AIDS最新文献

{"title":"Subcutaneous adipose tissue gene transcripts associated with progressive myosteatosis in persons with HIV.","authors":"Oliver S Zhao, Heidi J Silver, Run Fan, Fei Ye, Qi Liu, Sangeeta Nair, James G Terry, John J Carr, Celestine Wanjalla, Mona Mashayekhi, Samuel Bailin, Curtis Gabriel, John R Koethe","doi":"10.1097/QAD.0000000000004264","DOIUrl":"10.1097/QAD.0000000000004264","url":null,"abstract":"<p><strong>Objectives: </strong>Skeletal muscle fat infiltration (myosteatosis) is a clinical condition distinct from visceral and hepatic lipid accumulation and contributes to metabolic dysregulation, sarcopenia, and frailty in people with HIV (PWH). Altered subcutaneous adipose tissue (SAT) function contributes to visceral fat deposition and hepatic steatosis, but there are few data on SAT gene expression and myosteatosis in PWH on long-term antiretroviral therapy (ART).</p><p><strong>Design: </strong>A longitudinal analysis of 40 PWH on contemporary ART with sustained viral suppression to assess relationships between SAT gene transcripts and computed tomography (CT) imaging of skeletal muscle density, where lower density indicates higher lipid content, and area. CT imaging also measured other fat depots, including visceral adipose tissue (VAT) volume and liver density.</p><p><strong>Methods: </strong>SAT gene transcripts were quantified using a NanoString panel of 255 immune and 77 adipocyte-related genes. Linear mixed-effects models assessed baseline SAT gene expression and changes in skeletal muscle over a median of 3.3 years.</p><p><strong>Results: </strong>Decreasing skeletal muscle density over time correlated with increasing VAT volume and declining liver density. Gene-by-visit interaction revealed 34 SAT genes associated with muscle density change and 15 genes associated with muscle area change. Two key CCR4-binding chemokines, CCL17 and CCL22, were linked to reductions in both muscle density and area.</p><p><strong>Conclusion: </strong>A subset of SAT gene transcripts is associated with changes in skeletal muscle density and area over time, suggesting interventions to modulate SAT immune activity or improve lipid handling may hold therapeutic potential to slow the progression of myosteatosis and sarcopenia in PWH.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1739-1748"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315720","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":"Multisector global collaboration to advance the inclusion of pregnant and lactating people in HIV prevention research.","authors":"Robin Schaefer, Breanne Lievense, Suzanne Day, Logan Donaldson, Linda-Gail Bekker, Audrey Chigome, Grace Kumwenda, Lisa Noguchi, Chukwunomso Osakwe, Veronica Miller, Anne Drapkin Lyerly, Manju Chatani-Gada","doi":"10.1097/QAD.0000000000004257","DOIUrl":"10.1097/QAD.0000000000004257","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 12","pages":"1835-1838"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938738","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":"Metabolic dysfunction-associated steatotic liver disease was associated with liver fibrosis in people with HIV from Brazil.","authors":"Juliana Fittipaldi, Sandra W Cardoso, Estevão Portela Nunes, Cristiane Fonseca De Almeida, Patricia Dias De Brito, Valdilea G Veloso, Beatriz Grinsztejn, Hugo Perazzo","doi":"10.1097/QAD.0000000000004250","DOIUrl":"10.1097/QAD.0000000000004250","url":null,"abstract":"<p><strong>Objective: </strong>To describe the association of metabolic dysfunction-associated steatotic liver disease (MASLD) with clinically significant liver fibrosis (CSLF) in people with HIV from Rio de Janeiro (Brazil).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>We analyzed data from the baseline visit of the PROSPEC-HIV-study (NCT02542020). People with HIV aged ≥18 years were submitted to clinical evaluation, questionnaires, blood sample and transient elastography (TE) at INI/FIOCRUZ from June/2015 to March/2019. Exclusion criteria were unreliable TE or missing data. Steatosis and liver fibrosis were assessed by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) from TE, respectively. MASLD was determined by presence of steatosis (TE-CAP ≥ 263 dB/m) with at least one cardiometabolic-risk-factor (overweight/obesity, diabetes, hypertension or dyslipidemia) without hazard alcohol intake. CSLF was defined by TE-LSM ≥8.0 kPa. Multivariate logistic regression models were performed.</p><p><strong>Results: </strong>684 participants [47.8% male, median age= 45 [interquartile range (IQR), 36-53] years, 12% with diabetes and 13% with viral hepatitis coinfection] were included. The prevalence [95% confidence interval (CI)] of MASLD and CSLF were 19.3% [16.5-22.4] and 14.2% [11.8-17.0], respectively. In the multivariate analysis [odds ratio (OR) (95% CI)], older age [1.52 (1.75-1.96)], MASLD [2.20 (1.25-3.87)], viral hepatitis [4.93 (2.72-8.94)], higher ALT levels [1.11 (1.04-1.18)] and CD4 + cell count <350 cells/mm 3 [1.95 (1.07-3.53)] were significantly associated with presence of CSLF. MASLD remained independently associated with CSLF in people with HIV mono-infection ( n  = 595) [OR = 2.18 (95% CI, 1.19-3.98)].</p><p><strong>Conclusion: </strong>MASLD increased the odds of CSLF in people with HIV independently of viral hepatitis. Strategies to screen MASLD in are of paramount importance to reduce the burden of liver disease in people with HIV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1721-1730"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245767","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":"Not all costs are the same: understanding costs of opioid agonist treatment around the world.","authors":"Czarina N Behrends, Bruce R Schackman","doi":"10.1097/QAD.0000000000004293","DOIUrl":"10.1097/QAD.0000000000004293","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":"39 12","pages":"1831-1832"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938708","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":"Changes in multimorbidity burden and their impact on patient and healthcare outcomes in people with HIV over a 3-5-year period.","authors":"Luxsena Sukumaran, Alan Winston, Frank A Post, Jane Anderson, Marta Boffito, Memory Sachikonye, Patrick W G Mallon, Laura Waters, Jaime Vera, Fiona Burns, Caroline A Sabin","doi":"10.1097/QAD.0000000000004260","DOIUrl":"10.1097/QAD.0000000000004260","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing multimorbidity among people with HIV, its impact on health outcomes over time remains uncertain. We explored how distinct multimorbidity patterns affect a broad range of health outcomes over a 3-5-year period.</p><p><strong>Methods: </strong>Principal component analysis (PCA) was used to identify multimorbidity patterns at baseline. Burden z -scores were calculated for each individual/pattern at baseline and a follow-up visit, and the differences in scores over time were examined. Participants completed health assessments including questionnaires [physical/mental health (SF-36)], depressive symptoms (CES-D and PHQ-9, falls, frailty and healthcare utilization), cognitive testing and pain mannequins tests. Multivariable regression models assessed associations between changes in morbidity burden z -scores and health outcomes.</p><p><strong>Results: </strong>Six multimorbidity patterns were identified in 1073 participants: \" cardiovascular disease\" (CVD) , \" sexually transmitted infections\" (STIs) , \" metabolic\" , \" mental/joint\" , \" neurological\" , and \" cancer/other\" . Subsequent analyses included 793 participants (median [interquartile range; IQR] age 53 [47-59] years; 86% male; 97% on ART) with follow up data. CVD and metabolic burden were associated with specialist appointments (CVD: β = 1.47; metabolic: β = 1.53, P  < 0.01) and ED visits (CVD: β = 1.44; metabolic: β = 1.89, P  < 0.01), mental/Joint and neurological burden with poorer physical and mental health, frailty and recurrent falls ( P  < 0.01), and cancer/other burden with higher depressive scores (β = 3.28, P  < 0.001), widespread pain (odds ratio, OR = 2.20, P  < 0.001), and hospital visits (OR = 2.31, P  < 0.001).</p><p><strong>Conclusion: </strong>Distinct morbidity patterns differentially affected health outcomes and healthcare utilization over time, underscoring the need for targeted, integrated care to improve quality of life and address their complex needs.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1784-1793"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245684","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":"Risks for sudden cardiac and undetermined cause of death among people with HIV in the REPRIEVE primary cardiovascular prevention trial.","authors":"Christopher deFilippi, Aya Awwad, Gerald S Bloomfield, Isabelle R Weir, Heather Ribaudo, Markella V Zanni, Carl J Fichtenbaum, Carlos D Malvestutto, Judith A Aberg, Marissa R Diggs, Sarah M Chu, Kayla Paradis, Roger D MacArthur, Jose Pilotto, Kristen Marks, Cornelius Van Dam, Aimee Wilkin, Judith S Currier, Sophia Zhao, Stephen D Wiviott, Michael T Lu, Pamela S Douglas, Steve Grinspoon","doi":"10.1097/QAD.0000000000004243","DOIUrl":"10.1097/QAD.0000000000004243","url":null,"abstract":"<p><strong>Objective: </strong>People with HIV (PWH) are at increased risk of sudden cardiac death (SCD) but the mechanisms are unclear limiting prevention efforts. We leveraged the global REPRIEVE trial with carefully adjudicated atherosclerotic cardiovascular disease (ASCVD) outcomes to determine cardiac, behavioral, and HIV-specific risks associated with SCD and assess potential similarities to undetermined deaths (UDD).</p><p><strong>Design/methods: </strong>REPRIEVE included 7769 PWH with low-to-moderate traditional ASCVD risk without known ASCVD randomized to pitavastatin vs. placebo. Clinical features and ECGs were assessed at enrollment. Cox models assessed associations with SCD and UDD outcomes, adjusted for ASCVD risk and ART duration.</p><p><strong>Results: </strong>After a median of 5.6 years, 25 participants had SCD and 53 had UDD (incidence rate 0.61, 1.31 per 1000 person-years, respectively). Of those with SCD, 84% were males, and the median 10-year ASCVD risk-score was 6.9% (IQR 3.5, 8.3) vs. 5.7% (3.6, 8.8) for UDD vs. 4.4% (2.1, 7.0) for participants without either outcome ( n  = 7691). Notably, 16.0% of the participants with SCD, 9.4% with UDD and 3.0% without either had major ECG abnormalities. In adjusted Cox models, substance abuse, and detectable HIV viral load were associated with an increased hazard of UDD but not SCD. Infarct/ischemic pattern and axis abnormalities on ECG were associated with increased hazard for SCD.</p><p><strong>Conclusion: </strong>Among PWH with low-moderate ASCVD risk, subsequent SCD is associated with a higher burden of cardiovascular risk factors and ECG findings suggestive of subclinical structural abnormalities. In contrast, UDD is associated with a unique risk profile inclusive of HIV-specific and behavioral risks.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1709-1720"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155413","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":"Preferences for HIV prevention conditional cash transfers among Black/African American and Latinx cisgender MSM in Los Angeles.","authors":"Corrina Moucheraud, Dillon Trujillo, Zachary Wagner, Wendy Garland, Terry Smith, Risa M Hoffman, Raphael J Landovitz","doi":"10.1097/QAD.0000000000004361","DOIUrl":"10.1097/QAD.0000000000004361","url":null,"abstract":"<p><strong>Objectives: </strong>In Los Angeles, cisgender men who have sex with men (MSM) - particularly Black/African American and Latinx individuals - are a high-priority population for new HIV prevention interventions. Incentive programs that pay people for engaging in healthy behaviors, also known as \"conditional cash transfers\" (CCTs), are a promising strategy, but there is little evidence about their use in Black/African American and Latinx cisgender MSM.</p><p><strong>Design and methods: </strong>We surveyed 133 cisgender MSM who identified as Black/African American or Latinx and included a discrete choice experiment to elicit their preferences for CCTs to incentivize preexposure prophylaxis (PrEP) use and, separately, HIV testing.</p><p><strong>Results: </strong>Our findings suggest that respondents preferred more frequent payments of higher monetary value (e.g., a 35.2 percentage point increased probability of choosing a PrEP use CCT with $1200 versus $300 payment, and a 49.7 percentage point increased probability of choosing an HIV testing CCT with $1200 versus $300 payment). Additionally, respondents showed a preference for receiving CCT payments in cash over gift card payments (a 9.4 percentage point increased preference in the PrEP use CCT, and an 11 percentage point increased preference in the HIV testing CCT), particularly among those who were unemployed. Younger respondents had a stronger preference for more frequent payments. Higher monetary amounts were more strongly preferred by those with greater educational attainment and those who were employed.</p><p><strong>Conclusions: </strong>This preimplementation research highlights important, and heterogeneous, preferences in the design details of a HIV prevention CCT for Black/African American and Latinx cisgender MSM in Los Angeles.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147441","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":"Associations of repeated measures of plasma biomarkers of kidney tubular health with longitudinal kidney function in people with HIV.","authors":"Molly C Fisher, Rebecca Scherzer, Merve Postalcioglu, Teresa K Chen, Simon B Ascher, Jordan E Lake, Michelle Floris-Morre, Seble Kassaye, Igho Ofotokun, Jodie Dionne, Maria Alcaide, Mardge Cohen, Deborah Gustafson, Alison G Abraham, Joseph B Margolick, Ken Ho, Valentina Stosor, Phyllis C Tien, Michael Shlipak, Michelle M Estrella","doi":"10.1097/QAD.0000000000004359","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004359","url":null,"abstract":"<p><strong>Background: </strong>In people with HIV (PWH), urine tubular biomarkers have been linked to kidney function decline, but urine concentration variability limits their clinical utility. Plasma biomarkers may offer more stable indicators of kidney tubular health.</p><p><strong>Methods: </strong>We conducted a case-cohort study of 440 PWH from the MACS/WIHS Combined Cohort Study. Cases developed rapid kidney function decline (RKFD: ≥30% eGFR reduction). We measured plasma biomarkers of tubular injury (KIM-1), inflammation (TNFr1, TNFr2), and synthetic function (UMOD, EGF) at baseline and year 2. Associations with RKFD were assessed using multivariable risk regression, adjusting for CKD and HIV-related risk factors, eGFR, and albuminuria. In a random sub-cohort, linear mixed models evaluated associations with annualized eGFR change.</p><p><strong>Results: </strong>At baseline, median age was 49 years; 33% were women; 69% were virally suppressed; eGFR was similar in cases vs. non-cases (93 vs. 94 mL/min/1.73m2). Over a median of 4.5 years, 172 RKFD events occurred. Each 1-standard deviation higher baseline KIM-1, TNFr1, TNFr2, UMOD and EGF level was associated with adjusted relative risks (RR) for RKFD of 1.26 (95%CI: 1.15-1.39), 1.39 (1.24-1.55), 1.40 (1.24-1.57), 0.84 (0.77-0.93) and 0.85 (0.78-0.92), respectively. Findings were similar at year 2 and for 2-year biomarker changes. In joint models, baseline KIM-1, TNFr2, and UMOD remained independently associated with RKFD (RR: 1.19 [1.08-1.31], 1.27 [1.12-1.43], and 0.86 [0.78-0.95]), respectively. No biomarker was associated with annualized eGFR change in the sub-cohort.</p><p><strong>Conclusion: </strong>In PWH, plasma biomarkers reflecting impaired kidney tubular health were independently associated with RKFD and may be useful prognosticators of adverse kidney outcomes.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136000","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":"Infectious morbidity among children HIV-exposed uninfected in South Africa: elevated risk in infancy but not thereafter.","authors":"Kim Anderson, Hlengiwe P Madlala, Dorothy C Nyemba, Ryan Dinkele, Mariette Smith, Brian S Eley, Mark F Cotton, Rudzani Muloiwa, Graeme Spittal, Max Kroon, Andrew Boulle, Landon Myer, Mary-Ann Davies, Emma Kalk","doi":"10.1097/QAD.0000000000004358","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004358","url":null,"abstract":"<p><strong>Background: </strong>Increased risk of infectious morbidity and hospitalisation has been reported during infancy among children HIV-exposed uninfected (CHEU) compared to children HIV-unexposed uninfected (CHUU). However, data on risks beyond infancy are limited.</p><p><strong>Methods: </strong>We enrolled pregnant women with and without HIV from a primary healthcare facility in a lower-income area in Cape Town, South Africa (2017-2018). We tracked their children's HIV test results and hospitalisations using routine electronic healthcare data. We previously reported increased rates of infectious-cause hospitalisation among CHEU in the first year of life, and now extend the analysis to cover the period from age 1 to <5 years. Using random-effects Poisson regression, we calculated adjusted incidence rate ratios (aIRR) for infectious-cause hospitalisation among CHEU vs CHUU, clustered by infant and adjusted for child sex and vaccination status, maternal age and education, and housing type.</p><p><strong>Results: </strong>Among 446 CHEU and 455 CHUU, 147 admissions occurred from age 1 to <5 years; with 59% (n = 87) due to infections. All-cause hospitalisation occurred in 9.2% of CHEU and 10.5% of CHUU; infectious-cause hospitalisation occurred in 6.5% of CHEU and 7.3% of CHUU with crude incidence rates of 2.4 per 100 child-years for both groups (IRR = 1.0; 95% CI 0.6-1.6). Adjusted analyses showed no evidence of increased hospitalisation among CHEU (aIRR = 0.71; 95% CI 0.36-1.41).</p><p><strong>Conclusions: </strong>Elevated risk of infectious-cause hospitalisation among CHEU did not persist beyond the first year of life. These findings highlight infancy as a key window for targeted interventions, while providing reassurance regarding longer-term infectious morbidity risk.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136004","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":"Long-term liver stiffness dynamics after sustained virological response in patients with HIV/HCV co-infection and advanced fibrosis.","authors":"Jesica Martín-Carmona, Diana Corona-Mata, Francisco Téllez, Miguel Nicolás Navarrete Lorite, Isabel Barroso, Juan Carlos Alados, Rosario Palacios Muñoz, Ignacio de Los Santos, Francisco Jesús Vera-Méndez, Arkaitz Imaz, Miguel Raffo Márquez, Aitana Carla Morano Vázquez, María José Galindo, Olga Belinchón, Miriam Serrano Fuentes, Miguel Ángel López Zúñiga, Carlos Galera Peñaranda, Sergio Javier Reus-Bañuls, Juan A Pineda, Juan Macías, Anaïs Corma-Gómez","doi":"10.1097/QAD.0000000000004357","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004357","url":null,"abstract":"<p><strong>Objetive: </strong>This study analyses liver stiffness (LS) dynamics in people living with HIV (PLWH) and advanced liver fibrosis who achieved SVR and assess factors associated with LS normalization or progression, after long-term follow-up.</p><p><strong>Design: </strong>Prospective multicentre cohort study.</p><p><strong>Methods: </strong>this study included individuals with HIV/HCV co-infection from the Spanish GEHEP-011 cohort, fulfilling: 1) pre-treatment LS≥9.5kPa; 2) sustained virological response (SVR) with direct-acting antiviral regimen; 3) available measurement of LS at SVR. Factors associated with LS normalization (achieving ≤7.2kPa in two consecutive measurement) and progression (increase of >20% LS at the last measurement available) were analysed.</p><p><strong>Results: </strong>678 patients were included. The median follow-up was 40 (17-71) months. The repeated measures ANOVA revealed a significant main effect of time on LS. Overall, 221 (32.6%) achieved normalization. Lower probability of normalization was associated with advanced liver disease [baseline LS: sHR = 0.26 (95% CI, 0.19-0.37), p < 0.001; liver decompensation before SVR: sHR = 0.22 (0.05-0.97), p < 0.001; baseline MELD score: sHR = 0.81 (0.69-0.94), p = 0.006]. LS progression occurred in 50 (7.4%). Progression was associated with higher baseline LS [sHR = 1.04 (1.01-1.07), p = 0.007], controlled attenuation parameter (CAP) [CAP≥280 dB/m: sHR = 2.94 (1.16-7.44)] and older age [sHR 1.06 (1.00-1.13), per year, p = 0.04].</p><p><strong>Conclusions: </strong>In PLWH, LS significantly decreases after HCV cure in the long-term, achieving values of ≤7.2kPa. In a substantial proportion of patients, LS remain stable or even increases. Older age and concomitant steatotic liver disease are associated with LS progression.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136017","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}