AIDS Research and Therapy最新文献

{"title":"Exploring HIV self-testing as an early detection strategy among female sex workers in Waliso town, Ethiopia: a community based cross sectional study.","authors":"Kotu Merga, Tomas Benti, Gada Edea, Firaol Regea, Tesfu Zewdu, Hailu Merga","doi":"10.1186/s12981-025-00729-5","DOIUrl":"10.1186/s12981-025-00729-5","url":null,"abstract":"<p><strong>Background: </strong>The burden of HIV infection among key population like female sex workers (FSW) is higher and challenges the prevention and control of the virus compared to other population groups. HIV self-testing allows people to test themselves discreetly and conveniently and may provide opportunities to people not currently reached by existing HIV testing and counseling services. Hence, this study aimed to assess the magnitude of HIV Self-Testing (HIVST) and associated factors among Female sex workers in Waliso Town in Central Ethiopia.</p><p><strong>Method: </strong>A community-based Cross-sectional study was conducted from 1 October-November 30, 2023, among female sex workers using snowball sampling. A total of 400 participants were included in the study. Data was collected using pre-tested, structured self-administered, and interviewer-administered questionnaires using face-to-face interviews. A binary logistic regression model was fitted using SPSS version 26 to identify factors associated with HIV self-testing. Adjusted Odds Ratio (AOR), 95% confidence interval, and a p-value < 0.05 was used to judge the statistically significant variables.</p><p><strong>Results: </strong>The prevalence of HIV self-testing among female sex workers in Waliso town was found to be 37% (95% CI: 32, 42). Education status (attended high school and above) (AOR = 7.62[95% CI 2.55,24.67], marital status (divorced) (AOR = 2.1[95% CI 1.23,3.6], those whose both parents dead (AOR = 2.72[95% CI 1.4,5.28] and before sex whether they asked their partner test status (AOR = 0.17[95% CI 0.07,0.37] were statistically significant.</p><p><strong>Conclusion: </strong>This study revealed that HIV self-tests among female sex workers were lower than the 95% national target. Education status, marital status, parent`s living status and knowing the partner HIV status before sex were found to be predictors of HIV self-test. Our findings underscore the need to develop evidence-based strategies to improve HIV testing uptake by FSWs and improve community-based services.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"36"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655880","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: comparison of changes in metabolic parameters following antiretrovial therapy with treatment regimens containing tenofovir alafenamide and tenofovir disoproxil fumarate.","authors":"Hamed Mirmoezzi, Hamid Emadi Koochak, Seyed Ali Dehghan Manshadi, Malihe Hasannezhad, SeyedAhmad SeyedAlinaghi, Kiavash Semnani, Ladan Abbasian, Sara Ghaderkhani","doi":"10.1186/s12981-025-00728-6","DOIUrl":"10.1186/s12981-025-00728-6","url":null,"abstract":"<p><p>Concerns of increased metabolic dysfunction have been heightened for HIV patients on long-term antiretroviral therapy (ART). Among first-line ART agents, Tenofovir alafenamide (TAF) may entail a marked increase in weight compared to Tenofovir disoproxil fumarate (TDF). We retrospectively evaluated changes in weight and glucose regulation among 153 treament-naïve patients. Weight-gain was more pronounced after one year of treatment with TAF versus TDF (3.5 kg versus - 1 kg, P-value < 0.001). However, weight-gain was attenuated with longer follow-up, and no increase in glucose dysregulation was noted for TAF treatment. Attribution of increased metabolic risk to treatment with TAF remains questionable.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"35"},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633155","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":"High prevalence of low-level viremia among infants initiated on antiretroviral drugs following mother-to-child transmission of HIV.","authors":"Immaculate Nankya, Eva Natukunda, Diana Rutebarika, Christine Matama, Roy Basiimwa, Paul Arikod, Faryad Muwabe, Caroline Otike, Cissy Kityo","doi":"10.1186/s12981-025-00701-3","DOIUrl":"10.1186/s12981-025-00701-3","url":null,"abstract":"<p><strong>Background: </strong>With the current elimination of mother to child transmission (EMTCT) of HIV, the number of HIV-positive newborns has greatly reduced. Some countries have successfully eliminated HIV infections among newborn babies.</p><p><strong>Methods: </strong>This study was nested within the DRIBS (Drug Resistance testing among Infants at Baseline Study), which enrolled 100 infants at the time of treatment initiation between 2017 and 2023. Infants were followed for two years. Viral load (VL) was measured every six months and after completion of the three sessions of intensified adherence counseling (IAC). IAC and HIV drug resistance testing were performed for VL greater than 1000 copies/ml.</p><p><strong>Results: </strong>The median age at diagnosis was 79 (IQR, 57.75;140.75) days, with 4% of patients diagnosed within 6 weeks after delivery. The median age at the initiation of therapy was 110.5 (IQR, 87.0-162.0) days. The median baseline %CD4 was 26 (IQR, 18.75;32), with 9% of the babies being severely immunosuppressed (%CD4 < 15%). The median baseline log viral load was 4.44 (IQR, 3.19-5.58). At six months, 30% and 60% of the patients had a VL < 50 and < 1000 copies/ml, respectively. At 12 months, 36% and 69% of patients had a VL < 50 and < 1000 copies/ml, respectively. At 24 months, 63% and 83% had VL < 50 and < 1000 copies/ml, respectively. Post-IAC VL revealed that 35% of the children had low-level viremia (LLV) compared to mothers 11.5%. Kaplan-Meyer survival estimates showed that while it took 72 weeks for 50% of the mothers and infants to attain a VL less than 1000 copies/ml, it took 96 weeks for the infants to attain a VL < 50 copies/ml.</p><p><strong>Conclusion: </strong>A Viral load < 1000 copies/ml is achieved much more slowly in pediatric patients, implying that it might take longer for babies to achieve the third 95 (95% virally suppressed) of the UNAIDS targets. Furthermore, the greater prevalence of LLV in pediatric patients than in mothers has important implications for the response to therapy.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"34"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603477","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":"Time to initiation of antiretroviral therapy and its predictors among newly diagnosed HIV positive at the selected public health centers in Adama Town, Ethiopia.","authors":"Yobsan Girma, Ephrem Mannekulih, Hunde Lemi, Tesfaye Getachew Charkos","doi":"10.1186/s12981-025-00703-1","DOIUrl":"10.1186/s12981-025-00703-1","url":null,"abstract":"<p><strong>Introduction: </strong>Antiretroviral therapy (ART) has significantly reduced HIV infections, but late initiation remains a major issue. This study aimed to identify predictors of ART initiation among newly diagnosed HIV-positive patients in Adama town.</p><p><strong>Method: </strong>A retrospective cohort study was conducted, with 396 newly diagnosed HIV-positive patients. This study used a survival analysis approach, including Kaplan-Meier plots, the log-rank test, and the Cox proportional hazards model.</p><p><strong>Result: </strong>The incidence rate was 152 per 1000 person-days for early initiation after HIV positive confirmed. In the adjusted model, gender, VCT test, disclosure status, having children in the home, opportunistic infections, and HIV/TB co-infections were significantly associated with time to ART initiation.</p><p><strong>Conclusion: </strong>To enhance early ART initiation, healthcare programs should prioritize support for women patients, promote HIV serostatus disclosure, and improve access to VCT testing. Targeted interventions for those with comorbidities and support for families with children are also essential.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"33"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603481","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":"Impact of differentiated care service delivery systems on adherence among the HIV-positive patients receiving antiretroviral therapy in a Southeastern Nigerian State.","authors":"Azubuike A Ekwuofu, Obinna F Dim, Maxwell O Adibe","doi":"10.1186/s12981-024-00671-y","DOIUrl":"10.1186/s12981-024-00671-y","url":null,"abstract":"<p><strong>Aim: </strong>Globally, differentiated care has been adopted across human immunodeficiency virus (HIV) treatment cascades as part of the strategies of increasing and sustaining retention in care. This study examined the impact of this new service delivery approach on adherence among patients receiving antiretroviral therapy in Imo state, Nigeria.</p><p><strong>Methods: </strong>This was a cross sectional study carried at one tertiary and three secondary care hospitals selected across the state using a questionnaire. The study examined patients in three differentiated care models, and the usual care group. Collated data were analysed using the statistical product and service solutions (SPSS) version 24, at p ≤ 0.05 and 95% confidence level.</p><p><strong>Results: </strong>A total of 542 questionnaires were successfully retrieved from the respondents. The female gender was predominant in all the groups, accounting for total average of 70.8%. The percentage of respondents with optimum adherence score (≥ 96.6%) for multi-months scripting, fast track, support group, and usual care groups were 70.6,69, 97.4, 59.1 respectively. Of all the groups, the support group had the highest adherence to ART. Forgetfulness, traveling, avoidance of side effects, and feeling sick topped the reasons adduced for missing drugs. Age, place of residence, occupation and engagement of voluntary activities were socio-demographics influencing adherence. Adherence had significant association with the viral load suppression (Odds ratio = 3.147, p < 0.05, 95% C.I 2.025-4.891).</p><p><strong>Conclusion: </strong>The study demonstrated that the adoption of differentiated care has enhanced patients' adherence to ART which differed across the models. There is need for continual counseling and support to the patients by healthcare providers so as to further improve adherence.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"32"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596076","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":"Prevalence of Mpox vaccine acceptance and hesitancy among people living with HIV: a comprehensive systematic review and meta-analysis.","authors":"Ambanna Yappalparvi, Mahalaqua Nazli Khatib, Ashok Kumar Balaraman, M M Rekha, Mandeep Kaur, Girish Chandra Sharma, Puneet Sudan, K Satyam Naidu, Rajesh Singh, Sonam Ramashankar, Karan Khati, Sanjay Singh Chauhan, Lokesh Verma, Amritpal Sidhu, Rachana Mehta, Renu Sah, Abhay M Gaidhane, Muhammed Shabil, Joseph Clement Chipeta, Ganesh Bushi","doi":"10.1186/s12981-025-00726-8","DOIUrl":"10.1186/s12981-025-00726-8","url":null,"abstract":"<p><strong>Background: </strong>Vaccine acceptance among People Living with HIV (PLWH) is crucial for managing and mitigating the spread of infectious diseases, including Mpox. This systematic review and meta-analysis assess the rate of vaccine acceptance for Mpox among PLWH and identify factors influencing these rates.</p><p><strong>Methods: </strong>We searched major databases including PubMed, Embase, and Web of Science up to 30 August 2024 for observational studies involving PLWH that reported on mpox vaccine acceptance rates. A random-effects model was employed for the meta-analysis, utilizing R software version 4.4. Heterogeneity among the studies was quantified using the I² statistic, and the methodological quality of each study was assessed using a modified version of the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Out of 1,123 articles identified, 17 studies met the inclusion criteria and included 7,248 participants. The pooled estimate of the Mpox vaccine acceptance rate was 61.1% (95% CI: 44.2-75.7%), with high heterogeneity (I² = 99%). Additionally, a pooled vaccine hesitancy prevalence was 13.2%, (95% CI: 2.4-48.6%), reflecting substantial variability and had high heterogeneity (I² = 98%).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis reveal moderate Mpox vaccine acceptance and considerable hesitancy among PLWH. To further increase vaccine uptake and address any remaining hesitancy in this at-risk population, targeted public health strategies and ongoing research are necessary. Strengthening vaccine acceptance is critical to safeguarding PLWH against emerging infectious diseases such as Mpox.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"31"},"PeriodicalIF":2.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584331","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":"A survey weighted analysis of HPTN 071 (PopART) primary outcome of HIV incidence.","authors":"Timothy M Skalland, Jean de Dieu Tapsoba, Sahar Z Zangeneh, Sian Floyd, Helen Ayles, Peter Bock, Sarah Fidler, Susan H Eshleman, Richard J Hayes, Deborah Donnell","doi":"10.1186/s12981-025-00720-0","DOIUrl":"10.1186/s12981-025-00720-0","url":null,"abstract":"<p><strong>Introduction: </strong>HPTN 071 (PopART) implemented a comprehensive HIV prevention package which aimed to reduce HIV incidence within 21 communities of Zambia and South Africa: Arm A, PopART intervention of universal HIV testing and treatment; Arm B, PopART intervention of universal HIV testing with ART provided according to local guidelines; and Arm C, standard of care. Analyses so far have not accounted for the sampling design of the enrolled cohort. We performed a sample-weighted re-analysis of the primary outcome of the PopART trial to derive a population-based estimate of the intervention effect.</p><p><strong>Methods: </strong>Enrollment used a two-stage sampling design: household and adult participant within each household. We constructed post-stratification weights to match the age and sex distribution of the target population in these communities. Weighted Poisson regression was used to estimate community-level HIV incidence. The PopART intervention effect was estimated using log-transformed community-level incidence estimates in an ANCOVA model.</p><p><strong>Results: </strong>The analysis based on community-level incidence shows a 25% reduction in incidence for Arm B communities compared to standard of care (RR: 0.75, 95% CI: 0.56-1.02, p = 0.06) while Arm A communities show no difference in HIV incidence compared to standard of care (RR: 1.08, 95% CI: 0.81-1.46, p = 0.56).</p><p><strong>Conclusions: </strong>Our re-analysis shows 25% reduction in HIV incidence comparing Arm B to Arm C communities. No effect was observed comparing Arm A communities to Arm C communities. These results align with the primary results of the PopART trial.</p><p><strong>Clinicaltrials: </strong>gov number, NCT01900977, HPTN 071 [PopArt].</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"30"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584320","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":"Temporal trends from HIV diagnosis to ART initiation among adults living with HIV in the Asia-Pacific (2013-2023).","authors":"Thinh Toan Vu, Dhanushi Rupasinghe, Vohith Khol, Romanee Chaiwarith, Junko Tanuma, Nagalingeswaran Kumarasamy, Suwimon Khusuwan, IKetut Agus Somia, Sanjay Pujari, Man Po Lee, Rohidas T Borse, Sasisopin Kiertiburanakul, Evy Yunihastuti, Iskandar Azwa, Jun Yong Choi, Hsin-Pai Chen, Rossana Ditangco, Anchalee Avihingsanon, Yasmin Gani, Jeremy Ross, Awachana Jiamsakul","doi":"10.1186/s12981-025-00718-8","DOIUrl":"10.1186/s12981-025-00718-8","url":null,"abstract":"<p><strong>Introduction: </strong>Data on the impact of World Health Organization (WHO)'s guideline changes and COVID-19 on ART initiation in the Asia-Pacific remain scarce. This study described temporal trends from HIV diagnosis to ART initiation from 2013 to 2023 and its associated factors.</p><p><strong>Methods: </strong>Adults (≥ 18 years) diagnosed with HIV after 2013 in a regional observational cohort were included. Fine and Gray competing risk regression examined predictors of ART initiation (≥ 3 antiretroviral medications), accounting for those lost to follow-up or deceased before treatment considered as competing risks.</p><p><strong>Results: </strong>Among 14,968 participants, most were male (70.1%), with a median age of 36 years (interquartile range [IQR]: 28-44). At HIV diagnosis, median CD4 count was 208 cells/µL (IQR: 69-395), and median viral load was 86,296 copies/mL (IQR: 13,186-392,000). Over 85% of participants had initiated ART during the study period. Median time from HIV diagnosis to ART initiation differed across years of HIV diagnosis: 51 days (2013-2015), 28 days (2016-2019), and 26 days (≥ 2020). Factors associated with shorter time to ART initiation were higher country income-level (upper-middle: sub-distribution hazard ratio [SHR] = 1.34, 95% CI: 1.28, 1.40; high: SHR = 1.35, 95% CI: 1.28, 1.43; vs. lower-middle); HIV transmission via male-to-male contact (SHR = 1.06, 95% CI: 1.02, 1.11) or injection drug use (SHR = 1.23, 95% CI: 1.09, 1.38; vs. heterosexual contact); and later years of HIV diagnosis (2016-2019: SHR = 1.33, 95% CI: 1.28, 1.38; ≥ 2020: SHR = 1.40, 95% CI: 1.33, 1.48; vs. 2013-2015). Those with higher CD4 counts had longer time to ART start (350-499 cells/µL: SHR = 0.76, 95% CI: 0.67, 0.86; > 500 cells/µL: SHR = 0.55, 95% CI: 0.49, 0.61; vs. CD4 < 200 cells/µL).</p><p><strong>Conclusion: </strong>Time to ART initiation from HIV diagnosis decreased after 2016, aligning with evolving WHO guidelines, and did not appear to be impacted by COVID-19. Optimizing treatment initiation during the treat-all era is crucial, especially among those with higher CD4 counts.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"29"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555432","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: attitudes and preferences of long-acting injectable HIV preexposure prophylaxis among Thai adolescents and young adults.","authors":"Alisa Wongsethanatada, Wipaporn Natalie Songtaweesin, Prissana Wongharn, Juthamanee Moonwong, Sasiprapha Khamthi, Lucksanapon Pitikawinwong, Thanyawee Puthanakit","doi":"10.1186/s12981-025-00721-z","DOIUrl":"10.1186/s12981-025-00721-z","url":null,"abstract":"<p><p>This study aimed to explore willingness to use and preference for long-acting injectable PrEP (LAI-PrEP) among Thai youth at risk of HIV. A cross-sectional study was conducted in 100 Thai youth aged 18 to 24 years attending a sexual health clinic in Bangkok, Thailand. Participants received information about oral and LAI-PrEP before completing a questionnaire. Of the 98 participants willing to use pre-exposure prophylaxis, 47 preferred the injectable form. Preference for the injectable form was higher among individuals not currently using oral pre-exposure prophylaxis, affordability and longer injection intervals were key for acceptance of long-acting injectable pre-exposure prophylaxis.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"28"},"PeriodicalIF":2.1,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536463","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":"A United States HIV provider survey of antiretroviral therapy management in people living with HIV with co-occurring conditions.","authors":"Sonya Krishnan, Marina B Martinez Rivera, Christopher K Lippincott, Maunank Shah","doi":"10.1186/s12981-025-00724-w","DOIUrl":"10.1186/s12981-025-00724-w","url":null,"abstract":"<p><strong>Introduction: </strong>Simplified HIV treatment guidelines favor integrase strand transfer inhibitors (INSTIs). However, non-infectious comorbidities and co-occurring conditions (i.e. pregnancy) often necessitate individualized antiretroviral therapy (ART) regimens. This study aimed to characterize United States HIV provider strategies for ART selection when faced with concomitant health conditions.</p><p><strong>Methods: </strong>A survey of US HIV providers was conducted using hypothetical patient cases. Standardized clinical case-vignettes were developed and providers were asked to select their preferred regimen. Eleven cases focused on cardiometabolic syndrome, renal dysfunction, weight gain, and pregnancy.</p><p><strong>Results: </strong>119 providers responded across all cases (with a median 57 responses [interquartile range 55.5-72] per case), and were primarily Infectious Diseases physicians in academic settings from across the continental United States. Bictegravir/tenofovir alafenamide/emtricitabine was most commonly prescribed for three case-scenarios of cardiometabolic disease (62.3%). Diverse regimens were recommended for a case involving weight gain, with 98.5% switching from dolutegravir plus tenofovir alafenamide/emtricitabine, most commonly to doravirine/tenofovir disoproxil fumarate/lamivudine. Dolutegravir-based regimens were selected in case-scenarios of pregnancy (77.3%), with some use of bictegravir/tenofovir alafenamide/emtricitabine (13.6%). For two case-scenarios renal disease with worsening creatinine clearance to < 30 mL/minute, many providers used lamivudine or emtricitabine in fixed-dose combination (43.3%).</p><p><strong>Conclusion: </strong>This study reveals varied ART approaches for people living with HIV and non-infectious conditions, often diverging from standard regimens. While guidelines provide a framework, providers adapt treatment based on patient needs. Further research is crucial to optimize ART management in these complex situations.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"27"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536462","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}