AIDS Research and Therapy最新文献

{"title":"Matters Arising: on the willingness to trade-off years of life for an HIV cure.","authors":"Karine Dubé, Jeff Taylor, William Freshwater, Thomas J Villa, David Palm, Derrick Mapp, Lynda Dee","doi":"10.1186/s12981-025-00723-x","DOIUrl":"10.1186/s12981-025-00723-x","url":null,"abstract":"<p><p>This Matters Arising explores the article titled \"Willingness to Trade-Off Years of Life for an HIV Cure- An Experimental Exploration of Affective Forecasting,\" published in AIDS Research and Therapy in August 2024. We highlight the importance of considering ethical concerns and the inclusion of people with HIV (PWH) in the design of socio-behavioral research focused on HIV cure. While the authors suggest that PWH with lower quality of life may be more willing to trade years of life for a cure, we encourage further reflection on the potential emotional and psychological impacts of such hypothetical scenarios. The term \"cure\" could be clarified, as it traditionally implies an improvement in quality of life. We also note that future studies would benefit from clearer objectives and terminology that respects the dignity of PWH. We suggest that future research in this area prioritize the lived experiences of PWH and aim for both quality and quantity of life improvements, ensuring that research outcomes are aligned with the real-world needs and perspectives of PWH.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"25"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522334","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":"HIV self-testing and HIV nondisclosure to male sexual partners among adolescent girls and young women living with HIV in semi-rural northern Uganda: a cross-sectional study.","authors":"Edward Kumakech, Deo Benyumiza, Marvin Musinguzi, Wilfred Inzama, Ebong Doryn, James Okello, Lydia Kabiri, Vanja Berggren, Jasper Watson Ogwal-Okeng","doi":"10.1186/s12981-025-00716-w","DOIUrl":"10.1186/s12981-025-00716-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The burden of HIV remains disproportionally high among the adolescent girls and young women. This is often coupled with nondisclosure of HIV status partly due to delayed knowledge of HIV status which affects entry into HIV prevention interventions. HIV self-testing which provides instant knowledge of HIV status is being promoted to enable early disclosure. However, previous studies about the association between HIV self-testing (HIVST) and HIV disclosure are scarce. We, therefore, set out to determine the prevalence of HIVST, nondisclosure of HIV status to male partners, and the predictors among adolescent girls and young women living with HIV (AGYWLHIV) in Uganda.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a cross-sectional study design, a stratified random sample of AGYWLHIV were recruited from ART clinics in semi-rural northern Uganda between November 2022 and April 2023. The participants received an interviewer-administered questionnaire. HIV self-testing was defined as the use of the HIVST method by the AGYWLHIV to discover their HIV status. Similarly, HIV nondisclosure was defined as the AGYWLHIV's failure to disclose her initial HIV status to her current male sexual partner before their first sexual intercourse regardless of the use of condoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 423 participants with a mean age of 21.6 ± 2.5 years participated in the study. The study found that only 3.8% of the AGYWLHIV discovered their HIV status through HIVST. Furthermore, 26.7% of the AGYWLHIV did not disclose their status to their current male partners, 35.5% experienced non-disclosure from their current male partners, and 16.5% experienced bidirectional non-disclosure. The predictors for non-disclosure of initial HIV status were found to include the AGYWLHIV's knowledge of their initial negative HIV status [APR 0.3 (0.2-0.5), p 0.001], the AGYWLHIV's knowledge of their initial positive HIV status [APR 0.5 (0.3-0.7), p 0.002], the AGYWLHIV's prior knowledge of the positive initial HIV status of the male partner [APR 0.4 (0.2-0.8), p 0.010] and the male partner's nondisclosure of their initial HIV status to the AGYWLHIV [APR 2.0 (1.2-3.5), p 0.008].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The prevalence of HIVST and HIV nondisclosure to male sexual partners among the AGYWLHIV in semi-rural Uganda stood at 38 in 1000 and 267 in 1000 respectively. The HIVST wasn't associated with HIV nondisclosure but the women's initial negative or positive HIV status, the male partner's initial positive HIV status and the male partners' nondisclosure of their initial HIV status to the AGYWLHIV were found to be independent predictors. These findings point to the need for health workers to target the distribution of HIVST kits at the AGYWLHIV attending ART clinics to give them to men in their sexual and social networks to expand access to HIV testing, improve chances of two-way HIV disclosure and entry into the HIV prevention, treatment, and ca","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"26"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522329","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":"Predictors of survival among older adults with HIV in Uganda's AIDS support organization centers of excellence (1987-2023): a retrospective longitudinal study.","authors":"Christine Atuhairwe, Leonard Atuhaire, Stephen Ojiambo Wandera, Dinah Amongin, Titus Ochieng, Cyprian Misinde","doi":"10.1186/s12981-024-00687-4","DOIUrl":"10.1186/s12981-024-00687-4","url":null,"abstract":"<p><strong>Background: </strong>The growing number of older adults living with HIV, facilitated by wider access to antiretroviral therapy (ART), presents unique challenges. This study aims to identify predictors of survival among older persons living with HIV receiving ART in Uganda's AIDS Support Organization Centers of Excellence (1987-2023). Understanding these predictors can inform effective clinical interventions to improve outcomes for this population.</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of medical records from 11 TASO centers of excellence in Uganda (1987-2023). Using Cox proportional hazards regression, we identified factors associated with survival among older adults living with HIV. TASO centers of excellence in Entebbe, Gulu, Jinja, Masaka, Masindi, Mbale, Mbarara, Mulago, Rukungiri, Soroti, and Tororo. Cox proportional hazards regression analysis identified factors influencing survival among older persons living with HIV (OPLHIV).</p><p><strong>Results: </strong>Of the 30,758 OPLHIV medical records analyzed (1987-2023), 72.5% were active on ART, 5.9% had died, 15.2% were lost to follow-up, and 5.6% transferred to other facilities. Survival was significantly associated with: gender (female, HR = 1.19, p < 0.001), marital status (married, HR = 0.99, p < 0.001; separated/divorced, HR = 0.85, p < 0.001), WHO clinical stage (II, HR = 1.66, p < 0.001), viral load (> 200 copies/ml, HR = 1.49, p < 0.001), and ART adherence (fair, HR = 0.94, p = 0.157).</p><p><strong>Conclusion: </strong>Key predictors of survival among Older Adults Living with HIV (OPLHIV) include: female gender, age 50-59, weight 51-70 kg, married status, viral load > 200 copies/ml, WHO HIV clinical stage II, paid employment, and ART adherence. To improve survival outcomes, consistent clinical screenings of WHO clinical stages, viral load, and ART adherence are essential. These measures can guide healthcare providers in making informed treatment decisions to enhance survival and quality of life for OPLHIV in Uganda.</p><p><strong>Recommendations: </strong>Strengthen routine monitoring of viral load, ART adherence, and WHO clinical staging. Provide targeted support to married and separated/divorced adults to improve their survival chances. Address gender disparities in care to enhance outcomes for females. Focus on maintaining ART adherence and viral suppression to reduce mortality risks.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"24"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514336","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":"Hospitalized with HIV in Zambia: individual and system factors driving the high burden of admissions and post-discharge mortality in the era of HIV epidemic control.","authors":"Chiti Bwalya, Kirsten Stoebenau, Godfrey Muchanga, Mwangala Mwale, Choolwe Maambo, Swamie Banda, Palicha Halwiindi, Linah K Mwango, Caitlin Baumhart, Nyuma Mbewe, Mundia Mwitumwa, Priscilla Mulenga, Manhattan Charurat, Wilbroad Mutale, Michael J Vinikoor, Cassidy W Claassen","doi":"10.1186/s12981-024-00689-2","DOIUrl":"10.1186/s12981-024-00689-2","url":null,"abstract":"<p><strong>Background: </strong>Despite progress towards HIV epidemic control, people living with HIV (PLHIV) in Zambia continue to face high mortality during and especially after hospitalization, with suboptimal post-discharge care leading to poor outcomes. We conducted a qualitative study to better understand factors influencing post-discharge engagement in care for HIV and associated comorbidities.</p><p><strong>Methods: </strong>We conducted in-depth interviews with 16 recently discharged PLHIV, seven caregivers, and two doctors; and three focus group discussions with inpatient doctors (n = 8) and lay counsellors (n = 16) at two tertiary hospitals in Lusaka, guided by the social-ecological model. Data were audio-recorded, transcribed verbatim, managed with Atlas.ti 9, and thematically analyzed.</p><p><strong>Results: </strong>Individual and household-level barriers to post-discharge care for PLHIV included HIV status denial and stigma, limited disclosure, and limited social and emotional support. Health-related barriers included concomitant treatments for TB, HIV comorbidities, and behavioral health issues like depression and alcohol abuse. Health system barriers included limited confidentiality during admission and poor communication between healthcare providers and between facilities aftercare transitions following discharge. Social-economic factors included economic shocks of hospitalization and post-discharge recovery, which compounded pre-existing poverty and high transportation and food costs. Conversely, disclosure of HIV status, better social support, a financially stable household, and hospital follow-up appointment reminders facilitated better post-discharge care.</p><p><strong>Conclusion: </strong>After hospital discharge with HIV, system and individual challenges exacerbate pre-existing interpersonal, health, environmental, and system-related factors to cause poor outcomes. Holistic community-based interventions to facilitate these patients' re-engagement in care after discharge could help HIV programs reach the last mile in epidemic control.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"22"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490371","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 to: Scaling up access to antiretroviral treatment for HIV: lessons from a key populations program in Nigeria.","authors":"Abdulsamad Salihu, Ibrahim Jahun, David Olusegun Oyedeji, Wole Fajemisin, Omokhudu Idogho, Samira Shehu, Aminu Yakubu, Jennifer Anyanti","doi":"10.1186/s12981-025-00722-y","DOIUrl":"10.1186/s12981-025-00722-y","url":null,"abstract":"","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"23"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490370","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":"Neuropsychiatric and laboratory outcomes of hepatitis C treatment in an early-treated HIV cohort in Thailand.","authors":"Ferron Ocampo, Carlo Sacdalan, Suteeraporn Pinyakorn, Misti Paudel, Tanyaporn Wansom, Nathornsorn Poltubtim, Somchai Sriplienchan, Nittaya Phanuphak, Robert Paul, Denise Hsu, Donn Colby, Lydie Trautmann, Serena Spudich, Phillip Chan","doi":"10.1186/s12981-025-00707-x","DOIUrl":"10.1186/s12981-025-00707-x","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) coinfection may further compromise immunological and cognitive function in people with HIV (PWH). This study compared laboratory and neuropsychiatric measures across the periods of HCV seroconversion and direct-acting antiviral (DAA) therapy with sustained virologic response (SVR) among PWH who initiated antiretroviral therapy (ART) during acute HIV infection (AHI) and acquired HCV after 24 weeks of ART.</p><p><strong>Methods: </strong>Participants from the RV254 AHI cohort underwent paired laboratory and neuropsychiatric assessments during follow-up visits. The former included measurements of CD4 + and CD8 + T-cell counts, HIV RNA, liver enzymes, and lipid profiles. The latter included the Patient Health Questionnaire-9 (PHQ-9), Distress Thermometer (DT), and a 4-test cognitive battery that evaluated psychomotor speed, executive function, fine motor speed, and dexterity. The raw scores in the battery were standardized and averaged to create an aggregate performance (NPZ-4) score. Parameters of HCV-coinfected participants were compared across the periods of HCV seroconversion and DAA treatment.</p><p><strong>Results: </strong>Between 2009 and 2022, 79 of 703 RV254 participants acquired HCV after ≥ 24 weeks of ART; 53 received DAA, and 50 (94%) achieved SVR. All participants were Thai males (median age: 30 years); 34 (68%) denied past intravenous drug use, and 41 (82%) had a history of other sexually transmitted infections during follow-up. Following SVR, aspartate transferase (AST) and alanine transaminase (ALT) decreased (p < 0.001), while total cholesterol, low-density lipoprotein, and triglycerides increased (p < 0.01). The median CD4 + /CD8 + ratio increased from 0.91 to 0.97 (p = 0.012). NPZ-4 improved from 0.75 to 0.91 (p = 0.004). The median DT score increased from 1.7 to 2.7 (p = 0.045), but the PHQ-9 score remained unchanged.</p><p><strong>Conclusion: </strong>HCV coinfection is common in this group of high-risk PWH, highlighting the need for regular screening, early diagnosis, and treatment. The study participants exhibited a modest improvement in the CD4 + /CD8 + T-cell ratio and cognitive performance following DAA therapy and SVR. Future studies should examine potential neuropsychiatric impacts during early HCV infection as well as the longer-term neuropsychiatric outcomes after DAA treatment with SVR.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"20"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456666","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":"Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda.","authors":"Alisat Sadiq, Richard Kwizera, Tadeo K Kiiza, Peruth Ayebare, Cynthia Ahimbisibwe, Jane Frances Ndyetukira, David R Boulware, David B Meya","doi":"10.1186/s12981-025-00705-z","DOIUrl":"10.1186/s12981-025-00705-z","url":null,"abstract":"<p><strong>Background: </strong>Advanced HIV disease (AHD) is still a significant problem in Uganda despite the test-and-treat strategy and the increased access to antiretroviral therapy (ART). Meningitis remains a major cause of morbidity and mortality in people with AHD. HIV counselling is essential and plays an important role in managing persons with AHD-related meningitis. We sought to describe the experiences and challenges we faced during counselling of these individuals, highlighting the strategies, gaps and how we can fill them.</p><p><strong>Methods: </strong>First, we describe our experience and major challenges in counselling people with AHD-related meningitis. Second, we describe the strategies we used to overcome each of these challenges. Third, we highlight the health system gaps and recommend solutions.</p><p><strong>Results: </strong>Major challenges include the presence of altered mental status, unknown HIV status at admission, non-disclosure of HIV status to family, insufficient ART history, caretakers-related challenges, pill burden, multiple drug side effects, invasive clinical procedures, myths about medical procedures, poverty, lack of privacy during counselling in the wards, patients/caretakers seeking alternative non-medical interventions including religious, traditional, and herbal therapies before and after initiating meningitis treatment.</p><p><strong>Conclusions: </strong>Persons with AHD-related meningitis need daily and special consideration during counselling as part of the package of care to improve treatment outcomes.</p><p><strong>Trial registrations: </strong>NCT01075152 (23 Feb 2010), NCT01802385 (28 Feb 2013), ISRCTN42218549 (24 April 2018), ISRCTN72509687 (13 July 2017), NCT04031833 (01 January 2019), ISRCTN15668391 (23 May 2019), ISRCTN18437550 (05/11/2021).</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"21"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456646","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":"Remission of low-grade lymphomatoid granulomatosis with extensive pulmonary involvement following immune restoration via antiretroviral therapy in a newly diagnosed HIV patient.","authors":"Maria Kogan, Antonio Maria Alviano, Martina Catalano, Alessandra Casiraghi, Giulia Ghilardi, Giovanni Rindone, Luisa Verga, Vincenzo L'Imperio, Carlo Gambacorti Passerini, Paolo Bonfanti, Giuseppe Lapadula, Federica Cocito, Alessandro Soria","doi":"10.1186/s12981-025-00717-9","DOIUrl":"10.1186/s12981-025-00717-9","url":null,"abstract":"<p><p>Lymphomatoid granulomatosis (LYG) is a rare Epstein-Barr virus (EBV)-driven lymphoproliferative disease that usually arises in the context of reduced immunological surveillance. Based on histology, two forms of the disease are recognized, namely low-grade and high-grade LYG. Clinically, LYG universally involves the lungs and, frequently, also the skin, central nervous system, liver, and kidneys. Here, we present the case of a 55-year-old woman with a difficult-to-diagnose low-grade LYG with symptomatic lung involvement, who concomitantly was newly diagnosed with human immunodeficiency virus (HIV) infection. Rapid immune recovery achieved through antiretroviral therapy led to a complete and sustained clinical and radiological remission of LYG.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"19"},"PeriodicalIF":2.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424669","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":"Drug transporter mRNA expression and genital inflammation in South African women on oral pre-exposure prophylaxis (PrEP).","authors":"Nomusa M Zondo, Parveen Sobia, Aida Sivro, Sinaye Ngcapu, Sharana Mahomed, Leila E Mansoor, Kwabena Asare, Lara Lewis, Veron Ramsuran, Derseree Archary","doi":"10.1186/s12981-025-00713-z","DOIUrl":"10.1186/s12981-025-00713-z","url":null,"abstract":"<p><p>Globally HIV remains a major public health problem. In sub-Saharan Africa most new HIV infections occur in adolescent girls and young women. Previously tested antiretroviral drugs as different pre-exposure prophylaxis (PrEP) formulations have shown inconsistent levels of protection against HIV in African women. Besides adherence, biological factors such as drug transporter proteins are increasingly recognized as key modulators of PrEP levels. Drug transporter mRNA expression levels has been significantly correlated to altered PrEP levels in-vitro in different tissues, with inflammation identified as a further modifier of drug transporters mRNA expression and thus PrEP levels. We therefore, aimed to determine possible concordance between drug transporter mRNA expression in the female genital tract (FGT) and blood of N = 45 South African women taking oral PrEP-Truvada® [TDF/FTC)] over 6 months for HIV prevention. Additionally, we determined associations between drug transporter mRNA expression, genital inflammation, and blood-tenofovir diphosphate (TFV-DP). mRNA-expression of four efflux P-gp; MATE-1; MRP-2; MRP-4 and two influx OAT-1 and OAT-3 drug transporters were determined by qRT-PCR. Multiplexed technology was used to measure 27 cytokines to define genital inflammation. Significant positive correlations of mRNA expression for P-gp, MATE-1, MRP-2, and MRP-4 were observed between the FGT and blood at 3- and 6-months post-PrEP initiation (p < 0.05). For OAT-1 however, significant positive correlations were observed pre- and post-PrEP exposure (p < 0.05). Linear-mixed models showed moderate associations between FGT cytokines and drug transporter mRNA expression, with a  direct relationship observed between MIP-1β concentration and MATE-1 mRNA expression. Similarly, PLS-DA showed that in women with genital inflammation, consistently higher mRNA expression of MATE-1 was observed compared to women without genital inflammation. No significant associations were observed between drug transporter mRNA expression and blood TFV-DP. Our results suggest that drug transporters may be similarly expressed in the FGT and blood. Furthermore, genital inflammation may modify PrEP levels by altering drug transporter mRNA expression. Collectively, our data may be used to better understand biological factors that may affect PrEP efficacy in African women who remain vulnerable to HIV.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"18"},"PeriodicalIF":2.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424666","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":"Challenges in the implementation of a high-resolution anoscopy clinic for people with HIV in an oncologic center in Mexico City.","authors":"Patricia Volkow, Salim Barquet-Muñoz, Naomi Jay, Maria-José Mendoza, Paulina Moctezuma, Mariel Morales-Aguirre, Delia Pérez-Montiel, Víctor Larraga, Alexandra Martin-Onraet","doi":"10.1186/s12981-025-00709-9","DOIUrl":"10.1186/s12981-025-00709-9","url":null,"abstract":"<p><strong>Background: </strong>Anal cancer incidence is increased in people with HIV (PWH), up to 60 times higher in men who have sex with men, and almost 15 times higher among women with HIV. Screening and treating high-grade lesions (HSIL) have proven to reduce the incidence of invasive anal cancer. In 2020, we started implementing a high-resolution anoscopy (HRA) clinic at INCan, a tertiary care oncologic center, as part of a screening program for PWH from the HIV clinic.</p><p><strong>Objectives: </strong>We describe the barriers and difficulties in implementing an HRA Clinic from January 2020 to April 2021, including physician training, the certification process, discrepancies between cytology and histopathologist results, and the lack of experience of gastrointestinal pathologists in HPV-related lesions.</p><p><strong>Results: </strong>During the first 18 months of the HRA clinic implementation, 124 studies were performed, and 85 biopsies were done. The prevalence of HSIL was 22%. Initially, when a gastrointestinal pathologist reviewed anal canal biopsies, a second opinion was requested from a genitourinary pathologist who examined 72 of the biopsies; there were discrepancies in the diagnosis in 61% of the cases, with more advanced intraepithelial lesions in 43% of cases. Specifically, gastrointestinal pathologists missed 68% of HSILs. The difficulties we faced were not having access to adequate anoscopes. Training and certification are a long way to go. Also, women's reachability was low.</p><p><strong>Conclusions: </strong>Diagnosis and management of anal HSIL have become a standard of care in the prevention of Anal Carcinoma in PWIH, the population with the highest incidence of this neoplasia. Implementing HRA programs requires correct supplies and equipment, which are not always locally available; investing in physicians' training and an experienced pathologist in HPV-associated lesions interpretation is also imperative. More advocacy is needed for HIV programs to incorporate and invest in anal cancer screening.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"22 1","pages":"17"},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389874","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}