HIV Medicine最新文献

{"title":"Temporal shifts in antiretroviral therapy regimens and metabolic outcomes in people living with HIV: A systematic review and meta-analysis","authors":"Melani Ratih Mahanani, Myo Chit, Sophie Mohr, Elisenda Cama i Gibernau, Svetlana Hetjens, Volker Winkler, Hans-Michael Steffen, Florian Neuhann","doi":"10.1111/hiv.70260","DOIUrl":"10.1111/hiv.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Antiretroviral therapy (ART) for people living with HIV has led to dramatically reduced mortality and improved life expectancy. This achievement is accompanied by a higher risk for metabolic and other non-communicable diseases. The role and contribution of various ART regimens to adverse metabolic outcomes are not fully understood. We aimed to systematically evaluate the risk of metabolic outcomes associated with ART and to describe temporal trends in these risks across the modern ART era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following our prespecified, registered protocol, we conducted a systematic review and meta-analysis of non-randomized observational studies, comparing ART-treated and ART-naïve adult people living with HIV and report the metabolic outcomes of interest. We extracted ART regimen combinations and metabolic outcomes and calculated pooled odds ratios (ORs) with 95% confidence intervals (95% CI) using a random-effects model. Temporal patterns were summarized by publication year and year of ART rollout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 6827 studies, in which 39 studies were eligible for analysis with information from 24 632 people living with HIV. Nucleoside reverse transcriptase inhibitors (NRTIs) were present throughout the review period. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) predominated from the early 2000s to 2014, while protease inhibitors (PIs) dominated 1998–2014. Integrase strand transfer inhibitors (INSTIs) appeared from 2016 onwards. ART-treated adult people living with HIV had higher odds for metabolic syndrome (OR = 2.16, 95% CI = 1.33–3.52), while no statistically significant association was observed for type 2 diabetes mellitus (T2DM) (OR = 1.37, 95% CI = 0.65–2.90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Metabolic burden associated with modern HIV treatment shifted from lipid abnormalities to weight- and glucose-related outcomes. Meta-analysis results showed that ART-treated adults had nearly twice the odds of metabolic syndrome compared with ART-naïve adults. In contrast, our meta-analytic evidence did not demonstrate a statistically significant association between ART use and the odds of developing T2DM. Findings should be interpreted with caution given potential confounding by disease stage, access to healthcare and survivorship bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ART regimens and their met","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1399-1420"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981582","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":"Awareness and early implementation of the European AIDS Clinical Society Guidance on statin use in HIV for the primary prevention of cardiovascular disease: A cross-sectional survey of HIV clinicians in Europe","authors":"Jasmini Alagaratnam,&nbsp;Abiu Sempere,&nbsp;Susanne Dam Nielsen,&nbsp;Esteban Martinez","doi":"10.1111/hiv.70271","DOIUrl":"10.1111/hiv.70271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cardiovascular disease (CVD) is a major comorbidity and leading cause of morbidity and mortality in people with HIV (PWH). The REPRIEVE trial demonstrated that statin therapy significantly reduces cardiovascular events in PWH, prompting updated recommendations from major international societies. We assessed awareness and early implementation of the European AIDS Clinical Society (EACS) statin guidance among HIV clinicians in Europe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted an anonymous cross-sectional online survey among members of the EACS Young Investigators Network Group (YING). The questionnaire evaluated clinician characteristics, reported awareness and implementation of statin guidance, cardiovascular risk assessment practices, prescribing patterns and perceived barriers. Descriptive analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 125 individuals invited to take part in the survey, 22 (18%) physicians from multiple European countries responded. All respondents were aware of the EACS statin guidance, and 91% reported that it influenced clinical practice. Cardiovascular risk was routinely assessed by most clinicians (77% always or often), with HIV physicians primarily responsible for statin prescribing (59%). Structural barriers reported included reimbursement limitations, fragmented care pathways and patient-level barriers, such as low perceived CVD risk and statin hesitancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Awareness of EACS statin guidance among this cohort of HIV clinicians in Europe who are YING members is reported as high, but implementation gaps remain. Addressing structural and patient-level barriers and improving guideline implementation will be essential to optimize CVD prevention in PWH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1537-1547"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271284","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":"Preference for different PrEP formulations: A cross-sectional study in a PrEP cohort in Spain","authors":"Alfredo Soler-Carracedo,&nbsp;Allison R. Webel,&nbsp;Luis Ramos-Ruperto,&nbsp;Rafael Mican-Rivera,&nbsp;Rocio Montejano-Sanchez,&nbsp;Ana Milinkovic,&nbsp;Stephanie A. Ruderman,&nbsp;Joseph P. De Santis,&nbsp;Jose I. Bernardino","doi":"10.1111/hiv.70252","DOIUrl":"10.1111/hiv.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To gain a better understanding of PrEP-users' preference for long-acting vs. oral PrEP formulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From April 2023 to January 2024, participants who were prescribed PrEP completed an anonymous, structured, self-administered, cross-sectional survey as part of their routine PrEP care in a hospital setting in Madrid, Spain. Inclusion criteria were attendance at the clinic for PrEP care and the ability to understand the Spanish language. Eligibility was not restricted by age. A convenience sample of 200 participants was used. The ethics committee approved a waiver of written consent. Descriptive statistics and chi-square tests were used to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A sample of 201 participants completed the survey, of which 193 (96.5%) were male and most were 30–39 years old (48.8%). The response rate was estimated to be more than 90%. Among participants, 74.9% preferred LA-PrEP (53.9% preferred a subcutaneous (SC) injection every 6 months and 21.0% preferred an intramuscular (IM) injection every 2 months). Participants reported that LA-PrEP is more practical, indicating fewer visits to the clinic as a primary reason (67.4%). 29.4% of participants were aware of IM LA-PrEP, 10.0% of SC LA-PrEP and 10.4% were familiar with both. Respondents who selected LA-PrEP were more often under 40 years of age (<i>p</i> = 0.016) compared to those who preferred oral PrEP (73.7% vs. 61.2%, respectively). Limitations included the use of a cross-sectional design, a homogeneous sample and the use of one study location, among others.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LA-PrEP is the preferred form of PrEP for the majority of respondents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1530-1536"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837037","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":"History of sexually transmitted infections among mpox cases in the 2022 outbreak in Spain","authors":"Aina March-Yagüe,&nbsp;Diana Toledo,&nbsp;Asunción Díaz,&nbsp;Pere Godoy,&nbsp;Olaia Pérez-Martínez,&nbsp;Carles Pericas,&nbsp;Alonso Sanchez-Migallon,&nbsp;María Dolores Chirlaque,&nbsp;Jesús Ospina,&nbsp;María Grau,&nbsp;Francisco Roig,&nbsp;Angela Domínguez,&nbsp;and the MONKPOX-ESP22 Subproject 3.2 Working Group","doi":"10.1111/hiv.70270","DOIUrl":"10.1111/hiv.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim was to describe the history of sexually transmitted infections (STIs) among adult mpox men cases and to analyse sociodemographic and epidemiological characteristics according to the presence or absence of any STI diagnosed 1 or 6 months previous to mpox diagnosis during the 2022 outbreak in Spain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted as part of a multicentre study in seven Spanish regions. Mpox patients were enrolled by the epidemiological surveillance services from June 2022 to January 2023. We conducted descriptive and bivariate analyses to compare sociodemographic, epidemiological and clinical characteristics of mpox according to the presence of a previous STI diagnosis. Associations were assessed using logistic regression to estimate crude odds ratio (OR) and adjusted odds ratio (aOR) with 95% confidence intervals (95% CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1202 mpox individuals were included (96.4% were men); 36% (417/1159) of males had previous STI during the 6 months previous to mpox diagnosis. Chemsex practice (aOR 1.66, 95% CI: 1.11–2.47), practicing sex in leisure places (aOR 1.68, 95% CI: 1.12–2.51), having HIV diagnosis (aOR 1.91, 95% CI: 1.32–2.77) and using pre-exposure prophylaxis (PrEP) (aOR 4.43, 95% CI: 3.05–6.45) were more frequent among males with a history of STI in the 6 months previous to mpox diagnosis. No statistical differences were found in mpox clinical manifestations and hospitalization according to STI history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overlapping risk behaviours and shared transmission routes contributed to the high prevalence of STI history in mpox cases. Epidemiological characteristics studied in mpox cases with previous STI may help identify target populations and planning an integrated prevention strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1490-1502"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277252","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":"Comparison of four frailty scores to predict adverse health events and mortality in people living with HIV aged 70 years and more (ANRS EP 66 SEPTAVIH study)","authors":"Clotilde Allavena,&nbsp;Diane Abulizi,&nbsp;Hubert Blain,&nbsp;Valérie Andriantsoanirina,&nbsp;Sophie Abgrall,&nbsp;Laurence Slama,&nbsp;Valérie Pourcher,&nbsp;Miresta Previlon,&nbsp;Marianne Canonico,&nbsp;Marcia Trumeau,&nbsp;André Cabie,&nbsp;Fabrice Bonnet,&nbsp;Laurence Meyer,&nbsp;Alain Makinson","doi":"10.1111/hiv.70269","DOIUrl":"10.1111/hiv.70269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>As people living with HIV age, frailty has emerged as a determinant of adverse health outcomes. We evaluated four frailty assessment tools in their ability to predict adverse health outcomes and mortality in people living with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 508 people living with HIV aged ≥70 years. At baseline, frailty was assessed using the Fried frailty phenotype, the FRAIL scale, the Study of Osteoporotic Fractures (SOF) score and the French Health Authority (HAS) questionnaire. The primary outcome was adverse health events (serious or recurrent falls, emergency department visits, unscheduled hospitalizations, nursing home admission or death) over 36 months. Log-binomial regression models estimated relative risks (RRs) for adverse outcomes in the 355 participants with a 36 months visit follow-up or death. Cox proportional hazards models assessed mortality in all enrolled people living with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 36 months, 204 participants (40.2%) experienced our primary outcome, including 40 deaths. Frailty was associated with a higher risk of adverse outcomes with all tools: Fried phenotype [RR 1.41, 95% confidence interval (CI) 1.06–1.86], FRAIL scale (RR 1.88, 95% CI 1.54–2.29), SOF score (RR 1.45, 95% CI 1.05–2.00) and HAS questionnaire (RR 1.64, 95% CI 1.40–1.92). All tools were strongly associated with mortality, except the SOF score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In people living with HIV aged ≥70 years, all four frailty tools predicted adverse health outcomes, whilst mortality was best predicted by the Fried phenotype, FRAIL scale and HAS questionnaire. Simple, questionnaire-based tools such as the FRAIL scale and the HAS questionnaire offer practical and effective frailty screening tools in routine HIV care for older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1479-1489"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264295","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 for the determination of appropriate needle length for intragluteal injection of long-acting rilpivirine–cabotegravir","authors":"Candice Gueuning,&nbsp;Mrishta Brizmohun,&nbsp;Nicolas Dauby,&nbsp;Charlotte Martin","doi":"10.1111/hiv.70272","DOIUrl":"10.1111/hiv.70272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Long-acting (LA) intramuscular injections of cabotegravir (CAB) and rilpivirine (RPV) are an effective maintenance therapy for people living with HIV who are virologically suppressed. However, virological failures (VFs) have been reported, often associated with elevated body mass index (BMI), potentially due to inadequate intramuscular drug delivery. Current recommendations mainly rely on BMI to guide needle length selection and do not routinely incorporate imaging techniques. Furthermore, they do not recommend the use of ultrasound as an investigative tool in cases of LA treatment failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed anonymized records of two patients experiencing virological rebound under LA CAB/RPV. Clinical, virological and resistance data were extracted from their medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first case involves an obese patient. Ultrasound revealed subcutaneous adipose tissue thickness &gt;3 cm and intra-adipose injection granulomas, suggesting non-intramuscular injections. After adapting needle length, virological suppression was restored. The second case involves a patient with a normal BMI in whom ultrasound revealed a gluteal subcutaneous adipose tissue thickness of 45 mm and bilateral subcutaneous granulomas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ultrasound is a simple and accessible tool to help optimize drug injection in case of obesity or gynoid fat distribution and investigate injection technique–related issues in cases of VF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1548-1551"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301602","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 drug resistance and treatment success in the Republic of Congo: Implications for optimized treatment","authors":"Dominic Rauschning,&nbsp;Arcy Marcelin Elenga Ike,&nbsp;Johanna Holterhoff,&nbsp;Amira Stockinger,&nbsp;Darrel Ornelle Elion Assiana,&nbsp;Claujens Chastel Mfoutou Mapanguy,&nbsp;Freisnel Hermeland Mouzinga,&nbsp;Carola Horn,&nbsp;Isabelle Suarez,&nbsp;Ferdinand Heyn,&nbsp;Diane Alexia Fila,&nbsp;Hubert Banguissa,&nbsp;Fabien Roch Niama,&nbsp;Donatien Moukassa,&nbsp;Eva Heger,&nbsp;Francine Ntoumi,&nbsp;Clara Lehmann","doi":"10.1111/hiv.70261","DOIUrl":"10.1111/hiv.70261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Increasing rates of HIV-1 drug resistance (HIVDR) threaten the effectiveness of antiretroviral therapy (ART) programmes in sub-Saharan Africa, particularly among children, adolescents and young adults, who face limited treatment options. The Republic of Congo (ROC) lacks comprehensive national data on HIVDR in these vulnerable populations. The study aimed to determine the proportion of virologically unsuppressed young individuals receiving ART in ROC and to characterize the prevalence and patterns of HIVDR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A point prevalence analysis was conducted in Pointe-Noire to determine viral load and to characterize resistance-associated mutations (RAMs) in HIV-1 among children, adolescents and young adults receiving ART using next-generation sequencing. Sociodemographic and clinical data were collected to assess associations between resistance, treatment history and adherence.</p>\u0000 \u0000 <p>Ethical approval was obtained (Avis n° 034/CIE/FCRM/2021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 510 participants were included, with a median age of 19.5 (IQR 13–40) and a median CD4 T-cell count of 538/μl (IQR 279–901). Among them, 34% (<i>n</i> = 173) had detectable viral loads (&gt; 40 copies/ml) while on ART. Of the viremic cohort, 147 samples were successfully sequenced and showed diverse HIV subtypes, with subtype A1 (21%) being the most prevalent. Drug resistance was most frequently observed against NRTIs and NNRTIs, with M184V (54.1%) and K103N (40.8%) mutations predominating. Resistance to protease inhibitors was rare. Notably, no major resistance was found to integrase inhibitors or capsid inhibitors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HIV-1 drug resistance is highly prevalent in young people receiving ART in the ROC. This study highlights the urgent need to integrate HIVDR genotyping into clinical practice in the ROC to guide treatment and preserve future treatment options. Strengthened adherence support, resistance testing at treatment failure and equitable access to newer antiretroviral drugs are essential to sustain treatment effectiveness and support progress toward the 2030 global HIV targets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1421-1433"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054143","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":"Prevalence of cardiometabolic diseases among ART-naïve people with HIV: A global systematic review and meta-analysis","authors":"Peter Vanes Ebasone,&nbsp;Anastase Dzudie,&nbsp;Nasheeta Peer,&nbsp;Jerry Aseneh,&nbsp;Romain Ebene Mbende,&nbsp;Andre Pascal Kengne","doi":"10.1111/hiv.70254","DOIUrl":"10.1111/hiv.70254","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;The burden of cardiometabolic diseases (CMDs) is rising in people with HIV (PWH). While extensive data exist on CMD prevalence in PWH receiving antiretroviral therapy (ART), comprehensive data on ART-naïve PWH are scarce. We aimed to estimate the global prevalence of hypertension, diabetes, obesity and dyslipidaemia among ART-naïve PWH and compare estimates with those on ART and HIV-negative populations.&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;This systematic review and meta-analysis included a search of PubMed-MEDLINE, CINAHL, SCOPUS, Academic Search Premier, Africa-Wide Information and Africa-Journals Online for original articles published up to June 2024. Cross-sectional, cohort and case-control studies providing baseline data on CMD prevalence were included. Studies had to include ART-naïve PWH aged ≥15 years. Two independent reviewers conducted studies screening, data extraction and methodological quality assessment. A random-effects meta-analysis with double arc-sine transformation was used for prevalence estimates. The study was registered with PROSPERO (CRD42021226001).&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;We included 184 studies published between 2000 and 2024, involving a total of 424 629 participants. The global pooled prevalence among ART-naïve PWH was 14.2% (95% CI: 12.4–16.1) for hypertension, 3.6% (2.9–4.3) for diabetes, 11.5% (10.3–12.9) for body mass index-based obesity, 18.3% (12.7–24.6) for waist circumference-based obesity, 14.8% (12.1–17.8) for elevated total cholesterol, 17.6% (11.3–24.8) for elevated low-density lipoprotein cholesterol, 22.9% (19.3–26.7) for elevated triglycerides and 54.6% (48.2–61.0) for low high-density lipoprotein cholesterol, all with high heterogeneity. Significant regional variations in the prevalence of diabetes, obesity and dyslipidaemia were observed according to UNAIDS regions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We found a notable prevalence of CMDs in ART-naïve PWH, with significant regional variations in the prevalence of diabetes, obesity and dyslipidaemia. This highlights the need for targeted interventions and early screening to address the growing CMD burden among PWH.&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;ART-naïve PWH face a considerable CMD burden, emphasizing the importance of early detection and management. Regional differences in CMD prevalence call for tailored public health strategies and integration of ","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1382-1398"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836991","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":"Screening for bone health in older people with HIV: Uptake and outcomes from a large UK outpatient HIV service","authors":"Rhys Nicholas,&nbsp;Kate Alford,&nbsp;Colin Fitzpatrick,&nbsp;Jaime Vera","doi":"10.1111/hiv.70264","DOIUrl":"10.1111/hiv.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Bone health is negatively affected in people with HIV, and the risks of osteoporosis and fragility fractures are increased. The objective of this study was to describe the characteristics of those accessing bone health screening and identify factors associated with osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective data were collected from people accessing a large HIV outpatient service between September 2003 and December 2024. Inclusion criteria were age ≥ 60 years. Data were obtained from medical records, including patient demographics and clinical variables. The three most recent Dual Energy X-ray Absorptiometry (DEXA) scans were analysed. Descriptive statistics were used to summarise patient characteristics, and logistic regression was used to identify factors associated with the development of osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred eighty-eight people (90.1% male, 91% white, 81% Men who have sex with Men, median age 67 years) were analysed. Of these, 79.6% (<i>n</i> = 468) had at least one DEXA scan. The prevalence of osteopenia and osteoporosis was 52% (<i>n</i> = 306) and 18% (<i>n</i> = 106), respectively. Of those with osteopenia at baseline who had DEXA data available, 11.1% (<i>n</i> = 34) progressed to osteoporosis. Only 29% (<i>n</i> = 31) of individuals with osteoporosis were receiving bisphosphonate therapy. Prolonged duration on anti-retroviral therapy, fractures and low lumbar spine T-scores were risk factors for developing osteoporosis during follow-up (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bone health screening uptake was high in this cohort of older people with HIV, but management of established osteoporosis remained suboptimal. Previous fractures and low lumbar spine T-scores identified those at greater risk of progression to osteoporosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1460-1467"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149712","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":"Dolutegravir population pharmacokinetics in racially, sex- and age-diverse and antiretroviral therapy-experienced adults with HIV in the United States","authors":"Adrian Khoei,&nbsp;Andrew Edmonds,&nbsp;Yen Chang,&nbsp;Catalina Ramirez,&nbsp;Mackenzie Vogan,&nbsp;Amanda Poliseno,&nbsp;Steven Wolinsky,&nbsp;Ken Ho,&nbsp;Todd T. Brown,&nbsp;Joseph B. Margolick,&nbsp;Jacquett Batson,&nbsp;Jennifer Hoffmann,&nbsp;Mark A. Marzinke,&nbsp;Mirjam-Colette Kempf,&nbsp;Maria L. Alcaide,&nbsp;Joffi Effoe,&nbsp;Cecile D. Lahiri,&nbsp;Igho Ofotokun,&nbsp;Anandi N. Sheth,&nbsp;Stephen Gange,&nbsp;Audrey L. French,&nbsp;Bani Tamraz,&nbsp;Bradley E. Aouizerat,&nbsp;Phyllis C. Tien,&nbsp;Seble G. Kassaye,&nbsp;Jack DeHovitz,&nbsp;Kathryn Anastos,&nbsp;Kara W. Chew,&nbsp;Michelle Floris-Moore,&nbsp;Julie B. Dumond","doi":"10.1111/hiv.70278","DOIUrl":"10.1111/hiv.70278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Dolutegravir (DTG) has been associated with weight gain in women with HIV, Black people with HIV and people with HIV60 years. This study aimed to characterise DTG population pharmacokinetics (PopPK) in a diverse population including these sub-populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an intensive PK study nested within the Multicenter AIDS Cohort Study (MACS)/Women's Interagency HIV Study (WIHS) Combined Cohort Study (MWCCS) and retrospectively quantified DTG plasma concentrations in historical specimens from participants in the WIHS and the MACS over several study visits. PopPK models were developed using NONMEM; covariate searches included relevant demographics and co-medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 44 people with HIV from the MWCCS (56.8% women, 72.7% Black, 40.9% 60 years), 193 WIHS women (52.8% Black, 25.4% 60 years) and 137 MACS men (19.7% Black, 53.3% 60 years). A one-compartment model with first-order absorption and elimination and an absorption lag time (ALAG) best described DTG PK. Apparent clearance (CL/F) was 1.21, 1.26 and 0.95 L/h; apparent volume of distribution (V/F) was 21.2, 38.9 and 19.8 L, in the MWCCS, WIHS and MACS, respectively. For all three models, ALAG was 0.35 h. Sex, race and age were not statistically significant covariates. In the WIHS, lower total bilirubin and current cigarette smoking were significantly associated with higher CL/F, and higher body weight was significantly associated with higher V/F.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our analysis did not support different DTG PK in women with HIV, Black people with HIV and people with HIV aged 60 years compared to other sub-populations; causal analysis between DTG concentrations and weight gain over time are ongoing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 9","pages":"1517-1529"},"PeriodicalIF":3.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470383","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}