HIV Medicine最新文献

{"title":"Intersections of vitamin D deficiency, HIV and chronic liver diseases.","authors":"Francesca Farina, Aurgho Datta, Suzanne N Morin, Sahar Saeed, Bertrand Lebouche, Giovanni Guaraldi, Salvatore Petta, Giada Sebastiani","doi":"10.1111/hiv.70117","DOIUrl":"https://doi.org/10.1111/hiv.70117","url":null,"abstract":"<p><strong>Objectives: </strong>Despite effective antiretroviral therapy (ART), chronic liver diseases remain a leading cause of morbidity and mortality among people with HIV, with metabolic dysfunction-associated steatotic liver disease (MASLD) now the predominant etiology. Vitamin D deficiency is also highly prevalent in this population. We synthesize current evidence on the interplay between HIV, liver disease, and vitamin D deficiency, and highlight implications for risk stratification and therapeutic research in this population.</p><p><strong>Methods: </strong>A targeted PubMed search was conducted using terms for HIV, liver disease, fibrosis, and vitamin D, supplemented by reference screening. We prioritized peer-reviewed studies and guidelines addressing liver disease epidemiology and mechanisms in people with HIV, vitamin D biology, and associations between vitamin D status and hepatic injury. Comparative data from non-HIV populations were also reviewed.</p><p><strong>Results: </strong>People with HIV face a high burden for chronic liver diseases due to MASLD, viral hepatitis coinfections, and hepatotoxic exposures such as alcohol and ART. Pathogenesis involve persistent immune activation, hepatic stellate cell activation, and systemic inflammation. Vitamin D deficiency is frequent in people with HIV and, in non-HIV populations, correlates with higher prevalence of MASLD and fibrosis. Emerging evidence suggests plausible links through immune modulation, oxidative stress, and fibrogenesis, though causality remains unproven.</p><p><strong>Conclusions: </strong>The intersection of HIV, MASLD, and vitamin D deficiency is biologically plausible and clinically relevant yet underexplored. Longitudinal studies with standardized MASLD phenotyping and vitamin D assessment are warranted. Meanwhile, integrating metabolic risk assessment with vitamin D evaluation may support more holistic liver care in people with HIV, while interventional trials should clarify whether vitamin D optimization improves hepatic and extrahepatic outcomes.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091640","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 moderating effect of healthcare empowerment on the relationship between stigma and self-rated health in people living with HIV in Canada.","authors":"Jason M Lo Hog Tian, James R Watson, Alex Tran, Robert G Maunder, Janet A Parsons, Bulent Turan, Mallory O Johnson, Anthony R Boni, Arthur Dave Miller, Danita Wahpoosewyan, Deborah Norris, George Da Silva, Kim Samson, Lynne Cioppa, Patricia Ukoli, Adrian Betts, Apondi J Odhiambo, Catherine Pearl, Gordon Arbess, Jared Star, Jennifer Demchuk, Kristin McBain, Sean B Rourke","doi":"10.1111/hiv.70108","DOIUrl":"https://doi.org/10.1111/hiv.70108","url":null,"abstract":"<p><strong>Objective: </strong>To determine the moderating effect of healthcare empowerment on the relationship between enacted, internalized and anticipated stigma and self-rated health.</p><p><strong>Methods: </strong>Participants (n = 1318) were recruited to complete the People Living with HIV Stigma Index, a community-based cross-sectional survey administered across all provinces in Canada from August 2018 to October 2024. The survey contained externally validated quantitative scales measuring stigma, healthcare empowerment and health. Healthcare empowerment was broken down into subscales of Informed, Committed, Collaborative, and Engaged (ICCE) and Tolerance of Uncertainty (TU). Moderation models were created for each type of stigma as the antecedent, healthcare empowerment (total, ICCE and TU) as the moderator, and self-rated health as the outcome.</p><p><strong>Results: </strong>Total healthcare empowerment was a significant moderator for the relationship between enacted (b = 0.11, 95% CI: 0.00, 0.23) and internalized (b = 0.23, 95% CI: 0.09, 0.37) stigma and self-rated health. The ICCE subscale was a significant moderator for the relationship between internalized (b = 0.20, 95% CI: 0.08, 0.33) and anticipated (b = 0.17, 95% CI: 0.04, 0.31) stigma and self-rated health. Overall, for those with low levels of healthcare empowerment, greater enacted and internalized stigma resulted in worse self-rated health; however, high levels of healthcare empowerment buffered the negative impact of stigma.</p><p><strong>Conclusion: </strong>Healthcare empowerment may have the potential to buffer or mitigate the negative effect of stigma. Understanding how to bolster levels of healthcare empowerment, specifically dimensions of ICCE, may be important for the development of interventions aiming to reduce the impact of stigma for people living with HIV.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069463","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":"Outcomes of real-world initiation of long-acting injectable cabotegravir and rilpivirine (LA-I CAB + RPV) in individuals with viraemia: A systematic review of baseline characteristics, virological failure outcomes and discontinuations.","authors":"Alexa Elias, Chloé Pasin, Melanie Smuk, Amy Paterson, Chloe M Orkin","doi":"10.1111/hiv.70113","DOIUrl":"https://doi.org/10.1111/hiv.70113","url":null,"abstract":"<p><strong>Background: </strong>When using long-acting injectable cabotegravir and rilpivirine (CAB + RPV) in individuals with viraemia, beyond small cohorts, little is known about baseline characteristics, virological failure outcomes, resistance emergence, re-suppression and discontinuation.</p><p><strong>Methods: </strong>We identified evidence from PubMed, EMBASE, Cochrane and conference abstract databases through 17 March 2025 to synthesize data from observational cohort studies (OCS) that reported on virological failure (VF) events in individuals with viraemia at initiation of LA-I CAB + RPV. We extracted data on baseline clinical and socio-demographic characteristics, VF, resistance-associated mutations (RAMs) at VF, post-VF regimen choice, re-suppression and discontinuation.</p><p><strong>Results: </strong>Across 14 cohorts including 561 individuals, there were 36 VF events (OCS-level VF rate 0% (n/N = 0/12, 0/12 and 0/10) to 25% (n/N = 3/12)). VF definitions varied. 6/14 OCS (n = 436) reported on baseline CD4 count, 13/14 (n = 543) on baseline viral load and 7/14 (n = 459) on socio-demographic characteristics. Among the 14 VF events with genotypic information available at VF, NNRTI RAMs were identified in 13/14 individuals, INI RAMs in 9/14 and dual-class resistance in 8/14 individuals. Post-VF regimens were reported for 16/36 individuals with VF and included lenacapavir (LEN)-based regimens, protease inhibitor (PI)-based regimens or LA-I CAB + RPV continuation. Re-suppression outcomes were described in 10 VF events: re-suppression occurred in 5/10.</p><p><strong>Conclusions: </strong>In OCS, the follow-up duration was short and VF definitions were highly variable, with few cohorts reporting VF outcomes in people with baseline VL >10 000 c/mL. VF was frequently accompanied by resistance. Post-VF regimens varied, and their success was unclear due to the small sample size.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051286","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":"Evaluating birth outcomes following oral rilpivirine use in pregnancy in the United States: Findings from the antiretroviral pregnancy registry.","authors":"William R Short, Corinne Willame, Henry Nguyen, Bohui Zhang, Ping Xu, Eileen Birmingham, Rodica Van Solingen-Ristea, Bryan Baugh","doi":"10.1111/hiv.70112","DOIUrl":"https://doi.org/10.1111/hiv.70112","url":null,"abstract":"<p><strong>Introduction: </strong>The Antiretroviral Pregnancy Registry (APR) is designed to detect major teratogenic effects of antiretroviral medications; other pregnancy outcomes are also recorded when reported. We compared available pregnancy and birth outcomes of women exposed to oral rilpivirine-containing regimens (oral-RPV cohort) versus non-rilpivirine regimens (non-RPV cohort) over the period 2011 to 2023.</p><p><strong>Methods: </strong>Maternal age-adjusted prevalence ratio (aPR) of pregnancy and birth outcomes was compared for prospectively reported pregnancies; aPR of birth defects was compared between first-trimester exposures and combined second/third-trimester exposures.</p><p><strong>Results: </strong>In total, 6937 pregnancies were recorded, including 4617 (oral-RPV cohort, 781 [16.9%]; non-RPV cohort, 3836 [83.1%]) from the United States. Among live births, the prevalence of birth defects was lower in the oral-RPV cohort (1.6% versus 3.8%; aPR: 0.4 [95% confidence interval (CI): 0.2-0.8]). The prevalence of birth defects in the first-trimester oral-RPV exposure versus second/third-trimester exposure did not differ (aPR: 3.4 [95% CI: 0.4-26.3]). The aPR of induced abortions (1.1 [0.6-1.9]), stillbirths (0.6 [0.2-1.6]) and premature birth (0.8 [0.7-1.1]) were similar between cohorts. Prevalences for spontaneous abortion were 5.8% (oral-RPV cohort) versus 3.2% (non-RPV cohort) below the expected background rate (15%-20%). Low birth weights were less reported in oral-RPV, while very low birth weights were similar between cohorts.</p><p><strong>Conclusions: </strong>Review of available data from the APR does not indicate an association between adverse pregnancy or birth outcomes and oral-RPV exposure, overall or by timing of exposure. Since APR targets primarily teratogenic effects, findings for non-teratogenic effects should be interpreted with caution.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040013","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":"Cytokine biomarkers and their relationship to symptoms and quality of life in people with HIV-associated Kaposi sarcoma.","authors":"Fahmida Shaik, Thomas Smith Uldrick, Mikateko Mazinu, Nomonde Gwebushe, Anisa Mosam","doi":"10.1111/hiv.70107","DOIUrl":"https://doi.org/10.1111/hiv.70107","url":null,"abstract":"<p><strong>Introduction: </strong>Quality of life (QOL) is an essential component of care in people with HIV-associated Kaposi sarcoma (HIV-KS). Kaposi sarcoma herpes virus (KSHV) promotes cytokine expression and a dysfunctional inflammatory environment, contributing to KS pathogenesis and progression. However, disease-related inflammatory factors influencing QOL and symptoms remain underexplored. This study examines the relationship between baseline QOL parameters and inflammatory cytokine biomarkers in treatment-naïve Africans with HIV-KS participating in the randomized controlled KAART study. We hypothesized that inflammatory cytokines are linked with reduced QOL and symptom burden.</p><p><strong>Methods: </strong>Twenty-eight cytokines were measured from stored baseline serum using the Milliplex® multiplex assay. QOL was assessed using the validated EORTC QLQ-C30. Spearman Rho-Rank correlation was used to assess relationships between cytokine levels and QOL parameters, with p ≤ 0.01 considered statistically significant.</p><p><strong>Results: </strong>Paired cytokine and QOL data were available for 68 participants. IL-8 showed significant negative correlations with summary scores, a reliable indicator of overall QOL (r_s = -0.35, p = 0.005). Increased IL-8 also correlated significantly with reduced emotional functioning scales (r_s = -0.33, p = 0.01) and increased pain (r_s = 0.32, p = 0.01). By contrast, increased IL-10 correlated significantly with reduced pain (r_s = -0.31, p = 0.01). VEGF and MCP-1 levels correlated negatively with role functioning (r_s = -0.32, p = 0.01; r_s = -0.30, p = 0.01).</p><p><strong>Conclusion: </strong>IL-8 is a key cytokine affecting QOL in HIV-KS. Elevations have a negative impact on pain, emotional functioning and overall QOL. IL-10, VEGF and MCP-1 perturbations also impact QOL. These findings enhance understanding of cytokine involvement in KS pathogenesis.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029508","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":"Molecular epidemiological analysis and investigation of antiretroviral drug resistance profile, including capsid inhibitors, among treatment-naïve individuals with HIV-1 in Türkiye.","authors":"Adem Özdemir, Tülin Demir, Ceylan Polat, Mertcan Uzun, Meliha Çağla Sönmezer, Koray Ergünay, Serhat Ünal, Ahmet Çağkan İnkaya, Ahmet Pınar","doi":"10.1111/hiv.70109","DOIUrl":"https://doi.org/10.1111/hiv.70109","url":null,"abstract":"<p><strong>Introduction: </strong>Monitoring transmitted drug resistance is crucial for guiding first-line antiretroviral therapy (ART) and controlling the rising HIV epidemic in Türkiye. This study aimed to determine the prevalence of transmitted antiretroviral resistance to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase strand transfer inhibitors (INSTIs) and capsid assembly inhibitors (CAIs). We also assessed the distribution of HIV-1 subtypes and circulating recombinant forms (CRFs) at one of the main national referral centres in Türkiye.</p><p><strong>Methods: </strong>We included 104 consecutive ART-naïve people living with HIV who presented at Hacettepe University Hospital in Ankara between November 2021 and November 2022. Demographic data, probable transmission routes and geographic origins were recorded. HIV-1 genotyping was performed to identify subtypes and resistance-associated mutations using standard methods.</p><p><strong>Results: </strong>Of the 104 individuals, 97 were from 25 different cities in Türkiye, while 7 originated from 5 different countries. The most probable transmission routes were men who have sex with men (MSM) (64.42%), heterosexual contact (30.77%) and unknown (4.81%). Resistance-associated mutations were detected in 14.42% of individuals. Resistance rates were 1.92% for PI, 4.80% for NRTI and 7.69% for NNRTI. No resistance mutations were found against INSTI or CAI.</p><p><strong>Conclusion: </strong>Transmitted resistance to PI, NRTI and NNRTI remains present in Türkiye, though at moderate levels. The absence of resistance to INSTI and CAI supports their potential utility as effective components of treatment regimens in Türkiye.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015053","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":"Multidimensional frailty, sex differences, and quality of life among older Ugandans affected by HIV.","authors":"Gideon Dzando, Paul R Ward, Lillian Mwanri, Pascal Agbadi, Rachel C Ambagtsheer","doi":"10.1111/hiv.70111","DOIUrl":"https://doi.org/10.1111/hiv.70111","url":null,"abstract":"<p><strong>Background: </strong>Older people affected by HIV in sub-Saharan Africa are at increased risk of frailty and poor quality of life (QoL). However, the contributions of specific frailty domains to QoL and whether these associations differ by sex remain poorly understood.</p><p><strong>Methods: </strong>We analysed cross-sectional data from 444 older people aged ≥50 years (mean age 64.6 years, 62% female) from the WHO SAGE-WOPS HIV sub-study in Uganda. Frailty was assessed using 15 items from the Frailty Instrument for Sub-Saharan Africa (FiSSA), and QoL with a 7-item composite index. We used multiple linear examine the associations between overall and domain-specific frailty and QoL, including sex interaction terms.</p><p><strong>Results: </strong>Higher overall frailty was associated with lower QoL (β = -0.63, p < 0.001). Among the frailty domains, the physical (β = -0.43, p < 0.001) and socioemotional (β = -0.18, p < 0.001) domains exceeded the minimally important difference (MID) threshold, indicating clinically meaningful associations with lower QoL, whereas the visual and psychological domains were below this threshold. A significant sex interaction was observed for the psychological domain (β = -0.25, p = 0.004), indicating a stronger negative association among women. No significant sex interactions were observed for the physical, socioemotional, or visual domains.</p><p><strong>Conclusions: </strong>Frailty, particularly physical, socioemotional, and psychological domains, was associated with lower QoL among older Ugandans affected by HIV. Psychological frailty was more strongly associated with poorer QoL in women. Gender-sensitive, psychosocial interventions may help address these disparities and support healthy and equitable ageing in HIV-affected populations.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000401","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":"Dual drivers of polypharmacy in people with HIV: Quantifying the independent associations of aging and long-term antiretroviral therapy.","authors":"Shigeru Hasebe, Taiki Kusaka, Masayuki Tanaka, Shiori Iwane, Toshikazu Tsuji, Hiroyuki Kushida, Mari Nakamura, Masahiro Nakamura, Takumi Fujiwara, Maho Kikuta","doi":"10.1111/hiv.70106","DOIUrl":"https://doi.org/10.1111/hiv.70106","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to disentangle the independent effects of aging and cumulative antiretroviral therapy (ART) duration on polypharmacy in people with HIV. While successful ART has led to an aging population with HIV, polypharmacy may stem from both aging and ART's cumulaftive toxicity. Quantitative evidence separating these effects is scarce, particularly in Japan.</p><p><strong>Methods: </strong>In this retrospective study, we analysed a Japanese community pharmacy database (2014-2022) of 696 people on ART for ≥6 months. Using negative binomial regression, we assessed the independent effects of age and cumulative ART duration on the number of concomitant medications (a proxy for polypharmacy), adjusting for sex.</p><p><strong>Results: </strong>Both advanced age and cumulative ART duration were significant independent risk factors for polypharmacy. A strong dose-dependent relationship was observed with age (incidence rate ratio [IRR] for 60-69 years: 9.61; 95% confidence interval [CI], 4.92-18.78 vs. <30 years). After adjusting for age and sex, a cumulative ART duration of ≥9 years remained an independent predictor of more concomitant medications (IRR: 1.81; 95% CI, 1.05-3.13 vs. <1 year).</p><p><strong>Conclusions: </strong>We propose a \"dual-structure model\" for polypharmacy in people with HIV, comprising age-related multimorbidity and a distinct layer potentially linked to the long-term effects of ART. To our knowledge, this study provides the first quantitative evidence from Japan to statistically disentangle the associations with these two factors. Our findings highlight the need to integrate geriatric principles with HIV-specific toxicity management for optimal long-term strategies.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000458","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":"Examination of factors associated with mental health of people living with HIV in Kazakhstan: A cross-sectional study based on the two-continua model.","authors":"Adel Stoyanova, Faye Foster, Pavel Savin, Nurali Amanzholov, Raushan Alibekova","doi":"10.1111/hiv.70100","DOIUrl":"https://doi.org/10.1111/hiv.70100","url":null,"abstract":"<p><strong>Introduction: </strong>Human immunodeficiency virus (HIV) remains a significant global health problem, and the number of new cases is increasing in Central Asia, including Kazakhstan. This study aimed to examine the association of a range of demographic, physical health and psychosocial factors with the mental health of people living with HIV in Kazakhstan, applying the two-continua model of mental health, which holds that mental wellbeing and mental illness are two distinct continua that are interrelated in their contributions to overall mental health. The study findings can inform future interventions aimed to prevent mental illness and promote the mental wellbeing of people living with HIV.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in collaboration with the Kazakhstan Union of people living with HIV. The online survey link was disseminated via social networks of people living with HIV in various regions of Kazakhstan from January to February 2024. The questionnaire included questions on sociodemographic characteristics, general health information and standardized validated scales to measure flourishing, depressive and anxiety symptoms, HIV-related stigma, and social support. Descriptive, bivariate and multivariate multinomial regression analyses were performed in STATA software version 18.</p><p><strong>Results: </strong>A third of the sample was flourishing (33.53%) without depressive or anxiety symptoms, while 15.29% of participants were flourishing despite mental illness, 30.59% were not flourishing and had no mental illness, and 20.59% were experiencing mental illness and not flourishing. Participants with higher social support were more likely to flourish and have no symptoms of depression or anxiety, while flourishing despite mental illness was associated with the unemployment status of people living with HIV. High internalized stigma was associated with the increased risk of having depression or anxiety symptoms and low mental wellbeing, while better physical health and older age had a protective effect against mental illness and languishing.</p><p><strong>Conclusions: </strong>Study findings suggest that enhancing access to social support and reducing HIV-related stigma are key to improving mental wellbeing among people living with HIV in Kazakhstan, especially among individuals of younger age, and those with worse physical condition. Applying the dual continuum model of mental health and integrating mental wellbeing scales in physical and psychological examinations of people living with HIV is recommended to better determine their service needs and provide tailored interventions to those most in need.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000432","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":"Suppressed switch to Bictegravir/emtricitabine/tenofovir alafenamide compared with dolutegravir/lamivudine: Real-world evidence from the OPERA cohort.","authors":"Gerald Pierone, Laurence Brunet, Jennifer S Fusco, Michael G Sension, Megan S Dunbar, Joshua Gruber, Douglas T Dieterich, Gregory P Fusco","doi":"10.1111/hiv.70105","DOIUrl":"https://doi.org/10.1111/hiv.70105","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the virologic effectiveness and discontinuation of the commonly prescribed fixed-dose combination 3-drug and 2-drug regimens, bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and dolutegravir/lamivudine (DTG/3TC), in virologically suppressed individuals in routine clinical care in the US.</p><p><strong>Methods: </strong>From the OPERA cohort, ART-experienced, virologically suppressed (viral load <200 copies/mL) adults with HIV who switched to B/F/TAF or DTG/3TC (01AUG2020-30JUN2022) were followed through 31DEC2022, death, loss to follow-up or discontinuation. Cox proportional hazard models with stabilized inverse probability of treatment weights were used to assess the association between regimen and time to confirmed virologic failure (cVF₂₀₀; 2 viral loads ≥200 copies/mL or 1 viral load ≥200 copies/mL + discontinuation) or time to discontinuation.</p><p><strong>Results: </strong>A total of 3512 B/F/TAF users were followed for a median of 16 months (IQR: 11, 22); 2327 DTG/3TC users were followed for a median of 15 months (IQR: 10, 21). cVF₂₀₀ was observed among 2% of B/F/TAF and 3% of DTG/FTC users, for an adjusted hazard ratio of 0.84 (95% CI: 0.59, 1.18) for B/F/TAF compared with DTG/3TC. Regimen discontinuation was observed among 17% of B/F/TAF and 19% of DTG/3TC users, for an adjusted hazard ratio of 0.83 (95% CI: 0.73, 0.94) for B/F/TAF compared with DTG/3TC. Treatment-related reasons for discontinuation represented 6% of B/F/TAF and 9% of DTG/3TC discontinuations.</p><p><strong>Conclusions: </strong>In this large US cohort, both B/F/TAF and DTG/3TC were well tolerated and effective treatment options among virologically suppressed individuals in routine clinical care, although DTG/3TC tended to be discontinued faster than B/F/TAF.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952103","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}