HIV Medicine最新文献

{"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}

{"title":"Wellbeing of trans and gender-diverse people with HIV in the United Kingdom: Results from Positive Voices 2022.","authors":"H Kitt, C Kelly, A Aghaizu, M Ross, F C Lampe, C J Smith, V Martin, C Humphreys, A Brown, A Sparrowhawk, M Kall, J Sewell, E Wainwright, V Delpech, G Davis, A Farah, A Fasanya, A J Rodger, T Đuretić","doi":"10.1111/hiv.70286","DOIUrl":"https://doi.org/10.1111/hiv.70286","url":null,"abstract":"<p><strong>Objectives: </strong>This national cross-sectional observational study aimed to assess mental health, quality of life, supportive network, experiences of HIV-related stigma in healthcare and unmet service need among trans and gender-diverse people with HIV, compared to cisgender people with HIV.</p><p><strong>Methods: </strong>Positive Voices 2022 is a questionnaire survey of people accessing HIV care in England, Scotland and Wales carried out in 2022 and 2023 that included measures of depression and anxiety symptoms and suicidal ideation (PHQ-9 and GAD-7), health-related quality of life (EQ-5D-5L), supportive network (modified Duke FSSQ), experiences of HIV-related stigma in healthcare and service needs. Logistic and ordinal logistic regression assessed the association of gender identity with these measures unadjusted and adjusted for age group and ethnicity.</p><p><strong>Results: </strong>Overall, 67 trans or gender-diverse and 4551 cisgender people with HIV participated. Compared to cisgender participants, trans and gender-diverse participants were younger, more likely to be Asian and less likely to be black. They were less likely to be in employment, homeowners and financially secure. Trans and gender-diverse participants had a higher prevalence of depression symptoms (35.5% [22/62] vs. 20.5% [865/4219], adjusted odds ratio [aOR] [95% confidence interval, CI] = 1.96 [1.15, 3.34]; p = 0.014) and suicidal ideation (37.1% [23/62] vs. 14.6% [616/4219]; aOR = 3.09 [1.85, 5.17]; p < 0.001) compared to cisgender participants. They also had poorer health-related quality of life for three domains (anxiety and depression, usual activities and self-care) and lower levels of supportive network in unadjusted and adjusted analyses. A higher proportion of trans and gender-diverse participants than cisgender participants had unmet needs for health services, including mental health services (49.2% [31/63] vs. 30.2% [1310/4343]; aOR = 2.02 [1.22-3.35]; p = 0.007), lifestyle services, and welfare and social services.</p><p><strong>Conclusions: </strong>Trans and gender-diverse people with HIV have poorer mental health and wellbeing than cisgender people with HIV, and a higher prevalence of unmet service needs, highlighting the need for access to culturally competent mental health and other health and welfare services.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840233","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":"Medication burden and prescribing quality in older people living with HIV: Associations with quality of life.","authors":"Abdulkadir Sonkaya, Nurgül Ceran, Seniha Şenbayrak, Asuman Inan, Serpil Erol, Recep Balik, Vahibe Aydin Sarikaya","doi":"10.1111/hiv.70301","DOIUrl":"https://doi.org/10.1111/hiv.70301","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of polypharmacy, drug-drug interactions (DDIs), potential prescribing omissions (PPOs) and potentially inappropriate medications (PIMs) among people living with Human Immunodeficiency Virus (HIV) aged ≥50 years and to evaluate their association with quality of life.</p><p><strong>Methods: </strong>This cross-sectional analytical study was conducted between March and May 2025 at a tertiary infectious disease clinic. A total of 141 people living with HIV aged ≥50 years who were receiving antiretroviral therapy (ART) and under active follow-up were included. DDIs were assessed using the Liverpool HIV Drug Interactions database, while PPOs and PIMs were evaluated using the TIME-to-START and TIME-to-STOP criteria. Quality of life was assessed using the PozQoL scale.</p><p><strong>Results: </strong>Polypharmacy was identified in 42 participants (29.8%) and DDIs in 22 (15.6%). Although PPOs were initially identified in all participants according to TIME-to-START criteria, this was largely driven by vaccination-related items. Vaccination-related items were excluded when evaluating the association between PPOs and quality of life, and the prevalence of PPOs decreased to 32.6%. PIMs were detected in 16.3%. Polypharmacy was associated with low quality of life in the health concern domain (OR 3.52, 95% CI 1.34-9.27). DDIs were associated with low overall (OR 7.65, 95% CI 2.01-29.07) and psychological quality of life (OR 14.55, 95% CI 3.45-61.37). PPOs were associated with low psychological (OR 10.67, 95% CI 2.80-40.68) and health concern domains (OR 3.19, 95% CI 1.27-8.05).</p><p><strong>Conclusions: </strong>Medication-related problems were common among older people living with HIV. Polypharmacy, DDIs and PPOs were associated with impaired quality of life, highlighting the need for structured medication review and multidisciplinary care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827914","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":"CROI 2026-A summary from the BHIVA CROI Working Group.","authors":"Tristan J Barber, Marta Boffito, Yvonne Gilleece, Portia Jackson, Nadia Naous, Michael Rayment, Iain Reeves, Amanda Samarawickrama, Caroline Sabin","doi":"10.1111/hiv.70302","DOIUrl":"10.1111/hiv.70302","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818310","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":"Dietary counselling and exercise training for lipid management in people living with HIV: A systematic review and meta-analysis.","authors":"Maki Aomori, Hitomi Maeda","doi":"10.1111/hiv.70298","DOIUrl":"https://doi.org/10.1111/hiv.70298","url":null,"abstract":"<p><strong>Objectives: </strong>Dyslipidaemia is highly prevalent among people living with human immunodeficiency virus (HIV) and contributes to increased cardiovascular risk. Although lifestyle interventions are recommended, evidence specific to people living with HIV remains limited. Previous reviews have primarily focused on dietary interventions or low-density lipoprotein cholesterol (LDL-C). Here, we assessed the effects of dietary counselling and exercise training on serum lipid levels in people living with HIV.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials evaluating dietary and exercise interventions in people living with HIV, predominantly with dyslipidaemia. PubMed, CENTRAL, Cumulative Index to Nursing and Allied Health Literature and Web of Science were searched up to February 28, 2026. The primary outcome was the change in LDL-C level from baseline. Secondary outcomes included changes in total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels. Mean differences with 95% confidence intervals were pooled.</p><p><strong>Results: </strong>Seven RCTs involving 474 participants were included. Dietary counselling significantly reduced LDL-C, TC and TG levels compared with usual care, with LDL-C reductions ranging from approximately 6 to 13 mg/dL. Evidence from two trials suggested that exercise training may increase HDL-C levels, with no consistent effects on LDL-C, TC or TG levels. Differences in exercise protocols may have contributed to these findings.</p><p><strong>Conclusion: </strong>Dietary counselling may improve LDL-C, TC and TG levels, whereas limited evidence suggests that exercise training may increase HDL-C levels in people living with HIV. Lifestyle interventions may serve as adjunctive strategies for lipid management, although further large-scale studies are needed, particularly to evaluate the effects of exercise.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792445","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":"Migration pathways and HIV care Cascade among newly enrolled adult patients in a tertiary clinic in Montréal, Canada.","authors":"Kathy Nodzynski, David Lessard, Dominic Chu, Nadine Kronfli, Claire Dufrêne-Boelen, Sean Yaphe, Marina Klein, Jean-Pierre Routy, Alexandra Hamel, Cecilia Costiniuk, Alexandra de Pokomandy, Serge Vicente, Krescyn Moonsamy, Nashira Popovic, Joseph Cox, Bertrand Lebouché","doi":"10.1111/hiv.70296","DOIUrl":"10.1111/hiv.70296","url":null,"abstract":"<p><strong>Objectives: </strong>Migrants are disproportionately affected by HIV and face inequities in accessing care. This study examined the HIV care cascade among newly registered adults at the Chronic Viral Illness Service (CVIS).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults (≥18 years) living with HIV and newly registered at the CVIS, in Montréal, Canada, between January 1st, 2022, and December 31st, 2024. Sociodemographic, clinical and care cascade data were extracted from electronic records. Multivariable logistic regression models, adjusted for age, gender, region of birth and diagnosis type, examined associations between seven migration status categories and cascade outcomes.</p><p><strong>Results: </strong>Among 695 patients, 664 (95%) were born outside Canada and 528 (76%) were refugees/asylum seekers. Of these, 281/695 (40%) had a new HIV diagnosis. Among newly diagnosed refugees/asylum seekers, median time from diagnosis to linkage to care was 28 days (interquartile range [IQR]: 18-42). Median time from linkage to antiretroviral therapy (ART) prescription ranged from 0 (IQR: 0-0) to 18 (IQR: 9-27) days across groups. At 6 months, 618/695 (89%) were retained in care and 603/618 (98%) were on ART. At 12 months, 530/603 (88%) were in care and 511/530 (96%) were virally suppressed. In exploratory adjusted analyses, Canadian citizens had lower odds of retention (aOR 0.32, 95% CI 0.14-0.75) and viral suppression (aOR 0.33, 95% CI 0.15-0.75) at 12 months.</p><p><strong>Conclusions: </strong>Among newly diagnosed refugees/asylum seekers, linkage to care delays appear to have increased since pre-pandemic estimates. Meaningful heterogeneity across migration groups highlights the limitations of treating migrants as a homogeneous population in HIV care.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689103","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":"Renal function in African women receiving tenofovir disoproxil fumarate as pre-exposure prophylaxis for HIV during pregnancy and postpartum: A postpartum safety analysis in the CAP016 randomized control trial","authors":"Gaysheen Kistan,&nbsp;Tonya Esterhuizen,&nbsp;Megeshinee Naidoo,&nbsp;Alicia C. Desmond,&nbsp;Motshedisi Sebitloane,&nbsp;Dhayendre Moodley","doi":"10.1111/hiv.70258","DOIUrl":"10.1111/hiv.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The effect of tenofovir disoproxil fumarate (TDF) when used as pre-exposure prophylaxis (PrEP) on renal function in pregnant and postpartum women is understudied. An open-label clinical trial (CAP016 study) was designed to examine the safety of TDF-PrEP use during pregnancy and breastfeeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women were randomized (1:1) to either initiate PrEP at enrolment in pregnancy (Immediate PrEP-IP) or initiate PrEP (Deferred PrEP-DP) at the time of breastfeeding cessation. We compared changes in creatinine clearance and frequency of adverse renal events in women randomized to initiate TDF-PrEP in pregnancy versus women randomized to defer initiation of TDF-PrEP to the time of breastfeeding cessation. Participants were recruited between 28 September 2017 and 3 December 2019. Serum creatinine was measured at baseline during pregnancy and at 6, 26, 54 and 74 weeks postpartum. Creatinine clearance (CrCl) (mL/min) was calculated using the Cockroft–Gault equation. CrCl ≥90 mL/min was considered normal, CrCl 60–90 mL/min (moderate) and CrCl &lt;60 mL/min (abnormal). We used mixed-effects linear regression models to test for differences in the change in CrCl between the IP and DP arms. The frequency of adverse renal events between the randomization arms was examined using χ²/Fisher's exact tests. The CAP016 parent study was registered on ClinicalTrials.gov under NCT03227731.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean difference in CrCl change from 6 to 74 weeks between IP and DP arms was −0.67% (<i>p</i> = 0.809). There was no correlation between randomization arm and change in CrCl over time (β-2.08; <i>p</i> = 0.094). There were 16 (4%) moderate/Grade 2 CrCl abnormalities during the postpartum period, which were comparable between randomization arms. BMI of &lt;18.5 kg/m² was significantly associated with a moderate renal adverse event (OR 71.8; 95% CI 17.0–302.8) (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tenofovir disoproxil fumarate, when given in combination with emtricitabine as pre-exposure prophylaxis during pregnancy and lactation, appears not to have an effect on creatinine clearance and the frequency of adverse renal events in African women without HIV during the 74 week postpartum period. More research is needed to support our findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1333-1343"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947600","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}