JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Quality of Life in People With HIV at the End of Life: Preliminary Results From the Last Gift Observational Cohort Study.","authors":"Brahm Coler, Gordon Honerkamp Smith, Anish K Arora, Adam Wells, Stephanie Solso, Cheryl Dullano, Susanna Concha-Garcia, Eddie Hill, Patricia K Riggs, Anastasia Korolkova, Robert Deiss, Davey Smith, Erin E Sundermann, Sara Gianella, Antoine Chaillon, Karine Dubé","doi":"10.1097/QAI.0000000000003536","DOIUrl":"10.1097/QAI.0000000000003536","url":null,"abstract":"<p><strong>Background: </strong>As people living with HIV (PWH) age, they face new challenges that can have a negative impact on their quality of life (QOL) and mental health.</p><p><strong>Setting: </strong>This study enrolled PWH at the end of life (EOL) who were actively engaged in cure-related research in Southern California, United States. EOL was defined as having a prognosis of 6 months or less to live. We examined the relationship between QOL, mental health, and research participation.</p><p><strong>Methods: </strong>Structured assessments were used to collect comprehensive data on QOL and mental health.</p><p><strong>Results: </strong>From 2017 to 2023, 35 PWH in their final stages of life who were actively engaged in cure-related research were enrolled. Their median age was 62.7 years, and most were White or otherwise non-Hispanic/non-Latino (90.6%), and male (86.7%). Changes in QOL and the presence of neurologic and psychiatric conditions, with a focus on depression and anxiety, were the primary outcomes assessed in this study. Participants had stable QOL scores throughout the study. There was an inverse relationship between QOL and Beck Depression Inventory scores, with higher mean QOL scores being associated with lower mean Beck Depression Inventory scores ( P < 0.001).</p><p><strong>Conclusions: </strong>QOL remained stable among PWH who participate in cure-related research at EOL. The inverse relationship between QOL and depressive symptoms suggests that participation in cure-related research may improve QOL or reduce depressive symptoms in this population. Future interventions should look into ways to improve the well-being of PWH at EOL through research and customized mental health interventions.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"82-89"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365137","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":"Impact of COVID-19 Pandemic on HIV Testing, Recent Infections, and Annualized Incidence Among Cisgender Men Who Have Sex With Men and Transgender Women in Brazil.","authors":"Cristina M Jalil, Sylvia L M Teixeira, Carolina Coutinho, Sandro C Nazer, Eduardo Carvalheira, Brenda Hoagland, Sandra W Cardoso, Paula M Luz, Valdilea G Veloso, Beatriz Grinsztejn, Emilia M Jalil, Thiago S Torres","doi":"10.1097/QAI.0000000000003531","DOIUrl":"10.1097/QAI.0000000000003531","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to the COVID-19 pandemic period among cisgender men who have sex with men (MSM) and transgender women (TGW).</p><p><strong>Setting: </strong>HIV and sexually transmitted infection testing, prevention, and treatment referral service in Rio de Janeiro, Brazil.</p><p><strong>Methods: </strong>We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of a recent infection testing algorithm to identify recent HIV infection cases and estimate annualized HIV incidences in the pre- (March 2018-February 2020) and post-COVID-19 pandemic onset period (March 2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection.</p><p><strong>Results: </strong>Among 3814 MSM and 776 TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between the COVID-19 periods. Overall annualized HIV incidence rates were 6.0% (95% confidence interval [CI]: 4.2 to 7.7) and 6.6% (95% CI: 4.3 to 9.0) in the pre- and post-COVID-19 periods, respectively. During the post-COVID-19 period, higher incidence rates were observed among TGW (8.4% [95% CI: 2.9 to 13.9]), those aged 18-24 years (7.8% [95% CI: 4.0 to 11.7]), of Black race (7.9% [95% CI: 3.8 to 12.0]), and those with <12 years of schooling (7.8% [95% CI: 4.8 to 10.8]). Compared to the pre-COVID-19 period, incidence rates were significantly higher in the post-COVID-19 period for those aged >30 years and TGW, while being lower for those with more years of schooling.</p><p><strong>Conclusion: </strong>HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the COVID-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":"98 1","pages":"12-19"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789499","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":"Preadmission VACS Index as a Predictor of Hospital Acute Kidney Injury in People with HIV.","authors":"Molly C Fisher, David B Hanna, Melissa Fazzari, Uriel R Felsen, Christina M Wyatt, Matthew K Abramowitz, Michael J Ross","doi":"10.1097/QAI.0000000000003589","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003589","url":null,"abstract":"<p><strong>Background: </strong>The Veterans Aging Cohort Study (VACS) Index is a summary measure of routinely obtained clinical variables that predicts numerous health outcomes. Since there are currently no tools to predict acute kidney injury (AKI) in persons with HIV (PWH), we investigated the association of preadmission VACS Index with hospital AKI in PWH.</p><p><strong>Methods: </strong>We conducted an observational study of PWH hospitalized in a New York City health system between 2010-2019. The VACS Index, calculated using outpatient laboratory values within 8-365 days of admission, was examined continuously and in quartiles. Multivariable Cox proportional hazards models, adjusting for sociodemographic factors, comorbidities, and ICU admission, determined the association of the VACS Index with AKI.</p><p><strong>Results: </strong>Among 1,186 PWH, median age was 53, 43.5% were women, 86.2% were Hispanic or Black, 23.1% were coinfected with hepatitis C, and 65% were virally suppressed (<200 copies/mL). Overall AKI incidence was 20.9%. The proportion with AKI was higher by increasing VACS index quartile: 10.7%, 18.6%, 28.1% and 60.7% in quartiles 1-4, respectively. There was a graded, independent association of VACS Index quartile with AKI. Compared to those in the lowest quartile, the adjusted relative hazard of AKI was 1.55, 1.92, and 3.07 times higher in quartiles 2-4, respectively (P for trend <0.001).</p><p><strong>Conclusion: </strong>Preadmission VACS Index is associated with hospital AKI. Use of the VACS Index may allow for early identification of PWH at risk for AKI and initiation of preventative strategies. These findings should be externally validated in other health systems, including its predictive performance in specific hospital settings.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894741","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":"Poorer longitudinal growth among HIV exposed compared to unexposed infants in Kenya.","authors":"Delaney J Glass, Maureen Kinge, Irene Njuguna, Christine J McGrath, Kendall Lawley, Hellen Moraa, Alvin Onyango, Dalton Wamalwa, Eric Shattuck, Daniel A Enquobahrie, Grace John-Stewart","doi":"10.1097/QAI.0000000000003592","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003592","url":null,"abstract":"<p><strong>Background: </strong>Most infants born to women living with HIV (WLH) are HIV-exposed but uninfected exposed infants have poorer growth than HIV-unexposed uninfected children. Few large studies have compared children who are exposed (CHEU) and unexposed (CHUU) in the era of dolutegravir (DTG)-based antiretroviral treatment (ART).</p><p><strong>Setting: </strong>Longitudinal study of mother-infant CHEU and CHUU pairs in Nairobi and Western Kenya.</p><p><strong>Methods: </strong>Mother-infant pairs were enrolled at 6 weeks postpartum with 6-monthly growth assessments. We compared longitudinal growth between CHEU and CHUU infants during the first year and assessed biological and social factors affecting growth (length and weight-for-age z-scores [LAZ, WAZ] and weight for length z-scores [WLZ]) and stunting (LAZ<-2), underweight (WAZ<-2), and wasting (WLZ<-2) from birth to 1 year.</p><p><strong>Results: </strong>Among 2000 infants (1000 CHEU and 1000 CHUU), CHEU infants had significantly lower LAZ at 6 months (-0.165 (95% CI: -0.274, -0.056), p-value = 0.003) and 12 months (-0.195, 95% CI:-0.294, -0.095, p-value = 0.0001; n = 1616). CHEU infants had a higher prevalence of stunting at 6 months compared to CHUU infants (Prevalence Ratio: 1.45, 95% CI: 1.14, 1.85). Among all children, greater maternal BMI, education, and caregiver-perceived social support were positively associated with growth. Higher maternal and infant comorbidities were associated with growth deficits for CHEU infants. Among CHEU, ART timing (before versus during pregnancy) and ART regimen (dolutegravir(DTG)-based, efavirenz-based, and protease inhibitor/other) did not affect growth.</p><p><strong>Conclusion: </strong>Growth deficits among CHEU persist, despite DTG-based ART. Addressing comorbidities, amplifying social support, and education may improve growth outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894740","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":"The impact of a couple-based intervention on one-year viral suppression among pregnant women living with HIV and their male partners in Malawi: A randomized controlled trial.","authors":"Nora E Rosenberg, Lauren A Graybill, Tiwonge Mtande, Nuala McGrath, Suzanne Maman, Tiyamike Nthani, Robert Krysiak, Isaac Thengolose, Irving F Hoffman, William C Miller, Mina Hosseinipour","doi":"10.1097/QAI.0000000000003583","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003583","url":null,"abstract":"<p><strong>Introduction: </strong>Couple-based behavioral interventions (CBIs) have been associated with improved HIV virological outcomes for pregnant women and their male partners living with HIV in observational settings, but have never been tested in a randomized controlled trial (RCT).</p><p><strong>Setting: </strong>Bwaila District Hospital Antenatal clinic (Lilongwe, Malawi).</p><p><strong>Methods: </strong>An RCT was conducted among 500 pregnant women living with HIV (index clients) randomized 1:1 to the standard of care (SOC) or CBI and followed for one year. The CBI offered an initial session for index clients, HIV assisted partner notification, two enhanced couple counseling and testing sessions, illustrated materials, and antiretroviral therapy pick-up for either couple member at the antenatal clinic. At 12 months, viral load among index clients and male partners with HIV was measured. Risk differences (RD) and 95% confidence intervals (CIs) compared viral suppression (<1000 copies/ml) between arms.</p><p><strong>Results: </strong>Mean index client age was 26.6 years; most were married or cohabiting (93.3%). Index client viral suppression was 6.5% higher in the CBI arm (88.0%) than in the SOC arm (81.6%). Male partner viral suppression was 16.2% higher in the CBI arm (73.6%) than the SOC arm (57.4%). Overall couple viral suppression was 7.8% higher (CI: 0.5% to 15.1%, p=0.04) in the CBI arm (84%) than in the SOC arm (76.0%). Social harms were rare (3.6%) and comparable between arms (p=0.8).</p><p><strong>Conclusion: </strong>This CBI had a positive impact on couple viral suppression. Scaling this CBI to antenatal clients with HIV and their male partners could improve HIV outcomes among expecting families.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876499","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":"Uptake of HIV Preexposure Prophylaxis Among Medicare Beneficiaries - United States, 2014-2021.","authors":"Ya-Lin A Huang, Man-Huei Chang, Weiming Zhu, Karen W Hoover","doi":"10.1097/QAI.0000000000003590","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003590","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have estimated preexposure prophylaxis (PrEP) use among persons with commercial health insurance and Medicaid. However, data are lacking regarding PrEP use among those with Medicare.</p><p><strong>Methods: </strong>Using a previously developed algorithm, we estimated the number of Medicare beneficiaries (MBs) with fee-for-service (FFS) claims who were prescribed PrEP from 2014 to 2021. The analysis was stratified by age, sex, and race/ethnicity. We also examined trends in PrEP prevalence by U.S. state and demographic characteristics during 2014-2021.</p><p><strong>Results: </strong>The number of Medicare PrEP users increased 11-fold, from 388 in 2014 to 4,685 in 2021. MBs prescribed PrEP were predominantly younger men, White persons, residing in the South or West regions, living with a disability, and dually eligible for both Medicare and Medicaid. The prevalence of PrEP prescriptions among MBs increased 12-fold, from 9.7 per million in 2014 to to 120.0 per million in 2021. Black/African American persons had the highest prevalence of PrEP use, followed by Hispanic/Latino and White persons in 2021. The District of Columbia had the highest prevalence of PrEP use compared with other U.S. states in 2021. Significant increasing trends in PrEP use were observed across sex, age groups, and race/ethnicity.</p><p><strong>Conclusions: </strong>Disparities in PrEP uptake existed across MB demographic subgroups from 2014 to 2021. Public health interventions are needed to increase PrEP access and utilization, particularly among women, younger MBs, Black persons, and Hispanic persons, including those with Medicare. Strategies and policies to expand PrEP use are essential for optimal HIV prevention in the United States.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864184","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":"Model-Based Prioritization of Adolescent Girls and Young Women for HIV Prevention Services Based on Data from 13 Sub-Saharan African Countries.","authors":"Steve Gutreuter, Langan Denhard, Joseph E Logan, Jesse Blanton, Haddi Jatou Cham","doi":"10.1097/QAI.0000000000003588","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003588","url":null,"abstract":"<p><strong>Background: </strong>Adolescent girls and young women (AGYW) aged 15-24 years are more likely to acquire HIV than their male counterparts, and well-targeted prevention interventions are needed. We developed a method to quantify the risk of HIV acquisition based on individual risk factors and population viral load (PVL) to improve targeting of prevention interventions.</p><p><strong>Setting: </strong>This study is based on household health survey data collected in 13 sub-Saharan African countries, 2015-2019.</p><p><strong>Methods: </strong>We developed a Bayesian spatial model which jointly estimates district-level PVL and the probability of infection among individual AGYW, aged 15-24 years, based on individual behavioral/demographic risk factors and area-level PVL. The districts (second subnational level) typically comprise the areas of estimation. The model borrows strength across countries by incorporating random effects which quantify country-level differences in HIV prevalence among AGYW.</p><p><strong>Results: </strong>The combined survey data provided 52,171 questionnaire responses and blood tests from AGYW, and 280,323 blood samples from all respondents from which PVL was estimated. PVL was-by far-the most important predictor of test positivity (aOR = 70.6; 0.95-probability credible interval 20.7‒240.5). Having a partner with HIV increased the odds of testing positive among AGYW who were never (aOR = 12.1; 7.5‒19.6) and ever pregnant (aOR = 32.1; 23.7-43.4). The area under the cross-validated receiver-operating characteristic curve for classification of test positivity was 82%.</p><p><strong>Conclusion: </strong>The fitted model provides a statistically principled basis for priority enrollment in HIV prevention interventions of those AGYW most at risk of HIV infection and geographic placement of prevention services.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869301","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":"Pancreatic cancer in people with HIV: a case-control study.","authors":"Sylvain Chawki, Gwenn Hamet, Alexandre Brun, Nelson Lourenco, Olivier Bouchaud, Julie Bottero, Pierre Sellier, Jean-Michel Molina","doi":"10.1097/QAI.0000000000003585","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003585","url":null,"abstract":"<p><strong>Background: </strong>We aimed to estimate the incidence and to assess the risks factors associated with pancreatic cancer (PC) in people with HIV (PWH).</p><p><strong>Setting: </strong>We used electronic medical record data from 2009 to 2020 available in the COREVIH Ile-de-France Est database of PWH treated in Paris' public hospitals.</p><p><strong>Methods: </strong>We analyzed data on patient demographics, treatment history, and immuno-virologic status. A case-control study was designed, each case (PWH and PC) was matched on age, gender and duration of HIV infection to four controls (PWH without PC).</p><p><strong>Results: </strong>Twenty-four cases were identified from the database, with an incidence of PC estimated at 28 cases (95%CI [19-43]) per 100,000 persons-year. The median age was 57 years (IQR [51-68]) at cancer diagnosis. Twenty-one cases were male (88%). Median CD4+ T cell count at PC diagnosis was 587/mm3 (IQR [317-748]) and the nadir CD4+ T cell count was 194 (IQR [98-380]). Twenty cases (91%) had a suppressed HIV replication at PC diagnosis. Twelve patients (50%) had metastasis on diagnosis. Median time to death after cancer diagnosis was 11 months [IQR 1-19]. Twenty-two cases were matched with 88 controls. There was no statistically significant risk factors for PC identified in our analysis.</p><p><strong>Conclusion: </strong>Pancreatic cancer remains rare in PWH and is associated with a severe prognosis at a relatively young age. Further studies are needed to identify risk factors associated with pancreatic cancer development in people with HIV.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864183","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":"Longitudinal changes in tenofovir and tenofovir-diphosphate concentrations among pregnant women using oral PrEP for HIV prevention: Findings from Durban, South Africa.","authors":"Ivana Beesham, Manjeetha Jaggernath, Yolandie Kriel, Jiaying Hao, Patricia M Smith, Jessica E Haberer, Craig W Hendrix, Christina Psaros, David R Bangsberg, Jennifer A Smit, Lynn T Matthews","doi":"10.1097/QAI.0000000000003586","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003586","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women are vulnerable to HIV acquisition. Oral HIV pre-exposure prophylaxis (PrEP) is safe and effective for use during pregnancy. We describe PrEP adherence among pregnant women using multiple measures.</p><p><strong>Methods: </strong>We conducted a secondary data analysis among women enrolled in a study evaluating an adherence intervention for PrEP among those planning for and with pregnancy in South Africa. Our analysis included women who used PrEP and became pregnant. Longitudinal PrEP use was assessed using concentrations of tenofovir (TFV) in plasma, tenofovir diphosphate (TFV-DP) in dried blood spots, and electronic pillcap data from quarterly visits. Plasma TFV ≤ 10ng/mL and TFV-DP ≤ 16.6fmol/punch were below quantifiable limits. Data were analysed over pre-pregnancy (quarter prior to pregnancy) and pregnancy trimesters.</p><p><strong>Results: </strong>Among 35 women, 69% were 18-24 years old, 40% were nulliparous, and 94% did not know their partner's HIV-serostatus. Median pillcap adherence was 55%-80% and was highest during pre-pregnancy (72%, IQR:54%-86%) and third trimester (80%, IQR:30%-94%). The proportion of women with quantifiable TFV was 47% (n=8/17) pre-pregnancy and 33% (n=9/27), 19% (n=4/21), and 14% (n=2/14) for trimesters 1-3, respectively. TFV-DP was detected in 75% of samples (n=12/16) pre-pregnancy, and 50% (n=13/26), 29% (n=6/21), and 27% (n=4/15) for trimesters 1-3. No women acquired HIV during pregnancy.</p><p><strong>Conclusions: </strong>PrEP use declined during pregnancy by all measures. Discrepancies between pillcap measurements and drug concentrations could be due to physiologic changes during pregnancy or under- or over-use of the pillcaps. Determining what drug metabolite concentrations are needed to confer protection during pregnancy is important to optimizing counselling and prevention support.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869300","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":"Weight and metabolic changes with long-acting cabotegravir and rilpivirine or bictegravir/emtricitabine/tenofovir alafenamide.","authors":"Darrell H S Tan, Andrea Antinori, Beng Eu, María José Galindo Puerto, Clifford Kinder, Donna Sweet, Cornelius N Van Dam, Kenneth Sutton, Denise Sutherland-Phillips, Alessandro Berni, Feifan Zhang, Rimgaile Urbaityte, Bryan Baugh, William Spreen, Jean van Wyk, Harmony P Garges, Parul Patel, Rachel Batterham, Ronald D'amico","doi":"10.1097/QAI.0000000000003584","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003584","url":null,"abstract":"<p><strong>Background: </strong>Modest weight and lipid changes have been observed in cabotegravir plus rilpivirine long-acting (CAB+RPV LA) Phase 3/3b studies. The SOLAR study included standardized evaluations of weight and metabolic changes in people living with HIV switching to CAB+RPV LA dosed every 2 months (Q2M) vs. continuing bictegravir/emtricitabine/tenofovir (BIC/FTC/TAF).</p><p><strong>Setting: </strong>Phase 3b, randomized, open-label study conducted in 118 centres across 14 countries.</p><p><strong>Methods: </strong>Participants (n=687) were randomized 2:1; 454 switched to CAB+RPV LA Q2M and 227 continued BIC/FTC/TAF. Participants who started lipid-modifying agents or underwent cosmetic procedures were excluded. We analysed changes in body weight, body mass index (BMI), waist and hip circumferences (WC, HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), muscle mass, body fat, and proportion with insulin resistance or metabolic syndrome at 1 year.</p><p><strong>Results: </strong>Median (interquartile range) change in body weight from baseline was -0.40 kg (-2.95, +2.10) and +0.05 kg (-2.30, +1.95) in the LA and BIC/FTC/TAF arm, respectively. Median (interquartile range) changes in WC and HC were +0.06 cm (-4.50, 4.00) and +0.00 cm (-4.00, 3.97) in the LA arm, and +1.14 cm (-3.00, 5.09) and +0.13 cm (-3.10, 4.00) in the BIC/FTC/TAF arm. There were no clinically relevant changes in WHtR, WHR, or the proportion with metabolic syndrome or insulin resistance in either arm.</p><p><strong>Conclusion: </strong>Standardized changes in weight, BMI, and body composition were minor and similar between participant switching to CAB+RPV LA Q2M or continuing BIC/FTC/TAF, with no clinically relevant changes in metabolic syndrome or insulin resistance.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828560","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}