AIDS最新文献

{"title":"Association of Cytomegalovirus Immunoglobulin G Antibodies with Prevalent and De Novo Hypertension in People With HIV.","authors":"Kristiana A Nikolova, Dina L Møller, Josefine A Loft, Moises A Suarez-Zdunek, Nikolai Kirkby, Thomas Benfield, Raquel Martin-Iguacel, Andreas D Knudsen, Susanne D Nielsen","doi":"10.1097/QAD.0000000000004355","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004355","url":null,"abstract":"<p><strong>Objective: </strong>People with HIV (PWH) have high burden of cardiovascular diseases, with cytomegalovirus (CMV) suggested to contribute to the CVD pathogenesis. However, research on CMV and hypertension in PWH is limited. We investigated whether CMV IgG seropositivity and concentrations are associated with prevalent and de novo hypertension in PWH.</p><p><strong>Design: </strong>Longitudinal study of PWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study.</p><p><strong>Methods: </strong>Participants with available CMV IgG concentrations, blood pressure, and data on use of antihypertensives were included. Associations between CMV IgG seropositivity and high CMV IgG concentrations (>180 U/mL) with prevalent and de novo hypertension at two-year follow-up were analysed using logistic regression adjusted for age, sex, ethnic origin, body mass index, smoking, and CD4+ T-cell nadir.</p><p><strong>Results: </strong>We included 1,036 PWH, 95% were CMV IgG seropositive, and 41% had prevalent hypertension. Median CMV IgG concentration was higher among those with hypertension (159 U/mL, IQR 124-501) than those without (147 U/mL, IQR 114-455) (p = 0.001). The incidence rate of de novo hypertension was 8.3 cases per 100 person-years. CMV IgG seropositivity (adjusted odds ratio [aOR] 0.61 [95% confidence interval (CI): 0.32-1.16], p = 0.13) and high CMV IgG concentrations (aOR 1.09 [95% CI: 0.80-1.50], p = 0.58) were not associated with prevalent hypertension. Likewise, no associations were observed between CMV IgG seropositivity (aOR 1.75 [95% CI: 0.61-7.40], p = 0.36) or high CMV IgG concentrations (aOR 1.20 [95% CI: 0.74-1.93], p = 0.46) and de novo hypertension.</p><p><strong>Conclusions: </strong>We found no association between CMV IgG serostatus or concentrations and prevalent or de novo hypertension in PWH.</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":"145135922","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":"Cerebral toxoplasmosis in the twenty-first century: long-term clinical outcomes in a retrospective cohort study in the Netherlands.","authors":"C M van Deuzen, B J A Rijnders, H I Bax, C Rokx, T E M S de Vries-Sluijs, C A M Schurink, J L Nouwen, M de Mendonça-Melo, A A Anas, E van Gorp, L Slobbe, J J van Hellemond, E van Nood","doi":"10.1097/QAD.0000000000004356","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004356","url":null,"abstract":"<p><strong>Background: </strong>Cerebral toxoplasmosis is a common opportunistic infection in people with HIV (PWH), associated with high morbidity and mortality. It is unclear how clinical characteristics, treatment response and long-term clinical outcomes in PWH with cerebral toxoplasmosis have changed due to improved treatment of HIV.</p><p><strong>Methods: </strong>This single-centre retrospective observational cohort study of PWH with cerebral toxoplasmosis included patients over almost 25 years.</p><p><strong>Results: </strong>63 eligible patients were identified. Most patients were late presenters presenting with headache and neurological symptoms. Overall survival was 79% over a mean follow up of 15 years. 73% of deaths occurred within the first year after diagnosis. Almost 10% of patients experienced residual impairments.</p><p><strong>Conclusions: </strong>An earlier diagnosis of HIV reduces the incidence of cerebral toxoplasmosis due to timely initiation of cART and anti-Toxoplasma prophylaxis. High index of suspicion by clinicians is vital to timely start anti-Toxoplasma therapy. If treated correctly and timely, overall survival is high.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123914","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 and risk factors of cognitive frailty in people with HIV.","authors":"Jovana Milic, Stefano Calza, Luca Lazzarini, Mattia Cocchi, Federico Motta, Stefano Renzetti, Laura Sighinolfi, Michela Belli, Vera Todisco, Maddalena Albertini, Altea Gallerani, Marianna Menozzi, Gianluca Cuomo, Giuseppe Mancini, Chiara Mussi, Cristina Mussini, Andrea Calcagno, Giovanni Guaraldi","doi":"10.1097/QAD.0000000000004352","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004352","url":null,"abstract":"<p><strong>Background: </strong>Cognitive frailty (CF, the simultaneous presence of frailty and cognitive impairment) is recognized as a significant predictor of several adverse health outcomes. The objective of this study was to describe prevalence and risk factors for CF in people with HIV (PWH) >50 years.</p><p><strong>Methods: </strong>This was a cross-sectional observational study including PWH attending Modena HIV Metabolic Clinic (MHMC). Neurocognitive function was measured with Cogstate battery that comprises six domains. Each individual CogState raw score was transformed into z-score after correction for age and sex. Neurocognitive impairment was defined by total global deficit score >0.5. Frailty was assessed by 37-Item frailty index. Scores <0.25 were considered fit or >0.26 as frail.</p><p><strong>Results: </strong>A total of 1258 PWH were included, 916 (73%) were males, median age was 58 years, median time since HIV diagnosis was 27 years. The sample was divided into four groups (CF) based on the presence of frailty (F) and cognitive impairment (ICT): F + /ICT + , F + /ICT-, F-/ICT + , F-/ICT-. Age per 5-year increase (OR = 1.27, CI: 1.02-1.55, p = 0.022), nadir CD4 cell count (OR = 0.81, CI: 0.66 - 0.99, p = 0.042) and polypharmacy (OR = 3.47, CI: 2.00 - 6.00, p<0.001) were associated with CF after adjustment for time since HIV diagnosis, multimorbidity, depression and cumulative exposure to dolutegravir.</p><p><strong>Conclusion: </strong>CF prevalence in PWH >50 years was 6.8% and it is higher than what has been observed in the general population >65 years (1-4.4%). Nadir CD4 cell count and polypharmacy was associated with CF, suggesting an HIV specific contribution related to the development of this condition.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090982","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 levels of lipoprotein(a) in persons with HIV compared to the general population.","authors":"Tina Toppevad Stoltz, Anne Marie Reimer Jensen, Anna Katrine Haslund Roed, Ruth Frikke-Schmidt, Andreas Dehlbæk Knudsen, Moises Alberto Suarez-Zdunek, Thomas Benfield, Børge G Nordestgaard, Pia R Kamstrup, Sisse Rye Ostrowski, Marius Trøseid, Shoaib Afzal, Susanne Dam Nielsen","doi":"10.1097/QAD.0000000000004349","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004349","url":null,"abstract":"<p><strong>Objective: </strong>Elevated lipoprotein(a) increases the risk of cardiovascular disease, and previous research suggests that lipoprotein(a) levels are higher in patients with chronic inflammatory diseases. Knowledge about lipoprotein(a) in persons with HIV (PWH) is sparse. We aimed to assess if living with HIV is associated with high levels of lipoprotein(a).</p><p><strong>Methods: </strong>From the Copenhagen Comorbidity in HIV infection (COCOMO) study, we included 789 PWH matched on sex and age with 3156 controls from the Copenhagen general population study. All participants underwent uniform physical examinations, blood sampling and responded to questionnaires regarding lifestyle and health. Lipoprotein(a) was measured using isoform-insensitive immunoturbidimetric assays. High levels of lipoprotein(a) were defined as plasma levels >50 mg/dL.</p><p><strong>Results: </strong>Living with HIV was not associated with high levels of lipoprotein(a) (adjusted odds ratio [aOR] 0.98 [95% CI: 0.80 to 1.21], p = 0.88). Furthermore, none of the examined clinical and demographic factors - including age, sex, diabetes, statin therapy, cholesterol levels, renal function and HIV specific risk factors were significantly associated with elevated lipoprotein(a) levels as well as and none of the examined clinical or demographic risk factors were found to be significantly associated with elevated lipoprotein(a) levels.</p><p><strong>Conclusion: </strong>In this study, living with HIV was not independently associated with high levels of lipoprotein(a) and none of the examined clinical or demographic risk factors were found to be significantly associated with elevated lipoprotein(a) levels.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091005","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":"Tenofovir interruption among people with HIV and HBV: HBV monitoring and risk of HBV reactivation and hepatitis flare.","authors":"Douglas T Dieterich, Laurence Brunet, Ricky K Hsu, Karam Mounzer, Gerald Pierone, Michael B Wohlfeiler, Jennifer S Fusco, Megan S Dunbar, Joshua Gruber, Leland J Yee, Catherine Frenette, Travis Lim, Gregory P Fusco","doi":"10.1097/QAD.0000000000004353","DOIUrl":"10.1097/QAD.0000000000004353","url":null,"abstract":"<p><strong>Objective: </strong>To assess HBV monitoring, HBV reactivation and hepatitis flares during tenofovir interruptions among people with HIV and HBV.</p><p><strong>Design: </strong>Cohort study of electronic health records.</p><p><strong>Methods: </strong>All tenofovir (tenofovir disoproxil fumarate, tenofovir alafenamide) interruptions among people with HIV and positive HBV surface antigen (HBsAg) or positive HBV core antibody (HBcAb) were categorized by reactivation risk (high: HBsAg+; moderate: HBsAg-/HBcAb+/surface antibody [HBsAb] negative; low: HBsAg-/HBcAb+/HBsAb+). Incidence rates of HBV reactivation and hepatitis flare were assessed with Poisson regression.</p><p><strong>Results: </strong>Among 5343 individuals with HIV and HBV, there were 6252 tenofovir interruptions (11% high-, 19% moderate-, 69% low-risk). During the interruptions, HBV DNA/HBsAg testing was infrequent (high: 52%/25%; moderate: 8%/31%, low: 5%/28%), although ALT testing was performed during nearly all interruptions. The HBV reactivation rate was 9.59 per 100 person-years (95% confidence interval [CI]: 7.91, 11.64) during high-risk, 0.58 (0.36, 0.91) during moderate-risk, and 0.04 (0.02, 0.11) during low-risk interruptions. The HBV reactivation with hepatitis flare incidence rate was much lower, especially in the high-risk group (3.06 per 100 person-year; 95% CI: 2.19, 4.29).</p><p><strong>Conclusions: </strong>In this large US cohort of people with HIV and HBV, tenofovir interruptions were common and HBV monitoring was sub-optimal. HBV reactivation rates were highest among the high-risk group, but much lower among the moderate- and low-risk groups. However, some reactivations were likely missed due to low monitoring frequency. Primary and HIV care providers must incorporate HBV monitoring in their standard of care and proceed with caution if considering a tenofovir interruption for people with HIV and HBV.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090921","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":"Intersecting social determinants of health, multimorbidity and quality of life in people of Black ethnicities with HIV in South London: a mixed-methods study.","authors":"Luxsena Sukumaran, Lourdes Dominguez-Dominguez, Lisa Hamzah, Jia Liu, Heidi Lempp, Elena Nikiphorou, Caroline A Sabin, Frank A Post, Shema Tariq","doi":"10.1097/QAD.0000000000004343","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004343","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDoH) impact health outcomes and rarely exert their influence in isolation. We examined associations between SDoH patterns, multimorbidity, and quality of life (QoL) in people of Black ethnicities with HIV in England.</p><p><strong>Methods: </strong>This mixed-methods study comprised questionnaires, focus group discussions and semi-structured interviews with staff members from a community-based organisation. We used principal component analysis to identify patterns of SDoH and z-scores to describe the burden of each pattern. Associations between SDoH burden scores, multimorbidity and QoL (EQ-5D) were assessed using logistic regression, adjusting for sex and age.</p><p><strong>Results: </strong>Amongst 340 participants (median [interquartile range, IQR] age 52 [45-57] years, 54% female, 95% HIV RNA <200 copies/ml), we identified three SDoH patterns: Livelihood (food, employment and financial insecurity, loneliness and isolation), Shelter/Displacement (housing, migration and food insecurity) and Social Exclusion (discrimination, loneliness and isolation). An increase in SDoH z-scores was associated with higher odds of multimorbidity (Livelihood: aOR 2.09 [1.63-2.69], Shelter/Displacement: 1.41 [1.12-1.78], Social Exclusion: 1.78 [1.40-2.26]). Higher Livelihood and Social Exclusion z-scores correlated with all QoL domains (p<0.001), and Shelter/Displacement was associated with problems with usual activity (aOR 1.29 [1.04-1.61], p = 0.02) and pain/discomfort (1.29 [1.05-1.58], p = 0.02). Qualitative findings supported the quantitative findings whilst providing further context on how SDoH intersect and shape health.</p><p><strong>Conclusion: </strong>This study highlights how SDoH intersect and are associated with multimorbidity and lower QoL in people of Black ethnicities living with HIV. These findings emphasise the need for comprehensive, biopsychosocial interventions to address health inequities in this population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079394","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 antiretroviral regimens containing Integrase Inhibitors on achieving viral suppression at ultra-low levels compared to other ART strategies.","authors":"Roser Navarro-Soler, Juan Martín-Torres, María Lagarde, Otilia Bisbal, Adriana Pinto, Asunción Hernando, Cristina Martín-Arriscado Arroba, Rafael Rubio, Federico Pulido, David Rial-Crestelo","doi":"10.1097/QAD.0000000000004340","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004340","url":null,"abstract":"<p><strong>Background: </strong>Despite effective antiretroviral therapy (ART), residual low-level HIV viremia may persist. Integrase inhibitor (INSTI)-based regimens have become preferred treatments, but their impact on controlling residual viral replication remains unclear.</p><p><strong>Objective: </strong>To evaluate the impact of integrase inhibitor-based regimens on achieving target not detected (TND) rates compared to other antiretroviral strategies.</p><p><strong>Methods: </strong>This retrospective cohort study assessed 131 virologically suppressed people with HIV (PWH) categorized into 4 treatment groups: Group 1, treated with protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI) based regimens (n = 30); Group 2, treated with INSTI-based regimens (n = 30); Group 3, initially treated with PI/NNRTI regimens who switched to INSTI-based therapy (n = 26); and Group 4, initially treated with INSTI triple therapy who switched to dual therapy (n = 30). The primary endpoint was the proportion of \"target not detected\" (TND) HIV-1 RNA measurements.</p><p><strong>Results: </strong>INSTI-based regimens showed significantly higher TND rates compared to PI/NNRTI-therapies (difference: 18.5%, p < 0.001). Switching from PI/NNRTI to INSTI-based therapies increased TND rates from 52.6% to 92%. Multivariate analysis identified shorter time to viral suppression and absence of HCV co-infection as factors associated with higher TND rates. No significant differences were observed when switching from INSTI-based triple therapy to INSTI-based dual therapy.</p><p><strong>Conclusion: </strong>INSTI-based regimens, whether triple or dual therapy, achieve better control of residual viremia compared to other treatment strategies. This improved virological control was maintained during follow-up and was independent of the number of drugs.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079458","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 between cerebrospinal fluid N-acetyl-aspartyl-glutamate (NAAG) and cognitive function in people with HIV.","authors":"Atiksh Chandra, Jesse Alt, Raha M Dastgheyb, Rebecca T Veenhuis, Rana Rais, Jennifer M Coughlin, Barbara S Slusher, Leah H Rubin","doi":"10.1097/QAD.0000000000004341","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004341","url":null,"abstract":"<p><strong>Objectives: </strong>Despite effective antiretroviral therapy, many people with HIV (PWH) experience persistent deficits in attention and working memory (WM). Identifying neurometabolic drivers of these impairments is critical for precision diagnostics and targeted interventions. N-acetylaspartylglutamate (NAAG), the most abundant brain dipeptide and endogenous agonist of metabotropic glutamate receptor 3 (mGluR3), regulates glutamatergic transmission central to these cognitive domains. While prior magnetic resonance spectroscopy (MRS) studies have associated higher NAAG with better cognition, NAAG has never been quantified in cerebrospinal fluid (CSF) of PWH or linked to cognition in this population.</p><p><strong>Design: </strong>We tested whether CSF NAAG levels relate to domain-specific cognitive function in 28 PWH (plasma viral load <200 cp/mL).</p><p><strong>Methods: </strong>NAAG was quantified by a sensitive and selective liquid chromatography-tandem mass spectrometric (LC/MS-MS) method. Cognition was measured using a Research Domain Criteria (RDoC)-based battery, with principal component analysis deriving domain scores. Pearson correlations and age/viral load-adjusted regressions were used to assess NAAG- cognition associations.</p><p><strong>Results: </strong>Higher CSF NAAG was significantly associated with better spatial attention and WM (r = 0.479, P = 0.01), independent of age and viral load. In contrast, NAAG levels showed no relationship with verbal attention and WM or other domains such as verbal episodic memory and motor function.</p><p><strong>Conclusions: </strong>This is the first study to identify a CSF-based neurometabolic marker linked to specific cognitive domains in PWH, bridging MRS findings to a scalable fluid biomarker platform. NAAG CSF measurement opens new translational pathways for early detection, risk profiling, and glutamatergic-targeted interventions in neuroHIV. Longitudinal studies will determine its prognostic and therapeutic utility.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079348","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":"A randomized controlled trial to unveil the influence of an exercise intervention on brain integrity and gut microbiome structure in individuals with HIV.","authors":"Sarah A Cooley, Aura Ferreiro, Brittany Nelson, Kimberley Sukhum, Elizabeth Westerhaus, Kalen Petersen, June Roman Fox, Alex Rosenow, Christopher Sorensen, Florin Vaida, Dominic N Reeds, Phillip I Tarr, Gautam Dantas, Beau M Ances","doi":"10.1097/QAD.0000000000004346","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004346","url":null,"abstract":"<p><strong>Objective: </strong>Exercise intervention programs enhance physical fitness, cognition, neuroimaging measures, and alter the structure of the gut microbiome in individuals without HIV. However, interventional studies exploring the effects of exercise in persons with HIV (PWH) have not included neuroimaging or gut microbiome analyses.</p><p><strong>Design: </strong>A randomized controlled trial conducted at Washington University in St. Louis, MO, USA.</p><p><strong>Methods: </strong>65 PWH (aged ≥40 years, self-reported sedentary lifestyle) were randomly assigned to a six-month cardiorespiratory and resistance training (EXS) or stretching control (SIS) intervention in a 2:1 ratio. Longitudinal change in cognition, cerebral blood flow (CBF), physical and cardiorespiratory fitness, and gut microbiome diversity and composition were examined among participants (n = 62) who completed any portion of the intervention (ClinicalTrials.gov: NCT02663934).</p><p><strong>Results: </strong>Better fitness and better cognitive performance were associated with greater phylogenetic diversity in gut microbiome composition at baseline. Longitudinal findings indicated slight but significant improvements in psychomotor speed and executive function, reductions in body mass index, improvements in physical fitness, and increased gut microbiome diversity. These changes were observed regardless of assigned intervention group. There were no observed changes in CBF for either group.</p><p><strong>Conclusions: </strong>These findings highlight physical fitness as a modifiable factor in PWH that may improve cognitive performance and change gut microbiome composition. Both interventions were beneficial, suggesting light stretching exercise or study participation alone could have been sufficient to introduce positive cognitive shifts in previously sedentary PWH. Longer interventions with more participants are needed to identify changes in neuroimaging metrics related to brain integrity.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079291","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":"Advanced HIV disease and 30-day mortality among hospitalized adults with virally suppressed HIV in South Africa.","authors":"Samuel J Starke, Ziyang He, Ruan Hollamby, Tumelo Moloantoa, Pattamukkil M Abraham, Yukari C Manabe, Christopher J Hoffmann, Ebrahim Variava, Neil A Martinson","doi":"10.1097/QAD.0000000000004336","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004336","url":null,"abstract":"<p><strong>Objectives: </strong>An increasing proportion of hospitalized persons living with HIV (PWH) in South Africa are virally suppressed. This study aimed to characterize causes of hospitalization, the burden of advanced HIV disease (AHD), and 30-day post-discharge mortality among this patient population.</p><p><strong>Methods: </strong>We conducted a prospective observational study of adult PWH with a viral load <1,000 copies/mL admitted to a public tertiary hospital in Klerksdorp, South Africa from October 2023 to September 2024. Demographic, clinical, and laboratory data were collected, and 30-day follow-up was conducted to assess mortality. AHD was defined as a CD4 count < 200 cells / mm3 or WHO Stage 3 or 4 disease based on presence of an AIDS-defining illness. Comparisons between participants hospitalized with AIDS-defining conditions versus other causes, as well as between decedents and survivors, were conducted using Wilcoxon rank sum and Fisher's exact tests.</p><p><strong>Results: </strong>Of 1245 hospitalized patients screened, 99 virally suppressed PWH were enrolled. Median age was 45 years; 56% were female. AIDS-defining illnesses, primarily tuberculosis (TB), accounted for 27.3% of hospitalizations. Forty-four participants (44%) met criteria for AHD. Thirty-day mortality was 12.1% (6 in-hospital, 6 post-discharge). Most decedents were <50 years of age and had undetectable viral loads. Factors significantly associated with 30-day mortality included >10 years since HIV diagnosis and initial hemoglobin <12 g /dL.</p><p><strong>Conclusions: </strong>Despite virologic suppression, PWH who are hospitalized remain at high risk for death-particularly from TB and other AIDS-related illnesses. Strengthening early TB detection, expanding preventive therapy, and improving post-discharge care are critical to improving outcomes in this population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079297","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}