Lancet Hiv最新文献

{"title":"Lifestyle modification programme for people living with HIV with metabolic dysfunction-associated steatotic liver disease: a randomised controlled trial.","authors":"Guanlin Li,Vincent Wai-Sun Wong,Ruth Suk-Mei Chan,Daisy Man-Ching Sin,Winnie Chu,Vivian Wong,Catherine Cheung,Shirley Lam,Huapeng Lin,Suey Yeung,Timothy Chun-Man Li,Tracy Hang-Yee Ho,Grace Lai-Hung Wong,Terry Cheuk-Fung Yip,Grace Chung-Yan Lui","doi":"10.1016/s2352-3018(25)00032-3","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00032-3","url":null,"abstract":"BACKGROUNDMetabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease among people living with HIV, and preliminary evidence shows that lifestyle modification can reduce liver fat in people living with HIV with MASLD. We aimed to assess a dietitian-led lifestyle modification programme in inducing resolution of MASLD in this population.METHODSIn this single-blind, randomised controlled trial at the Prince of Wales Hospital, Hong Kong, people living with HIV with fatty liver defined by intrahepatic triglyceride content ≥5% on proton magnetic resonance spectroscopy (1H-MRS) were enrolled if they were aged 18 years or older, were on antiretroviral therapy, and had HIV RNA of ≤50 copies per mL for 6 months or longer. Participants were randomly assigned (1:1) to either receive a dietitian-led lifestyle modification programme or standard care for 12 months. Randomisation was performed using computer-generated random numbers in blocks of 4 stratified by presence or absence of diabetes. The primary outcome, assessed in the intention-to-treat population, was resolution of MASLD, defined as intrahepatic triglyceride content less than 5% at month 12, measured by 1H-MRS. This trial was registered with ClinicalTrials.gov, NCT03913351, and is completed.FINDINGSFrom May 21, 2019, to March 22, 2022, 203 people were screened for eligibility, of whom 84 were randomly assigned to either the lifestyle modification programme (n=43) or standard care (n=41). 74 (88%) participants were male and ten (12%) were female. 78 participants completed all assessments during the 12-month intervention. In the intention-to-treat analysis, 12 (28%) participants in the intervention group and four (10%) in the control group had resolution of MASLD (p=0·040 adjusted for baseline diabetes status). No deaths were reported during the follow-up period. One serious adverse event (hospitalisation due to cellulitis) was reported in the control group. The occurrence of adverse events was similar in the intervention and control groups. The majority of adverse events were of mild severity, and none were considered to be related to study intervention.INTERPRETATIONOur findings suggest that a lifestyle modification programme could be a routine behavioural strategy to improve a range of health outcomes in people living with HIV with MASLD.FUNDINGHealth and Medical Research Fund from the Health Bureau, Hong Kong Special Administrative Region.TRANSLATIONFor the Chinese translation of the abstract see Supplementary Materials section.","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"10 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932978","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 erasure is a crisis for HIV science.","authors":"Kristi E Gamarel,Arjee J Restar,Sari L Reisner,Don Operario","doi":"10.1016/s2352-3018(25)00126-2","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00126-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"96 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926443","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":"Modelling study shows staggering impact of HIV funding cuts.","authors":"Euphemia Lindelwe Sibanda, Andrew N Phillips","doi":"10.1016/S2352-3018(25)00076-1","DOIUrl":"10.1016/S2352-3018(25)00076-1","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e316-e318"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744167","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 use in HIV: European AIDS Clinical Society guidance for the primary prevention of cardiovascular disease.","authors":"Jasmini Alagaratnam,Kathrin van Bremen,Georg M N Behrens,Franck Boccara,Paola Cinque,Magnus Gisslén,Giovanni Guaraldi,Deborah Konopnicki,Justyna D Kowalska,Patrick W G Mallon,Catia Marzolini,Luis Mendão,José M Miró,Eugenia Negredo,Peter Reiss,Lene Ryom,Marc van der Valk,Alan Winston,Susanne D Nielsen,Esteban Martínez","doi":"10.1016/s2352-3018(25)00047-5","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00047-5","url":null,"abstract":"Atherosclerotic cardiovascular disease (ASCVD) is an important comorbidity in people ageing with HIV. Over-representation of classic risk factors such as smoking, and other factors such as HIV infection and its therapy, which are exclusive to people with HIV, are responsible for the increased risk of developing ASCVD. The tools to estimate risk, including Systematic Coronary Risk Evaluation 2 (SCORE2), generally underestimate risk in people with HIV. The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) study showed that pitavastatin among people with HIV with low-to-moderate ASCVD risk significantly reduced the incidence of major adverse cardiovascular events. Following these results, the European AIDS Clinical Society recommends the use of moderate-intensity statins for people with HIV with a SCORE2 value between 5% and less than 10%, or ≥2·5% if older than 50 years with no additional listed risk factors. Moderate-intensity statins can be considered in people with HIV aged 40 years and over with a SCORE2 <5%. Although the REPRIEVE study findings are expected to have a major effect on clinical care, implementation could be hampered by the absence of adequate guidance or access to statins, concerns about tolerability and potential drug interactions, and difficulties in maintaining adherence. These key recommendations from the European AIDS Clinical Society aim to provide support in this remit.","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"28 1","pages":"e382-e392"},"PeriodicalIF":16.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903116","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":"Tuberculosis disease among people with HIV: therapeutic advances.","authors":"Vidya Mave, Mandar Paradkar, Francesca Conradie, Amita Gupta, Anchalee Avihingsanon, Graeme Meintjes, Anna Turkova, Kelly E Dooley, Richard E Chaisson","doi":"10.1016/S2352-3018(25)00040-2","DOIUrl":"10.1016/S2352-3018(25)00040-2","url":null,"abstract":"<p><p>Over the past 80 years, tuberculosis treatment has evolved with the development of all-oral treatments, which are now given for 4-6 months for drug-sensitive tuberculosis and 6-9 months for drug-resistant tuberculosis. Treatment success is often reduced among people with HIV due to an interplay of factors, including immune dysregulation, lower drug concentrations, complexities of cotreatment (eg, high pill burden and overlapping toxicities), and social factors. Recent clinical trials have shown that among adults and adolescents, treatment duration can be decreased to 4 months with repurposed therapeutics for drug-sensitive tuberculosis, and a four-drug regimen of isoniazid, rifapentine, moxifloxacin, and pyrazinamide has become part of WHO recommendations. Among children with drug-sensitive, non-severe tuberculosis disease, a 4-month regimen of standard tuberculosis drugs (eg, isoniazid, rifampicin, pyrazinamide, and ethambutol) is non-inferior to a 6-month regimen. Following recent research advances for drug-resistant tuberculosis, a 6-month regimen containing a potent combination of bedaquiline, pretomanid, linezolid, and moxifloxacin is a new standard for people with and without HIV. The tuberculosis drug development pipeline contains promising new therapeutics in various stages of development. To accelerate tuberculosis elimination, future research should focus on shortened treatment duration, and safer and effective therapeutics for tuberculosis-affected populations globally, including people with HIV, children, and pregnant people, and should assess newer modalities of treatment delivery.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e367-e381"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731569","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":"Highlights from CROI 2025.","authors":"Adrian Gonzalez Lopez","doi":"10.1016/S2352-3018(25)00099-2","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00099-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 5","pages":"e322-e323"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993028","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":"Making America unhealthy again.","authors":"The Lancet Hiv","doi":"10.1016/S2352-3018(25)00107-9","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00107-9","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"12 5","pages":"e313"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021574","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":"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":"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":"e355-e366"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","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}

{"title":"Another step towards closing the paediatric treatment gap.","authors":"Niklaus D Labhardt","doi":"10.1016/s2352-3018(25)00035-9","DOIUrl":"https://doi.org/10.1016/s2352-3018(25)00035-9","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"43 1","pages":"e314-e315"},"PeriodicalIF":16.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903108","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":"Hospitalisation trends in people with HIV: what is our aim?","authors":"Caroline A Sabin","doi":"10.1016/S2352-3018(25)00009-8","DOIUrl":"10.1016/S2352-3018(25)00009-8","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e318-e319"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744147","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}