HIV Medicine最新文献

{"title":"Letter to the editor on “Effectiveness, safety and patient-reported outcomes of emtricitabine/tenofovir alafenamide-based regimens for the treatment of HIV-1 infection: Final 24-month results from the prospective German TAFNES cohort study”","authors":"Joaquín Borrás-Blasco, Alejandro Valcuende-Rosique, Silvia Cornejo-Uixeda","doi":"10.1111/hiv.70071","DOIUrl":"10.1111/hiv.70071","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 2","pages":"321-323"},"PeriodicalIF":3.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of discontinuing injectable cabotegravir/rilpivirine and virologic outcomes after resuming oral antiretroviral therapy","authors":"Tali Faggiano,&nbsp;Jeffrey Yin,&nbsp;Nimish Patel,&nbsp;Afsana Karim,&nbsp;Kari Abulhosn,&nbsp;Laura Bamford,&nbsp;Lucas Hill","doi":"10.1111/hiv.70128","DOIUrl":"10.1111/hiv.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluate factors associated with discontinuation of long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) and describe virologic outcomes in those that returned to oral antiretroviral therapy (ART).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective cohort study at a single-centre primary care HIV clinic. Included were adults who received at least one injection of LAI CAB/RPV between April 2021 and March 2024. Characteristics were compared between those that continued LAI CAB/RPV and those that discontinued treatment during the study period. HIV viral load (VL) outcomes were evaluated in those that returned to oral ART and included the most recent VL in the range of 1–24 weeks, 24–48 weeks and the most recently documented VL through September 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 92 and 346 patients were included in the discontinuation and continuation cohorts, respectively. Being male sex assigned at birth and having psychiatric disease was associated with continuing LAI CAB/RPV, whereas having active substance use and being on a multi-class regimen prior to initiation of LAI CAB/RPV was associated with discontinuation. In those with VL data after resuming oral ART, the percentage of those with HIV VL &lt;50 copies per mL up to 24 weeks (<i>n</i> = 58) was 91.4%, up to 48 weeks (<i>n</i> = 53) was 90.6%, and using the most recent documented VL (<i>n</i> = 74) was 91.9%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High viral suppression rates were observed in those that returned to oral therapy after discontinuing LAI CAB/RPV. Individuals with substance use demonstrated a higher rate of LAI discontinuation, despite the potential benefit from LAIs in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 2","pages":"217-225"},"PeriodicalIF":3.2,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I cry alone because I'm so exhausted”: Family caregivers' perspectives on mHealth support in paediatric HIV care in Indonesia","authors":"Syamikar Baridwan Syamsir,&nbsp;Agus Setiawan,&nbsp;Dhea Natashia,&nbsp;Nyimas Heny Purwati,&nbsp; Astuti,&nbsp;Rian Adi Pamungkas","doi":"10.1111/hiv.70126","DOIUrl":"10.1111/hiv.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Family caregivers of children living with HIV (CLHIV) in Indonesia navigate complex emotional and caregiving responsibilities amid stigma, isolation and limited support. This study aimed to explore the lived experiences of family caregivers in caring for children with HIV and to understand their perspectives on the potential use of mobile health (mHealth) applications to support paediatric HIV care in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative descriptive study was conducted using semi-structured interviews with fifteen purposively selected family caregivers at a national infectious disease referral hospital in Jakarta. Data were collected between June and August 2024, and analysed using conventional content analysis to inductively identify key themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three overarching themes were identified: (1) The Silent Burden of Caregiving, encompassing stigma, fear of disclosure, emotional fatigue and uncertainty about the child's future, (2) Supportive and Enabling Conditions, reflecting the role of social and spiritual support alongside interest in mHealth applications and their desired features, and (3) Barriers to Digital Technology Use, highlighting concerns over privacy, confidentiality and limited digital literacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Caregiving for a child with HIV is emotionally taxing and often undertaken in silence. mHealth applications may offer meaningful support when designed to be user-informed, culturally relevant and integrated with broader psychosocial services. Contextualized digital solutions have the potential to enhance HIV care outcomes in low-resource settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"156-167"},"PeriodicalIF":3.2,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiretroviral treatment in people living with HIV with late diagnosis initiating ART with DTG/3TC or BIC/TAF/FTC: A real-world cohort analysis","authors":"Gundolf Schuettfort,&nbsp;Jan Borch,&nbsp;Alfonso Cabello,&nbsp;Maria Crusells,&nbsp;Miguel Górgolas,&nbsp;Eva Herrmann,&nbsp;Carmen Hidalgo-Tenorio,&nbsp;Juan Lopez,&nbsp;Rafael Mican,&nbsp;Roser Navarro-Soler,&nbsp;Eugenia Negredo,&nbsp;Sebastian Noe,&nbsp;Jordi Puig,&nbsp;Federico Pulido,&nbsp;Rosario Serrao,&nbsp;Juergen Rockstroh,&nbsp;Sergio Rodriguez,&nbsp;Christoph Stephan,&nbsp;Miguel Torralba,&nbsp;Diva Trigo,&nbsp;Maria Vehreschild,&nbsp;Annette E. Haberl","doi":"10.1111/hiv.70119","DOIUrl":"10.1111/hiv.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the efficacy and safety of first-line antiretroviral treatment (ART) with 2DR dolutegravir/lamivudine (DTG/3TC) versus 3DR bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) in persons with low CD4 cell counts and/or an AIDS-defining disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective, multicentre, multinational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective, multicentre, multinational analysis to investigate the virological response and discontinuation rate in people living with HIV starting first-line ART with a CD4 cell count &lt;200/μL and/or an AIDS-defining condition. Proportions of discontinuations were compared using univariate analysis. Virological response was analyzed using FDA snapshot analysis (HIV-1 RNA &lt;50 copies/mL at week 48).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and fifty-nine people who were diagnosed late with HIV were included in the study. Sixty-nine of them were started on 2DR DTG/3TC and 190 on 3DR BIC/TAF/FTC. After matching 1 to 1 (matching criteria: age, sex, CD4 cell count, HI-viral load, Centers for Disease Control and Prevention (CDC) stage, <i>n</i> = 62 per group), the mean baseline CD4 cell count was 121/μL (standard deviation [SD] 65), including 21% presenting with an AIDS-defining condition. 96.2% and 91.8% of people living with HIV on 2DR and 3DR, respectively, had a viral load &lt;50 copies/mL at week 48 (<i>p</i> = 0.244). No significant differences in discontinuation rates were observed at week 48 (5.5% in the 2DR and 9.4% in the 3DR group; <i>p</i> = 0.301).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a European cohort of people diagnosed late with HIV who started first-line ART either with 2DR DTG/3TC or 3DR BIC/TAF/FTC, there were no significant differences in virological response and discontinuation rates after 48 weeks of treatment. With respect to the relatively small sample size and the inherent constraints of the study design, the possibility of establishing causal inference remains limited, and prospective studies are needed to further investigate on this topic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"96-105"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BHIVA guidelines on the management of HIV in pregnancy and the postpartum period 2025","authors":"Laura Byrne","doi":"10.1111/hiv.70091","DOIUrl":"https://doi.org/10.1111/hiv.70091","url":null,"abstract":"&lt;p&gt;Writing group members\u0000 &lt;/p&gt;&lt;p&gt;&lt;b&gt;Contents&lt;/b&gt;&lt;/p&gt;&lt;p&gt;&lt;b&gt;1 Introduction 1762&lt;/b&gt;&lt;/p&gt;&lt;p&gt;1.2 Key changes in the current guidelines 1763&lt;/p&gt;&lt;p&gt;1.3 Scope and purpose 1763&lt;/p&gt;&lt;p&gt;1.4 Methodology 1763&lt;/p&gt;&lt;p&gt;1.4.1 Guideline development process 1763&lt;/p&gt;&lt;p&gt;1.4.2 Involvement of people living with HIV 1764&lt;/p&gt;&lt;p&gt;1.4.3 Dissemination and implementation 1764&lt;/p&gt;&lt;p&gt;1.4.4 Inclusive language 1764&lt;/p&gt;&lt;p&gt;1.4.5 Guideline updates and date of next review 1764&lt;/p&gt;&lt;p&gt;1.5 Supporting women/people living with HIV during pregnancy and the postpartum period 1765&lt;/p&gt;&lt;p&gt;1.6 References 1765&lt;/p&gt;&lt;p&gt;&lt;b&gt;2 Summary of recommendations 1765&lt;/b&gt;&lt;/p&gt;&lt;p&gt;From Section 4.2 Managing women/people who decline HIV screening in pregnancy 1765&lt;/p&gt;&lt;p&gt;From Section 4.5 Preventing HIV acquisition during pregnancy and infant feeding from a partner living with HIV 1766&lt;/p&gt;&lt;p&gt;From Section 6.1 The antenatal HIV MDT 1766&lt;/p&gt;&lt;p&gt;From Section 6.2 Supporting emotional and psychological wellbeing 1766&lt;/p&gt;&lt;p&gt;From Section 6.3 Supporting social wellbeing 1766&lt;/p&gt;&lt;p&gt;From Section 6.4 Screening for domestic abuse in pregnancy 1766&lt;/p&gt;&lt;p&gt;From Section 6.6 Pregnancy care in specific populations living with HIV 1766&lt;/p&gt;&lt;p&gt;From Section 7.1 Sexual health screening 1766&lt;/p&gt;&lt;p&gt;From Section 8.1 What ART to start in women/people who may become pregnant and continue in those who are pregnant 1767&lt;/p&gt;&lt;p&gt;From Section 8.2 ART dosing in pregnancy 1769&lt;/p&gt;&lt;p&gt;From Section 8.3.1 Regimens for first-line ART in pregnancy 1769&lt;/p&gt;&lt;p&gt;From Section 8.4 When to start ART in pregnancy 1770&lt;/p&gt;&lt;p&gt;From Section 8.5 Laboratory monitoring of ART in pregnancy 1770&lt;/p&gt;&lt;p&gt;From Section 8.6 HIV-2 1770&lt;/p&gt;&lt;p&gt;From Section 8.7.1 Presenting late in pregnancy (&gt;28 weeks) not on ART 1770&lt;/p&gt;&lt;p&gt;From Section 8.7.2 Presenting in labour or after spontaneous rupture of membranes (SROM) (term and pre-term) 1771&lt;/p&gt;&lt;p&gt;From Section 8.7.3 Management of pregnant women/people with viraemia on ART 1771&lt;/p&gt;&lt;p&gt;From Section 9.1.3 Investigation and monitoring 1771&lt;/p&gt;&lt;p&gt;From Section 9.1.5 Antiviral treatment 1772&lt;/p&gt;&lt;p&gt;From Section 9.1.7 Obstetric management of HIV/HBV co-infection 1772&lt;/p&gt;&lt;p&gt;From Section 9.1.8 Management of neonates born to women/people with HIV/HBV co-infection 1772&lt;/p&gt;&lt;p&gt;From Section 9.2.2 Diagnosis and monitoring 1772&lt;/p&gt;&lt;p&gt;From Section 9.2.3 Antiviral treatment 1772&lt;/p&gt;&lt;p&gt;From Section 9.2.4 HBV vaccination 1772&lt;/p&gt;&lt;p&gt;From Section 9.2.5 Mode of delivery 1772&lt;/p&gt;&lt;p&gt;From Section 9.3 HAV vaccination 1773&lt;/p&gt;&lt;p&gt;From Section 10.1 Antenatal management 1773&lt;/p&gt;&lt;p&gt;From Section 10.2 Invasive prenatal testing 1773&lt;/p&gt;&lt;p&gt;From Section 10.4 External cephalic version (ECV) 1773&lt;/p&gt;&lt;p&gt;From Section 10.5 Fetal surveillance 1773&lt;/p&gt;&lt;p&gt;From Section 10.6 Management of term SROM 1773&lt;/p&gt;&lt;p&gt;From Section 10.7 Management of preterm prelabour rupture of membranes (PPROM) 1773&lt;/p&gt;&lt;p&gt;From Section 10.8 Preterm labour 1774&lt;/p&gt;&lt;p&gt;From Section 10.9 Mode of delivery 1774&lt;/p&gt;&lt;p&gt;From Section 10.10 Timing of birth 1774&lt;/p&gt;&lt;p&gt;From Section 10.11 Intrapartum management 1774&lt;/p","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1757-1880"},"PeriodicalIF":3.2,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived disabling physical pain and suicidal ideation in aging people living with HIV cured of hepatitis C: A multi-center survey in France (ANRS CO13 HEPAVIH)","authors":"Tangui Barré,&nbsp;Clémence Ramier,&nbsp;Camelia Protopopescu,&nbsp;Philippe Sogni,&nbsp;Karine Ory,&nbsp;Tounes Saidi,&nbsp;Sophie Abgrall,&nbsp;Sylvie Brégigeon-Ronot,&nbsp;Patrizia Carrieri,&nbsp;Fabienne Marcellin,&nbsp;the ANRS CO13 HEPAVIH Study Group","doi":"10.1111/hiv.70121","DOIUrl":"10.1111/hiv.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Suicidal ideation (SI) is highly prevalent among people living with HIV (PWH) and those with chronic hepatitis C virus (HCV) infection. Individuals with long-term HIV–HCV co-infection face specific health challenges, including heightened physical pain. We aimed to assess whether disabling physical pain is associated with SI in aging PWH who have been cured of HCV, after controlling for potential correlates or confounders such as depression and psychoactive substance use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed data from HCV-cured PWH who participated in a multi-center cross-sectional survey embedded within the French ANRS CO13 HEPAVIH cohort. We performed a multivariable logistic regression model with SI (score &gt;0 for the ninth item of the Patient Health Questionnaire-9) as the outcome. Disabling physical pain was assessed using an answer ≥'very much' to the third item from the WHOQOL-HIV BREF questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study population comprised 396 HCV-cured PWH (73.2% male), among whom 17.7% reported SI and 11.9% reported disabling physical pain. Participants reporting disabling physical pain had a three-fold higher risk of SI (adjusted odds ratio [95% confidence interval]: 3.07 [1.29–7.34]), after adjustment for depression (5.52 [2.66–11.43]), substance use, and lower social relationships-related quality of life (0.72 [0.64–0.80]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings highlight that disabling physical pain should be systematically addressed among PWH cured of HCV, given its independent association with SI. Routine HIV follow-up care should integrate systematic screening for pain, mental health problems, and lack of social support. Timely referral to specialized services may help prevent future suicidal behaviours in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"106-119"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact on weight of a Doravirine switch in people living with HIV","authors":"Nina Garofoli,&nbsp;Philippe Flandre,&nbsp;Jean-Paul Vincensini,&nbsp;Quentin Richier,&nbsp;Priscille Couture,&nbsp;Karine Lacombe,&nbsp;Gilles Pialoux,&nbsp;Jean-Luc Meynard","doi":"10.1111/hiv.70123","DOIUrl":"10.1111/hiv.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Doravirine is among the first-line recommended treatments for people living with HIV (PLHIV) in the 2025 EACS guidelines. As opposed to tenofovir alafenamide or anti-integrase, its use was not associated with weight gain in clinical trials, but limited data are currently available in real life. In this cohort study, we investigated weight variation in PLHIV switching to doravirine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis was conducted in two Parisian hospitals, including all PLHIV switching to doravirine between January 2019 and September 2022. Body Mass Index (BMI) variation was calculated from 48 months before to 36 months after the switch.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between January 2019 and December 2022, 300 patients were included, with 220 men (73%) and 185 (62%) patients born in France. The main antiretroviral combination before the switch was TAF/FTC/BIC (<i>n</i> = 47, 16%), and after the switch, doravirine with TDF and 3TC (<i>n</i> = 202, 67%). Twenty-eight patients (9.3%) discontinued doravirine after a median duration of 17.5 months. At 12 and 24 months after the switch, the median BMI variation was 0.0 kg/m², and this variation remained unchanged regardless of the pre-switch treatment. These results were less pronounced in subgroups of patients originating from sub-Saharan Africa (+0.2 and +0.4 kg/m²) and in women (+0.3 and 0.5 kg/m²).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Switching to doravirine led to a weight stabilisation, without reversal of the previously gained weight. In PLHIV at higher risk of weight gain, there was still a slight increase in BMI after the doravirine switch.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"136-145"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of the WHO clinical staging system for detection of immunologically defined advanced HIV disease: A systematic review and meta-analysis","authors":"Hussein H. Twabi,&nbsp;Akitoshi Ueno,&nbsp;Josephine Ives,&nbsp;Ross Murtagh,&nbsp;Madalo Mukoka,&nbsp;Seyed Alireza Mortazavi,&nbsp;David S. Lawrence,&nbsp;Augustine T. Choko,&nbsp;Robina Semphere,&nbsp;Kelvin Balakasi,&nbsp;Ajay Rangaraj,&nbsp;Nathan Ford,&nbsp;Joseph N. Jarvis,&nbsp;Peter MacPherson","doi":"10.1111/hiv.70122","DOIUrl":"10.1111/hiv.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>People with advanced HIV disease face high risks of severe illness and death. CD4 testing enables timely diagnosis and appropriate care, yet access remains limited in many settings. This review investigated the diagnostic accuracy of the WHO clinical staging for identifying advanced HIV disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of studies published between 1 January 1998 and 1 May 2024 that assessed both WHO clinical staging and CD4 counts in people living with HIV aged 5 years and older (PROSPERO: CRD42024558372). We pooled sensitivity and specificity estimates of WHO Stage 3/4 for detecting advanced HIV disease (CD4 &lt;200 cells/μL) using bivariate random-effects meta-analysis. Risk of bias was assessed using QUADAS-2, and certainty of evidence was appraised using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 15,194 studies screened, 335 relevant studies were identified, from which 25 were included in evidence synthesis and 21 in the meta-analysis. Most studies were from the WHO African (19/25) and South-East Asian (5/25) regions. Risk of bias was moderate to high in 88% of studies, primarily due to issues with clinical staging assessment. Pooled sensitivity and specificity of WHO Stage 3/4 were 60.7% (95% CI: 48.0%–72.1%) and 72.4% (95% CI: 61.4%–81.3%), respectively. Specificity was significantly higher outside the African region (<i>p</i> &lt; 0.001). In a population of 100,000 people living with HIV with 30% advanced HIV disease prevalence, WHO staging would miss 11,700 true advanced HIV disease cases and misclassify 19,600.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WHO clinical staging alone shows low accuracy for detecting advanced HIV disease, risking both missed diagnoses and overtreatment. CD4 testing remains essential for accurately identifying and managing advanced HIV disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"120-135"},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"People living with HIV on modern antiretrovirals do not display a pro-atherogenic lipid profile and have similar body composition compared to healthy controls","authors":"S. Savinelli,&nbsp;A. Heeney,&nbsp;W. Tinago,&nbsp;A. A. Garcia Leon,&nbsp;P. McGettrick,&nbsp;A. G. Cotter,&nbsp;I. Walsh,&nbsp;M. Fitzgibbon,&nbsp;C. A. Sabin,&nbsp;P. W. G. Mallon,&nbsp;E. R. Feeney,&nbsp;the HIV UPBEAT study group","doi":"10.1111/hiv.70118","DOIUrl":"10.1111/hiv.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Alterations in lipids and apolipoproteins contribute to cardiovascular disease (CVD) and are common in people with HIV. The aim of our study was to compare lipid profiles and body composition between people with and without HIV and to explore whether any associations with HIV could be explained by socio-demographic, clinical characteristics and body composition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional analysis of a cohort study enrolling people with HIV and HIV-negative controls. Apolipoproteins [ApoB-100, ApoA1, Lp(a)] were analysed by immunoturbidimetry. Lipids (total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL]), clinical/demographic data and dual-energy X-ray absorptiometry (DXA)-measured body composition parameters were collected. Between-group differences were assessed with Student's T-test. Linear regression models assessed associations of lipids and apolipoproteins with HIV status and associations with socio-demographic, clinical characteristics and body composition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 108 people with HIV on treatment (93.5% with viral suppression) and 96 controls. People with HIV were younger, more likely to be male, with obesity, of African ethnicity, smokers and with a higher representation of CVD, hypertension, diabetes and statin use. ApoB-100, TC, HDL and LDL were significantly lower in people with HIV, with no between-group difference in ApoA, Lp(a) and body composition. HIV infection remained independently associated with lower TC and LDL after adjustment for possible confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>People with HIV from a contemporary cohort had lower pro-atherogenic lipid parameters compared to controls, and no differences in body composition between people with HIV and controls were observed. Traditional risk factors for CVD and chronic inflammation might have a greater impact than dyslipidaemia itself on the increased CVD risk in people with HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"86-95"},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual dysfunction care needs of gay, bisexual, and other men who have sex with men living with HIV in Montreal, Canada","authors":"Francesco Avallone,&nbsp;Kim Engler,&nbsp;Ford Hickson,&nbsp;Joseph Cox,&nbsp;Eric Fortin,&nbsp;Sean Yaphe,&nbsp;Bertrand Lebouché","doi":"10.1111/hiv.70115","DOIUrl":"10.1111/hiv.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Sexual dysfunction (SD) is common among gay, bisexual and other men who have sex with men (GBM) with HIV, yet little is known about their views on SD care. We explored these views to inform patient-centred SD care to improve care delivery and sexual health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted in 2024 with 31 Montreal-based GBM with HIV who experienced SD in the last 5 years (reduced libido, erectile dysfunction, premature/delayed ejaculation and/or pain during sex), covering SD care experiences and preferences. Thematic analysis was applied to interview transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants mostly reported reduced libido (83.9%) and erectile dysfunction (ED(80.6%), with over half (58.0%) experiencing multiple SDs concurrently. Themes regarding SD care experiences were (1) costs and benefits of ED medication, (2) limited benefits of testosterone replacement therapy, (3) mixed views on talk therapy (and a preference for group therapy), and (4) not seeking care due to questions of SD definition and normalcy. SD care preferences concerned both provider characteristics (identity, approach to patients and expertise) and care delivery (information provision, involvement and respect and access to diverse resources).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Irrespective of the approach to SD care sought (medication or talk therapy), participants experienced limited success. For some, doubts about the severity of their SD impeded help-seeking. SD care preferences for the provider (e.g., expertise) and care provided (e.g., information, patient involvement) offer paths to more patient-centred care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"74-85"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}