HIV Medicine最新文献

{"title":"A cross-sectional analysis of cardiometabolic and lifestyle-related profiles in men living with HIV in Japan using linked nationwide claims and health checkup data.","authors":"Kohei Yamashita, Kazuhiko Ikeuchi, Ryoko Sekiya, Yuki Arisato, Shinya Matsumoto, Toshiyuki Kishida, Akira Kado, Kazuya Okushin, Hiroshi Yotsuyanagi, Takeya Tsutsumi","doi":"10.1111/hiv.70317","DOIUrl":"https://doi.org/10.1111/hiv.70317","url":null,"abstract":"<p><strong>Objectives: </strong>To compare objectively measured cardiometabolic health between people living with HIV (PLWH) and individuals without HIV using nationwide health checkup data linked to administrative claims, thereby partially mitigating surveillance bias associated with routine HIV care.</p><p><strong>Methods: </strong>We conducted a cross-sectional matched analysis using the JMDC database, which links administrative claims with annual health checkup data. Men with HIV receiving antiretroviral therapy (ART) and men without HIV who underwent health checkups between 2017 and 2023 were included. PLWH were exact-matched 1:5 to individuals without HIV by age and calendar year. Cardiometabolic outcomes included hypertension, diabetes mellitus, dyslipidaemia and BMI, defined using treatment information and objectively measured clinical parameters. Conditional logistic regression and matched-set fixed-effects linear regression were used.</p><p><strong>Results: </strong>We included 2596 PLWH and 12 980 matched individuals without HIV (median age 45.0 years [IQR 37.0-51.0]). PLWH were more likely to receive treatment for hypertension, diabetes mellitus and dyslipidaemia, whereas measured systolic blood pressure, HbA1c and LDL-C were comparable to or lower than those in individuals without HIV. HIV infection was not independently associated with hypertension (aOR 0.95, 95% CI 0.82-1.09) or diabetes mellitus (aOR 1.00, 0.82-1.22) but was associated with dyslipidaemia (aOR 1.22, 1.08-1.39) and slightly higher BMI (adjusted mean difference 0.28 kg/m², 0.02-0.55).</p><p><strong>Conclusions: </strong>Among men receiving contemporary HIV care in Japan, HIV infection was associated with modest differences in BMI and dyslipidaemia but not with hypertension or diabetes mellitus.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164538","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":"Gaps in diabetes care among people living with HIV and hypertension in Botswana: A cross-sectional analysis of the InterCARE study.","authors":"Onkabetse Julia Molefe-Baikai, Tshepo B Leeme, Moagedi K Mawi, Kago Kebotsamang, Thato Moshomo, Edwin Mogaetsho, Tendani Gaolathe, Kesaobaka Molebatsi, Matlhogonolo Kelepile, Keonayang Kgotlaetsile, Pooja Gala, Duolao Wang, Shabbar Jaffar, Laura M Bogart, Lisa R Hirschhorn, Mosepele Mosepele","doi":"10.1111/hiv.70318","DOIUrl":"https://doi.org/10.1111/hiv.70318","url":null,"abstract":"<p><strong>Objectives: </strong>Data on diabetes screening and monitoring, within HIV care programmes in sub-Saharan Africa, remain limited. This study describes the quality of diabetes screening and management among people living with HIV with comorbid hypertension receiving care at facilities participating in the InterCARE trial in Botswana.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of adults aged 20-75 years with a documented diabetes diagnosis at enrolment in InterCARE (January-September 2023). All participants were people living with HIV with hypertension receiving routine HIV clinic care. Descriptive statistics were used to summarize baseline characteristics and key diabetes care indicators, including glycated haemoglobin (HbA1c), low-density lipoprotein (LDL) cholesterol and blood pressure (BP), and their level of control.</p><p><strong>Results: </strong>Of 4655 InterCARE participants, 138 (3.0%) had a prior diabetes diagnosis. In this diabetes subgroup, 69.6% were female (n = 99), and the median age was 58 years (IQR 52-64). Among the 87 participants receiving diabetes treatment, 80.0% (n = 70) were on oral agents and 20.0% (n = 17) on insulin-based therapy. Glycaemic and LDL monitoring had been performed in only 5.1% and 2.2% of participants, respectively. Blood pressure control (BP <130/80 mmHg) was achieved in 60.9%. Among those with HbA1c results (n = 75.1%), only 28.6% (n = 2) had glycaemic control (HbA1c <7%); however, interpretation is limited by the small number of HbA1c measurements. Lipid control could not be assessed due to insufficient data. Among participants without diabetes, documented screening was rare (17/4517; 0.3%).</p><p><strong>Conclusion: </strong>Diabetes care among people living with HIV ith hypertension in Botswana is suboptimal with major gaps in screening and metabolic monitoring. These findings highlight broader challenges in the delivery of integrated chronic disease care within HIV services. Strengthening the integration of non-communicable disease care into HIV programmes, including routine diabetes screening and cardiometabolic risk management, is urgently needed to improve health outcomes and reduce the burden of cardiovascular and other chronic complications among people living with HIV.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167316","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":"A systematic review of evidence on weight change following initiation of long-acting cabotegravir for the prevention or treatment of HIV.","authors":"Jonathan Kitonsa, Ronald Komata, Wilber Ssembajjwe, Daniel Grint, Julian Robinson, Eugene Ruzagira, Robert Kalyesubula, Jaime Vera, Fiona Cresswell","doi":"10.1111/hiv.70319","DOIUrl":"https://doi.org/10.1111/hiv.70319","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Weight gain is an increasingly recognized concern among people receiving antiretroviral therapy (ART) and may increase the risk of non-communicable diseases. Integrase inhibitors (INSTIs) such as dolutegravir (DTG) have been associated with weight gain, but the metabolic effects of long-acting cabotegravir (CAB-LA), another INSTI, for HIV treatment and prevention remain incompletely characterized. We conducted a systematic review to synthesize evidence on weight and body mass index (BMI) changes associated with CAB-LA-based regimens across ART and pre-exposure prophylaxis (PrEP) trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We systematically searched major biomedical databases, Medline, Embase, Cochrane CENTRAL, supplemented by Google Scholar and proceedings from key HIV conferences to identify grey literature for randomized controlled trials that evaluated CAB-LA as PrEP or CAB-LA-based regimen as ART between 01st January 2010 to 01st August 2025, with no language restrictions. Two reviewers independently screened studies, extracted data and assessed risk of bias using the Cochrane Risk of Bias 2.0 tool. Given substantial heterogeneity in outcome reporting across studies, evidence was synthesized narratively following the Synthesis Without Meta-analysis (SWiM) guidance. Findings were summarized by intervention type (PrEP or ART), sex/gender and geographical setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1998 records identified, 234 were removed as duplicates, 1764 were screened at title and abstract level, and 42 full-text articles were assessed. This resulted in 11 reports from eight randomized controlled trials, with follow-up ranging from 41 to 185 weeks. Overall, weight remained stable or only increased modestly in both intervention and comparator groups across studies. Among HIV-negative individuals receiving CAB-LA for PrEP, weight gain was observed in both intervention and comparator groups, with no consistent evidence of excess weight gain attributable to CAB-LA. In HPTN 077, weight gain was similar between CAB-LA and placebo recipients, while HPTN 083 and HPTN 084 reported annualized weight gains ranging from 1.23 to 2.4 kg/year in CAB-LA recipients and 0.37 to 2.1 kg/year in comparator groups. Among people living with HIV receiving ART, weight changes at 48 weeks ranged from -0.4 to +1.8 kg with CAB-LA plus long-acting rilpivirine (RPV-LA) and 0.0 to +1.5 kg with comparator regimens, with no consistent evidence of greater weight gain in the CAB-LA plus RPV-LA arms. Only one trial among ART-experienced adults in Africa (CARES) reported greater weight gain with CAB-LA plus RPV-LA than with continued oral therapy (mean weight gain 1.5 kg vs. 0.0 kg, respectively), with more pronounced effects in women compared to men (2.1 kg vs. -0.2 kg). The overall risk of bias was low to moderate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CAB-LA-based regimens were associated with only small increases in weight in both the prevention a","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136293","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":"Beyond CD4 counts: Multi-biomarker assessment of estimated time since HIV-1 infection and risk factors for late diagnosis.","authors":"Kathleen Smith, Macauley Locke, Emmi Andersson, Sandra Broddesson, Christina Carlander, Aylin Yilmaz, Jan Albert, Thomas Leitner, Johanna Brännström","doi":"10.1111/hiv.70314","DOIUrl":"https://doi.org/10.1111/hiv.70314","url":null,"abstract":"<p><strong>Background: </strong>Late diagnosis (LD) of HIV, defined as CD4 count <350 cells/μL or AIDS at diagnosis, remains a substantial public health challenge, with half of individuals in Europe diagnosed late. How long these individuals have lived with HIV remains unclear. We applied a multi-biomarker model (MBM) to estimate the time since infection (ETI) in newly diagnosed individuals classified as LD.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of newly diagnosed people with HIV in Sweden between November 2017 and December 2022. Individuals were classified as LD or non-LD according to an updated consensus definition. We applied an MBM combining CD4 count, pol polymorphism counts, pol next-generation sequencing diversity, HIV-1 limiting-antigen avidity assay and last negative HIV test to probabilistically derive ETI distributions.</p><p><strong>Results: </strong>More than half (52.4%) were classified as LD. Risk factors for LD included age >50 years (adjusted odds ratio (aOR) 2.94, 95% CI 1.42-6.09), origin in Asia and Pacific (aOR 4.53, 95% CI 1.81-11.32) and HIV acquisition in Asia and Pacific (aOR 2.28, 95% CI 1.08-4.83). Men who have sex with men had reduced risk of LD versus persons with heterosexual acquisition (aOR 0.38, 95% CI 0.22-0.64). ETI in 344 individuals revealed diagnostic delays; 41% (95% CrI 36.7-46.0) were diagnosed within 1 year: 71% of non-LDs (CrI 95% 65.0-77.7) versus 12% of LDs (95% CrI 8.4-16.2). Among LDs, over 60% remained undiagnosed beyond 3 years.</p><p><strong>Conclusions: </strong>Multi-biomarker ETI reveals that most HIV-1 infections remain undiagnosed for over 1 year. The updated LD definition correlates better with time since infection and ETI distributions show substantial diagnostic delays. Expanded testing strategies targeting heterosexual and older populations are urgently needed.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109080","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 viral suppression in children and adolescents who transitioned from ritonavir-boosted lopinavir- to dolutegravir-based antiretroviral therapy in Lesotho.","authors":"Jacob Blankenberger, Teresa L F Steffy, Tristan Lee, Thithili Makhesi, Meenakshi Bakaya, Akash Devendra, Pheello Mothepu, Lipontso Motaboli, Nadine Tschumi, Anna Klicpera, Tapiwa Tarumbiswa, Frédérique Chammartin, Lineo K Thahane, Niklaus D Labhardt, Jennifer A Brown","doi":"10.1111/hiv.70316","DOIUrl":"https://doi.org/10.1111/hiv.70316","url":null,"abstract":"<p><strong>Objectives: </strong>Children and adolescents living with HIV previously taking ritonavir-boosted lopinavir (LPV/r)-based antiretroviral therapy (ART) have been programmatically transitioned to dolutegravir (DTG)-based regimens in many country programs. We aimed to describe treatment outcomes following this transition in Lesotho, southern Africa.</p><p><strong>Design: </strong>We analyzed routinely collected data from two open cohorts across 27 health facilities in Lesotho.</p><p><strong>Methods: </strong>We included children and adolescents (<18 years at transition to DTG) who transitioned from first- or second-line ART consisting of LPV/r and 2 nucleoside reverse transcriptase inhibitors (NRTIs) to DTG and 2 NRTIs between July 2019 and July 2023. We report viral load (VL) data before transition, 12 months post-transition, and 24 months post-transition.</p><p><strong>Results: </strong>Among 852 participants, 410 (48.1%) were female, the median age was 10.1 years (interquartile range [IQR] 7.6-13.0) and the median time on ART at transition was 8.1 years (IQR 5.6-11.1). Of 768 with a pre-transition VL, 617 (80.3%) had viral suppression (VS; <50 copies/mL), 85 (11.1%) had low-level viremia (LLV; 50-999 copies/mL), and 66 (8.6%) had a high VL (HVL; ≥1000 copies/mL). Among 822 with a 12-month post-transition VL, 721 (87.7%) had VS, 76 (9.2%) had LLV and 25 (3.0%) had HVL. Among 787 with 24-month post-transition VL, 686 (87.2%) had VS, 75 (9.5%) had LLV and 26 (3.3%) had HVL.</p><p><strong>Conclusion: </strong>We observed improved and sustained VS among children and adolescents in routine care in Lesotho after programmatic transition to DTG-based ART, supporting continued scale-up of DTG in paediatric HIV programmes.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109101","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":"Death after discharge among children living with HIV admitted with suspected sepsis in Uganda: A secondary analysis of two prospective observational studies","authors":"O. Mackenzie,&nbsp;C. Zhang,&nbsp;N. Kissoon,&nbsp;N. Ford,&nbsp;N. Sugandhi,&nbsp;E. Kumbakumba,&nbsp;J. Kabakyenga,&nbsp;C. Komugisha,&nbsp;N. K. Mugisha,&nbsp;M. O. Wiens","doi":"10.1111/hiv.70279","DOIUrl":"10.1111/hiv.70279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Children living with HIV in low-income countries contribute disproportionately to death after hospital discharge. This study investigates the effect of HIV on post-discharge mortality and readmission by exploring a wide range of clinical, maternal and socioeconomic variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis of children under 5 years old admitted with suspected sepsis. Participants were enrolled from two multisite observational studies conducted from 2012 to 2013 and 2017 to 2020 across six hospitals in Uganda. Participants were excluded if admitted outside the catchment area, for trauma, short-term observation or if admitted immediately after birth without prior discharge. We used a robust Poisson regression to identify risk factors of post-discharge mortality for three separate HIV groups: children living with HIV (CLHIV), children HIV-exposed uninfected (CHEU) and children HIV-unexposed uninfected (CHUU). We implemented Kaplan Meier curves to compare rates of post-discharge mortality and readmission between the three groups. In addition, we compared the risk ratio of the two outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 7658 children who were discharged alive and completed the 6-month follow-up, 266 (3.5%) were CLHIV, 458 (6.0%) were CHEU and 6934 (90.6%) were CHUU. Post-discharge mortality was statistically significantly higher in CLHIV compared to the CHUU, with rates of 12.8% (34/266) and 5.8% (402/6934), respectively. Contrastingly, readmission was higher in CHUU (17.7% (1227/6934)) compared to CLHIV (11.3% (30/266)). Severe malnutrition, indicated by a weight-for-age z-score of less than −3, was associated with post-discharge mortality among all three groups with aRRs of 4.32 (95% CI: 1.89–9.81), 3.96 (95% CI: 1.75–8.95) and 4.84 (95% CI: 3.94–5.96) for CLHIV, CHEU and CHUU, respectively, compounded by the fact that severe malnutrition is disproportionately higher in those living with HIV. Variables associated with post-discharge mortality in this group were prior antimalarial use (aRR = 2.27 [95% CI: 1.16–4.47]) and moderate anaemia (aRR = 2.33 [95% CI: 1.12–4.89]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children living with HIV represent an exceptionally vulnerable group following hospital discharge. Very low readmission rates alongside high mortality suggest that strategies to improve care transitions and follow-up in these children are essential to improving recovery and survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1597-1608"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375329","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":"Retention in care among women with HIV: A systematic review of treatment continuity during pregnancy and postpartum","authors":"Stine Hansen,&nbsp;Klara Tetzschner Madsen,&nbsp;Nina Weis,&nbsp;Ellen Moseholm","doi":"10.1111/hiv.70265","DOIUrl":"10.1111/hiv.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pregnant women with HIV are at risk of reduced engagement in HIV care during pregnancy and postpartum. Retention in care, defined as continuous engagement in HIV-related treatment and follow-up, is essential to achieve virological suppression and prevent vertical transmission. Contemporary evidence on retention in care during pregnancy and postpartum among women with HIV in high-income countries remains limited. Thus, the aim of this systematic review was to examine retention in care during pregnancy and postpartum in this population and context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase and CINAHL were searched for observational studies including pregnant and/or postpartum women with HIV in high-income countries reporting retention in care outcomes. Screening, data extraction and quality assessment were performed independently by two reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 5089 records identified, 11 cohort studies were included. Retention in care was higher during pregnancy than postpartum, with declines observed up to 24 months postpartum. Several studies reported improvements in retention in care between 1996 and 2019. Use of antiretroviral therapy (ART) with viral suppression during pregnancy was associated with more favourable postpartum retention in care and virological outcomes. Heterogeneity in outcome definitions and follow-up periods precluded meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In high-income countries, most studies show high retention in care during pregnancy and declines after delivery. Retention in care has improved over time, and sufficient ART during pregnancy is associated with enhanced postpartum outcomes. Future research should prioritize standardized outcome definitions to strengthen evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1584-1596"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204586","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":"Management of ritonavir shortage in people with long-standing HIV infection: A single-centre experience","authors":"S. Lazzarin,&nbsp;D. Cattaneo,&nbsp;A. Giacomelli,&nbsp;D. Visigalli,&nbsp;M. V. Cossu,&nbsp;A. Gori,&nbsp;A. L. Ridolfo,&nbsp;C. Gervasoni","doi":"10.1111/hiv.70289","DOIUrl":"10.1111/hiv.70289","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1722-1723"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561842","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":"Characteristics and management of low-level viraemia in people living with HIV in a resource-limited setting: A multicentre retrospective study in Greece","authors":"Lydia Leonidou,&nbsp;Giota Lourida,&nbsp;Konstantinos Protopapas,&nbsp;Charalampos D. Moschopoulos,&nbsp;Dimitrios Zoulas,&nbsp;Charisis Totsikas,&nbsp;Dimitrios Basoulis,&nbsp;Elpida Mastrogianni,&nbsp;Apostolos Beloukas,&nbsp;Maria Lagadinou,&nbsp;Markos Marangos,&nbsp;Vasileios Papastamopoulos,&nbsp;Antonios Papadopoulos,&nbsp;Mina Psichogiou","doi":"10.1111/hiv.70295","DOIUrl":"10.1111/hiv.70295","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Low-level viraemia (LLV) persists in some people living with HIV despite antiretroviral therapy, raising concerns about virologic failure. We assessed the characteristics, management and outcomes of LLV in Greece, where next-generation sequencing, therapeutic drug monitoring and electronic adherence monitoring are unavailable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective multicentre study included people living with HIV from four Greek clinics who had achieved virological suppression for at least 6 months. LLV was defined as two consecutive HIV-1 RNA measurements between 51 and 200 copies/mL. Patients were followed for 18 months, during which three subsequent viral load measurements were evaluated. Adherence was assessed using patient self-report and documentation in the medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 3800 patients, 35 (0.9%) experienced LLV. Median age was 49 years, and 69% were male. Patients were treatment-experienced (median 3.5 ART lines; median duration of viral suppression, 7 years), with 57% receiving high genetic-barrier regimens. Baseline genotypic resistance data were available for 30 of 35 patients (85.7%), and clinically relevant resistance-associated mutations were identified in 6 (20.0%). LLV resolved in 27 of 35 patients (77.1%), persisted in 7 (20.0%) and recurred in 1 (2.9%). No patient developed virologic failure. Presumed causes of LLV were unknown in 18 (51.4%), low adherence in 14 (40.0%) and drug–drug interactions in 3 (8.6%). ART was modified in 17 patients, of whom 13 (76.5%) achieved viral resuppression, most commonly after switching from lower- to higher-genetic-barrier regimens. One patient with persistent LLV developed lymphoma during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LLV was uncommon but clinically relevant in this multicentre Greek cohort and frequently resolved following targeted management. Adherence optimization and ART modification, particularly to higher genetic-barrier regimens, were associated with viral resuppression in this cohort. Ongoing monitoring remains essential, especially in settings with limited access to advanced diagnostic tools.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1663-1669"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678307","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":"Frailty and associated clinical factors among Japanese people with HIV: A multicentre cross-sectional study using the revised Japanese Cardiovascular Health Study criteria","authors":"Hideta Nakamura,&nbsp;Julian Falutz,&nbsp;Taro Naka,&nbsp;Sho Miyamori,&nbsp;Nanae Ikemiyagi,&nbsp;Kazutaka Yamaniha,&nbsp;Shuhei Ideguchi,&nbsp;Rumi Minami,&nbsp;Masashi Narita,&nbsp;Michinori Shirano,&nbsp;Sei Samukawa,&nbsp;Tomoyuki Endo,&nbsp;Junji Imamura,&nbsp;Mayumi Imahashi,&nbsp;Shinichiro Ueda,&nbsp;Kazuko Yamamoto","doi":"10.1111/hiv.70297","DOIUrl":"10.1111/hiv.70297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Frailty is relevant to HIV care across middle and later life, yet Japanese data remain limited. We evaluated frailty, prefrailty and associated factors in Japanese people with HIV using the revised Japanese Cardiovascular Health Study (J-CHS) criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicentre cross-sectional study at eight HIV care centres. Eligible participants were Japanese people with HIV aged ≥40 years on antiretroviral therapy for ≥12 months. Frailty was classified as robust, prefrail or frail. Multivariable logistic regression examined factors associated with frailty-related outcomes; sensitivity analyses excluded sex from the model and restricted analyses to men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 325 participants, median age was 55 [49–64] years and 311 (95.7%) were male; 70 (21.5%) were robust, 227 (69.8%) prefrail and 28 (8.6%) frail. Common components were low physical activity (36.6%), weight loss (33.2%) and slow gait (27.1%). In the frailty versus non-frailty model, higher PHQ-9 score (adjusted odds ratio [aOR] 1.12 per point, 95% confidence interval [CI] 1.04–1.21) and polypharmacy (aOR 3.34, 95% CI 1.23–9.10) were associated with frailty. In the prefrailty/frailty versus robust model, higher PHQ-9 score and body mass index were associated with the outcome. Sensitivity analyses yielded broadly consistent findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prefrailty was highly prevalent, and frailty was associated with depressive symptoms and polypharmacy. Frailty at a median age of 55 years suggests clinically relevant vulnerability in Japanese people with HIV, although longitudinal and comparative studies are needed. These findings support integrated HIV care combining mental-health screening, medication review and physical-function assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1670-1681"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684337","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}