Luxsena Sukumaran, Alan Winston, Catia Marzolini, Saye Khoo, Marta Boffito, Nadia Naous, Caroline A. Sabin
Polypharmacy, the concurrent use of multiple medications, presents a growing challenge in HIV care as people living with HIV age and experience earlier onset of age-related co-morbidities. However, how polypharmacy is defined and assessed in HIV research remains inconsistent. The commonly used threshold of five or more medications, often derived from geriatric medicine, may not adequately reflect the clinical complexity of HIV care, where lifelong antiretroviral therapy (ART) forms the foundation of treatment. This review examines how polypharmacy has been defined and operationalized in HIV studies and compares this to approaches in geriatric research, where tools (e.g., STOPP/START and the Beers criteria) have been more systematically applied. We argue that HIV care can benefit from, but must also adapt, these frameworks to address the unique pharmacologic, psychosocial and adherence-related considerations faced by people with HIV. We also review emerging evidence linking polypharmacy in HIV with negative outcomes, including increased risk of drug–drug interactions, hospitalization, reduced quality of life, and associated healthcare costs. At the same time, polypharmacy is not inherently inappropriate, as many regimens may reflect guideline-concordant care. Rather than focusing on medication count alone, attention should shift toward evaluating appropriateness, safety and alignment with the individual's evolving health needs. Finally, we explore the role of deprescribing in HIV care, acknowledging both its promise and the challenges it presents, particularly in preserving ART stability and supporting shared decision-making. Reframing polypharmacy through an HIV-specific lens can support safer prescribing and improve outcomes as the HIV population continues to age.
{"title":"Polypharmacy in HIV: Rethinking what counts and why it matters","authors":"Luxsena Sukumaran, Alan Winston, Catia Marzolini, Saye Khoo, Marta Boffito, Nadia Naous, Caroline A. Sabin","doi":"10.1111/hiv.70129","DOIUrl":"10.1111/hiv.70129","url":null,"abstract":"<p>Polypharmacy, the concurrent use of multiple medications, presents a growing challenge in HIV care as people living with HIV age and experience earlier onset of age-related co-morbidities. However, how polypharmacy is defined and assessed in HIV research remains inconsistent. The commonly used threshold of five or more medications, often derived from geriatric medicine, may not adequately reflect the clinical complexity of HIV care, where lifelong antiretroviral therapy (ART) forms the foundation of treatment. This review examines how polypharmacy has been defined and operationalized in HIV studies and compares this to approaches in geriatric research, where tools (e.g., STOPP/START and the Beers criteria) have been more systematically applied. We argue that HIV care can benefit from, but must also adapt, these frameworks to address the unique pharmacologic, psychosocial and adherence-related considerations faced by people with HIV. We also review emerging evidence linking polypharmacy in HIV with negative outcomes, including increased risk of drug–drug interactions, hospitalization, reduced quality of life, and associated healthcare costs. At the same time, polypharmacy is not inherently inappropriate, as many regimens may reflect guideline-concordant care. Rather than focusing on medication count alone, attention should shift toward evaluating appropriateness, safety and alignment with the individual's evolving health needs. Finally, we explore the role of deprescribing in HIV care, acknowledging both its promise and the challenges it presents, particularly in preserving ART stability and supporting shared decision-making. Reframing polypharmacy through an HIV-specific lens can support safer prescribing and improve outcomes as the HIV population continues to age.</p>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 2","pages":"186-199"},"PeriodicalIF":3.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345027","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}
Niroshan Dayalan, Suki Leung, Katherine Dahill, Adam Temple, Natasha Somani, Joao Matos, Sam Mann, Margherita Bracchi, Mark Nelson, Mark Bower, Marta Boffito, Pascal Migaud, Alessia Dalla Pria
{"title":"Integrase inhibitors and paclitaxel for Kaposi sarcoma: Clinical relevance of pharmacological interaction","authors":"Niroshan Dayalan, Suki Leung, Katherine Dahill, Adam Temple, Natasha Somani, Joao Matos, Sam Mann, Margherita Bracchi, Mark Nelson, Mark Bower, Marta Boffito, Pascal Migaud, Alessia Dalla Pria","doi":"10.1111/hiv.70130","DOIUrl":"10.1111/hiv.70130","url":null,"abstract":"","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 12","pages":"1994-1995"},"PeriodicalIF":3.2,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329106","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}
With increasing life expectancy among HIV-positive persons in China, comorbidities, polypharmacy and potential drug–drug interactions (DDIs) present growing challenges. We evaluated these issues in the integrase strand transfer inhibitor (INSTI) era of antiretroviral therapy (ART).
Methods
In this multi-site, cross-sectional study, we enrolled 5238 HIV-positive persons from four geographically diverse regions of China. Using the University of Liverpool HIV Drug Interactions Database, we categorized potential DDIs as follows: no interaction (green), weak interaction (yellow), interaction requiring dose adjustment/monitoring (amber) or contraindicated (red).
Results
The mean age of participants was 41.7 years; 1121 (21.4%) had at least one comorbidity. Notable treatment gaps were observed: 516 (46.0%) comorbid cases received no treatment, with particularly low treatment rates for hypertension (21.8%, 81/372), dyslipidaemia (45.3%, 86/190), diabetes (15.2%, 24/158), cardiovascular disease (23.0%, 20/87) and endocrine/metabolic disorders (58.6%, 85/142). Non-ART medication use was reported by 604 (11.5%), most commonly antihypertensives (6.1%, 320/5238), antidiabetics (3.4%, 176/5238). Among medication users, 253 (41.8%) had potential DDIs: red-flagged (1.0%, 4/604), amber-flagged (32.5%, 198/604) and yellow-flagged (8.3%, 51/604). Multivariable analysis revealed older age, overweight/obesity, urban insurance, lower income, lower CD4 counts and INSTI-based regimens were positively associated with comorbidities and comedication use. Potential DDI risk increased with older age, longer ART duration, smoking, polypharmacy and non-nucleoside reverse transcriptase inhibitors/protease inhibitor-based regimens.
Conclusions
Our findings reveal high comorbidity prevalence with significant treatment gaps and frequent potential DDIs among Chinese HIV-positive persons, particularly involving cardiometabolic medications and non-INSTI ART regimens. These results underscore the urgent need for integrated HIV/chronic care models incorporating routine DDI screening to improve clinical outcomes.
{"title":"Comorbidities, comedications and potential drug–drug interactions among people living with HIV in China","authors":"Yidan Zhao, Xiaobing Fu, Yuecheng Yang, Luqian Shi, Leshuang Wu, Qunbo Zhou, Yong Zhang, Xin Xin, Lei Han, Haibo Jiang, Yingying Ding","doi":"10.1111/hiv.70127","DOIUrl":"10.1111/hiv.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>With increasing life expectancy among HIV-positive persons in China, comorbidities, polypharmacy and potential drug–drug interactions (DDIs) present growing challenges. We evaluated these issues in the integrase strand transfer inhibitor (INSTI) era of antiretroviral therapy (ART).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multi-site, cross-sectional study, we enrolled 5238 HIV-positive persons from four geographically diverse regions of China. Using the University of Liverpool HIV Drug Interactions Database, we categorized potential DDIs as follows: no interaction (green), weak interaction (yellow), interaction requiring dose adjustment/monitoring (amber) or contraindicated (red).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of participants was 41.7 years; 1121 (21.4%) had at least one comorbidity. Notable treatment gaps were observed: 516 (46.0%) comorbid cases received no treatment, with particularly low treatment rates for hypertension (21.8%, 81/372), dyslipidaemia (45.3%, 86/190), diabetes (15.2%, 24/158), cardiovascular disease (23.0%, 20/87) and endocrine/metabolic disorders (58.6%, 85/142). Non-ART medication use was reported by 604 (11.5%), most commonly antihypertensives (6.1%, 320/5238), antidiabetics (3.4%, 176/5238). Among medication users, 253 (41.8%) had potential DDIs: red-flagged (1.0%, 4/604), amber-flagged (32.5%, 198/604) and yellow-flagged (8.3%, 51/604). Multivariable analysis revealed older age, overweight/obesity, urban insurance, lower income, lower CD4 counts and INSTI-based regimens were positively associated with comorbidities and comedication use. Potential DDI risk increased with older age, longer ART duration, smoking, polypharmacy and non-nucleoside reverse transcriptase inhibitors/protease inhibitor-based regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings reveal high comorbidity prevalence with significant treatment gaps and frequent potential DDIs among Chinese HIV-positive persons, particularly involving cardiometabolic medications and non-INSTI ART regimens. These results underscore the urgent need for integrated HIV/chronic care models incorporating routine DDI screening to improve clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"168-179"},"PeriodicalIF":3.2,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300141","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}
Juan Ambrosioni, Laura I. Levi, Jasmini Alagaratnam, Abiu Sempere, Andrea Mastrangelo, Paolo Paioni, Cristina Mussini, Catia Marzolini, Susanne Dam Nielsen, Charles Béguelin, Steven Welch, Anna Koval, Luis Mendao, Alasdair Bamford, Alexandra Calmy, Giovanni Guaraldi, Cristiana Oprea, Esteban Martínez, Jürgen K. Rockstroh, The EACS Governing Board
Background
The European AIDS Clinical Society (EACS) guidelines were revised for the 21st time in 2025, with updates covering all aspects of HIV care.
Key Points of the Guidelines Update
The structure of the guidelines has been reorganized into two parts: Part I focuses on the management and prevention of HIV and related infections, and Part II addresses comorbidities and other relevant topics. In Part I, Version 13.0 recommends the following first-line regimens for adults with HIV-1: tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) with either lamivudine or emtricitabine (XTC), in combination with dolutegravir (DTG), bictegravir (BIC), or doravirine (DOR); or a dual therapy option consisting of XTC plus DTG. Version 13.0 introduces a completely new section on HIV-2. The preferred first-line regimens for HIV-2 include triple therapy with a second-generation integrase inhibitor: either TAF/FTC/BIC or TDF/XTC + DTG. The PrEP section has been updated to include the use of long-acting injectable antiretrovirals. Drug–drug interaction (DDI) tables have been updated to include long-acting antiretrovirals and considerations related to substance use, including drugs used to enhance or prolong sexual activity (chemsex). Tables for preferred and alternative ART regimens in children and adolescents have been updated, with particular attention to neonates. A new section on transition to adult care has also been included. The co-infections section has undergone extensive revision, especially regarding HBV, sexually transmitted infections, opportunistic infections (particularly tuberculosis, leishmaniasis, and cryptococcosis) and mpox, incorporating recent clinical trial data on tecovirimat. In Part II, Version 13.0 introduces major updates to the comorbidities section. In the cancer section, screening recommendations for anal and breast cancer have been updated. Cardiovascular and metabolic health sections have been significantly modified, reflecting recent advances and the use of statins in people with HIV. Topics such as kidney and liver complications, mental health, travel and solid organ transplantation have been thoroughly revised. New sections on sleep health and a unified substance use section have been added.
Conclusions
In 2025, the EACS Guidelines underwent a comprehensive update and restructuring. They now consist of two distinct parts and include several new sections. The recommendations are available as a free mobile app and in an interactive web format.
{"title":"Major revision version 13.0 of the European AIDS Clinical Society guidelines 2025","authors":"Juan Ambrosioni, Laura I. Levi, Jasmini Alagaratnam, Abiu Sempere, Andrea Mastrangelo, Paolo Paioni, Cristina Mussini, Catia Marzolini, Susanne Dam Nielsen, Charles Béguelin, Steven Welch, Anna Koval, Luis Mendao, Alasdair Bamford, Alexandra Calmy, Giovanni Guaraldi, Cristiana Oprea, Esteban Martínez, Jürgen K. Rockstroh, The EACS Governing Board","doi":"10.1111/hiv.70120","DOIUrl":"10.1111/hiv.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The European AIDS Clinical Society (EACS) guidelines were revised for the 21st time in 2025, with updates covering all aspects of HIV care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Points of the Guidelines Update</h3>\u0000 \u0000 <p>The structure of the guidelines has been reorganized into two parts: Part I focuses on the management and prevention of HIV and related infections, and Part II addresses comorbidities and other relevant topics. In Part I, Version 13.0 recommends the following first-line regimens for adults with HIV-1: tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) with either lamivudine or emtricitabine (XTC), in combination with dolutegravir (DTG), bictegravir (BIC), or doravirine (DOR); or a dual therapy option consisting of XTC plus DTG. Version 13.0 introduces a completely new section on HIV-2. The preferred first-line regimens for HIV-2 include triple therapy with a second-generation integrase inhibitor: either TAF/FTC/BIC or TDF/XTC + DTG. The PrEP section has been updated to include the use of long-acting injectable antiretrovirals. Drug–drug interaction (DDI) tables have been updated to include long-acting antiretrovirals and considerations related to substance use, including drugs used to enhance or prolong sexual activity (chemsex). Tables for preferred and alternative ART regimens in children and adolescents have been updated, with particular attention to neonates. A new section on transition to adult care has also been included. The co-infections section has undergone extensive revision, especially regarding HBV, sexually transmitted infections, opportunistic infections (particularly tuberculosis, leishmaniasis, and cryptococcosis) and mpox, incorporating recent clinical trial data on tecovirimat. In Part II, Version 13.0 introduces major updates to the comorbidities section. In the cancer section, screening recommendations for anal and breast cancer have been updated. Cardiovascular and metabolic health sections have been significantly modified, reflecting recent advances and the use of statins in people with HIV. Topics such as kidney and liver complications, mental health, travel and solid organ transplantation have been thoroughly revised. New sections on sleep health and a unified substance use section have been added.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In 2025, the EACS Guidelines underwent a comprehensive update and restructuring. They now consist of two distinct parts and include several new sections. The recommendations are available as a free mobile app and in an interactive web format.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"18-32"},"PeriodicalIF":3.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292070","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}
<p><b>A</b></p><p>Abad, A. eP160, eP316</p><p>Abadía, J. MeP21.7</p><p>Abbate, I. eP080</p><p>Abbott, M. eP482</p><p>AbdelMagid, A.M. eP113, eP013</p><p>Abdelmalek, R. eP371</p><p>Abdi, B. eP159</p><p>Abdillahi Ahmed, I. eP306</p><p>Abdou, F. RO2.3</p><p>Abecasis, A.B. MeP18.4, O1.3, eP152</p><p>Abela, I.A. PS15.1, PS04.4</p><p>Abello, C. eP110, eP121</p><p>Aberg, J.A. eP125</p><p>Abgrall, S. MeP01.2, eP101</p><p>Abi Aad, Y. eP107, MeP16.4, eP502</p><p>Abu-Ba’are1, G.R. PS04.2, eP495</p><p>Abulizi, D. eP236</p><p>Abuogi, L. MeP14.3</p><p>Abutidze, A. PS05.3, eP457, eP399, eP400</p><p>Aceitón, J. PS02.3, eP397, MeP18.2</p><p>Acıkalın Arıkan, H.B. eP391, PS10.1</p><p>Adachi, I. eP272</p><p>Adami, M. MeP09.5.LB</p><p>Adamis, G. MeP01.3, eP485, eP321, eP353, eP147, eP104</p><p>Adams, E. eP418</p><p>Adams, T. MTE4.1, eP252</p><p>Adelakun, A. eP106</p><p>Adler, A. eP039</p><p>Adler, Z. eP241</p><p>Adlung, L. eP.LB001</p><p>Adoux, L. MeP04.1</p><p>Adriani, B.A. eP067</p><p>Adurosakin, D.F. eP389</p><p>Aebi-Popp, K. MeP22.4</p><p>Aeschelmann, A. PS07.2</p><p>Aganaba, V. <b>eP.LB027</b></p><p>Agbaje, A. eP.LB027</p><p>Agbo, M.F. eP389</p><p>Aghaizu, A. O2.8.LB</p><p>Agher, R. MeP14.2, eP073</p><p>Agraz Orozco, S. <b>eP410</b></p><p>Agrenzano, S. eP482</p><p>Aguilar, J.R. eP018</p><p>Aguilar Gonzalez, A. RO1.4</p><p>Aguilera García, M. eP369, MeP21.6, eP061, RO3.7, eP098, eP089, eP108, eP123, MeP21.7, eP078</p><p>Aguolu, D.R. eP389</p><p>Ahimbisibwe, A. eP163</p><p>Ahluwalia, P. eP308</p><p>Ahmadov, E. MeP17.2</p><p>Ahn, K.H. eP215</p><p>Ahn, S. eP506</p><p>Aho, I. O2.1</p><p>Ahumada Topete, V.H. eP392</p><p>Aigner, F. eP326</p><p>Aimée Prochnow, C. eP450</p><p>Aimla, K. eP368</p><p>Ainembabazi, B. <b>eP163</b></p><p>Aissi, E. eP263</p><p>Aiyana, O. eP017</p><p>Aizawa, Y. eP324</p><p>Ajdukiewicz, K. eP361</p><p>Ajiboye, W. eP378</p><p>Aka, N. eP063</p><p>Akalın, H. eP391, <b>eP069</b></p><p>Akbulut, İ. eP062</p><p>Akca, V. <b>eP270</b></p><p>Akgul, L. eP260</p><p>Akhan, S. eP277, eP092, eP062, eP.LB011</p><p>Akil Bandali, P. eP.LB008</p><p>Akimkin, V. eP151</p><p>Akinosoglou, K. eP317</p><p>Akkaya Işık, S. eP391</p><p>Akkoyunlu, Y. eP203</p><p>Akodu, J. eP037</p><p>Akotia, M.K. PS15.6.LB</p><p>Akpomiemie, G. MeP11.4</p><p>Aksak-Wąs, B. eP403</p><p>Aktas, B.C. eP472</p><p>Akusu, O. <b>eP377</b></p><p>Alain, T. eP107</p><p>Alalwan, D. <b>RO3.1</b></p><p>Alarcon Gutierrez, M. MeP18.2, eP397</p><p>Alarcón-Soto, Y. RO1.6</p><p>Albayrak-Rena, S. eP257, eP256, eP283</p><p>Albayrak-Ucak, H. MeP22.4</p><p>Albers, T. MeP18.3</p><p>Albertini, M. eP085, eP259</p><p>Albrecht, H. PS09.2</p><p>Aldamiz-Echevarría, T. RO3.7</p><p>Alejandria, M. eP018</p><p>Alejos, B. RO3.8.LB</p><p>Aleman, S. PS12.2</p><p>Alemán, R. eP078</p><p>Alemán Valls, M.R. MeP21.6, RO3.7, eP098, eP061, eP123, O2.2</p><p>Alessandri-Gradt, E. PS09.3, eP140, eP159</p><p>Alessi, F. <b>eP315</b></p><p>Alessio, G. <b>MeP17.4</b></p><p>Alexandrova Nikolova, K. PS03.2</p><p>Alexiev, I. O1.3, eP023</p><p>Ale
eP276, eP304Haller， S. PS05.4Halliday， B. eP273Hamani, N . eP268Hamdy， H. eP094Hamed Tamim， H. eP094Hamidi， M. RO2.2Hamilton， C. eP349, eP339Hamilton， M. eP。LB025Hampel， B. PS04.4Hampl， M. eP326Hampson， G. eP。LB014Han， M. MeP04.2Han， W.M. eP262, MeP02.2Handala， L. eP140Hanke， T. MeP17.3Hanna， S. eP308Hansen, a - b.e. eP390Hanu， L. eP452Harada， Y. eP222Harboe， Z.B. eP。lb023哈登，O. ep139哈丁，R. ep308哈珀，G. ep095哈林顿，K. eP349Harris， E. MeP22.3Harris， V. MeP18.3Hart， J. eP037Hart， S. MeP09.5。[4]李建平，李建平，李建平。LB025Hasson， H. MTE1.1, MeP21.3Hatakeyama， S. eP132Hatcher， A. MeP14.3Hatipoglu， C. eP153, ep063 hatenhauer， T. PS06.3Haufroid， V. eP165Haukila， K. eP335Havenar-Daughton， C. MeP17.2Haw， J. eP291Hayashi， M. eP334Hayes， H. eP。LB014He， H. eP418He， L. eP406He， S. MeP05.2, eP129, eP130, eP274, eP267He， Y. eP111Heath， S.L. eP319Hedberg， P. PS12.2, MeP09.4。LBHederova， D. PS12.1Hedgcock， M. eP128Heger， E. eP150Heideman， D. PS06.1Heinzkill， M. MeP05.3Hejzák， R. MeP09.5。LBHelgers， L.C. eP031Helova， A. MeP14.3Hemery， J. O2.6Henry， S. eP。[b008] hentzien， M. MeP05.1, eP101, ep306 . herbst， A. ro2.5 . hermus， M. eP。LB028Hernández-Gutiérrez， C. MeP10.4Hernandez Morales， A. eP。LB012Hernández-Ruiz， V. eP234 hernando， A. eP064Hertling， S. PS06.3Hertz， J. eP335Herwegh， N. eP284Hessamfar， M. eP234, eP。LB013Hetman， L. MeP07.3, eP528, eP436, eP188, eP527Hickens， N. eP382Hickson， F. eP493, MeP03.4Hidalgo Tenorio， C. MeP21.6, eP061, eP123, RO3.7, eP108, eP098, eP089, MeP12.4, PS05.1, eP078, MeP21.7Hijal， T. eP081Hill， A. eP126, MeP21.2, eP415, MeP20.2, RO1.8。磅,MeP09.6。LBHill， J.N. eP131Hill， S. eP103Hindman， J.T. eP136, MeP21.1Hinestrosa， F. eP052Hintz， A. eP138Hiranburana， N. eP289, eP171Hiransuthikul， A. eP508, eP262, MeP02.2Hlebowicz， M. MeP12.4Ho， M.- w。hocqueloux， L. MeP05.3, eP135, eP112, eP059, MeP05.1, eP101, eP456, eP049, eP107, eP124, O1.4, eP。[b003]郝德胜，李建平，李建平，等。LBHoellinger， B. PS07.2Hoelscher， M. MeP17.2Hoelzemer， A. PS07.4。磅,eP。LB021Hoffmann， C. PS06.3, RO1.2Hoffmann， M. PS05.4Hojman， M. eP402Holban， T. eP348Holterhoff， J. eP150Hölzemer， A. eP。LB001Homar， F. MeP11.6Homen， R. eP178, eP337Homen Fernández， J.R. eP489Honcharova， M. eP182Hong， C. eP458Hong， E. mep061 hongchokiat， P. eP508Hontañon， V. eP225Hontañón， V. eP224Hoornenborg， E. MeP13.1Hope， M. eP327Horgan， M. RO1.3, RO3.1Horn， C. eP150Horst Soares， V.G. eP341， M. ro395, ep450houdr<e:1>， C. MeP10.3Houghton， K. o2.7 hovannishan， E. MeP24.7Hove， K. RO2.5, eP456Hove-Skovsgaard， M. ps33.2 hovsepyan， T. eP151Hower， M. eP257, eP256, eP283Hoy， J.F. eP271Hridasova， O. eP375Hristamyan，M. ep228谢东罗，E. eP233Hsu， S. eP311Huang， L. eP291, eP248Huang， P. p。LB033Huang工程学系。eP194Huang， X. eP016, eP295, eP033Huang, y - s。ep194h<s:1>宾格，M. eP138Hudson， A. eP339Huefner， A. eP。LB021Hughes， C. ep383 huisingc . eP372Hung， C. C. C.eP128, eP194Hung, t.c c。亨斯廷，F. p .；LB021Hunt， P. eP180Hunter， A. eP037Hurzhii， O. eP182Huseynova， N. eP058Hutchinson， S. ep443httig， F. eP210Huynh， T.T. MeP09.1。LBHyatt， A.N. eP319Hyun， H.J. eP21
{"title":"Index","authors":"","doi":"10.1111/hiv.70103","DOIUrl":"https://doi.org/10.1111/hiv.70103","url":null,"abstract":"<p><b>A</b></p><p>Abad, A. eP160, eP316</p><p>Abadía, J. MeP21.7</p><p>Abbate, I. eP080</p><p>Abbott, M. eP482</p><p>AbdelMagid, A.M. eP113, eP013</p><p>Abdelmalek, R. eP371</p><p>Abdi, B. eP159</p><p>Abdillahi Ahmed, I. eP306</p><p>Abdou, F. RO2.3</p><p>Abecasis, A.B. MeP18.4, O1.3, eP152</p><p>Abela, I.A. PS15.1, PS04.4</p><p>Abello, C. eP110, eP121</p><p>Aberg, J.A. eP125</p><p>Abgrall, S. MeP01.2, eP101</p><p>Abi Aad, Y. eP107, MeP16.4, eP502</p><p>Abu-Ba’are1, G.R. PS04.2, eP495</p><p>Abulizi, D. eP236</p><p>Abuogi, L. MeP14.3</p><p>Abutidze, A. PS05.3, eP457, eP399, eP400</p><p>Aceitón, J. PS02.3, eP397, MeP18.2</p><p>Acıkalın Arıkan, H.B. eP391, PS10.1</p><p>Adachi, I. eP272</p><p>Adami, M. MeP09.5.LB</p><p>Adamis, G. MeP01.3, eP485, eP321, eP353, eP147, eP104</p><p>Adams, E. eP418</p><p>Adams, T. MTE4.1, eP252</p><p>Adelakun, A. eP106</p><p>Adler, A. eP039</p><p>Adler, Z. eP241</p><p>Adlung, L. eP.LB001</p><p>Adoux, L. MeP04.1</p><p>Adriani, B.A. eP067</p><p>Adurosakin, D.F. eP389</p><p>Aebi-Popp, K. MeP22.4</p><p>Aeschelmann, A. PS07.2</p><p>Aganaba, V. <b>eP.LB027</b></p><p>Agbaje, A. eP.LB027</p><p>Agbo, M.F. eP389</p><p>Aghaizu, A. O2.8.LB</p><p>Agher, R. MeP14.2, eP073</p><p>Agraz Orozco, S. <b>eP410</b></p><p>Agrenzano, S. eP482</p><p>Aguilar, J.R. eP018</p><p>Aguilar Gonzalez, A. RO1.4</p><p>Aguilera García, M. eP369, MeP21.6, eP061, RO3.7, eP098, eP089, eP108, eP123, MeP21.7, eP078</p><p>Aguolu, D.R. eP389</p><p>Ahimbisibwe, A. eP163</p><p>Ahluwalia, P. eP308</p><p>Ahmadov, E. MeP17.2</p><p>Ahn, K.H. eP215</p><p>Ahn, S. eP506</p><p>Aho, I. O2.1</p><p>Ahumada Topete, V.H. eP392</p><p>Aigner, F. eP326</p><p>Aimée Prochnow, C. eP450</p><p>Aimla, K. eP368</p><p>Ainembabazi, B. <b>eP163</b></p><p>Aissi, E. eP263</p><p>Aiyana, O. eP017</p><p>Aizawa, Y. eP324</p><p>Ajdukiewicz, K. eP361</p><p>Ajiboye, W. eP378</p><p>Aka, N. eP063</p><p>Akalın, H. eP391, <b>eP069</b></p><p>Akbulut, İ. eP062</p><p>Akca, V. <b>eP270</b></p><p>Akgul, L. eP260</p><p>Akhan, S. eP277, eP092, eP062, eP.LB011</p><p>Akil Bandali, P. eP.LB008</p><p>Akimkin, V. eP151</p><p>Akinosoglou, K. eP317</p><p>Akkaya Işık, S. eP391</p><p>Akkoyunlu, Y. eP203</p><p>Akodu, J. eP037</p><p>Akotia, M.K. PS15.6.LB</p><p>Akpomiemie, G. MeP11.4</p><p>Aksak-Wąs, B. eP403</p><p>Aktas, B.C. eP472</p><p>Akusu, O. <b>eP377</b></p><p>Alain, T. eP107</p><p>Alalwan, D. <b>RO3.1</b></p><p>Alarcon Gutierrez, M. MeP18.2, eP397</p><p>Alarcón-Soto, Y. RO1.6</p><p>Albayrak-Rena, S. eP257, eP256, eP283</p><p>Albayrak-Ucak, H. MeP22.4</p><p>Albers, T. MeP18.3</p><p>Albertini, M. eP085, eP259</p><p>Albrecht, H. PS09.2</p><p>Aldamiz-Echevarría, T. RO3.7</p><p>Alejandria, M. eP018</p><p>Alejos, B. RO3.8.LB</p><p>Aleman, S. PS12.2</p><p>Alemán, R. eP078</p><p>Alemán Valls, M.R. MeP21.6, RO3.7, eP098, eP061, eP123, O2.2</p><p>Alessandri-Gradt, E. PS09.3, eP140, eP159</p><p>Alessi, F. <b>eP315</b></p><p>Alessio, G. <b>MeP17.4</b></p><p>Alexandrova Nikolova, K. PS03.2</p><p>Alexiev, I. O1.3, eP023</p><p>Ale","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 S4","pages":"764-771"},"PeriodicalIF":3.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296910","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}
Mark O'Reilly, David Alain Wohl, Shauna Hall, Emil John Pastor Canĩta, Melania Mugamu
<div> <section> <h3> Introduction</h3> <p>Australia has made strong progress toward the UNAIDS 95:95:95 targets (UNAIDS, 2025). As of 2024, an estimated 92% of people with Human Immunodeficiency Virus (HIV) in Australia had been diagnosed, 97% of those diagnosed were receiving antiretroviral therapy (ART), and 98% of those on treatment had achieved viral suppression (Kirby Institute, 2024). While these outcomes reflect a well-functioning HIV care continuum, diagnosis gaps persist, particularly among people born overseas, heterosexual men, and Aboriginal and Torres Strait Islander peoples (Kirby Institute, 2024).</p> </section> <section> <h3> Methods</h3> <p>In October 13, 2023, Gilead Sciences and the National Association for People with HIV Australia (NAPWHA) partnered on a one-day educational symposium titled <i>Beyond Undetectable.</i> During the symposium the healthcare professionals and community representatives in attendance (<i>n</i> = 71) discussed persisting inequities in Australia's HIV response and workshopped potential solutions for reducing these inequities.</p> </section> <section> <h3> Results</h3> <p>The <i>Beyond Undetectable</i> meeting identified critical gaps in Australia's approach to HIV prevention, treatment and care, particularly in addressing the needs of marginalised populations, such as recently arrived migrants, women, and individuals residing outside of inner-suburban areas. Key recommendations included expanding peer navigation and telehealth services, promoting culturally competent care, and enhancing healthcare professional training to address disparities in access to care and reduce stigma. Delegates emphasised the importance of flexible, patient-centred care models, nurse-led care for HIV prevention, and innovative self-testing platforms. Additionally, the need for comprehensive mental health services, improved care coordination for aging people with HIV, and Medicare reform were highlighted as essential components to achieving the UNAIDS 2025 targets (UNAIDS, 2025) and long-term treatment success (Lazarus et al., HIV Med. 2023; Suppl 2:8–19). These recommendations provide actionable strategies to advance Australia's efforts toward the elimination of HIV transmission by 2030, while improving the quality of life for people with HIV.</p> </section> <section> <h3> Conclusions</h3> <p>This paper contains details of the symposium, and details of the proposed solutions to address critical gaps in Australia's approach to HIV which were devised and presented by delegates participating in the symposium.</p> <
导言：澳大利亚在实现联合国艾滋病规划署95:95:95目标方面取得了重大进展（联合国艾滋病规划署，2025年）。截至2024年，澳大利亚估计有92%的人类免疫缺陷病毒（HIV）感染者被诊断出来，其中97%的被诊断者正在接受抗逆转录病毒治疗（ART）， 98%的接受治疗者实现了病毒抑制（Kirby Institute, 2024）。虽然这些结果反映了一个运作良好的艾滋病毒护理连续体，但诊断差距仍然存在，特别是在海外出生的人、异性恋男性、土著人和托雷斯海峡岛民之间（Kirby Institute, 2024）。方法：2023年10月13日，吉利德科学公司和澳大利亚全国艾滋病病毒感染者协会（NAPWHA）合作举办了为期一天的教育研讨会，题为“超越不可检测”。在研讨会期间，与会的保健专业人员和社区代表（71人）讨论了澳大利亚艾滋病毒应对工作中持续存在的不平等现象，并就减少这些不平等现象的可能解决办法进行了讲习班讨论。结果：超越检测会议确定了澳大利亚在艾滋病毒预防、治疗和护理方面的关键差距，特别是在解决边缘化人群的需求方面，例如最近抵达的移民、妇女和居住在近郊地区以外的个人。主要建议包括扩大同伴导航和远程保健服务，促进具有文化能力的护理，以及加强卫生保健专业培训，以解决获得护理方面的差异并减少耻辱感。代表们强调了灵活的、以病人为中心的护理模式、护士主导的艾滋病毒预防护理以及创新的自我检测平台的重要性。此外，还强调需要全面的精神卫生服务、改善对艾滋病毒感染者的护理协调以及医疗保险改革，这些都是实现艾滋病规划署2025年目标（艾滋病规划署，2025年）和长期治疗成功的重要组成部分（Lazarus等人，HIV Med. 2023；补充资料2:8-19）。这些建议提供了可行的战略，以推进澳大利亚到2030年消除艾滋病毒传播的努力，同时改善艾滋病毒感染者的生活质量。结论：本文包含研讨会的细节，以及参加研讨会的代表设计和提出的解决方案的细节，以解决澳大利亚在艾滋病毒防治方面的关键差距。
{"title":"A community and clinical collaboration to optimize HIV treatment and care for people with HIV in Australia—Solutions from the Beyond Undetectable symposium","authors":"Mark O'Reilly, David Alain Wohl, Shauna Hall, Emil John Pastor Canĩta, Melania Mugamu","doi":"10.1111/hiv.70110","DOIUrl":"10.1111/hiv.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Australia has made strong progress toward the UNAIDS 95:95:95 targets (UNAIDS, 2025). As of 2024, an estimated 92% of people with Human Immunodeficiency Virus (HIV) in Australia had been diagnosed, 97% of those diagnosed were receiving antiretroviral therapy (ART), and 98% of those on treatment had achieved viral suppression (Kirby Institute, 2024). While these outcomes reflect a well-functioning HIV care continuum, diagnosis gaps persist, particularly among people born overseas, heterosexual men, and Aboriginal and Torres Strait Islander peoples (Kirby Institute, 2024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In October 13, 2023, Gilead Sciences and the National Association for People with HIV Australia (NAPWHA) partnered on a one-day educational symposium titled <i>Beyond Undetectable.</i> During the symposium the healthcare professionals and community representatives in attendance (<i>n</i> = 71) discussed persisting inequities in Australia's HIV response and workshopped potential solutions for reducing these inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The <i>Beyond Undetectable</i> meeting identified critical gaps in Australia's approach to HIV prevention, treatment and care, particularly in addressing the needs of marginalised populations, such as recently arrived migrants, women, and individuals residing outside of inner-suburban areas. Key recommendations included expanding peer navigation and telehealth services, promoting culturally competent care, and enhancing healthcare professional training to address disparities in access to care and reduce stigma. Delegates emphasised the importance of flexible, patient-centred care models, nurse-led care for HIV prevention, and innovative self-testing platforms. Additionally, the need for comprehensive mental health services, improved care coordination for aging people with HIV, and Medicare reform were highlighted as essential components to achieving the UNAIDS 2025 targets (UNAIDS, 2025) and long-term treatment success (Lazarus et al., HIV Med. 2023; Suppl 2:8–19). These recommendations provide actionable strategies to advance Australia's efforts toward the elimination of HIV transmission by 2030, while improving the quality of life for people with HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This paper contains details of the symposium, and details of the proposed solutions to address critical gaps in Australia's approach to HIV which were devised and presented by delegates participating in the symposium.</p>\u0000 <","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 S5","pages":"3-8"},"PeriodicalIF":3.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292053","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}
M. D. M. Arcos-Rueda, S. Gil Garrote, E. G. Torres García, A. de Gea Grela, C. Busca, R. Mican, L. Martin-Carbonero
Background
Hepatitis B virus (HBV) infection remains a significant concern among people with HIV (PWH), who are at higher risk of acquiring HBV and often show suboptimal responses to vaccination. In this context, we aimed to update the incidence of acute hepatitis B (AHB) in a cohort of PWH, given recent epidemiological shifts including the increase in migrant populations and the wider use of antiretroviral therapy (ART) regimens lacking anti-HBV activity.
Methods
We conducted a retrospective single-centre study including PWH under follow-up between 2000 and 2024. AHB cases were confirmed based on the recent positivity of HBsAg and anti-HBc IgM. Demographic, clinical, serological and ART-related data were collected. Incidence was calculated as cases per 100 person-years, and trends were analyzed in both the overall population and the susceptible subgroup (anti-HBc-negative).
Results
A total of 22 AHB cases were diagnosed among 5986 PWH. The overall incidence rate was 0.02 (0.01–0.15) cases per 100 person-years, and 0.05 (0.01–0.3) cases per 100 person-years in the susceptible subgroup. Incidence decreased over time, with no new cases from 2015 to 2022, and isolated cases re-emerged in 2023–2024. Most AHB cases (78.3%) were unvaccinated; 21.7% had received full vaccination but failed to develop a serologic response. Only 26.1% of cases were on ART at AHB diagnosis, and no one was receiving tenofovir. The rate of progression to chronic hepatitis B (CHB) was 17.4%, higher than in the general population; all CHB cases occurred in ART-naïve individuals.
Conclusions
AHB incidence among PWH has declined over the past 25 years but remains higher than in the general population. The recent reappearance of isolated cases may reflect changes in HBV exposure risk, suboptimal vaccination coverage, or the increasing use of ART regimens without anti-HBV activity. Universal HBV vaccination and the use of tenofovir-based therapies in non-responders remain critical strategies for prevention and control.
{"title":"Trends in acute hepatitis B among people living with HIV over 25 years: Incidence and clinical outcomes","authors":"M. D. M. Arcos-Rueda, S. Gil Garrote, E. G. Torres García, A. de Gea Grela, C. Busca, R. Mican, L. Martin-Carbonero","doi":"10.1111/hiv.70132","DOIUrl":"10.1111/hiv.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatitis B virus (HBV) infection remains a significant concern among people with HIV (PWH), who are at higher risk of acquiring HBV and often show suboptimal responses to vaccination. In this context, we aimed to update the incidence of acute hepatitis B (AHB) in a cohort of PWH, given recent epidemiological shifts including the increase in migrant populations and the wider use of antiretroviral therapy (ART) regimens lacking anti-HBV activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-centre study including PWH under follow-up between 2000 and 2024. AHB cases were confirmed based on the recent positivity of HBsAg and anti-HBc IgM. Demographic, clinical, serological and ART-related data were collected. Incidence was calculated as cases per 100 person-years, and trends were analyzed in both the overall population and the susceptible subgroup (anti-HBc-negative).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 22 AHB cases were diagnosed among 5986 PWH. The overall incidence rate was 0.02 (0.01–0.15) cases per 100 person-years, and 0.05 (0.01–0.3) cases per 100 person-years in the susceptible subgroup. Incidence decreased over time, with no new cases from 2015 to 2022, and isolated cases re-emerged in 2023–2024. Most AHB cases (78.3%) were unvaccinated; 21.7% had received full vaccination but failed to develop a serologic response. Only 26.1% of cases were on ART at AHB diagnosis, and no one was receiving tenofovir. The rate of progression to chronic hepatitis B (CHB) was 17.4%, higher than in the general population; all CHB cases occurred in ART-naïve individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AHB incidence among PWH has declined over the past 25 years but remains higher than in the general population. The recent reappearance of isolated cases may reflect changes in HBV exposure risk, suboptimal vaccination coverage, or the increasing use of ART regimens without anti-HBV activity. Universal HBV vaccination and the use of tenofovir-based therapies in non-responders remain critical strategies for prevention and control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 2","pages":"226-233"},"PeriodicalIF":3.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292078","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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