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Background: Immune checkpoint inhibitor (ICI) therapy has demonstrated safety and efficacy in a variety of malignancies, including cancers affecting patients with HIV (PWH). However, there is limited data directly comparing outcomes of ICI use between cancer patients with versus without HIV.

Methods: Real-world retrospective data were used to compare clinical outcomes between 24 PWH and cancer and 24 matched cancer patients without HIV, all treated with ICI therapy at a large tertiary cancer center in Florida.

Results: Adverse event rates did not differ by HIV status. Overall response (complete or partial response) to ICI therapy was observed in 29% of PWH compared to 38% of people without HIV (PWoH), but this difference was not statistically significant. The overall survival at end of study follow-up by HIV status was similar between both groups (63% in PWH and 67% in PWoH).

Conclusion: These findings suggest that HIV status alone should not preclude use of ICI therapy to improve prognosis among PWH and cancer.

Objective: Examine the proportion of people with HIV engaging in behaviours associated with hepatitis C virus (HCV) infection after successful direct-acting antiviral (DAA) treatment and establish longitudinal patterns of behavioural risk over time.

Design: Multinational, prospective cohort study (International Collaboration on Hepatitis C Elimination in HIV Cohorts).

Methods: Individuals with HIV successfully treated with DAAs and ≥2 follow-up visits with behavioural data were included. Changes in the proportion of any risk behaviour after treatment, which included sexual and drug use behaviours, were analysed using logistic regression with generalized estimating equations. We identified distinct trajectories of any risk behaviour over time using group-based trajectory models (GBTM).

Results: Of the 1,477 individuals included, 487 (33.0%) were people who inject drugs, 378 (25.6%) were men who have sex with men and 442 (29.9%) were both. During a median 2.7 years (IQR = 1.6-3.9) of follow-up, the proportion engaging in any risk behaviour slightly decreased over time (adjusted odds ratio per half year = 0.97, 95% confidence interval = 0.95-0.99). GBTM revealed four distinct behavioural trajectories: consistently low ( n = 433, 29.3% of total population), moderate at baseline and increasing ( n  = 119, 8.1%), high at baseline and decreasing ( n  = 184, 12.5%) and consistently high ( n  = 741, 50.2%).

Conclusions: Despite slight decreases in behaviours following successful DAA treatment, half of individuals had a consistently high probability of behaviours that put them at risk of HCV reinfection over time. As reinfections comprise a growing proportion of new incident HCV cases, these findings underscore the importance of ongoing primary prevention measures alongside testing and retreatment to eliminate HCV.

Between 2000 and 2019, the Stanford Healthcare Clinical Virology Laboratory performed HIV-1 resistance testing for 9199 individuals in Northern California. Nonsubtype B viruses were identified in 3.5%, most often CRF01_AE (1.0%), subtype C (1.0%), CRF02_AG (0.46%), and subtype A (0.45%). Non-B viruses, particularly CRF01_AE and CRF02_AG, increased significantly over time. Although subtype B remained dominant, the rising presence of non-B subtypes reflects growing viral diversity within the U.S. epidemic.

Introduction: The Global AIDS Strategy 2021-2026 calls for equitable access to HIV services for all populations. Transgender people have been marginalized and experience disproportionate risk of HIV infection in sub-Saharan Africa (SSA) and data to guide HIV programmes are severely limited. Surveillance data among cisgender men who have sex with men (cis-MSM) are comparatively abundant. We assessed whether HIV prevalence among cis-MSM was correlated with HIV prevalence among transgender women.

Methods: Data from key population surveys conducted in SSA between 2010 and 2022 were identified from existing databases and survey reports. Studies that collected HIV prevalence data among both transgender women and cis-MSM populations were analysed with random effect meta-analysis to estimate the ratio of HIV prevalence among cis-MSM:transgender women.

Results: Twenty-one studies were identified encompassing 8476 transgender women and 24 102 cis-MSM. Median HIV prevalence among transgender women was 23.5% [interquartile range (IQR) 11.5-39.8%] and 16.2% (IQR 8.1-26.8%) among cis-MSM. HIV prevalence among transgender women was 50% higher than in cis-MSM [prevalence ratio 1.48, 95% confidence interval (CI) 1.25-1.76]. HIV prevalence among transgender women was highly correlated with year/province-matched HIV prevalence among cis-MSM ( R2  = 0.60), but poorly correlated with year/province-matched total population HIV prevalence ( R2  = 0.01).

Conclusion: Transgender women experience a significantly greater HIV burden than cis-MSM in SSA, underscoring the need for HIV services addressing the disproportionate vulnerability experienced by transgender women. Further bio-behavioural surveys focused on determinants of HIV infection, treatment uptake, and risk behaviours among transgender people, distinct from cis-MSM, will improve understanding of HIV risk and vulnerabilities.

Introduction: To ensure the safe use of preexposure prophylaxis (PrEP) for HIV prevention, the Centers for Disease Control and Prevention (CDC) recommends laboratory testing with specific tests for all individuals before PrEP initiation.

Methods: We analyzed the Merative MarketScan commercial insurance database to assess the use of laboratory testing for HIV antigen/antibody (Ag/Ab), HIV RNA tests, sexually transmitted infections, hepatitis B virus (HBV) infection, and other CDC-recommended testing for persons who initiated PrEP during 2022-2023. We estimated testing rates for each laboratory assay based on its specific recommendation at the time of PrEP initiation, which was defined as the interval extending from 14 days prior to through 14 days following the recorded initiation date.

Results: Among 38 855 persons who initiated PrEP during 2022-2023, only 35.3% had a documented laboratory-based HIV Ag/Ab test during the ±14-day period. Among 757 injectable PrEP users, only 35.4% were tested for HIV RNA during the ±14-day period. Testing rates of other recommended laboratory tests were also low. Persons who were prescribed oral PrEP, who reside in the South and in nonmetropolitan areas had lower testing rates for all laboratory tests.

Conclusion: CDC-recommended laboratory testing was suboptimal at PrEP initiation. Some PrEP users might have been tested for HIV by using only a point-of-care (POC) test to facilitate rapid PrEP initiation despite a recommendation to confirm with a laboratory-based test. Implementation of clinical decision supports with laboratory order sets tailored to each type of PrEP medication could increase adherence to CDC-recommended laboratory testing at PrEP initiation.

Background: There is limited evidence concerning the relationship between cardiometabolic characteristics and health-related quality of life (HRQoL), and potential effects of statin therapy among people with HIV (PWH).

Methods: The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) enrolled PWH aged 40-75 years on antiretroviral therapy (ART) with low-to-moderate ASCVD risk. Coronary computed tomography angiography assessed coronary plaque among a subset of participants in the REPRIEVE Mechanistic Substudy at baseline and 24 months. The Short Form-36-Item Health Survey Version 2 was collected at baseline, and physical (PCS) and mental (MCS) component summary scores were determined. We explored the relationship of PCS and MCS with cardiometabolic characteristics, coronary atherosclerosis, and assessed change in score by treatment group (pitavastatin vs. placebo).

Results: Of 733 participants, median age was 51 years, 84% were male, 34% were Black non-Hispanic, and median years diagnosed with HIV was 15. At baseline, for participants randomized to pitavastatin vs. placebo the median PCS was 54.5 (Q1, Q3: 46.9, 57.7) vs. 54.1 (47.5, 58.0), and the median MCS was 52.9 (44.1, 57.6) vs. 52.8 (44.0, 57.9). In fully adjusted analyses, older age, Black non-Hispanic race/ethnicity, ART regimen class, elevated BMI, and cigarette smoking were associated with lower PCS. No clear trends were apparent with MCS. Between baseline and month 24, declines in PCS and MCS were minimal with no apparent difference by treatment group.

Conclusions: Among this cohort of ART-treated PWH, baseline cardiometabolic risk factors were associated with worse self-reported physical HRQoL, with no apparent effect of statin therapy.

Trial registration: REPRIEVE; NCT02344290; https://clinicaltrials.gov/study/NCT02344290.

Objectives: People with HIV (PWH) are unable to get private disability insurance on a regular basis in contrast with individuals with other chronic diseases. We aimed to estimate the risk of public disability pension and work absence due to sickness for PWH compared with the background population in Denmark.

Design: Nationwide, population-based, matched cohort study of employed PWH with favorable disease characteristics. A comparison cohort of employed individuals was matched 10 : 1 to PWH by date of birth and sex from the general population.

Methods: We computed time to first date of 4 weeks of uninterrupted sick leave, 26 weeks of uninterrupted sick leave, and disability pension being granted. We used Cox regression to obtain hazard ratios (HRs) as a measure of relative risk and competing risk analysis to assess absolute risk.

Results: After 6 months of observation, PWH had an increased risk of 4-week sick leave, 26-week sick leave and disability pension compared with the comparison cohort (HR of 1.1 [95% CI: 1.0-1.2), 1.4 (95% CI: 1.1-1.6) and 2.0 (95% CI: 1.5-2.6), respectively]. These risks were increased in most patient subgroups.

Conclusion: PWH have an increased risk of prolonged sick leave and disability pension, and a slightly increased risk of 4-week sick leave. These risks were within the range of what is described for other chronic diseases. PWH with contemporary cART and favorable disease characteristics should not be generally excluded from access to private disability insurance.

Objective: This study aimed to assess the burden, severity, and pattern of coronary artery disease (CAD) in people with HIV (PWH), as well as its relationship with metabolic syndrome, inflammation, and endothelial dysfunction.

Design: Cross-sectional study.

Methods: A comparative cross-sectional study was conducted on 72 PWH and 72 matched people without HIV at Aminu Kano Teaching Hospital (AKTH), in Kano, northern Nigeria. Data collection included demographics, metabolic parameters, viral load, brachial artery flow-mediated dilation (BAFMD) assessed via ultrasound, and coronary artery calcification (CAC) scores obtained using electrocardiogram (ECG)-gated computed tomography. CAD predictors were analyzed using t tests, linear regression, and chi-squared/Fisher's exact tests ( P  ≤ 0.05).

Results: Among 144 participants (72 PWH, 72 controls), PWH had higher CAD prevalence (31.9 vs. 4.2%, P  < 0.001) and mean CAC scores (23.2 vs. 2.7, P  < 0.001). CAD was significantly associated with longer ART duration ( P  = 0.04), higher BMI ( P  = 0.005), and reduced BAFMD ( P  = 0.020). In controls, hs-CRP predicted CAD ( P  = 0.004).

Conclusion: PWH in northern Nigeria have a higher burden of CAD compared to HIV-negative controls, with greater CAC and endothelial dysfunction, independent of viral load status. These findings highlight the need for routine cardiovascular screening and integration of cardiovascular disease prevention into HIV care.