Lancet Hiv最新文献

{"title":"Ukraine's HIV prevention supplies hit in Russian strike.","authors":"Ed Holt","doi":"10.1016/S2352-3018(26)00197-9","DOIUrl":"https://doi.org/10.1016/S2352-3018(26)00197-9","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585790","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 acquisitions, safety, and pharmacokinetics of lenacapavir for HIV pre-exposure prophylaxis in pregnant and lactating women (PURPOSE 1): a substudy of a phase 3, randomised controlled trial.","authors":"Linda-Gail Bekker,Dhayendre Moodley,Dazon Dixon Diallo,Ishana Harkoo,Godfrey Kigozi,Noah Kiwanuka,Cheryl E Louw,Moelo Malahleha,Lillian Mworeko,Thesla Palanee-Phillips,Ravindre Panchia,Nishanta Singh,Sarah B Puryear,Priyanka Arora,Jared M Baeten,Andrea Brown,Christoph C Carter,Marjorie Imperial,John Ling,Renu Singh,Pamela Wong,Moupali Das,Flavia Matovu Kiweewa","doi":"10.1016/s2352-3018(26)00112-8","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00112-8","url":null,"abstract":"BACKGROUNDLenacapavir demonstrated high efficacy and safety as pre-exposure prophylaxis (PrEP) in cisgender women, but its use during pregnancy and lactation when women are disproportionately vulnerable to HIV acquisition has not previously been described. We aimed to evaluate HIV acquisition, safety, and pharmacokinetics of lenacapavir for PrEP in pregnant and lactating women.METHODSThe randomised, double-blind, multicentre, active-controlled, phase 3 PURPOSE 1 study compared twice-yearly subcutaneous lenacapavir with daily oral emtricitabine-tenofovir alafenamide or emtricitabine-tenofovir disoproxil fumarate in women who were not pregnant at enrolment. Cisgender adolescent girls and young women aged 16-25 years were randomly assigned (2:2:1) to receive subcutaneous lenacapavir (927 mg, in two 1·5 mL injections) every 26 weeks following a 600 mg oral loading dose on days 1 and 2, daily oral emtricitabine (200 mg)-tenofovir alafenamide (25 mg), or daily oral emtricitabine (200 mg)-tenofovir disoproxil fumarate (300 mg). Participants who became pregnant could continue study drug in a planned substudy after providing additional written informed consent. We describe HIV infections, pregnancy outcomes, and adverse events during pregnancy and postpartum, and observed and model-derived lenacapavir plasma concentrations by pregnancy trimester and postpartum period. Pregnancy outcomes and infant congenital anomalies were determined by participant report and medical record review. Lenacapavir concentrations were measured in maternal plasma, breastmilk, and breastfed infant plasma.FINDINGSAmong 5345 women enrolled between Sept 28, 2021, and Sept 15, 2023, 487 participants (184 allocated to lenacapavir, 208 allocated to emtricitabine-tenofovir alafenamide, and 95 allocated to emtricitabine-tenofovir disoproxil fumarate) had one or more pregnancies, resulting in 509 total pregnancies with 512 pregnancy outcomes, including three sets of twins. Median age was 21 years (IQR 19-23). Most pregnancies resulted in livebirths (128 [66%] of 195 on lenacapavir, 119 [54%] of 219 on emtricitabine-tenofovir alafenamide, and 56 [57%] of 98 on emtricitabine-tenofovir disoproxil fumarate). Numbers of pregnancy losses were similar across groups (60 [31%] of 195 on lenacapavir, 89 [41%] of 219 on emtricitabine-tenofovir alafenamide, 41 [42%] of 98 on emtricitabine-tenofovir disoproxil fumarate). Adverse events during pregnancy and postpartum were balanced across groups, with 44 (33%) of 132 reporting injection site reactions on lenacapavir; all were grade 1 or 2 and none led to discontinuation. Population pharmacokinetic analysis showed no statistically significant differences in lenacapavir exposure by pregnancy trimester or postpartum versus non-pregnant participants. Lenacapavir was present in breastmilk (median breastmilk-to-plasma ratio 0·52 [IQR 0·38-0·77] in 102 mother-infant pairs); however, exposure in infant plasma was minimal (median breastfed-infant-to-maternal p","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"70 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148432887","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":"Advocacy and empowerment for people ageing with HIV.","authors":"Joe Daniels","doi":"10.1016/s2352-3018(26)00175-x","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00175-x","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"29 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148415796","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":"Nigeria's HIV survivors become its community safety net.","authors":"Paul Adepoju","doi":"10.1016/s2352-3018(26)00174-8","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00174-8","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"44 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148415797","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":"Expanding access to lenacapavir in low-income and middle-income countries.","authors":"Nam T Nguyen,Faraan O Rahim,Goodluck Valence,Anzibert A Rugakingira,Chris Beyrer","doi":"10.1016/s2352-3018(26)00169-4","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00169-4","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"43 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148408205","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":"Invisible populations: SOGI data and HIV drug safety.","authors":"Lauren B Beach,Benjamin Young,Craig Davenport,Kemi Williams,Garo Kiledjian","doi":"10.1016/s2352-3018(26)00143-8","DOIUrl":"https://doi.org/10.1016/s2352-3018(26)00143-8","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":"38 1","pages":""},"PeriodicalIF":16.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379810","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":"Are screening periods in ART-naive trials justified in the era of rapid ART?","authors":"William R Short, Serena Koenig, Pablo Tebas, Monica Gandhi","doi":"10.1016/S2352-3018(26)00106-2","DOIUrl":"10.1016/S2352-3018(26)00106-2","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e431-e433"},"PeriodicalIF":14.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943423","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":"Immigration enforcement and HIV care.","authors":"Mariam Davtyan, Toinette Frederick","doi":"10.1016/S2352-3018(26)00111-6","DOIUrl":"10.1016/S2352-3018(26)00111-6","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e434"},"PeriodicalIF":14.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206725","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 story of faith, stigma, and survival in Bangui.","authors":"Cahal McQuillan","doi":"10.1016/S2352-3018(26)00116-5","DOIUrl":"10.1016/S2352-3018(26)00116-5","url":null,"abstract":"","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e438"},"PeriodicalIF":14.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943400","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":"Epidemiological and economic effect of preference-driven HIV pre-exposure prophylaxis implementation for men who have sex with men and transgender women across 16 countries and territories in the Asia-Pacific region: a modelling study.","authors":"Shihao He, Warittha Tieosapjaroen, Xiaoyi Cui, Hao Lai, Ting Zhang, Yining Bao, Yudong Wei, Jason J Ong, Lei Zhang, Mingwang Shen","doi":"10.1016/S2352-3018(26)00053-6","DOIUrl":"10.1016/S2352-3018(26)00053-6","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) coverage remains low among men who have sex with men (MSM) and transgender women in the Asia-Pacific region, and discrete choice experiments identified user preferences for PrEP modalities. We aimed to evaluate the epidemiological and economic effects of implementing preference-driven PrEP among MSM and transgender women.</p><p><strong>Methods: </strong>We used preference data from large-scale discrete choice experiments in 16 Asia-Pacific countries and territories during May and November, 2022, involving MSM at substantial risk (MSMSR), MSM at low risk (MSMLR), and transgender women for daily oral, on-demand, and long-acting injectable modalities of PrEP. We developed a mathematical model to translate stated preferences into willingness to use PrEP and subsequent coverage levels. We then estimated the annual HIV acquisitions averted and the cost per acquisition averted for three single-modality and one mixed-modality PrEP strategies compared to baseline coverage. Results are reported as medians with 95% uncertainty intervals (UIs).</p><p><strong>Findings: </strong>Estimated willingness to use PrEP ranged from 46·8% (range 40·2-81·6) for on-demand PrEP (in MSMLR in Nepal) to 95·2% (95% UI 84·4-97·2) for the mixed-modality PrEP (in transgender women in Laos), with PrEP coverage of 10·8% to 30·8%. Long-acting injectable PrEP yielded the highest reductions in annual HIV acquisitions, from 17·1% (lowering the median number of acquisitions from 112 to 93) for transgender women in Cambodia to 31·8% (median reduction 457 to 310) among MSMSR in Australia. Median cost per acquisition averted was lowest for on-demand PrEP, from US$2302 (95% UI 1610-3370) among transgender women in Viet Nam to $742 727 (430 928-1 357 458) among MSMLR in Japan, and highest for long-acting injectable PrEP, from $21 132 (12 682-34 348) among transgender women in India to $10 315 297 (5 919 094-19 317 799) among MSMLR in Japan. Once HIV incidence is above the critical turning point (0·22-3·22 per 100 person-years), cost per acquisition averted drops sharply from a range of $9890-48 305 000 to $200-200 070.</p><p><strong>Interpretation: </strong>Implementation of preference-driven PrEP strategies could substantially reduce HIV incidence. Long-acting injectable PrEP offered the greatest efficacy at the highest cost, whereas on-demand PrEP was the most economically efficient modality. Targeting PrEP to areas with higher incidence can greatly decrease the cost.</p><p><strong>Funding: </strong>National Key R&D Program of China; National Natural Science Foundation of China; the Young Elite Professional of the Shaanxi Three Qin Talents Special Support Program; Australian National Health and Medical Research Council Emerging Leadership Grant.</p><p><strong>Translation: </strong>For the Chinese translation of the abstract see Supplementary Materials section.</p>","PeriodicalId":48725,"journal":{"name":"Lancet Hiv","volume":" ","pages":"e478-e489"},"PeriodicalIF":14.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240267","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}