AIDS最新文献

{"title":"Modeling the potential impact of viral load monitoring on vertical transmission of HIV in Kenya.","authors":"Horacio A Duarte, Jeanette K Birnbaum, James G Carlucci, Yara Ghazal, Rosa C Ndiema, Eva A Enns","doi":"10.1097/QAD.0000000000004207","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004207","url":null,"abstract":"<p><strong>Introduction: </strong>Viral load (VL) monitoring among pregnant and breastfeeding women (PBFW) can reduce vertical transmission (VT) by identifying PBFW with unsuppressed VL and promoting re-suppression. However, the impact of varying degrees of adherence to VL monitoring guidelines on the prevention of vertical transmission (PVT) is unknown.</p><p><strong>Methods: </strong>We developed a microsimulation model of HIV progression and PVT care for PBFW living with recently acquired HIV in Kenya. We used this model to evaluate VL monitoring in two key maternal populations: 1) newly positive (NP) pregnant women who initiate ART during antenatal care and 2) known positive (KP) women who are diagnosed and initiate ART prior to conception. For each population, we simulated three levels of adherence to Kenyan VL monitoring guidelines during pregnancy and 18 months of breastfeeding: 1) No testing (NT); 2) 50% adherence to indicated VL tests (VL-50%); 3) 100% adherence (VL-100%). We evaluated VL monitoring in each population by comparing live births, maternal deaths, and VT under VL-50% and VL-100% to NT.</p><p><strong>Results: </strong>Under NT, infants acquired HIV at a rate of 619 vs. 505 per 10,000 live births in the NP vs. KP populations, respectively. VL monitoring reduced VT by 1.6-2.7% in NP women vs. 9.1%-14.3% in KP women, and it reduced maternal deaths by 1.2-1.8% vs. 1.6-2.3%.</p><p><strong>Conclusion: </strong>Maternal VL monitoring in Kenya has considerably greater potential for achieving relative reductions in VT among KP women than among NP women. In KP women, even imperfect adherence to guidelines may achieve substantial relative reductions in VT.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957827","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":"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, Dian-Bing Wang, Xian-En Zhang","doi":"10.1097/QAD.0000000000004206","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004206","url":null,"abstract":"<p><strong>Objective: </strong>Nuclear import/export of HIV-1 is regulated by the 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-1NL4-3 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. Firstly, Nup210-knockdown increased the accumulation of integrated proviral DNA, while the levels of RT products and 2-LTR circles remained unaffected by either Nup210-knockdown or overexpression. Secondly, 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. Thirdly, 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":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Senescence-related cytokine levels are associated with HIV-1 serostatus and persistence.","authors":"Yijia Li, Zoamy N Soto-Ramirez, Jennifer Roscher, Tom Medvec, Mounia Alaoui-El-Azher, Paolo Piazza, Yue Chen, Nicolas Sluis-Cremer, Charles R Rinaldo, Bernard J C Macatangay","doi":"10.1097/QAD.0000000000004204","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004204","url":null,"abstract":"<p><strong>Background: </strong>HIV-1 infection is associated with accelerated aging. The senescence-associated secretory phenotype (SASP) includes biological and cytokine profiles that induce cellular senescence and inflammaging. In this study, we leveraged the Multicenter AIDS Cohort Study (MACS) to evaluate the role of SASP in aging, HIV-1 reservoir, and inflammation in people with HIV-1 (PWH) on long-term suppressive antiretroviral therapy (ART).</p><p><strong>Methods: </strong>In this retrospective study, we included plasma and serum samples from 27 virally suppressed PWH and 10 people without HIV-1 (PWoH) collected in 2019 and 2023. SASP markers were quantified in the 2019 and 2023 samples. Plasma residual viremia, intact and defective proviral DNA were quantified in the 2019 samples. Correlations between SASP markers and HIV-1 reservoir were performed using the Spearman test, and the sparse partial least squares discrimination analysis was used to identify variables that distinguish HIV-1 serostatus.</p><p><strong>Results: </strong>All study participants were male with a median age of 59 years. SASP markers did not show significant changes longitudinally in either group. We identified a set of markers that had moderate performance in distinguishing PWH and PWoH, including cytomegalovirus (CMV) serum antibody titer, matrix metalloproteinase 9 (MMP-9), growth/differentiation factor-15, Stanniocalcin-1 and SerpinE1. Among all the SASP markers, MMP-9 was significantly associated with intact HIV-1 proviral levels [ρ = 0.60, P = 0.002, false detection rate (FDR) = 0.03].</p><p><strong>Conclusion: </strong>In this cohort study, we revealed the relationship between SASP markers and HIV-1 persistence. Future interventions targeting the senescence pathways may impact HIV-1 persistence.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957820","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":"Predictors of unsuppressed viral load among men who have sex with men living with HIV in South Africa.","authors":"Jessica S van der Mannen, Stanford Furamera, Jacqueline Pienaar, Pontsho Komane, Luxolo Shokota, Boitumelo Ramashala, Lindiwe Tsope, Elise M van der Elst, Danielle Giovenco, Don Operario, Eduard J Sanders","doi":"10.1097/QAD.0000000000004205","DOIUrl":"10.1097/QAD.0000000000004205","url":null,"abstract":"<p><strong>Introduction: </strong>South Africa has the largest HIV epidemic of the world, but predictors of unsuppressed viral load among MSM are scarce.</p><p><strong>Methods: </strong>We did a cross-sectional study to assess socio-demographic characteristics, year of antiretroviral therapy (ART) initiation, and viral load data from 1385 MSM registered in five key population clinics in five districts in South Africa in 2023 and 2024. We used logistic regression to assess predictors of unsuppressed viral load (≥200 copies/ml). We then conducted a case--control study involving 57 cases (viral load≥200 copies/ml) and 57 matched controls (viral load<200 copies/ml; matched on age, ART start date, clinic, and outreach vs. facility attendance) drawn from the cross-sectional study to explore additional differences between groups.</p><p><strong>Results: </strong>In the cross-sectional study, predictors for unsuppressed viral load included on ART for 1-2 years [odds ratio (OR) 3.53; 1.77-7.69] or 3-5 years (OR 2.33; 1.18-5.04) vs. more than 5 years, being an outreach vs. facility-based client (OR: 2.64; 1.79-3.94), and enrolled at Johannesburg (OR: 3.53; 2.25-5.64), or Durban (OR: 0.36; 0.84-0.70), vs. Pretoria. The case-control study identified predictors for unsuppressed viral load, which included missing more than four ART dosages per month (OR: 5.55; 1.19-41,03), having moderate to severe anxiety (OR: 3.90; 1.34-12,52), hazardous alcohol use (OR: 2.70; 1.14-6.81), and Christian vs. no religion (OR: 3.89; 1.34-12.29).</p><p><strong>Conclusion: </strong>We identified regional differences and key predictors of unsuppressed viral load among MSM living with HIV in South Africa. Screening for risk factors for unsuppressed viral load at ART continuation may inform where adherence support and other health services are needed.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961605","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":"The cumulative prevalence of HIV-1 drug resistance in perinatal HIV.","authors":"Jessica S Glenn, Aisleen Bennett, Nicola Mackie, Hermione Lyall, Sarah Fidler, Graham Taylor, Caroline Foster","doi":"10.1097/QAD.0000000000004202","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004202","url":null,"abstract":"<p><strong>Objective: </strong>To describe acquired drug resistance mutations (DRMs) amongst children and adults with perinatal HIV stratified by age.</p><p><strong>Design: </strong>Retrospective observational cohort study.</p><p><strong>Methods: </strong>Data on demographics, antiretroviral therapy (ART), viral load (VL), CD4 count and lifetime cumulative acquired DRMs was collected and disaggregated by birth era; pre and post 2000; 0-24 and ≥ 25 years (n 113 vs 167).</p><p><strong>Results: </strong>280 individuals (median age 26 years, interquartile range 21,30), 235 (84%) Black ethnicity, 160 (57%) female, with median ART exposure 17 years. 99.6% currently on ART, 205 (73%) integrase strand transfer inhibitor (INSTI) regimens, with 252 (90%) VL<200 copies/ml. 121/280 (43%) acquired resistance to ≥ one ART class (37% 0-24 versus 47% ≥ 25 years), 69/280 (25%) ≥ two (14% v 32%), and 13/280 (4.6%) ≥ three class; 11/13 (85%) aged ≥ 25 years. DRMs by ART class; 104/280 (37%), non-nucleoside reverse transcriptase inhibitor (NNRTI), 78 (28%) nucleoside reverse transcriptase inhibitor (NRTI), 15 (5%) protease inhibitor and 4 (1%) INSTI. Uni/multivariate analysis; DRM acquisition was significantly associated with >2 anchor class exposure (p = 0.000), prior AIDS diagnosis (p = 0.001, 0.085) and early mono/dual NRTI exposure (p = 0.000, 0.029).</p><p><strong>Conclusion: </strong>Despite improved ART efficacy, DRMs limit treatment options, including to long-acting injectable therapies with one third having NNRTI-DRMs. Outcomes for second-generation INSTIs are promising with low rates of resistance but require continued monitoring. Whilst multi-drug resistance rates are lower in those born post-2000, over a third already have DRMs, highlighting the ongoing need for patient-centred approaches addressing adherence and novel ART class development.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959891","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":"Routine testing for chlamydia and gonorrhea in an HIV Pre-Exposure prophylaxis program in hanoi, vietnam: implications for low- and middle-income countries.","authors":"Paul C Adamson, Hao T M Bui, Loc Q Pham, Phuong T Truong, Ngan T Le, Giang M Le, Jeffrey D Klausner","doi":"10.1097/QAD.0000000000004203","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004203","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the prevalence, anatomical distribution, and correlates of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections within an HIV pre-exposure prophylaxis (PrEP) program in Hanoi, Vietnam.</p><p><strong>Design: </strong>Cross-sectional, observational study.</p><p><strong>Methods: </strong>Between January-December 2022, HIV PrEP program clients who were male at birth, ≥16 years old, reported ≥1 male sex partner in the prior 12 months, were enrolled. A questionnaire collected sociodemographics, sexual behaviors, and clinical data. CT/NG testing was performed on self-collected urine, rectal, and pharyngeal specimens. Multivariate logistic regression was used to identify factors associated with infections.</p><p><strong>Results: </strong>Among 529 participants, the prevalence of CT or NG was 28.9% (153/529). The prevalence of NG was 14.4% (76/529) and highest for pharyngeal infections (11.7%; 62/528), while for CT, the prevalence was 20.4% (108/529) and highest for rectal infections (15.0%; 74/493). Symptoms in the prior week were reported by 45.8% (70/153) of those with CT or NG infections. Among asymptomatic participants, there was a low prevalence of urethral CT (3.1%; 14/457) and NG (0.9%; 4/457). Condomless anal sex (aOR = 1.98; 95% CI: 1.27, 3.09) and sexualized drug use in the prior 6 months (aOR = 1.71; 95% CI: 1.09, 2.69) were associated with CT/NG infections.</p><p><strong>Conclusions: </strong>The study found a high prevalence of CT/NG infections, particularly pharyngeal and rectal infections, within an HIV PrEP program in Hanoi, Vietnam. The findings suggest testing for urethral infections among asymptomatic individuals is of limited value. Further research is needed for STI prevention strategies and updated guidelines for CT/NG screening in HIV PrEP programs in low- and middle-income countries.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956098","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":"Effectiveness of levonorgestrel implant and depot medroxyprogesterone acetate injectable for women living with HIV on efavirenz: a prospective cohort study.","authors":"Katie R Mollan, Brian W Pence, Daniel Westreich, Agatha Bula, Clara Lemani, John Chapola, Jill M Hagey, Karen Diepstra, Jennifer Winston, Sam Phiri, Jane Chiwoko, Lameck Chinula, Mina C Hosseinipour, Michael G Hudgens, Mackenzie L Cottrell, Audrey Pettifor, Michele Jonsson-Funk, Jennifer H Tang","doi":"10.1097/QAD.0000000000004201","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004201","url":null,"abstract":"<p><strong>Objective: </strong>We compared the contraceptive effectiveness of typical-use LNG implant and depot medroxyprogesterone acetate (DMPA) injectable during efavirenz use.</p><p><strong>Design: </strong>We conducted a prospective cohort study of women living with HIV (WLHIV) on efavirenz-containing antiretroviral treatment in Lilongwe, Malawi. Eligible participants were 18-40 years of age and initiating LNG implant or DMPA injectable with desire to prevent pregnancy for 4+ years. Study visits and urine pregnancy testing occurred at enrollment, week 4, and every 24 weeks up to week 192. Malawi's efavirenz-to-dolutegravir transition shortened our duration of efavirenz follow-up.</p><p><strong>Methods: </strong>Pregnancy incidence rates/100 person-years (PY) and an incidence rate difference (IRD) were estimated using an inverse-probability-weighted Poisson model.</p><p><strong>Results: </strong>We enrolled 1,179 WLHIV on efavirenz: 592 and 587 chose to initiate the LNG implant and DMPA, respectively. Median follow-up during efavirenz use was 1.1 years (IQR: 0.5-1.7). Estimated pregnancy incidence rates were 6.6/100 PY (95%CI: 5.0, 8.7) in the LNG implant enrollment group (50 pregnancies) and 7.3/100 PY (95%CI: 5.5, 9.7) in the DMPA enrollment group (54 pregnancies), IRD -0.7/100 PY (95%CI: -3.5, 2.0). Results were similar in an analysis of first incident pregnancy during continued typical use of LNG implant (5.7/100 PY) versus continued typical use of DMPA (5.7/100 PY), IRD 0.0/100 PY (95%CI: -2.6, 2.7).</p><p><strong>Conclusions: </strong>In many settings, LNG implant has better contraceptive effectiveness than DMPA injectable. However, for WLHIV on efavirenz, we observed similar typical-use effectiveness for LNG implant versus provider-administrated DMPA injectable during the initial 1-2 years of use.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771048","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":"Food insecurity and mental health outcomes among people living with HIV in West Africa.","authors":"Noelle A Benzekri, Marie K Plaisy, Jean Jacques Koffi, Ephrem Mensah, Albert Minga, Didier K Ekouevi, Raoul Moh, Charlotte Bernard, Antoine Jaquet","doi":"10.1097/QAD.0000000000004200","DOIUrl":"10.1097/QAD.0000000000004200","url":null,"abstract":"<p><strong>Objectives: </strong>This study was conducted in order to determine whether food insecurity is associated with poor mental health outcomes among PLHIV in Togo and Côte d'Ivoire, West Africa.</p><p><strong>Design: </strong>Cross-sectional study among participants enrolled in the International epidemiological Databases to Evaluate AIDS West Africa cohort.</p><p><strong>Methods: </strong>The Household Food Insecurity Access Scale was used to measure food insecurity. The PHQ-9, GAD-7, PCL-5, and AUDIT-C instruments were used to assess depressive symptoms, anxiety symptoms, symptoms of post-traumatic stress disorder (PTSD), and harmful alcohol use, respectively. Logistic regression was used to identify factors associated with poor mental health outcomes.</p><p><strong>Results: </strong>Among 584 participants (68.8% female, median age 52 years), nearly half (48.1%) were food insecure; 7.0% were mildly food insecure, 26.7% were moderately food insecure, and 14.4% were severely food insecure. Severe food insecurity [OR 2.63 (1.30-5.34)] and being widowed [OR 2.15 (1.07-4.30)] were associated with moderate-to-severe depressive symptoms and formal education was protective [OR 0.30 (0.15-0.61)]; there was a trend towards an association between severe food insecurity and moderate-to-severe anxiety symptoms [OR 2.14 (0.98-4.70)] and formal education was protective [OR 0.35 (0.18-0.71)]; severe food insecurity [OR 6.87 (2.89-16.38)] and being widowed [OR 3.55 (1.46-8.59)] were associated with PTSD; mild food insecurity [OR 2.74 (1.20-6.26)] and male sex [OR 11.58 (5.44-24.68)] were associated with high risk alcohol use.</p><p><strong>Conclusions: </strong>Food insecurity is associated with poor mental health outcomes among PLHIV in Togo and Côte d'Ivoire, West Africa. Future studies to understand and address the causal links between food insecurity and mental health among PLHIV are warranted.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771051","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":"Perinatal outcomes among pregnant women with HIV initiating antiretroviral therapy preconception and antenatally.","authors":"Pippa Boering, Claudia Murray, Clara Portwood, Molly Hey, Lucy Thompson, Katharina Beck, Imogen Cowdell, Harriet Sexton, Mary Kumarendran, Zoe Brandon, Shona Kirtley, Joris Hemelaar","doi":"10.1097/QAD.0000000000004104","DOIUrl":"10.1097/QAD.0000000000004104","url":null,"abstract":"<p><strong>Objective: </strong>Increasingly, pregnant women with HIV (WHIV) initiate antiretroviral therapy (ART) before conception. We assessed the risk of adverse perinatal outcomes among pregnant WHIV initiating ART preconception or antenatally, compared with women without HIV or ART-naive WHIV.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched PubMed, EMBASE, CINAHL, and Global Health for studies published between 1 January 1980 and 14 July 2023. We assessed the association of preconception/antenatal ART initiation with preterm birth (PTB), very PTB (VPTB), spontaneous PTB (sPTB), low birthweight (LBW), very LBW (VLBW), small for gestational age (SGA), very SGA (VSGA), stillbirth and neonatal death (NND). Data were analysed using random effects meta-analyses. Quality assessments, subgroup and sensitivity analyses were conducted. PROSPERO registration: CRD42021248987.</p><p><strong>Results: </strong>Thirty-one cohort studies were eligible, including 199 156 women in 19 countries. WHIV with preconception ART were associated with increased risk of PTB [risk ratio (RR) 1.55; 95% confidence interval (CI) 1.27-1.90], VPTB (RR 2.14, 95% CI 1.02-4.47), LBW (RR 2.19, 95% CI 1.32-3.63), VLBW (RR 3.34, 95% CI 1.08-10.35), SGA (RR 1.92, 95% CI 1.01-3.66), and VSGA (RR 2.79, 95% CI 1.04-7.47), compared with women without HIV. WHIV with antenatal ART were associated with increased risk of PTB (RR 1.35, 95% CI 1.15-1.58), LBW (RR 2.16, 95% CI 1.39-3.34), VLBW (RR 1.97, 95% CI 1.01-3.84), SGA (RR 1.77, 95% CI 1.10-2.84), and VSGA (RR 1.21, 95% CI 1.09-1.33), compared with women without HIV. Compared to ART-naive WHIV, WHIV with preconception or antenatal ART were associated with increased risk of SGA (preconception: RR 1.40, 95% CI 1.12-1.73; antenatal: RR 1.39, 95% CI 1.11-1.74) and VSGA (preconception: RR 2.44, 95% CI 1.63-3.66; antenatal: RR 2.24, 95% CI 1.48-3.40).</p><p><strong>Conclusion: </strong>Among WHIV, both preconception and antenatal initiation of ART are associated with increased risks of adverse perinatal outcomes, compared to women without HIV and ART-naive WHIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"584-596"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930409","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":"Differential systemic immune-inflammation index levels in people with and without HIV infection.","authors":"Crystal X Wang, Scott L Letendre, Suzi Hong, Mohammad Andalibi, Jennifer E Iudicello, Ronald J Ellis","doi":"10.1097/QAD.0000000000004088","DOIUrl":"10.1097/QAD.0000000000004088","url":null,"abstract":"<p><strong>Background: </strong>HIV infection is linked to persistent inflammation despite effective antiretroviral therapy (ART). The Systemic Immune-Inflammation Index (SII) is a marker of inflammation in various conditions.</p><p><strong>Methods: </strong>We compared SII values between PWH and PWoH. Clinical blood laboratory data were used to calculate the SII for each participant using the formula [(Platelet count × Neutrophil count)/Lymphocyte count]. Differences in SII values between the groups were analyzed using the Wilcoxon test, and the impact of potential confounders was assessed with multivariable regression models.</p><p><strong>Results: </strong>The study included 343 PWH and 199 PWoH. Age and race did not significantly differ, but sex distribution did (83.1% male in PWH vs. 55.8% in PWoH, P  < 0.0001). Among PWH, median [IQR] nadir and current CD4 + cell counts were 199 cells/μl [50, 350] and 650 [461,858], respectively. Nearly all PWH were on ART, with 97.2% achieving viral suppression. PWH had lower SII values than PWoH (327 [224, 444] vs. 484 [335,657], P  = 1.35e-14). PWH also had lower neutrophils and platelets ( P s < 0.001) and higher lymphocyte counts ( P  = 0.001). These differences remained significant after adjusting for age, sex, and other potential confounders.</p><p><strong>Discussion: </strong>Contrary to expectations, PWH had lower SII levels, likely due to altered hematologic parameters influenced by HIV and ART. These findings suggest that SII interpretation in PWH requires consideration of unique hematologic profiles and underscore the need for further research to understand the mechanisms and clinical implications of SII in HIV management.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"554-559"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816820","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}