AIDS Research and Therapy最新文献

{"title":"Long-term metabolic changes with bictegravir/emtricitabine/tenofovir alafenamide or dolutegravir-containing regimens for HIV.","authors":"Eric S Daar, Chloe Orkin, Paul E Sax, Debbie Hagins, Anton Pozniak, Kimberly Workowski, Cynthia Brinson, Juan Manuel Tiraboschi, Hui Liu, Chris Deaton, Cal Cohen, Sharline Madera, Jason T Hindman, Moti Ramgopal","doi":"10.1186/s12981-025-00732-w","DOIUrl":"https://doi.org/10.1186/s12981-025-00732-w","url":null,"abstract":"<p><strong>Background: </strong>To evaluate long-term changes in weight and metabolic parameters in people with HIV-1 (PWH) initiating first-line antiretroviral therapy.</p><p><strong>Methods: </strong>Analysis of two Phase 3, randomized, double-blind, active-controlled trials (1489: NCT02607930; 1490: NCT02607956). PWH received bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) or dolutegravir (DTG)-based treatment (Study 1489: dolutegravir/abacavir/lamivudine [DTG/ABC/3TC]; Study 1490: DTG + F/TAF) for 144 weeks, followed by B/F/TAF (96-week open-label extension up to Week 240). Weight and metabolic parameters were assessed through Week 144 by randomized treatment assignment. Weight changes by baseline viral load and CD4 count were evaluated in PWH receiving B/F/TAF from baseline through Week 240. Multivariate modeling explored baseline factors associated with absolute weight and weight change through Week 240 and weight gain ≥ 10% at Week 240.</p><p><strong>Results: </strong>Median weight and body mass index (BMI) increased over time with B/F/TAF (n = 628), DTG/ABC/3TC (n = 315), and DTG + F/TAF (n = 325). There were no significant differences in change in weight or BMI between the B/F/TAF and DTG + F/TAF groups or between the B/F/TAF and DTG/ABC/3TC groups at Week 144 in either trial, nor were there differences in other metabolic parameters, including incidence of treatment-emergent diabetes mellitus and hypertension through Week 144. Among PWH receiving B/F/TAF (baseline through Week 240), weight increases were greatest soon after initiating antiretroviral therapy (i.e., Weeks 0-48), particularly in participants with baseline viral load > 100,000 copies/ml and/or CD4 count < 200 cells/µl. In multivariate modeling (B/F/TAF pooled data), lower baseline CD4 count and higher HIV-1 RNA were associated with lower baseline weight and greater weight gain, but not absolute weight, from Week 48 through Week 240.</p><p><strong>Conclusions: </strong>No significant difference in weight change from baseline to Week 144 was found between bictegravir and DTG, or between B/F/TAF and a non-TAF-containing regimen, in these two randomized trials. Furthermore, weight gain following treatment initiation was greatest in the first year of treatment and most pronounced in individuals with more advanced HIV at baseline, supporting the hypothesis that weight gain following initial treatment is linked to a \"return to health\" in people with advanced HIV.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"45"},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Extensive cervical lesion and treatment outcomes in women with HIV/HPV co-infection.","authors":"Rosie Mngqibisa, Huichao Chen, Catherine Godfrey, Motshedisi Sebitloane, Unoda Chakalisa, Sharlaa Badal-Faesen, Gaerolwe Masheto, Frank Taulo, Wadzanai Samaneka, Jennifer Tiu, Cynthia Firnhaber, Timothy Wilkin","doi":"10.1186/s12981-025-00736-6","DOIUrl":"https://doi.org/10.1186/s12981-025-00736-6","url":null,"abstract":"","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"46"},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Swallowing these drugs every day, you get tired\": a mixed-methods study to identify barriers and facilitators to retention and HIV viral load suppression among the adolescents living with HIV in TASO Mbale and TASO Soroti centers of excellence.","authors":"Bonniface Oryokot, Andrew Kazibwe, Abraham Ignatius Oluka, David Kagimu, Baker Bakashaba, Saadick Mugerwa Ssentongo, Twaha Mafabi, Charles Odoi, Abubaker Kawuba, Yunus Miya, Bernard Michael Etukoit, Kenneth Mugisha, Eleanor Namusoke-Magongo","doi":"10.1186/s12981-025-00719-7","DOIUrl":"https://doi.org/10.1186/s12981-025-00719-7","url":null,"abstract":"<p><strong>Background: </strong>Adolescents aged 10-19 years, living with HIV (ALHIV) lag in attaining optimal viral load suppression (VLS) rates and retention in care. This study aimed to identify barriers and facilitators to both treatment outcomes in TASO Mbale and TASO Soroti centers of excellence.</p><p><strong>Methods: </strong>We used a mixed methods approach, extracting secondary data on ALHIV who were active in care during April-June 2022 quarter to determine one year retention and VLS (HIV RNA copies < 1000/ml). Analysis was done in STATA Corp, 15.0. We used logistic regression to determine predictors and adjusted odds ratio (aOR) to report levels of predictability, using 95% confidence interval (CI) and P < 0.05 for statistical significance. For qualitative component, purposive sampling of 59 respondents was done. Focused group discussions, key informant interviews, and in-depth interviews were used to collect data. Thematic content analysis was done using Atlas ti.</p><p><strong>Results: </strong>There were 533 ALHIV, median age of 15 years, interquartile range of 11-18 and 54.2% females. 12-month retention rate was 95.9% and VLS of 84.0%. Poor and fair adherence [aOR = 0.044, 95% CI 0.010-0.196, P < 0.001)], [aOR = 0.010, 95% CI (0.002-0.039) P < 0.001] respectively had decreased odds for VLS while multi-month dispensing of drugs (aOR = 3.403, 95% CI 1.449-7.991, P = 0.005) had increased odds of VLS. For retention, being with a non-biological caregiver (aOR = 0.325, 95% CI 0.111-0.9482 P = 0.04) decreased the odds. Meanwhile key barriers included: individual ones such as internal stigma and treatment/drug fatigue; facility-level such as prolonged waiting time and lack of social activities; community level include stigma and discrimination, inadequate social support and food shortage. In terms of facilitators, individual level ones included good adherence and knowledge of one's HIV status; facility-level such as provision of adolescent friendly services and community-level like social support and decent nutrition.</p><p><strong>Conclusions: </strong>VLS rate was sub-optimal mainly due to poor adherence. HIV programs could utilize the barriers and facilitators identified to improve VLS. Conversely, retention rate at one year was good, likely due to provision of adolescent friendly health services. ALHIV and their caregivers need to be empowered to sustain retention and improve VLS.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"43"},"PeriodicalIF":2.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trials of broadly neutralizing monoclonal antibodies in people living with HIV - a review.","authors":"Sharana Mahomed, Kayla Pillay, Razia Hassan-Moosa, Bruna P G V Galvão, Wendy A Burgers, Penny L Moore, Melissa Rose-Abrahams, Carolyn Williamson, Nigel Garrett","doi":"10.1186/s12981-025-00734-8","DOIUrl":"https://doi.org/10.1186/s12981-025-00734-8","url":null,"abstract":"<p><strong>Introduction: </strong>HIV-1 remains a major global health challenge, impacting approximately 39 million people worldwide. Although antiretroviral therapy has substantially reduced HIV incidence and enhanced the quality of life for those living with HIV, adherence difficulties, limited access, and persistent stigma continue to exacerbate the disease burden. A curative or long-term immunological control strategy without continuous medication would significantly advance pandemic management. In the 2010s, technological progress led to the development of a new generation of broadly neutralizing antibodies (bNAbs) with improved potency and breadth, targeting conserved regions of the HIV-1 envelope and facilitating viral neutralization and clearance.</p><p><strong>Methods: </strong>This review evaluates the clinical outcomes and potential of bNAbs in people living with HIV, summarizing findings from a review of 154 registered trials, of which 62 met the inclusion criteria focusing on adult PLWH.</p><p><strong>Results: </strong>Early trials confirmed bNAbs' safety but revealed transient and limited viral suppression, often due to viral escape. Second-generation bNAbs like VRC01 and 3BNC117, as well as combination therapies such as 3BNC117 with 10-1074, extended viral suppression but continued to face resistance challenges.</p><p><strong>Conclusion: </strong>More recent trials that paired bNAbs with latency-reversing agents or combined multiple bNAbs demonstrated promising results, including delayed viral rebound and enhanced CD8 + T-cell responses. While bNAbs show potential as an adjunct or alternative to ART, obstacles such as viral resistance, high production costs, and scalability must be addressed. Continued research is crucial to developing more potent, durable, and affordable bNAbs for sustainable HIV treatment and potential remission.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"44"},"PeriodicalIF":2.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological status of measles, mumps, and rubella antibodies in HIV-positive women of childbearing age at a referral hospital in Iran.","authors":"Sara Ghaderkhani, SeyedAhmad SeyedAlinaghi, Kousha Farhadi, Ladan Abbasian, Alireza Abdollahi, Malihe Hasannezhad, Seyed Ali Dehghan Manshadi, Erta Rajabi","doi":"10.1186/s12981-025-00735-7","DOIUrl":"10.1186/s12981-025-00735-7","url":null,"abstract":"<p><strong>Background: </strong>The human immunodeficiency virus (HIV) increases susceptibility to measles, mumps, and rubella (MMR) infections due to decreased cluster of differentiation 4 + T-cell levels and rapid waning of protective antibodies following vaccination, which imposes a significant impact on HIV-positive women of reproductive age, for whom MMR vaccination is a crucial preventive measure. This study aimed to shed light on the immunity status of women of childbearing age with HIV infection post-MMR-vaccination during their childhood and the necessity of further vaccination in these individuals.</p><p><strong>Methods: </strong>To evaluate seroconversion rates following vaccination through Iran's NIP or previous infection by assessing MMR IgG levels, all Iranian women aged 18-45 years referred to our voluntary counseling center, with or without HIV infection and CD4 levels 200 cells/mm³ or higher at the time of enrollment, were invited to participate. Data were collected through the Hospital Information System and questionnaires, and blood samples were taken to evaluate the seroconversion following MMR vaccination via NIP or previous MMR infection.</p><p><strong>Results: </strong>In this study, 150 women participated, with a mean age (± SD) of 36.49 (± 6.80). Mean rubella and measles IgG levels of HIV-positive participants (95.08 ± 79.42 IU/Ml) were higher than HIV-negative peers (8.98 ± 3.83 mg/dL) with no significant associations (p-value > 0.05). However, mumps IgG levels were significantly lower compared to HIV-negative participants (9.87 ± 28.70 mg/dL, p-value < 0.001). Additionally, HIV-positive participants significantly exhibited lower total immunity (n = 73, 97.3) compared to HIV-negative participants (n = 64, 85.3) (p-value = 0.07). HIV-positive individuals who did not have seroimmunity against mumps infection had significantly lower CD4 NADIR counts (cells/mm3) (mean ± SD = 259.00 ± 203.31, p-value: 0.025). Moreover, regression analyses demonstrated significant associations between decreased mumps IgG levels and lower CD4 NADIR counts (AOR = 1.004, 95% CI = 1-1.008, p value = 0.03).</p><p><strong>Conclusion: </strong>Our research found that HIV-positive women may need MMR revaccination due to increased susceptibility to at least one of these viruses. We also highlighted the significance of considering lower CD4 NADIR as a risk factor for mumps development in women living with HIV infection.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"42"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sero-prevalence of cryptococcal antigen and its immune-virological correlates in HIV-1 positive individuals: a prospective cross-sectional study.","authors":"Bukhari Isah Shuaib, Amina Momodu, Fareedah Momodu, Bumojo Hope Agada","doi":"10.1186/s12981-025-00738-4","DOIUrl":"10.1186/s12981-025-00738-4","url":null,"abstract":"<p><strong>Background: </strong>Cryptococcal infection remains a leading cause of mortality among HIV-1-positive individuals, particularly in regions with limited access to antiretroviral therapy and diagnostics. This study aimed to assess Cryptococcal Antigen (CrAg) seroprevalence and its immune-virological correlates among ART-naïve and ART-experienced HIV-1 positive individuals.</p><p><strong>Methods: </strong>This prospective cross-sectional study was conducted from May 2023 to August 2024 at Edo State University Teaching Hospital, Nigeria. Blood samples were analyzed for CD4 + T-cell counts using a Partec™ CyFlow analyzer, HIV-1 viral load using the COBAS^® AmpliPrep/COBAS^® TaqMan^® Test, and CrAg detection with the Immy Latex-Crypto Antigen Lateral Flow Assay.</p><p><strong>Results: </strong>Among 229 HIV-1 positive individuals, 72.5% were aged 15-20 years, and 69% were female. Most (68.6%) were ART-experienced, while 31.4% were ART-naïve. Severe immunosuppression (CD4 + < 200 cells/mm³) was present in 64.6%, and 71.2% had viral loads > 1,000 copies/mL. Cryptococcal infection (CI) prevalence was 10.04%. No significant link was found between CI and age or gender, but ART-naïve status, low CD4 + counts, and high viral loads were significantly associated with CI. ART-naïve individuals had higher viral loads (median 4.95 vs. 4.19 log10 copies/mL, p = 0.00). A stronger inverse correlation between CD4 + counts and viral load was observed in ART-experienced patients (r = -0.535).</p><p><strong>Conclusions: </strong>These findings emphasize the necessity for routine Cryptococcal screening, particularly in ART-naïve and severely immunocompromised individuals, to facilitate timely interventions and improve clinical outcomes.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"41"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda.","authors":"Moses Mugerwa, Juliana Namutundu, Joanita Nangendo, Victoria Babirye Tumusiime, Denis Ndekezi, Collins G K Atuheire, Kelvin Bwambale, Suzanne N Kiwanuka, David Kyaddondo","doi":"10.1186/s12981-025-00727-7","DOIUrl":"10.1186/s12981-025-00727-7","url":null,"abstract":"<p><strong>Background: </strong>HIV/AIDS remains a public health threat globally. The disclosure rates of positive HIV status by young people living with HIV (YPLHIV) to their sexual partners vary and have been reported as low as 31%, despite the consequences of non-disclosure. Little is known about disclosure to sexual partners among YPLHIV in most of Sub-Saharan Africa, including Uganda. We assessed the prevalence, determinants, barriers and facilitators of HIV status disclosure to sexual partners among YPLHIV in care at an urban HIV clinic in Uganda.</p><p><strong>Methods: </strong>The study utilized a cross sectional design using a parallel-convergent mixed method approach. We conducted 281 structured interviews through random sampling and 16 purposively sampled in-depth interviews (IDIs) among YPLHIV (18 to 24 years). Descriptive analysis was done to obtain the frequency and percentage of HIV status disclosure to sexual partners of YPLHIV. Modified Poisson regression was used to determine associated factors at multivariate analysis and adjusted prevalence ratios, 95% CI and p values were obtained using STATA version 14. Verbatim transcription and thematic analysis using NVIVO version 12 was used to explore the barriers and facilitators of HIV status disclosure to sexual partners using the health belief model.</p><p><strong>Results: </strong>The prevalence of HIV status disclosure to sexual partners was 45.2%. Having a known HIV free partner (aPR = 0.6, P < 0.001), being a partial or complete orphan (aPR = 1.4, P = 0.022), knowing one's HIV status for > 1 year (aPR = 0.7, P < 0.001), and having 2 rather than 3 sexual partners (aPR = 1.7, P = 0.013) were among the determinants of HIV status disclosure. Facilitators of disclosure included; health worker/peer support, nature of relationship, protecting partners against HIV, need for social/financial support. Barriers to disclosure included; lack of confidence to disclose, fear of sexual partners' reaction, awareness of undetectable HIV viral load equated to none HIV transmission, influence by parents among others.</p><p><strong>Conclusion: </strong>This study revealed a low HIV status disclosure prevalence to sexual partners among YPLHIV. Addressing potential barriers through comprehensive health education including the role of viral load in HIV transmission, and creating supportive environments to enhance their confidence, will improve disclosure rates among YPLHIV to their sexual partners.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"40"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standard of care in advanced HIV disease: review of HIV treatment guidelines in sub-Saharan African countries-an extension study of eight countries.","authors":"Thomas C Scheier, Tafese Beyene Tufa, Torsten Feldt, Yasmine Hardy, Albert Minga, Raoul Moh, Albertino Damasceno, Lucia Chambal, Francine Ntoumi, Carine Kades, Leopold Bitunguhari, Osee R Sebatunzi, Marco Missanga, Katanekwa Njekwa, Monde Muyoyeta, Sumathy Rangarajan, Graeme Meintjes, Dominik Mertz, John W Eikelboom, Sean Wasserman","doi":"10.1186/s12981-025-00733-9","DOIUrl":"10.1186/s12981-025-00733-9","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization (WHO) has published guidelines for the management of patients with advanced HIV disease (AHD) but mortality remains high. Adoption of WHO recommendations by national guidelines is poorly documented. We aimed to extend our prior review of six national management guidelines by including additional countries from sub-Saharan Africa.</p><p><strong>Methods: </strong>We identified guidelines of eight additional countries participating in a multicountry trial of azithromycin prophylaxis for AHD. Data was extracted in five domains including definition of AHD (1 item), screening (6 items), prophylaxis (6 items), supportive care (1 items), and HIV treatment (4 items) and scored agreement of each national guideline with the WHO guidelines.</p><p><strong>Results: </strong>Six of the eight national guidelines had a designated section for AHD. Compared with the WHO guideline, the agreement score for national guidelines was between 7 and 17 out of 18, whereby disagreement is mainly driven by missing information. None of the national guidelines had more than three items not in agreement with the WHO guidelines, and the maximum number of items not addressed by any one guideline was eight. Main areas of disagreement were the targeted population for start of ART in presence of tuberculosis meningitis (1/8 in agreement) and urine lipoarabinomannan screening (2/8 in agreement). The targeted population group for cotrimoxazole prophylaxis and its discontinuation was in line with the WHO recommendations in 3/8 national guidelines. Except one guideline, all documents showed similar overall agreement, irrespectively of publication date.</p><p><strong>Conclusion: </strong>National guidelines for the management of people with AHD are broadly in agreement with WHO guidelines. Main areas of disagreement are recommendations regarding urine lipoarabinomannan screening, cotrimoxazole prophylaxis and start of antiretroviral therapy in presence of tuberculosis.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"39"},"PeriodicalIF":2.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of peri-gestational weight change among women living with HIV in Nigeria receiving dolutegravir compared to alternative antiretroviral regimens: a retrospective cohort study.","authors":"Ammar Al Naimi, Charlotte Chang, Holly Rawizza, Oluwaseun Olaifa, Olabanjo Ogunsola, Prosper Okonkwo, Phyllis Kanki","doi":"10.1186/s12981-025-00731-x","DOIUrl":"10.1186/s12981-025-00731-x","url":null,"abstract":"<p><strong>Background: </strong>Weight change for women living with HIV (WLWH) who receive dolutegravir (DTG) is understudied around pregnancy. The aim of this study was to investigate the direction and magnitude of weight change among WLWH pre-, during, and post-gestation based on DTG exposure history.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated adult pregnant WLWH receiving antenatal care between 2016 and 2022 at two clinics in Nigeria and followed them over three 9-month periods (pregestational, antenatal, and postgestational). Patients were stratified into three DTG exposure groups for each follow-up period: non-DTG, DTG-switch, and DTG. Three mixed effects models with random intercepts and slopes were utilized to assess the association between DTG and weight. Sensitivity analysis was conducted using binomial DTG exposure with starting time.</p><p><strong>Results: </strong>The study included 2386 women, 851 (35.7%) of whom used DTG at some point. Average maternal weight was 63.8 ± 12.7 kg, 67.0 ± 13.1 kg, and 64.5 ± 12.7 kg during the pregestational, antenatal, and postgestational period. The weight difference in kg for DTG and DTG-switch compared to other ARTs were 0.06 (-1.66, 1.79) and -2.11 (-5.33, 1.11) pregestational, -0.613 (-2.14, 0.92) and 1.21 (-0.80, 3.21) antepartum, and 2.64 (0.37, 4.91) and 0.89 (-1.40, 3.18) postgestational. The antenatal slope (β) for DTG exposure and initiation time was 0.01 (0.001, 0.02) kg/day.</p><p><strong>Conclusions: </strong>DTG therapy is associated with more rapid weight gain during pregnancy without significantly affecting the total weight gained. Moreover, retained weight postgestation is higher in women on DTG. Therefore, they could face higher future metabolic and cardiovascular risks.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"38"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced HIV disease management and patient outcomes in rural setting - Malawi: a retrospective cohort study.","authors":"Gift C J Msowoya, Beatrice Matanje, Fabien Munyaneza, Jonathan Kalua, Basimenye Nhlema, Christopher Banda, Enoch Ndarama, Henry Ndindi, Jean Christophe Dimitri Suffrin, Charles Phiri, Limbani Thengo, Moses Banda Aron","doi":"10.1186/s12981-025-00725-9","DOIUrl":"10.1186/s12981-025-00725-9","url":null,"abstract":"<p><strong>Introduction: </strong>Advanced HIV disease (AHD) is increasingly becoming a threat to the survival of people living with HIV. Many countries, including Malawi, have adopted and adapted World Health Organization AHD management guidelines to manage the country's HIV cohort better. However, literature regarding adherence to these guidelines and the treatment outcomes remains limited. Therefore, we describe AHD management and patient outcomes at two rural hospitals in Southern Malawi.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at Neno District and Lisungwi Community Hospitals in Neno District, Malawi. We extracted data from inpatient files, patients' manual charts referred to as \"Mastercards\" for outpatients attending Integrated Chronic Care Clinic (IC3) and from Electronic Medical Records (EMR) between January 2022 and December 2022. IC3 is a specialized clinic for people with chronic diseases including HIV, AHD and Non-communicable diseases. We used counts and percentages for all categorical variables and median and Interquartile range (IQR) for all continuous variables.</p><p><strong>Results: </strong>During the study period, 343 HIV patients were hospitalized, of which 9.8% (n = 34) were new HIV infections. Of these, 50.4% (n = 173) had AHD, and 64.2% (n = 111) were admitted primarily due to infectious diseases. Tuberculosis (58.6%, n = 65) was the leading cause of admission. Of 173 hospitalized and classified as AHD, 75% had CD4 ordered, but only 43% (n = 74) were done. The viral load test was ordered for 34% (n = 59),) and only 28.8% (n = 17) were done. TB LAM and CrAg tests were ordered for 64.2% (n = 111) and 59.5% (n = 103) of which 69.4% and 72.8% were done, respectively. Among 146 IC3 AHD clients, 46%, 47%, 42% and 40% had CD4, viral load, TB LAM and CrAg tests done, respectively. Overall, 17.9% (n = 31) of inpatients with AHD died compared to 2.4%(n = 4) among HIV patients without AHD.</p><p><strong>Conclusions: </strong>We found sub-optimal adherence to management guidelines for patients with AHD, with higher deaths reported compared to those without AHD. Therefore, strengthening adherence to AHD management guidelines through quality improvement initiatives and increased availability of diagnostic resources could potentially improve health outcomes for people living with HIV. Further studies should explore patients' perspectives on the quality of AHD clinics.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"37"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}