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Contribution of HIV transmission bursts to future HIV infections. HIV传播对未来HIV感染的贡献,美国。
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2024-12-23 DOI: 10.1097/QAD.0000000000004101
Rachael M Billock, Anne Marie France, Neeraja Saduvala, Nivedha Panneer, Camden J Hallmark, Joel O Wertheim, Alexandra M Oster
{"title":"Contribution of HIV transmission bursts to future HIV infections.","authors":"Rachael M Billock, Anne Marie France, Neeraja Saduvala, Nivedha Panneer, Camden J Hallmark, Joel O Wertheim, Alexandra M Oster","doi":"10.1097/QAD.0000000000004101","DOIUrl":"10.1097/QAD.0000000000004101","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the influence of bursts of rapid HIV transmission on future transmission and describe populations affected by transmission bursts.</p><p><strong>Design: </strong>Phylogenetic analysis of US National HIV Surveillance System data.</p><p><strong>Methods: </strong>Time-scaled phylogenetic trees were inferred for six geographic regions using sequences from persons with HIV (PWH) with diagnoses of HIV infection 2014-2019. Transmission bursts were defined as at least three adjacent inferred transmission events in the phylogeny during a detection period. We calculated the relative contribution of transmission bursts 2015-2016 to transmission 2017-2019 compared with nonbursts. Then, we detected bursts within any sliding 2-year period 2014-2019 and assessed descriptive associations of characteristics of individuals involved with or descended from transmission bursts using univariate risk ratios.</p><p><strong>Results: </strong>The 5.6% of phylogenetic lineages involved in transmission bursts 2015-2016 contributed to 14.9% of inferred transmission events 2017-2019. The relative contribution of lineages involved in transmission bursts to future transmission was 2.94 times that of lineages not involved in bursts. Younger age at diagnosis, self-identification as transgender or an additional gender identity, or as a cisgender man, MMSC, IDU, or MMSC and IDU, and diagnosis during acute or early infection were most strongly associated with involvement in or descendance from transmission bursts.</p><p><strong>Conclusion: </strong>Transmission bursts contribute disproportionately to future HIV transmission, underscoring the value of detecting and responding to rapid transmission to reduce incidence. Bursts of rapid transmission may also contribute to enduring disparities in incidence among some key populations.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1403-1412"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-effectiveness of a 4 days-a-week triple therapy in persons with HIV: an ancillary study of the QUATUOR trial. 艾滋病毒感染者每周4天三联疗法的成本效益:QUATUOR试验的辅助研究
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-04-21 DOI: 10.1097/QAD.0000000000004215
Gilles Hejblum, Samih Daher, Paul Moulaire, Karine Amat, Sidonie Lambert-Niclot, Clotilde Allavena, Christine Katlama, Karine Lacombe, Diane Ponscarme, Jade Ghosn, Severine Gibowski, Jean-Claude Alvarez, Jacqueline Capeau, Laurence Morand-Joubert, Dominique Costagliola, Pierre De Truchis, Roland Landman, Lambert Assoumou
{"title":"Cost-effectiveness of a 4 days-a-week triple therapy in persons with HIV: an ancillary study of the QUATUOR trial.","authors":"Gilles Hejblum, Samih Daher, Paul Moulaire, Karine Amat, Sidonie Lambert-Niclot, Clotilde Allavena, Christine Katlama, Karine Lacombe, Diane Ponscarme, Jade Ghosn, Severine Gibowski, Jean-Claude Alvarez, Jacqueline Capeau, Laurence Morand-Joubert, Dominique Costagliola, Pierre De Truchis, Roland Landman, Lambert Assoumou","doi":"10.1097/QAD.0000000000004215","DOIUrl":"10.1097/QAD.0000000000004215","url":null,"abstract":"<p><strong>Objective: </strong>The ANRS 170 QUATUOR study demonstrated the noninferiority of a triple antiretroviral therapy (ART) taken four consecutive days on and 3 days off (hereafter referred to as a 4/7-days strategy) compared to a triple therapy taken 7 days a week (7/7-days strategy) for persons with HIV (PWH) and with suppressed viremia. We investigated corresponding cost-effectiveness issues.</p><p><strong>Design: </strong>Cost-effectiveness study.</p><p><strong>Setting: </strong>France.</p><p><strong>Participants: </strong>All 636 persons involved in the primary analysis of the QUATUOR trial (318 per arm). Analyses were based on 10 000 simulations replicating the trial. Additional analyses included estimating the national impact of spreading the 4/7-days strategy all over France.</p><p><strong>Intervention: </strong>A 4/7-days strategy, compared to a 7/7-days strategy.</p><p><strong>Main outcome measures: </strong>Effectiveness was considered as the noninferiority of the 4/7-days strategy, main criterion of the trial primary analysis. Direct health resource costs ( year2022 €) were considered and included costs for ART, laboratory tests, co-medications, hospitalizations, and medical consultations.</p><p><strong>Results: </strong>The mean individual costs for ART were €3678 [95% confidence interval (CI) 3593-3763] and €6450 (6301-6596) in the 4/7-days and 7/7-days arm, respectively ( P  < 0.0001), and constituted the single element with a statistical difference between the two strategies. Adopting a 4/7-days regimen in 20% of the potential recipients in France was estimated to provide annual savings of €61 752 467 (61 569 005-61 925 136).</p><p><strong>Conclusion: </strong>The 4/7-day strategy dominates the 7/7-day strategy, providing substantial ART-related cost savings while maintaining treatment effectiveness. Study results support generalizing the proposal of 4/7-days regimens in France, in persons eligible for this strategy.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1452-1461"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Longer-acting preexposure prophylaxis product and delivery preferences among U.S. populations disproportionately affected by HIV: a discrete choice experiment. 长期作用的暴露前预防产品和递送偏好在美国人群中不成比例地受艾滋病毒影响:一个离散选择实验。
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-05-23 DOI: 10.1097/QAD.0000000000004247
Sarah T Roberts, Erica N Browne, Damian Denson, Emily Moore, Jackie Mungo, Noah Mancuso, Miranda Diaz, Rupa Patel, Athena P Kourtis, Alexandra M Minnis, Karen W Hoover
{"title":"Longer-acting preexposure prophylaxis product and delivery preferences among U.S. populations disproportionately affected by HIV: a discrete choice experiment.","authors":"Sarah T Roberts, Erica N Browne, Damian Denson, Emily Moore, Jackie Mungo, Noah Mancuso, Miranda Diaz, Rupa Patel, Athena P Kourtis, Alexandra M Minnis, Karen W Hoover","doi":"10.1097/QAD.0000000000004247","DOIUrl":"10.1097/QAD.0000000000004247","url":null,"abstract":"<p><strong>Objective: </strong>Longer-acting preexposure prophylaxis (LA-PrEP) products have potential to increase PrEP uptake and continuation. This study sought to elicit preferences for LA-PrEP product and delivery program characteristics among populations disproportionately impacted by HIV to identify factors important to adoption and anticipate potential use challenges.</p><p><strong>Design: </strong>Cross-sectional, online discrete choice experiment.</p><p><strong>Methods: </strong>We recruited 940 men who have sex with men (MSM), people who inject drugs (PWID), and Black heterosexual men and women (BHMW) with PrEP indications. In a series of 10 tasks, participants chose between two hypothetical LA-PrEP options composed of 5 attributes (product type, side effects, clinic type, appointment duration, cost), or neither (their current HIV prevention method). Analysis used random-parameters logit models.</p><p><strong>Results: </strong>Respondents chose an LA-PrEP method over their current HIV prevention option in 96.8% of tasks. Cost was the most important determinant of LA-PrEP choice for all populations (relative importance [RI] of 10]. Side effects and product type were 1/3 to 1/2 as important as cost (RI 3.5-5.1). MSM and PWID most preferred the 12-month implant followed by semiannual dual injections and least preferred the monthly oral pill and 2-month single injection. BHMW most preferred the monthly pill and semiannual injections and least preferred the 12-month implant and 2-month injection. Clinic type and appointment duration had minimal influence (RI 0.1-2.1).</p><p><strong>Conclusions: </strong>Results suggest high demand for LA-PrEP among populations with disproportionately high HIV incidence. To facilitate use, programs should offer a range of LA-PrEP products, minimize out-of-pocket costs, and counsel on side effects.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1364-1374"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fetoplacental arteriolar dysfunction in placentas of HIV-exposed, small for gestational age birthweight neonates. 胎儿胎盘小动脉功能障碍的胎盘hiv暴露,小胎龄出生体重新生儿。
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-05-21 DOI: 10.1097/QAD.0000000000004242
Dan Wang, Katherine G Michel, Jason G Umans, Sean Dalby, Patricia Moriarty, Tranessa Hanson, Christopher S Wilcox, Rachel K Scott
{"title":"Fetoplacental arteriolar dysfunction in placentas of HIV-exposed, small for gestational age birthweight neonates.","authors":"Dan Wang, Katherine G Michel, Jason G Umans, Sean Dalby, Patricia Moriarty, Tranessa Hanson, Christopher S Wilcox, Rachel K Scott","doi":"10.1097/QAD.0000000000004242","DOIUrl":"10.1097/QAD.0000000000004242","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals with HIV are more likely to deliver small-for-gestational-age (SGA) neonates. We evaluated the associations between fetoplacental arteriolar function and HIV-exposure and SGA.</p><p><strong>Design: </strong>Case-control study of fetoplacental arteriolar function from placentas with/without HIV exposure and with/without SGA birthweight delivered between 36 and 41 weeks of gestation.</p><p><strong>Methods: </strong>Fetoplacental arterioles were harvested from the intervillous space of fresh placental specimens. We assessed arteriolar function by myograph. We measured dose-dependent contraction to U-46,619 (a thromboxane-prostanoid receptor agonist), endothelin (ET-1), as well as relaxation to AdipoRon (ApR, an adiponectin receptor agonist). ET-1-induced reactive oxygen species (ROS) were measured by DHE fluorescence and ApR-induced nitric oxide (NO) activity by DAF-FM fluorescence using a RatioMaster system. Comparisons across groups were determined using two-way ANOVA.</p><p><strong>Results: </strong>We analyzed specimens from 9 placentas of HIV-unexposed appropriate for gestational age (AGA)-birthweight neonates, 6 placentas of HIV-unexposed SGA neonates, 11 placentas of HIV-exposed AGA neonates, and 4 placentas of HIV-exposed SGA neonates. Contractions to ET-1 and U-46 619 were greater in placentas with HIV-exposure or of SGA neonates compared to AGA controls, and greatest in the setting of both HIV-exposure and SGA. Impaired arteriolar relaxation to ApR was associated with HIV-exposure, SGA, and combined HIV-exposure with SGA. Likewise, ApR-induced NO was decreased and ET-1-induced ROS was increased with HIV-exposure and SGA.</p><p><strong>Conclusions: </strong>Fetoplacental arteriolar relaxation was impaired and contraction was enhanced among placentas of HIV-exposed and SGA neonates.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1353-1363"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The transmembrane nucleoporin Nup210 weakens HIV-1 infection via modulating late events of viral nuclear import. 跨膜核孔蛋白Nup210通过调节病毒核输入的后期事件来减弱HIV-1感染。
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-06-13 DOI: 10.1097/QAD.0000000000004206
Lei Wang, Shi-Min Li, Xia Li, Hang-Shen Wu, Cong Ma, Dian-Bing Wang, Xian-En Zhang
{"title":"The transmembrane nucleoporin Nup210 weakens HIV-1 infection via modulating late events of viral nuclear import.","authors":"Lei Wang, Shi-Min Li, Xia Li, Hang-Shen Wu, Cong Ma, Dian-Bing Wang, Xian-En Zhang","doi":"10.1097/QAD.0000000000004206","DOIUrl":"10.1097/QAD.0000000000004206","url":null,"abstract":"<p><strong>Objective: </strong>Nuclear import/export of HIV-1 is regulated by the nuclear pore complexes (NPCs), but the impact of many individual nucleoporins on viral infection is unclear. Here, we investigated the role of a transmembrane nucleoporin Nup210 in HIV-1 infection.</p><p><strong>Design/methods: </strong>TZM-bl cells with Nup210-knockdown or overexpression were infected with either wildtype HIV-1 NL4-3 or VSV-G pseudotyped NL4-3-KFS. The efficiency of viral infection was assessed by measuring luciferase activity. The DNA levels of reverse transcription, nuclear entry, and proviral DNA integration were determined by qPCR. The levels of unspliced, singly spliced, and fully spliced mRNA were determined by RT-qPCR. The levels of viral key proteins were determined by western blotting. The viral DNA, mRNA, and protein assays were also performed in Raltegravir-treated Nup210-knockdown or overexpression cells.</p><p><strong>Results: </strong>Generally, Nup210-knockdown promoted HIV-1 infection, whereas Nup210-overexpression had no significant effect on entire infection. Several findings were obtained in further investigations. First, Nup210-knockdown increased the accumulation of integrated proviral DNA, while the levels of reverse transcription (RT) products and 2-LTR circles remained unaffected by either Nup210-knockdown or overexpression. Second, Nup210 regulated viral mRNA alternative splicing, particularly, Nup210-knockdown resulted in the highest increase in singly spliced Vpr mRNA, whereas Nup210-overexpression led to the biggest rise in unspliced Gag mRNA. Third, Vpr expression was elevated by Nup210-knockdown, suggesting that Vpr may act as a viral antagonist of Nup210. Additionally, Raltegravir, together with Nup210, inhibit viral infection by interfering proviral DNA integration, subsequent transcription and translation.</p><p><strong>Conclusion: </strong>The endogenous Nup210 is sufficient to suppress HIV-1 infection by downregulating late steps of viral nuclear entry.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1322-1330"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impaired autonomic cardiovascular control in people with HIV on long-term successful treatment. 长期成功治疗的HIV感染者自主心血管控制受损。
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-04-17 DOI: 10.1097/QAD.0000000000004208
Thomas A Bouwmeester, Iris A J van der Wulp, Yaw A Kusi Mensah, Ferdinand W N M Wit, Berend E Westerhof, Maarten F Schim van der Loeff, Henrike Galenkamp, Didier Collard, Marc van der Valk, Peter Reiss, Bert-Jan H van den Born
{"title":"Impaired autonomic cardiovascular control in people with HIV on long-term successful treatment.","authors":"Thomas A Bouwmeester, Iris A J van der Wulp, Yaw A Kusi Mensah, Ferdinand W N M Wit, Berend E Westerhof, Maarten F Schim van der Loeff, Henrike Galenkamp, Didier Collard, Marc van der Valk, Peter Reiss, Bert-Jan H van den Born","doi":"10.1097/QAD.0000000000004208","DOIUrl":"10.1097/QAD.0000000000004208","url":null,"abstract":"<p><strong>Objective: </strong>People with HIV have an increased cardiovascular disease risk. Persistent inflammation and mitochondrial dysfunction are considered important contributors to impaired autonomic cardiovascular control, as evidenced by decreased baroreflex sensitivity (BRS) and heart rate variability (HRV). We assessed differences in cross-correlation BRS (xBRS) and HRV between people with and without HIV and explored associations with HIV-specific characteristics.</p><p><strong>Design: </strong>We included participants with and without HIV from the AGE h IV cohort study, and general population participants from the multiethnic HEalthy LIfe in an Urban Setting (HELIUS) study, all European men aged 50-70 years.</p><p><strong>Methods: </strong>Using a noninvasive continuous blood pressure measurement, we calculated xBRS and two HRV parameters [successive differences in normal-to-normal intervals (SDNN) and the root mean square of differences between successive normal-to-normal intervals (RMSSD)]. Regression models, adjusted for traditional cardiovascular risk factors, assessed differences in xBRS and HRV between the participant groups and associated HIV-specific characteristics.</p><p><strong>Results: </strong>xBRS, SDNN, and RMSSD were significantly higher in both control groups compared to participants with HIV. Longer time since HIV diagnosis and longer prior use of dideoxynucleosides and thymidine analogues were significantly associated with lower xBRS. Nadir CD4 + cell count was positively associated with SDNN, while longer duration of thymidine analogue use was negatively associated with SDNN and prior use of dideoxynucleosides with lower RMSSD.</p><p><strong>Conclusion: </strong>Impaired autonomic cardiovascular control in men with HIV, potentially related to prior antiretroviral drug exposure and prior immunodeficiency, might contribute to HIV-associated cardiovascular disease risk.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1375-1384"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatitis B core antibody positivity and risk of hepatitis B reactivation following switch of antiretroviral therapy. 乙型肝炎核心抗体阳性与转换抗逆转录病毒治疗后乙型肝炎再激活的风险
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-07-10 DOI: 10.1097/QAD.0000000000004268
Firouzé Bani-Sadr, Brian R Wood
{"title":"Hepatitis B core antibody positivity and risk of hepatitis B reactivation following switch of antiretroviral therapy.","authors":"Firouzé Bani-Sadr, Brian R Wood","doi":"10.1097/QAD.0000000000004268","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004268","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 10","pages":"1481-1483"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of the steady-state drug-drug interactions between dolutegravir and ritonavir-boosted darunavir in adolescents. 多替格拉韦和利托那韦在青少年中增强的达那韦的稳态药物相互作用评估。
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-05-02 DOI: 10.1097/QAD.0000000000004223
Seef Abdalla, Alexandra Compagnucci, Alasdair Bamford, Man K Chan, José T Ramos, Yoann Riault, Yacine Saidi, Valentin Constant, Thao-Nguyen Nguyen, Carlo Giaquinto, Jean-Marc Tréluyer, Tim R Cressey, Déborah Hirt
{"title":"Assessment of the steady-state drug-drug interactions between dolutegravir and ritonavir-boosted darunavir in adolescents.","authors":"Seef Abdalla, Alexandra Compagnucci, Alasdair Bamford, Man K Chan, José T Ramos, Yoann Riault, Yacine Saidi, Valentin Constant, Thao-Nguyen Nguyen, Carlo Giaquinto, Jean-Marc Tréluyer, Tim R Cressey, Déborah Hirt","doi":"10.1097/QAD.0000000000004223","DOIUrl":"10.1097/QAD.0000000000004223","url":null,"abstract":"<p><strong>Objectives: </strong>DTG is primarily metabolized by the UDP-glycosyltransferase (UGT) 1A1, and to a lesser extent by the cytochrome P450 (CYP) 3A4. Co-administration of DRV/r has been reported to decrease DTG plasma concentrations. Our aim was to distinguish the extent of the drug-drug interactions between DRV/r and DTG, and to evaluate the consequences of this interaction, in adolescents at steady state.</p><p><strong>Design: </strong>SMILE (PENTA 17-ANRS152) was a phase II/III trial assessing the safety and efficacy of once-daily dual therapy, using dolutegravir (DTG) combined with ritonavir-boosted darunavir (DRV/r), in virologically suppressed adolescents aged 12 years and older.</p><p><strong>Methods: </strong>A joint population pharmacokinetic model for DTG and DRV/r was developed with prior individual drug models (involving unbound and total concentrations) using SMILE data.</p><p><strong>Results: </strong>Unbound DRV exposure, integrated as a power function on unbound DTG clearance best described DRV/r inhibition of DTG elimination. Nevertheless, no interaction was identified between DRV/r and total DTG clearance. Moreover, the influence of unbound DRV exposures to predict unbound DTG concentrations was relatively small.</p><p><strong>Conclusion: </strong>Administration of DRV/r 800/100 mg and DTG 50 mg once daily provides adequate concentrations and exposures with no clinically relevant drug-drug interactions at steady-state.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1385-1391"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic accuracy of the re-engineered urinary FujiLAM2 assay amongst hospitalized adults with advanced HIV disease. 重新设计尿液FujiLAM2检测对住院成人晚期HIV疾病的诊断准确性:一项前瞻性队列研究
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-04-21 DOI: 10.1097/QAD.0000000000004213
Jayne Ellis, Biyue Dai, Mable Kabahubya, Gila Hale, Emmanuel Mande, George Katende, Enock Kagimu, Jane Gakuru, Jane Frances Ndyetukira, Asmus Tukundane, Tessa Adzemovic, Laura J Nsangi, Joseph N Jarvis, Nathan C Bahr, Fiona V Cresswell, David B Meya, David R Boulware
{"title":"Diagnostic accuracy of the re-engineered urinary FujiLAM2 assay amongst hospitalized adults with advanced HIV disease.","authors":"Jayne Ellis, Biyue Dai, Mable Kabahubya, Gila Hale, Emmanuel Mande, George Katende, Enock Kagimu, Jane Gakuru, Jane Frances Ndyetukira, Asmus Tukundane, Tessa Adzemovic, Laura J Nsangi, Joseph N Jarvis, Nathan C Bahr, Fiona V Cresswell, David B Meya, David R Boulware","doi":"10.1097/QAD.0000000000004213","DOIUrl":"10.1097/QAD.0000000000004213","url":null,"abstract":"<p><strong>Background: </strong>A nonsputum-based, point-of-care tuberculosis (TB) diagnostic test is a global health priority. The impact of urinary mycobacterial lipoarabinomannan (LAM) testing has been limited by the diagnostic performance of current assays. We assessed the diagnostic accuracy of the re-engineered TB-LAM SILVAMP (FujjLAM2) assay (Fujifilm, Japan) to diagnose TB amongst hospitalized adults living with advanced HIV disease.</p><p><strong>Methods: </strong>We consecutively enrolled adults presenting with suspected meningitis at two hospitals in Uganda. We implemented a standardized TB diagnostic package: urine Alere TB lipoarabinomannan (TB-LAM), urine Xpert MTB/Rif Ultra, CSF Xpert MTB/Rif Ultra, TB CSF culture, mycobacterial blood culture and chest radiography. We performed FujiLAM2 testing on cryopreserved or fresh urine. We compared diagnostic accuracy against a composite microbiological reference standard of any positive TB test (including Alere-LAM). We assessed 30-day mortality.</p><p><strong>Findings: </strong>We performed FujiLAM2 testing on urine of 436 hospitalized participants. The median CD4 + cell count was 34 cells/μl [interquartile range (IQR) 11-96]. Using the microbiologic reference standard, FujiLAM2 sensitivity was 34% [95% confidence interval (CI) 25-43%], and specificity was 94% (95% CI 91-96%). When grade-1 Alere TB-LAM positives were excluded, sensitivity was 38% (95% CI 27-50%). Cryopreserved specimens were threefold more frequently positive.</p><p><strong>Interpretation: </strong>Amongst hospitalized adults with advanced HIV disease, the re-engineered FujiLAM2 urine assay had suboptimal sensitivity but high specificity for diagnosing TB disease. Antigen-antibody/protein complexes may be present accounting for better sensitivity with cryopreserved specimens.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1334-1343"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transformative potential of artificial intelligence in US CDC HIV interventions: balancing innovation with health privacy. 人工智能在美国疾控中心艾滋病干预措施中的变革潜力:平衡创新与健康隐私。
IF 3.4 2区 医学
AIDS Pub Date : 2025-08-01 Epub Date: 2025-07-10 DOI: 10.1097/QAD.0000000000004220
Emiko Kamitani, Linda J Koenig, Patrick Sullivan
{"title":"Transformative potential of artificial intelligence in US CDC HIV interventions: balancing innovation with health privacy.","authors":"Emiko Kamitani, Linda J Koenig, Patrick Sullivan","doi":"10.1097/QAD.0000000000004220","DOIUrl":"10.1097/QAD.0000000000004220","url":null,"abstract":"<p><p>Artificial intelligence (AI) holds significant potential to transform HIV prevention and treatment through the application of advanced technologies such as machine learning (ML), deep learning (DL), and generative AI (Gen AI). These technologies can enhance the monitoring, management, and analysis of vast and complex HIV-related datasets, enabling more timely predictions of potential risks and improving HIV care strategies. AI is poised to streamline HIV prevention interventions by increasing workforce efficiency, supporting expanded accessibility and sustainability of preexposure prophylaxis (PrEP) care in nontraditional settings, and supporting clinical decision-making. Additionally, when utilized within HIV care systems, AI can help close gaps in diagnosis, treatment, and continuous care engagement. However, to optimize AI's potential in HIV prevention, careful implementation is crucial. Challenges such as reducing bias, ensuring ethical standards (including health privacy standards) are maintained, and mitigating risks like AI hallucinations must be addressed. Thoughtful integration, community consultation, and continuous evaluation will be critical to ensuring that AI plays a beneficial role in HIV prevention and drives innovations that lead to more equitable health outcomes. This editorial review explores AI's transformative potential, focusing on the US CDC's key public health strategies for HIV prevention. When aligning with public health strategies - particularly in countries supported by initiatives like President's Emergency Plan for AIDS Relief (PEPFAR) - AI can contribute significantly to global efforts to end the HIV epidemic. It offers a vision for AI's future application in HIV prevention, emphasizing the need for a holistic and syndemic approach to improving HIV prevention worldwide.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 10","pages":"1311-1321"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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