Lancet Hiv最新文献

{"title":"Correction to Lancet HIV 2026; 13: e478–89","authors":"","doi":"10.1016/s2352-3018(26)00181-5","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00181-5","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"22 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087137","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: e569–610","authors":"","doi":"10.1016/s2352-3018(26)00233-x","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00233-x","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"1 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087136","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":"Integrating long-acting injectable cabotegravir for HIV prevention into the Brazilian public health system (ImPrEP CAB Brasil): a hybrid type-2 implementation-effectiveness cohort study.","authors":"Beatriz Grinsztejn, Thiago Silva Torres, Brenda Hoagland, Carolina Coutinho, Mayara Secco Torres Silva, Iuri Costa Leite, Marcelo Cunha, Monica Derrico, Emilia M Jalil, Sandra Wagner Cardoso, Roberta Trefiglio, Alessandro Farias, Maria Paula G Mourão, José Valdez Madruga, Josué N de Lima, Ronaldo Zonta, Gabrielle O'Malley, Julio Moreira, Keila Simpson, Alex R Rinehart, Nanlesta Pilgrim, Anna Hellstrom, Anne-Isabelle Cameron, Paula Mendes Luz, Raphael J Landovitz, Marcos Benedetti, Cristina Pimenta, Ronaldo Ismério Moreira, Valdilea Gonçalves Veloso","doi":"10.1016/S2352-3018(26)00201-8","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00201-8","url":null,"abstract":"<p><strong>Background: </strong>Daily oral pre-exposure prophylaxis (PrEP) requires sustained adherence, which remains challenging in real-world settings. Although long-acting injectable cabotegravir (CAB-LA) could improve prevention coverage, implementation evidence in Latin America is scant. We evaluated the feasibility of integrating same-day CAB-LA delivery within Sistema Único de Saúde (SUS), the Brazilian public health system.</p><p><strong>Methods: </strong>ImPrEP CAB Brasil was a multicentre, hybrid type-2 implementation-effectiveness, open-label cohort study done at 14 PrEP public health services in six Brazilian cities. Eligible participants were cisgender men, non-binary people assigned male at birth, and transgender men and women who have sex with men, aged 18-30 years, who tested HIV negative, and were PrEP-naive. Participants could choose either CAB-LA (CAB-LA choice cohort) or oral PrEP with tenofovir disoproxil fumarate and emtricitabine (oral PrEP choice cohort), We included a comparison cohort of people initiating PrEP in SUS (oral PrEP SUS cohort). The main outcomes were HIV incidence and follow-up days covered by PrEP. For CAB-LA, we evaluated on-time injection adherence, switching, loss to follow-up, and safety. Participants were given the option to switch PrEP modalities or remain off PrEP during follow-up. Adverse events of special interest in participants using CAB-LA were assessed at every study visit. The study was registered at ClinicalTrials.gov (NCT05515770) and is ongoing.</p><p><strong>Findings: </strong>Participants were enrolled from Oct 17, 2023, to Sept 16, 2024, and followed up until Oct 16, 2025. 3096 participants were included in this analysis: 1201 (38·8%) in the CAB-LA choice cohort, 246 (7·9%) in the oral PrEP choice cohort, and 1649 (53·3%) in the oral PrEP SUS cohort. Most participants were cisgender men (2893 [90·9%]), Pardo or Black (1663 [53·7%]), and completed secondary education or higher (2517 [81·3%]). Median age was 26 years (IQR 23-28). HIV incidence was 0·20 per 100 person-years (95% CI 0·04-0·57) for the CAB-LA cohort (three new HIV infections), 0·87 (0·11-3·16) for the oral PrEP choice cohort (two new HIV infections), and 1·48 (0·88-2·33) for the oral PrEP SUS cohort (18 new HIV infections). 590 091 (90·8%) follow-up days were covered by PrEP in the CAB-LA cohort versus 69 491 (47·3%) in the oral PrEP choice cohort and 328 025 (35·5%) in the oral PrEP SUS cohort (p<0·0001). 107 (8·8%) of 1220 participants were lost to follow-up in the CAB-LA cohort, and were mainly people who were non-White, had lower levels of education, and had moderate or severe depressive symptoms. On-time injection adherence was high (92%). Injection-site reactions were the most frequent adverse event (4212 events in 1067 [87·5%] participants) and were generally mild to moderate. 80 serious adverse events were reported: 43 adverse events of interest (one related to CAB-LA) and 37 other events (none related to CAB-LA).</p","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041453","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":"Psychedelic-assisted therapy research for people with HIV.","authors":"Nelson Vergel, Parya Saberi","doi":"10.1016/S2352-3018(26)00227-4","DOIUrl":"10.1016/S2352-3018(26)00227-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026443","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":"Trends in HIV-1 transmission in Switzerland: a retrospective molecular epidemiology study.","authors":"Marco Labarile, Paul Frischknecht, Tom Loosli, Nadia Neuner-Jehle, Marius Zeeb, Michael Huber, Karoline Leuzinger, Matthieu Perreau, Alban Ramette, Sabine Yerly, Matthias Cavassini, Marcel Stöckle, Eugénie Colin-Benoit, Alexandra Calmy, Patrick Schmid, Marco Bongiovanni, David H-U Haerry, Matthias Egger, Huldrych F Günthard, Chloé Pasin, Roger D Kouyos","doi":"10.1016/S2352-3018(26)00173-6","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00173-6","url":null,"abstract":"<p><strong>Background: </strong>The rapid identification of emerging transmission clusters could help reach the 2030 goal of halting transmission of HIV in Switzerland. We characterised the size, structure, and growth of recent HIV-1 transmission clusters in the Swiss HIV Cohort Study (SHCS).</p><p><strong>Methods: </strong>In this retrospective molecular epidemiology analysis in Switzerland, we analysed 32 294 HIV-1 pol sequences from 16 428 SHCS participants, enrolled between Aug 14, 1984, and May 19, 2025. Sequences were aligned and clustered using a 0·01 Tamura-Nei 93 distance threshold, and networks were constructed at the participant level to identify clusters and their growth. We defined and described a set of fast-growing clusters of HIV in Switzerland. Associations between clustering, demographic and clinical characteristics, and viral suppression were assessed.</p><p><strong>Findings: </strong>7387 (45·0%) participants were part of 1131 clusters. Cluster size distribution was highly skewed: 62% contained only two individuals, whereas a few large clusters accounted for thousands of participants. The epidemic fragmented from a single dominant cluster of people who inject drugs in the 1990s into numerous smaller clusters, predominantly among gay, bisexual, and other men who have sex with men (MSM). Since 2016, 32·6% of the total cluster growth was concentrated in a set of 23 fast-growing clusters. These fast-growing clusters mostly comprised western European MSM with high rates of condomless sex. Cluster growth was strongly associated with viraemia among connected participants.</p><p><strong>Interpretation: </strong>The Swiss HIV epidemic has evolved into fragmented, short transmission chains, with a small number of fast-growing clusters sustaining ongoing transmission. Molecular surveillance can identify such clusters, enabling tailored interventions that complement treatment as prevention. Achieving zero HIV transmission in Switzerland will require integration of molecular epidemiology into routine prevention.</p><p><strong>Funding: </strong>Swiss National Science Foundation.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018467","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":"Targeted point-of-care HIV testing at birth for newborns at high risk of vertical transmission in Botswana: a prospective cohort study.","authors":"Gbolahan Ajibola, Sean Brummel, Terence Mohammed, Maureen Sakoi-Mosetlhi, Kesaobaka Molebatsi, Oganne Batlang, Molly Pretorius Holme, Tendani Gaolathe, Modiegi Diseko, Max Kapanda, Jessica Mafa-Setswalo, Kathleen M Powis, Gwynn Stevens, Shahin Lockman, Joseph Makhema, Mathias Lichterfeld, Sikhulile Moyo, Roger Shapiro","doi":"10.1016/S2352-3018(26)00176-1","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00176-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;HIV testing at birth supports timely infant HIV diagnosis and treatment. We evaluated the operational feasibility and effectiveness of facility-based, risk-stratified birth testing for newborns at high risk and moderate risk of vertical HIV transmission in Botswana.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We tested newborns at high risk or moderate risk of HIV acquisition at 35 delivery facilities selected based on delivery volume. At-risk newborns were identified by maternal delivery record review and tested after mothers provided verbal consent during brief interviews. Included infants were born to mothers 18 years and older, weighing 1·5 kg and over, and had one or more maternal risk factors; infants unlikely to survive 24 months were excluded. High-risk was defined as documented maternal HIV-1 viral load of 40 copies per mL or above during pregnancy, maternal CD4 count under 350 cells per μL during pregnancy, fewer than 12 weeks of maternal antiretroviral therapy (ART) use before delivery, or self-reported poor maternal adherence to ART (ie, more than three missed doses during pregnancy). Moderate risk included a new HIV diagnosis in pregnancy or other clinical concerns. Dried blood spots were evaluated using GeneXpert, with positive results confirmed by COBAS TaqMan. Children testing negative were retested at 6 weeks, per national guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;From July 4, 2022, to July 4, 2024, 8844 total newborns were delivered to women living with HIV. Of these, 2737 newborns with any risk factor of concern to government midwives were identified, testing was offered to their mothers, and 96% accepted, yielding a total of 2627 newborns (30%) exposed to HIV who were tested at birth. HIV testing occurred at a median of 22 h of life (IQR 13-41). 1234 (14·0%) infants were high-risk and 1393 (15·8%) were moderate-risk by study-specific criteria; 1283 infants (48·8%) were female and 1344 (51·2%) were male; demographic data on race and ethnicity were not collected, although all participants were Black Africans. HIV was confirmed in 14 (0·5%) of 2627 newborns (13 classified as high-risk), with infant treatment-dose nevirapine-lamivudine-zidovudine started at a median of 2·7 days (IQR 2·0-3·3). Post-exposure prophylaxis for the 2613 newborns with negative birth testing results was zidovudine in 1037 (39·5%), nevirapine-lamivudine-zidovudine in 1497 (57·0%), and no prophylaxis documented in 79 (3·0%). 6-week follow-up testing was documented for 2211 infants (84·6%) with negative birth testing, with only three new infections (0·1%; one at high risk, two at moderate risk; and all were prescribed three-drug prophylaxis).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Near-point-of-care HIV testing at birth for high-risk newborns can identify the majority of HIV transmissions in early life. Simplified post-exposure prophylaxis may be appropriate in the setting of available maternal ART, even among infants at high risk.&lt;/p&gt;","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892636","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":"Social sciences at the centre of HIV stigma reduction.","authors":"Cristian Ortega, Alemka Tomicic","doi":"10.1016/S2352-3018(26)00223-7","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00223-7","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892560","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":"Low-level viraemia in children living with HIV.","authors":"Bianca Alvarez, Patricia Agaba, Rosemary Mrina, Meagan Stephenson, Shirley Lecher","doi":"10.1016/S2352-3018(26)00224-9","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00224-9","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888904","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":"Does U=U apply during breastfeeding? An urgent research priority.","authors":"Dvora Joseph Davey, Shahin Lockman, Roger Shapiro, Thokozile Malaba, Natasha Davies, Lee Fairlie, Rebecca Zash","doi":"10.1016/S2352-3018(26)00167-0","DOIUrl":"10.1016/S2352-3018(26)00167-0","url":null,"abstract":"<p><p>Whether undetectable equals untransmittable (U=U) applies during breastfeeding remains one of the most consequential unanswered questions in HIV prevention. Although sustained viral suppression eliminates sexual HIV transmission, evidence is insufficient to determine whether breastfeeding transmission risk reflects biological limits of U=U or failure to maintain viral suppression postpartum. Existing data suggest exceedingly low breastfeeding transmission risk with maternal viral suppression, but are limited by infrequent viral load monitoring, older antiretroviral therapy regimens, incomplete follow-up, and sparse breastmilk virology data. This uncertainty has important implications for women with HIV, clinicians, and policy makers, particularly in settings with high burden of HIV where breastfeeding is essential for infant health, survival, neurodevelopment, and nutrition, as well as maternal health. Rigorous prospective studies are urgently needed to answer the question of whether U=U applies during breastfeeding, using modern integrase inhibitor-based antiretroviral therapy, frequent plasma and breastmilk viral load testing, infant follow-up, and rights-based counselling frameworks. Regardless of whether future evidence demonstrates zero or very low residual risk, we strongly argue that women with HIV should be supported to make informed choices regarding infant feeding, grounded in autonomy, evidence, and shared decision making.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e675-e678"},"PeriodicalIF":14.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649390","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":"Interventions to improve viral suppression and adherence to antiretroviral therapy among people living with HIV: a systematic review and network meta-analysis.","authors":"Steve Kanters, David S Lawrence, Vanessa S McLennan, Catherine Orrell, Clarice Pinto, Roger Chou, Evan Popoff, Sean P Harrigan, Leah Yang, Nathan Ford","doi":"10.1016/S2352-3018(26)00119-0","DOIUrl":"10.1016/S2352-3018(26)00119-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In 2025, 78% of people living with HIV worldwide were on antiretroviral therapy 95% of people on treatment were virally suppressed. Suboptimal adherence, defined as not taking interventions as prescribed, threatens viral suppression and can lead to antiviral resistance, morbidity, mortality, and transmission. We updated a systematic review and network meta-analysis to estimate the effects of different adherence interventions on adherence and viral suppression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this systematic review and network meta-analysis, we searched MEDLINE, Embase, CENTRAL, and key conference proceedings for individually randomised trials of adherence interventions scalable in low-income and middle-income countries (LMICs) published from database inception to June 5, 2024. Trials were excluded if they were done among individuals receiving antiretroviral regimens associated with higher pill burden and toxicities or were assessing interventions reliant on costly technologies or highly specialised staff not scalable in LMICs. Two reviewers independently assessed all abstracts and subsequently full texts for inclusion. Discrepancies were resolved by consensus with a third reviewer. From the summary data, the initial reviewers then extracted the data, which included study characteristics, intervention types, and adherence. The primary outcome was adherence to antiretroviral therapy with different interventions, which was analysed in a network meta-analysis with fixed or random effects and in alignment with PRISMA guidelines. We assessed risk of bias using the Cochrane Risk of Bias 2 tool and evidence certainty using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;10 336 potentially eligible records were identified from the database search, of which 167 were eligible. Five additional records were added from manual searches, resulting in 172 records mapped to 164 unique trials. The studies focused on the effect of reminders (n=49 [30%]), supporters (n=47 [29%]), education (n=40 [24%]), counselling (n=47 [29%]), and complex interventions (n=4 [2%]) on adherence. For the network meta-analysis, across the eligible trials, reminders, supporters, counselling, and education had some effect on adherence. Overall, at 24 weeks, the only interventions that improved adherence compared with standard of care at 24 weeks were reminders (estimated odds ratio [OR] 1·53 [95% credible interval (CrI)]; risk difference [RD] 9·4% [95% CrI 2·5-16·0)] and supporters (1·82 [1·11-3·04]; 12·8% [2·5-21·4]). In LMICs, only counselling at 12 weeks (2·53 [1·03-6·75]; 18·8% [0·8-30·5]) and supporter at 24 weeks (2·11 [1·12-4·51]; 14·3% [2·4-23·7]) had improved effects. Subgroup patterns varied: adolescents benefited from reminders and supporters and education, and people with previous non-adherence benefited from counselling and supporters. Effects on viral suppression paralleled adherence; for example, supporters improved viral suppression at 48 weeks ","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e652-e662"},"PeriodicalIF":14.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680571","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}