HIV Medicine最新文献

{"title":"Diabetes risk in HIV infection and antiretroviral therapy: A systematic review and meta-analysis of prospective cohort evidence","authors":"Xuanlan Li,&nbsp;Kang Li,&nbsp;Yuxuan Li,&nbsp;Yue Zhao,&nbsp;Yingqiong Huang,&nbsp;Jun Luo,&nbsp;Li Jiang,&nbsp;Sisi Li,&nbsp;Juan Jing,&nbsp;Chuanyi Ning","doi":"10.1111/hiv.70256","DOIUrl":"10.1111/hiv.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To quantify the incidence rate (IR) of diabetes in people living with HIV (PLWH), assess disparities relative to HIV-negative individuals and clarify the associations of antiretroviral therapy (ART) exposure and treatment duration with diabetes incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed up to July 20, 2025, for prospective cohort studies including PLWH aged ≥18 with ≥6 months of follow-up and reported diabetes incidence. Two reviewers independently assessed study quality using the Newcastle-Ottawa Scale and extracted data. A random-effects model estimated pooled incidence rates and subgroup differences. Meta-regression was performed to evaluate study-level associations between ART duration and diabetes incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-one studies contributed 1 230 314 person-years (PY) of follow-up. The IR in PLWH was 12.98 cases per 1000 PY (95% CI: 10.97–14.98). No significant difference was observed between PLWH (12.97 cases per 1000 PY) and HIV-negative individuals (12.67 cases per 1000 PY; <i>p</i> = 0.9597), although this comparison was based on a limited number of studies. However, incidence among PLWH on ART (14.05 cases per 1000 PY) was significantly higher than in those not on ART (7.42 cases per 1000 PY; <i>p</i> = 0.0179). Each year of ART exposure was associated with an increase of 0.354 cases per 1000 PY in univariable meta-regression (<i>p</i> = 0.008). In multivariable meta-regression, the association between ART duration and diabetes incidence remained significant after adjustment for mean age (<i>p</i> = 0.038), while age was also independently associated with higher incidence (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Diabetes incidence in PLWH is substantial and varies across regions and diagnostic definitions. Evidence comparing PLWH with HIV-negative individuals remains limited. ART exposure and longer ART duration are associated with higher diabetes incidence, highlighting the importance of routine metabolic screening in long-term HIV care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1225-1240"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868053","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":"Prognostic value of ankle-brachial index and cardio-ankle vascular index for mortality and cardiovascular events in older people with HIV on long-term ART","authors":"Porntep Amornritvanich,&nbsp;Sarawut Siwamogsatham,&nbsp;Pairoj Chattranukulchai,&nbsp;Monravee Tumkosit,&nbsp;Tanakorn Apornpong,&nbsp;Hay Mar Su Lwin,&nbsp;Napon Hiranburana,&nbsp;Yanisa Jarusyingdumrong,&nbsp;Win Min Han,&nbsp;Stephen Kerr,&nbsp;Anchalee Avihingsanon","doi":"10.1111/hiv.70244","DOIUrl":"10.1111/hiv.70244","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the association of the Cardio-Ankle Vascular Index (CAVI) and ankle-brachial index (ABI) with all-cause mortality and major adverse cardiovascular events (MACE) in older people with HIV receiving long-term antiretroviral therapy (ART) in Thailand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective cohort study of 307 virologically suppressed participants aged ≥50 years who underwent baseline CAVI and ABI measurements. ABI was analysed both as a continuous variable and as a categorical variable using a cut-off &lt;0.9. Outcomes were all-cause mortality and MACE (non-fatal myocardial infarction, ischaemic stroke or percutaneous coronary intervention). Associations between high CAVI (≥9) or continuous CAVI and outcomes were examined using Cox proportional hazards models adjusted for age, smoking, hypertension and interleukin-6 (IL-6).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, 18.2% of participants had high CAVI (≥9). Over a median follow-up of 8 years, 50 participants (16.3%) experienced the composite outcome, including 37 deaths (12.1%). After adjustment, categorical CAVI ≥ 9 was significantly associated with all-cause mortality (aHR 2.67, 95% CI: 1.37–5.21, <i>p</i> = 0.004) but did not reach statistical significance for the composite outcome (aHR 1.64, 95% CI: 0.89–3.01, <i>p</i> = 0.112). However, when modelled as a continuous variable, each unit increase in CAVI was associated with an increased risk of composite outcome (aHR 1.29, 95% CI: 1.08–1.54, <i>p</i> = 0.004). Ever smoking, hypertension and elevated IL-6 were significantly associated with increased risk of mortality and MACE. ABI &lt; 0.9 was strongly associated with mortality (aHR 4.20, 95% CI: 1.43–12.27).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In older people with HIV on long-term ART, traditional cardiovascular risk, systemic inflammation (IL-6) and low ABI (&lt;0.9) were stronger predictors of mortality and MACE. CAVI demonstrated prognostic value for mortality and the composite outcome, suggesting a potential complementary role in cardiovascular risk assessment. Clinical trial registration: HIVNAT 006 (NCT00411983).</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1277-1286"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770142","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":"Effectiveness of switching regimen in people living with HIV and persistent low-level viraemia in the modern antiretroviral treatment era","authors":"Tommaso Clemente,&nbsp;Pierluigi Reali,&nbsp;Riccardo Lolatto,&nbsp;Flavia Passini,&nbsp;Girolamo Piromalli,&nbsp;Rebecka Papaioannu Borjesson,&nbsp;Gaia Catalano,&nbsp;Diana Canetti,&nbsp;Elena Bruzzesi,&nbsp;Emanuela Messina,&nbsp;Silvia Nozza,&nbsp;Antonella Castagna,&nbsp;Vincenzo Spagnuolo","doi":"10.1111/hiv.70251","DOIUrl":"10.1111/hiv.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Persistent low-level viraemia (pLLV) remains a clinical challenge despite antiretroviral therapy (ART). Evidence guiding optimal therapeutic management is still limited, particularly in the modern ART era dominated by second-generation integrase inhibitors. We aimed to evaluate virological outcomes following pLLV based on ART changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cohort study on adult people living with HIV (PLWH) on ART with ≥1 pLLV episode since 2014. pLLV was defined as ≥2 consecutive viral loads 50–199 copies/mL ≥30 days apart, preceded by a viral load &lt;50 copies/mL. The primary outcome was virological suppression (viral load &lt;50 copies). Follow-up accrued from the first viral load 50–199 copies/mL (baseline) to virological suppression, virological failure (≥2 consecutive viral loads ≥200 or ≥1 viral load ≥1000 copies/mL), a second ART modification among those who had already switched once during the follow-up or the last available viral load. Predictors of time to virological suppression were evaluated using Cox regression, treating ART switch as a time-dependent variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 6794 PLWH in care, 451 (6.6%) experienced pLLV. After a median follow-up of 9.0 months, 81.2% achieved virological suppression and 3.5% developed virological failure. ART was switched in 176 (39.0%) individuals. ART switching was associated with a shorter time to virological suppression (adjusted hazard ratio = 2.1, 95% confidence interval = 1.7–2.7, <i>p</i> &lt; 0.001), even in individuals on regimens with a higher barrier to resistance. Higher baseline viraemia was inversely associated with the hazard of virological suppression. Genotypic resistance data during pLLV were limited; however, resistance-associated mutations might have been potentially selected in 22 (4.9%) PLWH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the current ART era, switching ART during pLLV may shorten the time to virological suppression, even among individuals receiving regimens with a higher barrier to resistance. Prompt and careful evaluation of treatment optimization is reasonable in this setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1367-1375"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world clinical and laboratory changes after switching to two-drug regimen in HIV-suppressed individuals: 48 weeks and beyond","authors":"Tommy Hing-cheung Tang,&nbsp;Ruby Tsz-shan Kwong,&nbsp;Phillip Chan,&nbsp;Kwok-wai Lam,&nbsp;Helen Shuk-ying Chan,&nbsp;Man-yee Chu,&nbsp;Wilson Lam,&nbsp;Tak-chiu Wu,&nbsp;Wai-shing Leung,&nbsp;Sai-kwong Yung,&nbsp;Wan-man Ting,&nbsp;Annabel Kai-tung Choy,&nbsp;Joe Lok-fung Tung,&nbsp;Jason Ka-wah Fong,&nbsp;Daniel Kai-yeung Yeung,&nbsp;Man-po Lee","doi":"10.1111/hiv.70247","DOIUrl":"10.1111/hiv.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Two-drug regimens (2DRs) may reduce long-term drug toxicities and drug-drug interactions for people with HIV (PWH) on antiretroviral therapy (ART). This study evaluated clinical and laboratory outcomes in PWH who switched from standard ART to dolutegravir and lamivudine (DTG + 3TC) in real-world settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively identified virally suppressed PWH who switched from standard ART to DTG + 3TC at Queen Elizabeth Hospital, Hong Kong, China. They were grouped by age (PWH &lt;50 years: PWH &lt; 50; PWH &gt; =50 years: PWH &gt; =50). Their demographics, clinical and laboratory data before and 48 weeks after switch were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Subjects included 352 PWH (84.7% male, 48.7% PWH &gt; =50, median ART duration 8.3 years). At 48 weeks post-switch, 96.0% maintained DTG + 3TC with two (1.1%) in the PWH &lt; 50 and three (1.7%) in the PWH &gt; =50 experienced virological failure. There was no significant difference in virological failure (hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.11, 3.77, <i>p</i> = 0.613) or 2DR discontinuation (HR 0.95, 95% CI 0.33, 2.71, <i>p</i> = 0.926; restricted mean survival time (RMST) difference 0.23 weeks, 95% CI −0.64, 1.10, <i>p</i> = 0.600) between the groups. PWH &gt; =50 exhibited a greater total cholesterol reduction than PWH &lt; 50 post-switch (median change −4.8% (IQR −17.5%, 5.9%) versus 0.4% (IQR −8.1%, 8.2%), <i>p</i> = 0.005). Two sensitivity analyses excluding lipid-lowering drug users and restricting to INSTI-based ART users before switch yielded negative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this Chinese-majority cohort, switching from standard ART to DTG + 3TC was well tolerated at 48 weeks by both younger and older PWH. Despite more comorbidities in PWH &gt; =50, their changes in laboratory outcomes post-switch were comparable to PWH &lt; 50.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1241-1252"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836999","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":"Monitoring the HIV response for trans people in Europe and Central Asia","authors":"S. North,&nbsp;P. A. Calderon-Cifuentes,&nbsp;D. Raben,&nbsp;S. Bivol,&nbsp;A. Rinder Stengaard,&nbsp;T. Noori","doi":"10.1111/hiv.70250","DOIUrl":"10.1111/hiv.70250","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This paper aims to present available data on national responses to HIV for trans populations related to national policies, legal environments and prevention programmes, as reported by European and Central Asian countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between February and April 2024, the European Centre for Disease Prevention and Control disseminated an online questionnaire to nominated National HIV Focal Points in Europe and Central Asia to monitor implementation of the Dublin Declaration on partnership to fight HIV/AIDS. This included questions on national HIV policies, legal environments, prevention programmes, the continuum of HIV care and avoidance of healthcare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three of 50 countries involve trans people in the content and development of national HIV strategies and policies related to their health. Two of 47 countries enact punitive legislation against trans people, and there is some evidence of healthcare seeking avoidance among trans people due to stigma in healthcare settings. In half of reporting countries (23/46), trans people have free (no cost) access to sexually transmitted infection testing and treatment. Limited availability and quality of national HIV data on the number of trans people diagnosed, treated and virally suppressed prevent the accurate measurement of progress towards global HIV targets for this key population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Trans people are to a lesser extent than other key populations addressed in national HIV policies and strategies, and the data available from countries suggest lower levels of access to services because of costs, unsupportive legal environments and avoidance of seeking healthcare services. Without comprehensive and trans-inclusive data collection, national and regional HIV responses may risk neglecting the specific needs of trans people in HIV prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1358-1366"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836658","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":"CHildren of the Cohort Study (CHOC): Exploring parenting desire among people living with HIV in Switzerland","authors":"Clara Merlin,&nbsp;José Damas,&nbsp;Olivier Nawej Tshikung,&nbsp;Noémie Wagner,&nbsp;Anna Hachfeld,&nbsp;Andrea Duppenthaler,&nbsp;Marcel Stoeckle,&nbsp;Malte Kohns,&nbsp;Irene A. Abela,&nbsp;Paolo Paioni,&nbsp;Luigia Elzi,&nbsp;Lisa Kottanattu,&nbsp;Patrick Schmid,&nbsp;Christian R. Kahlert,&nbsp;Katharina Kusejko,&nbsp;Pierre Alex Crisinel,&nbsp;Pascal Pellegrino,&nbsp;Matthias Cavassini,&nbsp;Katharine E. A. Darling,&nbsp;the Swiss HIV Cohort Study","doi":"10.1111/hiv.70253","DOIUrl":"10.1111/hiv.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although HIV is now a chronic condition with an excellent life expectancy, some personal aspects affecting people living with HIV (PLWH), such as parenting desire, are relatively understudied. This study aimed to explore parenting desire among PLWH in Switzerland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From September 2022 until January 2024, PLWH (participants) enrolled in the Swiss HIV Cohort Study (SHCS) and followed up at seven university/cantonal hospitals were invited to complete a structured questionnaire co-designed with patient and public involvement. There were no exclusion criteria. The questionnaire covered parenting desire, the perceived influence of HIV on family planning and whether future parenthood had ever been discussed with an HIV physician.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 5038 PLWH attending SHCS clinic visits, 3006 (59.7%) completed the questionnaire (2974 (98.9%) complete datasets analysed). The median age was 54 years (IQR 44;61), 27% were female, 39% were men who have sex with men (MSM), 16% were of Black ethnicity, 94.5% had HIV RNA plasma viral loads &lt;50 copies/ml. Overall, 515 participants (17.3%) expressed a desire for parenting, with a desire associated with being aged &lt;45 years and of Black ethnicity, and 506 (17%) stated that HIV influenced family planning decisions. Discussing parenthood was associated with being female, Black, heterosexual and in a stable relationship. Among heterosexual male participants, 26.1% had ever had such discussions, compared to 6.8% of MSM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this sample of PLWH, a minority expressed parenting desire, possibly due to high median participant age, and 17% felt HIV influenced family planning decisions. While female participants were more likely to have discussed future parenthood than male participants, there was a further disparity between heterosexual men and MSM. Whilst surrogacy is prohibited in Switzerland, MSM may have access to parenthood in other ways. Our findings suggest there is room for HIV physicians to proactively invite parenting discussions with all PLWH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1287-1297"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868061","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":"Twice-daily bictegravir during rifampicin-based tuberculosis therapy: A pragmatic alternative","authors":"Juan Gabriel Sánchez-Cano,&nbsp;Laura Muñoz-Echeverría,&nbsp;María Casco-García,&nbsp;Leonor Moreno-Núñez","doi":"10.1111/hiv.70245","DOIUrl":"10.1111/hiv.70245","url":null,"abstract":"<p>HIV-tuberculosis coinfection remains a major global health challenge and the concomitant use of antiretroviral therapy with rifampicin-based tuberculosis treatment is frequently complicated by clinically relevant drug-drug interactions. Rifampicin strongly induces CYP3A4 and UGT1A1 enzymes, leading to significant reductions in plasma concentrations of several integrase strand transfer inhibitors, including bictegravir. As a result, recommended strategies usually involve modifying antiretroviral therapy to rifampicin-compatible regimens such as dolutegravir administered twice daily or using rifabutin-based tuberculosis therapy. However, these alternatives may not always be feasible or well tolerated in routine clinical practice. Increasing pharmacokinetic understanding of bictegravir and emerging clinical data suggest that dose intensification may partially overcome rifampicin-induced reductions in drug exposure. In this letter, we explore the potential role of bictegravir/emtricitabine/tenofovir alafenamide administered twice daily during rifampicin-based tuberculosis treatment as a pragmatic option in selected patients when standard therapeutic approaches cannot be used.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1376-1377"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728600","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":"Sustained effect of Scotland's HIV pre-exposure prophylaxis programme on transmission among gay and bisexual men who have sex with men: Population-based retrospective cohort study","authors":"Alan Yeung,&nbsp;Claudia Estcourt,&nbsp;Beth Cullen,&nbsp;Rebecca Metcalfe,&nbsp;Alison Rodger,&nbsp;Dan Clutterbuck,&nbsp;Nicola Steedman,&nbsp;Rak Nandwani,&nbsp;Duncan McCormick,&nbsp;Sharon Hutchinson","doi":"10.1111/hiv.70255","DOIUrl":"10.1111/hiv.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the population-level impact of seven years of Scotland's HIV pre-exposure prophylaxis (PrEP) programme among gay, bisexual and other men who have sex with men (GBMSM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>National administrative data were used to estimate PrEP coverage and HIV incidence among 35 342 GBMSM attending specialist sexual health services between July 2015 and March 2024. Poisson regression was used to investigate the risk of HIV acquisition and its association with the extent of PrEP prescribing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PrEP coverage increased from 21% in the initial PrEP period (July 2017 to March 2020) to 45% in the latter period (April 2022 to March 2024). HIV incidence reduced from 4.46 per 1000 person-years in the pre-PrEP period (July 2015 to June 2017) to 1.66 in the initial PrEP period (aIRR 0.37, 95% CI 0.25–0.54) and remained stable thereafter. During the entire PrEP period, the risk of HIV acquisition was reduced among those ‘currently prescribed’ (involving 4 HIV acquisitions among 11 720 person-years) compared to those never prescribed (60 HIV acquisitions among 34 328 person-years) (aIRR 0.19, 95% CI 0.07–0.51). Compared to those currently prescribed PrEP, risk was greatest in those prescribed 12+ months ago (11 HIV acquisitions among 3824 person-years) (aIRR 8.13, 95% CI 2.58–25.64).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HIV incidence was sustained at a low level as PrEP coverage broadened among GBMSM, but did not reduce further. Efforts to support persistence and re-engagement with PrEP are warranted in those at ongoing risk of HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1298-1311"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836989","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":"Models of care for women living with HIV in Europe: A scoping review","authors":"D. Rao,&nbsp;O. M. Inescu,&nbsp;C. A. Sabin,&nbsp;O. Sǎndulescu,&nbsp;G. Dragovic,&nbsp;Å. Mellgren,&nbsp;J. Kowalska,&nbsp;G. Lourida,&nbsp;E. Moseholm,&nbsp;EACS WAVE Health Care Perception Working Group","doi":"10.1111/hiv.70266","DOIUrl":"10.1111/hiv.70266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>With the widespread availability of antiretroviral therapy, human immunodeficiency virus (HIV) has become a chronic condition requiring long-term, integrated care. Women with HIV experience distinct clinical, reproductive, and psychosocial needs shaped by gender and social determinants. However, care models addressing these needs for women in Europe have not been comprehensively documented. In this scoping review, we aim to map existing literature on models of care for women with HIV in Europe and examine their key components and regional variation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched the Ovid database to identify studies on care models for women with HIV in Europe from 2000 onwards. We further included national guidelines provided by the European AIDS Clinical Society (EACS) country representatives. Two reviewers independently extracted data and synthesized findings using descriptive content analysis informed by the World Health Organization Social Determinants of Health framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 8183 records screened, 17 studies and guidelines met inclusion criteria. Most originated from Western and Central Europe, with only one source from Eastern Europe. We identified 10 core components of women-responsive HIV services: co-design of services with women with HIV, healthcare provider training, tailored programming for women, gender-inclusive and culturally sensitive approaches, HIV/AIDS continuum of care, multidisciplinary integration of services, emotional and psychological support services, peer-support programmes, social support services and gender-specific HIV research. These components collectively addressed clinical management, psychosocial well-being and structural determinants influencing engagement and retention in care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Effective HIV care for women in Europe requires integrated, life-course-oriented models beyond virological control, addressing psychosocial and structural determinants, while expanding women-centred services, particularly in Eastern Europe.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1212-1224"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163063","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":"Mortality trends for diabetes mellitus, hypertension and cardiovascular disease among people living with and without HIV in Brazil during the COVID-19 pandemic, 2020–2022","authors":"Tatyellen Natasha da Costa Oliveira,&nbsp;Rodrigo C. Moreira,&nbsp;Luiz Max Carvalho,&nbsp;Flávio Codeço Coelho,&nbsp;Marcelo Ferreira da Costa Gomes,&nbsp;Leonardo S. Bastos,&nbsp;Laís Picinini Freitas,&nbsp;Antonio G. Pacheco","doi":"10.1111/hiv.70240","DOIUrl":"10.1111/hiv.70240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>People living with HIV (PLWH) face an increasing burden of non-AIDS-related chronic conditions. However, how the COVID-19 pandemic affected chronic disease-related mortality in this population remains unclear. We assessed changes in mortality among PLWH in Brazil during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a nationwide analysis using Brazil's Mortality Information System, including adults aged ≥18 years with and without HIV mentioned on death certificates from 2016 to 2022. Age- and sex-adjusted mortality ratios (aMRs) were estimated for all-cause mortality and for deaths associated with diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD) using Poisson generalized linear mixed models, with the pre-pandemic period 2016–2019 used as the reference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2016 and 2022, 90 888 deaths occurred among PLWH and 9 723 490 among individuals without HIV. Among PLWH, adjusted all-cause mortality ratios were lower in 2020 (aMR 0.918; 95% CI 0.900–0.936) and 2022 (aMR 0.950; 95% CI 0.932–0.968), while estimates for 2021 were close to the reference period. In contrast, individuals without HIV experienced increased mortality in 2020 (aMR 1.106; 95% CI 1.104–1.108), 2021 (aMR 1.269; 95% CI 1.267–1.272) and 2022 (aMR 1.029; 95% CI 1.027–1.031). Among PLWH, mortality associated with DM (aMRs 1.573–1.666), HTN (aMRs 1.738–1.978) and CVD (aMRs 1.242–1.377) increased consistently across all pandemic years. Among individuals without HIV, chronic disease-related mortality showed greater temporal variability, with increases in 2020 and 2021 followed by reductions in 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Chronic disease-related mortality increased persistently among PLWH during the COVID-19 pandemic, contrasting with declining trends in the general population. These results emphasize distinct mortality dynamics among PLWH during public health crises.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 8","pages":"1265-1276"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633197","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}