Lancet Hiv最新文献

{"title":"The future of HIV diagnostics: an exemplar in infectious diseases.","authors":"Nitika Pant Pai, Rigveda Kadam, Ilesh Jani, George Alemnji, Ruslan Malyuta, Trevor Peter","doi":"10.1016/S2352-3018(25)00078-5","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00078-5","url":null,"abstract":"<p><p>Over the past 40 years, diagnostics have become the backbone of HIV prevention, treatment, and retention in care, and are central to the achievement of UNAIDS 95-95-95 targets. Over the next decade, the global HIV response will face difficult challenges. In addition to sustaining gains achieved in prevention and treatment, substantial gaps in care need to be addressed for underserved populations. Diagnostics will play an important role in control and prevention of HIV infection through novel technologies, digital solutions, and integrated service delivery innovations. The integration of diagnostics with digital health, machine learning, and generative artificial intelligence provides opportunities for more effective individual and public health disease control. These diagnostics and other futuristic innovations such as wearable technologies, omics, metaverse-based solutions, and quantum diagnostics could enable the achievement of the UNAIDS 95-95-95 targets; however, their use will face barriers related to health-care system financing, infrastructure, technological readiness and skills, and long-term sustainability. This Review highlights diagnostic strategies and innovations that could catalyse a new era in the management of the HIV pandemic.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053635","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":"CD4 cell counts at HIV diagnosis in the Eastern Mediterranean Region.","authors":"Mohammad Sharifi,Seyed Aria Nejadghaderi,Maliheh Sadat Bazrafshani,Elahe Amiri,Fatemeh Tavakoli,Soheil Mehmandoost,Ahmed S Alaama,Meraj Sharifi,Mohammad Karamouzian,Hamid Sharifi","doi":"10.1016/s2352-3018(25)00101-8","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00101-8","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"46 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902907","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":"The impact of homelessness and housing insecurity on HIV.","authors":"Julia C Dombrowski,Maria A Corcorran,Tara Carney,Miłosz Parczewski,Monica Gandhi","doi":"10.1016/s2352-3018(25)00048-7","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00048-7","url":null,"abstract":"Homelessness is a global problem with wide-ranging causes and contexts. People experiencing homelessness and unstable housing (HUH) are disproportionately affected by HIV and face worse treatment outcomes than those with stable housing due to multiple complex barriers to care. Even in settings with universal health coverage, access to HIV prevention and treatment services remains insufficient for people experiencing HUH. Health system barriers-such as difficult-to-navigate, fragmented care systems and the mistreatment faced in health-care settings-hinder the engagement of this population in HIV care. Tailored service delivery models, including low-barrier care, mobile and street-based care, and long-acting antiretroviral medications for prevention and treatment, show promise in addressing these barriers and improving HIV outcomes among people experiencing HUH. Future research should prioritise high-quality studies of differentiated service delivery, implementation science to optimise prevention and care programmes for this population in varied settings, and expanded access to long-acting pre-exposure prophylaxis and antiretroviral therapy, particularly in low-income and middle-income countries.","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"10 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889335","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":"HIV prevention and undiagnosed infections in children in sub-Saharan Africa.","authors":"Souleymane Tassembedo,Nicolas Meda,Chipepo Kankasa,Roger Shapiro,Theodore Ruel,Ameena Goga,Mwiya Mwiya,Isidore Tiandiogo Traore,Thorkild Tylleskär,Anais Mennecier,Jean Pierre Moles,Philippe Van de Perre,Nicolas Nagot","doi":"10.1016/s2352-3018(25)00070-0","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00070-0","url":null,"abstract":"Despite the efforts to prevent vertical transmission of HIV, about 130 000 children worldwide acquire HIV each year, and 40% of those remain undiagnosed. Many factors contribute to this poor outcome including, but not limited to, failure to identify mothers seroconverting during pregnancy or postpartum, suboptimal early infant diagnosis, misinterpretation of negative test results in children before the end of breastfeeding, and child testing not being a key indicator for national programmes. To close the paediatric HIV diagnosis gap and improve child mortality rates, several changes are necessary. These changes include intensifying HIV retesting efforts to identify women who seroconvert during pregnancy or breastfeeding, counselling caregivers and health-care providers on the necessity of doing a final HIV test in children after breastfeeding ends, setting a formal indicator for child testing between age 18 months and 24 months, and extending child HIV diagnosis as a concern for all health-care workers when the children leave the programme to prevent vertical transmission of HIV after 2 years.","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"9 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885475","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":"Impact of quasi-elimination of Wuchereria bancrofti on HIV incidence in southwest Tanzania: a 12-year prospective cohort study.","authors":"Inge Kroidl,Thomas F Marandu,Lucas Maganga,Sacha Horn,Agatha Urio,Antelmo Haule,Jacklina Mhidze,Jonathan Mnkai,Maureen Mosoba,Elizabeth Ntapara,Nhamo Chiwarengo,Petra Clowes,Bettina Pitter,Friedrich Riess,Basel Habboub,Elmar Saathoff,Manuel Ritter,Achim Hoerauf,Leonard Maboko,Christof Geldmacher,Nyanda E Ntinginya,Michael Hoelscher,Mkunde Chachage","doi":"10.1016/s2352-3018(25)00001-3","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00001-3","url":null,"abstract":"BACKGROUNDBefore introduction of anthelmintic treatment programmes in southwest Tanzania, our group described a 2·3-fold increase in HIV incidence among adults infected with the helminth Wuchereria bancrofti. Between 2007 and 2011, HIV incidence was 1·91 cases per 100 person-years in people with a W bancrofti infection and 0·80 cases per 100 person-years in those without the infection. We aimed to examine the impact of a reduction in W bancrofti infection as a result of mass drug administration on HIV incidence in southwest Tanzania.METHODSThe Risk of HIV Infections through Nematode Organism (RHINO) study is a prospective cohort study that used data from participants in one village collected during the Evaluation and Monitoring of the Impact of New Interventions (EMINI) study in 2007-11 and new data from EMINI participants collected in 2019. Study participants were tested for HIV and circulating filarial antigen (an indicator of W bancrofti infection), once a year from 2007 to 2011 and once in 2019. From 2009 to 2015, anthelmintics were annually distributed to all villagers through government programmes, followed by transmission assessment surveys. We analysed data from individuals aged 14-65 years with negative HIV test results at enrolment in EMINI in 2007. We did multilevel mixed-effects Poisson regression to describe and compare age-adjusted and sex-adjusted incidence rates.FINDINGSOf the 1299 previous study participants rescreened in 2019, 1139 had been HIV-negative at the end of the last surveillance period in 2011 and were included in this analysis. 552 (48·5%) participants were female and 587 (51·5%) were male, and the median age was 26.4 years (IQR 19·8-37·8). Of the 1139 participants included, 848 (74·5%) never tested positive for W bancrofti infection, 272 (23·9%) previously tested positive but did not have a W bancrofti infection in 2019 (cured individuals), 15 (1·3%) tested positive for W bancrofti infection both in 2007-11 and 2019, and four (0·4%) had a new W bancrofti infection in 2019. Between 2011 and 2019, HIV incidence rate was 0·68 cases (95% CI 0·50-0·93) per 100 person-years in the 848 participants with no W bancrofti infection (39 new HIV infections during 5724 person-years) and 0·73 cases (0·45-1·17) per 100 person-years in the 272 cured individuals (17 new HIV cases during 2344 person-years; incidence rate ratio (IRR) after adjusting for age and sex 1·14, 95% CI 0·64-2·04; p=0·65). HIV incidence rate was 1·5 cases (0·39-6·04) per 100 person-years in the 15 individuals who tested positive for W bancrofti infection both in 2007-11 and in 2019 (two new HIV infection in 131 person-years; adjusted IRR 3·43, 95% CI 0·8-15; p=0·10).INTERPRETATIONIn the group of participants cured of W bancrofti infection, the HIV incidence significantly decreased in 2011-19 compared with 2007-11, the period when they tested positive for W bancrofti infection. This effect was not observed in the group of individuals who never had a positive W ba","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"26 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827101","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":"Deworming of filariasis and reduction of HIV incidence.","authors":"Zilungile Lynette Mkhize-Kwitshana,Musawenkosi Lawrence H Mabaso","doi":"10.1016/s2352-3018(25)00010-4","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00010-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"108 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827123","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":"UK boosts HIV testing efforts.","authors":"Tony Kirby","doi":"10.1016/S2352-3018(25)00098-0","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00098-0","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991215","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":"A SWING in the right direction for sex workers.","authors":"Sima Barimina","doi":"10.1016/S2352-3018(25)00097-9","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00097-9","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796355","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":"Gender-affirming hormone therapy is a crucial component of HIV care.","authors":"Jill Blumenthal, Elizabeth Hastie","doi":"10.1016/S2352-3018(25)00067-0","DOIUrl":"10.1016/S2352-3018(25)00067-0","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e244-e246"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755387","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":"The Mexico City Policy, PEPFAR, and women's health.","authors":"Domonique M Reed, Salome Kuchukhidze, Jeffrey W Imai-Eaton","doi":"10.1016/S2352-3018(25)00050-5","DOIUrl":"10.1016/S2352-3018(25)00050-5","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e246-e248"},"PeriodicalIF":12.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543848","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}