGBA+) approach. The research questions were developed in consultation with community advisory stakeholders. A comprehensive search strategy was used, targeting categories related to 'aged,' 'HIV,' and 'women' based on scoping review and Peer Review of Electronic Search Strategies guidelines. We included peer-reviewed studies where at least 50% of participants were women aged ≥50 years and living with HIV, focusing on their age-related experiences in health or social contexts. Two independent reviewers applied inclusion criteria through a two-level screening process. Data extraction included details on publication type, study characteristics, participant recruitment, and results. Findings were synthesized and presented to a stakeholder advisory committee for additional insights. Stakeholder input from an advisory committee was incorporated into the findings, providing additional context and enhancing the interpretation of the results.</p><p><strong>Results: </strong>The review included 21 articles. Key findings revealed the intersectional challenges faced by women aged ≥50 years living with HIV, such as stigma, emotional resilience, social support networks, and health management strategies. These findings highlight the complex interplay of factors influencing their lives, from concerns about sharing HIV status to strategies for managing health. The review also identified research gaps and underscored the need for comprehensive studies on the intersectional dynamics affecting health outcomes in this population.</p><p><strong>Conclusions: </strong>This review underscores the complex challenges and strengths of women aged ≥50 years living with HIV, emphasizing the need for tailored interventions and support services that recognize their intersecting identities and unique needs. Addressing these issues is essential for ensuring equitable access to care and fostering resilience within this community.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817981","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":"Transient CD4 cell recovery after hepatitis C virus cure in HIV/hepatitis C virus coinfected patients (ANRS CO13 HEPAVIH cohort).","authors":"Tangui Barré, Clémence Ramier, Karine Ory, Philippe Sogni, Hugues Aumaitre, Tounes Saidi, Patrizia Carrieri, Fabienne Marcellin","doi":"10.1111/hiv.13752","DOIUrl":"https://doi.org/10.1111/hiv.13752","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813038","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":"Lenacapavir: Patient and healthcare provider perceptions and the potential role for a twice-yearly injectable HIV treatment.","authors":"Kate Alford, Shiraaz Sidat, Katherine Bristowe, Paola Cicconi, Jamie H Vera, Fiona Cresswell","doi":"10.1111/hiv.13748","DOIUrl":"https://doi.org/10.1111/hiv.13748","url":null,"abstract":"<p><strong>Background: </strong>The twice-yearly, long-acting lenacapavir (LA LEN) antiretroviral therapy (ART), when combined with an optimised background regimen, provides a subcutaneous injectable treatment option for people with HIV. This study aimed to understand the preferences, barriers and facilitators for uptake and implementation of LA LEN, with a view to informing clinical implementation.</p><p><strong>Methods: </strong>In-depth qualitative interviews and focus groups with purposively sampled people with HIV and healthcare workers (HCWs) from UK HIV services were conducted. Transcripts were analysed using summative and conventional content analysis.</p><p><strong>Results: </strong>Thirty-four people with HIV with varied ART experience were recruited from two HIV services. Participants included 22 (65%) identifying as cisgender men and 12 (35%) identifying as cisgender women; median age was 55 years (range 26-76 years). Fourteen HIV HCWs took part in three focus groups. Four key themes and 12 subthemes were identified: LA LEN as a treatment option; LA LEN versus oral ART; switching considerations; and administration of LA LEN. The majority (88%) of people with HIV were interested in switching to LA LEN if offered. Preference was markedly reduced if an oral ART pairing was required. Convenience of the dosing schedule, reduced pill burden and issues around stigma were reasons for interest in LA LEN, but concerns regarding efficacy, dosing interval windows, monitoring and side effects were described. HCWs felt the benefit of LA LEN was as a treatment option for those with adherence issues, drug resistance and a high pill burden. Broader use of LA LEN raised concerns over drug resistance, delivery capacity and storage.</p><p><strong>Conclusions: </strong>LA LEN was viewed as a preferable treatment choice for many people with HIV, provided an all-injectable regimen was available. Feasibility assessments for provision of injectable ART and research on its potential for self-administration are needed.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806937","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":"Performance of urine Xpert MTB/RIF ultra in a tuberculosis screening strategy in hospitalized patients with advanced HIV disease: Results from an implementation initiative in Brazil.","authors":"Diego R Falci, Alessandro C Pasqualotto, Tarsila Vieceli, Omar Sued, Nicole Reis, Renata B A Soares, Cassia S M Godoy, Nayla A Hatem, Nathalia Pereira Dos Santos, Bruna Regis Razzolini, Eduardo Sprinz, Freddy Perez","doi":"10.1111/hiv.13746","DOIUrl":"https://doi.org/10.1111/hiv.13746","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the performance of Xpert MTB/RIF Ultra testing in urine samples as part of a TB screening strategy in patients with advanced HIV disease (AHD).</p><p><strong>Methods: </strong>We conducted a multicentre prospective cohort study across three HIV reference hospitals in Brazil, between January and December 2023. The study included adult hospitalized patients with AHD, defined by a CD4 count of <200 cells/μL in the last 3 months or clinical presentation suggestive of opportunistic infection, without effective antiretroviral treatment. Participants underwent systematic tuberculosis (TB) screening using urine Xpert MTB/RIF Ultra and TB lipoarabinomannan (TB-LAM) tests. The diagnosis performance of urine Xpert MTB/RIF Ultra was assessed including sensitivity, specificity, and positive and negative predictive values. Disease characterization was based on the Global Tuberculosis Dictionary. Survival at 30 and 90 days was also evaluated.</p><p><strong>Results: </strong>Urine molecular testing was performed on 133 patients. Xpert MTB/RIF Ultra showed a sensitivity of 20.7% in bacteriologically confirmed TB cases and 21.2% in cases that included both clinically diagnosed and bacteriologically confirmed TB. The addition of urine Xpert MTB/RIF Ultra to TB-LAM led to the detection of three additional cases, representing a 6.3% increase from the 48 cases detected by TB-LAM. Xpert MTB/RIF Ultra had a specificity of 96.9% and no rifampicine resistance mutations were detected. Overall mortality was 16/133 (12.0%) at 30 days and 25/127 (19.7%) at 90 days.</p><p><strong>Conclusions: </strong>There was a high overlap between urine TB-LAM and Xpert MTB/RIF Ultra results, with the addition of Xpert MTB/RIF providing limited additional benefit for TB screening in patients with AHD.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806940","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":"Rapid HIV pre-exposure prophylaxis (PrEP) initiation is safe and feasible: Experience from Wroclaw All Saints cohort in Poland 2017-2021.","authors":"Bartosz Szetela, Mateusz Bozejko, Aleksandra Szymczak, Katarzyna Giniewicz, Jacek Gasiorowski","doi":"10.1111/hiv.13747","DOIUrl":"https://doi.org/10.1111/hiv.13747","url":null,"abstract":"<p><strong>Introduction: </strong>HIV pre-exposure prophylaxis (PrEP) still faces many barriers around the world. Additional barriers such as retesting or rescheduling for result analysis and prescription might lead to abandoning PrEP initiation altogether. We wanted to explore whether there would be a significant number of alert issues among people starting PrEP that would warrant more in-depth clinical analysis before commencing PrEP safely.</p><p><strong>Methods: </strong>A retrospective medical data analysis of people who started PrEP at All Saints Clinic in Wroclaw, Poland between October 2017 and January 2021 was performed. Rapid (during the first visit) or delayed PrEP initiation was chosen at the discretion of the attending physician.</p><p><strong>Results: </strong>A total of 308 people started PrEP in the analysed period and were included in the analysis. The median age was 33 years with 96.75% being men who have sex with men (MSM) and 68.5% opting for daily dosing at PrEP initiation. Most (n=233) started PrEP rapidly (i.e., during the first visit), whereas for 75 individuals the initiation was delayed by a median of 7 days. Logistic regression analysis showed that lack of test laboratory results, recent exposure or age over 50 years were reasons for delaying PrEP initiation. Median creatinine values increased from 0.93 mg/mL to 0.95 mg/mL 1 month after PrEP initiation. Despite being statistically significant (p = 0.0282, 95% CI 0.0015-0.027), the difference was not significant clinically.</p><p><strong>Conclusions: </strong>Rapid PrEP initiation was feasible and safe while contraindications were rare. HIV infection exclusion before PrEP initiation can be streamlined by utilizing remote consultations and patient self-interpretation of the results. Renal complications are either not clinically significant or occur rarely.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784935","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}