HIV Medicine最新文献

{"title":"HCV-HIV co-infection in people who inject drugs: Barriers to treatment and cure of HCV infection in the era of DAAs, a prospective study in Athens, Greece","authors":"Dimitris Basoulis,&nbsp;Elpida Mastrogianni,&nbsp;Irene Eliadi,&nbsp;Martha Papadopoulou,&nbsp;Mina Psichogiou","doi":"10.1111/hiv.13681","DOIUrl":"10.1111/hiv.13681","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>HIV/hepatitis C virus (HCV) co-infection among people who inject drugs (PWID) remains a global health problem. The goal of our study was to evaluate, in a real-world setting, success rates of sustained virological response (SVR) using direct-acting antivirals (DAAs) to treat a population of PWID living with HCV/HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective single-center observational study. We collected demographic, socioeconomic, and clinical data pertaining to HIV and HCV infection in PWID with several barriers to care. We identified risk factors for SVR failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 130 individuals retained to HIV care, we planned HCV treatment in 119/130 (91.5%); 106/119 (89.1%) started treatment with DAAs and 100/106 (94.3%) completed treatment. People not starting treatment were more often in active opioid drug use (odds ratio [OR] 0.25; 95% confidence interval [CI] 0.07–0.97, <i>p</i> = 0.045) and benzodiazepine abuse (OR 0.25; 95% CI 0.07–0.95, <i>p</i> = 0.042). Only 86/100 (86%) were tested for SVR at 12 weeks (SVR12) and 72/86 (83.7%) achieved SVR. PWID in opioid substitution programmes tended to return for SVR12 testing more often (54.7% vs. 30%, <i>p</i> = 0.081). Individuals in active opioid drug use (OR 0.226; 95% CI 0.064–0.793, <i>p</i> = 0.02) or with poor adherence (OR 0.187; 95% CI 0.043–0.814, <i>p</i> = 0.025) were less likely to achieve SVR. At the end of our study period, 113/119 (95%) treatment-eligible patients remained alive. HCV infection was cured in 68/113 (61.1%) people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings underscore the importance of prioritizing combatting substance use to achieve HCV elimination goals. A systematic approach with effort to overcome barriers to receiving and completing treatment and encourage to enrol in opioid substitution programmes if not possible to completely abstain from use, can help increase chances of HCV cure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 10","pages":"1135-1144"},"PeriodicalIF":2.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141547045","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 anal high-risk human papillomavirus (HR-HPV) types in people living with HIV and a history of cancer","authors":"Salim A. Barquet-Muñoz,&nbsp;Roxana A. López-Morales,&nbsp;Elizabeth A. Stier,&nbsp;Emmanuel Mejorada-Pulido,&nbsp;Diego Solís-Ramírez,&nbsp;Naomi Jay,&nbsp;Paulina Moctezuma,&nbsp;Mariel Morales-Aguirre,&nbsp;Alejandro García-Carrancá,&nbsp;Rocío Méndez-Martínez,&nbsp;Alexandra Martin-Onraët,&nbsp;Delia Pérez-Montiel,&nbsp;María José Mendoza-Palacios,&nbsp;Patricia Volkow","doi":"10.1111/hiv.13684","DOIUrl":"10.1111/hiv.13684","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>This study aimed to describe the prevalence of high-risk human papillomavirus (HR-HPV) types in the anal canal in a cohort of people living with HIV (PLWHIV) with a history of malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Referral tertiary care hospital for adult patients with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed data of patients from the AIDS Cancer Clinic on antiretroviral therapy in chronic control who were consecutively referred for high-resolution anoscopy (HRA), where they underwent anal evaluation, collection of specimens for anal cytology and anal human papillomavirus (HPV) followed by HRA with directed biopsy if needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 155 patients were included; 149 (96.1%) were men, all of them men who have sex with men (MSM); the median age was 39 (IQR 32-47) years; 105 (67.7%) with Kaposi sarcoma, 40 (25.8%) with non-Hodgkin lymphoma and 10 (6.4%) with other neoplasms; only 7 (4.5%) had active cancer. The prevalence of HR-HPV infection was 89% (<i>n</i>=138) (95% CI 83–93) with at least one HR-HPV infection, and 62% (96) had coinfection with at least two types; the median HR-HPV types of coinfection were 3 (IQR 2–4). The number of patients infected with HPV 16 was 64 (41.3%, 95% CI 33.8–49.3), HPV 18 was 74 (47.7%, 95% CI 39.9–55.7) and with both 35 (22.6%). Some 59 patients (38%) had high-grade squamous intraepithelial lesions (HSIL) and 49 (31.6%) had low-grade squamous intraepithelial lesions (LSIL). The prevalence of HR-HPV and HSIL among patients aged ≤35 and &gt;35 years was the same.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this cohort of PLWHIV with a history of malignancy we found a high prevalence of HR-HPV 16 and 18 and anal HSIL, even in persons aged ≤35 years. These data highlight the importance of anal cancer screening in PLWHIV and history of malignancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 10","pages":"1145-1153"},"PeriodicalIF":2.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141547046","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":"Clinically recognized sleep disorders in people living with HIV","authors":"Jennifer O. Lam,&nbsp;Craig E. Hou,&nbsp;Stacey Alexeeff,&nbsp;Tory Levine,&nbsp;Varada Sarovar,&nbsp;Alexandra N. Lea,&nbsp;Verena E. Metz,&nbsp;Michael A. Horberg,&nbsp;Derek D. Satre,&nbsp;Michael J. Silverberg","doi":"10.1111/hiv.13682","DOIUrl":"10.1111/hiv.13682","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite recognition that people with HIV (PWH) are more vulnerable to sleep issues, there is limited understanding of clinically recognized sleep disorders in this population. Our objective was to evaluate the full spectrum of sleep disorder types diagnosed among PWH in care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study of PWH, and a comparator group of people without HIV (PWoH), in a large healthcare system. The incidence of clinically diagnosed sleep disorders was calculated using Poisson regression for three outcomes: any type of sleep disorder, insomnia, and sleep apnea. Incidence was compared between PWH and PWoH by computing the adjusted incidence rate ratio (aIRR), accounting for sleep disorder risk factors. Comparisons to PWoH were made for all PWH combined, then with PWH stratified by HIV management status (well-managed HIV defined as being on antiretroviral therapy, HIV RNA &lt;200 copies/mL, and CD4 count ≥500 cells/μL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 9076 PWH and 205 178 PWoH (mean age 46 years, 90% men). Compared with PWoH, sleep disorder incidence was greater among PWH overall [aIRR = 1.19, 95% confidence interval (CI): 1.12–1.26], particularly for insomnia (aIRR = 1.56, 95% CI: 1.45–1.67). Sleep apnea incidence was lower among PWH (aIRR = 0.90, 95% CI: 0.84–0.97). In HIV management subgroups, PWH without well-managed HIV had lower sleep apnea incidence (vs. PWoH: aIRR = 0.79, 95% CI: 0.70–0.89) but PWH with well-managed HIV did not (vs. PWoH: aIRR = 0.97, 95% CI: 0.89–1.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PWH have high sleep disorder incidence, and insomnia is the most common clinical diagnosis. Lower sleep apnea incidence among PWH may reflect underdiagnosis in those with sub-optimally treated HIV and will be important to investigate further.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 10","pages":"1162-1168"},"PeriodicalIF":2.8,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418724","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":"Multicentre service evaluation of injectable cabotegravir and rilpivirine delivery and outcomes across 12 UK clinics (SHARE LAI-net)","authors":"Kyle Ring,&nbsp;Melanie Smuk,&nbsp;Moses Shongwe,&nbsp;Leroy Okonta,&nbsp;Nicola E. Mackie,&nbsp;Sara Ayres,&nbsp;Tristan J. Barber,&nbsp;Jane Akodu,&nbsp;Filippo Ferro,&nbsp;Daniella Chilton,&nbsp;Eliot Hurn,&nbsp;Bhavna Halai,&nbsp;Will Barchi,&nbsp;Asim Ali,&nbsp;Sandra Darko,&nbsp;Gemma White,&nbsp;Emily Clarke,&nbsp;Fiona Clark,&nbsp;Bazga Ali,&nbsp;Joseph Arumainayagam,&nbsp;Gaynor Quinn,&nbsp;Marta Boffito,&nbsp;Ruth Byrne,&nbsp;Nadia Naous,&nbsp;Suki Leung,&nbsp;Athavan Umaipalan,&nbsp;Brian Thornton,&nbsp;David Bayliss,&nbsp;Catherine McLoughlin,&nbsp;Jonathan Foster,&nbsp;Laura Waters,&nbsp;Chloe Orkin","doi":"10.1111/hiv.13679","DOIUrl":"10.1111/hiv.13679","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Long-acting injectable cabotegravir + rilpivirine (CAB + RPV LAI) was approved for use in virally suppressed adults in the England and Wales national health service in November 2021. We describe a service evaluation of delivery processes and outcomes in 12 clinics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Centres populated a database using information from local policies and clinical records. Services were asked to describe approval processes, clinic pathways, and adherence to national guidelines. Additional data were collected on reasons for regimen choice, treatment discontinuations, and management of viraemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 518 adults from 12 clinics were approved for CAB + RPV LAI between February 2022 and December 2023. Of the 518 people approved for CAB + RPV LAI, 423 received at least one injection. Median duration on CAB + RPV was 7.5 months (interquartile range 3.7–11.3). In total, 97% of injections were administered within the ±7-day window. Virological failure occurred in 0.7%, and 6% discontinued CAB + RPV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this large UK-based cohort, robust approval processes and clinic protocols facilitated on-time injections and low rates of both discontinuation and virological failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 10","pages":"1125-1134"},"PeriodicalIF":2.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300575","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":"Clinical characteristics of women with HIV in the RESPOND cohort: A descriptive analysis and comparison to men","authors":"J. Hutchinson,&nbsp;B. Neesgard,&nbsp;J. Kowalska,&nbsp;K. Grabmeier-Pfistershammer,&nbsp;M. Johnson,&nbsp;K. Kusejko,&nbsp;S. De Wit,&nbsp;F. Wit,&nbsp;C. Mussini,&nbsp;A. Castagna,&nbsp;M. Stecher,&nbsp;C. Pradier,&nbsp;P. Domingo,&nbsp;C. Carlander,&nbsp;J. Wasmuth,&nbsp;N. Chkhartishvili,&nbsp;V. Uzdaviniene,&nbsp;A. Haberl,&nbsp;A. d'Arminio Monforte,&nbsp;H. Garges,&nbsp;J. Gallant,&nbsp;M. Said,&nbsp;B. Schmied,&nbsp;M. van der Valk,&nbsp;D. Konopnicki,&nbsp;N. Jaschinski,&nbsp;A. Mocroft,&nbsp;L. Greenberg,&nbsp;F. Burns,&nbsp;L. Ryom,&nbsp;K. Petoumenos","doi":"10.1111/hiv.13662","DOIUrl":"10.1111/hiv.13662","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Women with HIV are globally underrepresented in clinical research. Existing studies often focus on reproductive outcomes, seldom focus on older women, and are often underpowered to assess sex/gender differences. We describe CD4, HIV viral load (VL), clinical characteristics, comorbidity burden, and use of antiretroviral therapy (ART) among women with HIV in the RESPOND study and compare them with those of the men in RESPOND.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RESPOND is a prospective, multi-cohort collaboration including over 34 000 people with HIV from across Europe and Australia. Demographic and clinical characteristics, including CD4/VL, comorbidity burden, and ART are presented at baseline, defined as the latter of 1 January 2012 or enrolment into the local cohort, stratified by age and sex/gender. We further stratify men by reported mode of HIV acquisition, men who have sex with men (MSM) and non-MSM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women account for 26.0% (<i>n</i> = 9019) of the cohort, with a median age of 42.2 years (interquartile range [IQR] 34.7–49.1). The majority (59.3%) of women were white, followed by 30.3% Black. Most women (75.8%) had acquired HIV heterosexually and 15.9% via injecting drug use. Nearly half (44.8%) were receiving a boosted protease inhibitor, 31.4% a non-nucleoside reverse transcriptase inhibitor, and 7.8% an integrase strand transfer inhibitor. The baseline year was 2012 for 73.2% of women and &gt;2019 for 4.2%. Median CD4 was 523 (IQR 350–722) cells/μl, and 73.6% of women had a VL &lt;200 copies/mL. Among the ART-naïve population, women were more likely than MSM but less likely than non-MSM (<i>p</i> &lt; 0.001) to have CD4 &lt;200 cells/μL and less likely than both MSM and non-MSM (<i>p</i> &lt; 0.001) to have VL ≥100 000 copies/mL. Women were also more likely to be free of comorbidity than were both MSM and non-MSM (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RESPOND women are diverse in age, ethnicity/race, CD4/VL, and comorbidity burden, with important differences relative to men. This work highlights the importance of stratification by sex/gender for future research that may help improve screening and management guidelines specifically for women with HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 9","pages":"1058-1074"},"PeriodicalIF":2.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between markers of hepatitis B virus infection and risk of virological rebound in people with HIV receiving antiretroviral therapy","authors":"Vincenzo Malagnino,&nbsp;Alessandro Cozzi-Lepri,&nbsp;Valentina Svicher,&nbsp;Enrico Girardi,&nbsp;Carlo Federico Perno,&nbsp;Annalisa Saracino,&nbsp;Gianluca Cuomo,&nbsp;Stefano Rusconi,&nbsp;Massimo Puoti,&nbsp;Antonella D'Arminio Monforte,&nbsp;Massimo Andreoni,&nbsp;Loredana Sarmati,&nbsp;ICONA Foundation Study Group","doi":"10.1111/hiv.13680","DOIUrl":"10.1111/hiv.13680","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this analysis was to investigate the impact of hepatitis B virus (HBV) coinfection on the risk of HIV viral rebound (VR) after achieving suppression for the first time following initiation of antiretroviral therapy (ART) in the real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Patients living with HIV (PLWH) who were enrolled in the ICONA Foundation Study cohort and achieved viral suppression ≤50 copies/mL for the first time after starting ART were prospectively evaluated and divided in three exposure groups according to serology test results: (a) HIV-monoinfected; (b) HIV-positive/HBcAb-positive/HBsAg-negative; (c) HIV-positive/HBsAg-positive. The occurrence of VR, defined as two consecutive HIV-RNA values &gt;50 copies/mL after achieving viral suppression for the first time (baseline), was investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Standard survival analysis by means of Kaplan–Meier curves and Cox regression analysis with the serology exposure fitted as a time-fixed covariate measured at baseline was employed after controlling for key confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of a total of 5657 patients included, 4090 (72%) were HIV-monoinfected, 1342 (23.7%)were HBcAb-positive, and 225 (3.9%) were HbsAg-positive coinfected. Overall, 654 (11.5%) PLWH experienced VR &gt; 50 copies/mL during follow-up. After controlling for all sources of measured confounding, coinfected PLWH showed an increased risk of experiencing VR compared with those who were HIV-monoinfected. In particular, the strongest associations were seen for the HIV/HBsAg-positive participants [adjusted hazard ratio (aHR) = 1.56, 95% confidence interval (CI): 1.03–2.38, <i>p</i> = 0.037] but an excess of risk was also seen in those who were HIV-positive/HBcAb-positive/HBsAg-negative (aHR = 1.25, 95% CI: 1.00–1.55, <i>p</i> = 0.047).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Coinfection with HBV seems to have an impact on the probability of maintaining HIV viral suppression achieved for the first time after ART initiation. Of note, even PLWH positive for HBcAb, a marker of inactive HBV infection, appeared to be at higher risk of VR compared with those who were HIV-monoinfected and their HIV-RNA should be carefully monitored.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 10","pages":"1101-1111"},"PeriodicalIF":2.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hormonal therapy on HIV-1 immune markers in cis women and gender minorities","authors":"Chloé Pasin,&nbsp;David Garcia Nuñez,&nbsp;Katharina Kusejko,&nbsp;Anna Hachfeld,&nbsp;Hélène Buvelot,&nbsp;Matthias Cavassini,&nbsp;Lauro Damonti,&nbsp;Christoph Fux,&nbsp;Begoña Martinez de Tejada,&nbsp;Julia Notter,&nbsp;Alexandra Trkola,&nbsp;Huldrych F. Günthard,&nbsp;Karoline Aebi-Popp,&nbsp;Roger D. Kouyos,&nbsp;Irene A. Abela,&nbsp;the Swiss HIV Cohort Study","doi":"10.1111/hiv.13677","DOIUrl":"10.1111/hiv.13677","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although sex hormones are recognized to induce immune variations, the effect of hormonal therapy use on immunity is only poorly understood. Here, we quantified how hormonal therapy use affects HIV-1 immune markers in cis women (CW) and trans women and non-binary people (TNBP) with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We considered CD4, CD8 and lymphocyte measurements from cis men (CM), CW and TNBP in the Swiss HIV Cohort Study. We modelled HIV-1 markers using linear mixed-effects models with an interaction between ‘gender’ (CW, TNBP) and ‘hormonal therapy use’ (yes/no). Models were adjusted on age, ethnicity, education level, time since start of antiretroviral therapy and use of intravenous drugs. We assessed the inflammatory effect of hormonal therapy use in 31 TNBP using serum proteomics measurements of 92 inflammation markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 54 083 measurements from 3092 CW and 83 TNBP, and 147 230 measurements from 8611 CM. Hormonal therapy use increased CD4 count and CD4:CD8 ratio in TNBP more than in CW (<i>p</i>_interaction = 0.02 and 0.007, respectively). TNBP with hormonal therapy use had significantly higher CD4 counts [median = 772 cells/μL, interquartile range (IQR): 520–1006] than without (617 cells/μL, 426–892). This was similar to the effect of CW versus CM on CD4 T cells. Hormonal therapy use did not affect serum protein concentrations in TNBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the potential role of hormonal therapy use in modulating the immune system among other biological and social factors, especially in TNBP with HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 10","pages":"1112-1124"},"PeriodicalIF":2.8,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13677","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237818","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":"Scars are frequently found as late sequelae in individuals affected by the 2022 mpox outbreak","authors":"David Chromy,&nbsp;Nikolaus Urban,&nbsp;Wolfgang Michael Bauer,&nbsp;Alexander Kreuter,&nbsp;Robert Strassl,&nbsp;Katharina Grabmeier-Pfistershammer","doi":"10.1111/hiv.13678","DOIUrl":"10.1111/hiv.13678","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The 2022 mpox outbreak continues, and while progress has been made in prevention strategies and potential treatment options, data on late sequelae following mpox are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This analysis aimed to assess the incidence of scar formation in individuals affected by the 2022 mpox outbreak.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All individuals diagnosed with mpox at the Department of Dermatology at the Medical University of Vienna in 2022 were included in this analysis. Follow-up data were collected throughout November 2023. ‘Scar formation’ was defined as having at least one scar at the former active mpox lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At our clinic, 28 cases of mpox presented between June 2022 and October 2022 and exclusively occurred in men who have sex with men (100%, 28/28), of whom 46% (13/28) were living with HIV, and 32% (9/28) were using pre-exposure prophylaxis (PrEP). Secondary bacterial infection of mpox lesions was suspected in six individuals, and all received systemic antibiotics. Overall, 26 were followed up in November 2023 after a median time of 15 months, and scar formations were found in 43% of cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data provide insights into the late yet cumulating disease burden caused by the 2022 mpox outbreak. Highly effective prevention strategies are warranted to overcome the mpox epidemic and its potential late sequelae.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 9","pages":"1091-1096"},"PeriodicalIF":2.8,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British HIV Association guidelines on the management of opportunistic infection in people living with HIV: Considerations in pregnancy 2024","authors":"J. Greig,&nbsp;A. Bamford,&nbsp;D. Chadwick,&nbsp;A. Darley,&nbsp;D. Gamoudi,&nbsp;J. Palit","doi":"10.1111/hiv.13645","DOIUrl":"10.1111/hiv.13645","url":null,"abstract":"<p>The scope, purpose and guideline topics were agreed by the writing group. The search (population, intervention, comparator and outcome [PICO]) questions were set and an independent systematic literature review carried out. The Medline, Embase and Cochrane Library databases were searched and the literature reviewed to address each question. The PICO questions and search strategies are outlined in Appendix 2.</p><p>Further details of the methodology can be found on the BHIVA website (https://www.bhiva.org/file/5d514ec9b503d/OI-guidelines-methods-general.pdf), including the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess and grade the evidence. Good practice points (GPPs) are recommendations, based on the clinical judgment and experience of the writing group, with which few clinicians are expected to disagree and for which evidence is unlikely to emerge as they are generally considered to be good practice.</p><p>From Section 6.2 Antifungal treatment for candidiasis and cryptococcal infection.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 S3","pages":"3-19"},"PeriodicalIF":3.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175389","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":"Recently acquired HCV infection in men who have sex with men in Germany in the direct-acting antivirals era and during the COVID-19 pandemic","authors":"Patrick Ingiliz,&nbsp;Thomas Lutz,&nbsp;Knud Schewe,&nbsp;Axel Baumgarten,&nbsp;Ivanka Krznaric,&nbsp;Stefan Mauss,&nbsp;Stefan Christensen,&nbsp;Markus Bickel,&nbsp;Axel J. Schmidt,&nbsp;Michael Sabranski,&nbsp;Feng He,&nbsp;Sonia Jain,&nbsp;Nastasha K. Martin,&nbsp;Jürgen K. Rockstroh,&nbsp;Christoph Boesecke","doi":"10.1111/hiv.13651","DOIUrl":"10.1111/hiv.13651","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Direct-acting antivirals (DAAs) are key to eliminating hepatitis C virus (HCV). In men who have sex with men (MSM) with HIV co-infection, recently acquired HCV infection is common. Sexual practices and reinfection rates may hamper micro-elimination despite high treatment rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The cohort included MSM with recently acquired HCV infection from 2014 to 2021. The patients' demographic, clinical, behavioural, and laboratory data and treatment and reinfection outcomes were documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 237 men with recently acquired HCV infection were included: 216 (91%) had HIV. The median age was 46 years (interquartile range [IQR] 39–52), and the median CD4 count was 660/mm³ (IQR 527–835).</p>\u0000 \u0000 <p>The annual incidence of recently acquired HCV remained between 0.28% and 0.43% but dropped to 0.02% in 2021 during the COVID pandemic, almost reaching micro-elimination. The reinfection incidence was 15.5 per 100 patient-years (95% confidence interval 12.6–18.8), and reinfection was associated with the use of crystal methamphetamine (<i>p</i> = 0.032) and ketamine (<i>p</i> = 0.042). In total, 31.3% had multiple reinfections, and four reinfections occurred in users of pre-exposure prophylaxis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High treatment and cure rates did not lead to HCV elimination. A change in sexual behaviour, potentially imposed by COVID-19 restrictions, led to micro-elimination in the NoCo cohort. As recently acquired HCV is prevalent in MSM with and without HIV, surveillance is necessary to consolidate elimination goals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"25 8","pages":"967-975"},"PeriodicalIF":2.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.13651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175383","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}