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Epidemiological, clinical and mortality trends in people with HIV over 60 years in the PISCIS population-based cohort from Catalonia and Balearic Islands.
IF 3.4 2区 医学
AIDS Pub Date : 2025-01-01 Epub Date: 2024-09-19 DOI: 10.1097/QAD.0000000000004018
Andreu Bruguera, Daniel K Nomah, Sergio Moreno-Fornés, Esteban Martinez, Eugènia Negredo, Juan Tiraboschi, Jordi Navarro, Pere Domingo, Francisco Fanjul, Aroa Villoslada, Joaquim Peraire, Angeles Jaen, José M Miró, Jordi Casabona, Juliana Reyes-Urueña
{"title":"Epidemiological, clinical and mortality trends in people with HIV over 60 years in the PISCIS population-based cohort from Catalonia and Balearic Islands.","authors":"Andreu Bruguera, Daniel K Nomah, Sergio Moreno-Fornés, Esteban Martinez, Eugènia Negredo, Juan Tiraboschi, Jordi Navarro, Pere Domingo, Francisco Fanjul, Aroa Villoslada, Joaquim Peraire, Angeles Jaen, José M Miró, Jordi Casabona, Juliana Reyes-Urueña","doi":"10.1097/QAD.0000000000004018","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004018","url":null,"abstract":"<p><strong>Objective: </strong>With HIV now a chronic condition and an aging population, understanding the evolving profiles of older people with HIV (PWH) is crucial. In this longitudinal study, we examined changes in epidemiological and mortality trends among aging PWH aged 60 and above from 1998 to 2021.</p><p><strong>Design: </strong>The study constructed four retrospective cohorts based on our calendar periods, reflecting the changing epidemiology of HIV - 1998-2003, 2004-2008, 2009-2014, and 2015-2021. Each calendar period included patients on follow-up that turned 60 during that period in PISCIS, the Populational HIV Cohort from Catalonia and Balearic Islands.</p><p><strong>Methods: </strong>Sociodemographic and clinical characteristics were analyzed and compared between periods, and 5-year mortality-associated factors were assessed.</p><p><strong>Results: </strong>Results indicate the proportion of those infected through intravenous drug use in older PWH has increased (4.7% in 1998-2003 vs. 24.7% in 2015-2021), as well as those born outside Spain (7.5% vs. 21.8%), alongside a lesser percentage of late HIV diagnoses (59.9% vs. 46.8%), reflecting a change in older PWH epidemiological profile. The presence of ≥3 comorbidities emerged as a significant predictor of 5-year mortality in the latest cohort, while CD4+ cell count of <200 cells/μl at the age of 60 lost significance [1998-2008: hazard ratio (HR): 3.19 (confidence interval, CI: 1.18-8.63) - 2015-2021: HR:1.38 (CI: 0.74-2.59)], underscoring the transition to the chronic disease era of the HIV pandemic.</p><p><strong>Conclusion: </strong>Despite advanced treatment strategies have improved HIV health indicators, new challenges have emerged among the older PWH. Tailored interventions addressing the unique difficulties faced by this population are essential to optimize HIV care outcomes.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 1","pages":"64-74"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Markers of extracellular matrix degradation and inflammasome activation are associated with carotid plaques in virally suppressed people with HIV in Botswana. 在博茨瓦纳,细胞外基质降解和炎症小体激活标志物与病毒抑制的艾滋病病毒感染者颈动脉斑块有关。
IF 3.4 2区 医学
AIDS Pub Date : 2025-01-01 Epub Date: 2024-09-13 DOI: 10.1097/QAD.0000000000004014
Thor Ueland, Isaac Nkele, Hedda Hoel, Shahin Lockman, Annika E Michelsen, Thato Moshomo, Pål Aukrust, Terence Mohammed, Marius Trøseid, Mosepele Mosepele
{"title":"Markers of extracellular matrix degradation and inflammasome activation are associated with carotid plaques in virally suppressed people with HIV in Botswana.","authors":"Thor Ueland, Isaac Nkele, Hedda Hoel, Shahin Lockman, Annika E Michelsen, Thato Moshomo, Pål Aukrust, Terence Mohammed, Marius Trøseid, Mosepele Mosepele","doi":"10.1097/QAD.0000000000004014","DOIUrl":"10.1097/QAD.0000000000004014","url":null,"abstract":"<p><strong>Background: </strong>HIV is associated with increased risk of cardiovascular disease. We investigated soluble markers of extracellular matrix (ECM) remodeling and inflammation in relation to presence of carotid plaques in a well characterized adult cross-sectional study of people with HIV (PWH) and matched people without HIV in Botswana.</p><p><strong>Methods: </strong>Using enzyme immunoassays we analyzed plasma ECM remodeling mediators including galectin-3 (GAL-3), cystatin B (CysB), and growth/differentiation factor 15 (GDF-15) and the inflammatory marker interleukin (IL)-18 in 196 without HIV and 197 PWH of which 36 were ART-naïve.</p><p><strong>Results: </strong>We found (i) PWH had higher plasma levels of the ECM markers GAL-3 and CysB and the NLRP3 inflammasome activation marker IL-18, mainly in ART naïve participants, (ii) PWH on ART had markedly higher GDF-15, associated with use of first generation nucleoside analogs; iii) high levels of CysB and IL-18 correlated with presence of carotid plaques.</p><p><strong>Conclusion: </strong>In PWH, high levels of CysB and IL-18 were associated with the presence of carotid plaques. For IL-18, this was observed in the study population as a whole, whereas the association for CysB was restricted to PWH.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"22-30"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increased risk of hospitalization among children who were HIV-exposed and uninfected compared to population controls. 与人群对照组相比,接触过艾滋病毒和未感染过艾滋病毒的儿童住院风险增加。
IF 3.4 2区 医学
AIDS Pub Date : 2025-01-01 Epub Date: 2024-09-26 DOI: 10.1097/QAD.0000000000004025
Jeanne Brochon, Thierry Ducruet, Suzanne Taillefer, Valérie Lamarre, Christian Renaud, Marie-Elaine Metras, Christos Karatzios, Joseph H Puyat, Joel Singer, Silvie Valois, Hugo Soudeyns, Isabelle Boucoiran, Fatima Kakkar
{"title":"Increased risk of hospitalization among children who were HIV-exposed and uninfected compared to population controls.","authors":"Jeanne Brochon, Thierry Ducruet, Suzanne Taillefer, Valérie Lamarre, Christian Renaud, Marie-Elaine Metras, Christos Karatzios, Joseph H Puyat, Joel Singer, Silvie Valois, Hugo Soudeyns, Isabelle Boucoiran, Fatima Kakkar","doi":"10.1097/QAD.0000000000004025","DOIUrl":"10.1097/QAD.0000000000004025","url":null,"abstract":"<p><strong>Objectives: </strong>While studies have demonstrated increased morbidity and mortality risk in infancy among children who are HIV-exposed and uninfected (CHEU), longitudinal data are limited. The objective of this study was to assess long-term risk of hospitalization among CHEU compared to children who are HIV-unexposed and uninfected (CHUU), and determine risk factors for hospitalization among CHEU.</p><p><strong>Design: </strong>A longitudinal cohort study (1988-2015) linking the Centre maternel et infantile sur le SIDA cohort (Montreal, Quebec) to administrative data from the Régie de l'assurance maladie du Québec (RAMQ), a universal health insurance provider in the province of Quebec.</p><p><strong>Methods: </strong>CHEU from the CMIS cohort were matched 1 : 3 by age, sex, and postal code with CHUU controls from the RAMQ database. Incidence and causes of hospitalization between CHEU and CHUU were compared using Poisson regression.</p><p><strong>Results: </strong>Seven hundred twenty-six CHEU were matched to 2178 CHUU. Risk of first hospitalization was significantly higher among CHEU at 1 year (incidence rate ratio [IRR] 2.22 [1.86-2.66]), 5 years (IRR 1.62 [1.39-1.90]), and over the lifespan (IRR 1.55 [1.33-1.81]). Among CHEU, significant risk factors for hospitalization on univariate regression analysis included birth year before 2005, prematurity, small for gestational age (SGA), detectable maternal viral load (dVL) at delivery, and maternal hepatitis C co-infection. In the adjusted analysis, small for gestational age and dVL remained significant risk factors.</p><p><strong>Conclusion: </strong>CHEU had a higher rate of hospitalization than CHUU controls across their lifespan. Significant risk factors included SGA and detectable maternal dVL, suggesting a need for enhanced pediatric care for these children.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"40-48"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Low food security is associated with frailty status and frailty components among people with HIV. 食物保障不足与艾滋病毒感染者的虚弱状况和虚弱成分有关。
IF 3.4 2区 医学
AIDS Pub Date : 2025-01-01 Epub Date: 2024-09-03 DOI: 10.1097/QAD.0000000000004006
Stephanie A Ruderman, Amanda L Willig, John D Cleveland, Greer Burkholder, Christine Horvat Davey, Julia Fleming, Barbara Gripshover, Mari Katundu, Thomas W Buford, Raymond Jones, Michael S Saag, Joseph A C Delaney, Heidi M Crane, Allison R Webel
{"title":"Low food security is associated with frailty status and frailty components among people with HIV.","authors":"Stephanie A Ruderman, Amanda L Willig, John D Cleveland, Greer Burkholder, Christine Horvat Davey, Julia Fleming, Barbara Gripshover, Mari Katundu, Thomas W Buford, Raymond Jones, Michael S Saag, Joseph A C Delaney, Heidi M Crane, Allison R Webel","doi":"10.1097/QAD.0000000000004006","DOIUrl":"10.1097/QAD.0000000000004006","url":null,"abstract":"<p><strong>Background: </strong>Low food security is common among people with HIV (PWH) and is associated with poorer health outcomes. Frailty, an aging-related outcome that is increasingly prevalent among PWH, may be stimulated by low food security. We assessed associations between food security and frailty among PWH.</p><p><strong>Methods: </strong>The Impact of Physical Activity Routines and Dietary Intake on the Longitudinal Symptom Experience of People Living with HIV (PROSPER-HIV) study follows PWH to evaluate how diet and physical activity impact symptoms. We utilized food security and frailty data from PROSPER-HIV Year 1 visits (January 2019 to July 2022) to estimate associations. Food security was measured via the validated two-item Food Security Questionnaire and categorized as Food Secure, Low Food Security, or Very Low Food Security. Frailty was measured with the Fried frailty phenotype, and categorized as robust, prefrail, and frail. We used relative risk regression to estimate associations between food security and frailty status, adjusted for demographic characteristics.</p><p><strong>Results: </strong>Among 574 PWH, nearly one-quarter were women (22%), mean age was 52 years old, 8% were frail, and 46% prefrail. Low food security was reported among nearly one-third of PWH: 13% Low Food Security and 18% Very Low Food Security. Compared with being Food Secure, we found Low Food Security was associated with frailty [prevalence ratio: 4.06 (95% confidence interval (CI) 2.16-7.62] and Very Low Food Security was associated with both prefrailty [1.48 (1.23-1.78)] and frailty [5.61 (3.14-10.0)], as compared with robust status.</p><p><strong>Conclusion: </strong>Low food security was associated with increased frailty among PWH in this study, suggesting a potential intervention point to promote healthy aging.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"57-63"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cumulative HIV viral load and lower CD4 cell count are associated with incident venous thromboembolism in people with HIV.
IF 3.4 2区 医学
AIDS Pub Date : 2024-12-18 DOI: 10.1097/QAD.0000000000004095
Stephanie A Ruderman, Robin M Nance, Heidi M Crane, Edward Cachay, Mari M Kitahata, Sonia Napravnik, Bridget M Whitney, Susan R Heckbert, Engi F Attia, Chris T Longenecker, Alexander P Hoffmann, Matthew J Budoff, Jimmy Ma, Katerina Christopoulos, Peter W Hunt, Richard D Moore, Jeanne C Keruly, Greer Burkholder, Laura Bamford, Amanda L Willig, Geetanjali Chander, Michael S Saag, Lydia N Drumright, Matthew J Feinstein, Kristina Crothers, Joseph Ac Delaney
{"title":"Cumulative HIV viral load and lower CD4 cell count are associated with incident venous thromboembolism in people with HIV.","authors":"Stephanie A Ruderman, Robin M Nance, Heidi M Crane, Edward Cachay, Mari M Kitahata, Sonia Napravnik, Bridget M Whitney, Susan R Heckbert, Engi F Attia, Chris T Longenecker, Alexander P Hoffmann, Matthew J Budoff, Jimmy Ma, Katerina Christopoulos, Peter W Hunt, Richard D Moore, Jeanne C Keruly, Greer Burkholder, Laura Bamford, Amanda L Willig, Geetanjali Chander, Michael S Saag, Lydia N Drumright, Matthew J Feinstein, Kristina Crothers, Joseph Ac Delaney","doi":"10.1097/QAD.0000000000004095","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004095","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) have benefited greatly from antiretroviral therapy, but face additional challenges from age-related comorbid conditions, particularly cardiovascular disease including venous thromboembolism (VTE). Little is known about the effect of HIV viremia and immunodeficiency on VTE risk in this population.</p><p><strong>Methods: </strong>We assessed incident, centrally adjudicated VTE among 21,507 PWH in care between 1/2009-12/2019 within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. We examined the association of three measures of HIV viral load (VL: baseline, current, cumulative) and current CD4 count with VTE. Cumulative VL (copy-days of viremia) was estimated with a time-weighted sum using the trapezoidal rule. We modeled the association between VL and VTE using Cox proportional hazards models (marginal structural Cox models for cumulative), adjusted for demographic and clinical characteristics. We compared the 75th percentile of the VL distribution with the 25th percentile using the hazard function from the model for all PWH with a VTE and those with a pulmonary embolism (PE).</p><p><strong>Results: </strong>During a median of 4.8 years of follow-up, 424 PWH developed VTE. In adjusted analyses, higher cumulative VL (75th percentile vs. 25th percentile), the strongest VL predictor, was associated with a 1.45-fold higher risk of VTE (95%CI:1.22-1.72). Low CD4 cell count <100 cells/mm3 was associated with higher VTE risk (HR: 4.03, 95%CI: 2.76-5.89) as compared to ≥500 cells/mm3. Findings were similar for PWH who had a pulmonary embolism (n = 189).</p><p><strong>Conclusions: </strong>Reducing HIV VL and maintaining CD4 cell count may help mitigate VTE risk in PWH.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hemophagocytic lymphohistiocytosis in HIV-associated HHV8-positive multicentric castleman disease.
IF 3.4 2区 医学
AIDS Pub Date : 2024-12-17 DOI: 10.1097/QAD.0000000000004094
Pascal Migaud, Alessia Dalla Pria, Kai Hosmann, Peter Kellerher, Claudia Anna Maria Fulgenzi, Hartmut Stocker, Mark Bower
{"title":"Hemophagocytic lymphohistiocytosis in HIV-associated HHV8-positive multicentric castleman disease.","authors":"Pascal Migaud, Alessia Dalla Pria, Kai Hosmann, Peter Kellerher, Claudia Anna Maria Fulgenzi, Hartmut Stocker, Mark Bower","doi":"10.1097/QAD.0000000000004094","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004094","url":null,"abstract":"<p><strong>Objective: </strong>The clinical and laboratory characteristics of HHV8-associated Multicentric Castleman Disease (MCD) in people living with HIV (PLWH) overlap with those of Hemophagocytic Lymphohistiocytosis (HLH) disease and indeed the two diagnoses may co-exist. A risk-stratified treatment approach to MCD based on Rituximab immunotherapy for mild cases and chemo-immunotherapy for severe cases has been shown to yield excellent outcomes in PLWH. In contrast, HLH disease, previously known as secondary HLH, has a dismal prognosis even when promptly treated according to guidelines.</p><p><strong>Design: </strong>A retrospective multicentre cohort study.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively collected clinical and pathological data on patients with biopsy proven HIV-associated MCD at the National Centre for HIV Malignancy at Chelsea and Westminster Hospital, London between 2008 and 2024 and at the Department of Infectious Diseases at St. Joseph Hospital Berlin-Tempelhof, Germany between 2020 and 2024.</p><p><strong>Results: </strong>In our UK-German cohort including 113 PWLH with MCD, we confirmed that HLH disease secondary to MCD is common (30%) and we demonstrated that HLH disease in this context does not adversely influence survival or risk of MCD relapse.</p><p><strong>Conclusion: </strong>We suggest that a high HScore in MCD should not lead to a change in the treatment in this specific setting.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between CD4 count, CD4/CD8 ratio, and fragility fractures in people living with HIV: a retrospective cohort study in China.
IF 3.4 2区 医学
AIDS Pub Date : 2024-12-17 DOI: 10.1097/QAD.0000000000004091
Bo Liu, Qiang Zhang
{"title":"Association between CD4 count, CD4/CD8 ratio, and fragility fractures in people living with HIV: a retrospective cohort study in China.","authors":"Bo Liu, Qiang Zhang","doi":"10.1097/QAD.0000000000004091","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004091","url":null,"abstract":"<p><strong>Background: </strong>People living with HIV (PLHIV) often exhibit reduced CD4+ T cell counts and altered CD4/CD8 ratios, but their impact on fragility fractures remains underexplored. This study investigated the association between CD4 count, CD4/CD8 ratio, and fragility fractures in PLHIV in China.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on PLHIV treated at Beijing Ditan Hospital from January 2011 to September 2023. Data on demographics, clinical status, and bone mineral density were collected. Fragility fractures were identified through medical records. Multivariate Cox regression was used to assess the relationship between CD4 count, CD4/CD8 ratio, and fracture risk, with restricted cubic splines (RCS) applied to explore potential nonlinear associations. Subgroup analyses evaluated the consistency of these findings.</p><p><strong>Results: </strong>The study included 1,107 participants (median age 37 years, 92.6% male). The median CD4 count was 547 cells/μL, and the median CD4/CD8 ratio was 0.7. Fragility fractures occurred in 185 participants (16.7%). Lower CD4 counts (<200 cells/μL) were associated with a higher risk of fractures (aHR = 2.78; 95% CI: 1.66-4.65; p < 0.001), as were lower CD4/CD8 ratios (<0.5) (aHR = 3.43; 95% CI: 2.16-5.44; p < 0.001). RCS indicated a curvilinear association, with increased fracture risk at CD4/CD8 ratios below 1.16. Subgroup analyses confirmed the stability of these associations.</p><p><strong>Conclusion: </strong>Lower CD4 counts and CD4/CD8 ratios are linked to an increased risk of fragility fractures in PLHIV, underscoring the importance of immune function in bone health.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of tenofovir-based PrEP among pregnant women in South Africa.
IF 3.4 2区 医学
AIDS Pub Date : 2024-12-17 DOI: 10.1097/QAD.0000000000004090
Lynn T Matthews, Katia J Bruxvoort, Manjeetha Jaggernath, Yolandie Kriel, Patricia M Smith, Jessica E Haberer, John Bassler, Kara Bennett, Christina Psaros, David R Bangsberg, Kathleen Wirth Hurwitz, Jennifer A Smit
{"title":"Use of tenofovir-based PrEP among pregnant women in South Africa.","authors":"Lynn T Matthews, Katia J Bruxvoort, Manjeetha Jaggernath, Yolandie Kriel, Patricia M Smith, Jessica E Haberer, John Bassler, Kara Bennett, Christina Psaros, David R Bangsberg, Kathleen Wirth Hurwitz, Jennifer A Smit","doi":"10.1097/QAD.0000000000004090","DOIUrl":"10.1097/QAD.0000000000004090","url":null,"abstract":"<p><strong>Objective: </strong>We developed Healthy Families-PrEP to support perinatal women to use HIV prevention strategies.</p><p><strong>Design: </strong>Single arm study to evaluate PrEP use among pregnant women exposed to the intervention.</p><p><strong>Methods: </strong>We offered safer conception counselling including TDF/FTC as PrEP with adherence support (Healthy Families-PrEP) for women planning for pregnancy in South Africa with a partner with HIV or unknown serostatus. Women completed pregnancy and HIV testing quarterly and were followed for one year or until pregnancy end. For those initiating PrEP, electronic pillcap data and plasma were collected. We described PrEP adherence by proportion of days with pillcap openings and proportion of women with detected (≥10ng/mL) plasma tenofovir.</p><p><strong>Results: </strong>From November 2017 to January 2020, 326 women with median age 24 (IQR: 22-27) years enrolled. Partner HIV-serostatus was unknown by 316 (97%). Over 3,204 person-months of follow-up, 56 women became pregnant. Twenty-six women used PrEP during pregnancy and opened pillcaps on a mean of 53.1% (95% CI 46.9-59.3%) of days. Plasma tenofovir was detected among 25.0%, 15.4%, and 12.5% of women providing samples during months 0-3, 4-6, and 7-9. No HIV seroconversions were observed.</p><p><strong>Conclusions: </strong>We observed low pregnancy incidence. Counselling may have encouraged delayed pregnancy plans; some women may have exaggerated pregnancy plans to enroll. About half of pregnant women used PrEP and took over half of doses by pillcap. Fewer than 25% had tenofovir detected, likely reflecting pregnancy-related pharmacokinetics and adherence challenges. High interest in pregnancy PrEP use highlights the need to optimize adherence support and prevention choice.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A randomized trial for combination nicotine replacement therapy for smoking cessation among people with HIV in a low-resourced setting.
IF 3.4 2区 医学
AIDS Pub Date : 2024-12-17 DOI: 10.1097/QAD.0000000000004093
Jessica L Elf, Limakatso Lebina, Katlego Motlhaoleng, Sandy Chon, Raymond Niaura, David Abrams, Ebrahim Variava, Nikhil Gupte, Neil Martinson, Jonathan E Golub
{"title":"A randomized trial for combination nicotine replacement therapy for smoking cessation among people with HIV in a low-resourced setting.","authors":"Jessica L Elf, Limakatso Lebina, Katlego Motlhaoleng, Sandy Chon, Raymond Niaura, David Abrams, Ebrahim Variava, Nikhil Gupte, Neil Martinson, Jonathan E Golub","doi":"10.1097/QAD.0000000000004093","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004093","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the efficacy of combination nicotine replacement therapy (c-NRT) for smoking cessation among people with HIV (PWH) in South Africa.</p><p><strong>Design: </strong>We conducted an open label, individually randomized clinical trial.</p><p><strong>Methods: </strong>Using a two-armed approach, PWH who smoke were randomized to receive either 1) intensive anti-smoking behavioral counseling (BC) or 2) intensive anti-smoking BC plus c-NRT (nicotine patches augmented by nicotine gum). Self-reported smoking abstinence was biochemically validated with exhaled breath carbon monoxide (CO) and urine cotinine at six months. Recruitment, provision of trial interventions, and follow-up of participants took place March 2014 through June 2016.</p><p><strong>Results: </strong>We randomly assigned 280 participants to the BC arm and 281 participants to the BC + c-NRT arm. 438 (78%) participants were male and 123 (22%) were female. For our primary outcome of biochemically verified abstinence at six months, 41 (15%) were quit in the BC + c-NRT arm versus 28 (10%) in the BC arm, resulting in a 5% (95% CI -1%, 10%) absolute difference in relative risk and an adjusted odd ratio of 1.47 (95% CI: 0.86, 2.52) comparing the BC + c-NRT to the BC arm.</p><p><strong>Conclusions: </strong>Although our results did not reach statistical significance, we found augmentation of BC with c-NRT to increase smoking abstinence at six months, which is consistent with performance in the general population. PWH in low-resource settings may benefit from the addition of c-NRT to existing tobacco cessation interventions.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differential systemic immune-inflammation index levels in people with and without HIV infection. 艾滋病毒感染者和非艾滋病毒感染者的全身免疫炎症指数水平差异。
IF 3.4 2区 医学
AIDS Pub Date : 2024-12-13 DOI: 10.1097/QAD.0000000000004088
Crystal Wang, Scott L Letendre, Suzi Hong, Mohammad Andalibi, Jennifer Iudicello, Ronald J Ellis
{"title":"Differential systemic immune-inflammation index levels in people with and without HIV infection.","authors":"Crystal Wang, Scott L Letendre, Suzi Hong, Mohammad Andalibi, Jennifer Iudicello, Ronald J Ellis","doi":"10.1097/QAD.0000000000004088","DOIUrl":"https://doi.org/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 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 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 (ps < 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":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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