HIV Medicine最新文献

{"title":"Hypertension among people living with HIV (PLHIV) compared with people without HIV (PWoH): A systematic review with meta-analysis.","authors":"Mariene Garcia Gomes, Kássio Silva Cunha, Erika Cardoso Abud Parreira, Caroline Becker, Geórgia das Graças Pena, Sinara Laurini Rossato","doi":"10.1111/hiv.70276","DOIUrl":"https://doi.org/10.1111/hiv.70276","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is a major cardiovascular risk factor and has increased among people living with HIV. However, evidence on its association with HIV status remains inconsistent. This systematic review aimed to assess the association between HIV status and hypertension and to examine, through subgroup analyses, whether this association varies according to specific participant characteristics.</p><p><strong>Methods: </strong>Searches were conducted in PubMed, Embase, Web of Science and Global Index Medicus, with an additional manual search of reference lists. Eligible observational studies included participants aged ≥18 years, with no geographical restrictions and defined hypertension using medical diagnosis, self-reported hypertension, antihypertensive medication use or electronic health records. Studies involving individuals <18 years, pregnant women, non-systemic hypertension and other study designs were excluded.</p><p><strong>Results: </strong>Twenty-six studies were included in the systematic review, and 23 cross-sectional studies were incorporated into the meta-analysis. In a synthesis of unadjusted associations, no association was observed between HIV status and hypertension (RR: 0.94; 95% CI: 0.79-1.12). Subgroup analyses by sex, overweight and obesity also showed no association. Among PLHIV with diabetes, a lower association with hypertension was observed compared with people without HIV with diabetes, although this finding should be interpreted with caution (RR: 0.32; 95% CI: 0.12-0.88). Substantial heterogeneity was observed (I² = 99.5%). Five studies were of low methodological quality and 18 of moderate to high quality. The funnel plot showed no asymmetry, confirmed by Egger's test.</p><p><strong>Conclusion: </strong>Although no association between HIV status and hypertension was observed, substantial heterogeneity and variable methodological quality limit definitive conclusions. High-quality studies are needed to clarify whether HIV status modifies hypertension risk.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520288","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":"Artificial intelligence for predicting antiretroviral therapy outcomes in people living with HIV: A systematic review of predictive models, predictors and clinical readiness.","authors":"Belayneh Endalamaw Dejene, Yaregal Assabie, Mulugeta Tadele, Bethelehem Adnew, Rosa Tsegaye, Yordanos Sintayehu, Akililu Alemu, Rawleigh Howe, Tsinuel Girma, Tesfa Tegegne, Alemseged Abdissa","doi":"10.1111/hiv.70277","DOIUrl":"https://doi.org/10.1111/hiv.70277","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Machine learning (ML), deep learning (DL) and other predictive modelling approaches are increasingly applied to predict antiretroviral therapy (ART) outcomes among people living with HIV, yet their methodological robustness and suitability for clinical and digital health integration remain uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To systematically review artificial intelligence (AI)-based models predicting ART outcomes among people living with HIV, focusing on predictors, methodological rigour, validation practices and clinical integration readiness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;For this review, AI was considered an umbrella concept encompassing ML and deep learning methods, while conventional predictive models such as logistic regression were synthesized separately were included in comparative studies. This review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251166548). Seven databases were searched from January 2000 to 25 September 2025. Data were extracted on model types, predictors, outcomes, validation strategies and performance metrics. Methodological quality and reporting completeness were assessed using PROBAST and the TRIPOD Statement. We proposed an exploratory clinical informatics framework for evaluating the translational readiness across data, workflow, interoperability and operational domains. This framework was applied to assess characteristics relevant to clinical readiness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-six studies were included. Virologic outcomes (34.6%), retention in care (30.8%) and adherence (19.2%) were most common. Ensemble methods, particularly Random Forest (65.4%) and XGBoost (23.1%), predominated, while deep learning approaches were less frequent (15.4%). Key predictors included duration on ART (61.5%), CD4 count (69.2%), adherence history (57.7%), age (73.1%) and sex (65.4%). Reported discrimination varied widely (area under the curve [AUC] 0.56-0.99), but interpretation is limited by poor calibration, limited external validation and potential overfitting. Most studies showed a high or unclear risk of bias. Validation practices were limited: 80.8% relied solely on internal validation, 19.2% performed external validation and 30.8% reported calibration assessment. Reporting completeness was also suboptimal, with frequent omissions of confidence intervals and model specifications, indicating incomplete adherence to TRIPOD. No study fulfilled all clinical informatics domains, highlighting a persistent gap between model development and real-world implementation. Longitudinal modelling was limited (15.4%), and random data splitting in such datasets introduced a risk of data leakage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although AI models demonstrate promising predictive performance, their clinical applicability is limited by substantial methodological limitations, including high risk of bias, inadequate validation, poor calibration and limited transpare","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411556","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":"Do people with HIV really have the choice between oral and injectable ART? Evidence from a multicentric survey in the Swiss HIV cohort study","authors":"Yonas Martin,&nbsp;Bernard Surial,&nbsp;Martin Müller,&nbsp;Lukas Baumann,&nbsp;David Jackson-Perry,&nbsp;David Haerry,&nbsp;Marie Ballif,&nbsp;Charles Béguelin,&nbsp;Miriam Bürgi,&nbsp;Aline Munting,&nbsp;Matthias Cavassini,&nbsp;Dominique Braun,&nbsp;Andri Rauch,&nbsp;Reto Auer,&nbsp;Gilles Wandeler,&nbsp;the Swiss HIV Cohort Study","doi":"10.1111/hiv.70239","DOIUrl":"10.1111/hiv.70239","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Injectable long-acting antiretroviral therapy (iLA-ART) offers a valuable alternative to oral ART (oART). While the efficacy of these treatment strategies is similar, adequate information on their specific characteristics is essential to enable people with HIV (PWH) to decide which option best suits their values and preferences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicentric survey of PWH on oART in the Swiss HIV Cohort Study (SHCS). Using a questionnaire co-developed with expert patients, we assessed participants' (1) values and preferences on characteristics of modern oART and treatment satisfaction, (2) knowledge about iLA-ART with cabotegravir/rilpivirine, (3) reasons influencing their interest to switch or not to iLA-ART and (4) perceived burden of treatment (BOT) taking oART. Outcomes were rated on an 11-point (0–10) Likert scale. We explored outcomes' determinants using multivariate analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 200 PWH on oART participated (response rate 87%), with a median age of 52 years (Interquartile Range 45–59), 58 (29%) were women, and 90 (45%) were men who have sex with men. Treatment satisfaction was very high (mean 9.3, Standard Deviation [SD] 1.3) and perceived BOT on oART was low (mean 2.5, SD 2.0). The two most valued oART characteristics were effectiveness (mean 9.9, SD 0.3) and absence of side effects (mean 9.5, SD 1.7). Overall, 76 (39%) participants had never heard about iLA-ART, with large differences between the 3 participating centres (60% vs. 3% vs. 50%). In multivariable analysis, women (Odds Ratio 0.35, 95% confidence interval [CI] 0.14–0.85) and PWH ≥60 years (0.27, 0.08–0.94) were less aware about iLA-ART. Reasons influencing PWH's potential interest to switch to iLA-ART varied individually, while the main reason for preferring to stay on oART was the bimonthly dosing interval of iLA-ART.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In Switzerland, over one-third of PWH were unaware of iLA-ART despite its reimbursed availability. The provider of care appears to be the main driver of these findings, while women and older individuals showed the lowest awareness. As ART characteristics are valued individually, providing systematic information on available treatment options and engaging PWH in shared decision-making could help address identified disparities and empower them to choose the treatment that best aligns with their preferences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1156-1167"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633246","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":"Longitudinal changes in plasma biomarkers of immune activation, neuronal inflammation and injury in persons with HIV initiating ART","authors":"Merle Henderson,&nbsp;Peter Dutey-Magni,&nbsp;Carolina Herrera,&nbsp;Wolfgang Stöhr,&nbsp;Alejandro Arenas-Pinto,&nbsp;Owen Swann,&nbsp;Amanda Heslegrave,&nbsp;Henrik Zetterberg,&nbsp;John Tregoning,&nbsp;Sarah Fidler,&nbsp;François Raffi,&nbsp;Andrea Calcagno,&nbsp;Ab Babiker,&nbsp;Alan Winston","doi":"10.1111/hiv.70236","DOIUrl":"10.1111/hiv.70236","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Data on changes in biomarkers of brain health, and their associations with cognitive function in adults commencing either dual- or triple-antiretroviral therapy (ART) are sparse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma biomarkers (neurofilament light [NfL], glial fibrillary acidic protein [GFAP], sCD14, CXCL10, neopterin and IL-6) were measured at baseline and after 96 weeks on ART in individuals randomized to darunavir/ritonavir and either tenofovir-DF/emtricitabine (triple-ART, <i>n</i> = 119) or raltegravir (dual-ART, <i>n</i> = 119) in NEAT-001/ANRS143. Regression models examined associations of baseline and week-96 biomarker concentrations with HIV clinical parameters, composite cognitive test scores (Standardized neuropsychological test [NPZ], 7-domains) and treatment arm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 238 individuals, median age was 38 (interquartile range [IQR] 31, 46) years, 87% male and 83% of white ethnicity. Baseline median log₁₀ HIV RNA 4.73 (IQR 4.23, 5.11) copies/mL and CD4 350 (IQR 285, 412) cells/mm³. At baseline, higher biomarker concentrations were associated with lower CD4 (NfL, GFAP, CXCL10; <i>p</i> &lt; 0.03), higher log₁₀ HIV RNA (sCD14, neopterin, CXCL10; <i>p</i> &lt; 0.02) and longer known duration of HIV (sCD14; <i>p</i> = 0.044). At week-96, 94% had plasma HIV &lt;50 copies/mL, and a decline in biomarker concentrations was observed: GFAP −14.4%, sCD14 −6.8%, neopterin −47.4%, CXCL10 −58.8%, IL-6 −29.5% (all <i>p</i> &lt; 0.001) and NfL −4.4% (<i>p</i> = 0.075). NPZ improved by 0.21 mean points. Change in GFAP, CXCL10, sCD14, neopterin and NfL was negatively associated with change in CD4 (all <i>p</i> ≤ 0.002) but not change in NPZ (<i>p</i> &gt; 0.05). A greater decline in neopterin concentration was observed with dual- (−50.2%) versus triple-ART (−44.3%; <i>p</i> = 0.022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Plasma biomarkers of brain health improved following ART initiation, associated predominantly with improvements in CD4 count and partly with treatment arm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1132-1143"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698495","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":"Use of long-acting cabotegravir and rilpivirine in people living with HIV: A prospective observational cohort study","authors":"Ana Codonal,&nbsp;Alicia Lázaro,&nbsp;Elena Martínez,&nbsp;Alberto Delgado,&nbsp;Miguel Torralba","doi":"10.1111/hiv.70230","DOIUrl":"10.1111/hiv.70230","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cabotegravir and rilpivirine long-acting (CAB+RPV LA) is a novel switch strategy for people living with HIV. Our aim was to identify factors associated with therapeutic failure (TF) and virological failure (VF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-centre prospective cohort study. We reviewed all people living with HIV who initiated CAB+RPV LA between 14 February 2023 and 6 May 2025 in the hospital. Reasons for treatment discontinuation (VF, toxicity, poor adherence, death, pregnancy, transfer to another centre or oral bridging) were analysed, as well as virological effectiveness and the emergence of resistance mutations. Safety, adherence and overall regimen durability were also evaluated. The proportion of patients with HIV-RNA &lt; 50 copies/mL at months 1, 7 and 13 was analysed using intention-to-treat (ITT) and on-treatment (OT) approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CAB+RPV LA was administered to 35% of the hospital's cohort (151/429). Of the 151 patients, 80% were male, with a median age of 40 years. A total of 116 patients reached 13 months of treatment. After a median follow-up of 18.8 months (interquartile range [IQR]: 11–23.7), 28 (18.5%) patients discontinued treatment, 3 (2%) of them due to VF (one with resistance mutations to both rilpivirine and cabotegravir). The proportions of patients with HIV-RNA &lt; 50 copies/mL at months 1, 7 and 13 were 96%, 91% and 85% (ITT) and 96%, 95% and 93% (OT), respectively. Reasons for discontinuation included VF (2%), adverse events (4%), poor adherence (3%), transfer to another hospital (5%), oral bridging (4%) and difficulty attending appointments (1%). The modified therapeutic failure rate (excluding oral bridging and transfers) was 7.42 (95% confidence interval [CI]: 4.3–12.0) per 100 person-years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CAB+RPV LA appears to be an effective, safe and durable option for a switch strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1075-1083"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511896","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-1 viral load and reservoir size remain stable following SARS-CoV-2 mRNA vaccination in people with HIV","authors":"Oscar Kieri,&nbsp;Bianca B Jütte,&nbsp;Jan Vesterbacka,&nbsp;Soo Aleman,&nbsp;Hans-Gustaf Ljunggren,&nbsp;Marcus Buggert,&nbsp;J Peter Svensson,&nbsp;Anders Sönnerborg,&nbsp;Piotr Nowak","doi":"10.1111/hiv.70235","DOIUrl":"10.1111/hiv.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The potent immunogenicity of mRNA vaccination raised concerns about its impact on HIV-1 viral load (VL) and reservoir size in people with HIV, which could drive vaccine hesitancy. As part of a prospective clinical trial, we investigated whether SARS-CoV-2 mRNA vaccination induced changes in VL and reservoir size after a 1-year three-dose regimen in people with HIV on antiretroviral therapy (ART).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We collected blood samples from 37 people with HIV with varying degrees of immune reconstitution before vaccination and after receiving their second and third doses of vaccine. Anti-SARS-CoV-2-Spike antibodies and Spike-specific CD4⁺T-cells were analysed as indicators of vaccine-induced immunogenicity. The Intact Proviral DNA Assay was used to quantify the intact and defective HIV-1 reservoir.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vaccination with three doses of SARS-CoV-2 mRNA vaccine over the course of 1 year did not result in plasma HIV-1 RNA rebound nor significantly alter the HIV-1 reservoir size regardless of immune status. The median intact HIV-1 reservoir size was 53 (IQR 34–193) copies/million CD4⁺T-cells at baseline and 86 (34–268) and 138 (33–334) 3 months after the second and third dose, respectively (<i>p</i> &gt; 0.38). We found no correlation between changes in VL or HIV-1 reservoir size and the anti-SARS-CoV-2-Spike levels, Spike-specific CD4⁺T-cells, CD4⁺/CD8⁺ ratio, nadir or CD4⁺T-cell count. However, the intact reservoir size negatively correlated with CD4⁺T-cell count, CD4⁺/CD8⁺ ratio and nadir CD4⁺T-cell count.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings show that three doses of SARS-CoV-2 mRNA vaccine did not affect the VL or HIV reservoir size regardless of immune status, supporting their safety in people with HIV. Notably, a higher CD4⁺T-cell count correlated with a reduced intact HIV-1 reservoir size.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1120-1131"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622778","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":"Three settings, one goal: Performance of different HIV testing strategies at a tertiary centre in Milan","authors":"Angelo Roberto Raccagni,&nbsp;Riccardo Lolatto,&nbsp;Nicolò Capra,&nbsp;Gabriele Loi,&nbsp;Diana Canetti,&nbsp;Alessia Siribelli,&nbsp;Maria Francesca Lucente,&nbsp;Matteo Moro,&nbsp;Davide Di Napoli,&nbsp;Adriano Lazzarin,&nbsp;Antonella Castagna,&nbsp;Silvia Nozza","doi":"10.1111/hiv.70242","DOIUrl":"10.1111/hiv.70242","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Timely HIV diagnosis remains suboptimal in Italy. The aims of this study are to assess how inpatient, outpatient and community HIV testing strategies differ in diagnostic yield, testers' demographics, immuno-virological status at diagnosis and linkage to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional analysis of all individuals tested for HIV in 2024–2025 at San Raffaele Hospital (Milan, Italy) through: (i) HIV-HOTE (NCT06282328), an inpatient, indicator-condition and behaviour-triggered testing study in medical and surgical wards; (ii) EasyTest, a community-based, rapid testing programme in territorial clinics and outreach events; and (iii) a hospital-based walk-in outpatient HIV/sexually transmitted infection (STI) clinic. Demographics and HIV test results are described across strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 4604 individuals were tested for HIV (inpatients <i>n</i> = 300; outpatients <i>n</i> = 2913; community <i>n</i> = 1391), with 43 new HIV diagnoses. Inpatient testers were older (median 54 vs. 35.1–36.2 years), more frequently women (38.0% vs. 11.7–35%) and less frequently men who have sex with men (10.7% vs. 77.7–36.4%) compared to outpatient and community-based testers. People with a reactive HIV test were 2% (6/300) among inpatients, 1.17% (34/2913) in the outpatient clinic and 0.22% (3/1391) in the community programme. Among people with newly diagnosed HIV, median CD4⁺ count at diagnosis was 540 cells/μL for inpatients, 460 cells/μL for outpatients and 198 cells/μL for community testers. Linkage to care was 100% across all strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Within a single tertiary Italian centre, HIV inpatient indicator-condition testing, a hospital walk-in pathway and a community point-of-care service tested distinct populations. A blended HIV testing model is essential to maximize HIV case-finding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1168-1176"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716641","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":"Scaling HIV self-testing to improve health equity among cisgender gay, bisexual and other men who have sex with men, trans and gender-diverse people in the United Kingdom: An HIV self-testing implementation action framework","authors":"T. Charles Witzel,&nbsp;Peter Weatherburn,&nbsp;Fiona M. Burns,&nbsp;Isaac Y.-H. Chu,&nbsp;Phil Samba,&nbsp;Alison J. Rodger","doi":"10.1111/hiv.70229","DOIUrl":"10.1111/hiv.70229","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;HIV self-testing (HIVST) is feasible, highly acceptable and can increase HIV testing uptake/frequency without harm while also reducing costs. Despite HIVST's benefits, UK service provision has been sporadic partially due to policymakers and commissioners' reluctance over concerns about linkage to care/surveillance, which ultimately reduces user choice.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We synthesized current evidence and in a multidisciplinary collaboration developed an Implementation Action Framework to facilitate and promote person-centred HIVST provision, focusing on reducing health inequalities among gay, bisexual and other men who have sex with men (GBMSM), trans and gender-diverse people. We do this by exploring implementation context, establishing a standard level of support for HIVST interventions and outlining intervention adaptations to support priority subgroups in the United Kingdom.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results and Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A large body of published evidence demonstrates that HIVST is feasible to deliver, highly acceptable, easy to perform and can make a meaningful difference to HIV testing behaviours among GBMSM, trans and gender-diverse people without leading to substantial harm or decreases in linkage to care. Synthesizing 29 publications from the United Kingdom or other high-income settings, we demonstrate that the UK implementation context can be harnessed by emphasizing the need to expand testing to meet the 2030 HIV elimination goals. Concerns around linkage to care/surveillance can be addressed by highlighting successful linkage approaches and the importance of respecting patient autonomy. We establish a minimum standard level of support for HIVST interventions, including a results reporting system with a user opt-out option, clear information on linkage to care, inclusion of a helpline and guidance to link to clinical follow-up for those who report reactive HIVST results. To address health inequalities, person-centred intervention adaptations include innovative approaches to HIVST delivery to reach underserved groups, provision of additional tests for other sexually transmitted infections (STIs), targeted demand generation and tailored support for the most marginalized.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Person-centred HIVST is critical to improving HIV testing uptake by responding to, and ultimately reducing, entrenched health inequalities in the United Kingdom. Our Framework provides a person-centred roadmap for implementing HIVST across a r","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1038-1054"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70229","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770120","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":"Systematic screening for age-related comorbidities: Health care optimization among persons with HIV in an outpatient setting","authors":"Anna Katrine Haslund Roed,&nbsp;Anne-Mette Lebech,&nbsp;Sabine Singh,&nbsp;Ole Kirk,&nbsp;Susanne Dam Nielsen","doi":"10.1111/hiv.70238","DOIUrl":"10.1111/hiv.70238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Age-related comorbidities occur earlier and more frequently in people with HIV (PWH) than in the general population and have emerged as a key challenge in long-term HIV care. Unfortunately, many of these conditions remain undiagnosed, and systematic screening in clinical practice remains limited. Therefore, we aimed to assess the burden of unrecognized age-related comorbidities in a clinical outpatient setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional cohort study was conducted from November 2023 to March 2025 at the HIV outpatient clinic, Copenhagen University Hospital, Rigshospitalet. A structured screening procedure was implemented to assess unrecognized comorbidities among PWH aged ≥60 years. The screening comprised multiple guideline-recommended risk evaluations, including 10-year cardiovascular risk score (SCORE2), 10-year fracture risk assessment (FRAX), assessment of chronic lung disease and frailty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 387/532 (72.7%) eligible patients participated. Of patients without a history of cardiovascular disease, 203/300 (67.6%) were categorized as high risk and 57/300 (19%) as very-high risk by SCORE2. Primary preventive lipid-lowering therapy was prescribed in 75/203 (36.9%) and 18/57 (31.6%) in the high-risk and very-high risk groups, respectively. Of participants without prior chronic lung disease, 29/324 (9%) reported symptoms, and 20/260 (7.7%) with available spirometry had airflow limitation. Among PWH without a history of osteoporosis, 127/335 (37.9%) were categorized as high risk of major fracture and/or hip fracture. Pre-frailty or frailty was identified in 88/387 (22.7%) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The considerable burden of unrecognized age-related comorbidities in PWH ≥60 years of age highlights the need for a systematic approach to early detection and preventative management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1144-1155"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722869","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":"A multidisciplinary, AI-supported quality improvement intervention to manage polypharmacy in aging people with HIV","authors":"Jovana Milic,&nbsp;Antonia Pugliese,&nbsp;Michela Belli,&nbsp;Gian Luca Lonardi,&nbsp;Caterina Ruffilli,&nbsp;Tommaso Albano,&nbsp;Marco Visicaro,&nbsp;Martina Ricciardetto,&nbsp;Pierluigi De Cosmo,&nbsp;Chiara Mussi,&nbsp;Francesca Gandolfi,&nbsp;Cristina Mussini,&nbsp;Costantino Grana,&nbsp;Giovanni Guaraldi","doi":"10.1111/hiv.70234","DOIUrl":"10.1111/hiv.70234","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Aging people with HIV are increasingly affected by multimorbidity and polypharmacy, which heighten the risk of drug–drug interactions (DDIs) and potentially inappropriate medications (PIMs). This study evaluated a multidisciplinary, AI-supported quality improvement intervention designed to optimize polypharmacy management in older people with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>People with HIV aged ≥50 years attending the Modena HIV Metabolic Clinic (MHMC) were invited to submit photos of their medications via WhatsApp. Images were processed by AI for optical character recognition and automatically reconciled with the electronic patient chart (EPC). AI recognition accuracy was 94% when validated against manual review. Pharmacists reviewed AI-generated reports from the NavFarma® decision support system, generated alerts for PIM, defined according to Beers and the STOPP/START criteria, DDIs, anticholinergic burden (ACB), and risks of QTc prolongation and nephrotoxicity. Primary outcome was agreement between patient-reported and EPC-recorded medications. Secondary outcomes included pill burden, total prescribed drugs and actionable alerts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 181 participants (median age 63 years; 72% male), 111 (61.3%) showed complete agreement between EPC and patient lists, while 70 (38.7%) had discrepancies. Pharmacist evaluation identified major DDIs in 70.4% of cases, ACB in 26.5%, QTc-prolonging drugs in 81.6% and nephrotoxic agents in 95.9%. Participants with ≥10 total prescribed drugs had higher frailty, pill burden and PIM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AI-assisted medication reconciliation combined with pharmacist review improved the identification of PIM and medication-related risks, supporting safer prescribing in people with HIV. This model aligns with international calls to improve prescribing safety and offers a scalable framework for integrating digital tools into multidisciplinary HIV care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 7","pages":"1109-1119"},"PeriodicalIF":3.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70234","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653985","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}