HIV Medicine最新文献

{"title":"Weight and mortality in people living with HIV and heart failure: Obesity paradox in the era of glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors","authors":"Natalia Nazarenko, Yi-Yun Chen, Pawel Borkowski, Luca Biavati, Matthew Parker, Coral Vargas-Pena, Ishmum Chowdhury, Joshua Bock, Vibhor Garg, Shivang Bhakta, Maisha Maliha, Dimitrios Raptis, Mandar Kalpesh Shah, Robert Faillace, Leonidas Palaiodimos","doi":"10.1111/hiv.13760","DOIUrl":"10.1111/hiv.13760","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Obesity is a recognized risk factor for heart failure (HF) in people living with HIV. However, among patients with HF, being overweight or having mild to moderate obesity has been associated with significantly improved survival rates compared with those at normal weight—a phenomenon known as the obesity paradox. This paradox has not yet been evaluated in patients with both HIV and HF in the era of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is). Our study aimed to assess the mortality risk associated with body mass index (BMI) in patients with both HIV and HF and evaluate the impact of GLP-1 RAs and SGLT-2is on mortality across different weight categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study analyzed data from the New York City Health + Hospitals Corporation (NYC HHC) cohort (NYC 4H), which included records from 11 major New York City Health + Hospitals facilities. The dataset combined retrospective baseline data with ongoing prospective follow-up. The cohort consisted of adults with confirmed HIV and HF who had inpatient or clinic visits between July 2017 and June 2022. HIV infection and HF were initially identified using relevant <i>International Classification of Diseases and Related Health Problems, 10th Revision</i> codes and were further confirmed through laboratory results and echocardiograms. Medication data were verified through electronic health records and cross-referenced with pharmacy records. The primary outcome was the hazard ratio (HR) of overall mortality across different BMI categories in patients with both HIV and HF, assessed using proportional hazard regression models adjusted for age, sex, race, comorbidities, smoking status, and functional status. Secondary analyses included re-hospitalization within 6 months of discharge and the association between GLP-1 RAs/SGLT-2is and overall mortality in patients with HIV and HF. Additional analyses were conducted to assess the efficacy of these medications within different BMI categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1044 patients were analyzed, including 657 males (62.9%) and 387 females (37.1%), with an average age of 61.6 years at baseline and an average follow-up of 3.8 years. A low BMI (<18.5) was associated with a 57% increase in mortality (HR 1.57; 95% confidence interval [CI] 1.03–2.39; <i>p</i> = 0.04), whereas class I obesity (BMI 30.0–35.9) was associated with a 35% reduction in mortality (HR 0.65; 95% CI 0.42–0.99; <i>p</i> = 0.04) compared with normal BMI, after adjusting for covariates. Class II obesity was associated with a lower rate of re-hospitalization within 6 months of dischar","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"581-591"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413235","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":"The role of atherosclerosis in HIV-associated vasculopathy in young South African stroke patients","authors":"Eitzaz Sadiq,&nbsp;Angela Woodiwiss,&nbsp;Grace Tade,&nbsp;Jeremy Nel,&nbsp;Gavin Norton,&nbsp;Girish Modi","doi":"10.1111/hiv.13764","DOIUrl":"10.1111/hiv.13764","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>HIV-associated vasculopathy is known to cause stroke in people living with HIV (PLWH). The role of atherosclerosis is unclear. We assessed the aetiology of vasculopathy in PLWH and tested the utility of markers of subclinical atherosclerosis to distinguish atherosclerotic (AV) from non-atherosclerotic vasculopathy (NAV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study recruited PLWH with stroke at a hospital in Johannesburg, South Africa, from 2014 to 2017. Patients with meningitis were excluded. Cerebrospinal fluid (CSF) was tested for multi-viral polymerase chain reaction, including varicella zoster virus (VZV). Once an aetiological category was assigned, carotid intima-media thickness (cIMT) and aortic pulse wave velocity (PWV) were compared in AV and NAV, and to predetermined thresholds for subclinical atherosclerosis (cIMT≥0.70 mm, PWV≥10.00 m/s).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Some 28/85 PLWH (32.9%) vs. 9/109 (8.3%, <i>p</i> &lt; 0.0001) people-without-HIV had vasculopathy on computed tomography angiography. Only four PLWH had AV. Compared with NAV (<i>n</i> = 11), those with AV were older (50.0 ± 4.1 vs. 39.2 ± 9.2 years, <i>p</i> = 0.04) and had more cardiovascular risk factors (median 2.0 [IQR 1.5–2.5] vs. 0.0 [IQR 0.0–1.0], <i>p</i> = 0.02). cIMT in AV was higher than in NAV (1.01 ± 0.07 mm [<i>n</i> = 4] vs. 0.63 ± 0.04 mm [<i>n</i> = 9], <i>p</i> &lt; 0.001). All with AV had cIMT and PWV above the predetermined thresholds, while all except one with NAV were below. We found evidence of VZV in eight PLWH and HIV-associated vasculitis in six.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vasculopathy in PLWH in our region appears to be predominantly non-atherosclerotic. cIMT and PWV were useful adjuncts in distinguishing AV from NAV. Despite excluding meningitis, VZV was implicated in a large proportion, emphasizing the likely underdiagnosis of this treatable infection. We thus recommend CSF VZV testing in all PLWH with stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"633-642"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413221","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":"Factors influencing the quality of life and social skills of children living with HIV: A case–control study","authors":"Qiuyi Yang,&nbsp;Jiechao Zhou,&nbsp;Guanghua Lan,&nbsp;Qi Qin,&nbsp;Hongyan Lu,&nbsp;Wei Chen,&nbsp;Jinming Su,&nbsp;Xiaoliang Zeng","doi":"10.1111/hiv.13758","DOIUrl":"10.1111/hiv.13758","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Our objective was to understand the current status of and factors influencing the quality of life and social skills of children living with HIV and to provide a reference for improving medical service management and formulating support policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 183 children aged 7–14 years, living with HIV, and admitted to the Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention from March 2022 to February 2024 were included retrospectively. We used the children's basic information and their scores from the Quality of Life Scale for Children and Adolescents (QLSCA) and Normal Development of Social Skills From Infant to Junior High School Children (S-M scale) to explore their the status of their quality of life and social skills and the factors influencing both.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four factors (life satisfaction, socio-psychological functioning, physical and mental health, and living environment) and QLSCA T-scores in the case group were significantly lower than those in the control group (<i>p</i> &lt; 0.01). S-M scale scores (self-help, locomotion, operation, communication, socialization, self-direction) in the case group were significantly lower than those in the control group (<i>p</i> &lt; 0.001). The main factors affecting the social skills of children living with HIV were side effects from antiretroviral therapy (odds ratio [OR] 7.365, <i>p</i> &lt; 0.003), comorbidities (OR 12.948, <i>p</i> &lt; 0.006), intellectual development (OR 6.045, <i>p</i> &lt; 0.027), and awareness of HIV infection status (OR 0.261, <i>p</i> &lt; 0.014).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Children living with HIV have low quality of life and poor social skills. Clinicians should pay attention to side effects from antiretroviral therapy, comorbidities, children's intellectual development, and their awareness of their HIV infection status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"569-580"},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189247","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":"Commentary on 'Exploring the cascade of mental healthcare among people with HIV experiencing depressive symptoms in the UK and Ireland: The POPPY study'.","authors":"Shubham Kumar, Rachana Mehta, Ranjana Sah, Amogh Verma","doi":"10.1111/hiv.13767","DOIUrl":"https://doi.org/10.1111/hiv.13767","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255632","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":"Impact of HBV serological status on HIV virological efficacy of two-drug antiretroviral regimens: A retrospective observational study on virologically suppressed people with HIV switching to lamivudine/dolutegravir","authors":"Pierluigi Francesco Salvo,&nbsp;Arturo Ciccullo,&nbsp;Elena Visconti,&nbsp;Francesca Lombardi,&nbsp;Carlo Torti,&nbsp;Simona Di Giambenedetto,&nbsp;Gianmaria Baldin","doi":"10.1111/hiv.13765","DOIUrl":"10.1111/hiv.13765","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the HIV virological efficacy of two-drug regimens (2DR) with lamivudine (3TC) and dolutegravir (DTG) in people with HIV (PWH), classified by their hepatitis B virus (HBV) serological status. Specifically, it explored whether isolated anti-hepatitis B core (anti-HBc) positivity impacts virological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study was conducted at Fondazione Policlinico Universitario Agostino Gemelli IRCCS, enrolling 606 virologically suppressed (HIV-RNA &lt; 50 copies/mL) PWH who switched to a 2DR regimen with 3TC/DTG. Participants were categorized into four groups based on their HBV serological status: hepatitis B surface antibody (HBsAb)-positive/hepatitis B core antibody (HBcAb)-positive, HBsAb-negative/HBcAb-negative, HBsAb-positive/HBcAb-negative, and isolated HBcAb positivity. Viral failure (VF) was defined as two consecutive HIV viral loads above 50 copies/mL or a single HIV viral load above 1000 copies/mL, and viral blips (VBs) as a single HIV-RNA measurement between 50 and 200 copies/mL followed by suppression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During 2216.4 patient-years of follow-up (PYFU), we observed 30 VFs (1.3 per 100 PYFU) and 63 VBs (2.9 per 100 PYFU). No statistically significant differences in VF or VB were noted between the serological groups. Additionally, no significant alanine aminotransferase (ALT) flares or HBV-DNA breakthroughs were observed, with HBV-DNA remaining undetectable throughout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study supports the virological efficacy of 3TC/DTG-based 2DR in PWH, regardless of HBV serological status. Isolated anti-HBc positivity did not influence virological outcomes independently. Larger studies are warranted to further investigate HIV–HBV interactions in this context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"650-653"},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189251","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":"Point-of-care nucleic acid testing – a step forward in controlling the HIV epidemic: A review","authors":"Suleyman Sarp Pinar,&nbsp;Mark Manak,&nbsp;Shanmugam Saravanan,&nbsp;Nesrina Imami,&nbsp;Catherine Kibirige","doi":"10.1111/hiv.13757","DOIUrl":"10.1111/hiv.13757","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The HIV/AIDS epidemic, with 85.6 million infections and 40.4 million AIDS-related deaths globally, remains a critical public health challenge. Current diagnostic methods, primarily fourth-generation immunoassays, have limitations due to their long window periods, and most viral load assays require centralized testing protocols that result in delays, especially in remote regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Nucleic Acid Testing</h3>\u0000 \u0000 <p>Point-of-care (POC) nucleic acid amplification testing (NAAT) presents a transformative approach by reducing the window period for detection to one week and significantly shortening turnaround times for viral load monitoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This review highlights the clinical utility of POC NAAT for acute HIV infection diagnosis, its role in timely combination antiretroviral therapy adjustments, and its potential to reduce the basic reproduction number (<i>R</i>₀), a critical threshold for suppressing the epidemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By improving early detection and facilitating faster clinical decisions, POC NAAT enhances the effectiveness of HIV prevention and treatment programmes, particularly in high-risk and remote communities, and supports the global effort to achieve the ambitious UNAIDS 95-95-95 targets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"536-545"},"PeriodicalIF":2.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046679","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 programmatic assessment of dolutegravir adverse events and discontinuations in Uganda","authors":"Eva Agnes Laker Odongpiny,&nbsp;Melanie Nicol,&nbsp;Elizabeth Katana,&nbsp;Joseph Owori,&nbsp;Allan Buzibye,&nbsp;Kay Sedan,&nbsp;Mike Kesby,&nbsp;Matthew Holden,&nbsp;Noela Owarwo,&nbsp;David Meya,&nbsp;Barbara Castelnuovo,&nbsp;Derek J. Sloan,&nbsp;Christine Sekaggya","doi":"10.1111/hiv.13761","DOIUrl":"10.1111/hiv.13761","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;Dolutegravir is now extensively used in sub-Saharan Africa as a preferred component of antiretroviral therapy (ART). There is a paucity of large studies using routinely collected data from African people living with HIV on dolutegravir-based regimens to inform HIV programmes. We reviewed data in a large programme clinic of people living with HIV on dolutegravir to determine the real-world safety and tolerability of dolutegravir and to describe drivers of treatment discontinuation.&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;We carried out a retrospective dynamic cohort analysis of people living with HIV who started on or switched to dolutegravir-based ART at the Infectious Diseases Institute in Kampala, Uganda, between February 2017 and December 2020. Types of adverse events (AEs) were classified according to the Medical Dictionary for Regulatory Activities. Incident rates for AEs and treatment discontinuation were determined using Cox proportional hazard methods.&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 4529 people living with HIV started on or switched to dolutegravir, 2094 (45.9%) were female, and the median age was 49 years (interquartile range [IQR] 41–56). During 8907.93 person-years (PY) of follow-up, 1069 (23.6%; 95% confidence interval [CI] 22.4–24.8) people living with HIV had an AE, at a rate of 10.43 per 1000 PY (95% CI 9.77–11.14). Neuropsychiatric, gastrointestinal, and endocrine AEs were most common. The main AEs driving dolutegravir discontinuation were hyperglycaemia (140/356; 39.3%) and erectile dysfunction (19/356; 5.3%). Only 1.2% (4/356) of the dolutegravir discontinuations were because of neuropsychiatric AEs. Being female (adjusted hazard ratio [aHR] 1.35; 95% CI 1.02–1.78) and previous use of stavudine (aHR 1.46; 95% CI 1.04–2.05) were the main predictors of neuropsychiatric AEs. Risk factors for hyperglycaemia included being overweight (aHR 1.66; 95% CI 1.11–2.47) or obese (aHR 1.84; 95% CI 1.12–3.05), having hypertension (aHR 1.92; 95% CI 1.35–2.73), having diabetes mellitus (aHR 12.6; 95% CI 8.34–19.1), and taking previous ART containing zidovudine (aHR 1.76; 95% CI 1.19–2.59) or stavudine (aHR 1.68; 95% CI 1.15–2.44). These risk factors for hyperglycaemia were also the main drivers of dolutegravir discontinuation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;AEs were common in this African cohort, and dolutegravir discontinuation was driven by hyperglycaemia and erectile dysfunction. Previous use of older ART with known mitochondrial toxicity was associated with neu","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"592-605"},"PeriodicalIF":2.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033101","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":"Health-related quality of life in people with HIV from the multicentre CoRIS cohort in Spain: Associated factors and short-term changes over time","authors":"Rebeca Izquierdo,&nbsp;Inés Suárez-García,&nbsp;Cristina Marco-Sánchez,&nbsp;Leire Pérez-Latorre,&nbsp;Melchor Riera,&nbsp;Joanna Cano,&nbsp;Consuelo Viladés,&nbsp;Sergio Reus,&nbsp;Julián Olalla,&nbsp;Patricia González-Ruano,&nbsp;Eva Orviz,&nbsp;Asunción Díaz,&nbsp;Santiago Moreno,&nbsp;Inma Jarrín,&nbsp;CoRIS cohort","doi":"10.1111/hiv.13762","DOIUrl":"10.1111/hiv.13762","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to describe health-related quality of life (HRQoL), overall and across its dimensions, identify associated factors, and assess changes over time among people with HIV (PWH) from the Spanish multicentre CoRIS cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a mobile app to collect HRQoL data every 3 months using the WHOQOL-HIV-BREF questionnaire (31 items across six domains), among PWH followed in CoRIS in 2021–2023. Factors associated with good/very good global HRQoL and with domain-specific mean scores were identified using multivariable logistic and linear regression, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 414 PWH (94.2% on antiretroviral treatment, 91.1% virally suppressed), 51.2% reported good/very good HRQoL. Latin American migrants (adjusted OR: 0.60 [95% CI: 0.36; 1.00]), and participants with lower educational level (0.36 [0.21; 0.64]), a previous AIDS diagnosis (0.56 [0.29; 1.11]) and a history of non-AIDS-related cancers (0.40 [0.14; 1.14]) were less likely to report good/very good global HRQoL. The most affected items included sexual satisfaction, forgiveness and blame, sleep and rest, and concerns about the future, with spirituality, religion and personal beliefs as the most affected domain. Latin American origin, lower educational level and shorter (&lt;2 years) or longer (&gt;15 years) time since HIV diagnosis were associated with poorer HRQoL in specific domains. No significant changes in HRQoL were observed after 12 months except slightly higher scores in physical health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Only half of PWH reported good/very good global HRQoL. This highlights the need to develop targeted strategies to improve HRQoL among PWH, focusing on addressing the most affected dimensions and supporting the most vulnerable groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"606-620"},"PeriodicalIF":2.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004692","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":"British HIV Association guidelines on the management of opportunistic infection in people living with HIV: The clinical management of non-tuberculous mycobacteria 2024","authors":"M. Nelson,&nbsp;M. Bracchi,&nbsp;E. Hunter,&nbsp;E. Ong,&nbsp;A. Pozniak,&nbsp;C. van Halsema","doi":"10.1111/hiv.13727","DOIUrl":"10.1111/hiv.13727","url":null,"abstract":"<p>A wide spectrum of non-tuberculous mycobacteria (NTM) has been reported as isolates from or causes of disease in people living with human immunodeficiency virus (HIV). This is typically in the context of very advanced immunosuppression (CD4 count &lt;50 cells/mm³) in the absence of virological suppression [<span>1</span>] and most individuals have presented with disseminated disease. Effective antiretroviral therapy (ART) has permitted control of viral replication, improvement in immune function and a significant decrease in the incidence of severe opportunistic infections [<span>2-4</span>], including disseminated <i>Mycobacterium avium</i> complex (DMAC) disease [<span>3, 5, 6</span>].</p><p>NTM are environmental organisms. Therefore it is important to determine, prior to treatment initiation, whether the organism is the cause of the disease process rather than a reflection of colonisation. With the exception of <i>M. avium</i> complex (MAC), there is limited evidence to guide the choice or duration of treatment and expert opinion should be sought from a clinician experienced in managing mycobacterial disease in the context of HIV or, if not available, in the context of immunosuppression or dissemination. Advice should also be sought from microbiologists (for drug susceptibility testing and interpretation), pharmacists or people with expertise and experience of managing mycobacterial disease in people without HIV. Also with the exception of MAC, most of the recommendations for the treatment of NTM have been extrapolated from trials of treatment for NTM pulmonary disease in individuals without HIV, although some evidence from early trials in populations with advanced HIV disease has added to this guidance.</p><p>Guidance on supporting people living with HIV with opportunistic infections, including NTM infections, can be found on the British HIV Association (BHIVA) website (https://www.bhiva.org/file/6225e44b53c49/OI-guidelines-supporting-patients.pdf).</p><p>A full review of these guidelines is due in 2029, with interim updates only if recommendations need updating in line with new data.</p><p>The scope, purpose and guideline topics were agreed by the writing group. The search (population, intervention, comparator and outcome [PICO]) questions were set and an independent systematic literature review performed. The Medline, Embase and Cochrane Library databases were searched and the literature reviewed to address each question. The PICO questions and search strategies are outlined in Appendix 1.</p><p>Further details of the methodology can be found on the BHIVA website (https://www.bhiva.org/file/5d514ec9b503d/OI-guidelines-methods-general.pdf), including the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess and grade the evidence.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 S4","pages":"3-25"},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004695","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":"Breaking down global barriers: A multinational and multi-community approach to combat stigma and enhance mental wellbeing in people with HIV","authors":"Ntombenhle Mkhize,&nbsp;Jorge Garrido,&nbsp;Susan Cole-Haley,&nbsp;Dázon Dixon Diallo,&nbsp;Gabriel Maldonado,&nbsp;Stéphan Vernhes,&nbsp;YoYo Wu,&nbsp;Mario Cascio","doi":"10.1111/hiv.13763","DOIUrl":"10.1111/hiv.13763","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Joint United Nations Programme on HIV/AIDS (UNAIDS) Global 2025 targets prioritize action to overcome the collective barriers affecting the people and communities sitting on the outer margins of HIV care. Addressing the social and structural disparities that drive greater HIV prevalence and burden requires well-resourced, community-led responses that are fully integrated into national and global HIV initiatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The HIV Community Council (HCC), composed of 10 leaders from diverse global communities, convened to share their insights, amplify the community's voice, and identify barriers and solutions to empower all to live well with HIV through a dynamic, stepwise process of preparative work, deep discussion, prioritization, and consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The HCC created six recommendations to address two important barriers to living well with HIV: stigma and poor mental wellbeing. These recommendations are informed by best practice and community experience. They include suggestions for developing and delivering actionable solutions at the community level to prompt opportunities for support from existing global and regional organizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The HCC calls for action to implement community-endorsed, culturally appropriate, and practical solutions to tackle stigma and poor mental wellbeing and improve the long-term health of people with HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 4","pages":"621-632"},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004689","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}