JAIDS Journal of Acquired Immune Deficiency Syndromes最新文献

{"title":"The implications of removing race from interpretation of pulmonary function among persons with or without HIV.","authors":"Richard J Wang, Ken M Kunisaki, Alison Morris, M Bradley Drummond, Mehdi Nouraie, Laurence Huang, Phyllis C Tien, Aaron D Baugh, Igor Barjaktarevic, Neha Bhandari, Surya P Bhatt, Gypsamber D'Souza, Margaret A Fischl, Robert F Foronjy, Robert L Jensen, Deepa G Lazarous, Ighovwerha Ofotokun, Divya Reddy, Valentina Stosor, Meredith C McCormack, Sarath Raju","doi":"10.1097/QAI.0000000000003579","DOIUrl":"10.1097/QAI.0000000000003579","url":null,"abstract":"<p><strong>Background: </strong>Studies suggest that the use of race-specific pulmonary function reference equations may obscure racial inequities in respiratory health. Whether removing race from the interpretation of pulmonary function would influence analyses of HIV and pulmonary function is unknown.</p><p><strong>Setting: </strong>Pulmonary function measurements from 1,067 men (591 with HIV) in the Multicenter AIDS Cohort Study (MACS) and 1,661 women (1,175 with HIV) in the Women's Interagency HIV Study (WIHS) were analyzed.</p><p><strong>Methods: </strong>Percent-of-predicted values for spirometry and single-breath diffusing capacity of carbon monoxide (DLCO) measurements were generated with race-specific reference equations derived from the National Health and Nutrition Examination Survey and with the race-neutral application of reference equations derived from the Global Lung Function Initiative database. Regression models were used to evaluate the association between HIV and percent-of-predicted measures of pulmonary function. Alpaydin's F test was used to compare how well these values predicted self-reported respiratory health-related quality of life.</p><p><strong>Results: </strong>Persons with HIV were observed to have significantly lower percent-of-predicted DLCO than those without HIV but no significant differences in spirometric measures of pulmonary function, regardless of whether a race-specific or race-neutral approach was used. Among men, but not women, the race-neutral application of reference equations to generate percent-of-predicted DLCO values performed better for predicting respiratory-related quality of life.</p><p><strong>Conclusion: </strong>The race-neutral application of pulmonary function reference equations continues to identify lung function impairment in persons with or at risk for HIV and, for DLCO, may be superior to the use of race-specific reference equations in identifying clinically relevant impairments.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768961","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":"Acceptability of Long-Acting Cabotegravir + Rilpivirine in a Large, Urban, Ambulatory HIV Clinic.","authors":"Casey Morgan Luc, Blake Max, Sarah Pérez, Kara Herrera, Gregory Huhn, Mark S Dworkin","doi":"10.1097/QAI.0000000000003500","DOIUrl":"10.1097/QAI.0000000000003500","url":null,"abstract":"<p><strong>Background: </strong>Outside of randomized controlled trials, there are limited data regarding the acceptability of injectable long-acting cabotegravir + rilpivirine (LA-CAB+RPV) among persons living with HIV. To evaluate acceptability, we described participant-reported outcomes of LA-CAB+RPV among a population underrepresented in randomized controlled trials.</p><p><strong>Setting: </strong>Ruth M. Rothstein Core Center (CORE), large urban HIV clinic in Chicago, IL, USA.</p><p><strong>Methods: </strong>We interviewed persons living with HIV prescribed LA-CAB+RPV who receive primary care at CORE. Participant-reported outcome endpoints included treatment satisfaction, reasons for switching to LA-CAB+RPV, tolerability of injections, and unexpected effects of LA-CAB+RPV. Mean and standard deviations (mean ± SD) and proportions (%) are reported.</p><p><strong>Results: </strong>Among respondents (N = 150), 67% identified as non-Hispanic Black, 24% Hispanic, 56% male; the average age was 43 years (SD: 13.2), and 37% were ≥50 years old. Most respondents (93%) completed ≥3 injection appointments at the time of interview. The most common reasons for switching to LA-CAB+RPV were no longer wanting to take pills (89%) and trouble taking their pills daily (58%). Treatment satisfaction was high (6.7 ± 0.5 out of 7). Two-thirds (61%) reported an unexpected aspect of their life improved. Pain from injections was common (89%), with a mean pain score of 4.3 out of 10. Among those reporting pain, half (47%) reported that pain decreased after initial injection. Among participants reporting pain score >6 (n = 36), most (78%) reported no improvement since initial injection.</p><p><strong>Conclusions: </strong>We found high treatment satisfaction with LA-CAB+RPV in a diverse population. Participants reported moderate injection pain, which improved with time. Results suggest injectable LA-CAB+RPV will be met with acceptability across diverse participant populations.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"409-415"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889259","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 Varying Pre-exposure Prophylaxis Programs on HIV and Neisseria gonorrhoeae Transmission Among MSM in the Netherlands: A Modeling Study.","authors":"Maarten Reitsema, Jacco Wallinga, Ard I van Sighem, Daniela Bezemer, Marc van der Valk, Fleur van Aar, Janneke Cornelia Maria Heijne, Elske Hoornenborg, Ganna Rozhnova, Birgit van Benthem, Maria Xiridou","doi":"10.1097/QAI.0000000000003511","DOIUrl":"10.1097/QAI.0000000000003511","url":null,"abstract":"<p><strong>Background: </strong>In 2019, a 5-year pre-exposure prophylaxis (PrEP) program started in the Netherlands, in which up to 8500 men who have sex with men (MSM) can obtain PrEP and 3-monthly consultations with HIV/STI testing.</p><p><strong>Setting: </strong>We assessed the impact of the PrEP program on transmission of HIV and Neisseria gonorrhea (NG) among MSM in the Netherlands and examined prospective variations of the program after 2024.</p><p><strong>Methods: </strong>We used an agent-based model to estimate the effect of the PrEP program. For hypothetical prospective PrEP programs starting in 2024, we varied the capacity (8,500; 12,000; 16,000 participants) and consultation frequency (3-monthly; 6-monthly; 70% 3-monthly and 30% 6-monthly).</p><p><strong>Results: </strong>At a capacity of 8,500 participants and 3-monthly consultations, the PrEP program could lead to 3,140 [95% credible interval (95% CrI): 1,780-4,780] and 27,930 (95% CrI: 14,560-46,280) averted HIV and NG infections, requiring 316,050 (95% CrI: 314,120-317,580) consultations. At a capacity of 16,000 participants, the programs with 3-monthly consultations and 6-monthly consultations could lead to comparable number of averted HIV [3,940 (95% CrI: 2,420-5,460), and 3,900 (2,320-5,630) respectively] and NG infections [29,970 (95% CrI: 15,490-50,350), and 29,960 (95% CrI: 13,610-50,620) respectively], while requiring substantially different number of consultations: 589,330 (95% CrI: 586,240-591,160) and 272,590 (95% CrI: 271,770-273,290), respectively.</p><p><strong>Conclusions: </strong>Continuation of a PrEP program could lead to a substantial reduction in HIV and NG transmission. More infections could be averted if the number of participants is increased. In turn, the consultation frequency could be reduced without reducing the number of averted infections if capacity is increased.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"325-333"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017501","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":"Characterizing HIV Acquisition Risk, Treatment Gaps, and Populations Reached Through Venue-Based Outreach and Clinical Services in Blantyre, Malawi: Findings From a District-wide CLOVE Study.","authors":"Emmanuel Singogo, Sharon S Weir, Evaristar Kudowa, Maganizo Chagomerana, John Chapola, Jessie K Edwards, Confidence Banda, Gift Kawalazira, Yohane Kamgwira, Andreas Jahn, Sarah Bourdin, Thomas Hartney, Lucy Platt, Brian Rice, James R Hargreaves, Mina C Hosseinipour","doi":"10.1097/QAI.0000000000003493","DOIUrl":"10.1097/QAI.0000000000003493","url":null,"abstract":"<p><strong>Background: </strong>In 2017, Blantyre district had the highest adult HIV prevalence in Malawi (17.7%) and lowest viral suppression (60%). In response, the Ministry of Health expanded prevention and treatment services. We assessed whether outreach to social venues could identify individuals with increased HIV acquisition risk or with unsuppressed HIV not currently reached by clinic-based services.</p><p><strong>Methods: </strong>We conducted a cross-sectional biobehavioral survey in Blantyre, Malawi, from January to March 2022. We visited social venues where people meet new sexual partners and government clinics providing HIV testing or STI screening. Participants older than 15 years were interviewed and tested for HIV infection if not on ART. HIV recency tests were performed on those testing positive, and dried blood spots (DBS) were collected to quantify viral load and also to identify acute infection in those with HIV- results.</p><p><strong>Results: </strong>HIV prevalence (18.5% vs 8.3%) and unsuppressed HIV infection (3.9% vs 1.7%) were higher among venue-recruited (n = 1802) than among clinic-recruited participants (n = 2313). Among PLHIV at both clinics (n = 199) and venues (n = 289), 79% were virally suppressed. Few had acute (n = 1) or recent infection (n = 8). Among women, HIV prevalence was 4 times higher (38.9% venue vs 8.9% clinic). At clinics, PLHIV reporting visiting venues were less likely to be suppressed (54.6 vs 82.6%). More men at venues than at clinics reported paying for sex (49% vs 30%) or having multiple sex partners in the past 4 weeks (32% vs 16%).</p><p><strong>Conclusions: </strong>Enhanced venue-based prevention and testing for men and women could reduce treatment lapses, onward transmission, and improve HIV treatment outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"315-324"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633499","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":"Evaluation of Four Interventions Using Behavioral Economics Insights to Increase Demand for Voluntary Medical Male Circumcision in South Africa Through the MoyaApp: A Quasi-Experimental Study.","authors":"Preethi Mistri, Silviu Tomescu, Simamkele Bokolo, Alexandra De Nooy, Pedro T Pisa, Skye Grove, Laura Schmucker, Candice Chetty-Makkan, Lawrence Long, Alison Buttenheim, Brendan Maughan-Brown","doi":"10.1097/QAI.0000000000003504","DOIUrl":"10.1097/QAI.0000000000003504","url":null,"abstract":"<p><strong>Background: </strong>While voluntary medical male circumcision (VMMC) reduces the risk of HIV transmission by 60%, circumcision coverage falls short of the UNAIDS 90% VMMC target. We investigated whether behaviorally informed message framing increased demand for VMMC.</p><p><strong>Setting: </strong>Adult users of the MoyaApp, a data-free application in South Africa, who viewed a form designed to generate interest in VMMC from August 2022 to November 2022.</p><p><strong>Methods: </strong>A quasi-experimental study was conducted to evaluate 4 MoyaApp VMMC intervention forms against the standard-of-care (SOC) form. All forms enabled users to provide contact details for follow-up engagement by a call center. The primary outcome was the proportion of forms submitted. Secondary outcomes included successful contact with the user, VMMC bookings/referrals, and confirmed circumcision. Multivariable ordinary least-squares regression was used for the analysis.</p><p><strong>Results: </strong>Of 118,337 MoyaApp VMMC form viewers, 6% submitted a form. foot-in-the-door form viewers were more likely (+1.3 percentage points, P < 0.01) to submit a form compared with the SOC group (6.3%). Active Choice (-1.1 percentage points, P < 0.01) and Reserved for You (-0.05 percentage points, P < 0.05) form viewers were less likely to submit a form compared with SOC form. Users submitting the foot-in-the-door form were less likely to be booked/referred compared with those using the SOC form (-5 percentage points, P < 0.05). There were no differences between the intervention and SOC forms for successful contact and circumcisions.</p><p><strong>Conclusions: </strong>Message framing using behavioral insights was able to nudge men to engage with VMMC services. However, more work is needed to understand how to convert initial interest into bookings and circumcisions.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"371-378"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906654","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":"The Diagnostic Performance of the Visitect Advanced Disease Point-Of-Care CD4 Platform: A Pragmatic, Mixed-Methods, Multisite Validation, Costing, and Qualitative Analysis.","authors":"Elizabeth Nalintya, Preethiya Sekar, Olive L Namakula, Kiiza Kandole Tadeo, Richard Kwizera, Lucy Apeduno, Diana Rose Naluyima, Rachel Nanano, Lilian Mujungu, Alice Lehman, Tessa Adzemovic, Mathius Amperiize, Paul Kavuma, Viola Kasone, Ann Fieberg, Patricia Nerima, Biyue Dai, David B Meya, David R Boulware, Radha Rajasingham","doi":"10.1097/QAI.0000000000003505","DOIUrl":"10.1097/QAI.0000000000003505","url":null,"abstract":"<p><strong>Background: </strong>The Visitect CD4 Advanced Disease test (AccuBio, Alva, United Kingdom) is a rapid, semiquantitative assay that estimates CD4 results above or below 200 cells per microliter. We evaluated the performance of the Visitect CD4 assay in semiurban laboratories in Uganda.</p><p><strong>Methods: </strong>We performed a pragmatic laboratory validation of the Visitect CD4 platform in 4 routine HIV clinics in Uganda, nested within a cluster randomized trial evaluating an enhanced package of screening and treatment for persons with advanced HIV disease (NCT05085171). As part of the clinical trial, samples processed on the Visitect CD4 platform were confirmed using another CD4 testing method. We compared the diagnostic performance of the Visitect CD4 platform against the confirmatory method by evaluating the sensitivity, specificity, and positive and negative predictive values.</p><p><strong>Results: </strong>Of 1495 venous blood samples that were processed both by the Visitect CD4 test and another confirmatory CD4 platform at clinics in Kampala, Uganda, specificity was 81% [95% confidence interval (CI): 79% to 84%] and the positive predictive value was 69% (95% CI: 66% to 73%). There were no samples for which the Visitect test was >200 cells per microliter and the confirmatory test was ≤200 cells per microliter, resulting in a sensitivity of 100%. Among Visitect CD4 tests that were read as ≤200 cells per microliter with confirmatory results >200 cells per microliter, the median confirmatory CD4 result was 397 (IQR, 281-590) cells per microliter. Specificity varied by clinic ranging from 63% to 99%.</p><p><strong>Conclusions: </strong>Given variable specificity of the Visitect CD4 Advanced Disease platform, successful implementation will require consideration of clinic context and laboratory staffing.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"387-396"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004249","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 and Correlates of Frailty Among Older People With and Without HIV in Rural Uganda.","authors":"Phoebe Mbabazi, Geoffrey Chen, Christine S Ritchie, Alexander C Tsai, Zahra Reynolds, Robert Paul, Janet Seeley, Yao Tong, Susanne Hoeppner, Samson Okello, Noeline Nakasujja, Brianne Olivieri-Mui, Jeremy A Tanner, Deanna Saylor, Stephen Asiimwe, Mark J Siedner, Meredith Greene","doi":"10.1097/QAI.0000000000003513","DOIUrl":"10.1097/QAI.0000000000003513","url":null,"abstract":"<p><strong>Background: </strong>The relationship between HIV and frailty, a predictor of poor outcomes in the face of stressors, remains unknown in older people in sub-Saharan Africa.</p><p><strong>Methods: </strong>We analyzed data from the Quality of Life and Ageing with HIV in Rural Uganda cohort study to estimate the prevalence and correlates of frailty among older people with HIV (PWH) on long-term antiretroviral therapy and among age- and sex-matched HIV-uninfected comparators. Frailty was defined as a self-report of 3 or 4 (and pre-frailty as 1 or 2) of the following phenotypic variables: weight loss, exhaustion, low activity, and slowness. We estimated the prevalence of frailty and prefrailty and fitted logistic regression models to estimate the association between HIV and frailty, adjusting for sociodemographic factors, depression, and other comorbidities.</p><p><strong>Results: </strong>We enrolled 599 participants (49% women) with a mean age of 58 years. PWH had a similar prevalence of frailty (8.1% vs. 10.9%, P = 0.24) but a lower prevalence of prefrailty (54.2% vs. 63.2%, P = 0.03) compared with their HIV-uninfected comparators. In multivariable regression models, people with depression [adjusted odds ratio (AOR) 7.52 (95% CI: 3.67 to 15.40), P < 0.001] and those with ≥1 comorbidities [AOR 3.15 (95% CI: 1.71 to 3.82), P < 0.001] were more likely to be frail. HIV serostatus was not significantly associated with frailty [AOR 0.71 (95% CI: 0.37 to 1.34), P = 0.29].</p><p><strong>Conclusions: </strong>Older PWH had a similar prevalence of frailty as those without HIV. These findings call for additional study of the factors that contribute to the robustness of older PWH in sub-Saharan Africa.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"402-408"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017502","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":"Comparison of IL-6, IL-10, and TNFα Levels Between PLWHIV With and Without Kaposi Sarcoma and Healthy Controls.","authors":"Beda Islas-Muñoz, Leslie Chávez-Galán, Lucero Ramón-Luing, Julio Flores-González, Ranferi Ocaña-Guzmán, Patricia Cornejo-Juárez, Andrea González-Rodríguez, Volkow Patricia","doi":"10.1097/QAI.0000000000003507","DOIUrl":"10.1097/QAI.0000000000003507","url":null,"abstract":"<p><strong>Introduction: </strong>Kaposi sarcoma (KS) is an angioproliferative disease caused by human herpesvirus 8 and is mediated by cytokines in an immunodeficient environment. This study aimed to compare IL-6, IL-10, and TNFα levels among patients with AIDS with disseminated KS (DKS), treatment naïve patients living with HIV without DKS, and healthy controls. Secondary outcomes were to compare cytokines levels in patients with DKS and unfavorable outcomes, and an analysis of the behavior of cytokines over time.</p><p><strong>Methods: </strong>This cohort study was performed at 2 centers in Mexico City. Three groups were included. Group 1: HIV+ treatment naïve with DKS, group 2: HIV+ treatment naïve without KS, and group 3: HIV negative, healthy controls. Plasmatic IL-6, IL-10, and TNFα levels were measured at baseline and over time in groups 1 and 2.</p><p><strong>Results: </strong>Seventy-six patients were included: 39 (52%) in group 1, 17 (22%) in group 2, and 20 (26%) in group 3. The median baseline IL-6, IL-10, and TNFα levels were significantly higher in group 1. In group 1, baseline IL-6 was higher in patients who died than in survivors (14.4 vs 5.8 pg/mL P = 0.048). Patients with severe immune reconstitution inflammatory syndrome because of KS had higher IL-6 values than those without it (14.4 vs 5.8 pg/mL P = 0.004). In the repeated measures model in group 1, IL-10 levels were higher in patients who died ( P < 0.001) and developed immune reconstitution inflammatory syndrome-KS ( P = 0.01).</p><p><strong>Conclusions: </strong>IL-6, IL-10, and TNF α levels were markedly higher in patients with DKS. IL-6 and IL-10 levels were higher in patients with unfavorable outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"416-422"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982288","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":"Obesity Is Associated With Higher Levels of Circulating Cytokines Involved in the Development of Cardiovascular Disease in People Living With HIV.","authors":"Stefano Savinelli, Pádraig McGettrick, Alejandro A Garcia Leon, Willard Tinago, Emma Haran, Elena Alvarez Barco, Alan L Landay, Patrick W G Mallon, Eoin R Feeney","doi":"10.1097/QAI.0000000000003508","DOIUrl":"10.1097/QAI.0000000000003508","url":null,"abstract":"<p><strong>Background: </strong>Obesity is increasingly described in people living with HIV (PLWH), but its impact on immune activation and inflammation in HIV is still poorly characterized. We aimed to analyze the difference in circulating cytokines involved in pathways associated with comorbidities in PLWH according to the presence or absence of obesity.</p><p><strong>Methods: </strong>Age- and sex-matched PLWH with and without obesity (body mass index ≥30 kg/m 2 ) from a multicenter, prospective cohort were recruited with a 1:2 ratio. Twenty-three biomarkers covering pathways associated with systemic inflammation (high sensitivity C-Reactive Protein [hsCRP], interleukin (IL)-2, IL-6, tumor necrosis factor receptor-1, tumor necrosis factor receptor-2, tumor necrosis factor-alpha, interferon-gamma, IL-18), coagulation (von Willebrand Factor [vWF], D-dimer, soluble CD40 ligand), endothelial function (E-selectin, P-selectin, soluble intracellular adhesion molecule-1, soluble vascular cell adhesion molecule-1), atherosclerosis (myeloperoxidase [MPO], lipoprotein-associated phospholipase A2), immune regulation (IL-1 receptor antagonist [IL-1RA]), innate immune activation (macrophage inflammatory protein-1, monocyte chemoattractant protein-1, soluble CD163, soluble CD14), and microbial translocation (lipopolysaccharide binding protein) were measured in the 2 groups. Between-group difference in biomarkers were assessed using Mann-Whitney test. Associations between obesity and biomarkers were assessed using logistic regression adjusted for age, sex, ethnicity, smoking status, and antiretroviral therapy.</p><p><strong>Results: </strong>Ninety-nine antiretroviral therapy-treated PLWH were included in the analysis (33 with obesity, 66 without obesity). PLWH with obesity had higher levels of hsCRP, IL-6, vWF, D-dimer, E-selectin, MPO, IL-1RA, and lipopolysaccharide binding protein. Six markers (hsCRP, IL-6, vWF, E-selectin, MPO, IL-1RA), reflecting systemic inflammation, coagulation, and atherosclerosis pathways, were associated with increased odds of obesity in the adjusted logistic regression model: hsCRP (adjusted odds ratio 2.7, 95% CI: [1.7 to 4.29]), IL-6 (3.77 [1.43-9.93]), vWF (5.33 [1.51-18.75]), E-selectin (6.28 [1.36-29.04]), MPO (6.85 [1.87-25.04]), and IL-1RA (6.45 [2.28-18.2]). No association was observed between obesity and markers of innate immune activation and gut microbial translocation.</p><p><strong>Conclusions: </strong>Obesity in PLWH was associated with activation of systemic inflammatory, endothelial, atherosclerosis, and coagulation pathways, rather than those associated with innate immune activation and gut microbial translocation. These pathways point toward an unfavorable cardiovascular profile in PLWH with obesity, which will have to be further explored in future studies on long-term outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"423-431"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982289","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":"Patterns of HIV Treatment Preferences Among People With Diverse Demographic, Social, and Behavioral Characteristics Who Are Living With HIV in the United States.","authors":"Elizabeth S Russell, Mo Zhou, Yan Song, Narquis Barak, Yipeng Gao, T Christopher Mast","doi":"10.1097/QAI.0000000000003509","DOIUrl":"10.1097/QAI.0000000000003509","url":null,"abstract":"<p><strong>Background: </strong>New dosage form and frequency options may improve HIV treatment outcomes and reduce disparities in access and use.</p><p><strong>Methods: </strong>People with HIV in the United States completed a demographic and discrete choice experiment survey of preference for 13 hypothetical HIV treatment options: daily and weekly oral tablets; 1-, 3-, or 6-monthly injections by self or a health care provider (HCP); yearly implant; or combinations. Best-Worst Scaling and a latent class model were used to analyze overall preference choices and for groups of individuals with similar patterns of preferences; the model also predicted uptake of products.</p><p><strong>Results: </strong>Among the diverse 829 respondents, weekly oral tablets and 6-monthly injections by an HCP were significantly more favored than daily oral tablets. Convenience of the treatment and being tired of taking pills were the top drivers of preference responses. Latent class analysis identified 4 groups of respondents with distinct preference patterns; approximately two-thirds belonged to groups strongly preferring products other than daily oral tablets. The modelled uptake of a weekly pill, yearly implant, 6-monthly HCP injection, oral daily pill, and 3-monthly HCP injections were 24%, 24%, 24%, 18%, and 11%, respectively.</p><p><strong>Conclusions: </strong>Patterns of HIV medication preference can inform development of new forms of HIV therapy products because the majority of patients do not prefer the currently most available treatment option of daily oral tablets. Looking beyond population-level preferences and into similar groups of people with HIV increases the ability to develop patient-centered products to fill gaps in care and increase treatment effectiveness.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"344-352"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982290","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}