AIDS最新文献

{"title":"Association between HIV and cytomegalovirus and neurocognitive outcomes among children with HIV.","authors":"Jillian Neary, Daisy Chebet, Sarah Benki-Nugent, Hellen Moraa, Barbra A Richardson, Irene Njuguna, Agnes Langat, Evelyn Ngugi, Dara A Lehman, Jennifer Slyker, Dalton Wamalwa, Grace John-Stewart","doi":"10.1097/QAD.0000000000004000","DOIUrl":"10.1097/QAD.0000000000004000","url":null,"abstract":"<p><strong>Objectives: </strong>Children with HIV may experience adverse neurocognitive outcomes despite antiretroviral therapy (ART). Cytomegalovirus (CMV) is common in children with HIV. Among children on ART, we examined the influences of early HIV viral load and CMV DNA on neurocognition.</p><p><strong>Design: </strong>We determined the association between pre-ART viral load, cumulative viral load, and CMV viremia and neurocognition using data from a cohort study.</p><p><strong>Methods: </strong>Children who initiated ART before 12 months of age were enrolled from 2007 to 2010 in Nairobi, Kenya. Blood was collected at enrollment and every 6 months thereafter. Four neurocognitive assessments with 12 domains were conducted when children were a median age of 7 years. Primary outcomes included cognitive ability, executive function, attention, and motor z scores. Generalized linear models were used to determine associations between HIV viral load (pre-ART and cumulative; N  = 38) and peak CMV DNA (by 24 months of age; N  = 20) and neurocognitive outcomes.</p><p><strong>Results: </strong>In adjusted models, higher peak CMV viremia by 24 months of age was associated with lower cognitive ability and motor z scores. Higher pre-ART HIV viral load was associated with lower executive function z scores. Among secondary outcomes, higher pre-ART viral load was associated with lower mean nonverbal and metacognition z scores.</p><p><strong>Conclusion: </strong>Higher pre-ART viral load and CMV DNA in infancy were associated with lower executive function, nonverbal and metacognition scores and cognitive ability and motor scores in childhood, respectively. These findings suggest long-term benefits of early HIV viral suppression and CMV control on neurocognition.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103432","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":"Distinct features of immune activation and exhaustion markers in people with perinatally acquired HIV.","authors":"Lucia Taramasso, Chiara Dentone, Isabella Cama, Daniela Fenoglio, Tiziana Altosole, Alessia Parodi, Cristina Campi, Michele Piana, Sara Mora, Mauro Giacomini, Laura Labate, Sara Garbarino, Bianca Bruzzone, Gilberto Filaci, Matteo Bassetti, Antonio Di Biagio","doi":"10.1097/QAD.0000000000004001","DOIUrl":"10.1097/QAD.0000000000004001","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to characterize T-cell activation, exhaustion, maturation and Treg frequencies in individuals who acquire perinatal HIV (PHIV), in individuals who acquired HIV as adult (AHIV), and in healthy controls.</p><p><strong>Design: </strong>This cross-sectional study included people with HIV at least 14 and younger than 40 years, HIV-RNA less than 50 copies/ml on antiretroviral therapy for at least 6 months, and HC.</p><p><strong>Methods: </strong>We assessed the expression of PD-1, TIM-3, EOMES, CD38 + DR+, maturation status by CD4 + and CD8 + T cells and the frequency of CD4 + and CD8 + Treg cells. Principal component analysis (PCA) and k-means cluster analysis investigated which combination of immunological parameters better associated with each group.</p><p><strong>Results: </strong>Twenty-six PHIV and 18 AHIV with median ages of 26 (8.0) and 28 (6.8) years were consecutively enrolled. PHIV showed significant higher frequency of naive and lower frequency of terminal effector memory CD4 + and CD8 + T cells than AHIV. AHIV exhibited higher expression of exhaustion and activation markers. The statistical analysis returned two clusters with 94% of specificity and 88% of sensitivity identifying PHIV vs. AHIV. The nine healthy controls had a lower expression of exhaustion markers on both CD4 + and CD8 + T lymphocytes than PHIV and AHIV.</p><p><strong>Conclusion: </strong>These data may exclude major alterations of lymphopoiesis in PHIV, with even lower state of immune-activation and exhaustion compared with AHIV. This suggests that recent lack of virological control, may affect immune activation and exhaustion of CD4 + and CD8 + T cells.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103433","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":"Binge eating correlates with weight excess in people with HIV.","authors":"Sepiso K Masenga, José I Bernardino","doi":"10.1097/QAD.0000000000003971","DOIUrl":"https://doi.org/10.1097/QAD.0000000000003971","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543090","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":"Markers of T-cell dysfunction and not inflammaging predict the waning of humoral responses to SARS-CoV-2 mRNA booster vaccination in people with HIV.","authors":"Matteo Augello, Valeria Bono, Roberta Rovito, Andrea Santoro, Camilla Tincati, Giulia Marchetti","doi":"10.1097/QAD.0000000000004010","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004010","url":null,"abstract":"<p><p>In this prospective longitudinal study, we evaluated the durability of humoral responses to SARS-CoV-2 mRNA booster vaccination in 93 people with HIV, exploring the possible role of T-cell dysfunction and inflammaging biomarkers in predicting antibody waning. We found that, despite a negligible influence of the inflammaging milieu, low CD4/CD8 ratio and CD4+CD127+ percentage as well as high CD8+CD38+CD45RO+ percentage are associated with faster antibody waning, in turn contributing to our understanding of the determinants of COVID-19 vaccine-elicited immune response in this population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543094","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 impact of diabetes mellitus on HIV virologic control: results of the MACS/WIHS combined cohort study.","authors":"Sarah C Mann, Weiqun Tong, Alison G Abraham, Frank Palella, Anjali Sharma, Phyllis C Tien, Margaret A Fischl, Samy I McFarlane, Cecile D Lahiri, Susan Koletar, Daniel Merenstein, Michelle Floris-Moore, Jordan E Lake, Elizabeth Daubert, Aubri Hickman, Todd T Brown, Jose Castillo-Mancilla","doi":"10.1097/QAD.0000000000003978","DOIUrl":"10.1097/QAD.0000000000003978","url":null,"abstract":"<p><strong>Objective: </strong>Diabetes mellitus (DM) is associated with lower antiretroviral (ART) drug exposure among persons with HIV (PWH) compared to PWH without DM. The association between DM and virologic control in PWH, however, remains unknown.</p><p><strong>Methods: </strong>We included participants in the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study (MWCCS) who had initiated ART between 1999 and 2020 and had a suppressed HIV viral load (≤200 copies/ml) within 1 year of ART initiation. We compared the frequency of incident HIV viremia (HIV-1 RNA >200 copies/ml) between adult PWH with and without DM. Poisson regression was used to examine the rate of incident viremia based on the diagnosis of DM among PWH. DM was defined as two consecutive fasting glucose measurements ≥126 mg/dl, use of antidiabetic medications, preexisting DM diagnosis, or a confirmed HbA1c >6.5%.</p><p><strong>Results: </strong>1061 women (112 with DM, 949 without DM) and 633 men (41 with DM, and 592 without DM) were included in the analysis. The relative rate (RR) of incident HIV viremia for women with HIV and DM was lower when compared to women without DM (0.85 [95% CI: 0.72-0.99]; P  = 0.04). The RR of incident viremia for women with uncontrolled DM (HbA1c > 7.5%) was higher when compared to women with controlled DM (HbA1c < 7.5%) (1.46 [95% CI: 1.03-2.07]; P  = 0.03). In contrast, the RR of incident viremia for men with HIV and DM was not statistically different compared to men without DM (1.2 [95% CI: 0.96-1.50]; P  = 0.12). The results were stratified by adherence levels (100%, 95-99%, and <95% based on self-report).</p><p><strong>Conclusions: </strong>Women with DM who are highly adherent to ART (100% self-reported adherence) have a lower risk of viremia compared to women with HIV without DM. However, women with poorly controlled DM were at higher risk of HIV viremia than women with controlled DM. Further research is necessary to understand the impact of sex, DM, and ART adherence on HIV viremia.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141722857","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":"Fetal, neonatal, and infant death among offspring of pregnant women with HIV in Tanzania.","authors":"Karim P Manji, Alfa Muhihi, Christopher P Duggan, Fadhlun M Alwy Al-Beity, Nandita Perumal, Nzovu Ulenga, Wafaie W Fawzi, Christopher R Sudfeld","doi":"10.1097/QAD.0000000000003985","DOIUrl":"10.1097/QAD.0000000000003985","url":null,"abstract":"<p><strong>Objective: </strong>Assess the risk of death for offspring of pregnant women with HIV (PWHIV) and the association with sociodemographic, pregnancy, HIV-related, and birth factors.</p><p><strong>Design: </strong>We conducted a prospective cohort study of PWHIV on antiretroviral therapy (ART) and their offspring in urban Tanzania who were enrolled in a vitamin D trial conducted from June 2015 to October 2019.</p><p><strong>Methods: </strong>We described rates of fetal, neonatal, and infant death and assessed risk factors for these outcomes with generalized estimating equations. We also estimated population-attributable risk percentages for the contribution of prematurity and small-for-gestational age (SGA) to neonatal and infant mortality.</p><p><strong>Results: </strong>Among 2299 PWHIV, there were a total of 136 fetal deaths (5.6%) and the stillbirth rate was 42.0 per 1000 total births. Among 2167 livebirths, there were 57 neonatal deaths (26.3 per 1000 livebirths) and 114 infant deaths (52.6 per 1000 livebirths). Twin birth was associated with neonatal death, while maternal CD4 + T-cell count <350 cells/μl in pregnancy was associated with infant death ( P -values < 0.05). As compared to term-appropriate-for-gestational age (AGA) births, the relative risks for neonatal mortality for term-SGA, preterm-AGA, and preterm-SGA infants were 2.07 [95% confidence interval (CI): 1.00-4.28], 2.87 (95% CI 1.54-5.35), and 7.15 (95% CI: 2.11-24.30), respectively. We estimated that 42.7% of neonatal and 29.4% of infant deaths were attributable to prematurity and SGA in the cohort.</p><p><strong>Conclusions: </strong>The risk of death is high for offspring of PWHIV in Tanzania and the combination of prematurity and fetal growth restriction may account for nearly half of neonatal deaths.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854527","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":"Twice-yearly lenacapavir may change the standard of HIV prevention for women.","authors":"Iulia Filip","doi":"10.1097/QAD.0000000000004013","DOIUrl":"10.1097/QAD.0000000000004013","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278970","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":"Higher non-HIV-comorbidity burden in long-term survivors.","authors":"Thom W Vonder, Tania Mudrikova","doi":"10.1097/QAD.0000000000004054","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004054","url":null,"abstract":"<p><strong>Objective: </strong>The possible differences in comorbidity burden were examined between people with longstanding HIV infection and those with shorter HIV duration of the same calendar age.</p><p><strong>Design: </strong>We performed a single-centre retrospective cohort analysis comparing long-term HIV survivors (LTS) diagnosed with HIV before 1996 (pre-HAART), with an age-matched and gender-matched group diagnosed after 2006 [modern ART era (mART)].</p><p><strong>Methods: </strong>Demographic and outcome data up to 1 May 2023 were obtained from electronic health records as well as from digitalized paper charts. Nine comorbidity domains were defined to overlook the comorbidity burden as on 1 May 2023: cardiovascular, musculoskeletal, neurological, oncological, liver, pulmonary, renal, psychiatric/cognitive, and metabolic.</p><p><strong>Results: </strong>Eighty-eight LTS and 88 people diagnosed in the modern ART era were included in the analysis. Median age in both groups was 60 years. LTS had a higher mean number of comorbidity domains than controls (2.6 vs. 1.9; P = .001). In both LTS and mART groups, metabolic and cardiovascular comorbidity was most prevalent (metabolic 70.5 and 52.3%, respectively, cardiovascular 44.3 and 38.6%, respectively). When stratified according to age, the distribution of the number of comorbidities for LTS roughly resembled the 10 years older mART subgroup. In a multivariate analysis, total ART duration and age were found to be statistically significantly associated with the number of comorbidity domains.</p><p><strong>Conclusion: </strong>Our analysis suggests that LTS have a higher comorbidity burden compared with people diagnosed in the modern ART era of similar calendar age.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589804","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":"Medical mistrust and vaccine-hesitant attitudes explain SARS-CoV-2 vaccination disparities in a mixed-serostatus cohort.","authors":"M Reuel Friedman, Gina Wingood, Kristen D Krause, Sarah Krier, Gypsyamber D'souza, Mirjam-Colette Kempf, Matthew J Mimiaga, Jenn Kwait, Deborah Jones, Jeremy Martinson, Ernesto T Marques, Phyllis Tien, Kathryn Anastos, Catalina Ramirez, Mardge Cohen, Marlene Camacho-Rivera, Lakshmi Goparaju, Charles R Rinaldo","doi":"10.1097/QAD.0000000000004053","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004053","url":null,"abstract":"<p><strong>Objectives: </strong>To understand the extent of racial disparities in SARS-CoV-2 vaccination among PWH and those vulnerable to HIV infection and to estimate the contributions of medical mistrust and vaccine-hesitant attitudes to these disparities.</p><p><strong>Design: </strong>Quantitative data analyses in a racially and gender diverse, mixed-serostatus prospective cohort, the MACS/WIHS Combined Cohort Study.</p><p><strong>Methods: </strong>Interviewer-assisted questionnaires assessed SARS-CoV-2 vaccination, medical mistrust, and vaccine-hesitant attitudes from March 2021-September 2022 (n=3948). Longitudinal analyses assessed effects of sociodemographics on medical mistrust and vaccine-hesitant attitudes. A hierarchical multivariable logistic regression assessed effects of these co-factors on SARS-CoV-2 vaccination. Causal mediation models assessed whether a) medical mistrust mediated the relationship between Black identity and vaccine-hesitant attitudes, and b) vaccine-hesitant attitudes mediated the relationship between Black identity and SARS-CoV-2 non-vaccination.</p><p><strong>Results: </strong>Participants' mean age was 56.7; 55.3% were Black, 52.6% cisgender female, 62.6% PWH. 10.1% reported never receiving SARS-CoV-2 vaccinations (13.4% of Black and 4.5% of white participants). Black-identified participants had higher odds of non-vaccination than white participants (aOR = 1.72; 95% CI: 1.08, 2.72). Medical mistrust mediated the relationship between Black identity and vaccine-hesitant attitudes, accounting for 46.0% of the effect (p < 0.0001). Vaccine-hesitant attitudes mediated the relationship between Black identity and SARS-CoV-2 non-vaccination to the extent that 57.7% (95% CI: 25.3%, 90.1%) of the disparity would be eliminated if vaccine-hesitant attitudes among Black respondents were reduced to levels reported among other racial groups.</p><p><strong>Conclusions: </strong>Findings indicate a profound need to build trustworthy healthcare environments to combat medical mistrust and vaccine-hesitant attitudes in Black communities in the U.S, including those affected by HIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575029","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 HIV seroconversion in Botswana: machine learning analysis in a representative, population-based HIV incidence cohort.","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":"https://doi.org/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 8,551 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, non-long-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>Conclusions: </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":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}