HIV Medicine最新文献

{"title":"Correction to “Perception of medical care among women living with HIV aged 40 years or older—a European-wide survey”","authors":"","doi":"10.1111/hiv.70032","DOIUrl":"10.1111/hiv.70032","url":null,"abstract":"<p>Miron VD, Sabin CA, Săndulescu O, et al. Perception working group perception of medical care among women living with HIV aged 40 years or olde—A European-wide survey. HIV. 2025;26(3):451–464. doi:10.1111/hiv.13749</p><p>The Acknowledgements section for this article was incomplete. The below statement has been added to this section:</p><p>The authors would also like to acknowledge the following collaborators in Ireland, who contributed to the distribution of the survey locally: Nijat Ahmadi (Centre of Experimental Pathogen Host Research, University College Dublin, Ireland), Laura O'Doherty (Mater Misericordiae University Hospital, University College Dublin, Ireland), Eoin Feeney (St Vincent's University Hospital, Centre of Experimental Pathogen Host Research, University College Dublin, Ireland), Stefano Savinelli (St Vincent's University Hospital, Centre of Experimental Pathogen Host Research, University College Dublin, Ireland), Helen Tuite (University Hospital Galway, Ireland), and Corinna Sadlier (Cork University Hospital, Ireland).</p><p>We apologize for this error.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981874","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":"Longitudinal associations between social determinants of health and well-being among women living with HIV in Canada: A latent class analysis","authors":"Zerihun Admassu,&nbsp;Carmen H. Logie,&nbsp;Luissa Vahedi,&nbsp;Angela Underhill,&nbsp;Logan Kennedy,&nbsp;Kath Webster,&nbsp;Brenda Gagnier,&nbsp;Angela Kaida,&nbsp;Alexandra de Pokomandy,&nbsp;Mona R. Loutfy","doi":"10.1111/hiv.70031","DOIUrl":"10.1111/hiv.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Social determinants of health (SDoH) can significantly impact overall well-being. While existing research has explored SDoH as predictors of well-being among women living with HIV, longitudinal studies examining these relationships over time remain limited. We examined SDoH typologies among women living with HIV in Canada and longitudinal associations with well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using longitudinal survey data collected at three time points from women living with HIV in Canada (2013–2018), we conducted latent class analysis (LCA) to identify subgroups of SDoH indicators, including income, experiences of violence, food security, substance use, housing stability, HIV-related stigma and social support at baseline (Time-1). Multivariable linear and logistic regression examined associations between SDoH classes and well-being (depression, discrimination [gender, racial] and HIV clinical outcomes [viral load, adherence, HIV care barriers]) at Time-3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified three distinct SDoH classes among participants (<i>n</i> = 1422, mean age = 42.8): high (<i>n</i> = 435; 30.6%), medium (<i>n</i> = 377; 26.5%) and low SDoH adversity (<i>n</i> = 610; 42.9%). In multivariate regression analyses, the high SDoH adversity class had lower odds of achieving an undetectable viral load (adjusted Odds Ratio [aOR] = 0.46; 95% CI: 0.21, 1.01; <i>p</i> = 0.050) and higher probability of facing barriers to accessing care (<i>aβ</i> = 0.32; 95% CI: 0.19, 0.45; <i>p</i> &lt; 0.001), depression (aOR = 2.52; 95% CI: 1.71, 3.71; <i>p</i> &lt; 0.001), racial discrimination (<i>aβ</i> = 3.42; 95% CI: 1.72, 5.12; <i>p</i> &lt; 0.001) and gender discrimination (<i>aβ</i> = 3.14; 95% CI: 1.42, 4.87; <i>p</i> &lt; 0.001), compared with the low SDoH adversity class at 5-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SDoH adversities were associated with poor wellbeing among women living with HIV in Canada. Integrated, comprehensive person-centred care approaches that address SDoH are needed to improve health and wellbeing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 6","pages":"962-969"},"PeriodicalIF":2.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009557","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":"Efficacy of long-acting cabotegravir plus rilpivirine in viraemic people living with HIV: A systematic review and meta-analysis","authors":"Beatrice Barda,&nbsp;Giuseppe Barilaro,&nbsp;Paola Bellini,&nbsp;Giulia Turicchi,&nbsp;Enos Bernasconi,&nbsp;Marco Bongiovanni","doi":"10.1111/hiv.70025","DOIUrl":"10.1111/hiv.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Long-acting cabotegravir/rilpivirine (LA-CAB/RPV) is currently approved as a switch strategy in people living with HIV virally suppressed on oral antiretroviral therapy. Although small reports on specific, difficult-to-treat populations demonstrated the efficacy of LA-CAB/RPV in people living with HIV and unsuppressed viraemia, cumulative data on this issue are still lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis based on PRISMA guidelines using PubMed, Scopus, Google Scholar and Medline, including papers or abstracts that evaluated the use of LA-CAB/RPV in viraemic people living with HIV. Two papers were excluded as they reported only single clinical cases; one study was excluded for including only three perinatally infected subjects. Two papers were reviews and two papers and one abstract reported result from Ward 86, which were later included in a final paper. One paper presenting preliminary results from the OPERA cohort was excluded, as these data were subsequently updated. The ACTG LATITUDE (A5359) study was not included, as it did not specifically report outcomes for people living with HIV who initiated LA-CAB/RPV while viraemic. After applying these selection criteria, five papers and three abstracts were included in the meta-analysis. The main outcome was virologic success, as defined by each individual study, in people living with HIV with at least one HIV-RNA evaluation after initiating LA-CAB/RPV. We did not perform a meta-analysis on other variables due to inconsistent assessment across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 244 people living with HIV started LA-CAB/RPV when viraemic. Most of them reported adherence, psychological or social issues that limited compliance to standard oral treatment. The cumulative probability of achieving virologic success was 87% (79%–95%). Most patients maintained adherence rates above 90% to their scheduled injection visits. Eleven patients living with HIV developed RPV-associated mutations and five CAB-associated mutations at virologic failure. No interruption of LA-CAB/RPV for adverse events was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first meta-analysis that assessed the efficacy of LA-CAB/RPV in viraemic people living with HIV; oral treatment efficacy was jeopardized by low compliance due to adherence or psychological issues. Our results can justify the use of LA-CAB/RPV also in viraemic patients without alternative oral options.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"993-1003"},"PeriodicalIF":2.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005755","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":"mRNA vaccines against HIV: Hopes and challenges","authors":"Akmal Zubair,&nbsp;Hanbal Ahmad,&nbsp;Muhammad Muaz Arif,&nbsp;Muhammad Ali","doi":"10.1111/hiv.70024","DOIUrl":"10.1111/hiv.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since the introduction of the first licensed mRNA-based vaccines against COVID-19, there has been significant interest in leveraging this technology for other vaccines. An unprecedented surge of mRNA vaccines has emerged in preclinical, clinical, and various research phases since 2020. The rapid development of mRNA formulations, delivery methods, and manufacturing processes has made this trend foreseeable. There is an urgent demand for effective and easily transportable vaccines in regions where the virus is prevalent, and mRNA technology shows promise in addressing this need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>The data was retrieved from various databases, including Google Scholar, PubMed, Science Direct, ClinicalTrials.gov, and government websites. The following terms were used in the search strategies: HIV, vaccines, mRNA vaccines, clinical trials, and preclinical trials. A total of 35 articles were identified and subsequently screened for data regarding mRNA vaccines for HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>mRNA vaccines are an effective solution for HIV treatment, as demonstrated by various research studies referenced in the article.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review evaluates the current state of HIV-1 mRNA vaccine development, clarifies various targeting strategies, highlights recent research findings, and provides insights into the challenges and potential solutions associated with these issues. In this review, we have explored mRNA vaccines, focusing on their functional structure, design, manufacturing, and distribution methodologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 6","pages":"824-838"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803103","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":"Strategies for strengthening same-day ART initiation, tracing people living with HIV lost to follow-up and viral load monitoring mechanisms in Ethiopia","authors":"Kidanu Hurisa Chachu,&nbsp;Kefiloe Adolphina Maboe","doi":"10.1111/hiv.70022","DOIUrl":"10.1111/hiv.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To meet the intended goal of eradicating the Human Immunodeficiency Virus (HIV) epidemic by 2030, the Joint United Nations Program on HIV/Acquired Immunodeficiency Syndrome (AIDS) has set 95-95-95 targets. Ethiopia has made progress towards these targets, but challenges continue to persist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the current same-day antiretroviral therapy (ART) initiation status and to develop strategies for strengthening same-day ART initiation, tracing HIV/AIDS patients lost to follow-up, viral suppression and retention of patients in HIV care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A three-phased (Phase 1, Phase 2 and Phase 3) exploratory sequential mixed methods design was employed in two healthcare facilities in Ethiopia. Strategies were developed based on qualitative findings from in-depth cell phone interviews with 30 healthcare providers, quantitative results from document analysis of 332 clinical records, integration of Phases 1 and 2, application of a theoretical framework, logical reasoning and review of relevant literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Phase 1 findings highlighted key barriers to same-day ART initiation, being patient resistance due to fear, stigma and religious concerns, as well as challenges with enrolment procedures and overburdened healthcare providers. Phase 2 results indicated varying retention rates over different time intervals: 35% at 6 months (<i>n</i> = 49), 81% at 12 months (<i>n</i> = 50), 89% from 13 to 18 months (<i>n</i> = 63) and 94% at 24 months (<i>n</i> = 34), with an overall retention in HIV/Care at 59%. Additionally, viral suppression rates were observed to be 93% at 6 months, 95% at 12 months and 86% at 24 months. In Phase 3, 15 strategies were adopted after validation by healthcare experts from HIV programmes at the Federal Ministry of Health and regional health bureaus by using the modified Delphi technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study contributed to the understanding of same-day ART initiation in Ethiopia by identifying key challenges that are patient reluctance, socio-economic factors and adherence issues and providing actionable strategies and recommendations for improving same-day ART initiation through targeted interventions and patient-centred strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 6","pages":"899-913"},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779853","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 late HIV diagnosis and its impact on mortality: A comprehensive systematic review and meta-analysis","authors":"Jiaqi Zhao,&nbsp;Mengying Gao,&nbsp;Di Zhao,&nbsp;Wenya Tian","doi":"10.1111/hiv.70023","DOIUrl":"10.1111/hiv.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The late diagnosis of HIV infection plays a crucial role in accelerating the disease progression and increasing the risk of death in the HIV population. However, there remains no consensus on the prevalence of late diagnosis or resulting mortality rates. Therefore, the objective of this meta-analysis was to assess both the prevalence of late diagnosis and resulting mortality rates, so as to provide valuable references and guidance for future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Web of Science, Embase and Cochrane database were comprehensively searched. Stata 15 was utilized to conduct a meta-analysis. Potential sources of heterogeneity were explored through subgroup analysis and meta-regression. Additionally, sensitivity analysis was performed to assess the robustness and reliability of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This meta-analysis comprised 52 studies with 1 009 808 individuals living with HIV. The late diagnosis rate of HIV was 44.0%. The subgroup analysis showed that the late diagnosis rate was higher among individuals aged 30 years or older, men, Africans, those infected through blood transmission, those with low education, those currently unemployed and those diagnosed from 2011 to 2020. The mortality rate due to late diagnosis was 13.0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this systematic review and meta-analysis indicate a relatively high prevalence of late HIV diagnosis and a high mortality rate. The issue of delayed HIV diagnosis remains pervasive and unresolved, necessitating global efforts to address it urgently. The late diagnosis rate of HIV was higher in older individuals, men, Africans, those with low education levels, those infected through blood transmission and those diagnosed in later years. Further research is imperative to identify effective strategies for promoting early detection of HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 7","pages":"982-992"},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779850","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 diagnosis of HIV among Ukrainian refugees in the Czech Republic: A retrospective, observational study","authors":"Zofia Bartovská,&nbsp;Ricardo Massmann,&nbsp;David Jilich,&nbsp;Tomáš Groh,&nbsp;Lukáš Fleischhans,&nbsp;Milan Zlámal,&nbsp;Radek Svačinka,&nbsp;David Vydrář,&nbsp;Dalibor Sedláček,&nbsp;Miroslav Kubiska,&nbsp;Jaroslav Kapla,&nbsp;Lucie Nepovímová,&nbsp;Daniela Bartková,&nbsp;Lenka Olbrechtová,&nbsp;Zdeňka Jerhotová,&nbsp;Eva Novotná,&nbsp;Jakub Wnuk,&nbsp;Vratislav Němeček,&nbsp;Pavel Dlouhý,&nbsp;Štěpán Cimrman,&nbsp;Marek Malý","doi":"10.1111/hiv.70021","DOIUrl":"10.1111/hiv.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This retrospective, observational, non-interventional study describes the demographics, characteristics, immunological and virological status, coinfections, healthcare unit of HIV diagnosis and follow-up status of Ukrainian refugees with newly diagnosed HIV in the Czech Republic, with a special focus on those with a late HIV diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ukrainian nationals with war refugee status, Ukrainian nationals with Czech Republic resident status and Czech Republic nationals who newly registered at HIV centres in the Czech Republic between March 2022 and June 2023 with a new diagnosis of HIV were included. Data were collected from medical records. The study was registered with the Czech State Institute for Drug Control (ID 2401240000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 298 patients with a new HIV diagnosis were included in the study. Of these, 58 patients were Ukrainian refugees who were retained in care. This cohort had a mean age of 37.0 years (min–max 13–60) and most (62.1%) were women. More than half of the Ukrainian refugees in this study (60.3%) had a late HIV diagnosis; these patients were older than those with a prompt diagnosis (mean age 40.7 vs. 31.5 years, <i>p</i> &lt; 0.001). Ukrainian refugees were infrequently diagnosed in primary care and significantly more likely to have a late HIV diagnosis (60.3% vs. 37.8%, <i>p</i> = 0.005) and be diagnosed at a later HIV stage (<i>p</i> = 0.021) than Czech nationals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ukrainian refugees were more likely to have a late HIV diagnosis than Czech nationals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 6","pages":"888-898"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742768","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":"Rethinking HIV treatment: How non-integrase strand regimens may hold the key to better immune health","authors":"Bogusz Aksak-Wąs,&nbsp;Karolina Skonieczna-Żydecka,&nbsp;Miłosz Parczewski,&nbsp;Rafał Hrynkiewicz,&nbsp;Filip Lewandowski,&nbsp;Karol Serwin,&nbsp;Kaja Mielczak,&nbsp;Franciszek Lenkiewicz,&nbsp;Paulina Niedźwiedzka-Rystwej","doi":"10.1111/hiv.70020","DOIUrl":"10.1111/hiv.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>HIV outcome changed drastically with antiretroviral (ARV) therapy, especially after the introduction of second-generation integrase strand transfer inhibitors (INSTIs). Despite these advances, however, chronic immune activation and exhaustion, marked by programmed cell death 1 (PD-1) and programmed death ligand 1 (PD-L1) upregulation, persist in patients. This study investigates the impact of various ARV regimens on these immune exhaustion markers in newly diagnosed HIV patients over 12 months, taking into consideration cardiovascular risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 58 newly diagnosed patients with HIV at Pomeranian Medical University, Szczecin, Poland. Participants received ARV regimens classified as INSTI + tenofovir alafenamide, INSTI + tenofovir disoproxil fumarate, or non-INSTI-based (VARIA). Flow cytometry was used to assess PD-1 and PD-L1 expression on CD3+, CD3+CD4+, CD3+CD8+ and CD19+ lymphocytes. Statistical analyses included Wilcoxon paired tests, Kruskal–Wallis tests and multivariate regression, with validation through residual analysis and linear discriminant analysis (LDA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>INSTI-based regimens were linked to higher PD-1 expression on CD3+ and CD3+CD4+ lymphocytes, indicating increased immune exhaustion. Conversely, non-INSTI regimens were associated with lower PD-1 levels, suggesting better retention of immune function. A positive correlation between cardiovascular risk a prediction model to estimate 10-year fatal and non-fatal cardiovascular disease (SCORE2) and PD-1 expression was observed. However, the modest explanatory power of the models suggests variability in the effects of different ARV regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study challenges the assumption that INSTI-based ARV regimens are universally superior, suggesting that non-INSTI therapies may better preserve immune function by reducing PD-1 expression. These findings highlight the potential benefits of non-INSTI regimens in improving long-term clinical outcomes in HIV treatment, warranting further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 6","pages":"879-887"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742770","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":"Trends of severe HIV disease and mortality among children in rural Tanzania","authors":"L. S. Moshi,&nbsp;J. Okuma,&nbsp;E. Luoga,&nbsp;A. V. Kalinjuma,&nbsp;G. J. Mollel,&nbsp;G. Sigalla,&nbsp;L. Wilson,&nbsp;E. Dotto,&nbsp;T. Glass,&nbsp;F. Vanobberghen,&nbsp;M. Weisser,&nbsp;the KIULARCO study group","doi":"10.1111/hiv.70015","DOIUrl":"10.1111/hiv.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess trends of severe HIV disease (SHD) and mortality/loss to follow-up (LTFU) among children living with HIV in rural Tanzania.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among children aged 0–14 years living with HIV enrolled in the prospective Kilombero &amp; Ulanga Antiretroviral Cohort in January 2005–December 2023, we determined WHO-defined SHD prevalences at enrolment, mortality/LTFU incidence during follow-up using Kaplan–Meier methods, and associated factors using regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At enrolment, among 1089 children [567 (52%) males, 587 (54%) aged &lt;5 years and 530 (49%) with a HIV WHO stage III/IV], 112/332 (34%) had CD4 cell count &lt;200 cells/μL among those aged 5–14 years. In children aged 5–14 years, SHD was diagnosed in 265/502 (53%) with a prevalence of 35–94% declining after 2013. Among children aged &lt;5 years, 374/587 (64%) had SHD with no change over time. Male gender [adjusted odds ratio = 1.45; 95% confidence interval: 1.10–1.90], age &lt;5 years versus older (1.64; 1.13–2.37), hospitalization versus outpatients (6.72; 3.35–13.5), antiretroviral treatment (ART) start within 30 days versus later (2.18; 1.52–3.13), and enrolment during 2013–2016 versus before (2.29; 1.54–3.41) were associated with SHD. After a median follow-up of 3.3 years [interquartile ratio: 0.8–7.8], 130 (12%) children died and 359 (35%) were LTFU. Predictors of mortality/LTFU were SHD [adjusted hazard ratio (aHR) = 1.54; 95% CI: 1.26–1.89], age &lt;5 years versus older (1.28; 1.01–1.66), hospitalization versus outpatients (1.93; 1.42–2.63), living ≥50 km versus ≤1 km away (1.72; 1.37–2.16) and delayed ART initiation versus within 30 days (3.40; 2.70–4,27), while enrolment 2017–2023 versus before (0.51; 0.37–0.70) was protective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The persisting high prevalence of paediatric SHD and high mortality/LTFU underscores the need for early diagnosis and care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 5","pages":"800-812"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709674","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":"Biomarkers of inflammation and coagulation predict non-AIDS-defining events in a prospective cohort of virologically suppressed people living with HIV","authors":"Maria Saumoy,&nbsp;Analuz Fernandez,&nbsp;Juan Tiraboschi,&nbsp;Judith Peñafiel,&nbsp;José Luis Sánchez-Quesada,&nbsp;Jaime Vega,&nbsp;Benito García,&nbsp;Irene Soriano,&nbsp;Daniel Podzamczer,&nbsp;Arkaitz Imaz","doi":"10.1111/hiv.70017","DOIUrl":"10.1111/hiv.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the association between biomarkers of inflammation, coagulation and immune activation and the incidence of non-AIDS-defining events in a contemporary, antiretroviral therapy (ART)-experienced and virologically suppressed cohort of people living with HIV (PLWH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective, observational cohort study. PLWH aged 30–70 years, with undetectable HIV viral load and no history of cardiovascular disease, randomly selected from outpatients were included. At baseline, plasma biomarkers (high-sensitivity C-reactive protein [hs-CRP], sCD163, sCD14, D-dimer, interleukin-6, soluble vascular cell adhesion molecule [s-VCAM] and lipoprotein-associated phospholipase A2 [Lp-PLA2] activity) were measured. Non-AIDS-defining events (non-AIDS cancer and cardiovascular events) and non-AIDS death were recorded until November 2022. Cumulative incidence was analysed for each endpoint and adjusted Cox regression used to assess associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 438 participants were included: 81.1% men, mean age 50.4 (SD 10.1) years. The median time on treatment was 15.5 (interquartile range [IQR] 8.69; 19.7) years and with undetectable viral load 7.05 (IQR 4.03; 11.6) years. A total of 77 non-AIDS-defining events were recorded in 70 patients (38 non-AIDS cancers, 21 cardiovascular events, 37 non-AIDS deaths) in a median follow-up of 6.72 (IQR 6.02; 7.36) years. The cumulative incidence for non-AIDS cancer, cardiovascular event and non-AIDS death was 8.7% (95% CI 6.2–11.7), 4.79% (95% CI 2.99–7.24) and 8.47% (95% CI 6–11.5), respectively. In adjusted models, sCD163 was associated with incident non-AIDS cancer (hazard ratio [HR] 1.23, 95% CI 1.08–1.39), hs-CRP with incident cardiovascular events (HR 1.61, 95% CI 1.05–2.47), sCD163 (HR 1.28, 95% CI 1.11–1.46) and D-dimer (HR 1.75, 95% CI 1.08–2.86) with non-AIDS death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Biomarkers of inflammation, monocyte activation and coagulation were associated with non-AIDS-defining events in a contemporary and long-term suppressed cohort of PLWH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 6","pages":"849-857"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699645","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}