HIV Medicine最新文献

{"title":"Clinical staff attitudes towards opt-out consent for blood-borne virus screening in emergency departments in England.","authors":"Esther G Blakey, Cassandra E L Fairhead, Alison J Rodger, Fiona M Burns, Lucie Ralph, David R Chadwick","doi":"10.1111/hiv.13735","DOIUrl":"https://doi.org/10.1111/hiv.13735","url":null,"abstract":"<p><strong>Objective: </strong>Opt-out screening for blood-borne viruses (BBVs) in emergency departments (EDs) has been established in areas with a high prevalence of HIV diagnoses in England. This multi-site study explored the attitudes of healthcare workers (HCWs) towards BBV screening in EDs post-implementation.</p><p><strong>Design: </strong>This was a cross-sectional electronic survey of HCWs.</p><p><strong>Methods: </strong>Between November 2023 and February 2024, HCWs across 33 EDs in England participating in opt-out BBV screening were invited to complete a survey about the feasibility and acceptability of screening, including the opt-out consent process. Factors independently associated with acceptability of opt-out screening were identified using multivariable logistic regression. Free-text responses were analysed thematically.</p><p><strong>Results: </strong>Responses from 610 HCWs in 19 EDs were provided: 50.4% were nurses, 43.1% doctors, and 6.5% other healthcare professionals. Acceptability of the screening programme and opt-out consent was high (90.3% and 77.7%, respectively), with some variation between EDs. Acceptability of opt-out consent was greater among doctors than among other HCWs, and among HCWs who proactively discussed screening further with patients who opted out. However, 50.8% of HCWs felt that patients should be verbally reminded at blood draw, and 44.3% of HCWs wanted more training in discussing opt-out screening with patients. Free-text answers suggested changes to test-ordering systems, including simple integration of tick boxes to document whether patients opted out and to block repeated testing.</p><p><strong>Conclusions: </strong>There was substantial support from ED HCWs for routine opt-out ED BBV screening, including opt-out consent. Key areas suggested for improvement included changes to test-ordering systems and additional training for HCWs. Frequent preference for verbal reminders at the point of blood draw suggests continued HIV testing exceptionalism.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619302","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":"Implementation of patient-reported outcomes for people living with HIV: Insights from patients and healthcare providers in a Danish outpatient clinic.","authors":"Lotte Ørneborg Rodkjær, Merete Storgaard, Liv Marit Valen Schougaard","doi":"10.1111/hiv.13734","DOIUrl":"https://doi.org/10.1111/hiv.13734","url":null,"abstract":"<p><strong>Objectives: </strong>Patient-reported outcomes (PROs) have emerged as a valuable tool for aligning HIV care with patient needs and priorities. This study aimed to explore patient and healthcare provider (HCP) experiences of integrating a PRO solution into standard clinical care for HIV in a Danish outpatient clinic.</p><p><strong>Methods: </strong>A tailored PRO solution for people living with HIV was developed in a Danish outpatient clinic. Patients were eligible if they were aged >18 years, spoke Danish, had been on effective antiretroviral therapy for 2 years, and had no additional health issues. Patients completed an electronic questionnaire 14 days before in-clinic consultations. HCPs reviewed patients' responses before these consultations. We assessed the usability, acceptability, and relevance of the PRO solution by conducting semi-structured interviews with 24 patients (12 responders and 12 non-responders) and six HCPs. A further 95 non-responders were interviewed over the phone. Data were analysed using thematic analysis.</p><p><strong>Results: </strong>Respondents found that PROs improved patient-provider communication, treatment planning, and self-management. Non-respondents faced barriers such as health literacy, cultural beliefs, and access to technology, necessitating alternative delivery methods. HCPs found that PROs facilitated person-centred care and symptom management, but HCPs faced challenges such as insufficient training, resources, and organizational support.</p><p><strong>Conclusions: </strong>Implementing PROs in HIV care is challenging because of the patient diversity, clinician training needs, and organizational adaptations. Nevertheless, the use of PROs is associated with enhanced person-centred care. Future recommendations include tailored use of PROs, better understanding of the impact on patient groups, on-site questionnaire completion, and emphasis on shared decision-making between patients and HCPs.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619304","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":"AI in medicine: No longer the future, but the present.","authors":"Abiu Sempere, Xoan González-Rioja, Esteban Martinez","doi":"10.1111/hiv.13732","DOIUrl":"https://doi.org/10.1111/hiv.13732","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619300","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":"Burden of liver steatosis and liver fibrosis in a large cohort of people living with HIV","authors":"Montserrat Laguno,&nbsp;Elisa de Lazzari,&nbsp;Leire Berrocal,&nbsp;Alexy Inciarte,&nbsp;Maria Martínez-Rebollar,&nbsp;Lorena de la Mora,&nbsp;Berta Torres,&nbsp;Ana Gonzalez-Cordón,&nbsp;Ivan Chivite,&nbsp;Alberto Foncillas,&nbsp;Júlia Calvo,&nbsp;Abiu Sempere,&nbsp;Juan Ambrosioni,&nbsp;Jose Luís Blanco,&nbsp;J. M. Miro,&nbsp;Josep Mallolas,&nbsp;Esteban Martínez","doi":"10.1111/hiv.13730","DOIUrl":"10.1111/hiv.13730","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Liver steatosis (LS) and liver fibrosis (LF) can increase the risk of cardiovascular disease in people with HIV, but their prevalence and associated factors are poorly understood. This study aimed to assess the prevalence of and factors associated with LS and LF in a large cohort of people with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study of consecutive people with HIV attending the Clinic of Barcelona from September 2022 to September 2023, excluding those with chronic B or/and C hepatitis virus coinfection. LS was assessed using the Hepatic Steatosis Index (HSI) and Fatty Liver Index (FLI), and LF was assessed using the Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS), Fibrosis-4 score (FIB-4), and the European AIDS Clinical Society (EACS) algorithm in both the whole cohort (cohort 1) and in a specific cohort more susceptible to liver disease (cohort 2). We identified independent variables associated with LS and LF using logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cohort 1 included 4664 people with HIV; 76% and 37% of them had available HSI and FLI data, LS was present in 28% and 19%, respectively. LF risk was present in 1%, 2%, and 1% of people with HIV according to NFS, FIB-4, and EACS algorithm scores, respectively. Cohort 2 included 1345 people with HIV; 60% and 30% of them had available HSI and FLI data, LS affected 55% and 43% and LF 2%, 5%, or 3%, respectively. Factors associated with LS included current CD4 cell count, diabetes, and hypertension, whereas LF was associated with previous exposure to dideoxynucleoside drugs and current CD4 to LF. Current integrase strand transfer inhibitor (INSTI) therapy appeared protective for LF in cohort 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this study, one in four people with HIV had LS, and the prevalence rose to one in two in those with cardiovascular risk factors. The prevalence of LF was low, but it should be considered in older people with HIV with low CD4 counts or high aspartate transaminase levels. A possible protective effect from INSTIs deserves further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 12","pages":"1308-1324"},"PeriodicalIF":2.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590661","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":"Viral rebound on antiretroviral therapy in France according to region of origin, sex, and HIV acquisition group. Results from the French Hospital Database on HIV (ANRS CO4-FHDH).","authors":"S Abgrall, H Selinger-Leneman, E Lanoy, A Becker, S Matheron, P de Truchis, J Pavie, A Canestri, M A Khuong, D Rey, F Caby, P Tattevin, R Palich, S Grabar","doi":"10.1111/hiv.13729","DOIUrl":"https://doi.org/10.1111/hiv.13729","url":null,"abstract":"<p><strong>Background: </strong>Assessing the potential increased risk of viral rebound (VR) in migrants requires adequate control for sex and acquisition risk groups.</p><p><strong>Methods: </strong>People living with HIV1, enrolled in the ANRS CO4-French Hospital Database on HIV, who achieved virological suppression with antiretroviral therapy (ART) initiated between 2006 and 2016 were included. We first compared the risk of VR, with loss to follow-up and death considered as competing events, across origin among the HIV acquisition groups, then across acquisition groups among the different origins, and finally across modality of a variable combining sex, acquisition group, and origin. Models were adjusted for clinical and biological confounding factors.</p><p><strong>Results: </strong>We included 21 571 French natives (FRA), 10 148 migrants from sub-Saharan Africa (SSA), 1137 migrants from the non-French West Indies (NFWI), and 4205 other migrants (OTHER). The 5-year probability of VR was 19% (95% confidence interval [CI] 19-20) overall, 15% in FRA, 21% in OTHER, 26% in SSA, and 34% in NFWI (p < 0.0001). It was 14% in men who have sex with men (MSM), 23% in heterosexual men, and 23% in women (p < 0.0001). After adjustment, all acquisition groups had a higher risk of VR than MSM from FRA, with men and women from NFWI having the highest risk (adjusted hazard ratio [aHR] 2.46; 95% CI 2.12-2.86 and aHR 2.59; 95% CI 2.20-3.04, respectively). Within each acquisition group, all groups of origin had a higher risk of VR than FRA. Within each region of origin, except the NFWI, heterosexual men had a higher risk of VR than MSM.</p><p><strong>Conclusions: </strong>After accounting for sex and acquisition group, migration, especially from NFWI, remains prognostic of VR.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576045","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":"Effectiveness, safety, and patient-reported outcomes of emtricitabine/tenofovir alafenamide-based regimens for the treatment of HIV-1 infection: Final 24-month results from the prospective German TAFNES cohort study.","authors":"Christoph Stephan, Christoph D Spinner, Ansgar Rieke, Stefan Christensen, Stefan Mauss, Sandra Schreiber, Boris Albuquerque, Marion Heinzkill, Heribert Ramroth, Hans-Jürgen Stellbrink","doi":"10.1111/hiv.13728","DOIUrl":"https://doi.org/10.1111/hiv.13728","url":null,"abstract":"<p><strong>Background: </strong>Tenofovir alafenamide (TAF) was introduced in the European Union in 2015 as a novel prodrug of tenofovir showing similar efficacy in clinical trials and a more favorable safety profile than tenofovir disoproxil fumarate (TDF). The German TAFNES cohort study (2016-2019) was conducted to generate real-world evidence.</p><p><strong>Methods: </strong>Treatment-naïve (TN) and treatment-experienced (TE) people with HIV (PWH) receiving elvitegravir/cobicistat/emtricitabine/TAF (E/C/F/TAF), rilpivirine/F/TAF (R/F/TAF) or F/TAF + 3rd agent were included. Month (M) 24 outcomes included virologic effectiveness (HIV RNA <50 copies/mL), treatment persistence, adverse drug reactions (ADRs) and patient-reported outcomes, using the HIV Symptom Index (HIV-SI), 36-Item Short Form Health Survey (SF-36) and HIV Treatment Satisfaction (HIVTSQ) questionnaires.</p><p><strong>Results: </strong>The study included 767 PWH (92% men, median age 46 years; 301 TN, 466 TE; E/C/F/TAF [n = 318], R/F/TAF [n = 192], F/TAF + 3rd agent [n = 257]). Among TN, 35% had late HIV diagnosis (CD4 < 350/μL and/or AIDS). Of TE, 95% were on suppressive antiretroviral therapy (ART) before switching. D:A:D (Data Collection on Adverse Effects of Anti-HIV Drugs) 5-year risks for chronic kidney disease were high for about 1 in 10 TN and 4 in 10 TE. Overall treatment persistence at M24 was 81% (E/C/F/TAF: 88%; R/F/TAF: 86%; F/TAF + 3rd agent: 70%, with ART simplification of multiple-tablet regimens in 13%). M24 viral suppression (missing = excluded) was 96% (479/501). Discontinuations due to virologic failure or ADRs were rare, 2% (12/767) and 4% (30/767), respectively. HIV-SI and SF-36 summary scores improved in TN; HIVTSQ change scores showed an improvement in treatment satisfaction in TE.</p><p><strong>Conclusion: </strong>Real-world data confirmed a favorable safety profile and high virologic effectiveness with high treatment satisfaction on F/TAF-based ART.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545181","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":"Cardiovascular prevention: Statins and beyond–A message from the editors of the special issue of HIV medicine","authors":"Laura Waters,&nbsp;Esteban Martinez","doi":"10.1111/hiv.13731","DOIUrl":"10.1111/hiv.13731","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 12","pages":"1281-1282"},"PeriodicalIF":2.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545180","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":"Comparison of risk factors and mortality in veterans with HIV and those without HIV suffering first major acute cardiovascular events.","authors":"William L Hicks, Suzan Khalil, Floyd W Burke, Minh Quang Ho, Ishak Mansi","doi":"10.1111/hiv.13724","DOIUrl":"https://doi.org/10.1111/hiv.13724","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated that people with HIV have an increased atherosclerotic plaque vulnerability, making them more susceptible to severe cardiovascular complications. This study aimed to examine the clinical characteristics of people with HIV in comparison to people without HIV admitted to Veterans Health Administration (VHA) with their first major acute cardiovascular events (MACE) and compare their total mortality.</p><p><strong>Methods: </strong>We used national VHA data to extract data of those admitted to VHA hospitals with MACE defined as acute myocardial infarction (AMI), acute cerebrovascular accident (CVA) or cardiac arrest during the fiscal years 2003-2021. The hazard ratio (HR) of mortality for people with HIV versus people without HIV was estimated using Cox proportional hazard regression analysis.</p><p><strong>Results: </strong>Out of 280 311 veterans, 2510 people with HIV and 277 801 people without HIV had their first MACE during the study period. People with HIV were younger, more likely to be African American, had a lower prevalence of diabetes mellitus and hypertension, similar total cholesterol levels and a lower mean 10-year cardiovascular risk score (25.4 in people with HIV vs. 28.7 in people without HIV). Among MACE components, people with HIV had a higher proportion of CVA (27% vs. 21.3%, p < 0.001) and cardiac arrest (13.0% vs. 8.4%, p < 0.001) but a lower incidence of AMI (62.4% vs. 72.5%, p < 0.001) than people without HIV. Additionally, people with HIV had a higher risk of total mortality (adjusted HR: 2.05, 95% confidence interval: 1.90-2.22) compared with people without HIV.</p><p><strong>Conclusion: </strong>People with HIV experience MACE at younger ages despite lower cardiovascular risks and similar baseline cholesterol and blood pressure levels. People with HIV had higher mortality and a higher risk of having ventricular fibrillation arrest and stroke as their first MACE.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499444","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":"Should we measure quality of life among people with HIV? A multicentre survey of physicians' opinions in Spain.","authors":"Rebeca Izquierdo, Inés Suárez-García, Teresa Gómez-García, Cristina Marco-Sánchez, Julián Puente-Ferreiro, Cristina Moreno, Asunción Diaz, Noemí Cabello-Clotet, David Vinuesa, José Luis Blanco, Estrella Melús, Cristina Gómez-Ayerbe, Julián Olalla, Melchor Riera, José Ignacio Bernardino, Juan Carlos de López Bernaldo de Quirós, Santiago Moreno, Inma Jarrín","doi":"10.1111/hiv.13726","DOIUrl":"https://doi.org/10.1111/hiv.13726","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the opinions of physicians caring for people with HIV (PWH) from the multicentre Spanish CoRIS cohort regarding the assessment of health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>We designed an online self-administered questionnaire comprising 27 structured questions across four domains: (i) sociodemographic and clinical data; (ii) usefulness of measuring HRQoL; (iii) information, training and resource needed; and (iv) whether and how HRQoL should be measured. Physicians completed the questionnaire between April and June 2023.</p><p><strong>Results: </strong>Of 131 physicians surveyed [53.8% men, median age 52 years (interquartile range: 42-60)], 90.9% and 88.6% agreed that measuring HRQoL is useful for both PWH and medical decision-making, respectively. However, 67.2% needed training on what HRQoL is and how to measure it, 79.4% required information on validated tools, and 80.9% felt that clinical guidelines are needed. Overall, 90.1% of physicians agreed that HRQoL should be measured among PWH. Most physicians (82.8%) supported using specific scales for PWH, with 74.1% recommending annual measurement, 49.1% suggesting that nurses from HIV units conduct the assessments, and 43.1% favouring personal interviews during medical visits. At the time of the survey, 55.3% of physicians did not measure HRQoL in any patients due to time or resource constraints (75.8%).</p><p><strong>Conclusions: </strong>Despite the recognized importance of HRQoL measurement in PWH, Spanish physicians encounter barriers such as time constraints and limited resources. Developing clear guidelines, using tailored scales, and integrating digital tools along with multidisciplinary support could enhance routine HRQoL assessments and improve patient-centred care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499446","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 postnatal prophylaxis and infant feeding policies vary across Europe: results of a Penta survey.","authors":"Georgina Fernandes, Elizabeth Chappell, Tessa Goetghebuer, Christian R Kahlert, Santa Ansone, Stefania Bernardi, Guido Castelli Gattinara, Elena Chiappini, Catherine Dollfus, Pierre Frange, Bridget Freyne, Luisa Galli, Vania Giacomet, Galia Grisaru-Soen, Christoph Königs, Hermione Lyall, Magdalena Marczynska, Mariana Mardarescu, Lars Naver, Tim Niehues, Antoni Noguera-Julian, Kim Stol, Alla Volokha, Steven B Welch, Claire Thorne, Alasdair Bamford","doi":"10.1111/hiv.13723","DOIUrl":"https://doi.org/10.1111/hiv.13723","url":null,"abstract":"<p><strong>Objectives: </strong>This survey was conducted to describe current European postnatal prophylaxis (PNP) and infant feeding policies with the aim of informing future harmonized guidelines.</p><p><strong>Methods: </strong>A total of 32 senior clinicians with relevant expertise, working in 20 countries within the European Region, were invited to complete a REDCap questionnaire between July and September 2023.</p><p><strong>Results: </strong>Twenty-three of the 32 invited paediatricians responded, representing 16/20 countries. There were multiple respondents from the same country for Italy (n = 5), the UK (n = 2), Germany (n = 2) and France (n = 2). All countries use risk stratification to guide PNP regimen selection. Nine out of 16 countries reported three risk categories, six out of 16 reported two, and one country reported differences in categorization. Criteria used to stratify risk varied between and within countries. For the lowest risk category, the PNP regimen reported ranged from no PNP to up to four weeks of one drug; the drug of choice reported was zidovudine, apart from one country which reported nevirapine. For the highest risk category, the most common regimen was zidovudine/lamivudine/nevirapine (20/23 respondents); regimen duration varied from two to six weeks with variation in recommended dosing. Guidelines support breastfeeding for infants born to people living with HIV in eight out of 16 countries; in the other eight, guidelines do not support/specify.</p><p><strong>Conclusions: </strong>Guidelines and practice for PNP and infant feeding vary substantially across Europe and within some countries, reflecting the lack of robust evidence. Effort is needed to align policies and practice to reflect up-to-date knowledge to ensure the vertical transmission risk is minimized and unnecessary infant HIV testing and PNP avoided, while simultaneously supporting families to make informed decisions on infant feeding choice.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499445","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}