HIV Medicine最新文献

{"title":"Mpox clinical outcomes among people living with HIV and PrEP users: Findings from the MASH-1 multicentre cohort study","authors":"Nicolo Girometti,&nbsp;Andrew Hill,&nbsp;Bryony Simmons,&nbsp;Ruth Byrne,&nbsp;José Luis Blanco,&nbsp;Vicente Estrada,&nbsp;Jade Ghosn,&nbsp;Adrian Curran,&nbsp;Justyna Kowalska,&nbsp;Toni Sobande,&nbsp;Esteban Martinez,&nbsp;the MASH-1 study group","doi":"10.1111/hiv.70283","DOIUrl":"10.1111/hiv.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical outcomes of mpox (clade IIb) among people living with HIV (PWH) require clarification, particularly the role of immune status in determining disease severity. This multicentre study assessed differences in mpox clinical outcomes and hospitalization between PWH and PrEP users across European clinical settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals with PCR-confirmed mpox attending sexual health/HIV and infectious diseases services in 11 European countries between May 2022–December 2023 were included. Comparisons between PWH versus PrEP users were made using Chi-square tests for categorical variables and <i>t</i>-tests for continuous variables; adjusted analyses accounting for study site used mixed-effects logistic and Cox regression models. Univariable and multivariable models assessed key predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proportion of clinic attendees with mpox ranged from 0.34%–3.07% across sites (946 PWH, 1054 PrEP users). Overall, 745/1989 (37%) individuals experienced at least one mpox-related clinical complication. Median time to lesion resolution was 18 days (IQR 13–23). No deaths occurred. In unadjusted analysis, hospitalization was more frequent among PWH (57/946, 6% vs. 38/1054, 4%; <i>p</i> = 0.011), but this difference was not significant after site-adjustment (<i>p</i> = 0.389). Despite low numbers, among PWH with recent CD4 measurements, CD4 &lt; 200/mm³ was associated with significantly increased hospitalization (36% vs. 4%; <i>p</i> = 0.003). Immunosuppression was linked to hospitalization (aOR 3.00, 95% CI 1.03–8.78).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Mpox clinical outcomes were generally favourable in both PWH and PrEP users with adequate immune function. Severe immunosuppression, rather than HIV status per se, was associated with hospitalization risk. These findings support prioritized clinical monitoring for individuals with advanced immunodeficiency and highlight the importance of immune status assessment in mpox management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1617-1628"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390593","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":"UltRaSoUnd-guided evaLuAtion of metabolic health in a cohort of midlife women with HIV: The URSULA study","authors":"Mariacristina Poliseno,&nbsp;Davide Capruzzi,&nbsp;Antonio Cianciaruso,&nbsp;Nicola Colavito,&nbsp;Felicia Dalitto,&nbsp;Vincenzo Giliberti,&nbsp;Vittoria Lobalsamo,&nbsp;Giuliana Metrangolo,&nbsp;Marica Noviello,&nbsp;Alessandra Vigna,&nbsp;Maurizio Zarcone,&nbsp;Francesco Di Gennaro,&nbsp;Vincenzo Ostilio Palmieri,&nbsp;Annalisa Saracino","doi":"10.1111/hiv.70290","DOIUrl":"10.1111/hiv.70290","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to determine the prevalence of metabolic disorders, liver steatosis and metabolic dysfunction-associated steatotic liver disease (MASLD) in a cohort of middle-aged women with HIV (WoWH) and to explore associations between liver steatosis, visceral fat depots and carotid atherosclerosis. We also assessed the contribution of lifestyle, HIV- and antiretroviral therapy (ART)-related factors to liver steatosis and the accuracy of United States National Cholesterol Education Program/Adult Treatment Panel III (NCEP–ATP III) criteria in identifying at-risk patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 1 April and 31 July 2025, all ART-experienced WoWH aged ≥40 years received comprehensive metabolic and laboratory assessment, including abdominal and carotid Doppler ultrasound (US). Visceral fat depots were evaluated, and metabolic syndrome (MetS) was defined according to NCEP–ATP III criteria. Demographic, clinical and immunovirological data were collected. Logistic regression analyses identified factors associated with liver steatosis. Spearman correlations assessed associations between steatosis and fat distribution, and receiver operating characteristic (ROC) curves evaluated NCEP–ATP III accuracy in identifying liver steatosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 98 WoWH, 55 (56%) had at least grade I liver steatosis, 24 (25%) had MetS. Overall, MASLD was diagnosed in 41 participants (76%). Slight carotid intima-media thickness (cIMT) increases were observed, and 35 participants (36%) had carotid plaques. MetS was the main risk factor for steatosis (OR 14.14, 95% C.I. 3.23–84.40, <i>p</i> = 0.001), with no HIV- or ART-related associations. Progressive liver steatosis correlated with increasing retroperitoneal (rho = 0.393; <i>p</i> = 0.0001), subcutaneous (rho = 0.277; <i>p</i> = 0.005) and epicardial fat (rho = 0.312; <i>p</i> = 0.002) thickness. Conversely, epicardial fat thickness was not linked to cIMT. NCEP–ATP III criteria showed limited accuracy (AUC = 0.67) in identifying patients at risk for liver steatosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the URSULA cohort, hepatic steatosis—largely driven by MetS—was highly prevalent and associated with abnormal visceral fat depots. US may offer a cost-effective tool for fast metabolic surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1650-1662"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602506","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":"A scoping review of the acceptability, feasibility and effectiveness of opt-out blood-borne virus (BBV) testing in secondary healthcare settings, in the UK and similar settings, using APEASE criteria","authors":"Becky Metcalfe,&nbsp;Karen J. Maxwell,&nbsp;Kirsten Trayner,&nbsp;Max Wilkinson,&nbsp;Sharon Hutchinson,&nbsp;Claudia Estcourt,&nbsp;Alison J. Rodger","doi":"10.1111/hiv.70284","DOIUrl":"10.1111/hiv.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Earlier diagnosis of blood-borne viruses (BBVs)—HIV, hepatitis B (HBV) and hepatitis C (HCV)—remains a significant public-health focus. Opt-out testing in secondary healthcare settings can improve early diagnosis and linkage to care as part of BBV transmission elimination targets. This scoping review used APEASE criteria (acceptability, practicability, effectiveness, affordability, side-effects and equity) to evaluate opt-out BBV testing interventions in emergency departments (EDs) and medical assessment units (MAUs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of three databases was conducted for peer-reviewed literature up to 30th June 2025. Inclusion criteria were: (a) opt-out BBV testing intervention; (b) taking place within a secondary care setting; and (c) in the UK, Ireland, Australia and Canada. Data were extracted and analysed using APEASE criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight studies met inclusion criteria. Opt-out testing was acceptable to patients and healthcare professionals, particularly when supported by clear communication, staff training and leadership engagement. Practicability varied by setting; barriers included time constraints, unclear responsibilities and logistical challenges. Automation using electronic systems facilitated implementation. Effectiveness was demonstrated through increased testing uptake and case identification, especially in EDs. Minimal evidence exists on affordability and is likely to vary by population prevalence. No significant side effects (unintended outcomes) were reported, and universal testing was associated with reduced stigma. Opt-out testing can improve access to testing for underserved populations, supporting its role in promoting health equity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Opt-out BBV testing in secondary care settings (EDs and MAUs) is a feasible, effective and equitable intervention when supported by appropriate infrastructure and resources. Efforts should focus on optimizing implementation strategies and extending opt-out testing, including to lower-prevalence settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1558-1583"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673674","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":"A multicentre evaluation of cardiovascular risk prediction tools in people living with HIV across England (ECARTH study)","authors":"Ming Jie Lee,&nbsp;Ashley Murray,&nbsp;Colette Smith,&nbsp;Zakee Abdi,&nbsp;Alastair Duncan,&nbsp;Ellen Dwyer,&nbsp;Mark Gompels,&nbsp;Merle Henderson,&nbsp;Margaret Johnson,&nbsp;Frances Lander,&nbsp;Gavin Manmathan,&nbsp;Jonathan Mok,&nbsp;Nnenna Ngwu,&nbsp;Coral Pratt,&nbsp;Iain Reeves,&nbsp;Razan Saman,&nbsp;Alice Sharp,&nbsp;Eleanor Taylor,&nbsp;Jhia Jiat Teh,&nbsp;Richard Stevens,&nbsp;Thomas R. Fanshawe,&nbsp;Jienchi Dorward,&nbsp;Ranjababu Kulasegaram,&nbsp;Anthony S. Wierzbicki","doi":"10.1111/hiv.70282","DOIUrl":"10.1111/hiv.70282","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;It remains unclear which cardiovascular disease (CVD) risk scores are optimized for people living with treated HIV with high rates of viral suppression. We evaluated the performance of commonly used CVD risk scores in a population of primarily well-treated HIV patients in England.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A multi-centre retrospective cohort analysis was performed, including people living with HIV (PLWH) above the age of 40 with no prior major adverse CVD events (MACE), regularly attending 7 HIV clinics in England during 2014. Outcomes were MACE over the following 5 years: myocardial infarction, invasive cardiac procedure e.g. primary angioplasty, cerebrovascular events, new heart failure, and CVD-related death. Clinical outcomes were aligned with the respective risk scores. The following CVD risk models were evaluated: the UK primary-care validated QRISK3, Framingham laboratory and non-laboratory (Office) scores, Data collection on Adverse events of anti-HIV Drugs (D:A:D), Pooled Cohort Equation (PCE), and the World Health Organization (WHO) laboratory and non-laboratory models. Models were scaled for 5-year CVD estimates. We assessed the discrimination and calibration of these 5-year models within our population. Multiple imputation was used to address missing data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of 2582 people, 94 had at least one MACE documented during follow-up. All seven scores demonstrated moderate discrimination. QRISK3 demonstrated the best calibration in this cohort with an O:E ratio of 1.169, 95% CI 0.950, 1.439, mean calibration-in-the-large (CITL) value of 0.156 (95% CI −0.052, 0.364) and slope of 0.897 (0.682, 1.113). Framingham Office generally overpredicted risk, while WHO scores and D:A:D generally underpredicted risk. Imputing for missing data yielded results similar to the complete case analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;CVD risk scores demonstrated moderate performance in a well-treated PLWH cohort. Our findings emphasize the need to calibrate each CVD risk score to the local population to guide prioritization of clinical resources for CVD prevention.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Evidence in Context&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Evidence before this study: We systematically searched Medline, Embase, and Cochrane Library database from January 1995 to August 2023, using the following terms ‘HIV/AIDS and Cardiovascular Disease (CVD) outcomes’, with an ","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1629-1641"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535727","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":"Menopause and comorbidity assessment in cisgender women living with HIV in Victoria: A clinic record review of women seen at three tertiary centres in Melbourne, Australia","authors":"Anna B. Pierce,&nbsp;Sushena Krishnaswamy,&nbsp;Philip Rawson-Harris,&nbsp;Wajeeha Fatima,&nbsp;Melanie Bissessor,&nbsp;Jennifer F. Hoy","doi":"10.1111/hiv.70281","DOIUrl":"10.1111/hiv.70281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Data on women ageing with HIV in Australia are limited, particularly regarding those in midlife and experiencing menopause. The aim of this study is to describe the demographic characteristics of cisgender women living with HIV who attend the Alfred Hospital, Monash Medical Centre and Melbourne Sexual Health Centre for primary HIV care. In particular, we sought to identify whether documentation of menopausal status, menopausal symptoms, use of menopausal hormone therapy (MHT) and comorbidity screening had occurred in these women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cisgender women currently in care (defined as attending the clinic between 1/7/2022 and 1/7/2024) were identified and a medical record review was conducted to identify demographic information, menopausal status, menopausal symptoms, use of MHT and documentation of related comorbidity screening results (cervical screening test [CST], mammogram, fracture risk (FRAX), bone density (DEXA), cardiovascular disease [CVD] risk).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 462 women were identified across the three sites. Median age was 47 years (range 20–85, interquartile range [IQR] 39–56) and the majority (342, 70%) were born overseas. Of these, 148 (32%) were pre-menopausal, 47 (10%) perimenopausal and 145 (31%) post-menopausal. Menopausal status was unable to be determined from clinical records for 122 (26%). Menopausal symptoms were documented for 70 women (age range 38–85, IQR 48–57). Cervical screening was completed in the last 3 years for 293 women (66%) aged 25–74 years, 58 (30%) over 50 years had documentation of a mammogram in the last 2 years, 105 (39%) over 45 years had CVD risk calculated and 17 (29%) over 50 years had FRAX calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Approximately half the women in this study were aged 40–56 years, yet menopausal status was unable to be determined for over a quarter of the cohort. Documentation of menstrual or menopausal symptoms was poor and significant gaps were identified in comorbidity screening. Further research is needed to understand the impact of menopause on women living with HIV in Australia. Clinical guidelines need updating to include gender-specific health needs of women living with HIV and to consider the impact of menopause on comorbidity management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1609-1616"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390531","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":"Semaglutide improves MASLD and MASH in people with HIV: The SLIM LIVER study","authors":"Jordan E. Lake,&nbsp;Douglas W. Kitch,&nbsp;Amy Kantor,&nbsp;Rebeca Mayo,&nbsp;Pablo Belaunzaran-Zamudio,&nbsp;Carl J. Fichtenbaum,&nbsp;Todd T. Brown,&nbsp;Kathleen E. Corey,&nbsp;Fred Sattler,&nbsp;Kristine M. Erlandson","doi":"10.1111/hiv.70292","DOIUrl":"10.1111/hiv.70292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We have shown that semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), is a highly effective therapy for metabolic dysfunction-associated steatotic liver disease (MASLD) in people with HIV (PWH). The OWLiver® metabolomics algorithms allow non-invasive MASLD severity staging without liver biopsy, but the use of metabolomic data for disease monitoring with GLP-1RA therapy has not been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>SLIM LIVER (ACTG A5371) was an open-label, phase 2b, single-arm trial of semaglutide in PWH and MASLD (2021–2022). Adult participants who showed clinical response (&gt;2.27 kg weight loss) to semaglutide during the study (<i>N</i> = 36) had their serum analysed for metabolomic profiling by the OWLiver® panel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four weeks of low-dose semaglutide led to significant improvement in MASLD disease severity by serum metabolomic profiling across all MASLD disease severity categories, suggesting histologic improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The OWLiver® metabolomics algorithms can be used to monitor MASLD severity during GLP-1RA therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1710-1714"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602502","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":"Material deprivation and its correlates in treatment-naïve migrants with HIV with rapid access to B/F/TAF at no cost: A sub-study of the ASAP cohort","authors":"Moustafa Laymouna,&nbsp;Kim Engler,&nbsp;David Lessard,&nbsp;Melchior Belin,&nbsp;Serge Vicente,&nbsp;Dominic Chu,&nbsp;Sean Yaphe,&nbsp;Joseph Cox,&nbsp;Nadine Kronfli,&nbsp;Jean-Pierre Routy,&nbsp;Joel Ishak,&nbsp;Alexandra Hamel,&nbsp;Marina Klein,&nbsp;Alexandra de Pokomandy,&nbsp;Cecilia T. Costiniuk,&nbsp;Bertrand Lebouché","doi":"10.1111/hiv.70299","DOIUrl":"10.1111/hiv.70299","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Material deprivation (MD), the inability to afford essentials, is linked with poorer HIV clinical outcomes. In Canada, migrants living with HIV are a growing group, yet little is known about their experience of MD, especially early in treatment. This study examined the prevalence, nature, sociodemographic and clinical correlates and longitudinal changes in MD among migrants living with HIV initiating antiretroviral therapy (ART).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analyses used data from 56 ART-naïve migrants enrolled in the Antiretroviral Speed Access Program (ASAP), a cohort at the McGill University Health Centre, Montreal, Canada receiving access to rapid, no-cost and onsite bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF). MD was assessed at Weeks 4 and 48 using the 17-item Canadian Material Deprivation Index (CMDI), with deprivation defined as checking ≥2 items. Statistical tests included Fisher's exact, Wilcoxon signed-rank, McNemar's exact and correlation coefficients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At Week 4, 48 (85.7%) participants were materially deprived, most commonly reporting inability to cover an unexpected expense (87.5%), afford dental care (73.2%) or buy small gifts (73.2%). Week 4 MD was significantly associated with occupation (<i>p</i> = 0.020) and migration status (<i>p</i> = 0.016). No statistically significant associations were observed between MD and HIV clinical outcomes. Between Weeks 4 and 48, MD scores declined significantly (median: 7.5 to 4.0; <i>p</i> &lt; 0.001), although 67.9% of participants remained deprived.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Associated with occupation and migrant status, MD was highly prevalent and persistent among migrants living with HIV, despite partial improvement over time, underscoring the need for structural supports. Short-term HIV clinical outcomes appeared unaffected, which may reflect access to rapid, no-cost and onsite ART delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1698-1709"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70299","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721223","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":"Outcomes of Kaposi sarcoma in people living with HIV who maintain long-term viral suppression: A prospective case-series","authors":"S. Bacquart,&nbsp;R. Palich,&nbsp;M. Veyri,&nbsp;S. Bregigeon-Ronot,&nbsp;M.-C. Picot,&nbsp;C. Vidal,&nbsp;L. Galicier,&nbsp;S. Choquet,&nbsp;J.-P. Spano,&nbsp;M.-A. Valantin,&nbsp;A. Makinson","doi":"10.1111/hiv.70280","DOIUrl":"10.1111/hiv.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Data on chemotherapeutic efficacy and tolerability for Kaposi Sarcomas (KS) in people living with HIV (PWH) and HIV-virological control are limited. We aimed to describe clinical responses and tolerability of KS therapies in PWH with HIV-aviraemic KS in a prospective cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed all PWH with active KS with an HIV plasma viral load &lt;200 copies/mL for more than 12 months under combination antiretroviral therapy (cART), whose clinical conditions were presented between the 1st of June 2021 and the 2nd of January 2023 to a national French Cancer HIV network panel. Clinicians completed a standardized questionnaire to assess KS history and standardized treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 18 PLHIV (94% male, median age 49 years). The median CD4 count was 614/mm3 and the median CD4/CD8 ratio was 0.8. Fifteen had already experienced relapses of KS. Median follow-up time was 30.1 months (IQR [24 to 34.2]). We observed seven well-controlled PWH with no KS relapse after a median follow-up of 16 months (IQR 9.5 to 22.5), eight well-controlled PWH who experienced KS relapse after a median of 6 months (IQR, 3–12) following chemotherapy, primarily limited to the skin, and two PWH with visceral KS relapse in a context of non-adherence. PWH who relapsed/progressed were older and had a longer duration of HIV virological control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>KS in PWH with virological control respond to chemotherapy, but are prone to relapses, primarily to the skin, and strategies can be limited by past and cumulative toxicities. Older age and longer duration of virological control may negatively impact the probability of KS response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1715-1721"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404495","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":"Psychosocial vulnerabilities and loss to follow-up in people living with HIV in France","authors":"Charlène Mafuta,&nbsp;Sophie Grabar,&nbsp;Laurence Lievre,&nbsp;Cécile Goujard,&nbsp;Jean-Paul Viard,&nbsp;Olivier Bouchaud,&nbsp;Laurence Meyer,&nbsp;Rémonie Seng,&nbsp;Sophie Abgrall","doi":"10.1111/hiv.70293","DOIUrl":"10.1111/hiv.70293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Migration status is consistently associated with a higher risk of loss to follow-up (LTFU). We investigated how sex, sexual orientation and social vulnerabilities affect the association between migration status and LTFU for hospital care in people living with HIV, using data from the ANRS CO9-COPANA cohort linked to the nationwide French hospital database on HIV (ANRS CO4-FHDH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The COPANA prospective cohort enrolled antiretroviral drug-naïve adults newly diagnosed with HIV-1 between 2004 and 2008 in France. LTFU in the hospital setting was defined as no clinical follow-up for ≥24 months before the study end. Fine and Gray models accounting for death as a competing event were used to assess factors associated with LTFU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 616 participants included 333 born in France, 209 born in sub-Saharan Africa and 74 born in other regions. There were 432 male participants, including 281 men who have sex with men (MSM). The cumulative incidence of LTFU was 17% (95% CI: 14–20) at 10 years. Migrant MSM and migrant women had a higher crude risk of LTFU than French-born MSM. After adjustment for several social factors, the risk of LTFU remained higher in migrant MSM. Lack of psychological support and non-disclosure of HIV status to friends were associated with a higher risk of LTFU and had the greatest impact on the difference between crude and adjusted sub-distribution hazard ratios for LTFU in both male and female migrants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The higher risk of LTFU from hospital-based care in migrant MSM and women was attenuated after adjustment for social vulnerabilities, suggesting that these factors contribute to the observed association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1682-1697"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725418","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":"Younger age as a key predictor of follow-up abandonment among PrEP users: A retrospective cohort study in Madrid","authors":"J. Mayoral-Alvarez,&nbsp;R. Fernandez-Ibanez,&nbsp;M. Sánchez-Conde,&nbsp;J. M. Hermida,&nbsp;M. J. Vivancos,&nbsp;R. Ron,&nbsp;J. Martínez-Sanz,&nbsp;S. Serrano-Villar,&nbsp;M. J. Perez-Elias,&nbsp;Santiago Moreno","doi":"10.1111/hiv.70287","DOIUrl":"10.1111/hiv.70287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pre-Exposure Prophylaxis (PrEP) is a cornerstone of HIV prevention, yet its population-level impact is limited by clinical attrition. This study analyses the sociodemographic and behavioural factors associated with follow-up abandonment in a tertiary hospital cohort in Madrid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study (August 2022–July 2025) was conducted involving 665 participants who initiated oral FTC/TDF PrEP (of 693 individuals assessed) at Hospital Universitario Ramón y Cajal. Abandonment was defined as a &gt;90-day lapse in contact beyond the scheduled visit or medication exhaustion. Independent predictors of discontinuation were identified using Cox proportional hazards regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Follow-up abandonment occurred in 21.2% (<i>n</i> = 141) (median age: 36.5 years). Three HIV infections were recorded (3/693; 0.43%), with only one occurring during active use. Multivariate analysis identified younger age as the primary predictor of abandonment, with a 5% risk reduction for every additional year of age (HR 0.95; 95% CI 0.92–0.98; <i>p</i> &lt; 0.001). Prior healthcare engagement, evidenced by HBV immunity (anti-HBs+), was significantly protective against attrition (HR 0.52; 95% CI 0.34–0.80; <i>p</i> = 0.003). Transgender women showed a trend towards higher abandonment (HR 3.11, <i>p</i> = 0.060). Notably, contracting a sexually transmitted infection (STI) during follow-up correlated with higher retention, likely due to increased clinical touchpoints and heightened risk perception.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Younger individuals face the highest risk of PrEP discontinuation despite being the demographic most vulnerable to HIV acquisition. Retention is driven more by structural healthcare integration and age than by individual risk behaviours. To improve persistence, healthcare systems must transition towards flexible, digital and decentralized care models tailored to younger, system-naïve users.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 10","pages":"1642-1649"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591232","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}