Lancet Hiv最新文献

{"title":"Safety and efficacy of switching to bictegravir-lenacapavir versus continuing bictegravir-emtricitabine-tenofovir alafenamide in virologically suppressed people with HIV-1 (ARTISTRY-2): a double-blind, multicentre, randomised, controlled, phase 3, non-inferiority trial.","authors":"Eric G Meissner, Moti Ramgopal, Peter J Ruane, William Sanchez, Gordon Crofoot, Jean-Pierre Routy, Cynthia Brinson, Edwin DeJesus, Claudia T Martorell, Marcus Tellez, Yoshiyuki Yokomaku, Mark O'Reilly, Sergio Lupo, Sven Schellberg, Jezer I Lezama-Mora, BumSik Chin, Keith Aizen, Michelle L D'Antoni, Hailin Huang, Kwad Mponponsuo, Jairo M Montezuma-Rusca, Peter Sklar, Martin Rhee, Chien-Ching Hung","doi":"10.1016/S2352-3018(26)00078-0","DOIUrl":"10.1016/S2352-3018(26)00078-0","url":null,"abstract":"<p><strong>Background: </strong>There is a continued need to expand the repertoire of effective single-tablet regimens to address the diverse needs of people with HIV-1. We aimed to evaluate the safety and efficacy of switching to bictegravir-lenacapavir compared with continuing bictegravir-emtricitabine-tenofovir alafenamide in virologically suppressed people with HIV-1.</p><p><strong>Methods: </strong>This double-blind, multicentre, randomised, controlled, phase 3, non-inferiority trial was conducted in 100 hospitals and HIV clinics across Argentina, Australia, Canada, Dominican Republic, Germany, Italy, Japan, Mexico, Puerto Rico, South Korea, Spain, Taiwan, the UK, and the USA. Eligible participants were aged 18 years or older, receiving bictegravir-emtricitabine-tenofovir alafenamide (for ≥6 months), and virologically suppressed (HIV-1 RNA <50 copies per mL for ≥6 months). Participants were randomly assigned (2:1) using an interactive response system (stratified by geographical region) to switch to bictegravir-lenacapavir (75-50 mg) or continue bictegravir-emtricitabine-tenofovir alafenamide (50-200-25 mg) once a day as single-tablet regimens for 48 weeks. The primary endpoint was the proportion of participants with HIV-1 RNA of 50 copies per mL or higher at week 48 (as per the US Food and Drug Administration Snapshot algorithm) assessed in the full analysis set (defined as all randomly assigned participants who received any dose of the study drug), with a non-inferiority margin of 4%. This trial is registered with ClinicalTrials.gov, NCT06333808 (active, not recruiting).</p><p><strong>Findings: </strong>Between March 25 and Oct 30, 2024, 666 people with HIV-1 were assessed for eligibility, 89 were ineligible, and 577 were randomly assigned (384 to bictegravir-lenacapavir and 193 to continue bictegravir-emtricitabine-tenofovir alafenamide). 574 participants received at least one dose of the study drug (full analysis set). The median age was 49 years (IQR 39-58). 111 (19%) of 574 participants were female and 463 (81%) were male at birth. At baseline, the median duration of HIV-1 treatment was 12·0 years (6·5-18·7). At week 48, five (1·3%) of 383 participants in the bictegravir-lenacapavir group and two (1·0%) of 191 in the bictegravir-emtricitabine-tenofovir alafenamide group had HIV-1 RNA of 50 copies per mL or higher (percentage difference 0·3% [95·002% CI -1·9 to 2·4]), meeting the non-inferiority criteria. Drug-related adverse events occurred in 40 (10%) participants in the bictegravir-lenacapavir group versus 23 (12%) in the bictegravir-emtricitabine-tenofovir alafenamide group; and serious adverse events occurred in 27 (7%) versus 13 (7%), with none deemed related to treatment. One participant in the bictegravir-emtricitabine-tenofovir alafenamide group died due to coronary artery disease.</p><p><strong>Interpretation: </strong>Bictegravir-lenacapavir has the potential to be a novel single-tablet antiretroviral regimen option for virolo","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e538-e547"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864588","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":"Viral load data from South Africa builds confidence in U=U.","authors":"Nigel Garrett, Jienchi Dorward","doi":"10.1016/S2352-3018(26)00123-2","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00123-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"13 8","pages":"e517-e518"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622065","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":"National and regional analysis of HIV transmission dynamics in Morocco: a mathematical modelling study.","authors":"Hiam Chemaitelly, Ibtissam Khoudri, Amina El Kettani, Meriem Ghannam, Houssine El Rhilani, Mohammed Youbi, Laith J Abu-Raddad, Ivana Bozicevic","doi":"10.1016/S2352-3018(26)00054-8","DOIUrl":"10.1016/S2352-3018(26)00054-8","url":null,"abstract":"<p><strong>Background: </strong>The Middle East and north Africa have the fastest-growing HIV epidemic globally. We aimed to present a national and regional analysis of HIV transmission dynamics in Morocco, using a decade of data to characterise epidemic patterns.</p><p><strong>Methods: </strong>In this mathematical modelling study, we parameterised the UNAIDS Modes of Transmission model using biological, behavioural, and programmatic data from 58 integrated biobehavioural surveys and national datasets provided by the Morocco Ministry of Health and Social Protection collected between 2010 and 2023 in Morocco. The model estimated incidence in 2025 by exposure category at the national level and across six priority regions (Casablanca-Settat, Fes-Meknes, Marrakech-Safi, Rabat-Sale-Kenitra, Souss-Massa, and Tangier-Tetouan-Al Hoceima) and quantified the impact of interventions. We also analysed cross-sectional and longitudinal treatment cascades.</p><p><strong>Findings: </strong>New HIV infections declined from 3163 (95% uncertainty interval [UI] 2404-4110) in 2013 to 874 (715-1136) in 2025. Key populations in 2025 accounted for 80·2% (95% UI 41·1-100) of new infections: 42·3% (22·6-62·6) from men who have sex with men (MSM) networks, 37·0% (18·2-66·7) from heterosexual sex-work networks, and 0·9% (0·2-1·9) from people who inject drugs networks. MSM had the highest incidence rate (0·80% per person-year [95% UI 0·39-1·05]). Women comprised 37·4% (26·7-50·2) of new infections, 75·0% (59·2-86·7) of which were acquired from a spouse with transmittable HIV. We found subnational heterogeneity, with MSM contributing 30·1% (95% UI 14·3-51·1) of new infections in Marrakech-Safi to 80·8% (67·9-93·7) of new infections in Fes-Meknes. Achieving the UNAIDS 95-95-95 targets could reduce incidence by 52·8%, and a 50% increase in condom use could avert 39·8% of infections. Scaling up oral and injectable pre-exposure prophylaxis (PrEP) could further reduce incidence, depending on adherence and coverage. Longitudinal cascade analysis indicated strong antiretroviral therapy (ART) retention across nine major sites (Agadir, Beni Mellal, Casablanca, Fes, Marrakech [two sites], Nador, Oujda, and Rabat), with median rates of 91·0% (IQR 89·0-93·0) at 24 (±3) months, 83·8% (77·1-88·3) at 36 (±3) months, and 83·3% (71·4-89·0) at 48 (±3) months. Median viral load suppression among individuals tested was 94·9% or higher in the 2015, 2016, and 2017 cohorts.</p><p><strong>Interpretation: </strong>Morocco's epidemic appears to have contracted markedly and shifted towards MSM, with increasing regional heterogeneity. Sustained scale-up of testing, ART, condom use, and PrEP is essential to consolidate progress and advance towards HIV elimination.</p><p><strong>Funding: </strong>Expertise France.</p><p><strong>Translations: </strong>For the Arabic translation of the abstract see Supplementary Materials section.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e557-e568"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220325","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 Lancet HIV Commission on ageing and HIV: a global perspective.","authors":"Amy C Justice, Keri N Althoff, A Mark Clarfield, Brenda Crabtree Ramirez, Nathan Ford, Mary-Anne Hartley, Jepchirchir Kiplagat, Grace C Y Lui, Aggrey S Semeere, Marco Vitoria, Stephen Watiti, Tristan J Barber, Till W Barnighausen, Marta Boffito, Mark Brennan-Ing, Jessica Castilho, Stephen R Connor, Claudia Cortes, Giovanni Guaraldi, Meredith Greene, Beatriz Grinsztejn, Catherine Godfrey, Workegegnehu Hailu, Virgilio A Hernandez Ruiz, Javier Hourcade Bellocq, Vanessa Johnson, John Joska, Parastu Kasaie, Oageng Moseki, Nadia Naous, Joel Negin, Daniel Ochieng, Dorothy Onyango, Nicoletta Policek, Yvette Raphael, Julia Rohr, Anat Rosenthal, Enid J Schatz, Melissa C Schnure, Kailey R Seiler, Tinei Shamu, Mikaela Smit, Kristen A Stafford, Omar Sued, Andrew Tan, Jaques D du Toit, Sandra Wagner Cardoso","doi":"10.1016/S2352-3018(26)00058-5","DOIUrl":"10.1016/S2352-3018(26)00058-5","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e569-e610"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609017","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":"Educating caregivers of people ageing with HIV.","authors":"Eugenia L Siegler, Atami S De Main, Emily E Frey, Carrie D Johnston, Marshall J Glesby","doi":"10.1016/S2352-3018(26)00141-4","DOIUrl":"10.1016/S2352-3018(26)00141-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e520-e522"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609094","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":"Growing old and well with HIV.","authors":"The Lancet Hiv","doi":"10.1016/S2352-3018(26)00179-7","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00179-7","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"13 8","pages":"e515"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622150","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":"Combining long-acting bNAbs for durable HIV suppression.","authors":"Susan L Moir, Tae-Wook Chun","doi":"10.1016/S2352-3018(26)00098-6","DOIUrl":"10.1016/S2352-3018(26)00098-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e516-e517"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044289","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":"Caregivers and healthy ageing with HIV in low-income and middle-income countries.","authors":"Jepchirchir Kiplagat, Daniel O Ofuwo","doi":"10.1016/S2352-3018(26)00142-6","DOIUrl":"10.1016/S2352-3018(26)00142-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e518-e520"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609041","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":"Time to HIV rebound after infusion of long-acting broadly neutralising antibodies 3BNC117-LS and 10-1074-LS and analytical treatment interruption (the RIO trial): a double-blind, randomised, placebo-controlled trial.","authors":"Ming J Lee, Louise-Rae Cherrill, Panagiota Zacharopoulou, Simon Collins, Marcilio Fumagalli, Emanuela Falaschetti, Mohammed Altaf, Timothy Tipoe, Piyumika Godakandaarachi, Julie Fox, Alison Uriel, Amanda Clarke, Sabine Kinloch-de Loes, Sarah Pett, Marta Boffito, Gary Whitlock, Ole S Søgaard, Kyle Ring, Irvine Mangawa, Jesal Gohil, Tamara Elliott, Henrik Nielsen, Jesper Damsgaard Gunst, Chloe Orkin, Rebecca Sutherland, Lisa Hamzah, Paola Cicconi, Graham P Taylor, Jacquie Ujetz, Ishrat Jahan, Helen Brown, Nicola Robinson, Stephen Fletcher, Hanna Box, Kelly E Seaton, Georgia D Tomaras, Margaret E Ackerman, Joshua A Weiner, Anna Kaczynska, Cintia Bittar, Jill Horowitz, Michel C Nussenzweig, Marina Caskey, John Frater, Sarah Fidler","doi":"10.1016/S2352-3018(26)00059-7","DOIUrl":"10.1016/S2352-3018(26)00059-7","url":null,"abstract":"<p><strong>Background: </strong>HIV-specific broadly neutralising antibodies (bNAbs) can maintain viral control after interrupting antiretroviral therapy (ART). We investigated the duration and efficacy of Fc-engineered long-acting bNAbs (LS-bNAbs) in maintaining ART-free HIV control compared with placebo.</p><p><strong>Methods: </strong>RIO is a double-blind, randomised, placebo-controlled trial. Eligibile participants were adults age 18-60 years, initiated on ART in early-stage HIV infection, virally suppressed on ART, and had no evidence of viral insensitivity to 10-1074. Participants were randomly assigned (1:1) to receive two LS-bNAbs (3BNC117-LS and 10-1074-LS) in arm A or saline placebo in arm B; participants and study staff were masked to assignment. Eligible participants interrupted ART after receiving blinded intravenous infusions of either bNAbs or placebo. A second optional infusion was offered after 20 weeks for participants who remained virally suppressed without ART. The primary outcome was time to viral rebound 20 weeks after ART interruption, defined as either the first of six consecutive plasma HIV RNA measurements greater than 1000 copies per mL, or two measurements greater than 100 000 copies per mL. All randomly assigned participants were included in the analyses. This study is registered with ClinicalTrials.gov, NCT04319367.</p><p><strong>Findings: </strong>68 participants were randomly assigned, 34 to each arm. By week 20, viral rebound had occurred in eight participants in arm A and 30 in arm B; 75% (95% CI 61-92) of participants in arm A did not have viral rebound, compared with 11% (4-29) of participants in arm B. Participants in arm A were 91% less likely to rebound than were those in arm B (hazard ratio 0·09; 95% CI 0·04-0·21, p<0·0001). There were 326 adverse events in arm A and 260 in arm B, including 19 treatment-related or procedure-related adverse events in arm A and 41 in arm B. Of nine serious adverse events, none were treatment-related. The most commonly reported treatment-related or procedure-related adverse events were fatigue, lethargy, or somnolence: 11 in arm A and nine in arm B. There were two severe adverse events (anal abscesses) possibly related to the study protocol, both in the placebo arm.</p><p><strong>Interpretation: </strong>Long-acting bNAbs can sustain extended ART-free viral control in people treated during early-stage HIV and represent a promising step towards achieving ART-free HIV remission.</p><p><strong>Funding: </strong>Gates Foundation.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e527-e537"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044306","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; 12: e774-88.","authors":"","doi":"10.1016/S2352-3018(26)00177-3","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00177-3","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"13 8","pages":"e526"},"PeriodicalIF":14.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622131","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}