AIDS最新文献

{"title":"Safety of semaglutide on depressive symptoms among people with HIV in routine clinical care.","authors":"Lara Haidar, Stephanie A Ruderman, Christine Leong, Malcolm B Doupe, Catherine Lesko, Joseph A C Delaney, Diana Alba, Lydia N Drumright, Anthony T Fojo, Rob J Fredericksen, Andrew Hahn, Sonya L Heath, Y Joseph Hwang, Maile Karris, Mari M Kitahata, Ryan P Kyle, Kenneth H Mayer, Sonia Napravnik, April C Pettit, Allan Rodriguez, Michael S Saag, Bridget M Whitney, George Yendewa, Heidi M Crane, Sherif Eltonsy","doi":"10.1097/QAD.0000000000004598","DOIUrl":"10.1097/QAD.0000000000004598","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide, widely used for diabetes and obesity, has raised concerns about neuropsychiatric risks, including depression and suicidality. Given the high burden of depression among people with HIV (PWH), we assessed whether semaglutide initiation worsens depressive symptoms.</p><p><strong>Methods: </strong>We conducted a within-person pre-post study of PWH initiating semaglutide at nine Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites between April 2018 and October 2024. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) collected during routine care before and after semaglutide initiation. We estimated changes in PHQ-9 scores after semaglutide initiation using linear mixed models, overall and stratified by baseline depression severity (0-4 no/minimal, 5-9 mild, 10-14 moderate, and ≥15 moderately-severe to severe), body mass index (BMI), diabetes, and antidepressant use.</p><p><strong>Results: </strong>Among 354 PWH (mean age 54; 77% male; 38% non-Hispanic White; 78% obesity; 60% diabetes), baseline PHQ-9 scores were 0-4 in 53%, 5-9 in 28%, 10-14 in 10%, and ≥15 in 9%. Semaglutide was not associated with overall changes in depressive symptoms (ΔPHQ-9 -0.1 [95% confidence interval (CI) -0.7, 0.5]). Scores increased slightly in those with no/minimal baseline depression (+1.2 [95% CI 0.5, 1.8]), were stable in mild/moderate depression, and decreased in moderately-severe to severe depression (-4.7 [95% CI -7.3, -2.2]). No worsening was observed across BMI, diabetes, or antidepressant subgroups.</p><p><strong>Conclusion: </strong>Semaglutide initiation was not associated with worsening depressive symptoms among PWH in care. While individual responses may vary, these findings add to evidence on semaglutide safety regarding mood in a high-risk population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1651-1660"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676813","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":"Cardiovascular risk prediction in people with HIV: looking beyond low-density lipoprotein cholesterol.","authors":"Iulia Filip","doi":"10.1097/QAD.0000000000004612","DOIUrl":"10.1097/QAD.0000000000004612","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"N9-N10"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872615","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":"Persistent injection-site nodules visible on cross-sectional imaging: clinical experience with injectable lenacapavir and review of the literature.","authors":"Stephen P Connolly, Alan Winston, Borja Mora Peris, Siraj Yusuf, Marta Boffito, Margherita Bracchi","doi":"10.1097/QAD.0000000000004590","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004590","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"40 11","pages":"1777-1779"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102540","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":"Real-life durability and virological outcomes of doravirine in people with multidrug-resistant HIV.","authors":"Tommaso Clemente, Nicolò Capra, Vincenzo Malagnino, Riccardo Lolatto, Sergio Lo Caputo, Laura Comi, Andrea Giacomelli, Giovanni Cenderello, Manuela Colafigli, Stefano Rusconi, Maurizio Zazzi, Antonella Castagna","doi":"10.1097/QAD.0000000000004574","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004574","url":null,"abstract":"<p><p>Outcomes of doravirine in heavily treatment-experienced people with HIV (PWH) remain poorly defined, despite in vitro activity against multiple resistance patterns. In this multicenter cohort of 4-class drug-resistant PWH, we evaluated durability and outcomes of doravirine-containing regimens. Among 52 individuals, doravirine was maintained in 63.5% over a median of 2.4 years. Viral load <50 copies/ml was achieved in 58.6% of viremic initiators, but maintained in 82.6% of nonviremics. Findings support genotype-informed doravirine use within complex regimens, particularly for switching in nonviremics.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"40 11","pages":"1769-1773"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102683","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":"Can low-burden HIV pre-exposure prophylaxis become affordable in low- and middle-income countries?","authors":"Iulia Filip","doi":"10.1097/QAD.0000000000004626","DOIUrl":"10.1097/QAD.0000000000004626","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"N11-N13"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001044","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":"Female sex is associated with continuous decline in intact HIV-1 proviruses during long-term antiretroviral therapy.","authors":"Yijia Li, Nadia R Roan, Tom Medvec, Sharon Riddler, Gregory Laird, Albine Martin, Stephen Gange, John W Mellors, Charles R Rinaldo, Phyllis C Tien, Bernard J C Macatangay","doi":"10.1097/QAD.0000000000004632","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004632","url":null,"abstract":"<p><strong>Background: </strong>Understanding the factors associated with long-term intact HIV-1 proviral dynamics during suppressive ART is critical for developing HIV-1 cure strategies. In this study, we sought to evaluate the association between sex assigned at birth and HIV-1 reservoir dynamics in people with HIV (PWH) on long-term suppressive ART.</p><p><strong>Methods: </strong>Adult participants (17 men; 18 women) of the MACS/WIHS Combined Cohort Study with ≥10 years of suppressive ART and samples collected at 4-5-year intervals were included. We used the intact proviral DNA assay (IPDA) to measure intact and defective HIV-1 proviruses. Soluble inflammatory markers and, in women only, sex hormones were measured. Correlation was evaluated using Spearman's rank correlation test.</p><p><strong>Results: </strong>Among the 35 PWH, median follow-up was 12  years; 16 demonstrated continuous decreases in intact proviruses, while 19 had non-decrease patterns. Female sex and age at viral suppression were associated with a higher proportion of continuous intact HIV-1 DNA decreases, while age at ART initiation and nadir CD4+ cell count were not. By contrast, decrease in total and defective proviruses were not significantly different between the sexes. Higher estradiol levels in female PWH negatively correlated with interleukin 6 (IL-6, rho = -0.53, P = 0.001), and IL-6 negatively correlated with intact proviruses (rho = -0.38, P = 0.01). In male PWH, D-dimer rather than IL-6 negatively associated with intact proviruses (rho = -0.34, P = 0.02). These soluble markers and hormones were not associated with reservoir decay patterns.</p><p><strong>Conclusions: </strong>Among PWH with decade-long suppressive ART, less than half had sustained decline in intact proviral DNA. Female PWH more often exhibited continuous decline in intact HIV-1 DNA.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134719","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 plasma kynurenine-tryptophan ratio predicts incident hepatic fibrosis in women with HIV.","authors":"Maria J Duarte, Phyllis C Tien, Yifei Ma, Audrey L French, Seble G Kassaye, Deborah Gustafson, Robert Burk, Steven Wolinsky, Mallory D Witt, Yue Chen, Chloe L Thio, Svenja Albrecht, Margaret A Fischl, Cecile Delille Lahiri, Michelle Floris-Moore, Eric Seaberg, Jennifer C Price","doi":"10.1097/QAD.0000000000004633","DOIUrl":"10.1097/QAD.0000000000004633","url":null,"abstract":"<p><strong>Objective: </strong>Chronic immune activation and microbial translocation may contribute to hepatic fibrosis in people with HIV. We evaluated whether plasma kynurenine-to-tryptophan (KT) ratio and other biomarkers of microbial translocation predict incident fibrosis in women with HIV.</p><p><strong>Design: </strong>Longitudinal cohort study of 709 women with HIV from the Women's Interagency HIV Study with baseline plasma biomarkers and serial vibration-controlled transient elastography. Participants with baseline fibrosis or viral hepatitis were excluded. Outcomes included incident fibrosis, steatotic liver disease (SLD)-associated fibrosis, non-SLD fibrosis, and advanced fibrosis.</p><p><strong>Methods: </strong>Poisson regression with robust standard errors clustered by participant was used to estimate incidence rate ratios (IRRs) for liver outcomes by log-transformed KT ratio, adjusted for demographic, metabolic, and HIV-related covariates. Models included an offset for follow-up time. Analyses were repeated for sCD163, sCD14, and I-FABP.</p><p><strong>Results: </strong>Over a mean follow-up of 42 months, 18.7% developed incident fibrosis, of whom 74% had SLD; 8.3% developed advanced fibrosis. In adjusted models, each log-unit increase in KT ratio was associated with incident fibrosis (IRR 1.46, 95% CI 1.21-1.76) and advanced fibrosis (IRR 1.59, 95% CI 1.27-1.99). KT ratio was associated with non-SLD fibrosis (IRR 1.59, 95% CI 1.31-1.94), but not SLD-associated fibrosis (IRR 1.16, 95% CI 0.94-1.42). Higher sCD163 was associated with all liver outcomes, whereas sCD14 and I-FABP were not.</p><p><strong>Conclusions: </strong>Higher KT ratio independently predicted incident hepatic fibrosis in women with HIV, particularly non-SLD fibrosis, suggesting a steatosis-independent pathway involving microbial translocation and macrophage activation.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134671","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":"Plasma-genital HIV-1 RNA discordance in women: early observations and biological interpretation in the U=U era.","authors":"Nicola Abrescia, Adelaide Maddaloni, Gabriella Molinaro, Maurizio D'Abbraccio, Alfredo Franco","doi":"10.1097/QAD.0000000000004634","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004634","url":null,"abstract":"<p><p>Even in light of reports of plasma-genital HIV-1 RNA discordance, the clinical and public-health message of undetectable = untransmittable (U = U) remains robust.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134701","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":"Consent understanding and willingness to participate in research among adolescents and young adults living with HIV.","authors":"Grace John-Stewart, Jessica Dyer, Wenwen Jiang, Jacinta Badia, Kawango Agot, Irene Njuguna, James Kibugi, Kristin Beima-Sofie, Seema Shah, Pam Kohler","doi":"10.1097/QAD.0000000000004638","DOIUrl":"10.1097/QAD.0000000000004638","url":null,"abstract":"<p><strong>Background: </strong>There are limited data regarding informed consent understanding and research decision-making among youth in sub-Saharan Africa.</p><p><strong>Methods: </strong>Adolescents and young adults living with HIV (AYLHIV) aged 10-24 years and adult caregivers of 10-17-year-old AYLHIV were enrolled. Consent understanding was assessed using the Informed Consent Comprehension Assessment (ICCA) tool. Willingness to participate was tested in four research scenarios (HIV-specific cross-sectional, non-HIV-specific cross-sectional, HIV-specific longitudinal, and HIV-specific interventional). ICCA scores, willingness to participate, and preference for deferred-larger vs. earlier-smaller reward were compared between AYLHIV and caregivers (CG).</p><p><strong>Results: </strong>Among 104 AYLHIV (median age 17), and 98 CG (median age 41), comprehension scores were lower among AYLHIV than CG (median 15.0 vs. 16.0, P = 0.027) with no difference between CG and AYLHIV >18 years old; video vs. written consent information elicited similar scores. Youth were more likely to prefer deferred-larger reward than CG. Youth were less willing to participate in studies involving blood collection, long-acting ART interventions, or sexual behavior surveys, than in general surveys or text-messaging interventions. For several scenarios CG were more willing for youth participation than youth themselves were. Contributing to science and helping future individuals were leading motivations for research participation and were similar for youth and CG.</p><p><strong>Conclusions: </strong>Adaptation of informed consent for youth <18 years old may improve comprehension. Higher desirability of deferred gratification among youth than caregivers was surprising and may reflect financial needs among caregivers. Mismatched interest in youth participation between youth and caregivers suggests that youth guidance on research design could enhance participation.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134711","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":"Tryptophan metabolomic profiling in persons with and without HIV.","authors":"Alan Winston, Jesal Gohil, Michael Keegan, Jasmini Alagaratnam, Alejandro Arenas-Pinto, Aoife G Cotter, Frank A Post, Nicki Doyle, Jaime Vera, Ken M Kunisaki, Caroline A Sabin","doi":"10.1097/QAD.0000000000004639","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004639","url":null,"abstract":"<p><strong>Background: </strong>Full tryptophan (T) profiling allows determination of T-metabolites from the serotonin, kynurenine (K) and gut-integrity/indole pathways. We assessed T-metabolites, depressive symptoms, cognitive function and sleep measures in persons with and without HIV.</p><p><strong>Methods: </strong>Persons with HIV on ART and lifestyle-similar persons without HIV completed depressive symptoms questionnaire (PHQ-9), cognitive testing (T-score), actigraphy sleep measures and early morning fasting blood sampling for metabolomic profiling (LC-MS, UK National Phenome Centre). Statistical analysis used Mann-Whitney U tests and Spearman rank correlation.</p><p><strong>Results: </strong>Of 468 individuals (345 with HIV), 81% were male individuals and median age was 58 (IQR 53-63) years. Several metabolites, including K, K/T ratio, citrulline and 5-hydroxyindole-acetic-acid, differed in those with and without HIV. Median (IQR) PHQ-9 scores were 5 (1-10) and 1 (0-3) in those with and without HIV, respectively. In those with HIV, higher PHQ-9 scores were associated with higher K-pathway markers [quinolinic acid (P = 0.05), K (P = 0.02) and K/T ratio (P = 0.02)] but associations were generally weaker in those without HIV. Cognitive testing T-score [with HIV: 50 (44-54.9); without HIV: 52 (48.3-55.8)] was positively associated with higher gut-integrity/indole-markers in those with HIV [citrulline (P < 0.0001), indole-3-acetic-acid (P < 0.0001)], but less so in those without HIV. No associations between any actigraphy sleep measures and T-metabolites were observed.</p><p><strong>Conclusions: </strong>K-pathway metabolites (driven by peripheral inflammatory responses) are associated with depressive symptoms and metabolites of gut health associated with cognitive function in those with HIV; these observations were less evident in those without HIV. Further understanding of these mechanisms could assist the development of future therapeutic interventions.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134760","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}