AIDS最新文献

{"title":"Dynamics of clustering rates in the rhode Island HIV-1 epidemic.","authors":"Vlad Novitsky, Jon Steingrimsson, August Guang, Casey W Dunn, Mark Howison, Fizza S Gillani, Joel Hague, John Fulton, Thomas Bertrand, Lila Bhattarai, Meghan MacAskill, Utpala Bandy, Joseph Hogan, Rami Kantor","doi":"10.1097/QAD.0000000000004062","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004062","url":null,"abstract":"<p><strong>Background: </strong>: Characterizing HIV clustering rates and their trends over time can improve understanding a local epidemic and enhance its control.</p><p><strong>Methods: </strong>Leveraging an academic-public health partnership in Rhode-Island, we explored longitudinal dynamics of statewide clustering rates among key populations from 1991 to 2023. Partial HIV-1 pol sequences were grouped by year of HIV-1 diagnosis. Molecular clusters were identified in cumulative annual phylogenies. Overall clustering rates, and clustering rates of newly-diagnosed and prevalent infections, and of specific socio-demographic characteristics of key populations over time were determined. Mann-Kendall statistics were used to estimate clustering rate trends and relationships among groups.</p><p><strong>Results: </strong>By the end of 2023, 2,630 individuals with sequences represented the statewide epidemic in Rhode Island. Overall clustering rates increased from 7% in 1991 to 46% in 2023, correlating with cumulative sequence increase. Clustering rates of newly-diagnosed and prevalent infections significantly increased over time, higher in newly-diagnosed individuals since the early 2000 s. Increases were also observed among groups defined by gender, age, transmission risks, race, mental illness, HIV-1 subtypes, and country of birth, with some crossovers and divergence patterns over time.</p><p><strong>Conclusions: </strong>Exploring dynamics of HIV clustering rates over three decades in a statewide HIV-1 epidemic expanded its characterization and provided insight into its evolving changes. These dynamics may indicate a gradual shift towards a more concentrated and localized HIV-1 epidemic, highlighting important opportunities for targeted interventions to effectively prevent new HIV transmissions.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612103","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":" ","pages":""},"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":"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":" ","pages":""},"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":" ","pages":""},"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}

{"title":"Prevalence of HIV-related stigma among people with HIV in Switzerland: addressing the elephant in the room.","authors":"Eleftheria Kampouri, José Damas, Katharina Kusejko, Bruno Ledergerber, Dominique Braun, Olivier Nawej Tshikung, Anna Hachfeld, Maja Weisser, Kerstin Wissel, Enos Bernasconi, Isabel Cobos Manuel, David Jackson-Perry, Lars E Eriksson, Maria Reinius, Matthias Cavassini, Katharine E A Darling","doi":"10.1097/QAD.0000000000003983","DOIUrl":"10.1097/QAD.0000000000003983","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to determine the prevalence of HIV-related stigma among people with HIV (PWH) in Switzerland.</p><p><strong>Design: </strong>A cross-sectional multicenter study nested within the Swiss HIV Cohort Study (SHCS).</p><p><strong>Methods: </strong>We included adult PWH enrolled in the SHCS, attending follow-up between March 1, 2020, and January 31, 2021. Inability to speak English, French, German, or Italian was the only exclusion criterion. Participants were invited to complete a validated 12-item HIV-stigma questionnaire comprising four stigma subscales (negative self-image, personalized stigma, disclosure concerns, and concerns regarding public attitudes), plus two healthcare-related stigma items. Questionnaire responses were graded using a four-point Likert-type scale, higher scores indicating higher stigma. \"Non-applicable,\" inferring HIV-status non-disclosure, was possible for personalized stigma; stigma scores from participants answering \"non-applicable\" to at least one item were analyzed separately. Factors associated with HIV-stigma were identified through multivariable linear models.</p><p><strong>Results: </strong>Of 9643 PWH with a SHCS visit, 5563 participated in the study: 26% were female, 13% Black, and 37% heterosexual; median age was 53 years (interquartile range 44-59); 2067 participants (37%) gave at least one \"non-applicable\" response. Disclosure concerns had the highest stigma scores and were reported by 4656/5563 (84%). HIV-stigma was reported across all demographic groups. However, being female, Black, and heterosexual were independently associated with higher scores. Higher education and longer follow-up duration were associated with lower scores. Healthcare-related stigma was reported in 37% of participants.</p><p><strong>Conclusion: </strong>HIV-stigma was prevalent across all demographic groups. The association with being female and Black suggests that HIV-stigma accentuates preexisting sex and race inequalities.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1874-1884"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756585","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":"Tenofovir alafenamide compared to tenofovir disoproxil fumarate, induces dysglycemia, and dyslipidemia in Wistar rats.","authors":"Rajendraparsad Hurchund, Sinegugu E Sibiya, Bernard O Owaga, Peter M O Owira","doi":"10.1097/QAD.0000000000003987","DOIUrl":"10.1097/QAD.0000000000003987","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the metabolic effects of tenofovir alafenamide (TAF) compared to tenofovir disoproxil fumarate (TDF) in vivo .</p><p><strong>Design and methods: </strong>Male Wistar rats ( Rattus novergicus , 250-300 g body weight) were divided into three groups ( n  = 8) and orally treated daily with 1.0 ml distilled water (group 1), TAF (0.42 mg/kg) (group 2), or TDF (5.0 mg/kg) (group 3), respectively, for 56 days. Glucose tolerance tests were done before the animals were sacrificed by halothane overdose, and blood was collected by cardiac puncture for the analysis of plasma lipids, electrolytes, and insulin. The kidney and pancreatic tissues were excised and homogenized to measure oxidative stress. Compartmentation of TAF and TDF was determined in NRK-52 and peripheral blood mononuclear cells (PBMCs).</p><p><strong>Results: </strong>There were no significant differences in weight gain among controls, TAF- or TDF-treated rats. TAF-treated rats had significantly increased fasting blood glucose (FBG), fasting plasma insulin (FPI), insulin resistance, impaired glucose tolerance, and dyslipidemia compared to control or TDF-treated rats, respectively. There was increased lipid peroxidation in the pancreas of TAF-treated compared to TDF-treated or control animals, respectively. TDF- treated rats presented with symptoms of Fanconi syndrome compared to TAF-treated or control animals, respectively. Kidney homogenates from TDF-treated animals had significantly reduced antioxidant enzyme activity compared to TAF-treated animals or controls, respectively. Intracellular concentrations of TAF were significantly higher than TDF in both NRK-52E cells and PBMC, respectively.</p><p><strong>Conclusions: </strong>TAF treatment is weight-neutral and causes dysglycemia, and dyslipidemia but not Fanconi syndrome compared to TDF.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1809-1818"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141873903","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":"Epicardial fat tissue and diastolic dysfunction in both men and women with HIV.","authors":"Win Min Han, Tanakorn Apornpong, Monravee Tumkosit, Anchalee Avihingsanon, Pairoj Chattranukulchai","doi":"10.1097/QAD.0000000000003997","DOIUrl":"https://doi.org/10.1097/QAD.0000000000003997","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"38 13","pages":"1893-1894"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339229","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":"Cost-effectiveness of different intervention strategies of HIV in Zhejiang, China.","authors":"Chensi Wu, Xiaolan Xu, Chunting Peng, Yin Dong, Zhuoqi Lou, Liya Pan, Lin Chen, Yifan Zeng, Bing Ruan","doi":"10.1097/QAD.0000000000003968","DOIUrl":"10.1097/QAD.0000000000003968","url":null,"abstract":"<p><strong>Objective: </strong>Mass screening for HIV and preexposure prophylaxis (PrEP) may be effective measures for reducing the probability of HIV transmission. Our study aimed to determine the cost-effectiveness of preliminary screening in the general population, PrEP for HIV-negative spouses in serodiscordant couples, or both approaches in Zhejiang Province.</p><p><strong>Design: </strong>From a policy-maker's perspective, a Markov model was constructed to compare four strategies over a 30-year horizon.</p><p><strong>Methods: </strong>In the Markov model, the implementation intensities of the strategies varied from 50 to 100%. Different strategies were evaluated by the reduction of unfavorable clinical outcomes, saved life-years, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and net monetary benefits (NMBs).</p><p><strong>Results: </strong>The PrEP-screening strategy reduced the most unfavorable clinical outcomes and saved the most life-years and QALYs from 2023 to 2052. It always gained the maximum QALYs and NMB, while its ICER was always lower than the willingness-to-pay (WTP). The NMB of the PrEP-screening strategy gradually increased as the implementation intensity increased.</p><p><strong>Conclusion: </strong>With adequate manpower and policies, we suggest implementing the PrEP-screening strategy in Zhejiang Province, suggesting that the broader the population coverage of the strategy, the better. In addition, the PrEP strategy is an alternative.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1850-1860"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454533","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":"Addressing methamphetamine use in persons with HIV.","authors":"Esteban Martinez, David Dorfman","doi":"10.1097/QAD.0000000000003998","DOIUrl":"https://doi.org/10.1097/QAD.0000000000003998","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"38 13","pages":"1888-1889"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339226","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":"Response to \"Epicardial fat tissue and diastolic dysfunction in both men and women with HIV\".","authors":"Rachel L Goldberg, Tess E Peterson, Sabina A Haberlen, Mallory D Witt, Frank J Palella, Jared W Magnani, Todd T Brown, Jordan E Lake, Joao A C Lima, Matt J Budoff, Chiadi E Ndumele, Katherine C Wu, Wendy S Post","doi":"10.1097/QAD.0000000000004003","DOIUrl":"10.1097/QAD.0000000000004003","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"38 13","pages":"1895"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339230","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}