Lancet HivPub Date : 2025-04-01DOI: 10.1016/S2352-3018(25)00077-3
The Lancet Hiv
{"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}
Lancet HivPub Date : 2025-04-01Epub Date: 2025-02-26DOI: 10.1016/S2352-3018(24)00346-1
Alexander Kay, Moorine Sekadde, Debrah Vambe, Anthony J Garcia-Prats
{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013517/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lancet HivPub Date : 2025-04-01Epub Date: 2025-03-12DOI: 10.1016/S2352-3018(24)00310-2
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
{"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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Findings: </strong>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.</p><p><strong>Interpretation: </strong>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}
Lancet HivPub Date : 2025-04-01Epub Date: 2025-03-11DOI: 10.1016/S2352-3018(25)00011-6
Anneli Uusküla, Anna Tisler, Jack DeHovitz, Gad Murenzi, Philip E Castle, Gary Clifford
{"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}
Lancet HivPub Date : 2025-03-20DOI: 10.1016/S2352-3018(25)00071-2
Wilbroad Mutale, Aggrey Semeere, Elizabeth A Bukusi, Dike Ojji, Francois Venter, Thomas Odeny, Roma Chilengi, Mosepele Mosepele, Elvin Geng, Izukanji Sikazwe, Samuel Bosomprah, Llyod Mulenga, Fred Simitala
{"title":"How can Africa sustain its HIV response amid US aid cuts?","authors":"Wilbroad Mutale, Aggrey Semeere, Elizabeth A Bukusi, Dike Ojji, Francois Venter, Thomas Odeny, Roma Chilengi, Mosepele Mosepele, Elvin Geng, Izukanji Sikazwe, Samuel Bosomprah, Llyod Mulenga, Fred Simitala","doi":"10.1016/S2352-3018(25)00071-2","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00071-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694136","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}
Lancet HivPub Date : 2025-03-14DOI: 10.1016/S2352-3018(25)00075-X
{"title":"Correction to Lancet HIV 2024; 11: e31-41.","authors":"","doi":"10.1016/S2352-3018(25)00075-X","DOIUrl":"https://doi.org/10.1016/S2352-3018(25)00075-X","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665183","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}
Lancet HivPub Date : 2025-03-01Epub Date: 2025-02-12DOI: 10.1016/S2352-3018(24)00306-0
Lisa M Noguchi, Maxensia Owor, Nyaradzo M Mgodi, Brenda Gati Mirembe, Sufia Dadabhai, Elizea Horne, Holly Gundacker, Barbra A Richardson, Katherine Bunge, Rachel Scheckter, Mei Song, Mark A Marzinke, Peter L Anderson, Edward Livant, Cindy Jacobson, Jeanna M Piper, Nahida Chakhtoura, Sharon L Hillier, Jennifer E Balkus
{"title":"Safety and drug quantification of the dapivirine vaginal ring and oral pre-exposure prophylaxis in breastfeeding mother-infant pairs (MTN-043): a phase 3B, open-label, randomised trial.","authors":"Lisa M Noguchi, Maxensia Owor, Nyaradzo M Mgodi, Brenda Gati Mirembe, Sufia Dadabhai, Elizea Horne, Holly Gundacker, Barbra A Richardson, Katherine Bunge, Rachel Scheckter, Mei Song, Mark A Marzinke, Peter L Anderson, Edward Livant, Cindy Jacobson, Jeanna M Piper, Nahida Chakhtoura, Sharon L Hillier, Jennifer E Balkus","doi":"10.1016/S2352-3018(24)00306-0","DOIUrl":"10.1016/S2352-3018(24)00306-0","url":null,"abstract":"<p><strong>Background: </strong>In 2021, WHO recommended dapivirine vaginal rings (DVRs) for HIV prevention, but noted evidence gaps for breastfeeding populations. This trial aimed to describe safety profiles associated with DVRs and oral pre-exposure prophylaxis (PrEP) use during breastfeeding and to summarise study-drug quantification and concentrations for mothers and infants.</p><p><strong>Methods: </strong>Microbicide Trials Network (MTN)-043 was a phase 3b, open-label, randomised trial in which mother-infant pairs were recruited from local health facilities and enrolled at four HIV clinical trial sites in Malawi, South Africa, Uganda, and Zimbabwe. Eligible mothers (aged ≥18 years) were HIV-negative, exclusively breastfeeding one infant (aged 6-12 weeks, birthweight ≥2000 g), and had not been exposed to HIV post-exposure prophylaxis in the previous 6 months. Mother-infant pairs were randomly assigned (3:1) via a computer-generated sequence to 12 weeks of 25 mg monthly DVR or daily oral PrEP (200 mg emtricitabine and 300 mg tenofovir disoproxil fumarate), with stratification by site using a permuted block design. Participants and staff were aware of study product assignment. Primary outcomes were maternal and infant safety (all serious adverse events and grade 3 or worse adverse events) and drug concentrations, which were measured in maternal plasma, maternal blood, breastmilk, infant plasma, and infant blood. All mother-infant pairs who received at least one dose of study product were included in the primary safety analysis, and those with at least one post-enrolment drug concentration result were included in the drug quantification analysis. The trial was registered at ClinicalTrials.gov (NCT04140266).</p><p><strong>Findings: </strong>Between Sept 24, 2020, and July 29, 2021, 197 mother-infant pairs enrolled (148 on DVR and 49 on PrEP), all of whom received at least one dose of study product and were included in the primary safety analysis. Two (1%) of 148 mothers in the DVR group had serious adverse events, and three (2%) in the DVR group and two (4%) in the oral PrEP group had a grade 3 or worse adverse event; four (3%) of 148 infants in the DVR group had a serious adverse event, and ten (7%) in the DVR group and one (2%) in the oral PrEP group had a grade 3 or worse adverse event. No mother or infant in the oral PrEP group had a serious adverse event. No HIV infections were detected. 144 participants in the DVR group and 48 in the oral PrEP group had at least one post-enrolment drug concentration result. Quantifiable median dapivirine concentrations ranged from 656·0 (IQR 407·0-878·0) pg/mL at week 1 to 558·5 (282·0-778·0) pg/mL at month 3, but were observed infrequently (5-15%) in specimens from infants, with median concentrations below the limit of quantification at all visits. Median tenofovir diphosphate concentrations ranged from 263·0 (193·0-363·0) fmol/punch at week 1 to 777·0 (381·0-1241·0) fmol/punch at month 3, but were not ob","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e180-e190"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426463","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}
Lancet HivPub Date : 2025-03-01Epub Date: 2025-02-14DOI: 10.1016/S2352-3018(24)00343-6
Monisha Sharma, Akash Malhotra
{"title":"Using life course events to target HIV services.","authors":"Monisha Sharma, Akash Malhotra","doi":"10.1016/S2352-3018(24)00343-6","DOIUrl":"10.1016/S2352-3018(24)00343-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e168-e170"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442469","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}