AIDS Research and Therapy最新文献

{"title":"Brief communication: Long-term treatment outcomes of transitioning to dolutegravir-based ART from efavirenz in HIV study participants in Mbeya, Tanzania.","authors":"Revocatus T Majula, Clement N Mweya","doi":"10.1186/s12981-024-00662-z","DOIUrl":"10.1186/s12981-024-00662-z","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization recommends dolutegravir-based antiretroviral therapy (ART) as the preferred first-line regimen for HIV treatment. This retrospective cohort study evaluated the long-term virologic outcomes and safety of transitioning from an efavirenz-based regimen (tenofovir, lamivudine, efavirenz [TLE]) to a dolutegravir-based regimen (tenofovir, lamivudine, dolutegravir [TLD]) among adult HIV participants in Mbeya, Tanzania.</p><p><strong>Methods: </strong>Medical records of 250 adult HIV participants who transitioned from TLE to TLD at Mbeya Zonal Referral Hospital were reviewed from August 2022 to December 2022. The primary outcome was virologic failure, defined as HIV RNA > 1000 copies/mL. Secondary outcomes included viral suppression (< 50 copies/mL) and adverse drug reactions (ADRs). Using appropriate statistical tests, participant characteristics and outcomes were compared before and six months after transitioning.</p><p><strong>Results: </strong>At baseline on TLE, 88% had viral suppression, and 3.6% had virologic failure. Six months after transitioning to TLD, viral suppression was 87.2% and virologic failure increased to 6.8%. Overall, 79.6% experienced ADRs with TLD, predominantly neurological effects and weight gain. No significant associations were found between viral load changes and participant characteristics like age, sex or treatment duration.</p><p><strong>Conclusions: </strong>Transitioning to dolutegravir maintained high rates of viral suppression comparable to efavirenz, albeit with a slight increase in virologic failure. Dolutegravir was well-tolerated overall despite a high ADR rate. Findings support the ongoing scale-up of dolutegravir in Tanzania and other resource-limited settings while highlighting the need for continued viral load monitoring and pharmacovigilance.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"98"},"PeriodicalIF":2.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880863","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":"Factor structure of the HIV-SM LMIC self-management questionnaire for people living with HIV in low- and middle-income countries.","authors":"Tegene Legese Dadi, Girmay Medhin, Mark Spigt","doi":"10.1186/s12981-024-00676-7","DOIUrl":"10.1186/s12981-024-00676-7","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the need for reliable questionnaires to monitor self-management in chronic disease patients, such tools are lacking in developing countries. This study aims to pilot and assess the construct validity of the HIV-SM LMIC questionnaire.</p><p><strong>Method: </strong>The validation of the HIV-SM LMIC questionnaire involved two cross-sectional studies in Ethiopia. The first round, for exploratory factor analysis (EFA), included 261 patients, while the second round, for confirmatory factor analysis (CFA), included 300 patients. Data was collected using the Kobo Collect electronic data entry template.</p><p><strong>Result: </strong>The sample adequacy test showed a good value of 0.82. In the first round, 6 of the 32 items were not loaded, forming three factors in the EFA. Four of these items were dropped, but two (PSMB2 and PSMB12) were retained for their content. In the second round, CFA on the remaining 28 items led to dropping 8 more items due to conceptual overlap, resulting in a 20-item questionnaire. The final items were structured into three dimensions: awareness and well-being (4 items), self-regulation (6 items), and self-management practices (10 items).</p><p><strong>Conclusion: </strong>The study refined the original 32-item HIV-SM LMIC questionnaire to a validated 20-item, three-dimensional tool with an acceptable goodness of fit. The authors recommend further cross-cultural and predictive validation and adaptation for newly diagnosed HIV patients, those with poor treatment outcomes.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"97"},"PeriodicalIF":2.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870996","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":"Effectiveness of dolutegravir-based regimens compared to raltegravir-, elvitegravir-, bictegravir, and darunavir-based regimens among older adults with HIV in the Veterans Aging Cohort Study (VACS).","authors":"Lei Yan, Cassidy E Henegar, Vincent C Marconi, Kirsha S Gordon, Charles Hicks, Vani Vannappagari, Amy C Justice, Mihaela Aslan","doi":"10.1186/s12981-024-00681-w","DOIUrl":"10.1186/s12981-024-00681-w","url":null,"abstract":"<p><strong>Background: </strong>Real-world data on treatment patterns and clinical outcomes for newer drugs, including integrase strand transfer inhibitors, among older people with human immunodeficiency virus (PWH) are limited.</p><p><strong>Methods: </strong>This cohort study included PWH enrolled in the Veterans Aging Cohort Study (VACS) who were prescribed a standard 3-drug antiretroviral therapy (ART) regimen containing dolutegravir (DTG), bictegravir (BIC), cobicistat boosted elvitegravir (EVG), raltegravir (RAL), or darunavir/ritonavir (DRV) plus 2 nucleoside reverse transcriptase inhibitors between January 1, 2014, and March 31, 2020, and who were ≥50 years at regimen initiation. The association between regimen and virologic effectiveness or discontinuation was assessed using logistic regression models with inverse probability of treatment weights. Pairwise comparisons were made between DTG-based regimen and each of the other 3-drug regimens, stratified by ART experience.</p><p><strong>Results: </strong>Among 15,702 PWH (across treatment groups, median age 58-62 years; 94-98% male; 5-11% Hispanic; 44-60% Black; 29-42% White), 5,800 received DTG-based regimens, 2,081 BIC-based regimens, 4,159 EVG-based regimens, 1,607 RAL-based regimens, and 2,055 received DRV-based regimens. Among ART-naïve PWH, there were no statistical differences in the odds of virologic suppression, and 6- and 12-month discontinuations were higher in those on DRV. Among ART-experienced PWH, compared to DTG, those on RAL and DRV were less likely to be suppressed at 6 months (RAL vs DTG: aOR 0.64, 95% CI 0.51-0.81; DRV vs DTG: aOR 0.63, 95% CI 0.51-0.76) and those on EVG and DRV were less likely suppressed at 12 months (EVG vs DTG: aOR 0.82, 95% CI 0.68-0.99; DRV vs DTG: aOR 0.64, 95% CI 0.52-0.80). Those on DRV were more likely to have virologic failure within 12 months (aOR 1.96, 95% CI 1.30-2.97). Six- and 12-month discontinuations were higher in those on RAL and DRV, but less likely for BIC-based regimens.</p><p><strong>Conclusions: </strong>DTG-based regimens demonstrated higher levels of effectiveness and durability compared to DRV- or RAL-based regimens and had similar treatment responses as BIC- and EVG-based regimens among ART-experienced older PWH.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"96"},"PeriodicalIF":2.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870986","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: Factors associated with willingness to use long-acting injectable Cabotegravir for HIV pre-exposure prophylaxis (PrEP) among female undergraduate students at a Ugandan university.","authors":"Bridget Atuhaire, Laban Muteebwa, Racheal Nabunya, Richard Muhindo, Tom Denis Ngabirano, Charles Peter Osingada, Patience A Muwanguzi","doi":"10.1186/s12981-024-00686-5","DOIUrl":"10.1186/s12981-024-00686-5","url":null,"abstract":"<p><strong>Background: </strong>We assessed the willingness of female students at a Ugandan public university to use long-acting Cabotegravir (CAB-LA) for HIV prevention, given their high prevalence of HIV risk behaviours.</p><p><strong>Methods: </strong>Using an online questionnaire, this cross-sectional study surveyed 346 female undergraduate students aged 18-25. Factors influencing their willingness were analysed with modified Poisson regression and robust standard errors.</p><p><strong>Results: </strong>More than half, 56.7% (95% CI: 51.4 to 61.8), were willing to use CAB-LA. Willingness was significantly associated with being sexually active in the past 3 months, using alcohol in the past 6 months, or being in the 4th year of study compared to the 1st year.</p><p><strong>Conclusion: </strong>Educational initiatives on innovative HIV prevention strategies, such as CAB-LA, should be introduced early in university students' studies to increase awareness and acceptance.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"95"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870985","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":"The effect of emotional freedom techniques on anxiety depression and sleep in older people living with HIV: a randomized controlled trial.","authors":"Wen Qi, You Xinyi, Wu Yuhan, Yang Wenwen, Song Yan","doi":"10.1186/s12981-024-00679-4","DOIUrl":"10.1186/s12981-024-00679-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of Emotional Freedom Techniques on anxiety, depression and sleep in older people living with HIV (PLWH).</p><p><strong>Methods: </strong>70 older PLWH experiencing anxiety, depression, and sleep disorders were randomly divided into control and experimental groups using a random number table system (RNT), with 35 participants in each group. The experimental group received Emotional Freedom Techniques once a day for 15-20 min as part of their routine care and health counselling, and the intervention lasted for 2 weeks. The control group received standard nursing care and health guidance. The two groups were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) to measure changes in anxiety, depression, and sleep quality before and after the intervention.</p><p><strong>Results: </strong>There are totally 67 participants in the trial. In the EFT group (n = 33), PSQI scores decreased from 12.36 ± 2.409 to 9.15 ± 2.476(mean ± SD P < 0.001), HA scores decreased from 12.39 ± 2.344 to 9.12 ± 2.176(mean ± SD P < 0.001), HD scores decreased from 11.58 ± 1.969 to 8.94 ± 2.015 (mean ± SD P < 0.001), compared with no change in the usual care group (n = 34). The EFT group showed significantly lower post-intervention scores than the control group on all scales (P < 0.001), indicating the effectiveness of the intervention.</p><p><strong>Conclusion: </strong>Emotional Freedom Techniques can effectively alleviate anxiety and depression in older PLWH and improve their sleep quality.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"94"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870997","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":"Incidence and risk factors regarding atherosclerotic cardiovascular disease in middle-aged and elderly people with HIV treated in Chongqing, China.","authors":"Min Liu, Mei Li, Qian Liu, Yongjia Fu, Yushan Wu, Rui Huang, Qi Cao, Honghong Yang","doi":"10.1186/s12981-024-00684-7","DOIUrl":"10.1186/s12981-024-00684-7","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic cardiovascular disease (ASCVD) has become an increasingly common cause of death among people living with HIV (PLHIV) receiving successful antiretroviral therapy (ART). In Chongqing, approximately half of the PLHIV were middle-aged or elderly, and their diets were mainly high in salt, spices and oil; however, there is still a lack of relevant research on the risk factors and whether the disease burden of ASCVD is greater in these areas. This study was to investigate the risk of ASCVD in middle-aged and elderly PLHIV receiving ART and analyze the factors influencing high risk.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Chongqing Public Health Medical Center. Questionnaire surveys, physical examinations and laboratory examinations were used to collect information from PLHIV aged ≥ 45 years. Pooled cohort equations (PCEs) were used to calculate the 10-year ASCVD risk and analyze the influencing factors. The 10-year ASCVD risk score was used to define patients in the low-risk subgroup (< 7.5%) and high-risk subgroup (≥ 7.5%), and the risk factors were compared between the two groups.</p><p><strong>Results: </strong>In total, 463 PLHIV (median age 55.0 years, male 68.5%) were included, and the median duration of ART was 45.0 (15.0, 70.3) months. Of the 463 PLHIV, 13 (2.8%) had a known history of ASCVD. In the present study, 153 PLHIV (33.0%) were classified into the high-risk group, and 310 PLHIV (67.0%) were classified into the low-risk group. Compared with the low-risk group, the high-risk group was more likely to be female, older age, live in urban areas, be unemployed, have poor sleep quality, have higher low-density lipoprotein cholesterol (LDL-c), have higher total cholesterol (TC), and have diabetes and hypertension; however, coffee consumption was associated with a low risk of ASCVD. In addition, there were no differences in HIV viral load, CD4 + T-cell count, or duration on ART, or ART regimes between the two groups. According to multiple logistic regression, older age [odds ratio (OR) = 62.469, 95% CI 27.456, 142.134], female sex [OR = 9.635, 95% CI 4.384, 21.179], higher LDL-c levels [OR = 1.018, 95% CI 1.000, 1.036], accompanied hypertension [OR = 8.642, 95% CI 3.373, 22.143] and diabetes [OR = 10.806, 95% CI 3.787, 30.834] were found to be independent risk factors for the 10-year risk of ASCVD.</p><p><strong>Conclusions: </strong>The overall 10-year ASCVD risk is great for middle-aged and elderly PLHIV in Chongqing, China. The risk factors for the 10-year risk of ASCVD were older age, female sex, elevated LDL-c level, and coexisting hypertension and diabetes.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"92"},"PeriodicalIF":2.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862571","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":"Effect of a multimodal continuing professional development initiative on HIV testing in primary care in British Columbia, Canada.","authors":"Brenna M Lynn, Jennifer A Barrows, Vivian W Y Lam, Vernon R Curran","doi":"10.1186/s12981-024-00688-3","DOIUrl":"10.1186/s12981-024-00688-3","url":null,"abstract":"<p><strong>Introduction: </strong>Many persons are unaware of HIV infection until they present in an advanced stage of the disease. Diagnosing HIV infection in its earliest stages reduces morbidity and mortality and contributes to improved public health. Increased testing for HIV is critical for prevention, and primary care providers play an essential role in early HIV screening. However, lack of knowledge and confidence are barriers to the adoption of screening practices. Continuing professional development (CPD) may enhance greater HIV testing uptake amongst primary care providers by improving awareness and comfort. This paper aims to report on the impact of a multimodal CPD initiative to increase HIV screening and test ordering across primary care settings in British Columbia, Canada.</p><p><strong>Methods: </strong>The 'HIV Testing Initiative in Family Practice' was designed as a multimodal education strategy to encourage family physicians to adopt routine HIV testing in their practices. The initiative encompassed a variety of core and supplementary educational activities, including interactive in-person CPD workshops, practice resources, and patient education materials. An interrupted time series study was undertaken to evaluate the effect on HIV test ordering before and after workshop participation. Participants also completed post-workshop surveys to assess satisfaction.</p><p><strong>Results: </strong>In total, 316 individuals participated in the core educational activities of the initiative. The number of HIV tests ordered increased significantly amongst participants following workshop participation (p < .001). HIV test ordering increased for both rural and urban providers with no significant difference (p = .075) on the number of tests ordered between these groups. Participants were very satisfied with workshop participation, with an overall mean satisfaction rating of 4.78 (out of 5) and reported high satisfaction with the format (4.64 out of 5) and interactivity (4.76 out of 5) features across the workshops.</p><p><strong>Discussion: </strong>The findings suggest that the introduction of a multimodal CPD intervention may have effected change in family physicians' HIV testing practices. The HIV testing rates of physicians who had participated in CPD workshops increased significantly, and participant evaluation data indicated a greater understanding of the rationale for routine HIV testing, as well as an increase in comfort with recommending HIV tests to patients.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"93"},"PeriodicalIF":2.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862569","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":"Case management strategy enhances virological response in people living with human immunodeficiency virus in a resource-limited region in Southwest China: a real-world prospective observational study.","authors":"Xiaozhen Song, Juan Zheng, Liyu Chen, Fanghua Ma, Changmin Li, Junjie Wang, Lingyao Du, Hong Tang","doi":"10.1186/s12981-024-00682-9","DOIUrl":"10.1186/s12981-024-00682-9","url":null,"abstract":"<p><p>This study assessed the effectiveness of case management compared to that of standard care in improving treatment outcomes for first-time antiretroviral therapy (ART) patients in Liangshan Prefecture, China. First-time ART patients (total n = 828) were divided into the Standard Care Group (SCG, n = 419) and Case Management Group (CMG, n = 409). At week 48, the CMG showed higher retention rates (97.7% vs. 93.6%), better adherence, and more complete virological responses (84.2% vs. 64.0%) compared to the SCG. These findings suggest that case management improves adherence and virological suppression in resource-limited areas, though further research is needed to confirm its broader applicability.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"91"},"PeriodicalIF":2.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851974","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":"TheU-shape association between on-admission resting heart rate and 60-day all-cause mortality of AIDS inpatients in Fujian China: a retrospective cohort study.","authors":"Rui Huang, Yan Li, Ling Chen, Yan Yang, Jinxiu Wang, Huan Zhao, Lifen Han","doi":"10.1186/s12981-024-00678-5","DOIUrl":"10.1186/s12981-024-00678-5","url":null,"abstract":"<p><strong>Background: </strong>An elevated resting heart rate (RHR) is associated with poor outcomes in both healthy individuals and those with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). This study aimed to investigated the association between on admission resting heart rate (RHR) and 60-day mortality.</p><p><strong>Methods: </strong>This single-center retrospective cohort study evaluated the effect of RHR on the 60-day mortality of patient with AIDS in Southeast China. A total of 2188 patients with AIDS admitted for the first time between January 2016 and December 2021 were included. The RHR was categorized into tertiles. Disease progression was estimated using 60-day mortality rates. Cox proportional hazards regression models were used to evaluate the RHR with disease progression, and a two-piecewise Cox regression model was used to reveal the RHR effect at admission on 60-day mortality.</p><p><strong>Results: </strong>We observed a U-shape relationship between RHR and 60-day mortality. For a above 90 bpm, the 60-day mortality rose rapidly with a multivariable adjusted odds ratio (OR) of 1.032 (95% confidence interval [CI 1.016-1.048, P < 0.001). Below the threshold, 60 days mortality decreased as the RHR increased to 90 bpm with a multivariate-adjusted OR of 0.943 (95% CI 0.904-0.984, P = 0.0065).</p><p><strong>Conclusions: </strong>This study identified a U-shape relationship between RHR and 60-day mortality in HIV/AIDS patients. Further research is needed to characterize the role of RHR in the timely prevention of mortality in HIV/AIDS patients.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"89"},"PeriodicalIF":2.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852023","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":"Cumulative incidence and treatment effectiveness of low bone mineral density among people living with HIV in Iran (2021-2023).","authors":"Hamidreza Rashidi, Soheil Mehmandoost, Noushin Fahimfar, Seyed Mohammad Hosseinian, Mohammad Reza Shakibi, Tarlan Hasan Aghaei, Farzaneh Yazdi Yahaabadi, Pouriya Salajegheh, Willi Mcfarland, Afshin Ostovar, Hamid Sharifi","doi":"10.1186/s12981-024-00683-8","DOIUrl":"10.1186/s12981-024-00683-8","url":null,"abstract":"<p><strong>Background: </strong>The introduction of antiretroviral therapy (ART) has significantly improved the life expectancy of people living with HIV (PLHIV), leading to an increased prevalence of age-related comorbidities such as osteoporosis. This study investigates the incidence and characteristics of low bone mineral density (BMD) and the treatment effectiveness of low BMD participants among PLHIV in Kerman, Iran.</p><p><strong>Methods: </strong>A longitudinal study utilized dual-energy X-ray absorptiometry (DEXA) to screen 94 PLHIV in Kerman, Iran, for low BMD. Participants were aged 30 or older and had received antiretroviral therapy (ART) for at least 12 months. Those with low BMD were entered into a single-arm clinical trial and received the appropriate treatment. These people were checked to assess the treatment effectiveness 11 months after completion of the treatment. Those with normal BMD entered a cohort study and were checked to determine the cumulative incidence of low BMD. Data on demographics, medical history, and laboratory tests were collected. A chi-square test was used to assess the association between the categorical variables. A t-test (for normally distributed variables), or Mann-Whitney U (for non-normally distributed variables) was used to assess the differences of BMD between the two groups. Statistical significance was set at p ≤ 0.05, with analyses conducted in Stata 17.</p><p><strong>Results: </strong>Among 94 PLHIV at baseline, 48 participants (51%) had low BMD. During the follow-up, 11 participants (11.7%) missed the follow-up visits. In the follow-up, 83 PLHIV (40 with low BMD and 43 with normal BMD at baseline) were available. Among 40 participants who received treatment, 5 had normal BMD (treatment effectiveness: 12.5%). However, among 43 PLHIV with normal BMD at baseline, 7 PLHIV had low BMD at the follow-up visit (cumulative Incidence 16.3%). Those with lower body mass index (BMI) had a higher prevalence of low BMD than those with normal BMI during the follow-up (p-value: 0.003). Lumbar spine BMD increased modestly (0.005 g/cm²), while femoral neck and total hip BMD declined in total participants (0.011, 0.007 g/cm², respectively). Osteocalcin and β-isomerized C-terminal telopeptides (β-CTx) levels were higher in the low BMD group in the follow-up, indicating increased bone turnover.</p><p><strong>Conclusions: </strong>The study highlights the high cumulative incidence of 16.3% and treatment effectiveness of 12.5% of low BMD among PLHIV in Kerman, Iran, with implications for fracture risk. Despite a steady state in spine BMD decline, the risk of fracture remains elevated due to continued femoral neck and total hip BMD reduction. Gender-specific factors and BMI may influence susceptibility to low BMD.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"90"},"PeriodicalIF":2.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851960","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}