HIV Medicine最新文献

{"title":"Same-night PrEP in community care: The Nightcafé model for male and transgender sex workers.","authors":"Elena Heizmann, Andrea Farnham, Christian Grolimund, Jorge Flores Real, Paul Halm, Veronika Braig, Hadrien Komaromi, Giulietta Mila Laffers, Jan Fehr, Benjamin Hampel","doi":"10.1111/hiv.70313","DOIUrl":"https://doi.org/10.1111/hiv.70313","url":null,"abstract":"<p><strong>Introduction: </strong>Despite high risk of HIV infection, uptake of pre-exposure prophylaxis (PrEP) remains limited among male and transgender sex workers (MSW and TSW), and data on tailored interventions to improve access are scarce. The Nightcafé programme addresses this gap by offering low-threshold PrEP provision in a community-centred setting. This study assessed the programme's uptake, clinical feasibility and subsequent engagement in PrEP care.</p><p><strong>Methods: </strong>Eligible MSW and TSW visiting the Nightcafé, a social space for sex workers, were offered same-night oral PrEP after a non-reactive HIV rapid test. Follow-ups were scheduled at 4 weeks and then quarterly at Checkpoint Zurich. We described participants' HIV exposure, baseline clinical findings, same-night PrEP provision and participants' stated intention to initiate PrEP and attendance at follow-up care.</p><p><strong>Results: </strong>Between January 2022 and December 2023, 99 participants enrolled in the programme; 57 agreed to share their data for research. Participants demonstrated substantial clinical indications for PrEP: 77% (n = 44) reported inconsistent condom use with a median of 20 sexual partners in the previous 3 months. No baseline clinical findings requiring deferral of PrEP initiation were identified. All expressed intent to initiate PrEP. Among participants not already enrolled in PrEP programmes abroad, 80% (95% CI: 70%-87%, n = 70) completed at least one follow-up. No known subsequent HIV seroconversions occurred.</p><p><strong>Conclusion: </strong>Community-based same-night PrEP provision was clinically feasible and resulted in high initial linkage to facility-based follow-up care among MSW and TSW. Longer-term follow-up and comparative studies are needed to determine whether this model improves sustained retention in PrEP care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109055","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":"Eight-year changes in hepatic steatosis and associated metabolic factors in a Japanese cohort of people with HIV.","authors":"Masayuki Murata, Yuji Matsumoto, Koji Takayama, Sho Yamasaki, Ken Yamamoto, Kosaku Sasaki","doi":"10.1111/hiv.70312","DOIUrl":"https://doi.org/10.1111/hiv.70312","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatic steatosis is an increasingly important liver-related comorbidity among people with HIV. We evaluated longitudinal changes in hepatic steatosis over 8 years and the associated clinical factors in a single-centre Japanese cohort of people with HIV.</p><p><strong>Methods: </strong>This single-centre retrospective cohort study included 94 people with HIV who underwent paired FibroScan assessments a median of 8.18 years apart. Hepatic steatosis was defined as a controlled attenuation parameter (CAP) ≥238 dB/m, with incident steatosis defined as CAP < 238 dB/m at baseline and CAP ≥238 dB/m at follow-up. Factors associated with incident steatosis and follow-up CAP were assessed using Firth's penalized logistic regression and an analysis of covariance (ANCOVA)-type multivariable linear model, respectively.</p><p><strong>Results: </strong>Median CAP increased from 232 to 282 dB/m (p < 0.001), while the prevalence of hepatic steatosis increased from 45/94 (48%) to 63/94 (67%) (p = 0.001). Of 49 participants without baseline steatosis, 24 (49%) developed incident steatosis. After adjustment for baseline CAP, greater percentage weight gain, higher baseline body mass index and triglycerides ≥200 mg/dL at follow-up were each associated with higher follow-up CAP, whereas tenofovir alafenamide (TAF) exposure during follow-up was not. Median liver stiffness measurement (LSM) did not change significantly.</p><p><strong>Conclusions: </strong>CAP values and the prevalence of hepatic steatosis increased over 8 years in this single-centre Japanese cohort of people with HIV. Greater weight gain and metabolic abnormalities were associated with higher CAP at follow-up. These observational findings suggest that monitoring body weight, metabolic parameters, hepatic steatosis and liver stiffness may be useful in long-term HIV care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080693","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-associated nephropathy: A decade of clinical outcomes, global disparities and emerging promise.","authors":"Deepak V Pathiyil, Nicola Wearne, Brendon Price, Frank Post, Dami A Collier","doi":"10.1111/hiv.70315","DOIUrl":"https://doi.org/10.1111/hiv.70315","url":null,"abstract":"<p><strong>Objective: </strong>To review the pathogenesis, epidemiology, clinical presentation, management and outcomes of HIV-associated nephropathy (HIVAN), with emphasis on global disparities, genetic susceptibility (APOL1) and emerging therapeutic and technological advances.</p><p><strong>Design: </strong>Narrative literature review synthesizing contemporary evidence from clinical cohorts, translational research and guideline-based practice, with comparative perspectives from high-resource (UK) and low-resource (sub-Saharan Africa) settings.</p><p><strong>Methods: </strong>Relevant studies were analysed to evaluate mechanisms of disease, epidemiological trends, diagnostic approaches, treatment strategies and long-term outcomes. Particular focus was placed on APOL1-associated risk, antiretroviral therapy (ART) impact and recent developments including artificial intelligence (AI) applications and targeted therapies.</p><p><strong>Results: </strong>HIVAN arises from direct HIV infection of renal epithelial cells in genetically susceptible individuals, particularly those with APOL1 risk variants. ART has significantly reduced incidence in high-income settings, whereas HIVAN remains prevalent in sub-Saharan Africa due to delayed diagnosis and limited healthcare access. Clinically, HIVAN presents with proteinuria and progressive kidney dysfunction, requiring biopsy for confirmation. Early ART initiation improves renal outcomes, supported by adjunctive therapies such as renin-angiotensin system blockade and SGLT2 inhibitors. Emerging therapies targeting APOL1 and advances in AI-driven risk prediction and diagnostics show promise.</p><p><strong>Conclusions: </strong>HIVAN reflects an interplay between viral, genetic and socio-economic factors. While ART has transformed outcomes in well-resourced settings, significant global disparities persist. Future progress depends on improving HIV care access, expanding renal services and advancing precision medicine approaches, including APOL1-targeted therapies and AI-enabled risk stratification.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074625","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":"Stability of the HIV cascade of care throughout the COVID-19 pandemic in Europe: Results from the multinational EuroSIDA cohort study (2016-2022).","authors":"Olga Fursa, Wendy Bannister, Giovanni Guaraldi, Justyna Kowalska, Jose M Miro, Robert Zangerle, David Jilich, Jean-Paul Viard, Katharina Kusejko, Piotr Nowak, Pere Domingo, Claire Mackintosh, Antonella Castagna, Thomas Benfield, Bartosz Szetela, Johannes Bogner, Marta Boffito, Lars Peters","doi":"10.1111/hiv.70305","DOIUrl":"https://doi.org/10.1111/hiv.70305","url":null,"abstract":"<p><strong>Background: </strong>Prior to the COVID-19 pandemic, antiretroviral therapy (ART) coverage and viral suppression were improving across Europe; however, the impact of the pandemic on HIV care remains uncertain.</p><p><strong>Methods: </strong>In-person visits, ART coverage and viral suppression among those on ART were described in the EuroSIDA cohort for each calendar year from 2016 to 2022 and compared across five European regions. Multivariable logistic regression was used to assess factors associated with having an in-person visit and with viral suppression.</p><p><strong>Results: </strong>Among 6740 participants, 71.9% were men, 34.9% were MSM, and the median age was 50 years (IQR: 42-56) at baseline (2016). The proportion of in-person visits dropped from 75.0% in 2019 to 67.8% in 2020, increased to 74.5% in 2021 and was 72.3% in 2022. We observed a consistent increase in ART uptake over the years and a slight increase in missing HIV-RNA data in 2020. The odds of attending clinic in person were lower in 2020 compared with 2016 (aOR: 0.81, 95% CI 0.75-0.87) but not in 2021 or 2022, while viral suppression increased over calendar time (p < 0.0001). Compared to Central-Western Europe, the other regions had lower odds of in-person visits (p < 0.0001, most prominently for Southern Europe, aOR: 0.18) and viral suppression (p < 0.0001, most prominently for Eastern Europe, aOR: 0.07).</p><p><strong>Conclusions: </strong>Our study confirmed the resilience of HIV care across Europe during the COVID-19 pandemic, whereas the regional and country differences in clinic attendance and viral suppression highlighted the need to address persisting gaps in HIV care on a national level.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074571","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":"Late HIV diagnosis: An application of flexible Bayesian approaches to understand associated factors and time to diagnosis in Ireland, 2015-2024.","authors":"Cian Dowling-Cullen, Katie O'Brien, Kate O'Donnell, Mary Archibald, Phil Downes, David Field, Caroline Hurley, Fiona Lyons, Eavan Muldoon, Peter Barrett, Cathal Walsh, Derval Igoe","doi":"10.1111/hiv.70311","DOIUrl":"https://doi.org/10.1111/hiv.70311","url":null,"abstract":"<p><strong>Objectives: </strong>Late HIV diagnosis is associated with increased morbidity, mortality and onward transmission. The proportion diagnosed late reflects the combined effects of testing delays, incidence and migration, complicating its interpretation. We analysed national HIV surveillance data for Ireland (2015-2024) to understand the factors associated with late HIV diagnosis and testing delays.</p><p><strong>Methods: </strong>We estimated prevalence ratios (PRs) for late diagnosis among new diagnoses using Bayesian logistic regression with marginal standardization. We investigated testing delays by estimating infection times and modelling truncation-adjusted delay distributions with Bayesian lognormal regression. We conducted several sensitivity analyses for the main findings.</p><p><strong>Results: </strong>Among 1551 included new HIV diagnoses with available information, 684 (44.1%) were late. This proportion exceeded 50% in several subgroups, including people aged over 50 years, people whose probable mode of transmission was heterosexual contact, and people born in sub-Saharan Africa. Increasing age (adjusted PR per decade 1.20; 95% credible interval [CrI] 1.15-1.26) and heterosexual transmission (adjusted PR for heterosexual men vs. sex between men 1.43; 95% CrI 1.23-1.67) were associated with late diagnosis in both univariable and multivariable models. For in-Ireland infections, median time from infection to diagnosis was estimated at 1.94 years (95% CrI 1.36-3.40), though this was particularly sensitive to modelling assumptions assessed in our sensitivity analyses, and the multivariable findings suggested longer time to diagnosis for men with heterosexual transmission in particular. For pre-migration infections, median time from arrival to diagnosis was estimated at 0.60 years (95% CrI 0.47-0.83), and an estimated 50.5% of those diagnosed to date were late.</p><p><strong>Conclusion: </strong>Late HIV diagnosis represents a significant challenge. Estimating time-to-diagnosis distributions may help separate the influence of testing delays from incidence and migration. The burden demonstrated across multiple groups highlights the need for normalization and expansion of HIV testing within and beyond traditional risk groups.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038414","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":"Real-world use and effectiveness of fostemsavir in a US clinical setting: Insights from Trio Health HIV Research Network.","authors":"Richard Elion, Cassidy Henegar, Isobel McEwen, Andrew Frick, Moti Ramgopal, Steven Santiago, Karam Mounzer, Gregory Huhn, Charles Walworth, Leigh Ragone, Vani Vannappagari","doi":"10.1111/hiv.70303","DOIUrl":"https://doi.org/10.1111/hiv.70303","url":null,"abstract":"<p><strong>Objective: </strong>To describe real-world patterns of use, virologic and immunologic outcomes and treatment persistence among people with HIV (PWH) initiating fostemsavir (FTR) in a diverse US cohort.</p><p><strong>Design: </strong>Retrospective cohort study of adults receiving FTR in clinical practice, stratified by baseline viral suppression status.</p><p><strong>Methods: </strong>Adults with ≥1 FTR prescription between July 2020 and August 2023 were included and followed for 12 months. Individuals with trial participation were excluded. Outcomes included virologic suppression (<50 and <200 copies/mL), confirmed virologic failure, viral blips, CD4 changes and immunologic recovery among those with baseline CD4 <350 cells/mm³. Persistence and adherence were assessed using dispensing data and proportion of days covered.</p><p><strong>Results: </strong>Seventy-seven PWH were included (60% viremic, 40% suppressed). Multidrug resistance was observed in a subset (31%). At 12 months, most individuals remained on FTR, with high adherence among the subset with available dispensing data. Among viremic initiators, a minority achieved viral suppression, though reductions in viral load were observed. Among suppressed initiators, most maintained suppression. CD4 counts increased in both subgroups, with greater gains among those suppressed at initiation. Modifications to optimized background therapy were infrequent.</p><p><strong>Conclusions: </strong>In this real-world, diverse cohort, FTR was well tolerated, with high persistence and, in the dispensing-data subset, high adherence. It effectively maintained viral suppression among suppressed individuals and provided immunologic benefits across subgroups, including viremic initiators. These findings support FTR as a valuable treatment option for heavily treatment-experienced PWH.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016791","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":"Quality of life among older adults with HIV after switching to bictegravir-based three-drug or dolutegravir-based two-drug regimens.","authors":"Fátima Brañas, M José Galindo, Miguel Torralba, Antonio Antela, María Luisa Montes, M Jesús Bustinduy, Noemí Cabello, Alfonso Cabello, Margarita Ramírez, Pablo Ryan, Iñigo Bustingorri, Isabel Machuca, Matilde Sánchez-Conde","doi":"10.1111/hiv.70310","DOIUrl":"https://doi.org/10.1111/hiv.70310","url":null,"abstract":"<p><strong>Background: </strong>Data on adults aged ≥60 years with HIV remain limited, despite their increasing representation in clinical practice. We evaluated whether age ≥60 years was associated with reasons for treatment switch, quality of life (QoL) and clinical outcomes among adults with HIV switching antiretroviral therapy in routine care.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of prospectively collected data from a real-world cohort established in 2018, including adults with HIV aged ≥50 years who switched to bictegravir-based three-drug regimens (BIC 3DR) or dolutegravir-based two-drug regimens (DTG 2DR). Participants were stratified by age (≥60 vs. <60 years). Outcomes included reasons for treatment switch, incident comorbidity and self-reported QoL. QoL was analysed as both ordinal and dichotomous (favourable vs. non-favourable). Multivariable analyses were adjusted for treatment strategy, sex and HIV acquisition route.</p><p><strong>Results: </strong>The distribution of reasons for treatment switch differed by age within the DTG 2DR group (p = 0.005), but not within the BIC 3DR group. In the DTG 2DR group, toxicity or adverse events accounted for 5.6% of switches among participants aged <60 years and 21.7% among those aged ≥60 years (p = 0.008), with a significant age-group-by-treatment-strategy interaction (p = 0.001). Age ≥60 years was independently associated with higher odds of favourable QoL (adjusted odds ratio [OR] 2.88, 95% confidence interval [CI] 1.15-7.24), with no interaction by treatment. No significant differences were observed in incident hypertension, type 2 diabetes mellitus or dyslipidemia in time-to-event analyses.</p><p><strong>Conclusions: </strong>Among adults with HIV switching antiretroviral therapy, age ≥60 years was associated with differences in the distribution of reasons for treatment switch and with better perceived QoL, but not with differences in clinical outcomes.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989957","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":"Clinical management of pregnancy, delivery and breastfeeding in women living with HIV in Italy: A survey of participating infectious diseases centres.","authors":"Daniela Piacentini, Lavinia Cosimi, Antonella Castagna, Annamaria Cattelan, Andrea Antinori, Vincenzo Esposito, Nicoletta Frattini, Vania Giacomet, Giuseppina Giupponi, Sergio Lo Caputo, Paolo Meli, Cristina Mussini, Giuseppe Nunnari, Saverio G Parisi, Stefano Rusconi, Massimiliano Lanzafame","doi":"10.1111/hiv.70308","DOIUrl":"https://doi.org/10.1111/hiv.70308","url":null,"abstract":"<p><strong>Introduction: </strong>Management of pregnancy in women living with HIV is evolving in high-income settings, with increasing attention to infant feeding under sustained virological suppression. Real-world data from Europe remain limited. This study aimed to describe self-reported organizational models and routine approaches to clinical care in participating Italian infectious diseases centres.</p><p><strong>Methods: </strong>An online survey was conducted among Italian infectious diseases centres via the Italian Cohort of Antiretroviral-Naïve Patients (ICAR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) networks. The questionnaire explored organizational models, ART management, delivery, neonatal prophylaxis and breastfeeding. Data were analysed descriptively.</p><p><strong>Results: </strong>Forty-one centres from 15 regions participated, reporting approximately 300 women living with HIV pregnancies in 2024. Most centres (78.0%) had local pregnancy protocols, typically involving multidisciplinary teams. Reported practices varied across several aspects of care, including ART management during pregnancy, obstetric follow-up, mode of delivery and neonatal prophylaxis. Elective caesarean section (CS) was recommended irrespective of virological status in 9.8% of centres; routine intrapartum intravenous zidovudine was reported in 17.1%. Neonatal zidovudine prophylaxis was used by 90.2% of centres (duration: 2-6 weeks). Requests for breastfeeding were reported by 53.7% of centres; eight centres supported breastfeeding under strict clinical conditions, involving 36 women.</p><p><strong>Conclusions: </strong>This survey highlights substantial heterogeneity in self-reported organizational models and reported practices among participating Italian infectious diseases centres caring for pregnant women living with HIV. Although direct clinical experience with supported breastfeeding remains limited, the findings support the development of harmonized, evidence-based guidance to promote equitable multidisciplinary care and informed shared decision-making and provide a framework for greater consistency in pregnancy and infant feeding management.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967921","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":"Association of delayed ART initiation with mortality according to documented concurrent clinical conditions in adults with HIV: A multicentre cohort study.","authors":"Qianning Liu, Ying Luo, Qingsong Shan, Daqing Zhu, Shifei Wen, Lilan Tu, Chengcheng Gong, Yan Yin, Leyao Zhang, Guihua Yang, Cuihua Fu, Huanxin Xu, Jiuyun Luo, Chengyun Yang, Shuhua Zhang, Jiehui Yuan, Jingwen Xiao, Shijie Zou, Shuqiang Ou, Xueping Tao, Yong Deng, Wei Zou","doi":"10.1111/hiv.70307","DOIUrl":"https://doi.org/10.1111/hiv.70307","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether the association between delayed antiretroviral therapy (ART) initiation and all-cause mortality differs according to documented concurrent clinical conditions at presentation in adults with HIV.</p><p><strong>Methods: </strong>We conducted a multicentre retrospective cohort study of 1826 treatment-naive adults with HIV in Jiangxi Province, China (2004-2024), linking clinical and surveillance records. Time zero was defined as ART initiation. The exposure was a delay of >30 versus ≤30 days from diagnosis; the outcome was all-cause mortality. Presenting risk was defined a priori from conditions documented by ART initiation (documented condition, none documented or untested/unknown). We fitted subgroup-specific Cox models and a full-sample interaction model. Multiple imputation was a co-primary approach for missing baseline HIV-RNA.</p><p><strong>Results: </strong>Overall, 142 participants (7.8%) died. A delay of >30 days was not associated with mortality overall (adjusted hazard ratio [aHR] 1.05, 95% confidence interval [CI] 0.83-1.33; p = 0.70). Among participants with documented concurrent conditions (n = 450), a delay of >30 days was associated with approximately two-fold higher mortality under multiple imputation (aHR 2.07, 95% CI 1.06-4.02; p = 0.033; 48-week cumulative mortality 12.1% vs. 6.2%); no association was seen without documented conditions (aHR 0.87, 95% CI 0.55-1.39). The interaction was borderline under multiple imputation (p = 0.064; fraction of missing information 0.04).</p><p><strong>Conclusions: </strong>Documented clinical complexity at presentation may identify a subgroup in whom prolonged ART delay is less well tolerated. These hypothesis-generating findings warrant external validation.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963433","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":"Venezuelan migrants living with HIV in Barcelona: Migration patterns and baseline immunovirological characteristics in a retrospective cohort study.","authors":"Alexy Inciarte, Elizabeth Zamora-Clemente, Leire Berrocal, Ana González-Cordón, Lorena De La Mora, María Martínez-Rebollar, Montserrat Laguno, Juan Ambrosioni, Iván Chivite, Elisa de Lazzari, Alberto Foncillas, Júlia Calvo, Abiu Sempere, Esteban Martínez, José M Miró, José Luis Blanco, Berta Torres, Josep Mallolas","doi":"10.1111/hiv.70300","DOIUrl":"https://doi.org/10.1111/hiv.70300","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the sociodemographic characteristics, migration patterns and immunovirological outcomes of Venezuelan migrants living with HIV (PLWH) in Barcelona, Spain, and to compare them with other Latin American (LA) migrant PLWH.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study including LA migrant PLWH who attended their first consultation at the HIV Unit of Hospital Clínic de Barcelona between 2000 and 2023. Venezuelan PLWH were compared with other LA migrant PLWH regarding demographics, HIV diagnosis timing, CD4 cell count, viral load, late HIV diagnosis (LHD) and advanced HIV disease (AHD).</p><p><strong>Results: </strong>A total of 493 Venezuelan PLWH were included, representing 16% of LA migrant PLWH in the cohort. Venezuelan PLWH were predominantly men (97%; n = 478). Most first consultations occurred after 2014 (81%; n = 399), peaking in 2018. Half were diagnosed with HIV after arrival in Spain (50%; 224/451), and 73% (328/451) had lived in Spain for less than 3 years. Among ART-naïve individuals, LHD was 38% in 2000-2008 and 53% in 2015-2023, while baseline CD4 counts progressively declined. Immunological outcomes were similar between Venezuelan and other LA migrants, including LHD (50%; n = 98 vs. 51%; n = 622) and AHD (24%; n = 48 vs. 25%; n = 301). However, ART-experienced Venezuelan PLWH showed lower virological suppression rates (67%; n = 191 vs. 72%; n = 1013; p = 0.068).</p><p><strong>Conclusion: </strong>Venezuelan PLWH in this Barcelona cohort represent a rapidly growing migrant population shaped by humanitarian displacement and disruption of HIV care. The high proportion of LHD and lower virological suppression among ART-experienced individuals is compatible with continuity-of-care disruptions before migration but do not establish causality.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944786","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}