AIDS最新文献

{"title":"Subcutaneous adipose tissue gene transcripts associated with progressive myosteatosis in persons with HIV.","authors":"Oliver S Zhao, Heidi J Silver, Run Fan, Fei Ye, Qi Liu, Sangeeta Nair, James G Terry, John J Carr, Celestine Wanjalla, Mona Mashayekhi, Samuel Bailin, Curtis Gabriel, John R Koethe","doi":"10.1097/QAD.0000000000004264","DOIUrl":"10.1097/QAD.0000000000004264","url":null,"abstract":"<p><strong>Objectives: </strong>Skeletal muscle fat infiltration (myosteatosis) is a clinical condition distinct from visceral and hepatic lipid accumulation and contributes to metabolic dysregulation, sarcopenia, and frailty in people with HIV (PWH). Altered subcutaneous adipose tissue (SAT) function contributes to visceral fat deposition and hepatic steatosis, but there are few data on SAT gene expression and myosteatosis in PWH on long-term antiretroviral therapy (ART).</p><p><strong>Design: </strong>A longitudinal analysis of 40 PWH on contemporary ART with sustained viral suppression to assess relationships between SAT gene transcripts and computed tomography (CT) imaging of skeletal muscle density, where lower density indicates higher lipid content, and area. CT imaging also measured other fat depots, including visceral adipose tissue (VAT) volume and liver density.</p><p><strong>Methods: </strong>SAT gene transcripts were quantified using a NanoString panel of 255 immune and 77 adipocyte-related genes. Linear mixed-effects models assessed baseline SAT gene expression and changes in skeletal muscle over a median of 3.3 years.</p><p><strong>Results: </strong>Decreasing skeletal muscle density over time correlated with increasing VAT volume and declining liver density. Gene-by-visit interaction revealed 34 SAT genes associated with muscle density change and 15 genes associated with muscle area change. Two key CCR4 binding chemokines, CCL17 and CCL22, were linked to reductions in both muscle density and area.</p><p><strong>Conclusions: </strong>A subset of SAT gene transcripts is associated with changes in skeletal muscle density and area over time, suggesting interventions to modulate SAT immune activity or improve lipid handling may hold therapeutic potential to slow the progression of myosteatosis and sarcopenia in PWH.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315720","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":"Higher plasma concentrations of von Willebrand factor in women than in men during both the acute and chronic phases of HIV infection.","authors":"Kathia Beddek, Faroudy Boufassa, Christelliah Mouanga, Marie Bitu, Véronique Avettand-Fenoel, Olivier Lambotte, Laurence Meyer, Cécile Goujard, Nicolas Noel, Christine Bourgeois","doi":"10.1097/QAD.0000000000004253","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004253","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic HIV infection is associated with increased cardiovascular risk, presumably due to the impact of chronic inflammation and immune activation on the vascular endothelium. We explored endothelial activation markers in chronically infected people with HIV (PWH) under antiretroviral therapy (ART) or with spontaneous viral control.</p><p><strong>Design: </strong>Studies on 50 samples collected from HIV controllers (HIC), 50 ART-treated participants (ART) (median duration of infection: 8 years) enrolled in cohort studies and 50 uninfected individuals. Forty-five additional samples collected during primary HIV infection (PHI) were also included.</p><p><strong>Method: </strong>The plasma levels of endothelial activation markers (vWF, sICAM-1, sVCAM-1, sE-Selectin, angiopoietin-1, angiopoietin-2) were determined by ELISA. Multivariate analyses were performed with adjustment for traditional confounding factors for cardiovascular diseases.</p><p><strong>Results: </strong>In univariate analysis, vWF and sICAM-1 concentrations were higher in PWH than in uninfected individuals. A sex-stratified analysis revealed higher vWF levels in ART-treated women than in HIC and uninfected women and ART-treated men. A sex-specific profile was also observed for sVCAM-1 that was higher in ART-treated women than in HIC and uninfected women, whereas no such pattern was observed in men. sICAM-1 levels were higher in male and female PWH, but this effect was essentially modulated by confounding factors. A sex-related impact on vWF and sVCAM-1 concentrations was also detected in PHI.</p><p><strong>Conclusion: </strong>vWF concentrations were higher in ART-treated women but not in men. This may reflect sex-differences in the sensitivity of the vascular endothelium during HIV infection. These results argue for closer cardiovascular monitoring in women living with HIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257098","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":"Are we ending the HIV epidemic among persons who inject drugs?: Key findings from 19 U.S. cities, 2022.","authors":"Amy R Baugher, Cyprian Wejnert, Dafna Kanny, Dita Broz, Jonathan Feelemyer, Rebecca B Hershow, Janet Burnett, Johanna Chapin-Bardales, Maya Haynes, Teresa Finlayson, Joseph Prejean","doi":"10.1097/QAD.0000000000004249","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004249","url":null,"abstract":"<p><strong>Objectives: </strong>National HIV Behavioral Surveillance (NHBS) conducts surveillance among key populations, including persons who inject drugs (PWID). NHBS data can be used to monitor progress toward national goals, including Ending the HIV Epidemic (EHE). EHE strategies include HIV testing (Diagnose), rapid linkage to HIV treatment (Treat), and increasing access to pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs) (Prevent). This analysis aimed to concisely compare NHBS key findings among PWID to EHE goals.</p><p><strong>Design/methods: </strong>Cross-sectional NHBS data were collected from PWID in 2018 (n = 9,786) and 2022 (n = 6,574) in 19 U.S. cities. We compared key findings from 2022 NHBS to 1) specified EHE goals for Diagnose (HIV testing) and Treat (linkage to care, current antiretroviral therapy (ART) use) or 2) 2018 NHBS key findings for Prevent (PrEP and SSP use).</p><p><strong>Results: </strong>In 2022, 45% of PWID were tested for HIV; 45% of PWID with HIV were linked to care within 1 month of diagnosis, and 79% were currently taking ART; 1% of PWID without HIV used PrEP; and approximately half of all PWID received syringes from an SSP. PrEP and SSP use among PWID have not changed since 2018.</p><p><strong>Conclusions: </strong>National HIV strategies are not yet adequately reaching PWID. To end the U.S. HIV epidemic, multi-level solutions are needed to tailor interventions for PWID and dismantle barriers to testing, treatment, and prevention. Structural solutions to improve access to basic needs and SSPs may have downstream benefits across the EHE strategies.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245683","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":"Exploring the PREVENT HF score and myocardial function among persons with HIV.","authors":"Allie R Walpert, Mansi Gupta, Carolyn N Dunderdale, Hanna H Haptu, Monica Manandhar, Christopher R deFilippi, Tricia H Burdo, Hang Lee, Raymond Y Kwong, Suman Srinivasa","doi":"10.1097/QAD.0000000000004252","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004252","url":null,"abstract":"<p><strong>Objective: </strong>Persons with HIV (PWH) are at risk for myocardial structural changes, which can progress to diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF). We explored the AHA PREVENT HF (Predicting Risk of cardiovascular disease EVENTs for Heart Failure) risk score in relation to cardiac magnetic resonance (CMR) imaging.</p><p><strong>Design: </strong>This cross-sectional study included 37 PWH on ART, ages 40-65, without known CVD who underwent CMR.</p><p><strong>Methods: </strong>The risk score was assessed using the AHA PREVENT HF calculator. Scores were correlated to variables on CMR that are known indicators of subclinical myocardial dysfunction [left atrial volume index (LAVI), global longitudinal strain (GLS), and left ventricular mass index (LVMI)] and inflammation[extracellular volume (ECV) and longitudinal relaxation (T1)].</p><p><strong>Results: </strong>PWH were age 55 (6) years[mean (SD)], predominantly male (76%) and white (57%) with BMI in the obese (≥30 kg/m2) range: 31 (5) kg/m2. Median PREVENT HF score was 2.6 (1.4,4.1)% [median (25th, 75th)]. The PREVENT HF score correlated to LAVI (ρ = 0.35, P = .04), T1 (ρ = 0.35, P = .04), IL-6 (ρ = 0.36, P = .03) and NT-proBNP (ρ = 0.42, P = .01). Risk scores were higher for those meeting clinical cutoffs LAVI>34 mL/m2 and T1≥1250 ms. For predicting LAVI >34 mL/m2, a PREVENT HF score 2.5 was the optimal cutoff[sensitivity 85%, specificity 65%, AUROC 0.769 (P < .05)]. In predicting T1≥1250 ms, a PREVENT HF score 3.6 was the optimal cutoff [71% sensitivity, 95% specificity, AUROC 0.727 (P < .05)].</p><p><strong>Conclusion: </strong>The PREVENT HF score related to indices of altered myocardial structure and inflammation among asymptomatic PWH with subclinical disease. These data begin to inform us about the utility of PREVENT HF score using radiographic findings, though more studies are needed among PWH to validate its use as a prediction tool.</p><p><strong>Clinical trials registration: </strong>NCT02740179.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245685","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 Metabolic syndrome in people with HIV without experienCe to antiretroviral Therapy who start doLutegravir based-regimen compared with bictegrAvir based-regimeN after 48 weeks (MICTLAN trial).","authors":"José Antonio Mata Marin, Mara Soraya Rodríguez Evaristo, Ana Luz Cano Díaz, Gloria Elizabeth Salinas Velázquez, Salma Triana Gonzalez, Alberto Chaparro Sánchez, Ericka Pompa Mera, Betzahida Meneses Cisneros, Jesús Enrique Gaytan Martínez","doi":"10.1097/QAD.0000000000004259","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004259","url":null,"abstract":"<p><strong>Objective: </strong>Evidence suggests that patients initiating a second-generation INSTI-based regimen may have a higher risk of developing metabolic syndrome (MetS) compared to those on other antiretroviral classes. This study aimed to describe the incidence of MetS at 48 weeks, based on ATP III criteria, in people with HIV (PWH) who started antiretroviral therapy (ART) with a DTG/ABC/3TC-based regimen compared to those receiving a BIC/TAF/FTC-based regimen.</p><p><strong>Design: </strong>A randomized, open-label clinical trial was conducted in PWH with no prior exposure to ART.</p><p><strong>Methods: </strong>Participants were randomized to receive either BIC/TAF/FTC or DTG/ABC/3TC. Anthropometric measurements, including weight, height, blood pressure, waist circumference, bioelectrical impedance analysis, and visceral fat assessment via ultrasonography, were performed at baseline, 24 weeks, and 48 weeks. Metabolic parameters were evaluated at each visit.</p><p><strong>Results: </strong>Out of 378 subjects, 311 provided informed consent and were included. Of these, 276 completed 48 weeks of follow-up. The incidence of MetS was 6 (3.9%) and 10 (6.3%) in BIC/TAF/FTC and DTG/ABC/3TC arms, respectively, with no significant difference between groups. In the BIC/TAF/FTC group, 24 patients (9%) experienced a weight gain of ≥10%, compared to 16 patients (6%) in the DTG/ABC/3TC group (p = 0.72). Risk factors for MetS were age ≥40 years old, baseline BMI ≥25 kg/m2, and baseline visceral fat ≥5 cm prior to ART initiation.</p><p><strong>Conclusion: </strong>Incidence of MetS among PWH receiving an INSTI-based regimen was high, with no difference between BIC/TAF/FTC and DTG/ABC/3TC groups. Age, overweight and elevated visceral fat at baseline were all associated with MetS.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245687","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":"Virological success despite archived INSTI drug resistance mutations on INSTI-based antiretroviral regimens.","authors":"Yanis Merad, Alice-Andrée Mariaggi, Marina Karmochkine, Laurence Slama, Etienne Brière, Odile Launay, Jean-Paul Viard, Caroline Charre","doi":"10.1097/QAD.0000000000004251","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004251","url":null,"abstract":"<p><strong>Objectives: </strong>The clinical relevance of archived drug resistance mutations (DRMs) detected by HIV-1 proviral genotypic resistance testing (GRT) in virologically suppressed (VS) people with HIV (PWH) remains unclear, especially since these mutations may reside in defective proviruses. We assessed the impact of archived full-class integrase strand transfer inhibitor (INSTI) DRMs in a real-life setting.</p><p><strong>Design: </strong>This was a retrospective study conducted in Paris, France, evaluating archived INSTI DRMs in VS PWH receiving INSTI-based regimens.</p><p><strong>Methods: </strong>We included VS PWH receiving INSTI-based regimens with archived full-class INSTI DRMs. We assessed mutational load and inferred proviral defectiveness based on the presence of stop codons or G-to-A hypermutations.</p><p><strong>Results: </strong>Among 883 PWH with INSTI proviral GRT since March 2022, 30 INSTI DRMs were identified in 26 VS PWH on INSTI-based regimens (69% male, median age 53). Median total HIV-1 DNA was 2.36 log10 copies/106 leukocytes (IQR: 2.24-2.65, n = 17), and median mutational load was 1.94 log10 copies/106 leukocytes (IQR: 1.34-2.39). Mutational load did not differ significantly between presumed defective and intact proviruses (p = 0.786). DRMs were found in presumed defective proviruses in 18/26 (69%) individuals. No virologic failure occurred on INSTI-based therapy during a median follow-up of 202 days (IQR: 105-366).</p><p><strong>Conclusion: </strong>In this study, virological control was not compromised by archived INSTI DRMs in VS PWH on INSTI-based therapy. Prospective studies evaluating INSTI-based regimen switching despite these archived DRMs, using advanced sequencing methods to better link DRMs to proviral genome integrity, are needed to accurately assess their impact and refine clinical practices.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245768","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":"Lower skeletal muscle density on CT imaging is associated with incomplete fatty acid oxidation, as measured by plasma acylcarnitines, in men with HIV.","authors":"John R Koethe, Michelle E Robles, Annaliese Widmer, Kate Lillegard, Run Fan, Qi Liu, Samuel Bailin, Heidi J Silver","doi":"10.1097/QAD.0000000000004258","DOIUrl":"10.1097/QAD.0000000000004258","url":null,"abstract":"<p><strong>Objective: </strong>The accumulation of excess lipids within skeletal muscle, which can progress to overt myosteatosis, is more common among persons with HIV (PWH) and contributes to the development of frailty, impaired mobility, and metabolic dysregulation. Excess free fatty acids (FFA) can impair muscle mitochondrial function, which is reflected in higher plasma levels of several acylcarnitines. We assessed the relationship between CT-determined skeletal muscle density and plasma acylcarnitines among male PWH on long-term antiretroviral therapy.</p><p><strong>Design: </strong>Cross-sectional analysis of two prospectively recruited clinical cohorts with harmonized study procedures and imaging.</p><p><strong>Methods: </strong>Linear regression models assessed the relationship of fasting plasma acylcarnitines measured by liquid chromatography/mass spectrometry and skeletal muscle density measured by CT, adjusted for study cohort, age, body mass index (BMI), CD4+ cell count, visceral adipose tissue area, total plasma triglycerides, and insulin resistance.</p><p><strong>Results: </strong>Among 160 male PWH (median age 54 years, median BMI 30.5 kg/m2, and 41% Black), higher plasma levels of short-chain acetylcarnitine (C2:0) and isobutyrylcarnitine (C4:0), the medium chain hexanoylcarnitine (C6:1), and the long chain myristoylcarnitine (C14:0) and palmitoylcarnitine (C16:0) were associated with skeletal muscle density, while others approached significance. None of the C3 and C5 acylcarnitines, largely the products of branched-chain amino acid metabolism, were associated with skeletal muscle density.</p><p><strong>Conclusions: </strong>CT measurements of skeletal muscle density in male PWH appear to identify impaired mitochondrial function as measured by FFA metabolites, which could serve as a biomarker for future intervention studies to mitigate skeletal muscle deterioration and metabolic dysregulation.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245766","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":"Hiv and herpes simplex virus 2 incidence among adolescent girls and young women who sell sex (YWSS) in rural south africa: a population-based cohort study.","authors":"Faith Magut, Lusanda Mazibuko, Nondumiso Mthiyane, Guy Harling, Kathy Baisley, Thembelihle Zuma, Jaco Dreyer, Nonhlanhla Okesola, Osee Behuhuma, Carina Herbst, Theresa Smit, Janet Seeley, Sian Floyd, Isolde Birdthistle, Frances Cowan, James R Hargreaves, Natsayi Chimbindi, Maryam Shahmanesh","doi":"10.1097/QAD.0000000000004255","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004255","url":null,"abstract":"<p><strong>Objective: </strong>We investigate the risk of acquiring HIV or HSV-2 among young women who sell sex (YWSS) in rural South Africa.</p><p><strong>Design: </strong>A representative population-based prospective cohort study of adolescent girls and young women (AGYW).</p><p><strong>Methods: </strong>Between 2017 and 2019 we interviewed a random sample of AGYW (13-30 years) annually and collected dried blood spot samples for HIV and HSV-2 serology. YWSS were defined as engaging in transactional sex and/or sex work in the past 12 months. We used Cox regression to estimate the association between selling sex and incident HIV or HSV-2 infections, using inverse probability weighting to adjust for potential confounding (age, education, rural/urban locality, socioeconomic status, food insecurity, and pregnancy status).</p><p><strong>Results: </strong>Among eligible AGYW (n = 3846), 89.2% provided responses for at least one follow-up time-point, of whom 17% reported selling sex in the past 12 months. HIV and HSV-2 prevalence at enrolment were 21% and 37.9% respectively and higher among YWSS at 42% and 69% respectively. HIV incidence was 3.4/100 person years(py) (95%CI: 2.6-4.2) higher among YWSS than others (8.2 vs 2.7/100py; Hazard Ratio [HR]: 2.70; 95%CI: 1.83-3.99). HSV-2 incidence was 18.4/100py (95%CI: 16.5-20.5), and was higher among YWSS than others (29.3 vs 17.2 100py; HR: 1.83; 95%CI 1.41-2.39). HSV-2 at baseline was associated with subsequent HIV infection (HR: 6.32; 95%CI 3.86-10.47, p<0.001).</p><p><strong>Conclusion: </strong>HIV and HSV-2 incidence was higher among AGYW selling sex compared those who did not sell sex. These findings highlight the need for PrEP and socio-economic support for this priority population of AGYW in rural settings.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245686","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":"Metabolic dysfunction-associated steatotic liver disease (MASLD) was associated with liver fibrosis in people living with HIV from Brazil.","authors":"Juliana Fittipaldi, Sandra W Cardoso, Estevão Portela Nunes, Cristiane Fonseca De Almeida, Patricia Dias De Brito, Valdilea G Veloso, Beatriz Grinsztejn, Hugo Perazzo","doi":"10.1097/QAD.0000000000004250","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004250","url":null,"abstract":"<p><strong>Objective: </strong>To describe the association of metabolic dysfunction-associated steatotic liver disease (MASLD) with clinically significant liver fibrosis (CSLF) in people with HIV from Rio de Janeiro (Brazil).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>We analyzed data from the baseline visit of the PROSPEC-HIV-study (NCT02542020). People living with HIV aged ≥ 18 years were submitted to clinical evaluation, questionnaires, blood sample and transient elastography (TE) at INI/FIOCRUZ from June/2015 to March/2019. Exclusion criteria were unreliable TE or missing data. Steatosis and liver fibrosis were assessed by Controlled Attenuation Parameter (CAP) and liver stiffness measurement (LSM) from TE, respectively. MASLD was determined by presence of steatosis (TE-CAP ≥ 263 dB/m) with at least one cardiometabolic-risk-factor (overweight/obesity, diabetes, hypertension or dyslipidemia) without hazard alcohol intake. CSLF was defined by TE-LSM ≥ 8.0 kPa. Multivariate logistic regression models were performed.</p><p><strong>Results: </strong>684 participants [47.8% male, median age= 45 (IQR,36-53) years, 12% with diabetes and 13% with viral hepatitis coinfection] were included. The prevalence [95%CI] of MASLD and CSLF were 19.3% [16.5-22.4] and 14.2% [11.8-17.0], respectively. In the multivariate analysis [OR (95%CI)], older age [1.52 (1.75-1.96)], MASLD [2.20 (1.25-3.87)], viral hepatitis [4.93 (2.72-8.94)], higher ALT levels [1.11 (1.04-1.18)] and CD4 count < 350 cells/mm3 [1.95 (1.07-3.53)] were significantly associated with presence of CSLF. MASLD remained independently associated with CSLF in people with HIV mono-infection (n = 595) [OR = 2.18 (95%CI,1.19-3.98)].</p><p><strong>Conclusion: </strong>MASLD increased the odds of CSLF in people with HIV independently of viral hepatitis. Strategies to screen MASLD in are of paramount importance to reduce the burden of liver disease in people with HIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245767","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":"Changes in multimorbidity burden and their impact on patient and healthcare outcomes in people with HIV over a 3-5-year period.","authors":"Luxsena Sukumaran, Alan Winston, Frank A Post, Jane Anderson, Marta Boffito, Memory Sachikonye, Patrick W G Mallon, Laura Waters, Jaime Vera, Fiona Burns, Caroline A Sabin","doi":"10.1097/QAD.0000000000004260","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004260","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing multimorbidity among people with HIV, its impact on health outcomes over time remains uncertain. We explored how distinct multimorbidity patterns affect a broad range of health outcomes over a 3-5-year period.</p><p><strong>Methods: </strong>Principal component analysis (PCA) was used to identify multimorbidity patterns at baseline. Burden z-scores were calculated for each individual/pattern at baseline and a follow-up visit, and the differences in scores over time were examined. Participants completed health assessments including questionnaires (physical/mental health (SF-36), depressive symptoms (CES-D and PHQ-9, falls, frailty and healthcare utilisation), cognitive testing and pain mannequins tests. Multivariable regression models assessed associations between changes in morbidity burden z-scores and health outcomes.</p><p><strong>Results: </strong>Six multimorbidity patterns were identified in 1073 participants: \"cardiovascular disease\" (CVD), \"sexually transmitted infections\" (STIs), \"metabolic\", \"mental/joint\", \"neurological\", and \"cancer/other\". Subsequent analyses included 793 participants (median [interquartile range; IQR] age 53 [47-59] years; 86% male; 97% on ART) with follow up data. CVD and metabolic burden were associated with specialist appointments (CVD: β = 1.47; metabolic: β = 1.53, p < 0.01) and ED visits (CVD: β = 1.44; metabolic: β = 1.89, p < 0.01), mental/Joint and neurological burden with poorer physical and mental health, frailty and recurrent falls (p < 0.01), and cancer/other burden with higher depressive scores (β = 3.28, p < 0.001), widespread pain (OR = 2.20, p < 0.001), and hospital visits (OR = 2.31, p < 0.001).</p><p><strong>Conclusion: </strong>Distinct morbidity patterns differentially affected health outcomes and healthcare utilisation over time, underscoring the need for targeted, integrated care to improve quality of life and address their complex needs.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245684","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}