AIDS Research and Therapy最新文献

{"title":"Low dietary diversity and associated factors among adult people with HIV patients attending ART clinics of Ethiopia. Systematic review and meta-analysis.","authors":"Bitew Tefera Zewudie, Yihenew Sewale","doi":"10.1186/s12981-025-00702-2","DOIUrl":"10.1186/s12981-025-00702-2","url":null,"abstract":"<p><strong>Introduction: </strong>Dietary diversity is the utilization of food and food groups consumed by individuals over 24 h, which is an indicator of a diet's micronutrient adequacy. Dietary management in people with HIV patients is the key to sustaining their day-to-day activities and contributing to their lively hood. The level of dietary diversity among HIV-positive patients in Ethiopia shows considerable variation, ranging from 29 to 71.3%. This study aimed to assess the pooled prevalence of low dietary diversity and associated factors among HIV-positive patients attending ART clinics in Ethiopia.</p><p><strong>Method: </strong>Multiple international database searching methods (articles found in PubMed/MEDLINE, Google scholar Africa, Hinari journal online, Embase, Scopus) and Ethiopian university repository online have been covered in this systemic review and meta-analysis. Data were extracted using Microsoft excel and analyzed by using the Stata version 14 software program. The heterogeneity between studies and publication bias was detected by using the I² test and a funnel plot test respectively.</p><p><strong>Results: </strong>The pooled prevalence of low dietary diversity among People with HIV patients on antiretroviral therapy in Ethiopia was 55.9% 95% CI (45.73, 66.09) based on the random effect analysis. This systemic review and meta-analysis showed that only HIV positive patients with an antiretroviral therapy duration of less than one year (AOR = 2.3, 95% CI 1.3, 4.1), and having low wealth quintile (AOR = 2.5, 95% CI 1.5, 4.4) were factors significantly associated with low dietary diversity among People with HIV patients on ant-retroviral therapy clinics of Ethiopia.</p><p><strong>Conclusion and recommendation: </strong>The overall pooled prevalence of low dietary diversity among People with HIV patients attending antiretroviral therapy clinics in Ethiopia was high. We strongly recommend holistic nutritional interventions to address nutritional problems and promote the overall health status of HIV-positive patients in Ethiopia.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"7"},"PeriodicalIF":2.5,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045176","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":"95-95-95 HIV indicators among children younger than 15 years in South Africa: results from the 2017 national HIV prevalence, incidence, behaviour, and communication survey.","authors":"Rindidzani E Magobo, Musawenkosi Mabaso, Sean Jooste, Lesiba Molopa, Inbarani Naidoo, Leickness Simbayi, Khangelani Zuma, Nompumelelo Zungu, Olive Shisana, Sizulu Moyo","doi":"10.1186/s12981-024-00691-8","DOIUrl":"10.1186/s12981-024-00691-8","url":null,"abstract":"<p><strong>Background: </strong>Early detection and initiation of care is crucial to the survival and long-term well-being of children living with HIV (CLHIV). However, there remain challenges regarding early testing and linking of CLHIV for early treatment. This study examines the progress made towards achieving the 95-95-95 HIV indicators and associated factors among CLHIV < 15 years in South Africa.</p><p><strong>Methods: </strong>The data was collected as part of the 2017 cross-sectional, multistage cluster randomized population-based household National HIV survey. Age-appropriate structured questionnaires were utilized to gather sociodemographic data, HIV-related knowledge, risk behaviours, and health-related information. Blood samples were collected to test for HIV serology, viral load suppression, and antiretroviral usage. Backward stepwise multivariable generalized linear regression models were fitted to identify factors associated with the 95-95-95 HIV indicators. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) are shown, and p < 0.05 indicates statistical significance.</p><p><strong>Results: </strong>A total of 12,237 CLHIV < 15 years were included (median 8 years, interquartile range 4-11 years). HIV prevalence was 2.8% (95% CI: 2.4-3.3). Overall, 40.0% of the CLHIV were tested and knew their status (first 95%), and among these, 72.6% (95% CI: 61.7-81.3) were on antiretroviral therapy (ART) (second 95%), and 95.0% (95% CI: 88.4-97.9) of these were virally suppressed (third 95%). Among CLHIV, the odds of testing and knowing the HIV-positive status were significantly higher among children whose health was rated as fair/poor than excellent/good [AOR = 1.32 (95%CI: 1.05-1.67), p = 0.022], and were significantly lower among females than males [AOR = 0.82 (95% CI: 0.71-0.95), p = 0.009], and were significantly lower among those attending private healthcare facilities than public health facilities [AOR = 0.64 (95% CI:0.57-0.74), p < 0.001]. Among those who knew their HIV-positive status, the odds of being on ART were significantly higher among children residing in farm areas than urban areas [AOR = 1.40 (95% CI:1.05-1.86), p = 0.017], and were significantly lower among children attending private healthcare facilities [AOR = 0.44 (95% CI:0.36-0.54), p < 0.001].</p><p><strong>Conclusions: </strong>Awareness of HIV status and initiation of treatment in children was low. The findings highlight the need to improve HIV status awareness and disclosure to children. The findings underscore the need for targeted interventions and programs tailored for CLHIV in urban areas.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"6"},"PeriodicalIF":2.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982463","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":"Brief communication: gaps and opportunities in HIV research in Venezuela.","authors":"Jesús A Morgado, María G Medina, Rafael N Guevara, Martín Carballo, Jaime R Torres, Fhabián S Carrión-Nessi, David A Forero-Peña","doi":"10.1186/s12981-025-00700-4","DOIUrl":"10.1186/s12981-025-00700-4","url":null,"abstract":"<p><p>Over the past decade, Venezuela has experienced a political and economic crisis that has affected the country's scientific research development. Currently, the state of HIV research in Venezuela remains unknown. We conducted a systematic review identifying 683 articles over the last 20 years of which only 101 met our inclusion criteria. A decrease in national scientific production was observed starting in 2017, although there was an increase in foreign research on the Venezuelan migrant population. Knowledge gaps were identified in areas such as epidemiology, efficacy and resistance to antiretroviral therapy, and HIV in pregnancy.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"5"},"PeriodicalIF":2.5,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969324","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":"Enablers of and barriers to ART adherence among female sex workers in mid-western Uganda: a qualitative study.","authors":"David Friday Apuulison, Brenda Nabawanuka, Michael Muhoozi, Julian Aryampa, Pauline Irumba, Edson Katsomyo, Moses Asiimwe, Joshua Epuitai, Pardon Akugizibwe, Wasswa George, John Rubaihayo","doi":"10.1186/s12981-025-00698-9","DOIUrl":"10.1186/s12981-025-00698-9","url":null,"abstract":"<p><strong>Introduction: </strong>Female sex workers (FSWs) in Uganda experience numerous barriers to antiretroviral therapy (ART) adherence. We used the planned behavior theory to help explore the enablers and barriers to ART adherence among FSWs. Understanding the barriers to ART adherence may help contribute to the development of interventions to improve ART adherence among the FSWs.</p><p><strong>Materials and methods: </strong>A descriptive qualitative study was conducted in Fort portal City. We conducted 30 in-depth interviews among FSWs who had been taking ART for at least six months. Furthermore, six key informant interviews were conducted with healthcare workers and leaders of the FSWs initiative. Data collection lasted for two months. Thematic deductive analysis was applied to analyse the data through the lens of the theory of planned behavior.</p><p><strong>Findings: </strong>The attitudes, subjective norms, and perceived behavioral control influenced adherence to ART. Positive attitudes including perceived benefits of ART, and experiencing positive outcomes from taking ART were seen to enable its adherence. Subjective norms such as social support, disclosure of HIV status, seeing others take ART, and aspirations of longer life enabled ART adherence. Taking ART in the morning, responsive and respectful healthcare workers, and availability of food/basic needs facilitated compliance with ART adherence. Negative attitudes such as misconceptions and fear of side effects hindered ART adherence. Social disapproval of sex work and or HIV, lack of social support, gender-based violence, non-disclosure, stigma, and abandonment hindered the use of ART among FSWs. Socio-economic constraints (e.g., food scarcity), and occupation-related factors (substance use, incarceration, busy and predictable schedules, and abrupt migrations) were the additional barriers to ART adherence.</p><p><strong>Conclusion: </strong>ART adherence among FSWs was influenced by attitudes, subjective norms, and perceived behavioral control. Addressing these barriers in ART adherence through targeted interventions could facilitate ART adherence and improve health outcomes among FSWs.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"4"},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942576","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":"Drivers of HIV self-test kit among Tanzanian men aged 15-49: findings from the 2022 TDHS-MIS cross-sectional study.","authors":"Mbwiga Sote Aloni","doi":"10.1186/s12981-024-00685-6","DOIUrl":"https://doi.org/10.1186/s12981-024-00685-6","url":null,"abstract":"<p><strong>Introduction: </strong>The introduction of the HIV self-test kit in the early 2000s was a major breakthrough in combating HIV. This study determines the social demographic and sexual behaviour driving the use of HIV self-test kits.</p><p><strong>Method: </strong>The study used secondary data obtained from Tanzania DHS-MIS 2022. The survey uses a stratified two-stage sample design. The first stage involved the selection of clusters consisting of enumeration areas, and in the second stage of sampling, 26 households were selected from each cluster.</p><p><strong>Results: </strong>The mean age = 28.6 years. Usage of HIV self-test kits was found to be low (3.9%). The odds of using HIV self-test kits were 2.2 and 6.6 times more likely among those with primary (aOR = 2.2, 95%CI = 2.2-2.3) and secondary (aOR = 6.6, 95%CI 6.6-6.7) education compared to those without education respectively. As age increases, the odds of using HIV self-test kits increases. Men residing in rural areas were about 40% less likely to use HIV self-test kits compared to those dwelling in urban areas (aOR = 0.6, P < 0.0001).</p><p><strong>Conclusion: </strong>Significant demographic and sexual behaviour factors associated with the usage of HIV self-test kits include sex of household head, education level, marital status, wealth status, age, ever heard of sexually transmitted infection and condom use during sexual intercourse. HIV self-test kits were used more in urban areas than in rural areas. It is essential to raise awareness and improve access to HIV self-test kits for less informed populations, such as those living in rural areas.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"3"},"PeriodicalIF":2.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942575","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":"Thyroid disorders in patients with human immunodeficiency virus infection: a meta-analysis.","authors":"Sagad O O Mohamed, Khalid Osman Mohamed, Ayoub A B Mohamed, Ali E A Mohamed, Solafa S M Salih, Duaa A S Ibrahim, Samia I E Mursal, Aseel E B Abdhameed, Ahmed A O Mahmoud, Khadeja F Abdallah, Khalid S K Salih, Ahmed S E E Abdelrahman, Mohamed S K Salih, Yusra E A Elmobashir, Mahmoud A M Abdelrahman, Amgad I A Mohamed, Hanaa A M Fadil","doi":"10.1186/s12981-024-00697-2","DOIUrl":"10.1186/s12981-024-00697-2","url":null,"abstract":"<p><strong>Background: </strong>Thyroid disorders have significant clinical sequelae, including impaired growth in children, metabolic abnormalities, and impaired cognitive function. However, available studies on burden of thyroid diseases in people with human immunodeficiency virus (HIV), particularly its prevalence and its interaction with HIV related factors (like CD4 count), are controversial. This review aimed to provide a comprehensive summary and analysis on the extent of thyroid dysfunctions in this population.</p><p><strong>Methods: </strong>Following Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines, a comprehensive search was done through Medline/PubMed, Web of Science, Science Direct, and World Health Organization Virtual Health Library Regional Portal. Using Comprehensive Meta-Analysis Software version 3.3, we calculated the pooled prevalence and standardized mean difference (SMD) estimates with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 30 studies met the eligibility criteria and were further included for the analyses. The most common types of thyroid dysfunction identified among HIV patients were subclinical hypothyroidism (7.7%), overt hypothyroidism (2.7%), sick euthyroid syndrome (2.47%), isolated low FT4 (1.80%), and overt hyperthyroidism (0.7%). Hypothyroidism among HIV patients was significantly associated with lower CD4 count (p < 0.001). The analysis revealed that only FT4 levels had significant differences between patients with HIV and healthy people (p = 0.013).</p><p><strong>Conclusion: </strong>Individuals with HIV are at risk of developing variable manifestations of thyroid abnormalities. While being not abundant in the HIV population, monitoring of thyroid dysfunction is essential due to the potential for progression to overt hypothyroidism and associated adverse health outcomes.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"2"},"PeriodicalIF":2.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926262","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":"Correction: Compliance with reporting standards in Mobile App interventions for ART adherence among PLHIV.","authors":"Abdulhammed O Babatunde, Dimeji A Olawuyi, Folashade A Olajuwon, Isaac O Ekundayo, Olatokun S Akano, Olutola V Awosiku","doi":"10.1186/s12981-024-00696-3","DOIUrl":"10.1186/s12981-024-00696-3","url":null,"abstract":"","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"1"},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926246","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":"Myelopathy as the first manifestation of AIDS.","authors":"Yuanyuan Li, Qianru Yang, Hong Lin, Qiong Zhou, Fangfang Ge, Jiankuan Shi","doi":"10.1186/s12981-024-00695-4","DOIUrl":"10.1186/s12981-024-00695-4","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus (HIV) is a retrovirus mainly infecting immune cells. Central nervous system diseases in HIV-infected patients can be caused by HIV or opportunistic infections. Neurological diseases associated with HIV have diverse manifestations and may occur in early or late stages. This article reports an HIV patient with myelopathy as initial symptom and negative spinal cord magnetic resonance imaging (MRI) and reviews common classifications of HIV-related spinal cord diseases.</p><p><strong>Case presentation: </strong>A 50-year-old male presented with weakness in both lower limbs and gait disorders for more than three months. Physical examination and various tests ruled out many possible causes. Given positive HIV and syphilis antibody in serological examination, normal spinal cord MRI and electromyogram, and after excluding other potential diagnoses through comprehensive analysis, the diagnosis of HIV-related myelopathy was established.</p><p><strong>Conclusions: </strong>Spinal cord lesions caused by HIV infection involve multiple aspects in terms of etiology and mechanism. HIV infection-related vacuolar myelopathy (HIV-VM) is the most common and typical spinal cord lesion. It usually appears at a relatively late stage of HIV infection, but it may also occur in the early stage and even serve as the initial manifestation of newly diagnosed HIV. The diagnosis of HIV myelopathy is usually exclusionary. In imaging, it often shows high T2 signal and spinal cord atrophy on spinal cord MRI, or it may also appear normal.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"102"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908942","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":"Factors associated with oxidative stress in virologically suppressed people living with HIV on long-term antiretroviral therapy.","authors":"Francesca Lombardi, Simone Belmonti, Alessia Sanfilippo, Alberto Borghetti, Valentina Iannone, Pierluigi Francesco Salvo, Massimiliano Fabbiani, Elena Visconti, Simona Di Giambenedetto","doi":"10.1186/s12981-024-00694-5","DOIUrl":"10.1186/s12981-024-00694-5","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress (OS) is the imbalance between oxidant and antioxidant molecules, in favour of oxidants, that has been associated with an increased risk of morbidity and mortality in ART-treated people living with HIV (PLWH). We aimed to assess factors associated with OS in virologically suppressed PLWH on long-term modern ART.</p><p><strong>Method: </strong>In this cross-sectional study we evaluated OS by measuring both the levels of derivatives-reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP). We also calculated the BAP/d-ROMs ratio, (OS index, OSi); a cut-off value < 7.3 indicated OS. Factors associated with OS markers were explored by linear regression model.</p><p><strong>Results: </strong>We enrolled 299 experienced PLWH with virological suppression (HIV-RNA < 50cps/mL). The mean of the d-ROMs levels was 409 UCARR (95%CI 394-422), whereas the mean of the BAP levels was 1.809 µmol/L (95%CI 1706-1851). The OSi mean value was 4.84, and 91.6% of the participants were below the cut-off value. By regression analysis, higher production of oxidants was associated with female sex (p < 0.001), current exposition to PIs (p = 0.030) and HCV co-infection (p = 0.006). Higher antioxidant capacity was correlated with higher HDL levels (p = 0.001). A lower OSi was associated with female sex (p = 0.003) and the current use of triple vs. dual regimen (p = 0.036). The OSi correlated negatively with cholesterol levels (p = 0.002) and positively with HDL (p < 0.001).</p><p><strong>Conclusions: </strong>Virologically suppressed PLWH on long-term ART showed a marked OS. Female sex, the exposure to PIs, and HCV co-infection were associated with higher oxidants, while higher HDL levels were linked to better antioxidant capacity. Interestingly, dual therapy, especially INSTI-based regimens, was associated with lower oxidative stress compared to triple therapy.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"100"},"PeriodicalIF":2.1,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902591","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":"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/s12981-024-00693-6","DOIUrl":"10.1186/s12981-024-00693-6","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is a common cancer worldwide, with > 85% of deaths occurring in Lower- and Middle-Income Countries where resources for screening programs are limited. Women living with HIV (WLHIV) are at increased risk. HPV test-and-treat is a screening strategy where women with HPV are offered ablative treatment of the cervix to reduce the risk of invasive cancer. WLHIV tend to have more extensive cervical lesions, necessitating more specialised surgical treatments.</p><p><strong>Method: </strong>ACTG A5282 was a randomised, open-label, Phase 2 trial conducted in seven countries that compared a cytology-based screening strategy to HPV test-and-treat for cervical cancer prevention in WLHIV. Women with cervical lesions inappropriate for ablative treatment were assigned to Arm C and underwent colposcopy and directed biopsies. Loop electro-excision procedure was performed if high-grade lesions (bHSIL) were present on cervical biopsies. Women were followed 26 weeks later for repeat evaluations. The Clopper-Pearson exact method was used to construct the 95% confidence interval for the proportion of WLHIV with lesions inappropriate for cryotherapy. Logistic regression models were used to assess the factors associated with these lesions.</p><p><strong>Results: </strong>Of 1046 women screened, 156 (88%) were Black/Non-Hispanic, with a median age of 36 years; 80% were on ART, and 73% had an HIV-1 RNA < 200 copies/mL. On cervical colposcopy, 17% (179/1046, 95% CI 14.9-19.4%) had cervical lesions inappropriate for cervical ablation. Among 428 (44%) women with High-risk HPV (hrHPV) detected, 112 (26%, 95% CI 22.2%, 30.5%) had cervical lesions inappropriate for ablative therapy. hrHPV was found more commonly among women having lesions inappropriate for ablative therapy as compared to lesions appropriate for ablative therapy (70% vs 54%, p < .001). Among 128 women with extensive cervical lesions undergoing colposcopic biopsies, 43 (34%) had bHSIL detected. Among women undergoing LEEP treatment of bHSIL, 24% had bHSIL detected 26 weeks later.</p><p><strong>Conclusion: </strong>Cervical lesions inappropriate for ablative therapy were common among WLHIV. This has implications for cervical cancer programs as these lesions can only be optimally treated with surgical therapies such as loop electroexcision procedures, and the capacity for this procedure should be increased to maximise cervical cancer prevention outcomes.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"101"},"PeriodicalIF":2.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906264","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}