AIDS research and human retroviruses最新文献

{"title":"The Risk Factors of High-Risk Human Papillomavirus Susceptibility and Clinical Features in People with HIV with Anal Condyloma Acuminatum: A Retrospective Cohort Study.","authors":"Shuli Huang, Yong Qing, Yongqiong Deng, Liehua Deng","doi":"10.1089/aid.2024.0051","DOIUrl":"10.1089/aid.2024.0051","url":null,"abstract":"<p><p>Anal condyloma acuminatum (ACA) has a high incidence and recurrence rate in people living with HIV (PWH) but there are few studies to systematically characterize its clinical features. We aimed to analysis the clinical features in PWH with ACA and elucidate the risk factors of high-risk human papillomavirus (HPV) infection. In total, 208 patients who had ACA surgically excised were enrolled (including 123 ACA subjects with HIV infection) from December 1, 2020, to June 31, 2023, and the sex, age, occupation, marital status, new versus recurrent, HPV genotypes, and treatment history of patients were involved. The HIV viral, CD4 and CD8 cell counts, and the antiretroviral therapy (ART) were also obtained from PWH. PWH with ACA were more likely to be male, employee, and age 19-59 and less likely to be under 18 or over 60 years old (<i>p</i> < .05). The proportion of high-risk HPV infection (30.1%) and triple or more HPV infection (20.5%) in PWH with ACA was significantly higher than those in patients without HIV infection (15.3% and 1.3%, respectively). Moreover, the prevalence of high-risk HPV infection (62.1%) and multiple HPV infection (76.0%) in PWH who were not on ART was significantly higher than those who received ART (20.0%,28.2%, respectively). The conditional logistic regression analysis suggested HIV positivity as the primary risk factor for the high-risk HPV infection in ACA and no ART is a risk factor for high-risk HPV infection. In conclusion, PWH with ACA are more likely to have a high-risk HPV and therefore will be at increased risk for anal SCC, and this risk can in part be mitigated using ART. PWH should start ART as soon as possible after diagnosis. And for PWH with ACA, routine histopathological evaluation and HPV typing of intra-anal warts and follow-up and treatment of all dysplastic warts should be recommended.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":"98-106"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequence Notes: Characterization of Two Novel HIV-1 Unique Recombinant Forms (CRF01_AE/B) in Hebei Province.","authors":"Zhen Zhang, Yuchen Zhang, Juan Meng, Weiguang Fan, Jianru Jia, Sisi Chen, Haoxi Shi","doi":"10.1089/aid.2024.0122","DOIUrl":"https://doi.org/10.1089/aid.2024.0122","url":null,"abstract":"<p><p>Many new circulating recombinant forms (CRFs) and unique recombinant forms (URFs) of human immunodeficiency virus type-1 (HIV-1) have been discovered in populations with multiple circulating HIV-1 genotypes. In this study, we report two novel URFs derived from two HIV-1-positive individuals in Hebei, China, who were infected through homosexual (BDD142) and heterosexual (BDD154) contact. Phylogenetic and recombinant analyses of the two NFLG revealed that they are second-generation recombinant strains originating from the CRF01_AE cluster 4/B and CRF01_AE cluster 5/B strains. The BDD142 viral genome consists of a subtype B fragment inserted into a CRF01_AE backbone, whereas the BDD154 virus genome consists of two subtype B fragments inserted into a CRF01_AE backbone. Prompt monitoring of molecular epidemiological shifts of HIV-1 within sexually transmitted populations and enhanced behavioral interventions targeting this group are imperative to mitigate the spread of HIV-1 effectively.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near Full-Length Genomic Characterization of a Novel HIV-1 Unique Recombinant (A1/D/K) from an Immigrant Worker in China Using Nanopore Sequencing.","authors":"Haibo Wang, Huina Huang, Weigang Li, Cheng Yuan, Ying Su, Xiaojian Zhou, Xinbin Chen, Yuxiang Huang","doi":"10.1089/aid.2024.0108","DOIUrl":"https://doi.org/10.1089/aid.2024.0108","url":null,"abstract":"<p><p>Recombination contributes substantially to the genetic diversity of HIV-1. Here we reported a novel HIV-1 recombinant detected from a Chinese labor who had been to Uganda as an immigrant worker using nanopore sequencing. Near full-length genome (NFLG) phylogenetic analysis showed that the novel HIV-1 recombinant HIV-sd1801 stood in a distinct branch between the CRF130_A1B/CRF131_A1B and CRF50_A1D/CRF84_A1D reference sequences. Recombinant analysis showed that the NFLG of HIV-sd1801 was composed of subtypes A1, D, and K, with 19 recombinant breakpoints observed in the <i>gag, pol, tat, rev, vpu, env,</i> and <i>nef</i> regions. This is the first detection of a novel HIV-1 recombinant (A1/D/K) in immigrant workers in China, which indicated the continuous evolution of HIV-1 among this population and underscored the importance of continuous surveillance of the dynamic changes of HIV-1.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Benefit of a Conservative Treatment for High-Risk Human Papillomavirus Lesions in Patients with HIV.","authors":"Jesús Joaquín Hijona Elósegui, Antonio Luis Carballo García, Ana Cristina Fernández Rísquez, Jesús Carlos Presa Lorite, Gabriel Fiol Ruiz","doi":"10.1089/aid.2024.0067","DOIUrl":"https://doi.org/10.1089/aid.2024.0067","url":null,"abstract":"<p><p>Infection with Human immunodeficiency virus (HIV) shows a higher risk of infection by Human papillomavirus (HPV). We aim to provide evidence about the effect of a <i>Coriolus versicolor</i>-based vaginal gel (Papilocare®) for treating HPV in women with HIV. Women ≥25 years coinfected by endocervical HPV and with low-grade abnormal cervicovaginal cytology were treated for 6 months with Papilocare® in this observational, prospective, non-controlled pilot study. Cytology, colposcopy, biopsy, hybrid capture test, and 5-point Likert scale were assessed to evaluate cervical lesions repair, HPV clearance, and changes in cervical reepithelization, respectively, at 6 months. Fifteen patients (25-54 years) were included. Overall HPV clearance and cytological normalization rates were 73.3% and 80.0%, respectively, and 55.6% of the abnormal colposcopies were normalized. Re-epithelialization index improved in 66.7% of cases. Papilocare® may be effective for managing endocervical HPV infection in patients living with HIV.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting the Epidemiological Characteristics of HIV-1 in Heterosexually Transmitted Population Based on Molecular Transmission Network in Kunming, Yunnan: A Retrospective Cohort Study.","authors":"Peng Cheng, Bao-Cui He, Zhi-Xing Wu, Jia-Fa Liu, Jia-Li Wang, Cui-Xian Yang, Sha Ma, Mi Zhang, Xing-Qi Dong, Jian-Jian Li","doi":"10.1089/aid.2023.0137","DOIUrl":"10.1089/aid.2023.0137","url":null,"abstract":"<p><p>Heterosexuals have become the most prevalent group of HIV-1 in Kunming, Yunnan Province. Utilizing the principle of genetic similarity between their gene sequences, we built a molecular transmission network by gathering data from earlier molecular epidemiological studies. This allowed us to analyze the epidemiological features of this group and offer fresh concepts and approaches for the prevention and management of HIV-1 epidemics. Cytoscope was used to visualize and characterize the network following the processing of the sample gene sequences by BioEdit and HyPhy. The number of possible links and the size of the clusters were investigated as influencing factors using a zero-inflated Poisson model and a logistic regression model, respectively. A scikit-learn-based prediction model was developed to account for the dynamic changes in the HIV-1 molecular network. Six noteworthy modular clusters with network scores ranging from 4 to 9 were found from 150 clusters using Molecular Complex Detection analysis at a standard genetic distance threshold of 0.01. The size of the number of possible links and the network's clustering rate were significantly impacted by sampling time, marital status, and CD4⁺ T lymphocytes (all <i>p</i> < 0.05). The gradient boosting machine (GBM) model had the highest area under the curve value, 0.884 ± 0.051, according to scikit-learn. Though not all cluster subtypes grew equally, the network clusters were relatively specific and aggregated. The largest local transmission-risk group for HIV-1CRF08_BC is now the heterosexual transmission population. The most suitable model for constructing the HIV-1 molecular network dynamics prediction model was found to be the GBM model.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV DNA Levels in Persons Who Acquired HIV in the Setting of Long-Acting Cabotegravir for HIV Prevention: Analysis of Cases from HPTN 083 and 084.","authors":"Jessica M Fogel, Deborah Persaud, Estelle Piwowar-Manning, Paul Richardson, Joseph Szewczyk, Mark A Marzinke, Zhe Wang, Xu Guo, Marybeth McCauley, Jennifer Farrior, Ha Viet Tran, Chaiwat Ungsedhapand, Carrie-Anne Mathew, Juliet Mpendo, Alex R Rinehart, James F Rooney, Myron S Cohen, Brett Hanscom, Beatriz Grinsztejn, Mina C Hosseinipour, Sinead Delany-Moretlwe, Raphael J Landovitz, Susan H Eshleman","doi":"10.1089/aid.2024.0049","DOIUrl":"10.1089/aid.2024.0049","url":null,"abstract":"<p><p>We evaluated HIV DNA levels in individuals who received long-acting cabotegravir (CAB-LA) or tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) pre-exposure prophylaxis in the HPTN 083 and 084 trials and had HIV DNA testing performed to help determine HIV status. HIV DNA testing was performed using peripheral blood mononuclear cell (PBMC) samples collected after a reactive HIV test was obtained at a study site. DNA was quantified using droplet digital PCR (lower limit of detection [LLOD]: 4.09 copies/million PBMCs). Final HIV status and the timing of the first HIV-positive visit were determined by an independent adjudication committee based on HIV test results from real-time site testing and retrospective testing at a centralized laboratory. HIV DNA testing was performed for 133 participants [21 HIV-positive (7 CAB-LA arm, 14 TDF/FTC arm) and 112 HIV-negative; 1-6 tests/person]. For persons with HIV, the time between the first HIV-positive visit and collection of the first sample for DNA testing was a median of 81 days for those receiving CAB-LA (range 41-246) and 11 days for those receiving TDF/FTC (range 3-127). Four (57.1%) of the seven CAB-LA cases with infection had a low initial DNA result [three detected <LLOD; one near the LLOD (4.2 copies/10⁶ PBMCs); in 2/4 cases, the DNA level was still <10 copies/10⁶ PBMCs ≥40 weeks after the first HIV-positive visit. In contrast, only 3/14 (21.4%) of the TDF/FTC cases had a low or negative initial DNA test result (one not detected; two <10 copies/10⁶ PBMCs). In this study, the time between the first HIV-positive visit and the first DNA test was longer in the CAB-LA cases than the TDF/FTC cases. Despite this difference, low or undetectable DNA levels were more frequently observed in the CAB-LA cases. This suggests that CAB-LA exposure may limit seeding of the HIV reservoir in early infection.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":"30-36"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492878","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":"Comparison of the Performance of Commercially Available Quantitative Viral Load Assays Using Clinical Samples from Patients from Regions Where Distinct HIV-1 Subtypes Co-Circulate: Potential Implications for Patient Management.","authors":"Maria Cecilia Araripe Sucupira, Mauro Schechter, Adauto Castelo Filho, Fernanda Ferreira, Lilian Amaral Inocêncio, Denise Ferreira de Souza, Ricardo Sobhie Diaz","doi":"10.1089/aid.2024.0055","DOIUrl":"10.1089/aid.2024.0055","url":null,"abstract":"<p><p>HIV RNA plasma viral load (VL) is the standard surrogate marker to monitor response to antiretroviral treatment (ART). We compared the linearity, repeatability, and concordance of six commercially available HIV RNA VL platforms using clinical samples from patients from Brazilian sites where different HIV-1 subtypes co-circulate. A total of 150 plasma samples from each city were collected in Curitiba, Southern Brazil (subtype C), São Paulo (subtype B), and Santos (BF recombinants), Southeast Brazil. Platforms were VERSANT^® Siemens HIV RNA 1.0 (kPCR); VERSANT^® Siemens HIV-1 RNA 3.0 (bDNA); Abbott Real-Time HIV-1; NucliSens EasyQ^® HIV-1 v2.0 Biomerieux; COBAS^® TaqMan^®, Roche; and <i>artus</i> HIV Virus-1 RT-PCR, QIAGEN. OptiQuant HIV-1 RNA quantification panel was used to compare VL linearity, using samples containing 50, 500,5,000, 50,000, 500,000, and 5,000,000 HIV copies/mL. HIV RNA panels with subtypes A, B, C, D, F, G, H, circulating recombinant form (CRF)1, and CRF2 were utilized. A high degree of linearity and repeatability was demonstrated for all platforms. When compared with a subtype B reference sample, 17 of 54 (31.48%) samples diverged by more than 0.5 log₁₀ copies/mL. Except for the Roche platform, all platforms underestimated subtype C VLs. A total of 743 (82.6%) valid results were obtained with samples from São Paulo, 707 (78.6%) from Santos, and 673 (74.8%) from Curitiba (São Paulo vs. Santos, <i>p</i> = .03; São Paulo vs. Curitiba, <i>p</i> = .00006; Santos vs. Curitiba, <i>p</i> = .06). The number of discordant samples between different methodologies when VL was undetectable in one method and detectable in the other ranged from 1.25% (Abbot vs. Siemens) to 44.8% (Abbott vs. Biomerieux). Finding samples with undetectable VL in one method and a high VL in another might have important individual and public health consequences. Standardization of VL measurements, particularly for non-B subtypes infections, especially subtype C, is necessary to maximize the individual and public health benefits of ART globally.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":"60-65"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV-1 Integrase T218I/S Polymorphisms Do Not Reduce HIV-1 Integrase Inhibitors' Phenotypic Susceptibility.","authors":"Elliott R Rodríguez-López, Pablo López, Yadira Rodríguez, Raphael Sánchez, Van-Sergei Acevedo, Jarline Encarnación, Grissell Tirado, Carmen Ortiz-Sánchez, Thibault Mesplède, Vanessa Rivera-Amill","doi":"10.1089/AID.2023.0128","DOIUrl":"10.1089/AID.2023.0128","url":null,"abstract":"<p><p>The recently Food and Drug Administration (FDA)-approved cabotegravir (CAB) has demonstrated efficacy as an antiretroviral agent for HIV treatment and prevention, becoming an important tool to stop the epidemic in the United States of America (USA). However, the effectiveness of CAB can be compromised by the presence of specific integrase natural polymorphisms, including T97A, L74M, M50I, S119P, and E157Q, particularly when coupled with the primary drug-resistance mutations G140S and Q148H. CAB's recent approval as a pre-exposure prophylaxis (PrEP) may increase the number of individuals taking CAB, which, at the same time, could increase the number of epidemiological implications. In this context, where resistance mutations, natural polymorphisms, and the lack of drug-susceptibility studies prevail, it becomes imperative to comprehensively investigate concerns related to the use of CAB. We used molecular and cell-based assays to assess the impact of T218I and T218S in the context of major resistance mutations G140S/Q148H on infectivity, integration, and resistance to CAB. Our findings revealed that T218I and T218S, either individually or in combination with G140S/Q148H, did not significantly affect infectivity, integration, or resistance to CAB. Notably, these polymorphisms also exhibited neutrality concerning other widely used integrase inhibitors, namely raltegravir, elvitegravir, and dolutegravir. Thus, our study suggests that the T218I and T218S natural polymorphisms are unlikely to undermine the effectiveness of CAB as a treatment and PrEP strategy.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":"43-54"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858768","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":"Central Memory CD4 T Cells from Persons with HIV Accumulate DNA Content Defects During Proliferative Response.","authors":"Dámaris P Romero-Rodríguez, Jessica Romero-Rodríguez, Fernanda Cervantes-Mejía, Gustavo Olvera-García, Santiago Pérez-Patrigeon, Akio Murakami-Ogasawara, Karla Romero-Mora, María Gómez-Palacio, Gustavo Reyes-Terán, Wei Jiang, Enrique Espinosa","doi":"10.1089/aid.2024.0062","DOIUrl":"10.1089/aid.2024.0062","url":null,"abstract":"<p><p>Central memory (T_CM) cells are a subpopulation of CD4 T cells that sustain overall CD4 T cell counts in HIV infection. The mechanisms underlying their eventual demise, which leads to loss of CD4 T cell counts, are not known. To understand their proneness to death despite their increased movement to proliferation, we examined cell division together with possible cell accumulation in different phases of the cell cycle. Purified circulating T_CM cells from untreated people living with HIV (PLWH) (<i>n</i> = 9) and healthy controls (<i>n</i> = 10) were stimulated <i>in vitro</i> using anti-CD3/CD28 agonistic antibodies plus IL-2 and cultured for 4 days. Cell viability, DNA content, proliferation, and cyclin A and cyclin B expression were measured. We found that PLWH T_CM cells more frequently had a DNA content lower than G0/G1, compared with controls (<i>p</i> = .043). These cells accumulated with each division. The proportion of cells with sub-G0/G1 DNA content that were cycling (expressing cyclin A) was greater in the PLWH group (<i>p</i> = .003). The percentage of T_CM cells expressing cyclin A+ among those in G0/G1 and was also greater in the PLWH group (<i>p</i> = .043), suggesting arrest before G2/M. While T_CM cells from PLWH can proliferate, during this process some of them accumulate defects in DNA content that are incompatible with viability, suggesting that they could be intrinsically prone to cell cycle-dependent death. This provides a possible mechanism underlying the increased T_CM cell turnover in HIV infection.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":"37-42"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492876","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":"\"They Have to Make an Effort Too\": What Decliners Can Teach Us About HIV Cure/Remission-Related Clinical Trials? Results from a French Qualitative Study.","authors":"Sarah Lefebvre, Jean-Daniel Lelièvre, Véronique Rieux, Laurence Weiss, Denise Ward, Anne Rachline, Morgane Bureau-Stoltmann, Raida Ben Rayana, Nadir Gaad, Mohamed Ben Mechlia, Giorgio Barbareschi, Guilio Maria Corbelli, Elizabeth Brodnicki, Bruno Spire, Sheena Mc Cormack, Christel Protière","doi":"10.1089/aid.2024.0064","DOIUrl":"10.1089/aid.2024.0064","url":null,"abstract":"<p><p>Only one study to date has focused on people living with HIV (PLWH) who refused to participate in a HIV cure/remission-related clinical trial (HCCT)-\"decliners\" hereafter-that included analytical treatment interruption (ATI). Exploring why these persons refuse may provide valuable information to ensure more ethical recruitment and support in HCCTs within the bigger picture of improving HIV cure research. The qualitative component of the AMEP-EHVA-T02/ANRS-95052 study, called AMEP-Decliners, documented the experiences of French PLWH who refused to participate in EHVA-T02/ANRS-VRI07, a phase II randomized, placebo-controlled HCCT with ATI. AMEP-Decliners comprised semi-structured individual interviews with six decliners in two HIV care sites in France between September 2022 and March 2023. The interviews documented their expectations regarding HCCTs, reasons for refusal, and perceived factors that might have led them to participate. Audio files were transcribed, and an inductive thematic analysis was performed. Surprisingly, the main reason for refusal was not ATI but the trial monitoring. Besides the frequency of appointments, respondents emphasized the incompatibility with their active life. One underlying reason for refusal was that participating would have meant \"break[ing] the carefree attitude about the disease,\" reflecting the substantial psychological burden associated with participation. Finally, respondents perceived that the trial's clinical team did not sufficiently recognize their \"normal life\" and the level of commitment required to participate, leading them to call for greater involvement by the team: \"they have to make an effort too.\" Results from decliners' discourses highlighted that two levels of commitment to participation must be considered when developing HCCTs: psychological burden and logistical constraints. We suggest allowing home examinations and flexible appointment times, prioritizing face-to-face invitations in order to address the psychological burden associated with HCCT participation, and explaining the reasons for monitoring constraints when they cannot be alleviated. Further studies are necessary to confirm our results.</p>","PeriodicalId":7544,"journal":{"name":"AIDS research and human retroviruses","volume":" ","pages":"20-29"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}