AIDS最新文献

{"title":"Treatment of prehypertension among adults with HIV.","authors":"Lily D Yan, Vanessa Rouzier, Rodney Sufra, Reichling St Sauveur, Colette Guiteau, Myung Hee Lee, Anju Ogyu, Nour Mourra, Suzanne Oparil, Michel Théard, Jean Pierre Brisma, Jean Patrick Alfred, Marie D Deschamps, Jean W Pape, Margaret L McNairy","doi":"10.1097/QAD.0000000000004065","DOIUrl":"10.1097/QAD.0000000000004065","url":null,"abstract":"<p><strong>Objective: </strong>Elevated blood pressure (BP), even at prehypertensive levels, increases cardiovascular disease risk among people with HIV (PWH); yet international guidelines in low-income countries recommend treatment initiation at BP at least 140/90 mmHg. We determined the efficacy, feasibility, and acceptability of treating prehypertension in PWH in Haiti.</p><p><strong>Design: </strong>An unblinded randomized clinical trial (enrolled April 2021-March 2022) with 12-month follow-up.</p><p><strong>Setting: </strong>GHESKIO Centres, Port-au-Prince, Haiti.</p><p><strong>Participants: </strong>Two hundred fifty adults with HIV with prehypertension (SBP 120-138 or DBP 80-89) not on medication, aged 18-65 years, virally suppressed, and without pregnancy, diabetes, or kidney disease.</p><p><strong>Intervention: </strong>Participants were randomized to treatment (amlodipine 5 mg) or control (no amlodipine unless two BP ≥140/90 mmHg).</p><p><strong>Main outcome measure: </strong>Primary outcome was mean change in SBP between intervention versus control groups from enrollment to 12 months.</p><p><strong>Results: </strong>Among 250 adults, median age was 49 years, 40.8% were women. Baseline median BP was 129/78 mmHg intervention versus 128/77 mmHg control. After 12 months, the difference in mean change between study groups for SBP was -5.9 mmHg [95% confidence interval (95% CI) -8.8 to -3.0] and for DBP was -5.5 mmHg (95% CI -7.9 to -3.2). At 12 months, 5.6% intervention and 23.0% control participants developed incident hypertension (hazard ratio 0.18; 95% CI 0.07-0.47). There were no differences in viral load suppression at 12 months or drug-related serious adverse events. Intervention acceptability was high among providers and participants in qualitative interviews.</p><p><strong>Conclusion: </strong>In PWH in a resource-poor setting, prehypertension treatment was feasible, acceptable, and effective in reducing mean SBP and incident hypertension.</p><p><strong>Registration: </strong>Clinicaltrials.gov NCT04692467.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 3","pages":"261-269"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055750","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}

{"title":"Global health solidarity in the HIV and hypertension disease response.","authors":"G Titus K Ngeno, Gerald S Bloomfield","doi":"10.1097/QAD.0000000000004083","DOIUrl":"10.1097/QAD.0000000000004083","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 3","pages":"319-320"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057763","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}

{"title":"Emerging integrase resistance in an international perinatal virtual clinic.","authors":"Ayolola Eni-Olotu, Nicola E Mackie, Jessica Glenn, Angela Bailey, Alasdair Bamford, Julia Kenny, Leon Levin, Hermione Lyall, Tiago Milheiro Silva, Katie Simon, Neil Tickner, Anna Turkova, Steven Welch, Caroline Foster","doi":"10.1097/QAD.0000000000004048","DOIUrl":"10.1097/QAD.0000000000004048","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify the prevalence of emergent integrase drug resistance mutations (INSTI-DRMs) in international referrals to a perinatal virtual clinic (PVC).</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>Monthly multidisciplinary PVC reviewing complex case management for children and adolescents with perinatally acquired HIV (CAWHIV).</p><p><strong>Participants: </strong>One hundred fourteen cases referred for virological failure between October 2018 and January 2024.</p><p><strong>Main outcome measures: </strong>Data collected included age, sex, weight, country of residence, antiretroviral therapy (ART) history, HIV viral load, CD4 + cell count, and comorbidities. Resistance mutations were interpreted using the Stanford HIV Drug Resistance database with emergent major INSTI-DRMs described.</p><p><strong>Results: </strong>Of 114 referrals, 103 (90%) had resistance sequences available. Prior INSTI exposure was documented in 61/103 (59%) with 19/61 (31%) having INSTI-DRMs. For these 19, median (IQR) age was 11 years (6-14), weight 25 kg (17-50), CD4 + cell count 485 cells/μl (153-805), and viral load 84 000 copies/ml (2380-137 000). Twelve of 19 (65%) were from low/middle-income countries (LMIC), 6/19 (32%) had current AIDS diagnoses with 14/19 (74%) referred from 2022 onwards. There were a median three prior regimens with 13/19 (68%) having at least 3 class resistance. Two developed INSTI-DRMs on first-line dolutegravir (DTG)-based ART, 17 on second+ line therapy. PVC recommendations were for tenofovir+ lamivudine/emtricitabine (six split adult tablets) with boosted darunavir [19; six twice daily (b.i.d.)], with b.i.d. DTG (6), plus fostemsavir (1) and ibalizumab (1).</p><p><strong>Conclusion: </strong>Although uncommon, INSTI resistance is emerging, mainly in highly treatment experienced CAWHIV from LMIC, highlighting the global need for access to boosted protease inhibitors and novel classes, including formulations for children less than 35 kg.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"276-280"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520712","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}

{"title":"Incidence of high blood pressure among Kenyan adults with HIV.","authors":"Kara Suvada, Erica Kocher, Nazha Diwan, Andrew Nagy, Mary Nderitu, Charles Kibaara, Richard Ngomoa, Tony J Cagle, Jacob Kariuki, Kristin M Wall, Ludivine Brunissen, Shashank Ramireddy, Leslie C M Johnson, Michael H Chung, Mohammed K Ali","doi":"10.1097/QAD.0000000000004050","DOIUrl":"10.1097/QAD.0000000000004050","url":null,"abstract":"<p><strong>Objective: </strong>People with HIV (PWH) face a heightened risk of cardiovascular diseases, partly because of increased high blood pressure risk. This study assessed high blood pressure burden (i.e. incidence and prevalence) among PWH in Kenya over time.</p><p><strong>Design: </strong>Longitudinal, open cohort study.</p><p><strong>Methods: </strong>We estimated the incidence and prevalence of high blood pressure in a large sample of Kenyans with HIV from the Coptic Hope Center using electronic medical records from 2004 to 2023. We defined incident high blood pressure as first visit after baseline at which each patient had a SBP at least 140 mmHg and/or a DBP at least 90 mmHg.</p><p><strong>Results: </strong>Our sample included 38 709 PWH seeking care at Coptic Hope Center clinics in Kenya (2004-2023). Nearly 40% of patients had high blood pressure at first visit. Among the 60% of patients initially normotensive, almost 40% developed high blood pressure within 20 years. The yearly prevalence of high blood pressure ranged from 8 to 58%. Average SBP was higher among patients who had their first visit from 2019 to 2023 compared with those visiting in the early 2000s and 2010s.</p><p><strong>Conclusion: </strong>Our findings reveal a high and rising burden of high blood pressure among PWH in a large, faith-based health system in Kenya. This underscores the need for stronger integration of care for individuals with concurrent HIV, high blood pressure, and other noncommunicable diseases (NCDs). Current systems are insufficient for achieving blood pressure control among PWH. Further research and funding for efforts to address HIV and NCD care in Kenya are warranted.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"281-289"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543089","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}

{"title":"Implementing conversational artificial intelligence technology for the prevention of HIV and other sexually transmitted infections in real-world settings.","authors":"Jun Tao, Amanda Maguire-Wilkerson, Jack Rusley, Tyler Wray, Philip A Chan","doi":"10.1097/QAD.0000000000004082","DOIUrl":"10.1097/QAD.0000000000004082","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 3","pages":"324-327"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057764","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}

{"title":"A blind spot in HIV diagnosis guidelines?","authors":"Sierra J Casper, Megan L Fix, Adam M Spivak","doi":"10.1097/QAD.0000000000004084","DOIUrl":"10.1097/QAD.0000000000004084","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 3","pages":"334-335"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057739","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}

{"title":"Beyond virologic suppression.","authors":"Brian Conway, Christina Wiesmann, Krit Pongpirul","doi":"10.1097/QAD.0000000000004063","DOIUrl":"10.1097/QAD.0000000000004063","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 3","pages":"315-316"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057743","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}

{"title":"Contextual factors related to the overlap of the overdose and HIV pandemics and their clinical implications.","authors":"Karl Goodkin, Harold A Pollack","doi":"10.1097/QAD.0000000000004092","DOIUrl":"10.1097/QAD.0000000000004092","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 3","pages":"321-323"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057745","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}

{"title":"Predictors of HIV seroconversion in Botswana.","authors":"Yifan Cui, Sikhulile Moyo, Molly Pretorius Holme, Kathleen E Hurwitz, Wonderful Choga, Kara Bennett, Unoda Chakalisa, James Emmanuel San, Kutlo Manyake, Coulson Kgathi, Ame Diphoko, Simani Gaseitsiwe, Tendani Gaolathe, M Essex, Eric Tchetgen Tchetgen, Joseph M Makhema, Shahin Lockman","doi":"10.1097/QAD.0000000000004055","DOIUrl":"10.1097/QAD.0000000000004055","url":null,"abstract":"<p><strong>Objective: </strong>To identify predictors of HIV acquisition in Botswana.</p><p><strong>Design: </strong>We applied machine learning approaches to identify HIV risk predictors using existing data from a large, well characterized HIV incidence cohort.</p><p><strong>Methods: </strong>We applied machine learning (randomForestSRC) to analyze data from a large population-based HIV incidence cohort enrolled in a cluster-randomized HIV prevention trial in 30 communities across Botswana. We sought to identify the most important risk factors for HIV acquisition, starting with 110 potential predictors.</p><p><strong>Results: </strong>During a median 29-month follow-up of 8551 HIV-negative adults, 147 (1.7%) acquired HIV. Our machine learning analysis found that for females, the most important variables for predicting HIV acquisition were the use of injectable hormonal contraception, frequency of sex in the prior 3 months with the most recent partner and residing in a community with HIV prevalence of 29% or higher. For the small proportion (0.3%) of females who had all three risk factors, their estimated probability of acquiring HIV during 29 months of follow-up was 34% (approximate annual incidence of 14%). For males, nonlong-term relationships with the most recent partner and community HIV prevalence of 34% or higher were the most important HIV risk predictors. The 6% of males who had both risk factors had a 5.1% probability of acquiring HIV during the follow-up period (approximate annual incidence of 2.1%).</p><p><strong>Conclusion: </strong>Machine learning approaches allowed us to analyze a large number of variables to efficiently identify key factors strongly predictive of HIV risk. These factors could help target HIV prevention interventions in Botswana.</p><p><strong>Clinical trials registration: </strong>NCT01965470.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"290-297"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575035","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}

{"title":"Aging with HIV and HIV-associated neurocognitive impairment.","authors":"Teresa Bennett, Sharon Walmsley, Reina Bendayan","doi":"10.1097/QAD.0000000000004057","DOIUrl":"10.1097/QAD.0000000000004057","url":null,"abstract":"<p><p>Antiretroviral therapy (ART) is the most effective therapeutic intervention for HIV infection. With improved survival, comorbidities, including neuropsychiatric and HIV-associated neurocognitive impairment (NCI) are of increasing concern to aging people with HIV (PWH). The clinical features and the inter-individual variability of the aging process confound the elucidation of the diagnosis and underlying mechanisms of cognitive dysfunction in aging PWH. Herein, we review the clinical aspects of HIV-associated NCI in the aging PWH contrasting to the normative neuro-aging seen in people without HIV (PWoH) and address the growing role of biomarkers to predict the onset of age-related diseases in PWH and their clinical significance. There is an urgent need for further research into the role of specific immune brain biomarkers in predicting the aging process and how these biomarkers may assist in understanding the mechanisms and possible prognosis of age-related neurocognitive comorbidities in aging PWH as an endpoint for interventional studies.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 3","pages":"215-228"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057741","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}