Gideon Dzando, Paul R. Ward, Lillian Mwanri, Pascal Agbadi, Rachel C. Ambagtsheer
Background
Older people affected by HIV in sub-Saharan Africa are at increased risk of frailty and poor quality of life (QoL). However, the contributions of specific frailty domains to QoL and whether these associations differ by sex remain poorly understood.
Methods
We analysed cross-sectional data from 444 older people aged ≥50 years (mean age 64.6 years, 62% female) from the WHO SAGE-WOPS HIV sub-study in Uganda. Frailty was assessed using 15 items from the Frailty Instrument for Sub-Saharan Africa (FiSSA), and QoL with a 7-item composite index. We used multiple linear regression to examine the associations between overall and domain-specific frailty and QoL, including sex interaction terms.
Results
Higher overall frailty was associated with lower QoL (β = −0.63, p < 0.001). Among the frailty domains, the physical (β = −0.43, p < 0.001) and socioemotional (β = −0.18, p < 0.001) domains exceeded the minimally important difference (MID) threshold, indicating clinically meaningful associations with lower QoL, whereas the visual and psychological domains were below this threshold. A significant sex interaction was observed for the psychological domain (β = −0.25, p = 0.004), indicating a stronger negative association among women. No significant sex interactions were observed for the physical, socioemotional, or visual domains.
Conclusions
Frailty, particularly physical, socioemotional, and psychological domains, was associated with lower QoL among older Ugandans affected by HIV. Psychological frailty was more strongly associated with poorer QoL in women. Gender-sensitive, psychosocial interventions may help address these disparities and support healthy and equitable ageing in HIV-affected populations.
{"title":"Multidimensional frailty, sex differences, and quality of life among older Ugandans affected by HIV","authors":"Gideon Dzando, Paul R. Ward, Lillian Mwanri, Pascal Agbadi, Rachel C. Ambagtsheer","doi":"10.1111/hiv.70111","DOIUrl":"10.1111/hiv.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older people affected by HIV in sub-Saharan Africa are at increased risk of frailty and poor quality of life (QoL). However, the contributions of specific frailty domains to QoL and whether these associations differ by sex remain poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed cross-sectional data from 444 older people aged ≥50 years (mean age 64.6 years, 62% female) from the WHO SAGE-WOPS HIV sub-study in Uganda. Frailty was assessed using 15 items from the Frailty Instrument for Sub-Saharan Africa (FiSSA), and QoL with a 7-item composite index. We used multiple linear regression to examine the associations between overall and domain-specific frailty and QoL, including sex interaction terms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher overall frailty was associated with lower QoL (β = −0.63, <i>p</i> < 0.001). Among the frailty domains, the physical (β = −0.43, <i>p</i> < 0.001) and socioemotional (β = −0.18, <i>p</i> < 0.001) domains exceeded the minimally important difference (MID) threshold, indicating clinically meaningful associations with lower QoL, whereas the visual and psychological domains were below this threshold. A significant sex interaction was observed for the psychological domain (β = −0.25, <i>p</i> = 0.004), indicating a stronger negative association among women. No significant sex interactions were observed for the physical, socioemotional, or visual domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Frailty, particularly physical, socioemotional, and psychological domains, was associated with lower QoL among older Ugandans affected by HIV. Psychological frailty was more strongly associated with poorer QoL in women. Gender-sensitive, psychosocial interventions may help address these disparities and support healthy and equitable ageing in HIV-affected populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1748-1756"},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000401","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}
This study aimed to disentangle the independent effects of aging and cumulative antiretroviral therapy (ART) duration on polypharmacy in people with HIV. While successful ART has led to an aging population with HIV, polypharmacy may stem from both aging and ART's cumulaftive toxicity. Quantitative evidence separating these effects is scarce, particularly in Japan.
Methods
In this retrospective study, we analysed a Japanese community pharmacy database (2014–2022) of 696 people on ART for ≥6 months. Using negative binomial regression, we assessed the independent effects of age and cumulative ART duration on the number of concomitant medications (a proxy for polypharmacy), adjusting for sex.
Results
Both advanced age and cumulative ART duration were significant independent risk factors for polypharmacy. A strong dose-dependent relationship was observed with age (incidence rate ratio [IRR] for 60–69 years: 9.61; 95% confidence interval [CI], 4.92–18.78 vs. <30 years). After adjusting for age and sex, a cumulative ART duration of ≥9 years remained an independent predictor of more concomitant medications (IRR: 1.81; 95% CI, 1.05–3.13 vs. <1 year).
Conclusions
We propose a “dual-structure model” for polypharmacy in people with HIV, comprising age-related multimorbidity and a distinct layer potentially linked to the long-term effects of ART. To our knowledge, this study provides the first quantitative evidence from Japan to statistically disentangle the associations with these two factors. Our findings highlight the need to integrate geriatric principles with HIV-specific toxicity management for optimal long-term strategies.
{"title":"Dual drivers of polypharmacy in people with HIV: Quantifying the independent associations of aging and long-term antiretroviral therapy","authors":"Shigeru Hasebe, Taiki Kusaka, Masayuki Tanaka, Shiori Iwane, Toshikazu Tsuji, Hiroyuki Kushida, Mari Nakamura, Masahiro Nakamura, Takumi Fujiwara, Maho Kikuta","doi":"10.1111/hiv.70106","DOIUrl":"10.1111/hiv.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to disentangle the independent effects of aging and cumulative antiretroviral therapy (ART) duration on polypharmacy in people with HIV. While successful ART has led to an aging population with HIV, polypharmacy may stem from both aging and ART's cumulaftive toxicity. Quantitative evidence separating these effects is scarce, particularly in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, we analysed a Japanese community pharmacy database (2014–2022) of 696 people on ART for ≥6 months. Using negative binomial regression, we assessed the independent effects of age and cumulative ART duration on the number of concomitant medications (a proxy for polypharmacy), adjusting for sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both advanced age and cumulative ART duration were significant independent risk factors for polypharmacy. A strong dose-dependent relationship was observed with age (incidence rate ratio [IRR] for 60–69 years: 9.61; 95% confidence interval [CI], 4.92–18.78 vs. <30 years). After adjusting for age and sex, a cumulative ART duration of ≥9 years remained an independent predictor of more concomitant medications (IRR: 1.81; 95% CI, 1.05–3.13 vs. <1 year).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We propose a “dual-structure model” for polypharmacy in people with HIV, comprising age-related multimorbidity and a distinct layer potentially linked to the long-term effects of ART. To our knowledge, this study provides the first quantitative evidence from Japan to statistically disentangle the associations with these two factors. Our findings highlight the need to integrate geriatric principles with HIV-specific toxicity management for optimal long-term strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1717-1726"},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000458","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}
Adel Stoyanova, Faye Foster, Pavel Savin, Nurali Amanzholov, Raushan Alibekova
<div> <section> <h3> Introduction</h3> <p>Human immunodeficiency virus (HIV) remains a significant global health problem, and the number of new cases is increasing in Central Asia, including Kazakhstan. This study aimed to examine the association of a range of demographic, physical health and psychosocial factors with the mental health of people living with HIV in Kazakhstan, applying the two-continua model of mental health, which holds that mental wellbeing and mental illness are two distinct continua that are interrelated in their contributions to overall mental health. The study findings can inform future interventions aimed to prevent mental illness and promote the mental wellbeing of people living with HIV.</p> </section> <section> <h3> Methods</h3> <p>This cross-sectional study was conducted in collaboration with the Kazakhstan Union of people living with HIV. The online survey link was disseminated via social networks of people living with HIV in various regions of Kazakhstan from January to February 2024. The questionnaire included questions on sociodemographic characteristics, general health information and standardized validated scales to measure flourishing, depressive and anxiety symptoms, HIV-related stigma, and social support. Descriptive, bivariate and multivariate multinomial regression analyses were performed in STATA software version 18.</p> </section> <section> <h3> Results</h3> <p>A third of the sample was flourishing (33.53%) without depressive or anxiety symptoms, while 15.29% of participants were flourishing despite mental illness, 30.59% were not flourishing and had no mental illness, and 20.59% were experiencing mental illness and not flourishing. Participants with higher social support were more likely to flourish and have no symptoms of depression or anxiety, while flourishing despite mental illness was associated with the unemployment status of people living with HIV. High internalized stigma was associated with the increased risk of having depression or anxiety symptoms and low mental wellbeing, while better physical health and older age had a protective effect against mental illness and languishing.</p> </section> <section> <h3> Conclusions</h3> <p>Study findings suggest that enhancing access to social support and reducing HIV-related stigma are key to improving mental wellbeing among people living with HIV in Kazakhstan, especially among individuals of younger age, and those with worse physical condition. Applying the dual continuum model of mental health and integrating mental wellbeing scales in physical and psychol
{"title":"Examination of factors associated with mental health of people living with HIV in Kazakhstan: A cross-sectional study based on the two-continua model","authors":"Adel Stoyanova, Faye Foster, Pavel Savin, Nurali Amanzholov, Raushan Alibekova","doi":"10.1111/hiv.70100","DOIUrl":"10.1111/hiv.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Human immunodeficiency virus (HIV) remains a significant global health problem, and the number of new cases is increasing in Central Asia, including Kazakhstan. This study aimed to examine the association of a range of demographic, physical health and psychosocial factors with the mental health of people living with HIV in Kazakhstan, applying the two-continua model of mental health, which holds that mental wellbeing and mental illness are two distinct continua that are interrelated in their contributions to overall mental health. The study findings can inform future interventions aimed to prevent mental illness and promote the mental wellbeing of people living with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted in collaboration with the Kazakhstan Union of people living with HIV. The online survey link was disseminated via social networks of people living with HIV in various regions of Kazakhstan from January to February 2024. The questionnaire included questions on sociodemographic characteristics, general health information and standardized validated scales to measure flourishing, depressive and anxiety symptoms, HIV-related stigma, and social support. Descriptive, bivariate and multivariate multinomial regression analyses were performed in STATA software version 18.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A third of the sample was flourishing (33.53%) without depressive or anxiety symptoms, while 15.29% of participants were flourishing despite mental illness, 30.59% were not flourishing and had no mental illness, and 20.59% were experiencing mental illness and not flourishing. Participants with higher social support were more likely to flourish and have no symptoms of depression or anxiety, while flourishing despite mental illness was associated with the unemployment status of people living with HIV. High internalized stigma was associated with the increased risk of having depression or anxiety symptoms and low mental wellbeing, while better physical health and older age had a protective effect against mental illness and languishing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Study findings suggest that enhancing access to social support and reducing HIV-related stigma are key to improving mental wellbeing among people living with HIV in Kazakhstan, especially among individuals of younger age, and those with worse physical condition. Applying the dual continuum model of mental health and integrating mental wellbeing scales in physical and psychol","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1694-1706"},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000432","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}
Gerald Pierone Jr, Laurence Brunet, Jennifer S. Fusco, Michael G. Sension, Megan S. Dunbar, Joshua Gruber, Douglas T. Dieterich, Gregory P. Fusco
Objectives
To compare the virologic effectiveness and discontinuation of the commonly prescribed fixed-dose combination 3-drug and 2-drug regimens, bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and dolutegravir/lamivudine (DTG/3TC), in virologically suppressed individuals in routine clinical care in the US.
Methods
From the OPERA cohort, ART-experienced, virologically suppressed (viral load <200 copies/mL) adults with HIV who switched to B/F/TAF or DTG/3TC (01AUG2020-30JUN2022) were followed through 31DEC2022, death, loss to follow-up or discontinuation. Cox proportional hazard models with stabilized inverse probability of treatment weights were used to assess the association between regimen and time to confirmed virologic failure (cVF200; 2 viral loads ≥200 copies/mL or 1 viral load ≥200 copies/mL + discontinuation) or time to discontinuation.
Results
A total of 3512 B/F/TAF users were followed for a median of 16 months (IQR: 11, 22); 2327 DTG/3TC users were followed for a median of 15 months (IQR: 10, 21). cVF200 was observed among 2% of B/F/TAF and 3% of DTG/FTC users, for an adjusted hazard ratio of 0.84 (95% CI: 0.59, 1.18) for B/F/TAF compared with DTG/3TC. Regimen discontinuation was observed among 17% of B/F/TAF and 19% of DTG/3TC users, for an adjusted hazard ratio of 0.83 (95% CI: 0.73, 0.94) for B/F/TAF compared with DTG/3TC. Treatment-related reasons for discontinuation represented 6% of B/F/TAF and 9% of DTG/3TC discontinuations.
Conclusions
In this large US cohort, both B/F/TAF and DTG/3TC were well tolerated and effective treatment options among virologically suppressed individuals in routine clinical care, although DTG/3TC tended to be discontinued faster than B/F/TAF.
{"title":"Suppressed switch to Bictegravir/emtricitabine/tenofovir alafenamide compared with dolutegravir/lamivudine: Real-world evidence from the OPERA cohort","authors":"Gerald Pierone Jr, Laurence Brunet, Jennifer S. Fusco, Michael G. Sension, Megan S. Dunbar, Joshua Gruber, Douglas T. Dieterich, Gregory P. Fusco","doi":"10.1111/hiv.70105","DOIUrl":"10.1111/hiv.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the virologic effectiveness and discontinuation of the commonly prescribed fixed-dose combination 3-drug and 2-drug regimens, bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and dolutegravir/lamivudine (DTG/3TC), in virologically suppressed individuals in routine clinical care in the US.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From the OPERA cohort, ART-experienced, virologically suppressed (viral load <200 copies/mL) adults with HIV who switched to B/F/TAF or DTG/3TC (01AUG2020-30JUN2022) were followed through 31DEC2022, death, loss to follow-up or discontinuation. Cox proportional hazard models with stabilized inverse probability of treatment weights were used to assess the association between regimen and time to confirmed virologic failure (cVF<sub>200</sub>; 2 viral loads ≥200 copies/mL or 1 viral load ≥200 copies/mL + discontinuation) or time to discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3512 B/F/TAF users were followed for a median of 16 months (IQR: 11, 22); 2327 DTG/3TC users were followed for a median of 15 months (IQR: 10, 21). cVF<sub>200</sub> was observed among 2% of B/F/TAF and 3% of DTG/FTC users, for an adjusted hazard ratio of 0.84 (95% CI: 0.59, 1.18) for B/F/TAF compared with DTG/3TC. Regimen discontinuation was observed among 17% of B/F/TAF and 19% of DTG/3TC users, for an adjusted hazard ratio of 0.83 (95% CI: 0.73, 0.94) for B/F/TAF compared with DTG/3TC. Treatment-related reasons for discontinuation represented 6% of B/F/TAF and 9% of DTG/3TC discontinuations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this large US cohort, both B/F/TAF and DTG/3TC were well tolerated and effective treatment options among virologically suppressed individuals in routine clinical care, although DTG/3TC tended to be discontinued faster than B/F/TAF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1707-1716"},"PeriodicalIF":3.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952103","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}
Judit Cacho, Daniel K. Nomah, Natalia Egri, Frederic Cofán, María Ángeles Marcos, María-Mar Mosquera, Sonsoles Sanchez-Palomino, Andreu Bruguera, Nuria Esforzado, Marta Bodro, Cristina Rovira, Carmen Hurtado, Anna Vilella, Fritz Diekmann, Asunción Moreno, José M. Miro, David Cucchiari, COVIHVAC investigators
Introduction
No data exists on responses to mRNA vaccines in kidney transplant recipients (KTRs) with HIV. We compared these responses in HIV-positive (HIV+KTR+) and negative KTRs (HIV-KTR+), and in people living with HIV (PLWH) without kidney transplantation (HIV+KTR-).
Methods
In across-sectional study of 33 patients receiving mRNA SARS-CoV-2 vaccination, we evaluated the humoral response to mRNA SARS-CoV-2 vaccination using a Luminex platform (IgG and IgM), and cellular response with specific T cell response (S-and N- protein) by ELISpot. We used logistic regression models to assess associated factors.
Results
The study comprised 11 HIV-KTR+, 11 HIV+KTR+, and 11 HIV+KTR-. PLWH had suppressed viral load on ART. Seroconversion rates were 72.7% among KTRs, with no significant differences between HIV-KTR+ (81.8%) and HIV+KTR+ (63.6%) (P = 0.338). In HIV+KTR-, seroconversion was 100%, higher than HIV+KTR+ (P = 0.027). Cellular response against protein S occurred in 63.6% of cases, regardless of HIV, transplantation, or dose number. Higher age negatively influenced cellular response in HIV+KTR- (OR 0.77, 95%CI 0.60-0.99).
Conclusion
Although cellular immune response was similar across all groups, humoral response was reduced in HIV+KTR+. In HIV+KTR-, age reduced cellular response. These findings enhance our understanding of vaccine response in immunosuppressed populations and aid in optimizing vaccination strategies.
{"title":"Cellular and humoral response after mRNA SARS-CoV-2 vaccination in kidney transplant recipients living with HIV: A cross-sectional study","authors":"Judit Cacho, Daniel K. Nomah, Natalia Egri, Frederic Cofán, María Ángeles Marcos, María-Mar Mosquera, Sonsoles Sanchez-Palomino, Andreu Bruguera, Nuria Esforzado, Marta Bodro, Cristina Rovira, Carmen Hurtado, Anna Vilella, Fritz Diekmann, Asunción Moreno, José M. Miro, David Cucchiari, COVIHVAC investigators","doi":"10.1111/hiv.70087","DOIUrl":"10.1111/hiv.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>No data exists on responses to mRNA vaccines in kidney transplant recipients (KTRs) with HIV. We compared these responses in HIV-positive (HIV+KTR+) and negative KTRs (HIV-KTR+), and in people living with HIV (PLWH) without kidney transplantation (HIV+KTR-).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In across-sectional study of 33 patients receiving mRNA SARS-CoV-2 vaccination, we evaluated the humoral response to mRNA SARS-CoV-2 vaccination using a Luminex platform (IgG and IgM), and cellular response with specific T cell response (S-and N- protein) by ELISpot. We used logistic regression models to assess associated factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study comprised 11 HIV-KTR+, 11 HIV+KTR+, and 11 HIV+KTR-. PLWH had suppressed viral load on ART. Seroconversion rates were 72.7% among KTRs, with no significant differences between HIV-KTR+ (81.8%) and HIV+KTR+ (63.6%) (<i>P</i> = 0.338). In HIV+KTR-, seroconversion was 100%, higher than HIV+KTR+ (<i>P</i> = 0.027). Cellular response against protein S occurred in 63.6% of cases, regardless of HIV, transplantation, or dose number. Higher age negatively influenced cellular response in HIV+KTR- (OR 0.77, 95%CI 0.60-0.99).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although cellular immune response was similar across all groups, humoral response was reduced in HIV+KTR+. In HIV+KTR-, age reduced cellular response. These findings enhance our understanding of vaccine response in immunosuppressed populations and aid in optimizing vaccination strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 10","pages":"1562-1573"},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952180","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}
Amy Keane, Lila Haberl, Inka Aho, Stefania Bernardi, Mariana Mărdărescu, Anna Hermine Markowich, Angelina Namiba, Nneka Nwokolo, Keren Olshtain-Pops, Annette Haberl, WAVE (Women Against Viruses in Europe), European AIDS Clinical Society
Introduction
A notable gap exists in research on HIV and breastfeeding in high-income settings with continuous access to antiretroviral therapy (ART) and suppressed HIV viral loads. The Women Against Viruses in Europe (WAVE) initiative aimed to consolidate European guidelines on HIV and breastfeeding to better inform medical staff and people living with HIV in the decision-making process for breastfeeding.
Methods
Representatives from 23 countries were contacted by WAVE to submit their guidelines on HIV and breastfeeding, translated into English. The initial contact was made on 20 April 2023, and the final response was received on 26 May 2023. The WAVE breastfeeding group summarized the guidelines into key topics related to breastfeeding for the purpose of this manuscript.
Results
A total of 19 guidelines from 20 countries were included in the review. While the majority of countries recommend formula feeding as the preferred feeding for infants born to mothers living with HIV, most provide recommendations to support parents who choose to breastfeed if certain criteria are met.
Conclusion
Despite recommendations being based on the same research, there is variation across guidelines. This review consolidates European guidelines, enabling us to learn from each other and pool our experiences to create a robust cohort for further research and guideline development for parents living with HIV and their infants.
{"title":"European Guidelines on HIV and breastfeeding: “Same, same, but different” - Results from a WAVE survey","authors":"Amy Keane, Lila Haberl, Inka Aho, Stefania Bernardi, Mariana Mărdărescu, Anna Hermine Markowich, Angelina Namiba, Nneka Nwokolo, Keren Olshtain-Pops, Annette Haberl, WAVE (Women Against Viruses in Europe), European AIDS Clinical Society","doi":"10.1111/hiv.70072","DOIUrl":"10.1111/hiv.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A notable gap exists in research on HIV and breastfeeding in high-income settings with continuous access to antiretroviral therapy (ART) and suppressed HIV viral loads. The Women Against Viruses in Europe (WAVE) initiative aimed to consolidate European guidelines on HIV and breastfeeding to better inform medical staff and people living with HIV in the decision-making process for breastfeeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Representatives from 23 countries were contacted by WAVE to submit their guidelines on HIV and breastfeeding, translated into English. The initial contact was made on 20 April 2023, and the final response was received on 26 May 2023. The WAVE breastfeeding group summarized the guidelines into key topics related to breastfeeding for the purpose of this manuscript.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 19 guidelines from 20 countries were included in the review. While the majority of countries recommend formula feeding as the preferred feeding for infants born to mothers living with HIV, most provide recommendations to support parents who choose to breastfeed if certain criteria are met.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite recommendations being based on the same research, there is variation across guidelines. This review consolidates European guidelines, enabling us to learn from each other and pool our experiences to create a robust cohort for further research and guideline development for parents living with HIV and their infants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 10","pages":"1515-1524"},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952086","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}
Guilherme Welter Wendt, Lara Wiehe Chaves, Angelo Brandelli Costa
Background
People living with HIV/AIDS face a myriad of discrimination and social stigma experiences. As a result of progress observed throughout the HIV epidemic, an ageing population of people living with HIV/AIDS exists, potentially facing greater mental health challenges from combined chronic conditions and stigma. Hence, this research aims to determine the additional value of age, years living with HIV, and gender, in conjunction with overall and internalized stigma in predicting clinically significant symptoms of depression and anxiety.
Methods
The sample consists of 1666 people living with HIV PLHA, aged between 18 and 76 years who participated in a community-based study across Brazil. Participants provided responses on HIV-related stigma, Internalized AIDS-Related Stigma, and to the Patient Health Questionnaire, which demonstrated excellent psychometric proprieties.
Results
Gender and stigma increased the likelihood of significant symptoms of anxiety, accounting for the influence of age and years of living with HIV. Odds were higher among those who reported transgender identity (ORa = 2.05; 95% CI: 1.13, 3.70). Also, women reported significantly higher chances for anxiety (ORa = 1.36; 95% CI: 1.05, 1.76). Both HIV-related (ORa = 1.05; 95% CI: 1.01, 1.08) and internalized stigma (ORa = 1.30; 95% CI: 1.21, 1.40) were associated with anxiety. General and internalized stigma were the unique predictors for depression, with adjusted OR ranging from 1.07 (95% CI: 1.03, 1.10) to 1.41 (95% CI: 1.31, 1.53), respectively.
Conclusions
Stigma constitutes a significant obstacle for initiatives aimed at HIV prevention and therapeutic programmes, and the main findings of this study revealed that factors associated with clinically significant symptoms of depression and anxiety were predominantly allied with psychosocial stressors and gender identity indicators. Limitations, implications for practice and policy are addressed.
{"title":"Exploring the influence of age, gender, stigma, and years living with HIV on mental health outcomes","authors":"Guilherme Welter Wendt, Lara Wiehe Chaves, Angelo Brandelli Costa","doi":"10.1111/hiv.70098","DOIUrl":"10.1111/hiv.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>People living with HIV/AIDS face a myriad of discrimination and social stigma experiences. As a result of progress observed throughout the HIV epidemic, an ageing population of people living with HIV/AIDS exists, potentially facing greater mental health challenges from combined chronic conditions and stigma. Hence, this research aims to determine the additional value of age, years living with HIV, and gender, in conjunction with overall and internalized stigma in predicting clinically significant symptoms of depression and anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The sample consists of 1666 people living with HIV PLHA, aged between 18 and 76 years who participated in a community-based study across Brazil. Participants provided responses on HIV-related stigma, Internalized AIDS-Related Stigma, and to the Patient Health Questionnaire, which demonstrated excellent psychometric proprieties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Gender and stigma increased the likelihood of significant symptoms of anxiety, accounting for the influence of age and years of living with HIV. Odds were higher among those who reported transgender identity (OR<sup>a</sup> = 2.05; 95% CI: 1.13, 3.70). Also, women reported significantly higher chances for anxiety (OR<sup>a</sup> = 1.36; 95% CI: 1.05, 1.76). Both HIV-related (OR<sup>a</sup> = 1.05; 95% CI: 1.01, 1.08) and internalized stigma (OR<sup>a</sup> = 1.30; 95% CI: 1.21, 1.40) were associated with anxiety. General and internalized stigma were the unique predictors for depression, with adjusted OR ranging from 1.07 (95% CI: 1.03, 1.10) to 1.41 (95% CI: 1.31, 1.53), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stigma constitutes a significant obstacle for initiatives aimed at HIV prevention and therapeutic programmes, and the main findings of this study revealed that factors associated with clinically significant symptoms of depression and anxiety were predominantly allied with psychosocial stressors and gender identity indicators. Limitations, implications for practice and policy are addressed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1684-1693"},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873010","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}
David W. J. Griffin, J. H. McMahon, D. A. Ruschena, J. F. Hoy
Objective
People with HIV experience disparate access to solid organ transplantation (SOT), despite mounting evidence for comparable outcomes. This review aims to understand the outcomes following SOT, obstacles to SOT and opportunities to improve access and outcomes following SOT.
Methods
We conducted a narrative review of the literature.
Results
SOT is safe and effective for people with HIV, and increasing evidence indicates that people with HIV may safely donate organs to others with HIV. People with HIV experience a higher risk of acute rejection following SOT, without a higher risk of graft loss or death, when compared with appropriately matched controls. Those with HIV experience systemic and structural barriers to SOT, in addition to barriers that occur at the level of healthcare providers and consumers. Opportunities exist to improve access to SOT, and to improve SOT-related care for people with HIV.
Conclusion
SOT should be considered standard of care for people with HIV when indicated. Further efforts are required to identify and address gaps in the SOT-related cascade of care; and to improve SOT outcomes for people with HIV.
{"title":"Solid organ transplantation in people with HIV: Outcomes, obstacles and opportunities","authors":"David W. J. Griffin, J. H. McMahon, D. A. Ruschena, J. F. Hoy","doi":"10.1111/hiv.70099","DOIUrl":"10.1111/hiv.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>People with HIV experience disparate access to solid organ transplantation (SOT), despite mounting evidence for comparable outcomes. This review aims to understand the outcomes following SOT, obstacles to SOT and opportunities to improve access and outcomes following SOT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a narrative review of the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SOT is safe and effective for people with HIV, and increasing evidence indicates that people with HIV may safely donate organs to others with HIV. People with HIV experience a higher risk of acute rejection following SOT, without a higher risk of graft loss or death, when compared with appropriately matched controls. Those with HIV experience systemic and structural barriers to SOT, in addition to barriers that occur at the level of healthcare providers and consumers. Opportunities exist to improve access to SOT, and to improve SOT-related care for people with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SOT should be considered standard of care for people with HIV when indicated. Further efforts are required to identify and address gaps in the SOT-related cascade of care; and to improve SOT outcomes for people with HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1632-1645"},"PeriodicalIF":3.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855069","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}
Brent Clifton, Phillip Keen, Janine Trevillyan, Nikki Sullivan, Karl Johnson, Melissa Warner, Cara Taheny, Heather Ellis, Jack Freestone, Brent Allan, Beau Newham
Introduction
In 2022, Australia met the global UNAIDS 95% targets for treatment and viral suppression. Achieving 95% of people knowing their HIV status requires implementation of a wider mix of HIV testing types and access points.
Methods
In October 2023, a community-led HIV testing roundtable meeting of 34 participants was convened to better understand current barriers and enablers to foster HIV testing equity. Delegates participated in data-informed discussions and a facilitated workshop. Outputs were collated and independently analysed to identify HIV testing barriers and potential actionable strategies.
Results
Current best practices for HIV testing are targeted towards at-risk populations and limited by funding and capacity constraints. Identified barriers to testing include ongoing stigma, cultural barriers, structural barriers to accessing and navigating the healthcare system, clinical reticence among non-expert practitioners and the need to expand access beyond at-risk groups. Current HIV testing practices are limited by a lack of provider-initiated (opt-out) testing, contributing to late diagnoses among people with high barriers to testing. Awareness of and access to HIV testing resources need to be expanded and should be underpinned by healthcare education. Wider exploration of opt-out testing is warranted, but requires consideration of jurisdictional infrastructure/funding differences and determination of optimal settings.
Conclusions
To achieve the UNAIDS 95% diagnosis target, we recommend three key strategies: implementing opt-out testing in selected settings, expanding access to self-testing and reducing barriers to point of care testing. These strategies should be supported by enhanced healthcare provider education and actions to reduce structural barriers to testing access.
{"title":"Strategies to achieve the UNAIDS 95% HIV diagnosis target in Australia: Insights from a multidisciplinary roundtable","authors":"Brent Clifton, Phillip Keen, Janine Trevillyan, Nikki Sullivan, Karl Johnson, Melissa Warner, Cara Taheny, Heather Ellis, Jack Freestone, Brent Allan, Beau Newham","doi":"10.1111/hiv.70083","DOIUrl":"10.1111/hiv.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In 2022, Australia met the global UNAIDS 95% targets for treatment and viral suppression. Achieving 95% of people knowing their HIV status requires implementation of a wider mix of HIV testing types and access points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In October 2023, a community-led HIV testing roundtable meeting of 34 participants was convened to better understand current barriers and enablers to foster HIV testing equity. Delegates participated in data-informed discussions and a facilitated workshop. Outputs were collated and independently analysed to identify HIV testing barriers and potential actionable strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Current best practices for HIV testing are targeted towards at-risk populations and limited by funding and capacity constraints. Identified barriers to testing include ongoing stigma, cultural barriers, structural barriers to accessing and navigating the healthcare system, clinical reticence among non-expert practitioners and the need to expand access beyond at-risk groups. Current HIV testing practices are limited by a lack of provider-initiated (opt-out) testing, contributing to late diagnoses among people with high barriers to testing. Awareness of and access to HIV testing resources need to be expanded and should be underpinned by healthcare education. Wider exploration of opt-out testing is warranted, but requires consideration of jurisdictional infrastructure/funding differences and determination of optimal settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To achieve the UNAIDS 95% diagnosis target, we recommend three key strategies: implementing opt-out testing in selected settings, expanding access to self-testing and reducing barriers to point of care testing. These strategies should be supported by enhanced healthcare provider education and actions to reduce structural barriers to testing access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 S3","pages":"3-16"},"PeriodicalIF":3.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855070","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}
Alejandra Cova, Christine S. Ritchie, Masette Godfrey, Brian Ghoshhajra, Geoffrey Erem, Rita Nassanga, Mangun Randhawa, Chris T. Longenecker, Eliza Passell, Zahra Reynolds, Rebecca F. Gilbert, Flavia Atwiine, Edna Tindimwebwa, Moses Acan, Yao Tong, Susanne Hoeppner, Alexander C. Tsai, Samson Okello, Stephen Asiimwe, Crystal M. North, Mark J. Siedner
Introduction
Although the risk of chronic inflammation among people living with HIV is well established in younger individuals, it is less well understood whether these relationships are persistent in older people living with HIV with long-term virologic suppression. Such data are particularly sparse in sub-Saharan Africa.
Methods
We assessed five inflammatory biomarkers (hs-CRP, sCD14, sCD163, D-dimer and FABP-2) among 290 older (antiretroviral therapy) ART-treated people living with HIV and an age-similar cohort of people without HIV in rural Uganda. We fit linear and logistic multivariable regression models with each biomarker as the outcome of interest, HIV serostatus as the primary exposure of interest, and age and sex as secondary exposures. Interaction terms between HIV and either age or sex were also explored.
Results
Among 591 participants, 49% (n = 290) were people living with HIV and 49% (n = 290) were women, the median age was 57 years (interquartile range 53–61). Adjusted linear analyses showed that people living with HIV had higher levels of sCD163 (β = 0.307, p < 0.001), D-dimer (β = 0.223, p < 0.01), and FABP-2 (β = 0.627, p < 0.001) than people without HIV. However, HIV did not modify relationships between increasing age and inflammation. In sub-analyses, we found that people living with HIV had lower levels of hs-CRP with each additional 10 years of age (β = −0.231, p < 0.01) and that women had higher D-dimer (p = 0.01), lower hs-CRP (p < 0.01) and greater increases in sCD163 with increasing age (β = 0.276, p < 0.01) than men.
Conclusion
Although older people living with HIV in Uganda tend to have higher biomarkers of inflammation than people without HIV, these differences appear to be stable with increasing age. Notably, older women with and without HIV tended to have higher levels of sCD163, which were exacerbated with increasing age.
尽管在年轻人群中HIV感染者慢性炎症的风险已经确定，但这些关系是否在长期病毒学抑制的老年HIV感染者中持续存在还不太清楚。这样的数据在撒哈拉以南非洲地区尤其稀少。研究人员在乌干达农村290名接受抗逆转录病毒治疗的老年HIV感染者和年龄相近的无HIV人群中评估了5种炎症生物标志物（hs-CRP、sCD14、sCD163、d -二聚体和FABP-2）。我们拟合线性和逻辑多变量回归模型，每个生物标志物作为感兴趣的结果，HIV血清状态作为感兴趣的主要暴露，年龄和性别作为次要暴露。还探讨了艾滋病毒与年龄或性别之间的相互作用条件。在591名参与者中，49% （n = 290）是艾滋病毒感染者，49% （n = 290）是女性，中位年龄为57岁（四分位数范围为53-61）。调整后的线性分析显示，艾滋病毒感染者的sCD163 （β = 0.307, p < 0.001）、d -二聚体（β = 0.223, p < 0.01）和FABP-2 （β = 0.627, p < 0.001）水平高于非艾滋病毒感染者。然而，HIV并没有改变年龄增长和炎症之间的关系。在亚组分析中，我们发现HIV感染者的hs-CRP水平每增加10岁就会降低（β = - 0.231, p < 0.01），而女性的d -二聚体水平较高（p = 0.01）， hs-CRP水平较低（p < 0.01）， sCD163水平随着年龄的增加而增加（β = 0.276, p < 0.01）。结论：尽管乌干达老年艾滋病病毒感染者的炎症生物标志物往往高于未感染艾滋病病毒的人，但随着年龄的增长，这些差异似乎是稳定的。值得注意的是，携带和不携带艾滋病毒的老年妇女往往有较高的sCD163水平，随着年龄的增长而加剧。
{"title":"Inflammatory profiles in older people with and without HIV in rural Uganda","authors":"Alejandra Cova, Christine S. Ritchie, Masette Godfrey, Brian Ghoshhajra, Geoffrey Erem, Rita Nassanga, Mangun Randhawa, Chris T. Longenecker, Eliza Passell, Zahra Reynolds, Rebecca F. Gilbert, Flavia Atwiine, Edna Tindimwebwa, Moses Acan, Yao Tong, Susanne Hoeppner, Alexander C. Tsai, Samson Okello, Stephen Asiimwe, Crystal M. North, Mark J. Siedner","doi":"10.1111/hiv.70097","DOIUrl":"https://doi.org/10.1111/hiv.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although the risk of chronic inflammation among people living with HIV is well established in younger individuals, it is less well understood whether these relationships are persistent in older people living with HIV with long-term virologic suppression. Such data are particularly sparse in sub-Saharan Africa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed five inflammatory biomarkers (hs-CRP, sCD14, sCD163, D-dimer and FABP-2) among 290 older (antiretroviral therapy) ART-treated people living with HIV and an age-similar cohort of people without HIV in rural Uganda. We fit linear and logistic multivariable regression models with each biomarker as the outcome of interest, HIV serostatus as the primary exposure of interest, and age and sex as secondary exposures. Interaction terms between HIV and either age or sex were also explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 591 participants, 49% (<i>n</i> = 290) were people living with HIV and 49% (<i>n</i> = 290) were women, the median age was 57 years (interquartile range 53–61). Adjusted linear analyses showed that people living with HIV had higher levels of sCD163 (<i>β</i> = 0.307, <i>p</i> < 0.001), D-dimer (<i>β</i> = 0.223, <i>p</i> < 0.01), and FABP-2 (<i>β</i> = 0.627, <i>p</i> < 0.001) than people without HIV. However, HIV did not modify relationships between increasing age and inflammation. In sub-analyses, we found that people living with HIV had lower levels of hs-CRP with each additional 10 years of age (<i>β</i> = −0.231, <i>p</i> < 0.01) and that women had higher D-dimer (<i>p</i> = 0.01), lower hs-CRP (<i>p</i> < 0.01) and greater increases in sCD163 with increasing age (<i>β</i> = 0.276, <i>p</i> < 0.01) than men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although older people living with HIV in Uganda tend to have higher biomarkers of inflammation than people without HIV, these differences appear to be stable with increasing age. Notably, older women with and without HIV tended to have higher levels of sCD163, which were exacerbated with increasing age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1894-1901"},"PeriodicalIF":3.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426069","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}
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