HIV Medicine最新文献_第6页

Oral Abstracts 口头摘要

IF 3 3区医学 Q2 Medicine

HIV Medicine

Pub Date : 2024-04-26 DOI: 10.1111/hiv.13626

引用次数: 0

Themed Poster Abstracts 主题海报摘要

IF 3 3区医学 Q2 Medicine

HIV Medicine

Pub Date : 2024-04-26 DOI: 10.1111/hiv.13627

引用次数: 0

Poster Abstracts 海报摘要

IF 3 3区医学 Q2 Medicine

HIV Medicine

Pub Date : 2024-04-26 DOI: 10.1111/hiv.13628

引用次数: 0

HIV-1 low-level viraemia predicts virological failure in first-line and second-line ART-experienced individuals in India: A retrospective longitudinal study HIV-1 低水平病毒血症可预测印度一线和二线抗逆转录病毒疗法经历者的病毒学失败：一项回顾性纵向研究。

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine

Pub Date : 2024-04-25 DOI: 10.1111/hiv.13641

Thongadi Ramesh Dinesha, Jayaseelan Boobalan, Chakkaravarthy Vishal Kumar, Paranthaman Manikandan, Mohanarangan Muhila, Sunil Suhas Solomon, Aylur Kailasom Srikrishnan, Kailapuri Gangatharan Murugavel

Objective

To study the prevalence of low-level viraemia (LLV) and its association with virological failure (VF).

Methods

We conducted a retrospective analysis of 3498 participants at YRG CARE, Chennai, India (2013–2018) on antiretroviral therapy (ART) for ≥6 months with two or more plasma viral load (pVL) measurements. Results were stratified for those with pVL <1000 copies/mL: fully suppressed (FS) (pVL <40), low-LLV (pVL 40–199), mid-LLV (pVL 200–399), and high-LLV (pVL 400–999). The study assessed the association with VF (pVL >1000 copies/mL) using Cox proportional hazard model.

Results

Among 3498 participants, 2965 (84.8%) were FS and 533 (15.2%) were LLV. During the follow-up, 348 (10%) experienced VF, with 222 (6.3%) experienced after LLV (42% of LLV) and 126 (3.6%) experienced after FS (4.3% of FS). When compared with FS, those with LLV had a greater risk of VF [adjusted hazard ratio (aHR) = 12.7; 95% confidence interval (CI): 10.2–15.9]. First-line participants had a higher VF incidence (aHR = 15.8, 95% CI: 11.4–21.9) than second-line participants (aHR = 5.6, 95% CI: 4.1–7.7). Those with high-LLV had the highest VF risk (aHR = 22.856, 95% CI: 15.204–34.359 vs. aHR = 8.186, 95% CI: 5.564–12.043, for first-line vs. second-line participants, respectively), followed by those with mid-LLV (aHR = 13.375, 95% CI: 8.327–21.483 vs. aHR = 6.261, 95% CI: 4.044–9.695) and low-LLV (aHR = 12.976, 95% CI: 7.974–21.118 vs. aHR = 4.158, 95% CI: 2.826–6.119).

Conclusions

The prevalence of LLV was intermediate in our study population. There was a higher risk of VF among individuals with LLV, and this risk increased with the increasing levels of LLV. Close monitoring of individuals experiencing LLV could help in the early identification of VF.

目的研究低水平病毒血症（LLV）的发生率及其与病毒学失败（VF）的关系。方法我们对印度钦奈 YRG CARE（2013-2018 年）3498 名接受抗逆转录病毒疗法（ART）治疗≥6 个月并进行过两次或两次以上血浆病毒载量（pVL）测量的参与者进行了回顾性分析。结果在 3498 名参与者中，2965 人（84.8%）为 FS，533 人（15.2%）为 LLV。随访期间，有 348 人（10%）出现 VF，其中 222 人（6.3%）在 LLV 后出现 VF（占 LLV 的 42%），126 人（3.6%）在 FS 后出现 VF（占 FS 的 4.3%）。与 FS 相比，LLV 患者发生 VF 的风险更高[调整后危险比 (aHR) = 12.7；95% 置信区间 (CI)：10.2-15.9]。一线参与者的 VF 发生率（aHR = 15.8，95% 置信区间：11.4-21.9）高于二线参与者（aHR = 5.6，95% 置信区间：4.1-7.7）。高 LLV 患者的 VF 风险最高（一线参与者与二线参与者的 aHR = 22.856，95% CI：15.204-34.359；一线参与者与二线参与者的 aHR = 8.186，95% CI：5.564-12.043），其次是中 LLV 患者（aHR = 13.375，95% CI：8.327-21.483 vs. aHR = 6.261，95% CI：4.044-9.695）和低 LLV（aHR = 12.976，95% CI：7.974-21.118 vs. aHR = 4.158，95% CI：2.826-6.119）。LLV患者发生室颤的风险较高，且随着LLV水平的升高，风险也随之升高。对 LLV 患者进行密切监测有助于早期识别 VF。

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引用次数: 0

Telemedicine in HIV health care during the COVID-19 pandemic: An implementation research study in Buenos Aires, Argentina COVID-19 大流行期间艾滋病毒医疗保健中的远程医疗：阿根廷布宜诺斯艾利斯的实施研究。

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine

Pub Date : 2024-04-24 DOI: 10.1111/hiv.13646

Manuela Bullo, Tomas Kierszenowicz, Maria Cecilia Acosta, Maria Jose Rolon, Diego Cecchini, Claudia Rodriguez, Pablo Scapellato, Edgardo Bottaro, Marcelo H. Losso

Background

From October 2020 to October 2022, we conducted an implementation study to offer telemedicine (TM) across four HIV units of general public hospitals in Buenos Aires. The intervention used TM to provide a continuum of care to patients with HIV.

Methods and Setting

We used the RE-AIM framework to evaluate the strategy. The study started during a COVID-19 outbreak with strict lockdown policies and continued until return to normal practices. Implementation facilitation served as the core implementation strategy.

Results

We reached 4118 patients (58% of eligible individuals), and the main perceived benefits were the ability to avoid exposure to infectious diseases and reduced travel time and cost. After a median of 515 days of follow-up, 95.7% of participants with HIV were receiving antiretroviral therapy, and 87.8% were virally suppressed, with a median CD4+ count of 648 cells/μL. In total, 36.6% reported clinical events, and 20.4% presented with COVID-19 infection. The proportion of physicians adopting TM was 69.37%. After enrolment, 2406 of 5640 (43%) follow-up visits were conducted via TM. By the end of the study, 26.29% of appointments offered in the four centres were through TM, whereas 73.71% were in-person appointments.

Conclusion

It was feasible to implement TM in the four centres in the public health sector in Buenos Aires, Argentina. It was acceptable for both patients and healthcare workers, and effectively reached a large proportion of the population served in these clinics. Both healthcare workers and patients consider it a model of care that will continue to be offered in the future.

背景从 2020 年 10 月到 2022 年 10 月，我们开展了一项实施研究，在布宜诺斯艾利斯的四家综合公立医院的 HIV 科室提供远程医疗（TM）。我们采用 RE-AIM 框架对该策略进行评估。研究始于 COVID-19 爆发期间，当时实行了严格的封锁政策，研究一直持续到恢复正常。结果我们惠及了 4118 名患者（占符合条件者的 58%），他们所感受到的主要益处是能够避免接触传染病并减少了旅行时间和费用。经过中位数为 515 天的随访，95.7% 的艾滋病毒感染者正在接受抗逆转录病毒治疗，87.8% 的患者病毒得到抑制，CD4+ 细胞计数中位数为 648 cells/μL。总共有 36.6% 的人报告了临床事件，20.4% 的人出现了 COVID-19 感染。采用 TM 的医生比例为 69.37%。注册后，5640 次随访中有 2406 次（43%）是通过 TM 进行的。研究结束时，四个中心 26.29% 的预约是通过 TM 进行的，而 73.71% 的预约是面对面进行的。患者和医护人员都能接受这种方式，而且有效地覆盖了这些诊所服务的大部分人口。医护人员和患者都认为这是一种今后将继续提供的护理模式。

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引用次数: 0

Real-world use of long-acting cabotegravir and rilpivirine: 12-month results of the inJectable Antiretroviral therapy feasiBility Study (JABS) 长效卡博替拉韦和利匹韦林的实际使用情况：可检测抗逆转录病毒疗法可行性研究（JABS）的 12 个月结果。

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine

Pub Date : 2024-04-21 DOI: 10.1111/hiv.13647

M. John, L. Williams, G. Nolan, M. Bonnett, A. Castley, D. Nolan

Objectives

The inJectable Antiretroviral feasiBility Study (JABS) aimed to evaluate the implementation of long-acting regimens in a ‘real world’ Australian setting, with inclusion of participants with complex medical needs, social vulnerability and/or historical non-adherence.

Methods

JABS was a 12-month, single-centre, single-arm, open-label phase IV study of long-acting cabotegravir 600 mg plus rilpivirine 900 mg administered intramuscularly every 2 months to adults with treated HIV-1 infection. The primary endpoint was the proportion of attendances and administration of injections within a 14-day dosing window over 12 months, out of the total prescribed doses. Secondary endpoints included proportions of missed appointments, use of oral bridging, discontinuations, virological failures, adverse events and participant-reported outcomes. A multidisciplinary adherence programme embedded in the clinical service known as REACH provided support to JABS participants.

Results

Of 60 participants enrolled by May 2022, 60% had one or more complexity or vulnerability factors identified, including absence of social supports (50%), mental health issues, alcohol or drug use (30%) and financial hardship or instability (13%), among others. Twenty-seven per cent of participants had historical non-adherence to antiretroviral therapy. Out of 395 prescribed doses, 97.2% of injections were administered within correct dosing windows at clinic visits. Two courses of short-term oral bridging were required. The rate of injection site reactions was 29%, the majority being grade 1–2. There were no virological failures, no serious adverse events and only one injection-related study discontinuation. High baseline treatment satisfaction and acceptability of injections increased by month 12. Those with vulnerability factors had similar adherence to injections as those without such factors. Ninety-eight per cent of the participants who completed 12 months on the study have maintained long-acting therapy, virological suppression and retention in care.

Conclusions

Long-acting cabotegravir plus rilpivirine was associated with very high adherence, maintenance of virological suppression, safety and treatment satisfaction in a diverse Australian clinic population, comparable to results of phase III randomized clinical trials. Individuals with vulnerability factors can achieve adherence to injections with individualized support. Long-acting thera

方法JABS是一项为期12个月、单中心、单臂、开放标签的IV期研究，对接受治疗的成人HIV-1感染者每2个月肌肉注射一次长效卡博替拉韦600毫克加利匹韦林900毫克。主要终点是12个月内14天给药窗口期内的就诊和注射比例，占处方总剂量的比例。次要终点包括失约比例、口服桥接疗法的使用、停药、病毒学失败、不良事件和参与者报告的结果。结果在2022年5月注册的60名参与者中，60%的人有一个或多个复杂或脆弱因素，包括缺乏社会支持（50%）、精神健康问题、酗酒或吸毒（30%）、经济困难或不稳定（13%）等。27% 的参与者曾不坚持抗逆转录病毒治疗。在 395 次处方剂量中，97.2% 的注射剂量是在门诊就诊时的正确剂量窗口内注射的。需要两个疗程的短期口服桥接疗法。注射部位反应发生率为 29%，大多数为 1-2 级反应。没有出现病毒学失败、严重不良事件，只有一次因注射而中止研究。基线治疗满意度高，注射的可接受性在第 12 个月时有所提高。有易感因素者与无易感因素者的注射依从性相似。结论长效卡博替拉韦加利匹韦林在澳大利亚不同的临床人群中具有很高的依从性、病毒学抑制维持率、安全性和治疗满意度，与 III 期随机临床试验的结果相当。有易感因素的患者可以在个性化支持下坚持注射。对这一群体采用长效疗法可以提高其对临床治疗的参与度。

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引用次数: 0

Residential and healthcare mobility during pregnancy among women living with HIV in the UK, 2009–2019 2009-2019 年英国感染艾滋病毒妇女在怀孕期间的居住和医疗流动情况

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine

Pub Date : 2024-04-10 DOI: 10.1111/hiv.13648

Emily Dema, Helen Peters, Yvonne Gilleece, Claire Thorne

Introduction

The extent to which individuals living with HIV experience residential and healthcare mobility during pregnancy in the UK is unknown. We aimed to determine a minimum estimate of residential and healthcare mobility during pregnancy in people living with HIV in the UK in 2009–2019 to explore patterns of and factors associated with mobility and to assess whether mobility was associated with specific HIV outcomes.

Methods

We analyzed data from the Integrated Screening Outcomes Surveillance Service to assess pregnancies with HIV in the UK and included livebirths and stillbirths with estimated delivery in 2009–2019. Residential mobility was defined as changing residential postcode between notification and delivery, and healthcare mobility was defined as changing NHS Trust or Strategic Health Authority (SHA) in that same timeframe. We used logistic regression to determine factors associated with residential and healthcare mobility and with detectable delivery viral load.

Results

Among 10 305 pregnancies, 19.6% experienced residential mobility, 8.1% changed NHS Trust, and 4.5% changed SHA during pregnancy. Mobility was more likely to be experienced by younger women, migrants, and those with new antenatal diagnosis; residential but not healthcare mobility declined over time. In a fully adjusted model, mobility was not associated with having a detectable viral load at delivery. Higher proportions of infants were lost to follow-up after mobile pregnancies than after non-mobile pregnancies.

Conclusions

This analysis provides new knowledge on mobility during pregnancy in the context of HIV, but further research is needed to understand its broader impacts and its utility as a marker to help identify families requiring additional follow-up and support.

导言在英国，艾滋病病毒感染者在怀孕期间经历居住和医疗保健流动的程度尚不清楚。我们旨在确定 2009-2019 年英国 HIV 感染者在妊娠期间居住地和医疗保健流动性的最低估计值，以探索流动性的模式和相关因素，并评估流动性是否与特定的 HIV 结果相关。居住地流动性的定义是在通知和分娩之间更换居住地邮编，医疗保健流动性的定义是在同一时间段内更换 NHS 信托机构或战略卫生局 (SHA)。我们使用逻辑回归法来确定与居住地和医疗保健流动性以及与可检测到的分娩病毒载量相关的因素。结果在 10 305 例妊娠中，19.6% 的人在怀孕期间经历了居住地流动，8.1% 的人更换了 NHS 信托机构，4.5% 的人更换了 SHA。年轻女性、移民和新产前诊断者更有可能经历流动；居住地流动性随时间推移有所下降，但医疗保健流动性并未下降。在完全调整模型中，流动性与分娩时检测到的病毒载量无关。与非流动性妊娠相比，流动性妊娠后失去随访的婴儿比例更高。结论：这项分析提供了有关孕期流动性对艾滋病影响的新知识，但还需要进一步的研究来了解其更广泛的影响，以及其作为帮助识别需要额外随访和支持的家庭的标志物的作用。

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引用次数: 0

Prevalence of HIV drug resistance at antiretroviral treatment failure across regions of Russia 俄罗斯各地区抗逆转录病毒治疗失败时艾滋病毒耐药性的流行情况

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine

Pub Date : 2024-04-07 DOI: 10.1111/hiv.13642

Ekaterina Ozhmegova, Aleksey Lebedev, Anastasiia Antonova, Anna Kuznetsova, Elena Kazennova, Kristina Kim, Aleksandr Tumanov, Marina Bobkova

Background

This study aimed to investigate mutations associated with, the causes of, and the conditions that contribute to HIV drug resistance (DR). This research provides crucial insights into the mechanisms through which HIV evades antiretroviral drugs and suggests strategies to counter this phenomenon. Our objective was to assess the prevalence and structure of DR in HIV-1 across various regions in Russia and identify the primary factors influencing the development of HIV DR.

Methods

The study used nucleotide sequences from the HIV-1 pol gene obtained from 1369 patients with a history of therapy and virological failure between 2005 and 2019 to analyze the frequency and structure of DR and the factors associated with it.

Results

The analysed HIV-1 genotypes included viruses resistant to nucleoside reverse transcriptase inhibitors (NRTIs; 11.8%), non-nucleoside reverse transcriptase inhibitors (NNRTIs; 6.4%), and NRTIs + NNRTIs (31.7%). The mutations M184V/I and G190A/S/E were the most prevalent, accounting for 54.5% and 26.6%, respectively. The dominance of multiple DR persisted throughout the entire observation period. The likelihood of encountering drug-resistant variants was increased among men, patients in the late stage of infection, and those with a viral load <30 000 RNA copies/mL. Injection drug use was not associated with DR.

Conclusion

This study has yielded new insights into HIV DR in Russia, offering valuable information to identify clinical or programmatic events warranting closer attention and support.

背景这项研究旨在调查与艾滋病病毒耐药性（DR）相关的突变、产生原因和条件。这项研究有助于深入了解艾滋病病毒逃避抗逆转录病毒药物的机制，并提出应对策略。我们的目标是评估俄罗斯不同地区 HIV-1 中 DR 的流行率和结构，并确定影响 HIV DR 发展的主要因素。方法该研究使用了从 2005 年至 2019 年期间 1369 名有治疗史和病毒学失败史的患者身上获得的 HIV-1 pol 基因核苷酸序列，以分析 DR 的频率和结构以及与之相关的因素。结果分析的HIV-1基因型包括对核苷类逆转录酶抑制剂（NRTIs；11.8%）、非核苷类逆转录酶抑制剂（NNRTIs；6.4%）和NRTIs + NNRTIs（31.7%）耐药的病毒。突变 M184V/I 和 G190A/S/E 最为普遍，分别占 54.5% 和 26.6%。在整个观察期内，多种 DR 变异一直占主导地位。在男性、感染晚期和病毒载量为 30000 RNA拷贝/毫升的患者中，出现耐药变体的可能性增加。结论这项研究为了解俄罗斯艾滋病病毒的耐药性提供了新的视角，为确定值得密切关注和支持的临床或计划事件提供了宝贵的信息。

{"title":"Prevalence of HIV drug resistance at antiretroviral treatment failure across regions of Russia","authors":"Ekaterina Ozhmegova, Aleksey Lebedev, Anastasiia Antonova, Anna Kuznetsova, Elena Kazennova, Kristina Kim, Aleksandr Tumanov, Marina Bobkova","doi":"10.1111/hiv.13642","DOIUrl":"10.1111/hiv.13642","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate mutations associated with, the causes of, and the conditions that contribute to HIV drug resistance (DR). This research provides crucial insights into the mechanisms through which HIV evades antiretroviral drugs and suggests strategies to counter this phenomenon. Our objective was to assess the prevalence and structure of DR in HIV-1 across various regions in Russia and identify the primary factors influencing the development of HIV DR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study used nucleotide sequences from the HIV-1 <i>pol</i> gene obtained from 1369 patients with a history of therapy and virological failure between 2005 and 2019 to analyze the frequency and structure of DR and the factors associated with it.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysed HIV-1 genotypes included viruses resistant to nucleoside reverse transcriptase inhibitors (NRTIs; 11.8%), non-nucleoside reverse transcriptase inhibitors (NNRTIs; 6.4%), and NRTIs + NNRTIs (31.7%). The mutations M184V/I and G190A/S/E were the most prevalent, accounting for 54.5% and 26.6%, respectively. The dominance of multiple DR persisted throughout the entire observation period. The likelihood of encountering drug-resistant variants was increased among men, patients in the late stage of infection, and those with a viral load <30 000 RNA copies/mL. Injection drug use was not associated with DR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study has yielded new insights into HIV DR in Russia, offering valuable information to identify clinical or programmatic events warranting closer attention and support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588508","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}

引用次数: 0

Improvement in insulin sensitivity after switching from an integrase inhibitor-based regimen to doravirine/tenofovir disoproxil fumarate/lamivudine in people with significant weight gain 体重明显增加者从基于整合酶抑制剂的方案转为多拉韦林/替诺福韦二吡呋酯/拉米夫定方案后，胰岛素敏感性得到改善

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine

Pub Date : 2024-04-03 DOI: 10.1111/hiv.13644

Leonardo Calza, Maddalena Giglia, Vincenzo Colangeli, Isabella Bon, Salvatore Vitale, Pierluigi Viale

Objectives

We performed an observational, retrospective, cohort study to assess changes in insulin sensitivity after a switch from dolutegravir/lamivudine (DOL/3TC) or bictegravir/emtricitabine/tenofovir alafenamide (BIC/F/TAF) to doravirine/tenofovir disoproxil fumarate/3TC (DOR/TDF/3TC) in virologically suppressed people living with HIV with recent significant weight gain.

Methods

All non-diabetic patients with HIV treated with DOL/3TC or BIC/F/TAF for ≥12 months, with HIV RNA <20 copies/mL, and with a weight increase ≥3 kg in the last year, who underwent a switch to DOR/TDF/3TC were enrolled into the study. Serum levels of glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) index were evaluated every 6 months during a 12-month follow-up.

Results

Overall, 81 patients were enrolled: 41 were treated with DOL/3TC and 40 with BIC/F/TAF. At baseline, median HOMA-IR index was 3.18 and insulin resistance (HOMA-IR index >2.5) was present in 49 subjects (60%). At 12 months after the switch to DOR/TDF/3TC, change in mean serum glucose concentration was not significant, but the reduction in median concentration of insulin was significant (−3.54 mcrUI/L [interquartile range −4.22 to −2.87]; p = 0.012), associated with a significant reduction in mean HOMA-IR index (−0.54 [interquartile range −0.91 to −0.18]; p = 0.021). A significant reduction in total and low-density lipoprotein cholesterol was also reported, whereas decreases in mean body weight and mean body mass index were not significant.

Conclusions

In our retrospective study in virologically suppressed people living with HIV treated with DOL/3TC or BIC/F/TAF and with recent weight gain, the switch to DOR/TDF/3TC led to a significant improvement in insulin sensitivity and plasma lipids, with a trend to decreased body weight.

目的我们进行了一项观察性、回顾性、队列研究，以评估近期体重明显增加的病毒学抑制的 HIV 感染者从多鲁曲韦/拉米夫定（DOL/3TC）或比特格韦/恩曲他滨/替诺福韦-阿拉非那胺（BIC/F/TAF）转用多拉韦林/替诺福韦二吡呋酯富马酸盐/3TC（DOR/TDF/3TC）后胰岛素敏感性的变化。方法所有接受 DOL/3TC 或 BIC/F/TAF 治疗≥12 个月、HIV RNA 为 20 拷贝/毫升且在过去一年中体重增加≥3 公斤、转用 DOR/TDF/3TC 的非糖尿病 HIV 感染者均被纳入研究。在为期 12 个月的随访期间，每 6 个月对血糖、胰岛素和胰岛素抵抗稳态模型评估（HOMA-IR）指数的血清水平进行一次评估：41人接受了DOL/3TC治疗，40人接受了BIC/F/TAF治疗。基线时，中位 HOMA-IR 指数为 3.18，49 名受试者（60%）存在胰岛素抵抗（HOMA-IR 指数为 2.5）。转用 DOR/TDF/3TC 12 个月后，平均血清葡萄糖浓度变化不显著，但胰岛素中位浓度显著降低（-3.54 mcrUI/L [四分位距范围-4.22 至-2.87]；p = 0.012），与此同时，平均 HOMA-IR 指数显著降低（-0.54 [四分位距范围-0.91 至-0.18]；p = 0.021）。结论在我们对接受 DOL/3TC 或 BIC/F/TAF 治疗且近期体重增加的病毒得到抑制的 HIV 感染者进行的回顾性研究中，改用 DOR/TDF/3TC 可显著改善胰岛素敏感性和血浆脂质，并有减轻体重的趋势。

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引用次数: 0

Cascade analysis of awareness, willingness, uptake and adherence with regard to PrEP among young men who have sex with men (YMSM) in China: A comparison between students and non-students 对中国年轻男男性行为者（YMSM）对 PrEP 的认知、意愿、接受和坚持情况进行逐级分析：学生与非学生之间的比较。

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine

Pub Date : 2024-03-27 DOI: 10.1111/hiv.13639

Yuanyuan Liu, Zhaoyu Cheng, Yidan Xian, Xuan Liu, Siyue Wei, Ju Ma, Jiageng Chen, Zhongdan Chen, Fengli Liu, Jie Yang, Maohe Yu, Changping Li, Zhuang Cui

Introduction

In China, young men who have sex with men (YMSM) are one of the groups most at risk of HIV/AIDS. The uptake of pre-exposure prophylaxis (PrEP) among YMSM has not been well documented. A cascade analysis of awareness, willingness, use and adherence with regard to PrEP was conducted separately among YMSM students and non-students.

Methods

From 20 October to 30 December 2021, all adolescents aged 16–24 years were selected for the study from among MSM recruited from 31 provincial administrative regions in mainland China. Participants were included in a cross-sectional study of awareness, willingness, use and adherence with regard to PrEP among YMSM. Logistic regression modelling was used to identify factors associated with the four outcomes.

Results

Among 1014 student and 866 non-student YMSMs, respectively, 88.07% and 81.64% had heard of PrEP; 58.16% and 50.35% were willing to use PrEP; 7.59% and 7.62% had used PrEP; and 3.16% and 3.58% had adhered to PrEP. Among students, those living in high-risk areas and pilot cities and those who had engaged in commercial sex and group sex had a positive effect on PrEP use, and the same trends were found among non-students living in high-risk areas and pilot cities and those who had engaged in group sex. ‘Daily oral’ and ‘flexible’ PrEP use positively influenced adherence among both groups.

Conclusions

A differentiation strategy of PrEP promotion should be implemented among YMSM. Material support for students, such as financial resources, should increase, while non-students should increase their level of perception of HIV risk.

导言：在中国，男男性行为者（YMSM）是感染艾滋病风险最高的群体之一。关于男男性行为者对暴露前预防疗法（PrEP）的接受程度，目前还没有很好的记录。我们分别对青年学生和非学生对 PrEP 的认识、意愿、使用和坚持情况进行了逐级分析：方法：2021 年 10 月 20 日至 12 月 30 日，从中国大陆 31 个省级行政区的男男性行为者中选取了所有 16-24 岁的青少年作为研究对象。参与者被纳入一项横断面研究，以了解青年男男性行为者对 PrEP 的认知、意愿、使用和坚持情况。研究采用逻辑回归模型来确定与上述四项结果相关的因素：在 1014 名学生和 866 名非学生 YMSMs 中，听说过 PrEP 的分别占 88.07% 和 81.64%；愿意使用 PrEP 的分别占 58.16% 和 50.35%；使用过 PrEP 的分别占 7.59% 和 7.62%；坚持使用 PrEP 的分别占 3.16% 和 3.58%。在学生中，居住在高危地区和试点城市的学生以及从事过商业性行为和群交的学生对使用 PrEP 有积极的影响，在居住在高危地区和试点城市的非学生以及从事过群交的学生中也发现了同样的趋势。每日口服 "和 "灵活 "使用 PrEP 对这两类人群的依从性都有积极影响：结论：应在青少年中实施差异化的 PrEP 推广策略。结论：应在青年学生中实施差异化的 PrEP 推广策略，增加对学生的物质支持，如财政资源，而非学生则应提高他们对艾滋病风险的认知水平。

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引用次数: 0

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