HIV Medicine最新文献

{"title":"An overview of consent requirements for HIV and viral hepatitis B and C testing in Europe","authors":"Annemarie Rinder Stengaard,&nbsp;Ann K. Sullivan,&nbsp;Daniel Simões,&nbsp;Josephine Diderichsen,&nbsp;Dorthe Raben,&nbsp;Jürgen K. Rockstroh,&nbsp;the EuroTEST Steering Committee","doi":"10.1111/hiv.70248","DOIUrl":"10.1111/hiv.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Complicated consent procedures for bloodborne virus (HIV, HBV and HCV) testing present barriers to implementation, particularly in non-specialist healthcare settings. European and global guidelines no longer recommend written consent. An overview of testing consent requirements in Europe is lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey on legal and policy frameworks and implementation/practice was developed by a working group under the EuroTEST Initiative and disseminated to clinical and community-based testing facilities and national public health institutions and/or HIV/hepatitis organizations/societies in the countries of the WHO European Region. Data collection and validation occurred between October 2023 and April 2024. Responses were validated via email and/or bilateral discussions if diverging across same-country respondents to obtain one answer per country.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A total of 84 responses from 36 community-based testing sites, 33 healthcare facilities and 15 public health institutes in 34 countries were included. Written or documented verbal consent remained a policy requirement for HIV testing in 12 countries (4/18 western, 6/11 central, 2/5 eastern). For viral hepatitis, opt-out testing was much more common and written/documented verbal consent a policy requirement in five countries only. Practices for how consent is obtained in reality varied by setting and did not always follow legal/policy requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Written/documented consent remains a requirement for HIV testing in more than a third of responding countries. Removing the need for written/documented verbal consent and expanding opt-out testing will reduce testing barriers, reduce HIV exceptionalism, align national requirements with global standards and support European countries in reaching the first UNAIDS 95–95–95 target of 95% of those infected, diagnosed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1253-1264"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770110","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":"Migration-related inequalities in HIV diagnosis, treatment initiation and retention in care among migrants in Greece.","authors":"Nikos Pantazis, Varvara Vasalou, Olga Tsachouridou, Vasileios Papastamopoulos, Konstantinos Protopapas, Myrto Astriti, Maria Chini, Mina Psichogiou, Georgios Chrysos, Nikolaos V Sipsas, Helen Sambatakou, Markos Marangos, Diamantis Kofteridis, Periklis Panagopoulos, Giota Touloumi","doi":"10.1111/hiv.70294","DOIUrl":"https://doi.org/10.1111/hiv.70294","url":null,"abstract":"<p><strong>Objectives: </strong>Migrants account for a substantial proportion of people living with HIV in Europe, yet inequalities across the HIV care continuum remain insufficiently characterized. We examined migration-related differences in HIV diagnosis, treatment initiation and retention in care in Greece.</p><p><strong>Methods: </strong>We analyzed data from the Athens Multicenter AIDS Cohort Study (AMACS), including individuals diagnosed with HIV between 1996 and 2024. Participants were classified by region of origin. Markers of HIV diagnosis (CD4 cell count, late presentation, advanced disease and time from seroconversion to diagnosis) and post-diagnosis outcomes (time to antiretroviral therapy [ART] initiation and loss to follow-up [LTFU]) were evaluated using appropriate regression and flexible parametric survival models.</p><p><strong>Results: </strong>Among 11 467 individuals, 19.3% were migrants. Migrants presented with more advanced disease, including higher rates of late presentation (71.0% among those from Africa vs. 48.9% among Greek-born) and longer diagnostic delays (median 4.8 vs. 3.1 years, respectively). Over time, differences in late presentation narrowed, although advanced disease and diagnostic delay remained higher among some groups. Time to ART initiation decreased substantially with attenuated differences between groups after adjustment for CD4 levels at diagnosis. In contrast, recorded LTFU in AMACS increased over time and remained higher among migrants, reaching 49% within 3 years among individuals from Africa compared with 12% among Greek-born.</p><p><strong>Conclusions: </strong>Inequalities in HIV care outcomes across region-of-origin groups in Greece persist but have shifted along the care continuum. While timely ART initiation has largely equalized, disparities remain in delayed diagnosis and recorded follow-up. Targeted strategies to mitigate observed inequalities are essential.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663790","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":"Colorectal cancer screening uptake and lesion detection in people living with HIV: A systematic review and meta-analysis.","authors":"Motoki Kaneko, Atsushi Sakuraba","doi":"10.1111/hiv.70288","DOIUrl":"10.1111/hiv.70288","url":null,"abstract":"<p><strong>Introduction: </strong>As people living with HIV age, the absolute colorectal cancer (CRC) burden rises, yet the extent of routine CRC screening delivery and clinical yield is unclear. We synthesized evidence on screening uptake and lesion detection in people living with HIV, including comparisons with HIV-negative controls.</p><p><strong>Methods: </strong>We searched PubMed, EMBASE and Cochrane CENTRAL through 8 November 2025. We included antiretroviral therapy-era studies of adults with HIV (mean/median age ≥50 years) reporting CRC screening uptake in routine care or pathology-confirmed lesions at screening lower endoscopy (colonoscopy/sigmoidoscopy). Random-effects restricted maximum likelihood (REML) meta-analyses pooled single-arm proportions and comparative risk ratios; sensitivity, influence and cumulative analyses were prespecified.</p><p><strong>Results: </strong>Twenty-two studies were included. For screening uptake, 15 studies (people living with HIV n = 29 469) contributed single-arm estimates and 6 studies (people living with HIV n = 26 001; controls n = 858 658) contributed comparative data. Pooled uptake of screening among people living with HIV was 43% (95% confidence interval [CI] 36%-50%). Pooled detection of adenoma, villous/tubulovillous adenoma and CRC by screening lower endoscopy in people living with HIV was 27%, 3.8% and 1.4%, respectively. Screening uptake and lesion detection rates showed no significant difference from controls, though study numbers were limited and heterogeneous.</p><p><strong>Conclusion: </strong>In people living with HIV, CRC prevention is constrained by low and variable screening uptake. Screening lower endoscopy identifies clinically significant lesions, highlighting the need to improve CRC screening delivery in this population.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578441","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 the impact, barriers and facilitators of peer-driven interventions on the prevention of mother-to-child transmission of HIV in low- and middle-income countries: A systematic review and meta-analysis.","authors":"Victor Oluwafemi Femi-Lawal, Rhoda Fadairo, Joshua Alabi, Christian Tague, Mubarak Mustapha, Chukwuebuka Asogwa, Emmanuel Agboke, Oluwatimilehin Oladapo, Emmanuel Ngwu, Gideon Olajide, Daniel Esanju, John Ibeh, Temidayo Lawrence, Ismail Abdullahi, Marvellous Jesujevwe","doi":"10.1111/hiv.70285","DOIUrl":"https://doi.org/10.1111/hiv.70285","url":null,"abstract":"<p><strong>Introduction: </strong>Peer interventions may improve retention across the prevention of mother-to-child transmission (PMTCT) cascade in low- and middle-income countries (LMICs), where poor adherence to antiretroviral therapy (ART) remains a major barrier. This systematic review and meta-analysis evaluated the impact of peer support interventions on PMTCT outcomes to inform scalable strategies.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched PubMed, Cochrane Library, Scopus and Google Scholar (2008-2025) using terms including 'peer mentors,' 'PMTCT' and 'LMICs.' Independent reviewers conducted data extraction and quality appraisal using Cochrane risk-of-bias tools. Random-effects meta-analysis was performed in R (v4.4.3), with significance set at p < 0.05. Qualitative findings were thematically synthesized.</p><p><strong>Results: </strong>Twenty-seven studies (n = 26 431) across 10 countries were included. Peer interventions improved ART adherence at one year (OR: 1.19, 95% CI: 1.05-1.35) and two years (OR: 2.04, 95% CI: 1.58-2.64), PMTCT retention at six weeks postpartum (OR: 2.63, 95% CI: 1.56-4.43), infant uptake of HIV prophylaxis (OR: 2.95, 95% CI: 1.90-4.59), early infant diagnosis (OR: 1.64, 95% CI: 1.01-2.67) and viral load testing (OR: 1.21, 95% CI: 1.07-1.38). No significant effects were observed for ART initiation, PMTCT retention at 12 months or HIV status disclosure. Most studies (75%) reported improved exclusive breastfeeding. Barriers included stigma, inadequate mentor training, logistical and economic constraints and poor male involvement; facilitators included training, incentives and community trust.</p><p><strong>Conclusion: </strong>Peer interventions improve adherence, infant prophylaxis and retention but have limited effects on viral suppression and disclosure. Addressing stigma, strengthening health systems and enhancing male engagement may optimize impact.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535768","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":"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}