HIV Medicine最新文献

{"title":"Screening for Trypanosoma cruzi infection (Chagas disease) in the Latin American population living with HIV in London.","authors":"Natalie Elkheir, Shivani Singh, Birgit Barbini, Lucy Campbell, Alice Sharp, Jacqueline O'Connell, Louise Terry, Margherita Bracchi, Javier Rubio, Nicolo Girometti, Mohammed Hassan, Hannah Davies, Frank A Post, Laura Nabarro, Debbie Nolder, Geraldine O'Hara, Julie Fox, Peter L Chiodini, David A J Moore","doi":"10.1111/hiv.70201","DOIUrl":"https://doi.org/10.1111/hiv.70201","url":null,"abstract":"<p><strong>Background: </strong>There are an estimated 2482 people born in Latin American countries receiving care for HIV in the United Kingdom. Although national guidance recommends screening for Trypanosoma cruzi infection (Chagas disease) in this population, there is no formal screening programme. The aim of this study was to investigate the sero-epidemiology of T. cruzi in Latin American people living with HIV in London, with a view to informing screening strategies.</p><p><strong>Methods: </strong>This was a cross-sectional study, using serological screening for T. cruzi and questionnaires. Adults receiving HIV care in three London hospital outpatient clinics and who were born in one of the 21 Chagas-endemic countries of South America, Central America or Mexico were identified by searching electronic medical records for country of birth codes. Eligible participants were invited to undergo T. cruzi screening (a single recombinant immunoglobulin G (IgG)-enzyme-linked immunosorbent assay (ELISA)) during routine HIV outpatient appointments. Positive screening tests were confirmed with an immunofluorescence antibody test, with discordant results resolved by an adjudicating immunoblot.</p><p><strong>Results: </strong>A total of 351 participants were recruited between June 2023 and March 2025, including 181 (52%) who were born in Brazil, 73 (21%) in Colombia, 19 (5%) in Ecuador, 16 (5%) in Argentina, 15 (4%) in Venezuela and 12 (3%) in Bolivia. Uptake of serological screening was high (97% when offered face to face). Four participants (1%) had a positive screening test, of whom one had confirmed T. cruzi infection (seroprevalence 0.3%, 95% CI 0.01-1.6%), and three were deemed false positive screening tests.</p><p><strong>Conclusions: </strong>We report a low seroprevalence of T. cruzi infection in Latin American migrants in London living with HIV. Since the clinical consequences of untreated T. cruzi infection can be fatal, screening uptake is high, and individuals in non-endemic countries generally only need to be screened once, we recommend testing all Latin American people with HIV, especially women of reproductive age, those from high-prevalence countries and those with poor immune-virological control.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 5","pages":"796-802"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837035","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":"Peer-supported digital collection of patient-reported outcomes in HIV care: Promise, practical barriers and lessons from a pilot study within the ICONA cohort.","authors":"S De Benedittis, A Tavelli, R Gagliardini, T Bini, M Guastavigna, V Mazzotta, C Muccini, M Farinella, L Cosmaro, A Perziano, G Guaraldi, A Cozzi-Lepri, A Giacomelli, M Cernuschi, A d' Arminio Monforte, A Cingolani","doi":"10.1111/hiv.70214","DOIUrl":"10.1111/hiv.70214","url":null,"abstract":"<p><strong>Purpose: </strong>To explore whether peer support could enhance patient-reported outcome (PRO) completion through a mobile health platform within the ICONA cohort of people with HIV in Italy, and to identify practical lessons for integrating peers into digital, person-centred HIV care.</p><p><strong>Materials and methods: </strong>A pilot intervention was implemented in four cohort centres where trained peers, affiliated with the ICONA Community Advisory Board, supported PRO completion using the e-QoL mobile app over a five-month period. Fourteen additional centres without peer involvement served as comparisons. The primary outcome was the proportion of people with HIV fully completing ≥1 PRO before and during the intervention. A Difference-in-Difference (DiD) model, adjusted for demographic, HIV-related and socioeconomic variables, estimated the effect of the peer intervention.</p><p><strong>Results: </strong>During the intervention, 2421 people with HIV were followed in peer-supported centres and 2640 in peer-free centres. PRO completion increased from 1.24% to 3.08% in peer-supported sites, while a slight decline was observed in comparison centres (0.97% to 0.83%). The adjusted DiD analysis indicated a 2.0% absolute increase (95% CI: -0.40 to 4.5) attributable to peer support. Respondents were predominantly cisgender Italian men with higher education, suggesting limited reach to more digitally or socially vulnerable groups.</p><p><strong>Conclusion: </strong>Peer support modestly improved PRO completion and fostered greater awareness of PROs within HIV care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"815-818"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305371","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":"Exploring the impact of Cabotegravir-Rilpivirine long-acting on weight gain, body composition and quality of life in adults living with HIV.","authors":"Andrea De Vito, Andrea Marongiu, Antonella Cano, Mariangela Puci, Agnese Colpani, Susanna Maria Nuvoli, Maria Grazia Catte, Giulia Moi, Maria Antonietta Deledda, Sergio Uzzau, Giovanni Sotgiu, Franca Deriu, Angela Spanu, Giordano Madeddu","doi":"10.1111/hiv.70202","DOIUrl":"10.1111/hiv.70202","url":null,"abstract":"<p><strong>Introduction: </strong>Long-acting injectable antiretroviral therapy (ART) with Cabotegravir (CAB) and Rilpivirine (RPV) offers an alternative to daily oral regimens, improving adherence and patient satisfaction. However, its impact on body composition and metabolism remains underexplored.</p><p><strong>Methods: </strong>We conducted a prospective cohort study involving 29 people with HIV initiating CAB + RPV LA at a single centre in Italy. Body composition was assessed using dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA) at baseline, 24 and 48 weeks. Anthropometrics, laboratory parameters and patient-reported outcomes were also collected. Statistical comparisons across time points were performed using paired tests (p < 0.05 considered significant).</p><p><strong>Results: </strong>At 48 weeks, weight and BMI remained stable. Waist circumference significantly decreased (median 97 (IQR 91-102) to 94 (IQR 89-98) cm, p = 0.026), with no significant change in total fat percentage or visceral adipose tissue. A modest but statistically significant increase in trunk/limb fat ratio (mean 1.19 (SD 0.39) to 1.25 (SD 0.41), p = 0.035). Lean mass and muscle function were unchanged. BIA findings confirmed stable fat mass and body water compartments. Virologic suppression was maintained in all participants throughout follow-up. High-density lipoprotein (HDL) cholesterol increased significantly, accompanied by a rise in total cholesterol, while low-density lipoprotein (LDL) cholesterol, triglycerides and the total cholesterol/HDL ratio remained stable. Serum creatinine significantly decreased, mainly among individuals switching from bictegravir- or dolutegravir-based regimens. Glycaemia, insulin, HOMA-IR, Metabolic Score for Insulin Resistance (METS-IR), liver enzymes and hepatic steatosis and fibrosis indices remained stable. Adverse events, mostly injection-site reactions, decreased over time. Only one participant discontinued treatment. Treatment satisfaction improved throughout the study.</p><p><strong>Conclusion: </strong>CAB + RPV LA was not associated with significant weight gain, clinically relevant changes in body composition or adverse metabolic effects over 48 weeks. Virologic suppression was maintained, renal laboratory parameters improved in prior INSTI users and treatment was well tolerated with increasing satisfaction. These findings support CAB + RPV LA as a safe, effective and metabolically neutral alternative to daily oral ART.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"727-739"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146062709","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":"Supporting long-term engagement in HIV clinical care: Learning from the COVID-19 pandemic.","authors":"R Dhairyawan, Sara Paparini, M Smuk, S Sidat, R Mbewe, Silvia Petretti, V Martin, S Dakshina, H Alexander, T D Appleby, K Childs, M Bracchi, B Dragovic, G Haidari, N Mackie, I Reeves, A Umaipalan, L J Waters, J Anderson, C M Orkin","doi":"10.1111/hiv.70181","DOIUrl":"10.1111/hiv.70181","url":null,"abstract":"<p><strong>Objectives: </strong>SHIELD is a London-based study of engagement in HIV clinical care during and after the COVID-19 pandemic. We document the characteristics of service users who either re-engaged or disengaged with HIV care, together with reflections of HIV clinical service-providers to inform recommendations that address care retention for the long term.</p><p><strong>Methods: </strong>Using an exploratory mixed methods approach, service-users aged ≥18 years who re-engaged (1 March 2020-31 August 2020) or disengaged from clinical care (no contact with service 1 March 2020-28 February 2021) at 8 London HIV services were identified by retrospective records review. Demographics and clinical data were summarized descriptively. For people who re-engaged, follow-up data were collected at 24 months and in those who disengaged, at a single timepoint (1 March 2023). Semi-structured interviews with clinic staff were analysed thematically.</p><p><strong>Results: </strong>There were 122 people disengaged and 89 re-engaged. In those who re-engaged, a 24-month follow-up showed 71.3% on antiretrovirals, 63.6% virally suppressed and 67.9% had a future clinician appointment booked. For people who disengaged, by 1 March 2023, 21% were on antiretrovirals and 27% had a future appointment booked. Interviews with 11 service providers explored COVID-19's impact on clinical services, multilevel interactions that influenced engagement, and approaches to re-engaging people.</p><p><strong>Conclusions: </strong>We found that COVID-19 exposed existing vulnerabilities deterring access to HIV clinical care, as well as being itself an additional factor. For some people, the pandemic provided an opportunity to re-engage. We recommend that retention in care is prioritized in policy and financially, that clinical services provide holistic person-centred care, and improve ways to identify those who leave care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"678-689"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862802","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":"Midlife and beyond: Integrating menopause and cervical screening for women and gender-diverse people living with HIV.","authors":"Kristina M Kokorelias, Paula Rochon, Alice Zhabokritsky, Sharon L Walmsley, Luxey Sirisegaram","doi":"10.1111/hiv.70186","DOIUrl":"10.1111/hiv.70186","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"658-661"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834088","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":"Achieving reimbursable PrEP is insufficient to increase and diversify the users attending community-based services.","authors":"Enrico Caruso, Alessandro Tavelli, Anna De Bona, Nicoletta Frattini, Davide Moschese, Camilla Muccini, Daniele Tesoro, Alessandro Guido Soria, Alessandra Bianchi, Antonella D' Arminio Monforte, Massimo Cernuschi, Roberto Rossotti","doi":"10.1111/hiv.70209","DOIUrl":"10.1111/hiv.70209","url":null,"abstract":"<p><strong>Objectives: </strong>The reimbursement of HIV pre-exposure prophylaxis (PrEP) in Italy was expected to increase uptake and diversify users. We assessed changes in PrEP initiation patterns before and after reimbursement at a community-based service.</p><p><strong>Methods: </strong>We conducted a monocentric retrospective cohort study that included all individuals who initiated PrEP between September 2017 and October 2024. Participants were stratified according to PrEP initiation before and after June 2023, when reimbursed PrEP was made available. Monthly PrEP initiations were analysed using single-group interrupted time series analysis (ITSA) with segmented linear regression, including two intervention points (July 2020 and June 2023) and accounting for autocorrelation.</p><p><strong>Results: </strong>We included 1394 individuals who initiated PrEP: 1019 (73.1%) before and 375 (26.9%) after June 2023. Participants were predominantly cisgender men (96.7%), gay, bisexual and other men who have sex with men (GBMSM) (95.1%) and white (82.1%). After reimbursement, modest differences were observed, including a higher proportion of white individuals (84.0% vs. 81.5%) and fewer lifetime sexual partners (≥30 partners: 73.7% vs. 81.0%), while discontinuation rates remained similar. ITSA showed a marked immediate increase in PrEP initiations after the COVID-19 lockdown (+12.7/month; 95% CI 9.3, 16.1), followed by a flat trend thereafter. PrEP reimbursement was not associated with a significant immediate increase (+4.7/month; 95% CI -1.5, 10.9) and was followed by a negative change in the trend (-0.54/month; 95% CI -0.92, -0.15).</p><p><strong>Conclusions: </strong>In this community-based setting, reimbursed PrEP was not associated with a substantial increase in uptake or diversification of users, suggesting that additional implementation strategies beyond drug reimbursement may be required to improve equitable access.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"785-795"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270852","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":"Pharmacovigilance study of INSTIs associated with weight gain and glucose/lipid metabolism adverse events based on the FDA adverse event reporting system.","authors":"Leidan Zhang, Ling Chen, Jia Tang, Xiaosheng Liu, Liyuan Zheng, Fada Wang, Xin Huang, Wei Cao, Taisheng Li","doi":"10.1111/hiv.70205","DOIUrl":"10.1111/hiv.70205","url":null,"abstract":"<p><strong>Objective: </strong>Integrase strand transfer inhibitors (INSTIs) are widely used in antiretroviral therapy (ART) for people with HIV due to their efficacy and tolerability. However, concerns about weight gain and metabolic disturbances have emerged. This study aimed to evaluate the association between INSTIs and metabolic adverse events (AEs), including weight gain and glucose/lipid disorders.</p><p><strong>Design: </strong>The US Food and Drug Administration Adverse Event Reporting System (FAERS) reports from the first quarter (Q1) of 2004 through Q1 2025 were analysed for AEs associated with bictegravir (BIC), dolutegravir (DTG), elvitegravir (EVG) and raltegravir (RAL), focusing on weight gain and glucose/lipid metabolism disorders. Kaplan-Meier curves and Weibull shape parameter tests were used to analyse the cumulative incidence and time to onset of AEs.</p><p><strong>Results: </strong>All four INSTIs were associated with safety signals for weight gain and glucose/lipid metabolism disorders. BIC had the highest reporting odds ratio (ROR) for weight gain (ROR: 7.70, 95% CI: 7.00-8.47), while DTG had the highest for glucose/lipid disorders (1.81, 95% CI: 1.66-1.97). Younger age and female sex were linked to BIC-related weight gain; older age was a risk factor for DTG-, EVG- and RAL-related glucose/lipid AEs. DTG-associated events occurred earlier than those with other agents.</p><p><strong>Conclusion: </strong>This study identified metabolic AEs associated with INSTIs, with agent-specific differences in risk and timing, highlighting the need for regular monitoring and individualized management during INSTI-based ART.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"749-760"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343616","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":"Calibration and discrimination ability of the Dat'AIDS score in people living with HIV aged 70 years and older from the Dat'AIDS cohort.","authors":"Abeo Mousse, Clotilde Allavena, Amandine Gagneux-Brunon, François Raffi, Laurent Hocqueloux, Claire Genet, Madeline Pascard, Damien Jolly, Firouzé Bani-Sadr, Lukshe Kanagaratnam, Maxime Hentzien","doi":"10.1111/hiv.70207","DOIUrl":"10.1111/hiv.70207","url":null,"abstract":"<p><strong>Objective: </strong>The Dat'AIDS score was developed to predict 5-year mortality risk in people living with HIV aged 60 and older. However, its validity in people living with HIV aged 70 years and older needed confirmation.</p><p><strong>Methods: </strong>This was a multicentre prospective cohort study in the Dat'AIDS French cohort. We calculated the Dat'AIDS score and Veterans Aging Cohort Study (VACS) indices 1.0 and 2.0 in people living with HIV aged 70 or older, at their first medical visit between 01/06/2014 and 31/12/2017. Participants were followed until 31 December 2019 (before the COVID-19 era). Discrimination and calibration of the Dat'AIDS score were assessed using Harrell's C-statistic and comparisons of predicted versus observed survival probabilities. The comparison of the discriminative capacity of the Dat'AIDS score with the VACS indices was performed.</p><p><strong>Results: </strong>A total of 1330 participants (75.5% male, median age: 73.7 years, median time since HIV diagnosis: 21.7 years, median time under combination antiretroviral therapy (cART): 19.9 years, median CD4 cell count: 553 cells/μL, HIV-1 RNA ≤50 copies/mL: 88.7%) were included. Overall, 221 (16.6%) deaths were recorded during 5598 patient-years of follow-up. The Dat'AIDS score showed good discrimination (C-statistic: 0.72; 95% confidence interval [CI; 0.68-0.75]). Calibration was good except for the moderate-risk group (5% difference). The Dat'AIDS score showed better discrimination than VACS 1.0 and 2.0 with albumin, aspartate aminotransferase (AST) and alanine transaminase (ALT) normal value imputation (C-statistic: 0.72 vs. 0.69 for both) and was similar to VACS 2.0 without imputation (0.72 vs. 0.71), that could be calculated in 99.1%, 98.6% and 34.0%, respectively.</p><p><strong>Conclusions: </strong>The Dat'AIDS score showed good discrimination and calibration in people living with HIV aged 70 years and older, providing an easy and valuable tool for clinical decision-making and research.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"771-784"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165209","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":"Long-acting cabotegravir and rilpivirine in people with HIV and obesity: Real-world outcomes from the RELATIVITY cohort.","authors":"Jesús Troya, Rafael Mican, María José Galindo, Otilia Bisbal, Lucía Romero, Miguel Torralba, Luis Buzón-Martín, Sara de la Fuente, Francisco Fanjul, Adrián Rodríguez, Alfonso Cabello, Isabel Sanjoaquin, María Del Carmen Navarro, María Aguilera, Carmen Hidalgo-Tenorio, Luis Enrique Morano, Clara Martínez, Inmaculada Poquet, Enrique Bernal, Ruth Caballero, Noemí Cabello-Clotet, Analuz Fernández, María Del Carmen Montero, María Jesús Vivancos-Gallego, Francisco Tejerina, Guillermo Soria, Miguel Alberto de Zárraga, Mireia Cairó, Alberto Romero, Rebeca Cabo, Víctor Arenas, María Antonia Sepúlveda, Antonia Alcaraz, Cristina Escrich, Claudia González-Rico, Eva María Ferreira, Beatriz Valentín, Magdalena Muelas-Fernández, Jara Llenas-García, Sara García, Juan Emilio Losa-García, Bárbara Alonso, José Sanz, Félix Gutiérrez, Nuria Vázquez, Juan José Corte, María Ángeles Garcinuño, Juan Carlos Gainzarain, Miriam Estébanez, Roberto Pedrero-Tomé, María Luisa Montes","doi":"10.1111/hiv.70196","DOIUrl":"10.1111/hiv.70196","url":null,"abstract":"<p><strong>Introduction: </strong>Long-acting injectable cabotegravir and rilpivirine (LAI CAB + RPV) is a well-established regimen for people with HIV (PWH) that offers high efficacy and tolerability. However, data are limited for obese individuals with a body mass index (BMI) ≥ 30 kg/m², which may represent a potential risk factor for virologic failure (VF).</p><p><strong>Methods: </strong>We conducted a multicentre, ambispective study (RELATIVITY cohort, Spain) of virologically suppressed PWH with BMI ≥ 30 kg/m² who switched to LAI CAB + RPV. This study characterized this population and evaluated the factors associated with virologic outcomes, tolerability and adherence using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Among the 3,203 individuals recruited in the RELATIVITY cohort, 57 were excluded due to detectable HIV RNA at the time of switching to LAI CAB+RPV, and 3,146 were finally included, all of whom had HIV RNA levels <50 copies/mL at baseline. BMI data were available for 2,736 participants, of whom 362 (11.5%) had a BMI ≥30 kg/m² and 2,374 had a BMI <30 kg/m². Obese participants were older (median age 48 vs. 45 years) and included a higher proportion of women (21.9% vs. 13.7%). Comorbidities included dyslipidaemia (36.7%), hypertension (22.9%), diabetes (11.6%), chronic lung disease (6.4%), MASLD (5.5%) and coronary disease (3.3%). The main reasons for switching included quality-of-life improvement (49.2%), patient requests (35.4%), and therapy simplification (26%). VF was rare, occurring in 1.1% of obese individuals and 0.6% of non-obese participants over a median follow-up of 13.8 months (p = 0.284). Emergent resistance mutations were detected in 2/4 VF in obese participants. The discontinuation rate was low across all study groups. Among participants with obesity, local adverse events accounted for 1.9% of discontinuations, systemic adverse events for 0.8%, and other causes for 3.9% of discontinuations. In this subgroup, 72.9% of injections were administered using a 38-mm needle. Injection adherence was excellent, with 83.1% of participants with obesity achieving full (100%) coverage and an additional 16.3% maintaining 90-99.9% coverage.</p><p><strong>Conclusions: </strong>In this real-world cohort, LAI CAB + RPV was safe and effective in PWH with obesity, with comparable VF rates, tolerability, and adherence to participants without obesity. These findings support the use of LAI CAB + RPV across diverse PWH populations, including those with a BMI ≥ 30 kg/m², and highlight its feasibility in PWH with multiple comorbidities.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"690-709"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046526","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":"Virological outcomes with Bictegravir/Emtricitabine/Tenofovir alafenamide (B/F/TAF) in people previously treated with darunavir-based antiretroviral therapy.","authors":"Rhianna Sheridan, Yasmin Osei-Kuffour Ekert, Lucy Campbell, Mark Zuckerman, Sally Hawkins, Kate Childs, Frank A Post","doi":"10.1111/hiv.70204","DOIUrl":"10.1111/hiv.70204","url":null,"abstract":"<p><strong>Background: </strong>Darunavir-based antiretroviral therapy (ART) is commonly used in people with HIV who experience adherence challenges and/or have complex resistance patterns. Changes in ART commissioning have led to an increased use of Bictegravir/Emtricitabine/Tenofovir alafenamide (B/F/TAF) in these populations despite limited real-world outcome data.</p><p><strong>Methods: </strong>Single centre, retrospective analysis of virological outcomes in individuals previously treated with Darunavir who initiated B/F/TAF before 01/01/2025. Logistic regression was used to analyse associations with sustained virological suppression (HIV RNA <200 copies/mL) on B/F/TAF.</p><p><strong>Results: </strong>Of the 223 individuals who initiated B/F/TAF, 207 (median age 52 [40-58] years, 38% female, 69% Black ethnicity, 24% with CD4 < 200 cells/mm³ and 36% with HIV RNA ≥200 copies/mL) contributed virological outcome data. Over a median of 2.4 [1.3-3.3] years, 153 (74%) maintained or achieved sustained virological suppression, 11 (5.3%) had a single viral load ≥200 copies/mL and 43 (20.8%) experienced virological failure. Participants with CD4 < 200 cells/mm³ (aOR 0.15 [95%CI 0.07-0.33]) and HIV RNA ≥200 copies/mL (aOR 0.17 [0.08-0.34]) at B/F/TAF initiation were less likely to achieve sustained virological suppression; historical resistance-associated mutations (RAMs) were not associated with virological outcome. Of the 32 participants successfully genotyped, 3 had novel INSTI mutations (E157Q, L74LM) and 4 had not previously documented NRTI mutations (M184V/I, D67DN, Y115F) mutations.</p><p><strong>Conclusions: </strong>Substituting of Darunavir-based ART with B/F/TAF in this challenging population was associated with treatment-emergent INSTI and NRTI resistance. Historical resistance did not predict virological outcomes and treatment-emergent resistance did not preclude re-suppression on B/F/TAF, suggesting that adherence remains a major barrier to achieving long-term virological success.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":"803-808"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100092","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}