Journal of the International AIDS Society最新文献

{"title":"Global prevalence of advanced HIV disease in healthcare settings: a rapid review","authors":"Nathan Ford, Reshma Kassanjee, Dominik Stelzle, Joseph N Jarvis, Omar Sued, Georges Perrin, Meg Doherty, Ajay Rangaraj","doi":"10.1002/jia2.26415","DOIUrl":"https://doi.org/10.1002/jia2.26415","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Recent studies have indicated a high enduring burden of advanced HIV disease, but estimates across regions and settings are lacking. The aim of this study was to estimate the prevalence of advanced HIV disease since 2015 among those people with CD4 measured in healthcare settings, disaggregated by age group, level of healthcare and region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched MedLine via Pubmed and Hinari for studies that reported the proportion of individuals with advanced HIV disease (defined as CD4 cell count <200 cells/mm<sup>3</sup>) in healthcare settings since 2015; this search was complemented by conference abstracts and data from the International epidemiology Databases to Evaluate AIDS Consortium (IeDEA). We estimated pooled prevalence of advanced HIV disease using random-effects models and performed subgroup and sensitivity analyses to explore heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We obtained data from 117 cohorts, representing 1,814,362 individuals from 52 countries across all six World Health Organization regions. The majority of studies (<i>n</i> = 83) were conducted among adults and recorded CD4 cell count among treatment naïve individuals at antiretroviral therapy start (<i>n</i> = 86). Studies included data reported up to 2023. The proportion of individuals with advanced HIV disease was higher in inpatient settings (44.3%, 95% CI 39.1−49.6%) compared to outpatient settings (33.5%, 95% CI 31.5−35.4%). Prevalence was similar across age groups, time since HIV diagnosis and treatment status, and highest in West and Central Africa, South-East Asia and the Eastern Mediterranean region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This review finds that at least a third of people presenting to healthcare settings have advanced HIV disease, with no evidence that this has changed in recent years. Screening for advanced HIV remains important to be able to direct appropriate preventive, diagnostic and therapeutic interventions to prevent progression to severe illness and death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review summarizes recent evidence of the continued high proportion of individuals who (re)present to care with advanced HIV disease. These findings underscore the urgent need to reinforce programme capacity to diagnose, prevent and treat advanced HIV disease as an essential pillar of the global AIDS response.</p>\u0000 ","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics, safety and efficacy of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide in children with HIV aged from 2 years and weighing at least 14 kg","authors":"Eva Natukunda,&nbsp;Aditya H. Gaur,&nbsp;Pope Kosalaraksa,&nbsp;Elizabeth Hellström,&nbsp;Renate Strehlau,&nbsp;Afaaf Liberty,&nbsp;Stephanie Cox,&nbsp;Rory Leisegang,&nbsp;Ramesh Palaparthy,&nbsp;Susanne Crowe,&nbsp;Vinicius Vieira,&nbsp;Kathryn Kersey,&nbsp;Natella Rakhmanina","doi":"10.1002/jia2.26414","DOIUrl":"10.1002/jia2.26414","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) was efficacious and well tolerated in children/adolescents with HIV (aged ≥6 years, weighing ≥25 kg) in a Phase 2/3 study. Here, we report data from children aged ≥2 years and weighing ≥14–&lt;25 kg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is an analysis of data from the youngest cohort in an open-label, multicentre, multi-cohort, single-group, international study of children/adolescents with HIV. Participants in this cohort were children aged ≥2 years, weighing ≥14–&lt;25 kg at screening and able to swallow tablets, on stable antiretroviral therapy with virologic suppression (HIV-1 RNA &lt;50 copies/ml for ≥6 consecutive months) and a CD4 count ≥400 cells/µl. Eligible participants received low-dose E/C/F/TAF (90/90/120/6 mg) once daily through Week 48. The study included pharmacokinetic evaluation of the low-dose E/C/F/TAF tablet at Week 2. Safety, efficacy, palatability and acceptability were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 16 January and 25 November 2019, 27 participants were enrolled with a median (quartile [Q]1, Q3) age of 6 (4, 8) years, body weight of 19.3 (17.0, 20.5) kg, CD4 count of 1061 (895, 1315) cells/µl and CD4 cell percentage of 37.4 (30.6, 40.3). Most (92.6%) participants acquired HIV through vertical transmission. On 6 October 2020 (data-cut), median (Q1, Q3) exposure to E/C/F/TAF was 48.3 (48.0, 60.1) weeks. Pharmacokinetic parameters were within the safe and efficacious range of previous data in adult and paediatric populations. Drug-related treatment-emergent adverse events occurred in 4/27 (15%) participants. There were no Grade 3/4 adverse events, or adverse events leading to E/C/F/TAF discontinuation. One participant experienced a serious treatment-emergent adverse event (Grade 2 pneumonia not considered E/C/F/TAF related). Virologic suppression (US FDA Snapshot algorithm) was maintained by 26/27 (96%) participants at Weeks 24 and 48. At Week 48, most children reported positive palatability (84.6%) and acceptability (96.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These data support the use of single-tablet E/C/F/TAF (90/90/120/6 mg) regimen for the treatment of HIV in children aged ≥2 years and weighing ≥14–&lt;25 kg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Number</h3>\u0000 \u0000 <p>NCT01854775</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mother-child dyads living with HIV in the Western Cape, South Africa: Undetectable = Undetectable?","authors":"Kim Anderson,&nbsp;Helena Rabie,&nbsp;Brian S. Eley,&nbsp;Lisa Frigati,&nbsp;James Nuttall,&nbsp;Emma Kalk,&nbsp;Alexa Heekes,&nbsp;Gayathri Sridhar,&nbsp;Leigh Ragone,&nbsp;Vani Vannappagari,&nbsp;Vanessa Mudaly,&nbsp;Andrew Boulle,&nbsp;Mary-Ann Davies","doi":"10.1002/jia2.26418","DOIUrl":"10.1002/jia2.26418","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Globally, children living with HIV continue to lag behind UNAIDS targets for viral suppression (VS). Because studies with linked mother-child data are limited, we describe VS and associated factors among young children in a setting with early infant HIV testing (at birth, age 10 weeks and 6 months) and early protease inhibitor-based first-line antiretroviral therapy (ART).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed routinely collected mother-child data for children living with HIV born 2018–2022 in Western Cape province, South Africa (followed through mid-2023). We assessed associations between child and maternal viral load (VL) results at 12 and 24 months after child ART start using logistic regression, adjusted for child sex, birthyear, severity of child immunodeficiency at ART start, maternal age and timing of maternal HIV diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2219 children living with HIV; 30% were diagnosed at birth (≤7 days), 41% before age 1 year (8−365 days) and 29% at age &gt;1 year. Overall, 5% (<i>n</i> = 112/2219) of children died, a third of whom had not started ART; 90% of children (<i>n</i> = 1990) started ART, at median age 5 months (IQR 1–16). Median follow-up from ART start was 26 months (IQR 14–40). Among children with available VL at 12 months (<i>n</i> = 853/1582), 24 months (<i>n</i> = 614/1129) and 36 months (<i>n</i> = 350/658) after ART start, 36%, 43% and 48% were virally suppressed, respectively (VL&lt;100 copies/ml). VS among children at 12 and 24 months was more likely if maternal VL was &lt;100 versus ≥100 copies/ml at 12 months (adjusted odds ratio [aOR] = 3.5; 95% CI 1.9−6.5) and 24 months (aOR = 6.1; 95% CI 2.8−13.1) after child ART start. Children with no/mild versus advanced/severe immunodeficiency at ART start were more likely to achieve VS at 12 months (aOR = 2.3; 95% CI 1.3−4.2) but not at 24 months. Eligible children with missing VL at 24 months (39%) were more likely to have gaps in care of &gt;6 months than those with VL≥100 or VL&lt;100 copies/ml (84% vs. 28% vs. 14%, respectively; <i>p</i>&lt;0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Less than half of children on ART achieved VS, and children were more likely to achieve VS if their mothers were also virally suppressed. Significant efforts are needed to support mother-child dyads to achieve optimal VS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of HIV-1 transmission cluster surveillance: a French retrospective observational study of the molecular and epidemiological co-evolution of recent circulating recombinant forms 94 and 132","authors":"Marc Wirden,&nbsp;Fabienne Tombette,&nbsp;Sidonie Lambert-Niclot,&nbsp;Marie-Laure Chaix,&nbsp;Stéphanie Marque-Juillet,&nbsp;Magali Bouvier-Alias,&nbsp;Benedicte Roquebert,&nbsp;Moise Machado,&nbsp;Veronique Avettand-Fenoel,&nbsp;Pierre Gantner,&nbsp;Enagnon Kazali Alidjinou,&nbsp;Karl Stefic,&nbsp;Jean-Christophe Plantier,&nbsp;Vincent Calvez,&nbsp;Diane Descamps,&nbsp;Anne-Genevieve Marcelin,&nbsp;Benoit Visseaux,&nbsp;the ANRS-MIE resistance study group","doi":"10.1002/jia2.26416","DOIUrl":"10.1002/jia2.26416","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Molecular surveillance is an important tool for detecting chains of transmission and controlling the HIV epidemic. This can also improve our knowledge of molecular and epidemiological factors for the optimization of prevention. Our objective was to illustrate this by studying the molecular and epidemiological evolution of the cluster including the new circulating recombinant form (CRF) 94_cpx of HIV-1, detected in 2017 and targeted by preventive actions in 2018.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In June 2022, 32 HIV-1 sequence databases from French laboratories were screened to identify all individuals who had acquired CRF94_cpx or a similar strain, whatever the date of diagnosis. Phylogenetic analyses were performed with the sequences identified, and biological parameters were collected at the time of diagnosis and after the start of treatment to analyse the evolution of the cluster. Full genomes were sequenced to characterize the new strains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analysed 98 HIV-1 isolates: 63 were CRF94, three were unclassifiable, and the other 32 formed a new cluster containing a new recombinant, CRF132_94B, derived from CRF94 and a subtype B strain. At least 95% of the individuals in both the CRF94 and CRF132 clusters were men who have sex with men (MSM), most of whom had acquired HIV less than 12 months before diagnosis. The number of CRF94 diagnoses declined drastically after 2018, but CRF132 strains spread widely between 2020 and 2022, into a different area of Ile-de-France region and within a younger population nevertheless aware of pre-exposure prophylaxis. Higher viraemia, lower CD4 cell counts and delayed treatment efficacy suggested that CRF94 was more virulent than CRF132, possibly due to the F subtype fragment of the <i>vif</i> gene.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings highlight the role of the MSM transmission cluster in spreading HIV and new variants. They show also the benefits of cluster surveillance for improving the targeting of preventive interventions, detecting the emergence of new strains and enriching our knowledge on virulence mechanisms. However, these investigations require support with sufficient resources dedicated to a regional or national programme to be responsive and effective.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of STI screening during pregnancy on vertical transmission of HIV and adverse pregnancy outcomes in South Africa: a modelling study","authors":"Dorothy C. Nyemba,&nbsp;Dvora L. Joseph-Davey,&nbsp;Sinead Delany-Moretlwe,&nbsp;Landon Myer,&nbsp;Leigh F. Johnson","doi":"10.1002/jia2.26410","DOIUrl":"10.1002/jia2.26410","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sexually transmitted infections (STIs) in pregnancy are associated with an increased risk of vertical HIV transmission and adverse pregnancy and birth outcomes. In South Africa, syndromic management is the standard of care for STI management. We assessed the potential impact of point-of-care (POC) screening for curable STIs (<i>Chlamydia trachomatis</i> [CT], <i>Trichomonas vaginalis</i> [TV] and <i>Neisseria gonorrhoeae</i> [NG]) during pregnancy on vertical HIV transmission and adverse pregnancy and birth outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We developed a static mathematical model to estimate the impact of syndromic management compared to POC screening of STIs in pregnant women attending antenatal clinics in South Africa over one calendar year (2022). Our model assumptions regarding the effect of CT, NG and TV on adverse pregnancy/birth outcomes and vertical HIV transmission were informed by two separate meta-analyses that we conducted. Local studies informed estimates of STI prevalence, POC screening uptake and treatment, and sensitivity of syndromic management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the absence of POC screening for curable STIs, 25.5% of pregnant women without HIV and 34.6% of pregnant women living with HIV were estimated to have undiagnosed and untreated STIs. In the POC scenario, 92% (95% CI: 85−100%) of STIs were diagnosed and treated during pregnancy, reducing antenatal maternal HIV incidence by 10.0% (95% CI: 1.0−20.1%). Overall, vertical HIV transmission was anticipated to reduce by 8.6% (5.2−13.8%), with reductions of 20.9% (15.2−27.0%) at birth and 2.5% (−0.9% to 9.0%) postnatally, in the POC screening scenario compared to current syndromic management. POC screening of curable STIs is further estimated to reduce the incidence of stillbirth by 10.1% (1.3–18.7%), preterm delivery by 6.3% (3.4–9.7%), infants born small for gestational age by 2.7% (0.7–4.9%) and low birth weight by 9.1% (0.9–18%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>POC STI screening and treatment may modestly reduce maternal HIV incidence, vertical HIV transmission, and the risk of adverse pregnancy and birth outcomes, and would substantially reduce the burden of curable STIs in pregnancy. The study provides evidence to move beyond the syndromic management of STIs in South Africa, particularly in antenatal care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A global review of national guidelines of post-exposure prophylaxis for the prevention of HIV","authors":"Marcus Maisano,&nbsp;Daniel Tran,&nbsp;Virginia Macdonald,&nbsp;Rachel C. Baggaley,&nbsp;Nathan Ford,&nbsp;Cheryl C. Johnson,&nbsp;Ying Zhang,&nbsp;Jason J. Ong","doi":"10.1002/jia2.26333","DOIUrl":"10.1002/jia2.26333","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The World Health Organization (WHO) recommends the use of antiretroviral drugs as post-exposure prophylaxis (PEP) for preventing HIV acquisition for occupational and non-occupational exposures. To inform the development of global WHO recommendations on PEP, we reviewed national guidelines of PEP for their recommendations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Policies addressing PEP from 38 WHO HIV priority countries were obtained by searching governmental and non-governmental websites and consulting country and regional experts; these countries were selected based on HIV burden, new HIV acquisitions and the number of HIV-associated deaths. We reviewed national guidelines to collate data on where PEP can be offered, who can prescribe PEP, PEP eligibility, recommended drug regime, linkage to other interventions, recommended investigations prescribed with PEP, HIV self-test recommendation related to PEP and stopping rules for PEP.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In total, 46 guidelines from January 2010 to May 2023 across 36 countries were included, with 70% of documents published during or after 2020. There was significant variation across national guidelines regarding where PEP can be accessed and who can provide or prescribe PEP. Six countries (17%) described being able to access PEP from a primary care facility, four countries (11%) from hospitals and two (6%) from community-based services. Only three countries (8%) specifically considered dispensing PEP by professionals other than doctors (e.g. nurses). None mentioned pharmacists as prescribers. We found a lack of consistency across countries regarding who is eligible for PEP, regimens used, interventions integrated into PEP provision and recommended investigations for PEP users. No country guidance provided considerations on using HIV self-tests for starting or stopping PEP.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Despite PEP being recommended for more than three decades, many national policies were lacking in terms of PEP guidance. There are opportunities for countries to update and optimize guidance to consider ways to improve the accessibility of PEP. Greater efforts are needed to support the development of global consensus on how best to implement and integrate PEP, as well as how to include decentralization and task-sharing to achieve sufficient scale for impact.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Impro","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Updated guidelines on HIV post-exposure prophylaxis: continued efforts towards increased accessibility”","authors":"","doi":"10.1002/jia2.26409","DOIUrl":"10.1002/jia2.26409","url":null,"abstract":"&lt;p&gt;Allan-Blitz, L.-T. and Mayer, K.H. (2024), Updated guidelines on HIV post-exposure prophylaxis: continued efforts towards increased accessibility. J Int AIDS Soc., 27: e26393. https://doi.org/10.1002/jia2.26393&lt;/p&gt;&lt;p&gt;In the article, the errors detailed below were identified:&lt;/p&gt;&lt;p&gt;In Discussion, 2.4 Emerging PEP strategies, third paragraph, the sentences originally read:&lt;/p&gt;&lt;p&gt;Every six month injections of lenacapravir were also recently shown to be safe and effective in preventing HIV acquisition among men who have sex with men as well as among transgender and non-binary individuals [75]. MK-8527 is a long-acting nucleoside reverse transcriptase translocation inhibitor, which was recently shown to be well tolerated in both single- and multidose forms [76]. A clinical trial is ongoing evaluating a single monthly dose of MK-8527 in humans (NCT05494736). Several studies have demonstrated the efficacy of CAB-LA for HIV PrEP [77, 78]. Long-acting lenacapavir is another emerging injectable alternative [79], with recent data demonstrating its superiority to oral PrEP in cisgender African women [80].&lt;/p&gt;&lt;p&gt;The sentences should read:&lt;/p&gt;&lt;p&gt;MK-8527 is a long-acting nucleoside reverse transcriptase translocation inhibitor (similar to islatravir), which was recently shown to be well tolerated in both single- and multidose forms [75]. A clinical trial is ongoing evaluating a single monthly dose of MK-8527 in humans (NCT05494736). Several studies have demonstrated the efficacy of CAB-LA for HIV PrEP [76, 77]. Long-acting lenacapavir is another emerging injectable alternative [78], with recent data demonstrating its superiority to oral PrEP in cisgender African women [79]. Every six month injections of lenacapravir were also recently shown to be safe and effective in preventing HIV acquisition among men who have sex with men as well as among transgender and non-binary individuals [80].&lt;/p&gt;&lt;p&gt;In References, nos. 75−82 were reordered and should be:&lt;/p&gt;&lt;p&gt;75. Gillespie G, Carstens RP, Zang X, Vargo R, Karpoor Y, Bhattacharyya A, et al. Safety and pharmacokinetics of MK-8527, a novel nRTTI, in adults without HIV. Presented at the Conference on Retroviruses and Opportunistic Infections, March 3–6, 2024. Abstract. 2024. Available at: https://www.croiconference.org/abstract/safety-and-pharmacokinetics-ofmk-8527-a-novel-nrtti-in-adults-without-hiv. Accessed July 16, 2024.&lt;/p&gt;&lt;p&gt;76. Fonner VA, Ridgeway K, Van Der Straten A, Lorenzetti L, Dinh N, Rodolph M, et al. Safety and efficacy of long-acting injectable cabotegravir as preexposure prophylaxis to prevent HIV acquisition. AIDS. 2023;37(6):957–66.&lt;/p&gt;&lt;p&gt;77. Delany-Moretlwe S, Hughes JP, Bock P, Ouma SG, Hunidzarira P, Kalonji D, et al. Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial. Lancet. 2022;399(10337):1779–89. https://doi.org/10.1016/S0140-6736(22)00538-4&lt;/p&gt;&lt;p&gt;78. Bekerman E, Yant SR, Vanderveen L, Hansen D, Lu B, Rowe W, et al. Long-acting lena","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142941980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the National Syphilis Prevention Program on the prevalence of syphilis among people living with HIV in China: a systematic review and meta-analysis","authors":"Qingling Zeng,&nbsp;Yuhui Yang,&nbsp;Limin Zhang,&nbsp;Jiangyu Yan,&nbsp;Jian Wang,&nbsp;Jingmin Nie,&nbsp;Qingmei Wang,&nbsp;Yu Luo,&nbsp;Gaoming Li","doi":"10.1002/jia2.26408","DOIUrl":"10.1002/jia2.26408","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In 2010, China launched the 10-year National Syphilis Prevention and Control Program to curb the spread of syphilis by integrating syphilis screening and treatment with HIV services. Herein, we aimed to evaluate changes in the prevalence of syphilis among people living with HIV (PLHIV) in China.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted this systematic review and meta-analysis by searching the PubMed, Embase, Web of Science, China Biomedical Literature, China National Knowledge Infrastructure, Wanfang and CQVIP databases from inception to 1 June 2024 to obtain relevant articles. A total of 75 studies were ultimately included. We used a DerSimonian‒Laird random effects model to estimate the prevalence and 95% confidence interval of syphilis among PLHIV.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The overall prevalence of syphilis among PLHIV in China was 18.6% (95% CI 16.5–21.0). Regional differences (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 15.29%) were observed in the prevalence rates: 22.2% (18.9–25.8) in the eastern region, 19.0% (15.1–23.8) in the central region and 14.0% (11.1–17.5) in the western region. The prevalence decreased from 22.8% (18.4–27.9) before 2010 to 17.0% (14.6–19.6) in 2010 and thereafter (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 5.82%). Among PLHIV via homosexual transmission, the prevalence of syphilis was 24.9% (21.3–28.9), which significantly declined from 33.8% (27.5–40.8) to 21.4% (18.3–24.9) in 2010 and thereafter (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 22.35%). The prevalence of syphilis was significantly higher in men living with HIV than in women living with HIV (pooled odds ratio 1.67, 95% CI 1.29–2.15), with the highest prevalence in the eastern region (2.55, 95% CI 1.80–3.59).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The prevalence of syphilis among PLHIV, particularly in cases of homosexual transmission, has declined. There was a correlation between the prevalence of syphilis and regional economic conditions, with a greater burden in developed eastern coastal areas. Additionally, the risk of syphilis differed across sexes, with men living with HIV having a higher risk.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;There has been preliminary success in the control of syphilis among PLHIV, but there is still a long way to go to meet the WHO's 2030 syphilis prevention and control goal. Syphilis prevention measures should be integrated into broader health policies and development plans, partic","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142941982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing populations prioritized for PrEP in 19 African countries: a review of national guidance","authors":"Lauren A. Graybill,&nbsp;Caroline N. McKay,&nbsp;Jiayu Wang,&nbsp;Nadia A. Sam-Agudu,&nbsp;Marcel Yotebieng,&nbsp;Friday Saidi,&nbsp;Linda-Gail Bekker,&nbsp;Bonnie E. Shook-Sa,&nbsp;Benjamin H. Chi,&nbsp;Nora E. Rosenberg","doi":"10.1002/jia2.26407","DOIUrl":"10.1002/jia2.26407","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;While African countries have expanded access to HIV pre-exposure prophylaxis (PrEP) since 2015, regional targets for PrEP uptake remain unmet. Understanding which populations are prioritized for PrEP at the policy level is an important step in determining the scope of PrEP distribution across Africa and identifying gaps in programme implementation. We reviewed national guidance to characterize populations prioritized for PrEP in Africa.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Between January and June 2023, we searched for current National HIV Treatment and Prevention Guidelines, National HIV Strategic Plans, and the United States President's Emergency Plan for AIDS Relief (PEPFAR) Country Operational Plans (COPs) for all African countries implementing PrEP programmes supported by PEPFAR in 2022. From each document, we summarize the populations prioritized for PrEP within a country and describe PrEP eligibility.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In 2022, 19 African countries implemented PrEP programmes supported by PEPFAR. Eighteen of these countries contributed National Guidelines (2016−2022), 18 contributed National Strategic Plans (2017−2023) and 19 contributed COPs (2022) to this review. Twenty-nine population groups were prioritized for PrEP in these documents. All countries prioritized HIV-serodifferent couples, female sex workers (FSWs), adolescent girls and young women (AGYW), pregnant and breastfeeding women (PBFW) and people who inject drugs (PWID), and most prioritized men who have sex with men (MSM; &lt;i&gt;n&lt;/i&gt; = 18), transgender people (&lt;i&gt;n&lt;/i&gt; = 18) and people in prisons (&lt;i&gt;n&lt;/i&gt; = 17). The remaining 21 populations were prioritized in fewer than two-thirds of countries.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;FSWs, MSM, PWID, transgender people and people in prisons were typically prioritized for PrEP with no eligibility restrictions. In contrast, most countries had at least one document indicating that HIV-serodifferent couples, AGYW and PBFW were only eligible for PrEP if classified as high risk. Few documents specified how risk was determined, and no document included validated HIV risk assessment tools to guide implementation. We observed similarities in priority populations across countries with different HIV epidemics and inconsistencies in who was prioritized for PrEP within a country's own set of policy documents.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of same-day and rapid ART initiation under the Universal Health Coverage programme on HIV outcomes in Thailand: a retrospective real-life cohort study","authors":"Sirinya Teeraananchai,&nbsp;David C. Boettiger,&nbsp;Cheewanan Lertpiriyasuwat,&nbsp;Rattaphon Triamwichanon,&nbsp;Patchara Benjarattanaporn,&nbsp;Nittaya Phanuphak","doi":"10.1002/jia2.26406","DOIUrl":"10.1002/jia2.26406","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Antiretroviral therapy (ART) initiation, regardless of CD4 count, has been recommended in Thailand since 2014, with same-day initiation recommended since 2021. We assessed HIV treatment outcomes among Thai people living with HIV (PLHIV) by the time from HIV diagnosis to ART initiation under the Universal Health Coverage (UHC) programme and identified factors associated with virological failure (VF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PLHIV aged ≥15 years initiating ART between 2014 and 2022 were included from the UHC database. We categorized participants into four groups using the duration from HIV diagnosis to ART initiation: (1) ≤ 7 days (same-day ART); (2) 8 days to &lt;1 month; (3) 1–3 months; and (4) &gt;3 months. Viral load (VL) was measured 6 months after starting ART, and annually thereafter. VF was defined as VL ≥1000 copies/ml. Factors associated with VF were analysed using competing risk models considering death and loss to follow-up (LTFU) as competing events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 252,239 PLHIV who started ART, the median age at initiation was 34 years (interquartile range [IQR]: 26–43 years). The median (IQR) pre-ART CD4 count was 233 (76–420) cells/mm³. ART initiation occurred within 7 days for 25% (17% on the same day, 8% in 2–7 days), 24% in 8 days to &lt;1 month, 23% in 1–3 months and 28% in &gt;3 months. ART initiation within 7 days increased from 20% (2014–2016) to 32% (2021–2022). VF occurred with a rate of 3.11 (95% CI 3.07–3.159) per 100 person-years (PYs). PLHIV initiating ART 8 days to 1 month were at lower risk of VF (aSHR 0.52, 95% CI 0.50–0.54) when compared to ART initiation &gt;3 months. ART initiation within 7 days resulted in the lowest mortality (6%: 1.28 [95% CI 1.24–1.32] per 100 PYs), but the highest rate of LTFU (12%: 2.69 [95% CI 2.63–2.75] per 100 PYs) when compared to other ART initiation groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although ART initiation within 7 days has increased in Thailand, the overall rate of early initiation remains low. ART initiation within 1 month significantly lowered the risk of VF. ART initiation within 7 days significantly reduced mortality. To further optimize health outcomes, innovative strategies are urgently needed to promote earlier ART initiation in Thailand.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}