JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"Impact of Age of Sexual Debut on HIV Care Engagement Among Sexual and Gender Minorities in Nigeria.","authors":"Connor Volpi, Ruxton Adebiyi, John Chama, Uche Ononaku, Abayomi Aka, Andrew Mitchell, Ashley Shutt, Afoke Kokogho, Abdulwasiu B Tiamiyu, Stefan D Baral, Man Charurat, Sylvia Adebajo, Trevor A Crowell, Rebecca G Nowak","doi":"10.1097/QAI.0000000000003574","DOIUrl":"10.1097/QAI.0000000000003574","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minorities (SGM) bear a high burden of HIV. The age of anal sexual debut may influence HIV care engagement. Our objective was to evaluate this relationship to help health care providers promote and anticipate future HIV care engagement among at-risk SGM.</p><p><strong>Methods: </strong>The TRUST/RV368 study provided HIV testing and treatment at SGM-friendly clinics in Abuja and Lagos, Nigeria. Self-reported age of sexual debut was dichotomized as <16 or ≥16 years. Multivariable logistic models estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association of sexual debut with (1) HIV testing history, (2) HIV testing at the clinics, (3) initiation of antiretroviral therapy (ART) within 6 months of a clinic diagnosis, and (4) viral suppression within 12 months of ART initiation.</p><p><strong>Results: </strong>Of the 2680 participants, 30% (n = 805) reported a sexual debut <16 years. Those with an <16-year debut had significantly more receptive sex partners, condomless sex, and transactional sex (all P < 0.01) and were 24% less likely to have tested for HIV before enrollment (aOR: 0.76; CI: 0.62 to 0.93). However, <16-year debut was not associated with HIV testing, receiving ART, or achieving viral suppression once engaged with TRUST/RV368 (all P > 0.05).</p><p><strong>Conclusions: </strong>SGM with <16-year debut engaged in behaviors that could increase HIV risk and were less likely to have a history of HIV testing. However, once enrolled in SGM-friendly clinics, uptake of HIV care was not associated with <16-year debut, suggesting that SGM-friendly care models may promote HIV care engagement.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"242-251"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768945","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":"Bone mineral content, growth, and renal health of infants with perinatal exposure to maternal dolutegravir vs efavirenz and tenofovir disoproxil fumarate vs tenofovir alafenamide: the randomized IMPAACT 2010 (VESTED) trial.","authors":"Tapiwa Mbengeranwa, Lauren Ziemba, Sean S Brummel, Ben Johnston, Haseena Cassim, Gerhard Theron, Zukiswa Ngqawana, Deo Wabwire, Katie McCarthy, John Shepherd, Shahin Lockman, Lameck Chinula, Lynda Stranix-Chibanda","doi":"10.1097/QAI.0000000000003656","DOIUrl":"10.1097/QAI.0000000000003656","url":null,"abstract":"<p><strong>Background: </strong>The impact on infant bone, growth, and renal health of in utero and breastmilk exposure to contemporary antiretroviral treatment (ART) remains unclear.</p><p><strong>Methods: </strong>643 pregnant women with HIV in nine countries in Africa, Asia and the Americas were randomized to start ART with dolutegravir (DTG) + emtricitabine (FTC)/tenofovir alafenamide (TAF), DTG + FTC/tenofovir disoproxil fumarate (TDF), or efavirenz (EFV)/FTC/TDF between 14-28 weeks' gestation and continued for 50 weeks postpartum. Pairwise comparisons used two-sample t-tests of mean week 26 infant bone mineral content (BMC) assessed by dual-energy X-ray absorptiometry (DXA) in a subset; mean infant z-scores for length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) at 26 and 50 weeks; and mean infant creatinine and estimated creatinine clearance at birth and 26 weeks.</p><p><strong>Results: </strong>577 infants were included in the growth analysis, and 169 in the DXA analysis. Week 26 infant spine BMC was significantly lower in the EFV/FTC/TDF arm (133.5g) compared to the DTG+FTC/TAF (143.4g; mean difference [95% CI]: 0.22 [0.02, 0.42] g) and DTG+FTC/TDF (137.4; mean difference [95%CI]: 0.20 [0.01, 0.40] g) arms. Mean LAZ and WAZ scores through week 50 were also significantly lower in the EFV/FTC/TDF versus DTG arms, but not WLZ. Infant obesity was rare (2-4%) and similar between arms. There was no apparent by-arm difference in infant creatinine or estimated creatinine clearance through week 50 (p-values ≥ 0.18).</p><p><strong>Conclusion: </strong>It is reassuring that maternal DTG-based ART during pregnancy and breastfeeding was associated with higher infant spine bone mineral content, better growth, and less stunting than EFV/FTC/TDF.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501379","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":"Outcomes following prenatal exposure to raltegravir-containing antiretroviral therapy: a multi-cohort European study.","authors":"Rebecca Sconza, Georgina Fernandes, Heather Bailey, Helen Peters, Luis Manuel Prieto Tato, Marta Illán Ramos, Karoline Aebi-Popp, Christian Kahlert, Anna Maria Gamell, Antoinette Frick, Luminita Ene, Anna Samarina, Claire Thorne","doi":"10.1097/QAI.0000000000003645","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003645","url":null,"abstract":"<p><strong>Background: </strong>Raltegravir is an HIV integrase strand transfer inhibitor recommended for use in pregnancy. The aim of this study was to assess risk of birth defects and other suboptimal outcomes following prenatal exposure to raltegravir.</p><p><strong>Methods: </strong>We used pooled, prospectively-collected individual patient data from studies in the European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC). Pregnancies with any prenatal exposure to raltegravir with outcomes in 2008-2020 were included. Birth defects were classified according to World Health Organization's International Classification of Diseases: Tenth Revision (ICD-10) and EUROCAT criteria. Earliest prenatal exposure timing was classified as periconception (exposure at ≤6 completed gestational weeks [GWs]), later first trimester (T1) (exposure in T1 at >6 completed GWs), and second/third trimester (exposure at >12 completed GWs).</p><p><strong>Results: </strong>A total of 1499 pregnancies across nine cohorts were included. Where timing was available (n=1449), earliest raltegravir exposure was in the periconception period for 505 (34.8%), later T1 in 65 (4.5%), and T2/T3 in 879 (60.7%). The overall prevalence of birth defects among live-born infants with prenatal raltegravir exposure was 3.9% (95% CI 2.9, 5.0) (1443/1466) (ICD-10), with no increased risk observed for those exposed in the periconception period (p=0.290). Among singleton live-born infants, 11.9% (160/1346) were born preterm, 11.3% (148/1307) low birthweight, and 8.6% (111/1291) small for gestational age, with no difference in outcomes observed by timing of raltegravir exposure.</p><p><strong>Conclusion: </strong>These findings add to the evidence base around safety of raltegravir use in pregnancy, though ongoing safety monitoring is needed to rule out risk of rare outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491550","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":"Social Impacts of Multi-City HIV Research Participation Among Sexual and Gender Expansive Individuals in Kazakhstan.","authors":"Vitaliy Vinogradov, Yong Gun Lee, Gulnara Zhakupova, Gaukhar Mergenova, Alissa Davis, Emily Allen Paine, Kelsey G Reeder, Caitlin I Laughney, Jimin Sung, Sholpan Primbetova, Assel Terlikbayeva, Jeremy Sugarman, Elwin Wu","doi":"10.1097/QAI.0000000000003654","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003654","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender expansive (SGE) individuals in Kazakhstan are disproportionately affected by HIV yet stigma and discrimination pose ethical and practical challenges for HIV prevention research involving them. Although researchers are tasked with ensuring that risks of research participation are reasonable in relation to its benefits, participant-reported risks and benefits of research participation-including negative (NSIs) and positive social impacts (PSIs) on personal relationships, social status, health, and other life domains-among SGE populations have received little attention.</p><p><strong>Methods: </strong>We examined NSIs and PSIs of research participation among SGE individuals in a three-city HIV prevention study in Kazakhstan at the trial's follow-up visits. We analyzed responses from 579 unique participants who completed a total of 2648 follow-up visits over the 36-month study period (2019-2022).</p><p><strong>Results: </strong>Overall, NSIs were rare: 9 (2%) participants reported NSIs during the study; nearly no NSIs ( =0.0037, SD=0.03) were reported at follow-up visits. These few NSIs included 'trouble with friends, family, or acquaintances' and 'other'. By contrast, PSIs were extensive: 515 (89%) participants reported PSIs during the study; an average of almost five PSIs ( =4.8, SD=3.4) were reported at follow-up visits. The most frequently reported PSIs were 'gained knowledge', 'improvement in HIV-related issues', and 'improvement in mental health'.</p><p><strong>Conclusions: </strong>Our findings demonstrate the potential for HIV prevention research to be associated with PSIs for SGE individuals experiencing stigmatization and discrimination. Future research should address NSIs, particularly confidentiality breaches and interpersonal challenges, within HIV prevention research to minimize risks and burdens of participation.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483092","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":"Efficacy and Safety of the Two-Drug Regimen Dolutegravir/Lamivudine in Adolescents Living With HIV-1 Naive to Antiretroviral Therapy at 48 Weeks (DANCE): A Single-Arm, Open-label, Phase 3b Trial.","authors":"Thanyawee Puthanakit, Linda Aurpibul, Monica Lopez, Marcia Wang, Marika Ciuffa, Gilda Bontempo, S Y Amy Cheung, Isabelle Deprez, Ann M Buchanan, Cindy Vavro, Michael McKenna, Sherene Min, Lionel K Tan","doi":"10.1097/QAI.0000000000003655","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003655","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir/Lamivudine is recommended for initial antiretroviral therapy (ART) in adults living with HIV-1; however, no clinical trials have assessed this regimen in adolescents, a potentially more challenging population to treat. We evaluated efficacy, safety, and pharmacokinetics of dolutegravir/lamivudine as initial ART in adolescents living with HIV-1.</p><p><strong>Setting: </strong>Nine centers in Thailand, Kenya, and South Africa.</p><p><strong>Methods: </strong>In the single-arm, open-label, phase 3b DANCE study (NCT03682848), adolescents naive to ART aged ≥12 to <18 years, weighing ≥25 kg, with plasma HIV-1 RNA 1000 to ≤500,000 copies/mL received single once-daily dolutegravir/lamivudine fixed-dose combination tablet orally for 48 weeks (treatment phase). The primary endpoint was proportion of participants with HIV-1 RNA <50 copies/mL at Week 48 (Snapshot; intention-to-treat-exposed [ITT-E] population). Safety outcomes were evaluated in the safety population. Both the ITT-E and safety populations consisted of participants who received ≥1 dose of dolutegravir/lamivudine (N=32). A sensitivity analysis was performed using data from all but two participants who were withdrawn before Week 48 due to site closure (n=30).</p><p><strong>Results: </strong>At Week 48, 26/32 (81%; 95% CI, 64%-93%) participants had HIV-1 RNA <50 copies/mL; in sensitivity analyses, 26/30 (87%; 95% CI, 69%-96%) achieved virologic suppression. No confirmed virologic withdrawals or deaths were reported. One drug-related adverse event was reported (grade 3 decreased glomerular filtration rate) and was the only adverse event leading to study withdrawal at data cut. Pharmacokinetic parameters were comparable to adult systemic exposure ranges.</p><p><strong>Conclusion: </strong>Dolutegravir/Lamivudine demonstrated efficacy and safety as initial ART in adolescents with HIV-1 through 48 weeks.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483090","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 Association of Anemia on Non-AIDS Defining Cancer and Subsequent Survival among People with HIV following Antiretroviral Initiation.","authors":"Raynell Lang, Sally B Coburn, M John Gill, Jennifer Grossman, Angel Mayor, Michael A Horberg, Michael J Silverberg, Charles S Rabkin, Richard D Moore, Greg D Kirk, Maile Y Karris, Amy C Justice, Keri N Althoff","doi":"10.1097/QAI.0000000000003647","DOIUrl":"10.1097/QAI.0000000000003647","url":null,"abstract":"<p><strong>Background: </strong>The association of anemia as a predictive and prognostic indicator of non-AIDS defining cancer (NADC) among people with HIV (PWH) remains unknown. We evaluated the presence of anemia and its severity as a predictor of NADC and 5-year all-cause survival following an NADC diagnosis among PWH who had initiated antiretroviral therapy.</p><p><strong>Setting: </strong>North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).</p><p><strong>Methods: </strong>We included PWH (≥18 years) on ART between 01/01/2007-12/31/2016 with no prior cancer diagnosis. Annual median hemoglobin was categorized into mild (11.0-12.9g/dL men, 11.0-11.9g/dL women) and moderate/severe (<10.9g/dL regardless of sex) anemia. Discrete time-to-event models using a complementary log-log link estimated crude and adjusted hazards ratios (aHR) and 95% confidence intervals for NADC by anemia severity. Five-year mortality following NADC diagnosis by anemia was evaluated.</p><p><strong>Results: </strong>Among 67,228 PWH contributing 301,421 annual median hemoglobin observations, 244,658 (81%) were not anemic, 40,134 (13%) had mild and 16,629 (6%) had moderate/severe anemia. The risk of NADC was higher among PWH with anemia (aHR 2.40[2.19-2.63]) (vs. no anemia) and greater among males (aHR 2.42[2.20-2.66]) than females (aHR 2.02[1.42-2.89]). NADC risk increased with worsening anemia (mild: aHR 2.01[1.81-2.23], moderate/severe: aHR 3.59[3.13-4.11]). The five-year all-cause mortality following NADC diagnosis was higher (aHR 1.37[1.21-1.55]) among PWH with anemia.</p><p><strong>Conclusions: </strong>Among PWH who initiated ART, anemia may serve as a predictive indicator of NADC risk. Identification of anemia should warrant investigations into the underlying etiology, including evaluation for NADC. Anemia is also a prognostic indicator among PWH diagnosed with NADC.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457886","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":"Single Doses of Pediatric Dolutegravir-Dispersible Tablets in Neonates Support Multi-Dosing: PETITE-DTG Study.","authors":"Tim R Cressey, Nicolas Salvadori, Helena Rabie, Samantha du Toit, Kanchana Than-In-At, Maria Groenewald, Edmund Capparelli, Andrew Owen, Ratchada Cressey, Marc Lallemant, Mark F Cotton, Adrie Bekker","doi":"10.1097/QAI.0000000000003652","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003652","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir dispersible tablets (DTG-DT) are approved for infants ≥4 weeks and ≥3 kg but their suitability for neonates remains unknown.</p><p><strong>Methods: </strong>PETITE-DTG is a Phase I/II, open-label, single center, two-stage trial in South Africa to evaluate the pharmacokinetics (PK) and safety of DTG in term neonates of pregnant individuals receiving DTG-based therapy. In Stage 1, neonates on standard antiretroviral prophylaxis received a single dose of 5 mg DTG-DT between ≥14 and <28 days of life (Cohort 1A); or <14 days of life (Cohort 1B), followed by PK and safety assessments. A population PK model was developed and multi-dose scenarios simulated [DTG targets: geometric mean (GM) Ctau>0.67 µg/mL and Cmax<17.0 µg/mL].</p><p><strong>Results: </strong>16 neonates, 8 per cohort, completed Stage 1. Median (range) birth weight was 3.1 (2.6-4.2) kg and PK sampling was performed between 3-22 days of life. No Grade 3 or higher adverse events were observed. DTG clearance was influenced by body weight and postnatal age. Simulations predicted that >10% of neonates would have a Cmax>17.0 µg/mL with DTG once daily (q24) during the first 2 weeks of life. Administration of DTG every 48 hours (q48) from day 1-14 of life, followed by DTG every 24 hours through day 28, predicted a GM Ctau between 0.86-4.35 µg/mL; 98% with a Cmax<17.0 µg/mL.</p><p><strong>Conclusions: </strong>Due to the slow postnatal DTG clearance after birth, a multi-dose strategy of 5 mg DTG-DT q48 for the first 2 weeks of life, followed by q24 through 28 days, was selected for assessment in Stage 2.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457878","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":"Preferences for monthly oral PrEP over other PrEP modalities among a national sample of gay, bisexual, and other men who have sex with men in the United States.","authors":"Ronnie M Gravett, Dustin M Long, Katie B Biello, Kenneth H Mayer, Douglas S Krakower, Jonathan Hill-Rorie, Rebecca A Lillis, Yohance Whiteside, Latesha Elopre","doi":"10.1097/QAI.0000000000003651","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003651","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-exposure prophylaxis (PrEP) cannot meaningfully impact the HIV epidemic in the United States without improving access to PrEP and reducing PrEP disparities among gay, bisexual, and other men who have sex with men (GBM), especially GBM of color. A patient-centered approach to increase PrEP options will offer better PrEP solutions to GBM. We sought to understand how GBM prefer current and emerging PrEP modalities.</p><p><strong>Methods: </strong>We conducted a national online survey among adult GBM to determine preferences for current and emerging PrEP modalities (daily, on-demand, and monthly oral, subcutaneous and intramuscular injectable, implantable, and rectal douche) and perceived barriers, based on their lived experiences. We determined PrEP modality preferences and associations using multivariable exploded logit regression model.</p><p><strong>Results: </strong>723 GBM completed the survey. The largest proportion preferred monthly oral PrEP (n=207, 28.6%), and over half preferred some form of oral PrEP. Race was significantly associated with PrEP modality preference, and Black GBM preferred daily oral PrEP most. Side effects, healthcare visits, administration route and frequency influenced PrEP preferences. PrEP and HIV knowledge, and HIV risk were associated with PrEP modality choice. GBM considered out-of-pocket cost and side effects as the significant barriers to PrEP care.</p><p><strong>Conclusions: </strong>Monthly oral PrEP was most preferred with oral options preferred more than other modalities. Black GBM most preferred daily oral PrEP, which could be due to lack of familiarity with the emerging products. Future PrEP provision must include patient-centered prevention plans that include enhanced education and counseling to promote use of newer agents.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457731","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":"Liver fibrosis regression in people living with HIV after successful treatment for hepatitis C.","authors":"Jim Young, Shouao Wang, Rachel Sacks-Davis, Ashleigh Stewart, Daniela K van Santen, Marc van der Valk, Joseph S Doyle, Gail Matthews, Juan Berenguer, Linda Wittkop, Karine Lacombe, Andri Rauch, Mark Stoové, Margaret Hellard, Marina B Klein","doi":"10.1097/QAI.0000000000003646","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003646","url":null,"abstract":"<p><strong>Background: </strong>Successful treatment of hepatitis C virus (HCV) can lead to liver fibrosis regression. It is not known who will experience fibrosis regression or how quickly it will occur.</p><p><strong>Methods: </strong>We modelled transient elastography (TE) measurements from 1470 HIV-HCV coinfected participants followed in cohorts contributing data to InCHEHC, an international collaboration. Participants were eligible if they had at least one TE measurement in the year prior to starting a successful direct acting antiviral treatment for HCV. This measurement was used to classify participants into one of three fibrosis subgroups. We analysed measurement sequences in each subgroup using a covariate adjusted generalised additive mixed model, with an adaptive spline representing changes in the mean measurement before, during and after treatment.</p><p><strong>Results: </strong>Each fibrosis subgroup had a distinctly different response. Most participants with cirrhosis (F4, TE ≥14.6 KPa) prior to HCV treatment did not show meaningful fibrosis regression - almost 70% were predicted to remain above 12 KPa three years after treatment ended. Participants with significant fibrosis (F2-F3, TE ≥7.2 and <14.6KPa) showed appreciable regression in the first two years after treatment, falling on average to levels below 7.2 KPa. Those without fibrosis prior to treatment (F0-F1) did not progress.</p><p><strong>Conclusion: </strong>Most coinfected people with cirrhosis prior to HCV cure will remain cirrhotic. For those with significant fibrosis, regression can be expected within two years to levels not normally associated with an increased risk of endstage liver disease. A TE measurement two years after cure should give a reliable estimate of residual fibrosis.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457811","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 ASSOCIATION BETWEEN HIV-RELATED STIGMA, ART ADHERENCE AND CARDIOVASCULAR DISEASE RISK IN PEOPLE LIVING WITH HIV.","authors":"Patane S Shilabye, Karine Scheuermaier, Alinda G Vos-Seda, Roos E Barth, Walter Devillé, Roel A Coutinho, Chijioke J Umunnakwe, Diederick E Grobbee, Francois Venter, Hugo Tempelman, Kerstin Klipstein-Grobusch","doi":"10.1097/QAI.0000000000003653","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003653","url":null,"abstract":"<p><strong>Introduction: </strong>HIV/AIDS continues to be a significant health issue in Sub-Saharan Africa, with stigma likely affecting ART adherence, and subsequently viremia, inflammation, and cardiovascular disease (CVD). We investigated the association between stigma, ART adherence, and CVD risk among people living with HIV (PLWH).</p><p><strong>Setting: </strong>A longitudinal study was conducted among 325 PLWH from the Ndlovu Cohort Study, South Africa.</p><p><strong>Methods: </strong>Stigma was assessed using a 12-item questionnaire (range: 0-44; higher scores indicate greater stigma). Pulse wave velocity (PWV, CVD surrogate marker) and viral load (VL) were assessed at 12 and 36 months. VL was considered a surrogate marker of ART adherence: VL>1000 copies indicating poor/no adherence, VL 50-1000 copies suboptimal, and VL<50 copies good adherence. The relationship between stigma, VL, and PWV, was assessed by linear regression and changes in PWV overtime by mixed linear models.</p><p><strong>Results: </strong>At baseline, PLWH (n=325, mean age (SD)=41.1 (10.2) years, 67% female) had mean PWV of 7.3m/s. Good, suboptimal, and poor adherence were 78%, 15%, and 7%, respectively. Mean (SD) stigma score was 16.9 (1.4) and was not associated with viral load and PWV. Suboptimal and poor adherence were associated with higher PWV [Beta=4.18 (95%CI 1.79_6.57)] at 12 months and between 12 and 36 months [Beta=1.30 (95%CI 0.06_2.55)] in mixed model analyses in PLWH>49 years, respectively. PWV increased by 0.21m/s (95%CI 0.02_0.40; p=0.03) between 12 and 36 months overall.</p><p><strong>Conclusion: </strong>In this study, poor ART adherence was associated with higher PWV. Stigma score was low and not associated with ART adherence and PWV.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457881","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}