Tangui Barré, Clémence Ramier, Camelia Protopopescu, Philippe Sogni, Karine Ory, Tounes Saidi, Sophie Abgrall, Sylvie Brégigeon-Ronot, Patrizia Carrieri, Fabienne Marcellin, the ANRS CO13 HEPAVIH Study Group
Introduction
Suicidal ideation (SI) is highly prevalent among people living with HIV (PWH) and those with chronic hepatitis C virus (HCV) infection. Individuals with long-term HIV–HCV co-infection face specific health challenges, including heightened physical pain. We aimed to assess whether disabling physical pain is associated with SI in aging PWH who have been cured of HCV, after controlling for potential correlates or confounders such as depression and psychoactive substance use.
Methods
We analysed data from HCV-cured PWH who participated in a multi-center cross-sectional survey embedded within the French ANRS CO13 HEPAVIH cohort. We performed a multivariable logistic regression model with SI (score >0 for the ninth item of the Patient Health Questionnaire-9) as the outcome. Disabling physical pain was assessed using an answer ≥'very much' to the third item from the WHOQOL-HIV BREF questionnaire.
Results
Study population comprised 396 HCV-cured PWH (73.2% male), among whom 17.7% reported SI and 11.9% reported disabling physical pain. Participants reporting disabling physical pain had a three-fold higher risk of SI (adjusted odds ratio [95% confidence interval]: 3.07 [1.29–7.34]), after adjustment for depression (5.52 [2.66–11.43]), substance use, and lower social relationships-related quality of life (0.72 [0.64–0.80]).
Conclusions
These findings highlight that disabling physical pain should be systematically addressed among PWH cured of HCV, given its independent association with SI. Routine HIV follow-up care should integrate systematic screening for pain, mental health problems, and lack of social support. Timely referral to specialized services may help prevent future suicidal behaviours in this population.
{"title":"Perceived disabling physical pain and suicidal ideation in aging people living with HIV cured of hepatitis C: A multi-center survey in France (ANRS CO13 HEPAVIH)","authors":"Tangui Barré, Clémence Ramier, Camelia Protopopescu, Philippe Sogni, Karine Ory, Tounes Saidi, Sophie Abgrall, Sylvie Brégigeon-Ronot, Patrizia Carrieri, Fabienne Marcellin, the ANRS CO13 HEPAVIH Study Group","doi":"10.1111/hiv.70121","DOIUrl":"10.1111/hiv.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Suicidal ideation (SI) is highly prevalent among people living with HIV (PWH) and those with chronic hepatitis C virus (HCV) infection. Individuals with long-term HIV–HCV co-infection face specific health challenges, including heightened physical pain. We aimed to assess whether disabling physical pain is associated with SI in aging PWH who have been cured of HCV, after controlling for potential correlates or confounders such as depression and psychoactive substance use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed data from HCV-cured PWH who participated in a multi-center cross-sectional survey embedded within the French ANRS CO13 HEPAVIH cohort. We performed a multivariable logistic regression model with SI (score >0 for the ninth item of the Patient Health Questionnaire-9) as the outcome. Disabling physical pain was assessed using an answer ≥'very much' to the third item from the WHOQOL-HIV BREF questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study population comprised 396 HCV-cured PWH (73.2% male), among whom 17.7% reported SI and 11.9% reported disabling physical pain. Participants reporting disabling physical pain had a three-fold higher risk of SI (adjusted odds ratio [95% confidence interval]: 3.07 [1.29–7.34]), after adjustment for depression (5.52 [2.66–11.43]), substance use, and lower social relationships-related quality of life (0.72 [0.64–0.80]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings highlight that disabling physical pain should be systematically addressed among PWH cured of HCV, given its independent association with SI. Routine HIV follow-up care should integrate systematic screening for pain, mental health problems, and lack of social support. Timely referral to specialized services may help prevent future suicidal behaviours in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"106-119"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Doravirine is among the first-line recommended treatments for people living with HIV (PLHIV) in the 2025 EACS guidelines. As opposed to tenofovir alafenamide or anti-integrase, its use was not associated with weight gain in clinical trials, but limited data are currently available in real life. In this cohort study, we investigated weight variation in PLHIV switching to doravirine.
Methods
A retrospective cohort analysis was conducted in two Parisian hospitals, including all PLHIV switching to doravirine between January 2019 and September 2022. Body Mass Index (BMI) variation was calculated from 48 months before to 36 months after the switch.
Results
Between January 2019 and December 2022, 300 patients were included, with 220 men (73%) and 185 (62%) patients born in France. The main antiretroviral combination before the switch was TAF/FTC/BIC (n = 47, 16%), and after the switch, doravirine with TDF and 3TC (n = 202, 67%). Twenty-eight patients (9.3%) discontinued doravirine after a median duration of 17.5 months. At 12 and 24 months after the switch, the median BMI variation was 0.0 kg/m2, and this variation remained unchanged regardless of the pre-switch treatment. These results were less pronounced in subgroups of patients originating from sub-Saharan Africa (+0.2 and +0.4 kg/m2) and in women (+0.3 and 0.5 kg/m2).
Conclusion
Switching to doravirine led to a weight stabilisation, without reversal of the previously gained weight. In PLHIV at higher risk of weight gain, there was still a slight increase in BMI after the doravirine switch.
{"title":"Impact on weight of a Doravirine switch in people living with HIV","authors":"Nina Garofoli, Philippe Flandre, Jean-Paul Vincensini, Quentin Richier, Priscille Couture, Karine Lacombe, Gilles Pialoux, Jean-Luc Meynard","doi":"10.1111/hiv.70123","DOIUrl":"10.1111/hiv.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Doravirine is among the first-line recommended treatments for people living with HIV (PLHIV) in the 2025 EACS guidelines. As opposed to tenofovir alafenamide or anti-integrase, its use was not associated with weight gain in clinical trials, but limited data are currently available in real life. In this cohort study, we investigated weight variation in PLHIV switching to doravirine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis was conducted in two Parisian hospitals, including all PLHIV switching to doravirine between January 2019 and September 2022. Body Mass Index (BMI) variation was calculated from 48 months before to 36 months after the switch.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between January 2019 and December 2022, 300 patients were included, with 220 men (73%) and 185 (62%) patients born in France. The main antiretroviral combination before the switch was TAF/FTC/BIC (<i>n</i> = 47, 16%), and after the switch, doravirine with TDF and 3TC (<i>n</i> = 202, 67%). Twenty-eight patients (9.3%) discontinued doravirine after a median duration of 17.5 months. At 12 and 24 months after the switch, the median BMI variation was 0.0 kg/m<sup>2</sup>, and this variation remained unchanged regardless of the pre-switch treatment. These results were less pronounced in subgroups of patients originating from sub-Saharan Africa (+0.2 and +0.4 kg/m<sup>2</sup>) and in women (+0.3 and 0.5 kg/m<sup>2</sup>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Switching to doravirine led to a weight stabilisation, without reversal of the previously gained weight. In PLHIV at higher risk of weight gain, there was still a slight increase in BMI after the doravirine switch.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"136-145"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hussein H. Twabi, Akitoshi Ueno, Josephine Ives, Ross Murtagh, Madalo Mukoka, Seyed Alireza Mortazavi, David S. Lawrence, Augustine T. Choko, Robina Semphere, Kelvin Balakasi, Ajay Rangaraj, Nathan Ford, Joseph N. Jarvis, Peter MacPherson
Introduction
People with advanced HIV disease face high risks of severe illness and death. CD4 testing enables timely diagnosis and appropriate care, yet access remains limited in many settings. This review investigated the diagnostic accuracy of the WHO clinical staging for identifying advanced HIV disease.
Methods
We conducted a systematic review and meta-analysis of studies published between 1 January 1998 and 1 May 2024 that assessed both WHO clinical staging and CD4 counts in people living with HIV aged 5 years and older (PROSPERO: CRD42024558372). We pooled sensitivity and specificity estimates of WHO Stage 3/4 for detecting advanced HIV disease (CD4 <200 cells/μL) using bivariate random-effects meta-analysis. Risk of bias was assessed using QUADAS-2, and certainty of evidence was appraised using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).
Results
Of 15,194 studies screened, 335 relevant studies were identified, from which 25 were included in evidence synthesis and 21 in the meta-analysis. Most studies were from the WHO African (19/25) and South-East Asian (5/25) regions. Risk of bias was moderate to high in 88% of studies, primarily due to issues with clinical staging assessment. Pooled sensitivity and specificity of WHO Stage 3/4 were 60.7% (95% CI: 48.0%–72.1%) and 72.4% (95% CI: 61.4%–81.3%), respectively. Specificity was significantly higher outside the African region (p < 0.001). In a population of 100,000 people living with HIV with 30% advanced HIV disease prevalence, WHO staging would miss 11,700 true advanced HIV disease cases and misclassify 19,600.
Conclusions
WHO clinical staging alone shows low accuracy for detecting advanced HIV disease, risking both missed diagnoses and overtreatment. CD4 testing remains essential for accurately identifying and managing advanced HIV disease.
{"title":"Diagnostic accuracy of the WHO clinical staging system for detection of immunologically defined advanced HIV disease: A systematic review and meta-analysis","authors":"Hussein H. Twabi, Akitoshi Ueno, Josephine Ives, Ross Murtagh, Madalo Mukoka, Seyed Alireza Mortazavi, David S. Lawrence, Augustine T. Choko, Robina Semphere, Kelvin Balakasi, Ajay Rangaraj, Nathan Ford, Joseph N. Jarvis, Peter MacPherson","doi":"10.1111/hiv.70122","DOIUrl":"10.1111/hiv.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>People with advanced HIV disease face high risks of severe illness and death. CD4 testing enables timely diagnosis and appropriate care, yet access remains limited in many settings. This review investigated the diagnostic accuracy of the WHO clinical staging for identifying advanced HIV disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of studies published between 1 January 1998 and 1 May 2024 that assessed both WHO clinical staging and CD4 counts in people living with HIV aged 5 years and older (PROSPERO: CRD42024558372). We pooled sensitivity and specificity estimates of WHO Stage 3/4 for detecting advanced HIV disease (CD4 <200 cells/μL) using bivariate random-effects meta-analysis. Risk of bias was assessed using QUADAS-2, and certainty of evidence was appraised using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 15,194 studies screened, 335 relevant studies were identified, from which 25 were included in evidence synthesis and 21 in the meta-analysis. Most studies were from the WHO African (19/25) and South-East Asian (5/25) regions. Risk of bias was moderate to high in 88% of studies, primarily due to issues with clinical staging assessment. Pooled sensitivity and specificity of WHO Stage 3/4 were 60.7% (95% CI: 48.0%–72.1%) and 72.4% (95% CI: 61.4%–81.3%), respectively. Specificity was significantly higher outside the African region (<i>p</i> < 0.001). In a population of 100,000 people living with HIV with 30% advanced HIV disease prevalence, WHO staging would miss 11,700 true advanced HIV disease cases and misclassify 19,600.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WHO clinical staging alone shows low accuracy for detecting advanced HIV disease, risking both missed diagnoses and overtreatment. CD4 testing remains essential for accurately identifying and managing advanced HIV disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"120-135"},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Savinelli, A. Heeney, W. Tinago, A. A. Garcia Leon, P. McGettrick, A. G. Cotter, I. Walsh, M. Fitzgibbon, C. A. Sabin, P. W. G. Mallon, E. R. Feeney, the HIV UPBEAT study group
Objectives
Alterations in lipids and apolipoproteins contribute to cardiovascular disease (CVD) and are common in people with HIV. The aim of our study was to compare lipid profiles and body composition between people with and without HIV and to explore whether any associations with HIV could be explained by socio-demographic, clinical characteristics and body composition.
Methods
Cross-sectional analysis of a cohort study enrolling people with HIV and HIV-negative controls. Apolipoproteins [ApoB-100, ApoA1, Lp(a)] were analysed by immunoturbidimetry. Lipids (total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL]), clinical/demographic data and dual-energy X-ray absorptiometry (DXA)-measured body composition parameters were collected. Between-group differences were assessed with Student's T-test. Linear regression models assessed associations of lipids and apolipoproteins with HIV status and associations with socio-demographic, clinical characteristics and body composition.
Results
We included 108 people with HIV on treatment (93.5% with viral suppression) and 96 controls. People with HIV were younger, more likely to be male, with obesity, of African ethnicity, smokers and with a higher representation of CVD, hypertension, diabetes and statin use. ApoB-100, TC, HDL and LDL were significantly lower in people with HIV, with no between-group difference in ApoA, Lp(a) and body composition. HIV infection remained independently associated with lower TC and LDL after adjustment for possible confounders.
Conclusions
People with HIV from a contemporary cohort had lower pro-atherogenic lipid parameters compared to controls, and no differences in body composition between people with HIV and controls were observed. Traditional risk factors for CVD and chronic inflammation might have a greater impact than dyslipidaemia itself on the increased CVD risk in people with HIV.
{"title":"People living with HIV on modern antiretrovirals do not display a pro-atherogenic lipid profile and have similar body composition compared to healthy controls","authors":"S. Savinelli, A. Heeney, W. Tinago, A. A. Garcia Leon, P. McGettrick, A. G. Cotter, I. Walsh, M. Fitzgibbon, C. A. Sabin, P. W. G. Mallon, E. R. Feeney, the HIV UPBEAT study group","doi":"10.1111/hiv.70118","DOIUrl":"10.1111/hiv.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Alterations in lipids and apolipoproteins contribute to cardiovascular disease (CVD) and are common in people with HIV. The aim of our study was to compare lipid profiles and body composition between people with and without HIV and to explore whether any associations with HIV could be explained by socio-demographic, clinical characteristics and body composition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional analysis of a cohort study enrolling people with HIV and HIV-negative controls. Apolipoproteins [ApoB-100, ApoA1, Lp(a)] were analysed by immunoturbidimetry. Lipids (total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL]), clinical/demographic data and dual-energy X-ray absorptiometry (DXA)-measured body composition parameters were collected. Between-group differences were assessed with Student's T-test. Linear regression models assessed associations of lipids and apolipoproteins with HIV status and associations with socio-demographic, clinical characteristics and body composition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 108 people with HIV on treatment (93.5% with viral suppression) and 96 controls. People with HIV were younger, more likely to be male, with obesity, of African ethnicity, smokers and with a higher representation of CVD, hypertension, diabetes and statin use. ApoB-100, TC, HDL and LDL were significantly lower in people with HIV, with no between-group difference in ApoA, Lp(a) and body composition. HIV infection remained independently associated with lower TC and LDL after adjustment for possible confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>People with HIV from a contemporary cohort had lower pro-atherogenic lipid parameters compared to controls, and no differences in body composition between people with HIV and controls were observed. Traditional risk factors for CVD and chronic inflammation might have a greater impact than dyslipidaemia itself on the increased CVD risk in people with HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"86-95"},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Avallone, Kim Engler, Ford Hickson, Joseph Cox, Eric Fortin, Sean Yaphe, Bertrand Lebouché
Objectives
Sexual dysfunction (SD) is common among gay, bisexual and other men who have sex with men (GBM) with HIV, yet little is known about their views on SD care. We explored these views to inform patient-centred SD care to improve care delivery and sexual health outcomes.
Methods
Semi-structured interviews were conducted in 2024 with 31 Montreal-based GBM with HIV who experienced SD in the last 5 years (reduced libido, erectile dysfunction, premature/delayed ejaculation and/or pain during sex), covering SD care experiences and preferences. Thematic analysis was applied to interview transcripts.
Results
Participants mostly reported reduced libido (83.9%) and erectile dysfunction (ED(80.6%), with over half (58.0%) experiencing multiple SDs concurrently. Themes regarding SD care experiences were (1) costs and benefits of ED medication, (2) limited benefits of testosterone replacement therapy, (3) mixed views on talk therapy (and a preference for group therapy), and (4) not seeking care due to questions of SD definition and normalcy. SD care preferences concerned both provider characteristics (identity, approach to patients and expertise) and care delivery (information provision, involvement and respect and access to diverse resources).
Conclusions
Irrespective of the approach to SD care sought (medication or talk therapy), participants experienced limited success. For some, doubts about the severity of their SD impeded help-seeking. SD care preferences for the provider (e.g., expertise) and care provided (e.g., information, patient involvement) offer paths to more patient-centred care.
{"title":"Sexual dysfunction care needs of gay, bisexual, and other men who have sex with men living with HIV in Montreal, Canada","authors":"Francesco Avallone, Kim Engler, Ford Hickson, Joseph Cox, Eric Fortin, Sean Yaphe, Bertrand Lebouché","doi":"10.1111/hiv.70115","DOIUrl":"10.1111/hiv.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Sexual dysfunction (SD) is common among gay, bisexual and other men who have sex with men (GBM) with HIV, yet little is known about their views on SD care. We explored these views to inform patient-centred SD care to improve care delivery and sexual health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted in 2024 with 31 Montreal-based GBM with HIV who experienced SD in the last 5 years (reduced libido, erectile dysfunction, premature/delayed ejaculation and/or pain during sex), covering SD care experiences and preferences. Thematic analysis was applied to interview transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants mostly reported reduced libido (83.9%) and erectile dysfunction (ED(80.6%), with over half (58.0%) experiencing multiple SDs concurrently. Themes regarding SD care experiences were (1) costs and benefits of ED medication, (2) limited benefits of testosterone replacement therapy, (3) mixed views on talk therapy (and a preference for group therapy), and (4) not seeking care due to questions of SD definition and normalcy. SD care preferences concerned both provider characteristics (identity, approach to patients and expertise) and care delivery (information provision, involvement and respect and access to diverse resources).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Irrespective of the approach to SD care sought (medication or talk therapy), participants experienced limited success. For some, doubts about the severity of their SD impeded help-seeking. SD care preferences for the provider (e.g., expertise) and care provided (e.g., information, patient involvement) offer paths to more patient-centred care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"74-85"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesca Farina, Aurgho Datta, Suzanne N. Morin, Sahar Saeed, Bertrand Lebouche, Giovanni Guaraldi, Salvatore Petta, Giada Sebastiani
Objectives
Despite effective antiretroviral therapy (ART), chronic liver diseases remain a leading cause of morbidity and mortality among people with HIV, with metabolic dysfunction–associated steatotic liver disease (MASLD) now the predominant etiology. Vitamin D deficiency is also highly prevalent in this population. We synthesize current evidence on the interplay between HIV, liver disease, and vitamin D deficiency, and highlight implications for risk stratification and therapeutic research in this population.
Methods
A targeted PubMed search was conducted using terms for HIV, liver disease, fibrosis, and vitamin D, supplemented by reference screening. We prioritized peer-reviewed studies and guidelines addressing liver disease epidemiology and mechanisms in people with HIV, vitamin D biology, and associations between vitamin D status and hepatic injury. Comparative data from non-HIV populations were also reviewed.
Results
People with HIV face a high burden for chronic liver diseases due to MASLD, viral hepatitis coinfections, and hepatotoxic exposures such as alcohol and ART. Pathogenesis involve persistent immune activation, hepatic stellate cell activation, and systemic inflammation. Vitamin D deficiency is frequent in people with HIV and, in non-HIV populations, correlates with higher prevalence of MASLD and fibrosis. Emerging evidence suggests plausible links through immune modulation, oxidative stress, and fibrogenesis, though causality remains unproven.
Conclusions
The intersection of HIV, MASLD, and vitamin D deficiency is biologically plausible and clinically relevant yet underexplored. Longitudinal studies with standardized MASLD phenotyping and vitamin D assessment are warranted. Meanwhile, integrating metabolic risk assessment with vitamin D evaluation may support more holistic liver care in people with HIV, while interventional trials should clarify whether vitamin D optimization improves hepatic and extrahepatic outcomes.
{"title":"Intersections of vitamin D deficiency, HIV and chronic liver diseases","authors":"Francesca Farina, Aurgho Datta, Suzanne N. Morin, Sahar Saeed, Bertrand Lebouche, Giovanni Guaraldi, Salvatore Petta, Giada Sebastiani","doi":"10.1111/hiv.70117","DOIUrl":"10.1111/hiv.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Despite effective antiretroviral therapy (ART), chronic liver diseases remain a leading cause of morbidity and mortality among people with HIV, with metabolic dysfunction–associated steatotic liver disease (MASLD) now the predominant etiology. Vitamin D deficiency is also highly prevalent in this population. We synthesize current evidence on the interplay between HIV, liver disease, and vitamin D deficiency, and highlight implications for risk stratification and therapeutic research in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A targeted PubMed search was conducted using terms for HIV, liver disease, fibrosis, and vitamin D, supplemented by reference screening. We prioritized peer-reviewed studies and guidelines addressing liver disease epidemiology and mechanisms in people with HIV, vitamin D biology, and associations between vitamin D status and hepatic injury. Comparative data from non-HIV populations were also reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>People with HIV face a high burden for chronic liver diseases due to MASLD, viral hepatitis coinfections, and hepatotoxic exposures such as alcohol and ART. Pathogenesis involve persistent immune activation, hepatic stellate cell activation, and systemic inflammation. Vitamin D deficiency is frequent in people with HIV and, in non-HIV populations, correlates with higher prevalence of MASLD and fibrosis. Emerging evidence suggests plausible links through immune modulation, oxidative stress, and fibrogenesis, though causality remains unproven.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The intersection of HIV, MASLD, and vitamin D deficiency is biologically plausible and clinically relevant yet underexplored. Longitudinal studies with standardized MASLD phenotyping and vitamin D assessment are warranted. Meanwhile, integrating metabolic risk assessment with vitamin D evaluation may support more holistic liver care in people with HIV, while interventional trials should clarify whether vitamin D optimization improves hepatic and extrahepatic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"4-17"},"PeriodicalIF":3.2,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091640","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}
Jason M. Lo Hog Tian, James R. Watson, Alex Tran, Robert G. Maunder, Janet A. Parsons, Bulent Turan, Mallory O. Johnson, Anthony R. Boni, Arthur Dave Miller, Danita Wahpoosewyan, Deborah Norris, George Da Silva, Kim Samson, Lynne Cioppa, Patricia Ukoli, Adrian Betts, Apondi J. Odhiambo, Catherine Pearl, Gordon Arbess, Jared Star, Jennifer Demchuk, Kristin McBain, Sean B. Rourke
Objective
To determine the moderating effect of healthcare empowerment on the relationship between enacted, internalized and anticipated stigma and self-rated health.
Methods
Participants (n = 1318) were recruited to complete the People Living with HIV Stigma Index, a community-based cross-sectional survey administered across all provinces in Canada from August 2018 to October 2024. The survey contained externally validated quantitative scales measuring stigma, healthcare empowerment and health. Healthcare empowerment was broken down into subscales of Informed, Committed, Collaborative, and Engaged (ICCE) and Tolerance of Uncertainty (TU). Moderation models were created for each type of stigma as the antecedent, healthcare empowerment (total, ICCE and TU) as the moderator, and self-rated health as the outcome.
Results
Total healthcare empowerment was a significant moderator for the relationship between enacted (b = 0.11, 95% CI: 0.00, 0.23) and internalized (b = 0.23, 95% CI: 0.09, 0.37) stigma and self-rated health. The ICCE subscale was a significant moderator for the relationship between internalized (b = 0.20, 95% CI: 0.08, 0.33) and anticipated (b = 0.17, 95% CI: 0.04, 0.31) stigma and self-rated health. Overall, for those with low levels of healthcare empowerment, greater enacted and internalized stigma resulted in worse self-rated health; however, high levels of healthcare empowerment buffered the negative impact of stigma.
Conclusion
Healthcare empowerment may have the potential to buffer or mitigate the negative effect of stigma. Understanding how to bolster levels of healthcare empowerment, specifically dimensions of ICCE, may be important for the development of interventions aiming to reduce the impact of stigma for people living with HIV.
{"title":"The moderating effect of healthcare empowerment on the relationship between stigma and self-rated health in people living with HIV in Canada","authors":"Jason M. Lo Hog Tian, James R. Watson, Alex Tran, Robert G. Maunder, Janet A. Parsons, Bulent Turan, Mallory O. Johnson, Anthony R. Boni, Arthur Dave Miller, Danita Wahpoosewyan, Deborah Norris, George Da Silva, Kim Samson, Lynne Cioppa, Patricia Ukoli, Adrian Betts, Apondi J. Odhiambo, Catherine Pearl, Gordon Arbess, Jared Star, Jennifer Demchuk, Kristin McBain, Sean B. Rourke","doi":"10.1111/hiv.70108","DOIUrl":"10.1111/hiv.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the moderating effect of healthcare empowerment on the relationship between enacted, internalized and anticipated stigma and self-rated health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 1318) were recruited to complete the People Living with HIV Stigma Index, a community-based cross-sectional survey administered across all provinces in Canada from August 2018 to October 2024. The survey contained externally validated quantitative scales measuring stigma, healthcare empowerment and health. Healthcare empowerment was broken down into subscales of Informed, Committed, Collaborative, and Engaged (ICCE) and Tolerance of Uncertainty (TU). Moderation models were created for each type of stigma as the antecedent, healthcare empowerment (total, ICCE and TU) as the moderator, and self-rated health as the outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total healthcare empowerment was a significant moderator for the relationship between enacted (<i>b</i> = 0.11, 95% CI: 0.00, 0.23) and internalized (<i>b</i> = 0.23, 95% CI: 0.09, 0.37) stigma and self-rated health. The ICCE subscale was a significant moderator for the relationship between internalized (<i>b</i> = 0.20, 95% CI: 0.08, 0.33) and anticipated (<i>b</i> = 0.17, 95% CI: 0.04, 0.31) stigma and self-rated health. Overall, for those with low levels of healthcare empowerment, greater enacted and internalized stigma resulted in worse self-rated health; however, high levels of healthcare empowerment buffered the negative impact of stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Healthcare empowerment may have the potential to buffer or mitigate the negative effect of stigma. Understanding how to bolster levels of healthcare empowerment, specifically dimensions of ICCE, may be important for the development of interventions aiming to reduce the impact of stigma for people living with HIV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 11","pages":"1727-1738"},"PeriodicalIF":3.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069463","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}
When using long-acting injectable cabotegravir and rilpivirine (CAB + RPV) in individuals with viraemia, beyond small cohorts, little is known about baseline characteristics, virological failure outcomes, resistance emergence, re-suppression and discontinuation.
Methods
We identified evidence from PubMed, EMBASE, Cochrane and conference abstract databases through 17 March 2025 to synthesize data from observational cohort studies (OCS) that reported on virological failure (VF) events in individuals with viraemia at initiation of LA-I CAB + RPV. We extracted data on baseline clinical and socio-demographic characteristics, VF, resistance-associated mutations (RAMs) at VF, post-VF regimen choice, re-suppression and discontinuation.
Results
Across 14 cohorts including 561 individuals, there were 36 VF events (OCS-level VF rate 0% (n/N = 0/12, 0/12 and 0/10) to 25% (n/N = 3/12)). VF definitions varied. 6/14 OCS (n = 436) reported on baseline CD4 count, 13/14 (n = 543) on baseline viral load and 7/14 (n = 459) on socio-demographic characteristics. Among the 14 VF events with genotypic information available at VF, NNRTI RAMs were identified in 13/14 individuals, INI RAMs in 9/14 and dual-class resistance in 8/14 individuals. Post-VF regimens were reported for 16/36 individuals with VF and included lenacapavir (LEN)-based regimens, protease inhibitor (PI)-based regimens or LA-I CAB + RPV continuation. Re-suppression outcomes were described in 10 VF events: re-suppression occurred in 5/10.
Conclusions
In OCS, the follow-up duration was short and VF definitions were highly variable, with few cohorts reporting VF outcomes in people with baseline VL >10 000 c/mL. VF was frequently accompanied by resistance. Post-VF regimens varied, and their success was unclear due to the small sample size.
{"title":"Outcomes of real-world initiation of long-acting injectable cabotegravir and rilpivirine (LA-I CAB + RPV) in individuals with viraemia: A systematic review of baseline characteristics, virological failure outcomes and discontinuations","authors":"Alexa Elias, Chloé Pasin, Melanie Smuk, Amy Paterson, Chloe M. Orkin","doi":"10.1111/hiv.70113","DOIUrl":"10.1111/hiv.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>When using long-acting injectable cabotegravir and rilpivirine (CAB + RPV) in individuals with viraemia, beyond small cohorts, little is known about baseline characteristics, virological failure outcomes, resistance emergence, re-suppression and discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified evidence from PubMed, EMBASE, Cochrane and conference abstract databases through 17 March 2025 to synthesize data from observational cohort studies (OCS) that reported on virological failure (VF) events in individuals with viraemia at initiation of LA-I CAB + RPV. We extracted data on baseline clinical and socio-demographic characteristics, VF, resistance-associated mutations (RAMs) at VF, post-VF regimen choice, re-suppression and discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 14 cohorts including 561 individuals, there were 36 VF events (OCS-level VF rate 0% (<i>n</i>/<i>N</i> = 0/12, 0/12 and 0/10) to 25% (<i>n</i>/<i>N</i> = 3/12)). VF definitions varied. 6/14 OCS (<i>n</i> = 436) reported on baseline CD4 count, 13/14 (<i>n</i> = 543) on baseline viral load and 7/14 (<i>n</i> = 459) on socio-demographic characteristics. Among the 14 VF events with genotypic information available at VF, NNRTI RAMs were identified in 13/14 individuals, INI RAMs in 9/14 and dual-class resistance in 8/14 individuals. Post-VF regimens were reported for 16/36 individuals with VF and included lenacapavir (LEN)-based regimens, protease inhibitor (PI)-based regimens or LA-I CAB + RPV continuation. Re-suppression outcomes were described in 10 VF events: re-suppression occurred in 5/10.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In OCS, the follow-up duration was short and VF definitions were highly variable, with few cohorts reporting VF outcomes in people with baseline VL >10 000 c/mL. VF was frequently accompanied by resistance. Post-VF regimens varied, and their success was unclear due to the small sample size.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"42-57"},"PeriodicalIF":3.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051286","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}
William R. Short, Corinne Willame, Henry Nguyen, Bohui Zhang, Ping Xu, Eileen Birmingham, Rodica Van Solingen-Ristea, Bryan Baugh
Introduction
The Antiretroviral Pregnancy Registry (APR) is designed to detect major teratogenic effects of antiretroviral medications; other pregnancy outcomes are also recorded when reported. We compared available pregnancy and birth outcomes of women exposed to oral rilpivirine-containing regimens (oral-RPV cohort) versus non-rilpivirine regimens (non-RPV cohort) over the period 2011 to 2023.
Methods
Maternal age-adjusted prevalence ratio (aPR) of pregnancy and birth outcomes was compared for prospectively reported pregnancies; aPR of birth defects was compared between first-trimester exposures and combined second/third-trimester exposures.
Results
In total, 6937 pregnancies were recorded, including 4617 (oral-RPV cohort, 781 [16.9%]; non-RPV cohort, 3836 [83.1%]) from the United States. Among live births, the prevalence of birth defects was lower in the oral-RPV cohort (1.6% versus 3.8%; aPR: 0.4 [95% confidence interval (CI): 0.2–0.8]). The prevalence of birth defects in the first-trimester oral-RPV exposure versus second/third-trimester exposure did not differ (aPR: 3.4 [95% CI: 0.4–26.3]). The aPR of induced abortions (1.1 [0.6–1.9]), stillbirths (0.6 [0.2–1.6]) and premature birth (0.8 [0.7–1.1]) were similar between cohorts. Prevalences for spontaneous abortion were 5.8% (oral-RPV cohort) versus 3.2% (non-RPV cohort) below the expected background rate (15%–20%). Low birth weights were less reported in oral-RPV, while very low birth weights were similar between cohorts.
Conclusions
Review of available data from the APR does not indicate an association between adverse pregnancy or birth outcomes and oral-RPV exposure, overall or by timing of exposure. Since APR targets primarily teratogenic effects, findings for non-teratogenic effects should be interpreted with caution.
{"title":"Evaluating birth outcomes following oral rilpivirine use in pregnancy in the United States: Findings from the antiretroviral pregnancy registry","authors":"William R. Short, Corinne Willame, Henry Nguyen, Bohui Zhang, Ping Xu, Eileen Birmingham, Rodica Van Solingen-Ristea, Bryan Baugh","doi":"10.1111/hiv.70112","DOIUrl":"10.1111/hiv.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Antiretroviral Pregnancy Registry (APR) is designed to detect major teratogenic effects of antiretroviral medications; other pregnancy outcomes are also recorded when reported. We compared available pregnancy and birth outcomes of women exposed to oral rilpivirine-containing regimens (oral-RPV cohort) versus non-rilpivirine regimens (non-RPV cohort) over the period 2011 to 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Maternal age-adjusted prevalence ratio (aPR) of pregnancy and birth outcomes was compared for prospectively reported pregnancies; aPR of birth defects was compared between first-trimester exposures and combined second/third-trimester exposures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 6937 pregnancies were recorded, including 4617 (oral-RPV cohort, 781 [16.9%]; non-RPV cohort, 3836 [83.1%]) from the United States. Among live births, the prevalence of birth defects was lower in the oral-RPV cohort (1.6% versus 3.8%; aPR: 0.4 [95% confidence interval (CI): 0.2–0.8]). The prevalence of birth defects in the first-trimester oral-RPV exposure versus second/third-trimester exposure did not differ (aPR: 3.4 [95% CI: 0.4–26.3]). The aPR of induced abortions (1.1 [0.6–1.9]), stillbirths (0.6 [0.2–1.6]) and premature birth (0.8 [0.7–1.1]) were similar between cohorts. Prevalences for spontaneous abortion were 5.8% (oral-RPV cohort) versus 3.2% (non-RPV cohort) below the expected background rate (15%–20%). Low birth weights were less reported in oral-RPV, while very low birth weights were similar between cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Review of available data from the APR does not indicate an association between adverse pregnancy or birth outcomes and oral-RPV exposure, overall or by timing of exposure. Since APR targets primarily teratogenic effects, findings for non-teratogenic effects should be interpreted with caution.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"27 1","pages":"33-41"},"PeriodicalIF":3.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040013","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}
Fahmida Shaik, Thomas Smith Uldrick, Mikateko Mazinu, Nomonde Gwebushe, Anisa Mosam
Introduction
Quality of life (QOL) is an essential component of care in people with HIV-associated Kaposi sarcoma (HIV-KS). Kaposi sarcoma herpes virus (KSHV) promotes cytokine expression and a dysfunctional inflammatory environment, contributing to KS pathogenesis and progression. However, disease-related inflammatory factors influencing QOL and symptoms remain underexplored. This study examines the relationship between baseline QOL parameters and inflammatory cytokine biomarkers in treatment-naïve Africans with HIV-KS participating in the randomized controlled KAART study. We hypothesized that inflammatory cytokines are linked with reduced QOL and symptom burden.
Methods
Twenty-eight cytokines were measured from stored baseline serum using the Milliplex® multiplex assay. QOL was assessed using the validated EORTC QLQ-C30. Spearman Rho-Rank correlation was used to assess relationships between cytokine levels and QOL parameters, with p ≤ 0.01 considered statistically significant.
Results
Paired cytokine and QOL data were available for 68 participants. IL-8 showed significant negative correlations with summary scores, a reliable indicator of overall QOL (rs = −0.35, p = 0.005). Increased IL-8 also correlated significantly with reduced emotional functioning scales (rs = −0.33, p = 0.01) and increased pain (rs = 0.32, p = 0.01). By contrast, increased IL-10 correlated significantly with reduced pain (rs = −0.31, p = 0.01). VEGF and MCP-1 levels correlated negatively with role functioning (rs = −0.32, p = 0.01; rs = −0.30, p = 0.01).
Conclusion
IL-8 is a key cytokine affecting QOL in HIV-KS. Elevations have a negative impact on pain, emotional functioning and overall QOL. IL-10, VEGF and MCP-1 perturbations also impact QOL. These findings enhance understanding of cytokine involvement in KS pathogenesis.
生活质量（QOL）是hiv相关卡波西肉瘤（HIV-KS）患者护理的重要组成部分。卡波西肉瘤疱疹病毒（KSHV）促进细胞因子表达和功能失调的炎症环境，促进KS的发病和进展。然而，影响生活质量和症状的疾病相关炎症因素仍未得到充分探讨。本研究探讨了参与随机对照KAART研究的treatment-naïve非洲HIV-KS患者的基线生活质量参数与炎症细胞因子生物标志物之间的关系。我们假设炎症细胞因子与生活质量降低和症状负担有关。方法：使用Milliplex®多重检测法从储存的基线血清中检测28种细胞因子。使用经验证的EORTC QLQ-C30评估生活质量。采用Spearman Rho-Rank相关评价细胞因子水平与生活质量参数的关系，p≤0.01认为有统计学意义。结果：获得68例受试者的配对细胞因子和生活质量数据。IL-8与综合评分呈显著负相关（rs = -0.35, p = 0.005），综合评分是总体生活质量的可靠指标。IL-8的升高与情绪功能量表的降低（rs = -0.33, p = 0.01）和疼痛的增加（rs = 0.32, p = 0.01）也显著相关。相比之下，IL-10升高与疼痛减轻显著相关（rs = -0.31, p = 0.01）。VEGF和MCP-1水平与角色功能呈负相关（rs = -0.32, p = 0.01; rs = -0.30, p = 0.01）。结论：IL-8是影响HIV-KS患者生活质量的关键细胞因子。血压升高对疼痛、情绪功能和总体生活质量有负面影响。IL-10、VEGF和MCP-1的扰动也会影响生活质量。这些发现增强了对细胞因子参与KS发病机制的理解。
{"title":"Cytokine biomarkers and their relationship to symptoms and quality of life in people with HIV-associated Kaposi sarcoma","authors":"Fahmida Shaik, Thomas Smith Uldrick, Mikateko Mazinu, Nomonde Gwebushe, Anisa Mosam","doi":"10.1111/hiv.70107","DOIUrl":"10.1111/hiv.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Quality of life (QOL) is an essential component of care in people with HIV-associated Kaposi sarcoma (HIV-KS). Kaposi sarcoma herpes virus (KSHV) promotes cytokine expression and a dysfunctional inflammatory environment, contributing to KS pathogenesis and progression. However, disease-related inflammatory factors influencing QOL and symptoms remain underexplored. This study examines the relationship between baseline QOL parameters and inflammatory cytokine biomarkers in treatment-naïve Africans with HIV-KS participating in the randomized controlled KAART study. We hypothesized that inflammatory cytokines are linked with reduced QOL and symptom burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-eight cytokines were measured from stored baseline serum using the Milliplex® multiplex assay. QOL was assessed using the validated EORTC QLQ-C30. Spearman Rho-Rank correlation was used to assess relationships between cytokine levels and QOL parameters, with <i>p</i> ≤ 0.01 considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Paired cytokine and QOL data were available for 68 participants. IL-8 showed significant negative correlations with summary scores, a reliable indicator of overall QOL (<i>r</i><sub><i>s</i></sub> = −0.35, <i>p</i> = 0.005). Increased IL-8 also correlated significantly with reduced emotional functioning scales (<i>r</i><sub><i>s</i></sub> = −0.33, <i>p</i> = 0.01) and increased pain (<i>r</i><sub><i>s</i></sub> = 0.32, <i>p</i> = 0.01). By contrast, increased IL-10 correlated significantly with reduced pain (<i>r</i><sub><i>s</i></sub> = −0.31, <i>p</i> = 0.01). VEGF and MCP-1 levels correlated negatively with role functioning (<i>r</i><sub><i>s</i></sub> = −0.32, <i>p</i> = 0.01; <i>r</i><sub><i>s</i></sub> = −0.30, <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IL-8 is a key cytokine affecting QOL in HIV-KS. Elevations have a negative impact on pain, emotional functioning and overall QOL. IL-10, VEGF and MCP-1 perturbations also impact QOL. These findings enhance understanding of cytokine involvement in KS pathogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":"26 12","pages":"1983-1993"},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hiv.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029508","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}
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