AIDS最新文献

{"title":"Antiretroviral therapy in people with HIV and end-stage kidney disease.","authors":"Matthew Spencer, Christopher Pieri, Lisa Hamzah, Joyce Popoola, Sapna Shah, Rachael Jones, Jeremy Levy, Maurice Murphy, John Booth, Frank A Post","doi":"10.1097/QAD.0000000000004128","DOIUrl":"10.1097/QAD.0000000000004128","url":null,"abstract":"<p><strong>Objective: </strong>To summarize antiretroviral therapy (ART) use in the setting of end-stage kidney disease (ESKD).</p><p><strong>Design: </strong>Cross-sectional analysis.</p><p><strong>Methods: </strong>Descriptive analysis of ART regimens and dose of nucleoside/nucleotide reverse-transcriptase inhibitors (NRTI) in people with HIV and ESKD (dialysis, kidney transplantation, or estimated glomerular filtration rate (eGFR) <15 mL/min/1.73m 2 ) receiving HIV and renal care at five London centres. Exposures of interest were use of dual/unboosted ART regimens and higher than recommended doses of renally-cleared NRTI.</p><p><strong>Results: </strong>A total of 157 participants were included (median age 55 years, 66% male, 84% black ethnicity, median CD4 cell count 382 cells/mm 3 , 99% HIV RNA <200 copies/mL). Fifty-eight (37%) were on dual/unboosted ART regimens, mainly dolutegravir/lamivudine. Participants on dual/unboosted ART had similar rates of HIV suppression as those on triple-ART. Two participants currently virologically controlled on triple-ART had previously failed to suppress on dual/unboosted ART (dolutegravir/rilpivirine and dolutegravir/lamivudine [50 mg]). Lamivudine doses were higher than recommended in 75 (77%) and lower than recommended in 8 (8%) participants. Full dose lamivudine (300 mg daily) was used by 24 (32%) participants with eGFR <30 mL/min/1.73m 2 . None of those currently on reduced-dose lamivudine had required dose reductions for previous toxicity concerns.</p><p><strong>Conclusions: </strong>Dual/unboosted ART regimens such as dolutegravir/lamivudine provide robust viral efficacy in the setting of ESKD, and higher than recommended, including full-dose, lamivudine was well tolerated. The dolutegravir/lamivudine (300 mg) fixed-dose combination provides a single-tablet regimen for use across the eGFR spectrum, avoids under-exposure to lamivudine, and merits further evaluation in this population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057734","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":"Drug resistance testing at regimen failure in individuals diagnosed with HIV-1 between 2010 and 2018 in Israel.","authors":"Tali Wagner, Itzchak Levy, Anat Wieder-Finesod, Marina Wax, Yael Gozlan, Daniel Elbirt, Eynat Kedem, Karen Olshtain-Pops, Hila Elinav, Michal Chowers, Valery Istomin, Rozalia Smolyakov, Natasha Matus, Shirley Girshengorn, Rotem Marom, Dan Turner, Orna Mor","doi":"10.1097/QAD.0000000000004138","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004138","url":null,"abstract":"<p><strong>Objective: </strong>Assess virological failures, analyze the results of resistance testing (RET), and investigate factors associated with acquired drug resistance mutations (aDRM).</p><p><strong>Design: </strong>A retrospective longitudinal cohort study.</p><p><strong>Methods: </strong>Virological failures (viral load >50 copies/ml) from a cohort of 1130 individuals, diagnosed with HIV-1 in 2010-2018 and followed up until 2020, were included. Demographic, clinical, and virological data were collected. A piecewise exponential additive mixed model was employed to estimate the association of various factors with aDRM.</p><p><strong>Results: </strong>Only 82 individuals had virological failure, 20/82 had multiple virological failures. The majority of virological failures (77%) were men, 48% were Israeli-born,79% were diagnosed in 2010-2014. Only 18% initiated with second-generation integrase-inhibitor (INI) based regimens. Although no baseline differences were identified between those with single and multiple virological failures, the latter had lower CD4+ levels before first virological failure. NRTI M184IV and INI N155H were identified in more than 10% of the cases. In those with additional failures, INI N155H was more prominent in cases with subtype B compared to those with non-B subtypes (P = 0.039). Diagnoses with CD4+ cell count less than 200 cells/μl and AIDS [hazard ratio = 3.46, 95% confidence interval (95% CI): 1.51-7.92, P = 0.003], second-generation INI at the first virological failure (HR = 0.32, 95% CI: 0.11-0.91, P = 0.033), and RET at baseline (hazard ratio = 0.34, 95% CI: 0.13-0.86, P = 0.022) had a significant and persistent relative effect on aDRM.</p><p><strong>Conclusion: </strong>The risk for aDRM is reduced in those who are treated with second-generation INI-based regimens. Diagnosis with low CD4+ cell counts and AIDS is associated with detection of aDRM.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253998","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":"Physical, psychosocial and sexual health among people aged 50 years and above with and without HIV: a nationwide study.","authors":"Ditte Scofield, Morten Frisch, Mikael Andersson, Merete Storgaard, Gitte Pedersen, Isik S Johansen, Terese L Katzenstein, Christian Graugaard, Lars H Omland, Nina Weis, Ellen Moseholm","doi":"10.1097/QAD.0000000000004140","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004140","url":null,"abstract":"<p><strong>Objective: </strong>To investigate physical, psychosocial and sexual health outcomes in ≥50 years-old people with and without HIV.</p><p><strong>Design: </strong>Cross-sectional study in Denmark comparing health outcomes by HIV status.</p><p><strong>Methods: </strong>Data were drawn from the SHARE study, a nationwide survey conducted between 2021 and 2022, examining psychosocial, sexual and reproductive health in people with HIV (PWH), and compared to data from people without HIV (PWOH) in the nationally representative Project SEXUS cohort study. Health outcomes were assessed using validated patient-reported outcome measures, with sex-stratified logistic regression models adjusting for sociodemographic and other confounding factors.</p><p><strong>Results: </strong>The study included 322 men and 67 women with HIV and 15 548 men and 13 926 women without HIV. PWH were more likely to report being single and having non-Danish parentage. HIV was associated with higher odds of liver disease in both men and women, cardiovascular and lung diseases in men, and osteoporosis and hypertension in women. Compared with PWOH, men with HIV more often reported depressive symptoms or a history of treatment for anxiety, while women with HIV more often reported loneliness, suicidal thoughts and domestic abuse. Sexually, PWH more often reported reduced sexual desire and activity, men with HIV more often reported erectile dysfunction or orgasmic dysfunction and women with HIV more often reported lubrication dysfunction or genital pain dysfunction.</p><p><strong>Conclusions: </strong>PWH aged ≥50 years in Denmark face significantly more physical, psychosocial and sexual health challenges than PWOH. Clinical attention to these disparities is crucial for improving the overall health of ageing PWH.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254019","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":"Impact of smoking habits on cardiovascular and neoplastic events and all-cause death in people with HIV from the STOPSHIV cohort.","authors":"Giuseppe Vittorio De Socio, Elena Ricci, Stefania Piconi, Nicola Squillace, Paolo Maggi, Giancarlo Orofino, Debora Altobelli, Carmen Santoro, Marta Guastavigna, Barbara Menzaghi, Elena Salomoni, Antonio Di Biagio, Marco dell'Omo, Daniela Francisci, Paolo Bonfanti","doi":"10.1097/QAD.0000000000004042","DOIUrl":"10.1097/QAD.0000000000004042","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to assess the impact of smoking exposure on major clinical events (MCEs) in a real-life setting of people with HIV (PWH).</p><p><strong>Design: </strong>An observational, longitudinal, multicenter cohort study from Italy.</p><p><strong>Methods: </strong>Consecutive 983 PWH were enrolled in \"STOP Smoking in HIV people\" (STOPSHIV) projects and followed from July 2014 until September 2023. The observed MCE defined as cardiovascular events, neoplastic diseases, or death for any reason was assessed according to smoking status and related variables (number of cigarettes smoked daily, pack-years, Fagerström test) in participants. The association between exposure variables and the event was evaluated using the Cox proportional hazard model [hazard ratios, and 95% confidence interval (95% CI)].</p><p><strong>Results: </strong>Over 6997.6 person-years of follow-up (PYFU), we found a total of 49 cardiovascular events, 61 neoplastic events, and 47 deaths. The overall incidence rate of MCE was 17.6 /1000 PYFU (95% CI 14.7-21.0). All-cause death rate was 6.7 (95% CI 5.0-8.9)/1000 PYFU. In a multivariate analysis, older age (hazard ratio 1.07, CI 1.05-1.09), high Fagerström Test for Nicotine Dependence (hazard ratio 1.09, CI 1.03-1.15), a low nadir CD4 + cell count less than 200 cells/μl (hazard ratio 1.63, CI 1.10-1.41), history of previous neoplasm (hazard ratio 2.41; CI 1.34-4.43), and IDU as a risk factor for HIV infection (hazard ratio 2.36; CI 1.52-3.68) were independent predictors of any MCE.</p><p><strong>Conclusion: </strong>Non-AIDS clinical conditions are the most observed clinical events in PWH from Italy. Smoking exposure significantly increases the risk of MCE in PWH, and a high Fagerström Test for Nicotine Dependence is a predictor of MCE.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"143-152"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The case for integrating menopause care and HIV management.","authors":"Iulia Filip","doi":"10.1097/QAD.0000000000004069","DOIUrl":"10.1097/QAD.0000000000004069","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"N1-N2"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685790","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":"Biomarkers of microbial translocation and generalized inflammation are associated with frailty among people with HIV.","authors":"Stephanie A Ruderman, Peter W Hunt, Gabriele Beck-Engeser, Gabrielle Ambayec, Amanda L Willig, Michael S Saag, Sonia Napravnik, Edward Cachay, Laura Bamford, Alan Landay, Lydia N Drumright, L Sarah Mixson, Bridget M Whitney, Robin M Nance, Mari M Kitahata, Heidi M Crane, Joseph A C Delaney, Andrew W Hahn","doi":"10.1097/QAD.0000000000004047","DOIUrl":"10.1097/QAD.0000000000004047","url":null,"abstract":"<p><strong>Background: </strong>Frailty occurs at higher rates and younger ages among people with HIV (PWH) compared with the general population and is often attributed to chronic inflammation and subsequent immune exhaustion. We assessed how inflammatory biomarkers are associated with frailty among PWH.</p><p><strong>Methods: </strong>The Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) cohort is comprised of adult PWH in care at 10 sites, and harmonizes demographic, clinical, and patient-reported outcomes (PRO) data. A panel of 13 inflammatory biomarkers was collected from a subset of virally suppressed PWH once per person between 2010 and 2018. Frailty was measured with a validated PRO phenotype, scored 0-4, from biomarker collection date through July 2022. With adjusted linear mixed models, we estimated longitudinal associations between standard deviation-scaled log 2 -transformed biomarkers and frailty score.</p><p><strong>Results: </strong>Among 273 PWH, most were men (91%), average age at baseline was 45, 42% were non-Hispanic White whereas 35% were non-Hispanic Black, and average follow-up time was 5.5 years. Several biomarkers were associated with higher frailty, including those linked to microbial translocation (sCD14, LBP, KT ratio) and systemic inflammation (CRP, IL-6, suPAR, sTNFR1, sTNFR2). Higher IL-6 was associated with a 0.25-point higher frailty score [95% confidence interval (CI) 0.12-0.39]. Higher sTNFR1 [0.35 (0.13-0.56)], sCD14 [0.21 (0.11-0.31)], and suPAR [0.24 (0.11-0.36)] levels were also associated with higher frailty scores over follow-up.</p><p><strong>Conclusion: </strong>Higher levels of biomarkers linked to microbial translocation and systemic inflammation are associated with higher average frailty scores over time in a cohort of virally suppressed PWH, highlighting these pathways as potential interventional targets for mitigating frailty in PWH.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"153-161"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492842","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":"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 L 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 Multicenter AIDS Cohort Study (MACS)/Women's Interagency HIV Study (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 to 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 medical mistrust mediated the relationship between Black identity and vaccine-hesitant attitudes, and vaccine-hesitant attitudes mediated the relationship between Black identity and SARS-CoV-2 nonvaccination.</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 nonvaccination than White participants [aOR = 1.72; 95% confidence interval (CI) 1.08-2.72]. Medical mistrust mediated the relationship between Black identity and vaccine-hesitant attitudes, accounting for 46% of the effect ( P  < 0.0001). Vaccine-hesitant attitudes mediated the relationship between Black identity and SARS-CoV-2 nonvaccination 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>Conclusion: </strong>Findings indicate a profound need to build trustworthy healthcare environments to combat medical mistrust and vaccine-hesitant attitudes in Black communities in the United States, including those affected by HIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"193-203"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","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":"Plasma anti-CD4 IgG levels are associated with poor immune recovery in people with HIV initiating antiretroviral therapy.","authors":"Scott A Bowler, Thomas A Premeaux, Leo Ratzan, Courtney Friday, Sara Gianella, Alan L Landay, Lishomwa C Ndhlovu","doi":"10.1097/QAD.0000000000004044","DOIUrl":"10.1097/QAD.0000000000004044","url":null,"abstract":"<p><p>A segment of people with HIV on effective antiretroviral therapy (ART) continue to experience poor immune recovery, leaving them at heightened risk of non-AIDS-defining events (NAEs). The production of anti-CD4 IgG autoreactive antibodies is suggested as one contributing mechanism to these complications. Here, we found that plasma anti-CD4 levels do not discriminate immunological responders from nonresponders nor predict the occurrence of NAEs, suggesting it is unlikely a contributing immunopathological factor associated with these complications.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 2","pages":"208-210"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942572","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":"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":"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 sociodemographic 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, 2630 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 2000s. 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>Conclusion: </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":"105-114"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717628/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epicardial fat and liver stiffness by acoustic radiation force impulse elastography in people with HIV-1 infection without liver disease.","authors":"Daniele Pastori, Francesco Del Sole, Tommaso Brogi, Maria Del Ben, Caterina Fimiani, Claudio Maria Mastroianni, Ivano Mezzaroma","doi":"10.1097/QAD.0000000000004028","DOIUrl":"10.1097/QAD.0000000000004028","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between increased epicardial fat thickness (EFT) and liver stiffness measurement (LSM), as assessed by elastography in people with human immunodeficiency virus type 1 (HIV-1) infection (PWH).</p><p><strong>Methods: </strong>Ninety-one PWH on effective antiretroviral treatment (ART) were enrolled. EFT was measured by transthoracic echocardiography. Liver steatosis was evaluated by ultrasound Hamaguchi criteria and LSM by elastography with acoustic radiation force impulse (ARFI) technique. LSM ≥8 kPa was suggestive of clinically relevant fibrosis.</p><p><strong>Results: </strong>Mean age was 54.3 years and 27.5% were women. EFT correlated with HIV-1 infection duration (rS 0.252, P  = 0.016), age at study entry (rS 0.527, P  < 0.001), BMI (rS 0.363, P  < 0.001), waist circumference (rS 0.549, P  < 0.001), HDL (rS -0.391, P  < 0.001), triglycerides (rS 0.375, P  < 0.001), Hamaguchi score (rS 0.279, P  = 0.007), right lobe of the liver (rS 0.259, P  = 0.014), left ventricular mass/body surface area (rS 0.220, P  = 0.036).A LSM ≥8 kPa was found in 20.9% of PWH, more commonly in those with EFT above the median >5.6 mm (30.4% vs. 11.1%, P  = 0.038). LSM significantly correlated with EFT (rS 0.274, P  = 0.009), CD4 + cells (rS -0.320, P  = 0.003) and nadir of CD4 + cells (rS -0.292, P  = 0.007).In a subgroup ( n  = 53), a homeostasis model assessment of insulin resistance (HOMA-IR) index >2.33 identified increased EFT, [area under the curve (AUC) 0.73, 95% confidence interval (CI) 0.59-0.84, P  = 0.001) while an HOMA-IR >3.27 predicted increased LSM (AUC 0.76, 95% CI 0.62-0.87, P  = 0.005).</p><p><strong>Conclusions: </strong>PWH with increased EFT have worse metabolic profile and a high proportion of clinically relevant fibrosis at ARFI elastography, despite normal liver function tests. The HOMA-IR index might be used to identify PWH with increased EFT and liver fibrosis.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"115-122"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339223","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}