HIV Medicine最新文献

{"title":"Impact of COVID-19 and factors associated with long COVID and COVID-19 vaccine uptake in people with HIV in the United Kingdom: Results from Positive Voices 2022.","authors":"F Nakagawa, R Palich, M Kall, J Sewell, C Smith, C Kelly, H Kitt, A Pelchen-Matthews, A Aghaizu, A Sparrowhawk, N Mackie, T Djuretic, S Schoeman, C Humphreys, M Lipman, F C Lampe, A J Rodger","doi":"10.1111/hiv.70026","DOIUrl":"https://doi.org/10.1111/hiv.70026","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the impact of COVID-19, and the prevalence and factors associated with a history of COVID-19 infection, long COVID and incomplete COVID-19 vaccine uptake among people with HIV.</p><p><strong>Methods: </strong>Positive Voices 2022 is a questionnaire study of people accessing HIV care in the United Kingdom (March 2022-April 2023). Logistic regression assessed factors associated with a history of COVID-19 (previous positive test), long COVID among those with a history of COVID-19 (ongoing symptoms, with COVID-19 onset >3 months previously) and incomplete COVID-19 vaccine uptake (less than three doses of vaccine), adjusted for: age; gender; ethnicity; and year of HIV diagnosis.</p><p><strong>Results: </strong>In all, 4188 participants were included. Commonly reported negative impacts of the pandemic were on social contact (44% of participants), mental health (30%), healthcare access (26%) and financial security (25%). Overall, 2068 of 4188 (49.4%) participants had a history of COVID-19. Of these, 10.8% met criteria for long COVID, associated with female gender, unemployment, financial hardship, earlier HIV diagnosis date, diabetes diagnosis, asthma/chronic obstructive pulmonary disease diagnosis, obesity and symptoms of depression and anxiety. Overall, 95.8% reported having at least one vaccine dose, but 649 (15.7%) participants had incomplete vaccine uptake, associated with younger age, female gender, Black African ethnicity, lower education, financial hardship, unemployment, multioccupancy household, more recent HIV diagnosis, detectable HIV viral load and symptoms of depression and anxiety.</p><p><strong>Conclusions: </strong>About half of participants had a history of COVID-19, of whom 11% had persistent symptoms (long COVID). COVID-19 vaccine uptake was high, but incomplete uptake was apparent for 16% of participants and was more common among women, younger people, Black African individuals and those with socio-economic disadvantage.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012225","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":"Cytomegalovirus serostatus among people with HIV, characterizing the prevalence, risk factors, and association with immune recovery.","authors":"Joshua Quisias, M John Gill, Sally B Coburn, Hartmut B Krentz, Brenda Beckthold, Kevin Fonseca, Michael D Parkins, Raynell Lang","doi":"10.1111/hiv.70036","DOIUrl":"https://doi.org/10.1111/hiv.70036","url":null,"abstract":"<p><strong>Introduction: </strong>Cytomegalovirus (CMV) infection is common among people with HIV (PWH), and may be associated with negative outcomes. We aimed to identify the seroprevalence of CMV between 01 January 1998 and 01 June 2022 among PWH accessing care at the Southern Alberta Clinic (SAC) and the associated risk factors. We also aimed to assess the impact of CMV seropositivity on CD4+ T-cells and CD4+/CD8+ ratio recovery among PWH who maintain HIV viral suppression.</p><p><strong>Methods: </strong>Poisson regression models with robust variance estimated crude and adjusted prevalence ratios and 95% confidence intervals to identify risk factors for CMV seronegativity. Among PWH maintaining viral suppression, trends in the median CD4+ T-cell count and CD4+/CD8+ ratio were visualized, and continuous time-to-event Cox proportional hazard models estimated hazards ratios (aHR) for CD4+ cell count recovery to ≥500 cells/mm³ and CD4+/CD8+ ratio of >1 at 10 years by CMV serostatus.</p><p><strong>Results: </strong>Among 3249 PWH, 2954 (91%) were CMV seropositive. CMV seronegativity was associated with younger ages, male sex, non-Hispanic white race and an education of ≥12 years. While CMV seronegativity did not affect CD4+ T-cell recovery following HIV viral suppression (aHR 1.15 [0.89-1.48]), it was associated with a greater likelihood of CD4+/CD8+ ratio normalization (aHR 2.38 [1.85-3.07]) at 10 years of follow-up.</p><p><strong>Conclusions: </strong>CMV is a common coinfection among PWH. We found that CMV positivity among PWH maintaining HIV viral suppression, while not associated with CD4+ T-cell recovery, was associated with a reduced CD4+/CD8+ ratio recovery. This suggests an association with chronic CMV infection-mediated immune activation and inflammation among PWH.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005982","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":"Safety and effectiveness of switch to bictegravir/emtricitabine/tenofovir alafenamide following dual regimen therapy in people with HIV: Insights from the Icona cohort.","authors":"Andrea De Vito, Alessandro Tavelli, Alessandro Cozzi-Lepri, Andrea Giacomelli, Roberto Rossotti, Giacomo Ponta, Nicoletta Bobbio, Alice Ianniello, Antonella Cingolani, Giordano Madeddu, Andrea Antinori, Antonella d'Arminio Monforte","doi":"10.1111/hiv.70037","DOIUrl":"https://doi.org/10.1111/hiv.70037","url":null,"abstract":"<p><strong>Objectives: </strong>Most treatment switches are for simplification from three-drug (3DR) to dual regimens (2DR). However, a proportion of people with HIV may switch back to 3DR, like bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) after 2DR.</p><p><strong>Methods: </strong>We included people with HIV enroled in the Icona cohort who switched to B/F/TAF after 2DR INSTI-based (3TC/DTG, RPV/DTG, RPV/CAB, or DOR + DTG). Virological rebound (VR), virological suppression (VS), and treatment discontinuation (TD) due to toxicity or failure were evaluated using Kaplan-Meier curves. Random intercept and slopes before and after the switch were used to evaluate the trajectories of triglycerides, cholesterol, CD4, and CD4/CD8. Viro-immunological analyses were stratified according to HIV-RNA at switch.</p><p><strong>Results: </strong>Among the 3662 people with HIV who started a 2DR INSTI-based regimen, 71 (1.9%) switched to B/F/TAF; 60 had been followed up after the switch, for a median of 10.9 months (interquartile range: 3.6-24.7). Forty people with HIV switched with HIV-RNA <50 copies/mL (uVL), 20 with HIV-RNA ≥50 copies/mL (dVL). Among the uVL group, one participant experienced VR (HIV-RNA: 99, 71 followed by 29 copies/mL). Among the dVL group, the 1-year cumulative probability of undetectable VL was 75% (95% confidence interval [CI] 57.6-95.1). Fourteen people with HIV interrupted B/F/TAF for simplification (50.0%), toxicity (28.6%), VR (14.2%), and patient's choice (7.1); the 1-year cumulative probability of TD for toxicity/failure was 10.7% (95% CI 14.5-24.5). We observed an increase in the CD4/CD8 ratio (+0.02 CD4/CD8/month, p = 0.026) only in the dVL group.</p><p><strong>Conclusions: </strong>Switching from 2DR-INSTI to B/F/TAF is infrequent; this switch results in a low rate of toxicity and failure, along with a favourable immunovirological and lipid profile. CD4/CD8 gain is observed in those switching with detectable HIV-RNA.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981806","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":"Using an automated decision support tool to improve HIV prescribing: A feasibility study.","authors":"Aidan T Ireland, Jennifer Ward, Heather Dolby, Christopher Lawrence","doi":"10.1111/hiv.70028","DOIUrl":"https://doi.org/10.1111/hiv.70028","url":null,"abstract":"<p><strong>Objectives: </strong>The selection of antiretroviral therapy (ART) regimens for people living with HIV is complex and dependent on individual and clinician-perceived risk factors and preferences. The British HIV Association (BHIVA) advocates cost-effective prescribing and shared decision-making between patients and clinicians. We evaluated the acceptability and potential impact of a prototype multi-patient automated decision support tool (DST) for improving individualized, safe, and cost-effective prescribing.</p><p><strong>Methods: </strong>We surveyed people living with HIV and clinicians regarding treatment preferences and the acceptability of a DST. We developed a DST to interpret electronic patient record data, using 2022 BHIVA guidelines to identify optimal ART switch options. This was applied to patients prescribed ART between June 2022 and May 2023 in the local HIV service, and potential cost savings were calculated.</p><p><strong>Results: </strong>Among people living with HIV, 86.7% (144/166) respondents were open to switching to more cost-effective ART. While 94% (15/16) of clinician respondents prioritized lower-cost treatments where possible, only 38% (6/16) reported knowing about ART costs. Regimen switch options were identified for 274 of 503 people living with HIV meeting the inclusion criteria. Overall, potential cost savings of 28.4% of total ART spend (£26630.25 per month) were calculated if all possible switches to the most cost-effective option identified by the DST were made.</p><p><strong>Conclusions: </strong>A DST based on BHIVA recommendations and using routinely collected data may be acceptable to patients, useful to clinicians, and could provide significant cost savings. A substantial proportion of people living with HIV in our cohort were open to considering changing their ART based on cost effectiveness.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993721","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":"Oral abstracts","authors":"","doi":"10.1111/hiv.70010","DOIUrl":"https://doi.org/10.1111/hiv.70010","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 S2","pages":"3-16"},"PeriodicalIF":2.8,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852904","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":"Poster abstracts","authors":"","doi":"10.1111/hiv.70013","DOIUrl":"https://doi.org/10.1111/hiv.70013","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 S2","pages":"17-137"},"PeriodicalIF":2.8,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852996","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":"HCV incidence in people with HIV in southwest China: A retrospective cohort study (2004-2023).","authors":"Minyang Xiao, Yuhua Shi, Yunfei Lao, Yanling Ma, Jincheng Lou, Zuyang Zhang, Liru Fu, Yu Han, Junli Huo, Xiaobin Zhang, Yan Guo, Manhong Jia, Jian Li","doi":"10.1111/hiv.70033","DOIUrl":"https://doi.org/10.1111/hiv.70033","url":null,"abstract":"<p><strong>Introduction: </strong>Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections are global public health concerns. Little research has been conducted on HCV incidence in people with HIV (PWH).</p><p><strong>Methods: </strong>This was a retrospective cohort study to investigate HCV incidence and associated factors in PWH. HCV-negative PWH registered in national HIV databases were enrolled and followed up from 2004 to 2023. Cox proportional hazards models were utilized to identify factors associated with HCV infections.</p><p><strong>Results: </strong>The study followed 50 245 HCV-negative PWH, totaling 272 979.3 person-years (PYs) of observation. We noted an HCV incidence rate of 0.70 per 100 PYs (95% confidence interval (CI) 0.67-0.73). Multivariate analysis indicated that being female (adjusted hazard ratio [aHR] 0.70), married (aHR 0.88), and those involved in homosexual intercourse (aHR 0.57) were associated with a lower risk of HCV infection. Conversely, an increased risk was found among those aged 20-39 years (aHR 2.97), 40-59 years (aHR 3.11), ≥ 60 years (aHR 1.80), treated at county-level antiretroviral therapy (ART) clinics (aHR 1.19), township-level ART clinics (aHR 1.83), those with a history of intravenous drug use (aHR 21.72), and individuals without CD4 testing (aHR 66.05) or HIV viral load testing (aHR 2.09). A 36% relative reduction in HCV transmission (aHR 0.64) was observed from 2010 to 2015, and a 29% relative reduction (aHR 0.71) was noted after 2016 compared with the pre-2010 levels.</p><p><strong>Conclusions: </strong>Despite the decrease in HCV incidence after 2010, achieving HCV elimination in PWH remains challenging. Future endeavours should prioritize improving HCV testing, intervention, and treatment in PWH.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010630","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":"Correction to \"Perception of medical care among women living with HIV aged 40 years or older-a European-wide survey\".","authors":"","doi":"10.1111/hiv.70032","DOIUrl":"https://doi.org/10.1111/hiv.70032","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981874","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":"Longitudinal associations between social determinants of health and well-being among women living with HIV in Canada: A latent class analysis.","authors":"Zerihun Admassu, Carmen H Logie, Luissa Vahedi, Angela Underhill, Logan Kennedy, Kath Webster, Brenda Gagnier, Angela Kaida, Alexandra de Pokomandy, Mona R Loutfy","doi":"10.1111/hiv.70031","DOIUrl":"https://doi.org/10.1111/hiv.70031","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDoH) can significantly impact overall well-being. While existing research has explored SDoH as predictors of well-being among women living with HIV, longitudinal studies examining these relationships over time remain limited. We examined SDoH typologies among women living with HIV in Canada and longitudinal associations with well-being.</p><p><strong>Methods: </strong>Using longitudinal survey data collected at three time points from women living with HIV in Canada (2013-2018), we conducted latent class analysis (LCA) to identify subgroups of SDoH indicators, including income, experiences of violence, food security, substance use, housing stability, HIV-related stigma and social support at baseline (Time-1). Multivariable linear and logistic regression examined associations between SDoH classes and well-being (depression, discrimination [gender, racial] and HIV clinical outcomes [viral load, adherence, HIV care barriers]) at Time-3.</p><p><strong>Results: </strong>We identified three distinct SDoH classes among participants (n = 1422, mean age = 42.8): high (n = 435; 30.6%), medium (n = 377; 26.5%) and low SDoH adversity (n = 610; 42.9%). In multivariate regression analyses, the high SDoH adversity class had lower odds of achieving an undetectable viral load (adjusted Odds Ratio [aOR] = 0.46; 95% CI: 0.21, 1.01; p = 0.050) and higher probability of facing barriers to accessing care (aβ = 0.32; 95% CI: 0.19, 0.45; p < 0.001), depression (aOR = 2.52; 95% CI: 1.71, 3.71; p < 0.001), racial discrimination (aβ = 3.42; 95% CI: 1.72, 5.12; p < 0.001) and gender discrimination (aβ = 3.14; 95% CI: 1.42, 4.87; p < 0.001), compared with the low SDoH adversity class at 5-year follow-up.</p><p><strong>Conclusions: </strong>SDoH adversities were associated with poor wellbeing among women living with HIV in Canada. Integrated, comprehensive person-centred care approaches that address SDoH are needed to improve health and wellbeing.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009557","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":"Efficacy of long-acting cabotegravir plus rilpivirine in viraemic people living with HIV: A systematic review and meta-analysis.","authors":"Beatrice Barda, Giuseppe Barilaro, Paola Bellini, Giulia Turicchi, Enos Bernasconi, Marco Bongiovanni","doi":"10.1111/hiv.70025","DOIUrl":"https://doi.org/10.1111/hiv.70025","url":null,"abstract":"<p><strong>Background: </strong>Long-acting cabotegravir/rilpivirine (LA-CAB/RPV) is currently approved as a switch strategy in people living with HIV virally suppressed on oral antiretroviral therapy. Although small reports on specific, difficult-to-treat populations demonstrated the efficacy of LA-CAB/RPV in people living with HIV and unsuppressed viraemia, cumulative data on this issue are still lacking.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis based on PRISMA guidelines using PubMed, Scopus, Google Scholar and Medline, including papers or abstracts that evaluated the use of LA-CAB/RPV in viraemic people living with HIV. Two papers were excluded as they reported only single clinical cases; one study was excluded for including only three perinatally infected subjects. Two papers were reviews and two papers and one abstract reported result from Ward 86, which were later included in a final paper. One paper presenting preliminary results from the OPERA cohort was excluded, as these data were subsequently updated. The ACTG LATITUDE (A5359) study was not included, as it did not specifically report outcomes for people living with HIV who initiated LA-CAB/RPV while viraemic. After applying these selection criteria, five papers and three abstracts were included in the meta-analysis. The main outcome was virologic success, as defined by each individual study, in people living with HIV with at least one HIV-RNA evaluation after initiating LA-CAB/RPV. We did not perform a meta-analysis on other variables due to inconsistent assessment across studies.</p><p><strong>Results: </strong>Overall, 244 people living with HIV started LA-CAB/RPV when viraemic. Most of them reported adherence, psychological or social issues that limited compliance to standard oral treatment. The cumulative probability of achieving virologic success was 87% (79%-95%). Most patients maintained adherence rates above 90% to their scheduled injection visits. Eleven patients living with HIV developed RPV-associated mutations and five CAB-associated mutations at virologic failure. No interruption of LA-CAB/RPV for adverse events was reported.</p><p><strong>Conclusions: </strong>This is the first meta-analysis that assessed the efficacy of LA-CAB/RPV in viraemic people living with HIV; oral treatment efficacy was jeopardized by low compliance due to adherence or psychological issues. Our results can justify the use of LA-CAB/RPV also in viraemic patients without alternative oral options.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005755","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}