Lancet Hiv最新文献

{"title":"Epidemiology and management of HIV-2.","authors":"Serge Paul Eholié, Charlotte Charpentier, Zelica Diallo, Oumarou I Wone Adama, David da Silva Té, Diane Descamps, Didier Koumavi Ekouevi","doi":"10.1016/S2352-3018(26)00170-0","DOIUrl":"10.1016/S2352-3018(26)00170-0","url":null,"abstract":"<p><p>HIV-2 remains a neglected component of the global HIV epidemic, predominantly affecting west Africa but also present in Europe and other regions through historical and migratory links. Although generally characterised by lower transmissibility and slower disease progression than HIV-1, HIV-2 poses distinct diagnostic, therapeutic, and programmatic challenges. Research, implementation, and advocacy efforts aimed at reducing HIV-2 infection must account for the limitations of available typing tools, the restricted access to validated viral load assays, the virus' intrinsic resistance to certain antiretroviral drug classes, and the gaps in retention in care that hinder progress towards global treatment targets. Strengthening collaborative research, improving diagnostic capacity, and integrating HIV-2 into broader HIV policy frameworks are essential to optimise patient outcomes and to advance the global HIV response.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e735-e744"},"PeriodicalIF":14.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charting the USA's spiralling HIV response","authors":"Andrew Green","doi":"10.1016/s2352-3018(26)00260-2","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00260-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"3 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149150379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virological failure and treatment interruption among people with unsuppressed viral load on antiretroviral therapy: a cross-sectional analysis of Population-based HIV Impact Assessment surveys in seven sub-Saharan African countries","authors":"Mansoor Farahani,Suzue Saito,Shannon M Farley,Theodore F Smart,Felix Ndagije,Eduardo Samo Gudo,Wilford L Kirungi,Rose Kolola Nyirenda,Owen Mugurungi,Wolfgang Hladik,Hetal K Patel,Samuel Sendagala,Talent Maphosa,Munyaradzi Pasipamire,Alexander Kailembo,Fred Asiimwe,Andrew C Voetsch,Wafaa M El-Sadr","doi":"10.1016/s2352-3018(26)00171-2","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00171-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"13 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimagining HIV service integration","authors":"Gifty Marley,Nittaya Phanuphak,Weiming Tang","doi":"10.1016/s2352-3018(26)00254-7","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00254-7","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"22 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma dolutegravir exposure testing to identify people with HIV at highest risk for dolutegravir resistance (ITREMA-2): a two-centre, prospective implementation study in South Africa.","authors":"Kim Steegen, Jeremy Nel, Erin H Smeijsters, Chijioke N Umunnakwe, Karabo Mophiring, Sean Currin, Wouter M Tiel Groenestege, Matthijs van Luin, Lucas E Hermans, Hugo A Tempelman, Lucia Hans, Lise Jamieson, Siphamandla Gumede, Athini Nyatela, Willem D F Venter, Monique Nijhuis, Annemarie M J Wensing","doi":"10.1016/S2352-3018(26)00144-X","DOIUrl":"10.1016/S2352-3018(26)00144-X","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir resistance is increasingly reported in treatment-experienced people with HIV in low-income and middle-income countries. Resistance testing resources are sparse, and viral rebound often reflects adherence lapses rather than resistance. Efficient strategies are needed to target testing to individuals at highest risk. We evaluated a reflex laboratory approach using plasma dolutegravir exposure to guide resistance testing in routine care.</p><p><strong>Methods: </strong>In this prospective implementation study at two public-sector clinics in Johannesburg, South Africa, we analysed adults (aged ≥18 years) on dolutegravir-based antiretroviral therapy (ART) with viral rebound of 400 copies per mL or higher. From May 18, 2023, to Jan 10, 2025, we tested residual routine viral load samples for dolutegravir exposure using an enzyme immunoassay. If dolutegravir was detectable (≥20 ng/mL), we did reflex resistance testing on the same specimen; retrospective sequencing was done at study end for dolutegravir-undetectable samples. We modelled costs comparing the reflex approach with standard of care.</p><p><strong>Findings: </strong>We analysed 400 samples from 288 individuals; 160 (56%) were female and 128 (44%) male, the median age was 44 years (IQR 35-50), and 240 (83%) had previous non-dolutegravir ART exposure. Plasma dolutegravir was detectable in 108 (38%) participants. Among those with successful sequencing, dolutegravir resistance occurred in 13 (13%) of 102 participants with detectable dolutegravir and three (2%) of 138 with undetectable dolutegravir, yielding an overall prevalence of 6·7% dolutegravir resistance and a negative predictive value for absence of dolutegravir resistance of 97·8% (95% CI 93·5-99·5). Dolutegravir resistance was associated with detectable dolutegravir (odds ratio [OR] 3 [95% CI 1-9], p=0·031), nucleoside reverse transcriptase inhibitor mutations (OR 33 [4-264], p=0·0009), non-nucleoside reverse transcriptase inhibitor mutations (OR 17 [2-135], p=0·0068), or M184V (OR 20 [4-92], p=0·0002). Cost modelling showed a 23% reduction in monitoring cost per person using the reflex strategy after confirmed viraemia versus current national guidelines.</p><p><strong>Interpretation: </strong>Laboratory-initiated reflex plasma dolutegravir exposure testing provides an objective, cost-efficient strategy to predict the absence of dolutegravir resistance and supports adherence management, enabling timely, individualised treatment decisions. Reflex dolutegravir exposure testing could enhance clinical decision making, improve treatment outcomes, and strengthen HIV treatment and resistance monitoring algorithms in programmatic settings.</p><p><strong>Funding: </strong>The Amsterdam Dinner Foundation and Aidsfonds, the Netherlands Organisation for Scientific Research, ZonMw, and WOTRO.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e713-e722"},"PeriodicalIF":14.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"100% committed to life.","authors":"Ed Holt","doi":"10.1016/S2352-3018(26)00196-7","DOIUrl":"10.1016/S2352-3018(26)00196-7","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e687"},"PeriodicalIF":14.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turkish Government crackdown on HIV and LGBTQ+ groups.","authors":"The Lancet Hiv","doi":"10.1016/S2352-3018(26)00232-8","DOIUrl":"10.1016/S2352-3018(26)00232-8","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e679"},"PeriodicalIF":14.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ebola virus disease outbreaks and HIV control","authors":"Marguerite Massinga Loembe, Edlom P Tchadie, Selidji T Agnandji","doi":"10.1016/s2352-3018(26)00225-0","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00225-0","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"225 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet HIV 2026; 13: e557–68","authors":"","doi":"10.1016/s2352-3018(26)00235-3","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00235-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"41 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet HIV 2026; 13: e440–51","authors":"","doi":"10.1016/s2352-3018(26)00234-1","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00234-1","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"3 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}