Lancet Hiv最新文献

{"title":"US funding cuts as a catalyst for African-led HIV solutions.","authors":"Daniel A Adeyinka, Bukola Ologunagba, Babayemi O Olakunde","doi":"10.1016/S2352-3018(25)00049-9","DOIUrl":"10.1016/S2352-3018(25)00049-9","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e248-e249"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544025","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 2025; published online March 26. https://doi.org/10.1016/S2352-3018(25)00074-8.","authors":"","doi":"10.1016/S2352-3018(25)00095-5","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00095-5","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789102","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":"Pitavastatin not so pleiotropic in people with HIV?","authors":"Peter Reiss, Peter Hunt","doi":"10.1016/S2352-3018(25)00006-2","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00006-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 4","pages":"e241-e242"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781708","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":"Long-acting PrEP for adolescent girls and young women.","authors":"Wipaporn Natalie Songtaweesin, Thanyawee Puthanakit","doi":"10.1016/S2352-3018(25)00042-6","DOIUrl":"10.1016/S2352-3018(25)00042-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e240-e241"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634880","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":"Statin effects on the incidence of major non-cardiovascular disease events among a global cohort of people with HIV: a randomised controlled trial.","authors":"Marissa R Diggs, Triin Umbleja, Sara McCallum, Markella V Zanni, Sarah M Chu, Kathleen V Fitch, Gerald S Bloomfield, Judith S Currier, Esteban Martinez, Philip E Castle, Aya Awwad, Mamta K Jain, Roger Bedimo, Bronwyn Hendricks, Jose Narrea, Vincente Estrada, Jorge Pinto, Judith A Aberg, Carlos D Malvestutto, Carl J Fichtenbaum, Michael T Lu, Heather J Ribaudo, Pamela S Douglas, Steven K Grinspoon","doi":"10.1016/S2352-3018(24)00345-X","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00345-X","url":null,"abstract":"<p><strong>Background: </strong>Given the pleiotropic effects of statins beyond lipid-lowering, statins might positively impact other, non-cardiovascular diseases (non-CVDs). In this study, we prospectively assessed statin effects on non-CVD events and their incidence among people with HIV globally.</p><p><strong>Methods: </strong>The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE; ClinicalTrials.gov, NCT02344290) was a randomised, placebo-controlled trial of pitavastatin for CVD prevention took place from 2015 to 2023 at 145 research sites in 12 countries and is completed. In this analysis of prespecified secondary outcomes of REPRIEVE, we assessed effects of pitavastatin 4 mg daily (vs placebo) on major non-CVD events (including AIDS-defining events, non-AIDS-defining cancers, renal disease, and liver disease) and the Strategic Timing of Antiretroviral Treatment (START) trial outcome (a collective measure of morbidity including CVD among people with HIV) using Cox proportional hazards regression, stratified by sex and CD4 cell count.</p><p><strong>Findings: </strong>Among the 7769 people with HIV enrolled (3888 in the pitavastatin group and 3881 in the placebo group), 6402 participants completed the study (3201 in each group). Over a median 5·6 years (IQR 4·7-6·3) of follow-up, the incidence of major non-CVD events was 9·17 per 1000 person-years in the pitavastatin group and 9·90 per 1000 person-years in the placebo group (hazard ratio [HR], cause-specific: 0·92, 95% CI 0·76-1·13; p=0·44). The incidence of the START outcome was 15·2 per 1000 person-years in the pitavastatin and 18·3 per 1000 person-years in the placebo group (HR 0·83, 95% CI 0·71-0·97; p=0·016), driven by the effect on CVD. In the placebo group, incidences of the non-AIDS-defining cancer and CVD components of the START Trial outcome were highest (5·83 per 1000 person-years and 5·48 per 1000 person-years) whereas AIDS-defining events were less frequent (3·60 per 1000 person-years), and varied across global regions. With pitavastatin, the incidence of CVD was lower compared with placebo (3·36 per 1000 person-years), however non-AIDS-defining cancers remained high (5·40 per 1000 person-years). Non-AIDS-defining cancers were the leading cause of mortality for both groups.</p><p><strong>Interpretation: </strong>Among a global cohort of people with HIV, treatment with pitavastatin showed no major reduction in non-CVD events, including non-AIDS-defining cancers. These findings outline the limitations of statin therapy for the prevention of non-CVD, highlighting the need for other strategies for such events.</p><p><strong>Funding: </strong>National Institutes of Health, Kowa Pharmaceuticals America, Gilead Sciences, and ViiV Healthcare.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 4","pages":"e261-e272"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781709","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":"Transgender Day of Visibility more crucial than ever.","authors":"The Lancet Hiv","doi":"10.1016/S2352-3018(25)00077-3","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00077-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 4","pages":"e239"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781710","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":"Treating HIV-associated tuberculosis in children without compromise.","authors":"Alexander Kay, Moorine Sekadde, Debrah Vambe, Anthony J Garcia-Prats","doi":"10.1016/S2352-3018(24)00346-1","DOIUrl":"10.1016/S2352-3018(24)00346-1","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e242-e244"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537893","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":"Prevention and control of HPV-related cancers in people living with HIV.","authors":"Anneli Uusküla, Anna Tisler, Jack DeHovitz, Gad Murenzi, Philip E Castle, Gary Clifford","doi":"10.1016/S2352-3018(25)00011-6","DOIUrl":"10.1016/S2352-3018(25)00011-6","url":null,"abstract":"<p><p>The advent of effective antiretroviral therapy (ART) has increased the lifespan of many people living with HIV. As a result, cancers driven by high-risk human papillomavirus (HPV) infection have emerged as an increasingly important cause of mortality in this population. The complex interplay between HIV and HPV necessitates a deep understanding of the HPV-related cancer burden in people living with HIV and the integration of effective prevention strategies into their care. Although cervical cancer is a global concern, anal cancer is more important among people living with HIV in settings where HIV is more concentrated among men who have sex with men. High HPV prevalence, coupled with resource constraints, particularly in sub-Saharan Africa, where the majority of people living with HIV reside, creates substantial barriers to successful prevention and management of HPV-related malignancies. Implementing preventive measures, such as HPV vaccination and comprehensive screening programmes, is crucial and will require addressing existing health inequities and developing tailored interventions for people living with HIV. The development of enhanced secondary prevention tools and innovative treatment modalities is essential to mitigate the burden of HPV-associated cancers and improve the overall health outcomes for this vulnerable population.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e293-e302"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630955","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":"Safety, tolerability, and acceptability of long-acting injectable cabotegravir for HIV prevention in cisgender female adolescents (HPTN 084-01): a single-arm, open-label, phase 2b trial.","authors":"Lynda Stranix-Chibanda, Erica L Hamilton, Julie Ngo, Yuqing Jiao, Brett Hanscom, Rahul Paul Choudhury, Yaw Agyei, Estelle Piwowar-Manning, Mark Marzinke, Sinead Delany-Moretlwe, Nyaradzo Mgodi, Bekezela Siziba, Ishana Naidoo, Brenda Gati Mirembe, Betty Kamira, Cynthia McCoig, Adeola Adeyeye, Hans M L Spiegel, Sybil Hosek","doi":"10.1016/S2352-3018(24)00310-2","DOIUrl":"10.1016/S2352-3018(24)00310-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Long-acting formulations of HIV pre-exposure prophylaxis (PrEP) appear particularly well suited to adolescents. We aimed to establish the safety, tolerability, and acceptability of long-acting injectable cabotegravir as PrEP in cisgender adolescent girls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;HPTN 084-01 is a single-arm, open-label, phase 2b trial conducted at three clinical research sites in South Africa, Uganda, and Zimbabwe. Girls were recruited via community study-outreach teams, reproductive health clinics, and peer referral. Sexually active adolescent girls (younger than 18 years) willing to use long-acting contraception, weighing at least 35 kg, and able to participate with parental or guardian consent (unless an emancipated minor) were eligible. After an oral lead-in, if no adverse events occurred, participants received a 3 mL intramuscular gluteal injection (long-acting injectable cabotegravir 600 mg) at weeks 5, 9, 17, 25, and 33. The product was discontinued for grade 3 or higher toxic effects or pregnancy. The primary outcomes were safety, tolerability, and acceptability. Safety (ie, proportions of grade 2 or higher clinical and laboratory events) was assessed at weeks 6, 10, 18, 26, and 34 in all enrolled participants. Injection tolerability (ie, proportions of premature discontinuation due to intolerability, frequency of injections, or burden of study procedures) and product acceptability (ie, proportions of scheduled injections completed and participants preferring long-acting injectable cabotegravir for future use) were assessed in all participants who received at least one injection at study end. The trial was registered with ClinicalTrials.gov (NCT04824131) and is completed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between Nov 1, 2020, and Aug 31, 2021, 69 participants were assessed for eligibility and 55 met inclusion criteria. The mean age was 16·0 years (SD 1·1), 39 (71%) had a recent primary sexual partner, 12 (22%) reported transactional sex, and 22 (40%) had sexually transmitted infections at baseline. Two participants dropped out and did not initiate long-acting injectable cabotegravir due to adverse events unrelated to the study drug during the oral lead-in. One participant stopped long-acting injectable cabotegravir after three injections due to pregnancy. 51 (93%) participants reported at least one adverse event of grade 2 or higher, mostly unrelated, transient laboratory abnormalities. There were no long-acting injectable cabotegravir discontinuations due to intolerability. Of the 52 participants who completed step 2, all scheduled injections were completed and 32 (62%) participants reported they would consider using long-acting injectable cabotegravir for HIV prevention in the future.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Long-acting injectable cabotegravir is a safe, tolerable, and acceptable option for the prevention of HIV in adolescent girls. Our study findings expand the HIV prevention options","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e252-e260"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634884","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":"Causes of hospitalisation among people living with HIV worldwide, 2014-23: a systematic review and meta-analysis.","authors":"Rachael M Burke, Nadia Sabet, Jayne Ellis, Ajay Rangaraj, David S Lawrence, Joseph N Jarvis, Jane Falconer, Lillian Tugume, Gabriella Bidwell, Rebecca H Berhanu, Peter MacPherson, Nathan Ford","doi":"10.1016/S2352-3018(24)00347-3","DOIUrl":"https://doi.org/10.1016/S2352-3018(24)00347-3","url":null,"abstract":"<p><strong>Background: </strong>Despite improved access to antiretroviral therapy (ART), HIV-related morbidity and mortality remain high. A previous review (2007-14) found that AIDS-related illnesses were the leading causes of hospitalisations. We aimed to summarise the causes of hospitalisations among people living with HIV from 2014 to 2023.</p><p><strong>Methods: </strong>For this meta-analysis we searched eight databases (Ovid Medline ALL, Ovid Embase Classic and Ovid Embase, Ovid Global Health, EBSCOhost CINAHL Complete, EBSCOhost Africa-Wide Information, Clarivate Analytics Web of Science Core Content, Clarivate Analytics Web of Science SciELO, and Global Index Medicus) on April 26, 2023. We included studies of any design that reported on the cause of admission to hospital for at least 20 people after Jan 1, 2014. We extracted summary-level data about CD4 cell counts, ART use, cause of admission, and incidence of death, and assessed risk of bias with the use of a modified Newcastle-Ottowa Scale. We constructed random effects models to estimate prevalence of various diseases as a cause of hospital admission.</p><p><strong>Findings: </strong>From the 19 629 records identified, we obtained data from 110 studies representing 100 628 hospital admissions. The weighted median CD4 count was 111 cells per μL (range of medians 25-713); 60% of admissions (95% Cl 54-66) were people receiving ART. The most common cause of admission was AIDS-related illnesses (42% of admissions, 95% CI 35-49), including tuberculosis (19%, 15-23). The second most common cause was bacterial infection (26%, 20-33). AIDS-related illnesses were more common in WHO regions of South and Central America (62%, 53-71), Africa (49%, 39-60), Western Pacific (68%, 57-77), and South-East Asia (40%, 31-50) than in Europe (30%, 23-37) and North America (13%, 6-25). Wasting and parasitic infections were more common in children (malnutrition 31%, 11-63; parasitic infection 13%, 4-37) than in adults. In-hospital mortality was 17% (13-20), with substantial regional variation.</p><p><strong>Interpretation: </strong>Our results indicate providing high-quality care to hospitalised people with HIV-related conditions (AIDS-related illness and severe bacterial infections) should be prioritised.</p><p><strong>Funding: </strong>The Bill & Melinda Gates Foundation.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744144","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}