Journal of acquired immune deficiency syndromes (1999)最新文献

{"title":"Missed opportunities for PrEP among the partners of people newly initiated in HIV care in western Tanzania.","authors":"Lila A Sheira, Matilda Mlowe, Emmanuel Katabaro, Babuu Joseph, Janeth Msasa, Kassim Hassan, Hamza Maila, Solis Winters, Amon Sabasaba, Werner Maokola, Prosper Njau, Sandra I McCoy","doi":"10.1097/QAI.0000000000003968","DOIUrl":"10.1097/QAI.0000000000003968","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-exposure prophylaxis (PrEP) has the potential to significantly reduce incident HIV globally, especially among individuals in sero-discordant partnerships with repeated HIV exposure and/or whose partners are not virally suppressed (undermining \"Undetectable = Untransmittable\"). Partner-based referrals may enhance PrEP uptake, yet data on PrEP awareness and willingness among people living with HIV (PLHIV) in east Africa is limited. We assessed PrEP knowledge and willingness to support partner uptake of PrEP among antiretroviral therapy (ART) initiates in Tanzania.</p><p><strong>Methods: </strong>Data were from the Afya II cluster RCT, which recruited ART initiates (n=1,990) randomized to usual care or monthly cash incentives for clinic visits. At the twelve-month visit, participants completed a sub-section on PrEP knowledge and attitudes, partner PrEP use, and understanding of U=U. We used multivariable regression to analyze correlates of U=U agreement (linear) and PrEP awareness (logistic).</p><p><strong>Results: </strong>Over half (59%) of participants had never heard of PrEP and 52% were in sero-discordant relationships. Among those in sero-discordant relationships, 22% reported their partner PrEP use. Participants showed high support for partner PrEP use (70% very supportive). Median U=U agreement was high (4.0/5.0). Female sex was associated with higher U=U concordance (β=0.84, 95%CI: 0.73-0.97). Among those in sero-discordant relationships, PrEP awareness was higher among those with greater education (AOR=2.91, 95%CI: 1.21-6.98).</p><p><strong>Conclusions: </strong>PrEP awareness was low despite over half of participants being in sero-discordant partnerships. Ensuring PrEP promotion during routine HIV care visits, particularly among ART initiates who have yet to achieve viral suppression, may support secondary prevention of HIV efforts.</p><p><strong>Clinical trial number: </strong>NCT04201353.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At-Home Point-of-Care Urine Tenofovir Testing for Adherence Monitoring: Feasibility and Comparison with Adherence Metrics in Dried Blood Spots.","authors":"Renata Buccheri, Matthew A Spinelli, Parya Saberi, Torsten B Neilands, Stefany Coxe, David V Glidden, Monica Gandhi, Judy Y Tan","doi":"10.1097/QAI.0000000000003953","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003953","url":null,"abstract":"<p><strong>Background: </strong>Scalable, low-cost strategies for monitoring antiretroviral therapy adherence are increasingly important, particularly in decentralized and telehealth-based care settings. This study assessed both the feasibility and performance of at-home, point-of-care (POC) urine tenofovir (TFV) testing for adherence monitoring, using tenofovir diphosphate (TFV-DP) levels in dried blood spots (DBS) as a pharmacological standard of adherence.</p><p><strong>Setting: </strong>This study was conducted within the LetSync cohort of people with HIV in primary romantic relationships, primarily Black men who have sex with men, across the U.S.</p><p><strong>Methods: </strong>Participants self-collected POC urine TFV testing and DBS samples over five timepoints across eight months. Adequate adherence was defined as TFV-DP ≥4 doses/week in DBS. Generalized estimating equation models evaluated associations between urine TFV results and DBS-based adherence, as well as the probability of sample return over time.</p><p><strong>Results: </strong>Among 86 participants and 341 paired samples, detectable urine TFV was strongly associated with adequate adherence in DBS (aRR = 2.86; 95% CI: 1.37-5.99). The urine POC test demonstrated high sensitivity (97%) and positive predictive value (85%), with lower specificity (31%). Across timepoints, urine samples showed higher return rates compared to DBS (aRR = 1.04; 95% CI: 1.01-1.08). Participants with detectable viral load had lower return rates for DBS compared to urine.</p><p><strong>Conclusions: </strong>At-home POC urine TFV testing is a sensitive and feasible approach for monitoring adherence. Its simplicity and consistently high return rates support its potential as a practical adherence monitoring tool, particularly in settings where VL testing is infrequent or logistically limited.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community priorities for programs using HIV molecular epidemiology: A best-worst scaling.","authors":"Anne Lr Schuster, Juli Bollinger, Travis Sanchez, Jeremy Sugarman, John Fp Bridges","doi":"10.1097/QAI.0000000000003962","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003962","url":null,"abstract":"<p><strong>Background: </strong>HIV molecular epidemiology (HIV-ME) uses genetic sequencing to study viral evolution, detect transmission clusters, and guide public health responses. Ethical, legal, and social implications of HIV-ME have been raised, yet quantitative evidence on community perspectives remains limited. We quantified community priorities for HIV-ME program features and examined their heterogeneity.</p><p><strong>Methods: </strong>Adult cisgender men who have sex with men, including people living with HIV (PLWH), were recruited from the 2023-2024 American Men's Internet Survey. Best-worst scaling assessed the importance of 11 HIV-ME features across 11 choice tasks using a Youden experimental design. Aggregate results were estimated using conditional logit models and rescaled to importance scores summing to 100%. Heterogeneity in priorities was assessed using stratified models and latent class analysis.</p><p><strong>Results: </strong>Among 747 people who completed the survey, 18% were PLWH, 35% were under 40, 34% reported concern about stigma, and 38% resided in states with active HIV criminalization statutes. \"Ensuring privacy\" was the most important feature, followed by HIV-ME uses for cluster detection and response, studying viral evolution, and evaluating prevention. Priorities did not differ when stratified by HIV status (p<0.01). Two latent classes emerged: a larger \"Use the Data\" group (n=472, 63%) placed 64% of importance on HIV-ME uses, and a smaller 'Protect the Data' group (n=275, 37%) placed 26% of importance on HIV-ME uses and 64% on: ensuring privacy, obtaining permission for and providing disclosure about data use, and limiting law-enforcement access.</p><p><strong>Conclusions: </strong>Community support is broad for HIV-ME uses, particularly with protections for data privacy, access, and use.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-acting Injectable Antiretroviral Therapy in South African Adolescents and Young Adults - Week 48 results from the AFINAty Study.","authors":"Chantel Schreuder, Nyiko Mashele, Rufaro Mvududu, Millicent Atujuna, Linda-Gail Bekker, Catherine Orrell, Lauren Jennings","doi":"10.1097/QAI.0000000000003973","DOIUrl":"10.1097/QAI.0000000000003973","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable antiretroviral therapy (LAI-ART) with cabotegravir and rilpivirine offers a promising alternative to daily oral ART, particularly for young people living with HIV (YLHIV). However, there are limited data on the feasibility, acceptability and efficacy of LAI-ART delivery in lower- and middle-income countries.</p><p><strong>Methods: </strong>We conducted a 48-week, community-based study of cabotegravir and rilpivirine LAI-ART among YLHIV aged 12-24 years in Cape Town, South Africa. Participants (virally suppressed, struggling with adherence or ART naïve) were required to be virally suppressed (<50 copies/ml) on first-line ART at the end of the screening phase before switching to cabotegravir and rilpivirine LAI-ART every 8 weeks for 48 weeks. Feasibility, retention, adherence to injection schedules, viral suppression and safety were assessed. Virological failure was defined as two consecutive viral loads ≥200 copies/ml.</p><p><strong>Results: </strong>Between December 2022 and December 2023, 172 participants were screened and 134 (77·9%) switched to LAI-ART. The median age was 20 years and 62·7% were assigned female at birth. Nearly one quarter (23·1%) were under 18 years of age. Overall, 47% had prior NNRTI exposure. Retention at week 48 was 98·5% with 97·5% of all injections given on schedule. Viral suppression, as indicated by VL <50 copies/ml, at week 48 was achieved by 95·5% with no confirmed virological failures. All participants who completed week 48 opted to remain on LAI-ART.</p><p><strong>Interpretation: </strong>LAI-ART was safe, highly acceptable and effective among YLHIV. These findings support the feasibility of implementing LAI-ART through community-based models in sub-Saharan Africa.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Tuberculosis Preventive Therapy Prescribing Among People Living with HIV in South Africa, 2005-2022.","authors":"Abigail Lucas, Laura Steiner, Leisha Genade, Abraham Pattamukkil, Bareng A S Nonyane, Jill Owczarzak, Ebrahim Variava, Limakatso Lebina, Jonathan E Golub, Neil A Martinson, Christopher J Hoffmann","doi":"10.1097/QAI.0000000000003976","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003976","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis preventive therapy (TPT) reduces tuberculosis incidence among people living with HIV (PLHIV), yet uptake has been sub-optimal. We evaluated trends of TPT prescribing among people initiated on antiretroviral therapy (ART).</p><p><strong>Setting: </strong>Thirty-six public sector clinics in South Africa.</p><p><strong>Methods: </strong>We retrospectively analyzed individual-level clinical data abstracted from clinics in the Free State and North West provinces, South Africa. We included PLHIV who initiated ART 2005-2022 and had ≥1 HIV-related clinic visits on or after 15 September 2021. The timing of TPT prescribing was defined by the earliest recorded TPT prescription date as: (1) TPT prescription within ≤6 months, (2) TPT prescription >6 months, or (3) no recorded TPT prescription on or after ART initiation.</p><p><strong>Results: </strong>Among 48,718 ART initiators, 23,168 (47.6%) were prescribed TPT on or after ART initiation; 15,510 (31.8%) were prescribed TPT ≤6 months and 7,658 (15.7%) were prescribed TPT >6 months after ART initiation. Early TPT prescribing increased from 0.7% in the 2005-2010 cohort to 71.3% in 2022 ART initiators, while TPT prescribing >6 months after ART initiation declined from 28.5% in the 2005-2010 cohort to 1.3% among those who initiated ART in 2022. Cumulative TPT prescribing was 29.2% in the 2005-2010 cohort, 34.2% in the 2011-2015 cohort, and 72.6% in the 2022 cohort.</p><p><strong>Conclusions: </strong>Over 2005-2022, TPT prescribing shifted markedly toward initiation near the time of ART initiation, with early prescribing exceeding 70% by 2022. Cumulative prescribing remained low among people from earlier ART cohorts, underscoring the need for targeted catch-up strategies.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Performance of Self-Reported ART Adherence Compared With Tenofovir Diphosphate in Dried Blood Spots in South Africa.","authors":"Christopher M Ferraris, Paul A D'Avanzo, Naomi Fireman Schiavoni, Justin Knox, Jose R Castillo-Mancilla, Peter L Anderson, Lauren Jennings, Catherine Orrell, Robert H Remien","doi":"10.1097/QAI.0000000000003975","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003975","url":null,"abstract":"<p><strong>Background: </strong>Self-reported ART adherence is widely used in resource-limited settings but may not accurately reflect cumulative drug exposure. Few longitudinal studies in sub-Saharan Africa have directly compared self-report with pharmacologic adherence measures, specifically tenofovir diphosphate concentrations (TFV-DP) in dried blood spots (DBS).</p><p><strong>Setting: </strong>Observational cohort study conducted in four public-sector ART clinics in Cape Town, South Africa.</p><p><strong>Methods: </strong>We analyzed data from 250 adults living with HIV, followed monthly for 13 visits. Participants reported missed ART doses in the prior 30 days and provided DBS for TFV-DP concentration. Longitudinal associations between missed doses and TFV-DP were examined using generalized estimating equations. Receiver operating characteristic (ROC) analyses evaluated the ability of SR to identify low TFV-DP in DBS (<699 fmol/punch). Logistic GEE models assessed the association between self-reported nonadherence and low TFV-DP.</p><p><strong>Results: </strong>Most participants were female (78%), median age 34 years (IQR, 27-42). Median TFV-DP concentrations declined with increasing self-reported missed doses: 1206 (IQR, 943-1442), 1009 (IQR, 773-1364), and 859 (IQR, 542-1194) fmol/punch for 0, 1-2, and ≥3 missed doses, respectively. Each additional missed dose was associated with lower TFV-DP concentrations in adjusted models (β = -29.2 fmol/punch per missed dose; p<0.001). Reporting ≥2 missed doses was associated with higher odds of low TFV-DP in longitudinal models (adjusted OR 1.50; p<0.001).</p><p><strong>Conclusions: </strong>Self-report missed doses correlated with TFV-DP concentrations over time but lacked sensitivity for detecting low drug exposure. Self-report remains pragmatic but may be optimized when paired with objective biomarkers to identify those at risk for treatment failure.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderate-to-Vigorous Physical Activity, Muscle Function, and Contemporary Sarcopenia Definitions in Older Adults With HIV.","authors":"Vitor Hf Oliveira, Andre P Dos Santos, Christine Horvat Davey, Julie K Schexnayder, Maia Cunningham, Thomas W Buford, Dustin M Long, John D Cleveland, Heidi M Crane, Greer A Burkholder, Barbara M Gripshover, Julia G Fleming, Michael S Saag, Amanda L Willig, Allison R Webel","doi":"10.1097/QAI.0000000000003974","DOIUrl":"10.1097/QAI.0000000000003974","url":null,"abstract":"<p><strong>Background: </strong>We examined associations between physical activity (PA), muscle function, and sarcopenia in older people with HIV (PWH).</p><p><strong>Setting: </strong>Multi-site PROSPER-HIV Study, including data from Seattle, WA, Cleveland, OH, and Birmingham, AL.</p><p><strong>Methods: </strong>In this cross-sectional study, we analyzed data from 148 PWH aged ≥50 years. Assessments included dual-energy X-ray absorptiometry for lean mass, handgrip strength, gait speed, chair stands, and Short Physical Performance Battery (SPPB). PA was objectively measured with ActiGraph accelerometers. Sarcopenia was defined using EWGSOP2, SDOC, and SDOC-HIV criteria. Regression models assessed associations between PA and sarcopenia, adjusting for age, sex, race, and body mass index.</p><p><strong>Results: </strong>Participants were 62.5 years old on average and 29.1% female. Sarcopenia prevalence varied widely: 1.4% under EWGSOP2, 4.1% under SDOC, and 15.2% under SDOC-HIV, with poor agreement across definitions (κ≤0.16). Participants presented a median of 105 minutes/week of moderate-to-vigorous PA (MVPA) and 4,123 steps/day. Higher MVPA was associated with lower odds of probable/confirmed sarcopenia using EWGSOP2 (OR=0.982; p<0.01). No significant associations were observed using SDOC or SDOC-HIV definitions (all p>0.05). MVPA was positively associated (p<0.05) with handgrip strength and SPPB. Our fully adjusted model indicated that approximately 83 additional minutes of MVPA per week would be required to increase handgrip strength by 1 kg.</p><p><strong>Conclusion: </strong>Higher MVPA was associated with better muscle strength and physical performance, and with lower odds of probable/confirmed sarcopenia using EWGSOP2, whereas no significant associations were observed using SDOC or SDOC-HIV. These findings support further investigation of MVPA as a potentially important lifestyle strategy for maintaining muscle health in older PWH.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD4 Count and CD4/CD8 Ratio Impact Antibody Responses to COVID-19 mRNA Booster Vaccination in People with HIV on Suppressive ART.","authors":"Roser Navarro-Soler, Megan J Heise, Thomas Dalhuisen, Halle Grebe, Dylan Ryder, Antonio E Rodriguez, Melissa Buitrago, Rebecca Hoh, Alessandro Sette, Peter W Hunt, Michiko Shimoda, Timothy J Henrich, Kara Lynch, Raul Andino-Pavlosky, Jeffrey N Martin, Steven G Deeks, Rachel L Rutishauser, Matthew A Spinelli, Michael J Peluso","doi":"10.1097/QAI.0000000000003972","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003972","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the durability of SARS-CoV-2-specific humoral and cellular immune responses after booster vaccination in people living with HIV (PLWH) in a prospective longitudinal cohort study.</p><p><strong>Methods: </strong>We analyzed 46 PLWH with no prior history of SARS-CoV-2 infection who received a booster dose. Anti-receptor-binding domain (RBD) IgG concentrations, neutralization titers, and T cell responses were measured over time. The associations between CD4+ T cell count and CD4/CD8 ratio with antibody dynamics were assessed, adjusting for age, sex, and vaccine type.</p><p><strong>Results: </strong>Anti-RBD IgG and neutralization titers declined significantly over time. Participants with CD4+ T cell counts <500 cells/μL exhibited a 3-fold faster decline in anti-RBD IgG compared to those with ≥500 cells/μL. Neutralization capacity declined similarly across both groups, suggesting that CD4+ T cell count primarily influences antibody quantity rather than functional quality. A lower CD4/CD8 ratio was independently associated with reduced baseline IgG concentrations but did not influence the rate of antibody decay. In a subset of 30 participants, a lower CD4/CD8 ratio was also associated with altered follicular helper (Tfh) CD4+ T cell frequencies and faster decline of Spike-specific Tfh over time.</p><p><strong>Conclusions: </strong>CD4+ T cell count influences antibody persistence, while the CD4/CD8 ratio affects initial antibody magnitude and Tfh cell frequencies, highlighting complementary roles in shaping vaccine responses in PLWH.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics/Pharmacodynamics, Safety, and Tolerability of Rivaroxaban with Cobicistat or Darunavir/Cobicistat in Healthy Participants.","authors":"Lilian W Adeojo, Cheryl Pauls, Doris Swaim, Parag Kumar, Haden T Bun, Alice Pau, Safia Kuriakose, Khanh Nghiem, Alina Dulau-Florea, Xiaobai Li, Yi Zeng, Cody J Peer, William D Figg, Colleen Hadigan, Jomy M George","doi":"10.1097/QAI.0000000000003971","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003971","url":null,"abstract":"<p><strong>Background: </strong>Direct oral anticoagulants such as rivaroxaban are a feasible and convenient option for anticoagulation in people living with HIV. Here, we assess the effect of cobicistat or darunavir/cobicistat on the pharmacokinetics (PK), pharmacodynamics (PD), and safety of rivaroxaban.</p><p><strong>Methods: </strong>This open-label, fixed sequence, intrasubject drug-drug interaction PK study enrolled healthy participants who received oral study drugs sequentially as follows: rivaroxaban 10 mg once on day 1, cobicistat 150 mg once-daily on days 2 to 7, rivaroxaban 10 mg once on day 7, darunavir/cobicistat 800/150 mg once-daily on days 8 to 13 followed by rivaroxaban 10 mg once on day 13. Serial PK and PD plasma samples were obtained on days 1, 7, and 13 over 24 hours. Safety was assessed throughout the study.</p><p><strong>Results: </strong>Twelve participants enrolled and completed three phases of the study. Rivaroxaban geometric mean ratios (GMR, rivaroxaban + cobicistat versus rivaroxaban alone) and 90% confidence interval (CI) for Cmax and AUC0-∞ were 1.50 (1.10-1.90) and 2.14 (1.70-2.58), respectively. Rivaroxaban GMR (rivaroxaban + darunavir/cobicistat versus rivaroxaban alone) and 90% CI for Cmax and AUC0-∞ were 1.53 (1.13-1.94) and 2.12 (1.68-2.56), respectively. Rivaroxaban concentrations were positively correlated with PD markers in a linear fashion and returned to near-baseline 24 hours post-dose. All adverse events were mild to moderate in severity and resolved by the end of the study.</p><p><strong>Conclusion: </strong>Coadministration of cobicistat and cobicistat-boosted darunavir with rivaroxaban resulted in a clinically significant increase in rivaroxaban drug exposure. Further study can inform safety and efficacy of rivaroxaban dose reduction.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between retention in HIV care, psychiatric comorbidities, and outcomes in veterans with HIV.","authors":"Ravishankar Jayadevappa, Knashawn Morales, Rina Hanumali, David Metzger, Sumedha Chhatre","doi":"10.1097/QAI.0000000000003966","DOIUrl":"https://doi.org/10.1097/QAI.0000000000003966","url":null,"abstract":"<p><strong>Background: </strong>In the US, the Veterans Health Administration is the largest single institutional provider of Human Immunodeficiency Virus (HIV) care for veterans. Retention in care can affect treatment adherence and care outcomes. Psychiatric disorders are prevalent in people with HIV and may lead to poorer retention in care and outcomes.</p><p><strong>Objectives: </strong>To examine the association between retention in HIV care, psychiatric comorbidities, and clinical outcomes among veterans with HIV.</p><p><strong>Research design: </strong>In this retrospective study, veterans aged ≥18, seen with a diagnosis of HIV between 2000 and 2017, were identified from the Corporate Data Warehouse. We identified those with and without psychiatric comorbidities in the HIV cohort. Outcomes (mortality, viral suppression, and inpatient and outpatient visits) were assessed over a five-year follow-up period. Retention in care was measured during the first year of follow-up. We modeled outcomes as a function of retention in care and tested the moderating effects of psychiatric comorbidity and treatment for psychiatric comorbidity.</p><p><strong>Results: </strong>Cohort consisted of 59,649 veterans with a diagnosis of HIV; 66% had psychiatric comorbidity, and 90% received treatment for it. Overall, 49% were retained in HIV care. Retention in care was associated with better survival and viral suppression, regardless of psychiatric comorbidity; however, psychiatric comorbidity influenced healthcare utilization.</p><p><strong>Conclusions: </strong>Our study provides important insights into the relationship between retention in care, psychiatric comorbidity, and outcomes in veterans with HIV. Future research must assess the barriers to care and strategies to integrate mental health and HIV treatments for veterans.</p>","PeriodicalId":520658,"journal":{"name":"Journal of acquired immune deficiency syndromes (1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}