AIDS最新文献

{"title":"Adherence to European AIDS clinical society hepatitis B management guidelines in people with HIV: real-world evidence from Spain and Germany.","authors":"Juan Berenguer, Pablo Ryan, Thomas Lutz, Luz Martín-Carbonero, Leire Pérez-Latorre, María J Vivancos, Jordi Navarro, Roser Navarro-Soler, Oscar L Ferrero, Rosario Palacios, Christoph Wyen, Pere Domingo, Malte B Monin, Xavier Camino, Marta Montero, Alexander Killer, Jakob J Malin, Ignacio De Los Santos, Stefan Esser, Luis E Morano, Ian López-Cruz, Jorge Valencia, Roger Vogelmann, Stefan Mauss, Antonio Rivero, Fauzi Elamouri, Carmen Hidalgo-Tenorio, Kathrin Van Bremen, Juncal Pérez-Somarriba, José Sanz, Daniel Beer, Axel Baumgarten, Annette Haberl, María J Galindo, María C Fariñas, Florian Voit, Nazifa Qurishi, Sebastian Noe, Sergio Reus, Pavel Khaykin, Stephan M Schneeweiss, Anders Boyd, Marta De Miguel, José M Bellón, Jürgen K Rockstroh","doi":"10.1097/QAD.0000000000004635","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004635","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate adherence to hepatitis B virus (HBV) management recommendations among people with HIV (PWH) and chronic HBV infection.</p><p><strong>Design: </strong>A multicenter cross-sectional study.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in 42 centers in Spain and Germany between June 2024 and March 2025. Chronic HBV infection was defined as at least two positive hepatitis B surface antigen tests obtained more than 6 months apart. Adherence to 2023 European AIDS Clinical Society recommendations regarding anti-HBV treatment, liver enzyme monitoring, HBV-DNA testing, antihepatitis D virus (HDV) screening, and HDV-RNA confirmation was assessed. Hepatocellular carcinoma surveillance was evaluated separately and has been reported elsewhere.</p><p><strong>Results: </strong>A total of 1235 PWH with chronic HBV infection were included. The median age was 56 years, 84% were men, and 36% were born outside Europe. Overall, 88% had HIV-RNA less than 50 copies/ml, and the median CD4+ cell count was 623 cells/μl. Among participants with available HBV-DNA result, 87% had undetectable HBV-DNA. Guideline-recommended anti-HBV treatment was documented in 88% of individuals. During the previous 12 months, liver enzyme monitoring was performed in 94% and HBV-DNA testing in 71%. Overall, 81% had ever undergone anti-HDV testing and, among anti-HDV-positive individuals, 66% had undergone HDV-RNA testing.</p><p><strong>Conclusion: </strong>Although adherence to several components of HBV care was high, gaps remain in the implementation of current recommendations for PWH, particularly in HBV-DNA monitoring and HDV evaluation. Better integration of these measures into routine HIV care may improve long-term prevention of liver-related complications.</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":"149134698","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":"Exercise testing and single-photon emission computed tomography myocardial perfusion imaging to detect silent coronary heart disease in people with HIV.","authors":"Melanie Cresta, Alexandre Brun, Pascal Merlet, Gwenn Hamet, Georgios Sideris, Nathalie De Castro, Willy Rozenbaum, Caroline Lascoux-Combe, Jean-Michel Molina","doi":"10.1097/QAD.0000000000004637","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004637","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relevance of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) combined with exercise testing, performed in asymptomatic people with HIV receiving effective antiretroviral therapy (ART), for detecting baseline silent coronary heart disease (SCHD) and predicting incident cardiac events.</p><p><strong>Design: </strong>Retrospective observational study conducted between November 2015 and July 2024 at Saint-Louis Hospital, Paris.</p><p><strong>Methods: </strong>We screened people with HIV with no history of coronary artery disease for SCHD using MPI combined with exercise testing. Patients with abnormal findings underwent coronary angiography. Baseline SCHD was defined as the presence of significant coronary stenosis confirmed by coronary angiography. Incident cardiac events during follow-up included incident SCHD, myocardial infarction, chest pain associated with significant coronary stenosis, and sudden death. Baseline risk factors associated with SCHD and cardiac events were assessed using univariate and multivariate analyses.</p><p><strong>Results: </strong>A total of 475 people with HIV were analyzed, with a median follow-up of 6 years. The median age was 56 years, 87.8% were male, 58.1% were current or ex-smokers, and 29.9% were on statins. The baseline prevalence of SCHD was 2.1% [95% confidence interval (CI): 1.1-4]. During follow-up, the incidence of cardiac events was 1.2 per 100 person-years (95% CI: 0.8-1.7). Only a combined positive MPI and exercise testing was associated with a significantly increased risk of SCHD and cardiac events [adjusted odds ratio (aOR) 4.0; 95% CI: 1.91-8.35; P < 0.001].</p><p><strong>Conclusion: </strong>SPECT MPI combined with exercise testing can detect SCHD and may help identify people with HIV at increased cardiovascular risk.</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":"149134744","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":"Traditional healers in HIV differentiated service delivery.","authors":"Srija Gogineni, Gabriel Nuwagaba, Misha Hooda, Sylvia Natukunda, Constance Birungi, William Bugeza, Maureen Tushabe, Denis Nansera, Winnie Muyindike, Carolyn M Audet, Juliet Mwanga-Amumpaire, Radhika Sundararajan","doi":"10.1097/QAD.0000000000004631","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004631","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread adoption of differentiated service delivery (DSD) models for HIV care in Uganda, nearly one-third of people with HIV remain virally unsuppressed, and 30-60% of those initiating antiretroviral therapy (ART) in sub-Saharan Africa are lost to follow-up. Current DSD frameworks primarily serve clinically stable clients, overlooking disengaged or unstable people with HIV who face barriers like stigma, lack of social support, and negative clinic experiences. Traditional healers, trusted and accessible community figures, may complement formal systems to enhance care engagement.</p><p><strong>Methods: </strong>This qualitative sub-study, embedded within a cluster-randomized hybrid effectiveness-implementation trial in rural southwestern Uganda, explored traditional healer-delivered HIV support. Traditional healers in the intervention arm were trained to facilitate HIV self-testing, provide adherence counseling, and offer psychosocial support to unsuppressed people with HIV. Semi-structured interviews were conducted with 18 traditional healers, 15 people with HIV, and 5 clinicians after 9-12 months of follow-up. Median age of traditional healers is 47, people with HIV is 25, and clinicians is 34 years. Inductive thematic analysis identified perceptions and experiences related to traditional healer-delivered support and engagement with care.</p><p><strong>Results: </strong>Three themes emerged: traditional healers fostered re-engagement with HIV services through time, attention, and personalized care often unavailable in overburdened clinics; they provided individualized adherence support, including reminders and accompaniment; and traditional healers offered counseling that reduced stigma, facilitated disclosure, and promoted self-acceptance.</p><p><strong>Conclusion: </strong>Traditional healers can extend DSD principles to disengaged people with HIV by providing culturally grounded, patient-centered support. Integrating traditional healers into HIV care frameworks may strengthen re-engagement, adherence, and viral suppression, advancing progress toward HIV epidemic control.</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":"149134755","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":"Tuberculosis in children who are HIV-exposed uninfected.","authors":"Jeffrey I Campbell, Ojasvi Vachharajani, Melanie M Dubois, Leonardo Martinez, Paul J Christos, Julie M Herlihy, Helen E Jenkins, C Robert Horsburgh, Karen R Jacobson, Kathleen M Powis","doi":"10.1097/QAD.0000000000004543","DOIUrl":"10.1097/QAD.0000000000004543","url":null,"abstract":"<p><strong>Objectives: </strong>1.3 million children are born each year to mothers with HIV but remain HIV-uninfected; more than 70% of these children live in settings with high tuberculosis (TB) burden. Whether children who are HIV-exposed uninfected (cHEU) are at increased risk of TB infection and disease is debated.</p><p><strong>Design: </strong>We performed a systematic review and meta-analysis of TB infection and disease in cHEU versus children who are HIV-unexposed uninfected (cHUU) and children with HIV (CWH).</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, and publication bibliographies through October 2025, using terms related to gestational HIV exposure and TB. We performed a qualitative synthesis and a meta-analysis of TST/IGRA positivity prevalence and disease cumulative incidence in cHEU versus cHUU, and cHEU versus CWH.</p><p><strong>Results: </strong>: We included 26 studies in a systematic review and 18 studies in meta-analyses; 21/26 (81%) studies were restricted to children less than 2 years of age. Prevalence of TST/IGRA positivity [RR 1.26; 95% confidence interval (CI) 0.92-1.72, I2  = 0.0%] and cumulative disease incidence (RR 0.72; 95% CI 0.48-1.08, I2  = 0.0%) were similar between cHEU and cHUU. Prevalence of TST/IGRA positivity (RR 0.24; 95% CI 0.02-3.91, I2  = 93.2%) was not significantly different between cHEU and CWH. cHEU had lower risk of TB disease cumulative incidence than CWH (RR 0.29; 95% CI 0.16-0.51, I2  = 71.5%).</p><p><strong>Conclusion: </strong>cHEU and cHUU experience similar risk of TB infection and disease, while cHEU experience lower risk of disease than CWH. Findings were limited by a lack of studies after infancy and a small number of studies.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1517-1529"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947428","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":"Rethinking HIV resistance in the era of long-acting therapy: from isolated events to durable exposure.","authors":"Luis Buzón, Enrique Bernal-Morell, Marisa Luisa Montes, Laura Gisbert, Jesús Troya","doi":"10.1097/QAD.0000000000004581","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004581","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"40 10","pages":"1577-1581"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823881","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":"Heterogeneity of baseline immune activation and SARS-CoV-2 vaccine responses in people with HIV: a multicenter prospective study.","authors":"Majdouline El Moussaoui, Aurélie Ladang, Nathalie Maes, Etienne Cavalier, Francesco Genderini, Hafid Dahma, Charlotte Martin, Nicolas Dauby, Gilles Darcis","doi":"10.1097/QAD.0000000000004557","DOIUrl":"10.1097/QAD.0000000000004557","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine whether baseline immune activation and inflammation contribute to heterogeneity in SARS-CoV-2 vaccine-induced immunity in antiretroviral therapy (ART)-treated people with HIV (PWH) compared to controls.</p><p><strong>Methods: </strong>In this multicenter prospective study, 159 ART-treated PWH from two cohorts and 56 HIV-negative controls were enrolled. The two PWH cohorts differed in immunovirological control: one showed sustained viral suppression and CD4 + T-cell recovery, the other persistent CD4 + T-cell lymphopenia despite ART, sometimes with residual viremia. Baseline plasma levels of 20 cytokines, chemokines and soluble endothelial markers, were measured before SARS-CoV-2 mRNA vaccination. Post-vaccination anti-spike IgG, neutralizing antibodies, and IFN-γ-producing T cells were quantified and correlated with baseline immune mediators.</p><p><strong>Results: </strong>PWH had higher baseline levels of innate immune activation and endothelial inflammation markers than controls, particularly among immunological nonresponders. Principal component analysis identified two inflammatory profile groups among PWH: one characterized by Th1/Th17-oriented cytokine profile, and the other with dominant monocyte activation and endothelial markers. Higher baseline inflammation in PWH was associated with reduced humoral vaccine responses and elevated ICAM-1 levels with decreased IFN-γ T-cell responses, irrespective of prior SARS-CoV-2 infection. In contrast, among HIV-negative participants with prior SARS-CoV-2 exposure, higher sCD14, IL-12p70, MCP-1, and E-selectin levels correlated with stronger humoral responses, whereas ICAM-1 was associated with increased IFN-γ T-cell responses.</p><p><strong>Conclusion: </strong>Baseline inflammatory and endothelial profiles may constitute additional determinants of SARS-CoV-2 vaccine-induced immune responses in PWH. The opposite associations observed in controls highlight the context-dependent immunological effects of these pathways across chronic immune dysfunction and immunocompetent states.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1480-1487"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142373","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":"Predictors of detectable viral load among adolescents with HIV in low resource settings who are receiving care in youth-friendly clinics.","authors":"Alexander Kay, Abigail Seeger, Phumzile Dlamini, Teresa Steffy, Mbongeni Dube, Buoang Mothobi, Mphanya Sekhantso, Ntaoleng Mohlabane, Nobuhle Mthethwa, Anna Masheane-Moseneke, Elizabeth Chiao, Donald Skinner, Yvonne Maldonado, Vambe Debrah, H Lester Kirchner, Anna Mandalakas","doi":"10.1097/QAD.0000000000004564","DOIUrl":"10.1097/QAD.0000000000004564","url":null,"abstract":"<p><strong>Objective: </strong>Adolescents with HIV (AWH) have higher rates of detectable viral loads (DVL) than adults. We sought to identify clinical and psychosocial predictors of DVL among AWH in optimized care environments.</p><p><strong>Methods: </strong>We prospectively recruited 1250 AWH (aged 10-19) from four youth-friendly HIV clinics in Eswatini and Lesotho (May 2023-October 2024). Participant clinical data was abstracted from an electronic medical record, and participants completed validated surveys assessing depression, anxiety, stigma, self-efficacy, adverse childhood experiences, and substance use. We developed predictive models from clinical and survey data using logistic regression, elastic net regression, and random forest algorithms, with 70/30 train-test splits.</p><p><strong>Results: </strong>Of 1222 participants with viral loads, 165 (13.5%) had DVL (≥50 copies/ml). The cohort was evenly distributed by gender and predominantly included older adolescents (72.3% aged 15-19) with perinatally-acquired HIV (median age at diagnosis 2 years). Most (95.1%) received dolutegravir-based therapy. Key features associated with DVL from the models included: prior DVL within 2 years [odds ratio (OR) 5.4, 95% confidence interval (CI) 3.34-8.74], nondolutegravir regimens (OR 4.11, 95% CI 1.36-12.42), and survey responses related to low self-efficacy, stigma fears, size of the household, and adherence behaviors. Model performance for prediction of DVL was moderate, with AUROCs for all models ranging between 0.729 and 0.748.</p><p><strong>Conclusions: </strong>While clinical factors, particularly a prior DVL and non-DTG regimen, were associated with DVL, few psychosocial features consistently emerged across predictive models. The high viral suppression rates (86.5%) in these youth-friendly environments demonstrate effective comprehensive care. Results suggest individualized rather than algorithmic approaches may better support adolescents with persistent adherence challenges.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1561-1570"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203719","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":"Food insecurity and cardiometabolic diseases among people with HIV in West Africa.","authors":"Noelle A Benzekri, Marie K Plaisy, Jean Jacques Koffi, Ephrem Mensah, Albert Minga, Didier K Ekouevi, Raoul Moh, Antoine Jaquet","doi":"10.1097/QAD.0000000000004541","DOIUrl":"10.1097/QAD.0000000000004541","url":null,"abstract":"<p><strong>Objectives: </strong>This study was conducted in order to evaluate the associations between food insecurity and cardiometabolic diseases among people with HIV in Togo and Côte d'Ivoire, West Africa.</p><p><strong>Design: </strong>Cross-sectional study among ART experienced participants ≥40  years of age contributing to the Sentinel Research Network (SRN) cohort of IeDEA West Africa.</p><p><strong>Methods: </strong>Study encounters took place from November 2021 through June 2022. Food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS). Moderate-to-severe food insecurity was defined as HFIAS category ≥3. Dietary diversity was assessed using the Dietary Diversity Scale (DDS). Poor dietary diversity was defined as DDS 0-6. Clinical data were obtained using standard, validated instruments and clinical assays. Multivariable logistic regression was used to evaluate the associations between food insecurity and clinical outcomes, including HIV outcomes (virologic failure, CD4 + cell count), cardiometabolic outcomes (hypertension, type 2 diabetes, hyperlipidemia, hepatic steatosis, obesity) and other indicators of poor nutritional status (anemia, underweight, poor dietary diversity).</p><p><strong>Results: </strong>Among 584 participants (69% women; median age 52  years), 240 (41%) were moderately-to-severely food insecure. Food insecurity was more prevalent among women (46.3% versus 29.7%; P  < 0.001), those who had not received any formal education, and those with an income less than 50k FCFA/month. Food insecurity was associated with higher odds of virologic failure [odds ratio (OR) 1.85; 95% confidence interval (CI) 1.04-3.28], CD4 + cell count less than 200 cells/μl (OR 2.98; 95% CI 1.28-6.90), and hypertension (OR 1.89; 95% CI 1.30-2.73). Food insecurity was associated with lower odds of hyperlipidemia (OR 0.34; 95% CI 0.16-0.72) and lower odds of obesity among men (OR 0.09; 95% CI 0.01-0.69), but not among women (OR 0.78; 95% CI 0.50-1.20). Food insecurity was associated with underweight (OR 2.95; 95% CI 1.09-7.97), and poor dietary diversity (OR 1.60; 95% CI 1.14-2.23) in univariable analysis but not multivariable analysis. Food insecurity was not associated with type 2 diabetes, liver steatosis, or anemia. Women had greater odds of obesity (OR 3.07; 95% CI 1.88-5.04) and anemia (OR 1.80; 95% CI 1.19-2.72) compared to men.</p><p><strong>Conclusion: </strong>Among people ageing with HIV in West Africa, food insecurity is common and is associated with poor clinical outcomes, including virologic failure and hypertension. Our findings support the need for integrated programs that address food insecurity and improve the prevention and treatment of cardiometabolic diseases among PWH in the region.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1495-1507"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925449","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":"Prevalence and clinical correlates of frailty among adults with HIV infection and unhealthy alcohol or drug use.","authors":"Theresa W Kim, Kristine M Erlandson, Kara M Magane, Michael R Winter, Michael D Stein","doi":"10.1097/QAD.0000000000004559","DOIUrl":"10.1097/QAD.0000000000004559","url":null,"abstract":"<p><strong>Objective: </strong>Unhealthy alcohol and/or other drug use (substance use) may increase the risk of frailty among people with HIV (PWH), a population already at higher risk of frailty. A better understanding of conditions associated with frailty among PWH with substance use is needed to guide management of frailty in these patients. The study objectives were to identify the prevalence and clinical correlates of frailty among PWH with a history of substance use.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Methods: </strong>We compared clinical characteristics of frail, prefrail, and nonfrail (Fried's phenotype) PWH and a history of substance use using Kruskal-Wallis (for continuous variables) or chi-square (for categorical variables).</p><p><strong>Results: </strong>Among 250 participants with mean age of 52 years, most were frail ( n  = 68, 27%) or prefrail ( n  = 148, 59%). HIV viral load was well controlled with no differences between frailty groups. More frail participants had impaired physical functioning (90%), pain interference (71%), at least 1 fall (53%), and tobacco use (82%) compared to prefrail and nonfrail participants. Past-year alcohol (49%) and cocaine (40%) use disorders and overdose [lifetime (44%) and past-year (16%)] were also more common among frail compared to prefrail and nonfrail participants.</p><p><strong>Conclusion: </strong>Frailty and prefrailty were highly prevalent among people with stable HIV and a history of substance use. Care for frail and prefrail PWH should address modifiable factors including overdose, pain, falls, as well as management of substance use disorders. Understanding the clinical and addiction-related experiences of frail PWH is critical for the care of this vulnerable population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1488-1494"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203706","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":"Semaglutide improves markers of cardiovascular risk in people with HIV.","authors":"Jordan E Lake, Douglas W Kitch, Amy Kantor, Cristina Alonso, Pablo F Belaunzaran-Zamudio, Grace L Kulik, Ana N Hyatt, Carl J Fichtenbaum, Todd T Brown, Alan Landay, Fred Sattler, Kristine M Erlandson","doi":"10.1097/QAD.0000000000004538","DOIUrl":"10.1097/QAD.0000000000004538","url":null,"abstract":"<p><strong>Objective: </strong>Semaglutide improves cardiovascular disease (CVD) risk in people who are diabetic, overweight, or obese through incompletely understood mechanisms. To address this, we explored novel lipidomic and lipoprotein/glycoprotein profiling with semaglutide therapy.</p><p><strong>Design: </strong>Secondary analysis of SLIM LIVER (ACTG A5371), an open-label, phase 2b, single-arm trial of 1 mg semaglutide weekly in adult people with HIV (PWH) and metabolic dysfunction-associated steatotic liver disease.</p><p><strong>Methods: </strong>Participants ( n  = 36) experiencing clinical response (>5 lb weight loss) to semaglutide were included. Lipidomic and lipoprotein/glycoprotein profiling was performed from stored serum.</p><p><strong>Results: </strong>Median age was 52 years and BMI 34 kg/m 2 ; 39% were Hispanic, 28% Black, 45% female, and 22% had stable statin use. Lipidomics: semaglutide reduced triglycerides, diglycerides, and sphingomyelins and increased some bile acids and phosphatidylcholines. Lipoproteins: CVD-linked species decreased; LDL particle size increased and large HDL particle number decreased. Glycoproteins: most participants had elevated baseline GlycA and GlycB, CVD-associated markers of systemic inflammation. 56% with elevated Glyc A improved and 32% normalized; 41% with elevated Glyc B improved and 42% normalized. Lipoprotein/glycoprotein concentrations generally did not correlate with baseline weight, liver fat, or insulin resistance or their magnitude of change.</p><p><strong>Conclusion: </strong>In this first human report of lipidomic and lipoprotein/glycoprotein profiling during semaglutide therapy in any population, lipidomic changes suggest reductions in toxic lipid species and improved hepatic insulin sensitivity. Significant reductions in CVD-risk associated lipoprotein/glycoprotein species were observed that did not correlate with magnitude of changes in weight, liver fat. or insulin resistance, suggesting an independent mechanism.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1467-1473"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832272","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}