To evaluate the effects of long-term combination antiretroviral therapy (cART) on carotid artery lesions, cardiac structure/hemodynamics, and dyslipidemia in HIV-infected patients via multimodal ultrasound, and explore independent risk factors for cardiovascular comorbidities, with adjustment for key confounding factors such as age and CD4 + T-cell count. A cross-sectional study included 100 HIV-infected patients, divided into a cART-treated group (58 cases, receiving standardized cART for ≥ 3 years) and an untreated group (42 cases, no antiretroviral therapy since diagnosis). Multimodal ultrasound was applied to measure carotid intima-media thickness (IMT), plaque characteristics, vascular hemodynamic parameters, and cardiac structural/functional indicators. Laboratory tests included lipid profiles, glucose metabolism indices, CD4 + T-cell count, and HIV viral load (VL). Univariate bivariate analysis and multivariate logistic regression analyses (adjusted for age and CD4 + T-cell count) were performed, with P < 0.05 considered statistically significant. Compared with the untreated group, the cART-treated group had higher carotid IMT (0.81 ± 0.03 vs. 0.71 ± 0.03 mm), carotid plaque incidence (37.9
Persistent systemic inflammation in people living with HIV (PLWH) is associated with non-AIDS comorbidities despite virologically suppressive antiretroviral therapy (ART). The transforming growth factor-β (TGF-β)/Smad signaling pathway is a central immunoregulatory axis; however, its potential coordination with peripheral blood mononuclear cell (PBMC)-derived microRNA (miRNA) expression and the mechanistic associations with monocyte activation and hepatic inflammation remain uncharacterized. In this exploratory cross-sectional study (n = 70; 33 PLWH, 37 HIV-negative controls), serum TGF-β1, soluble CD14 (sCD14), C-reactive protein (CRP), and interferon-γ-inducible protein 10 (IP-10/CXCL10) were quantified by enzyme-linked immunosorbent assay (ELISA); Smad2/3/4/7 and TGFβ-R1/R2 mRNA by quantitative reverse transcription PCR (RT-qPCR); and eight PBMC-derived miRNAs by RT-qPCR. Age- and sex-adjusted multivariable linear regression and partial Spearman rank correlation analyses, stratified by HIV status, were performed. PLWH-only multivariable sensitivity models additionally adjusted for age, sex, CD4 + T-cell count, and ART duration. PLWH exhibited significantly elevated sCD14 [10.56 (10.11, 10.81) vs. 9.61 (9.31, 9.89) log2 ng/mL; p < 0.001; r_rb = + 0.78] and downregulated TGF-β1 [3.44 (2.14, 3.89) vs. 4.61 (4.04, 5.09) log2 ng/mL; p < 0.001; r_rb = − 0.62] and Smad4 mRNA (p = 0.013; r_rb = − 0.35). Three PBMC-derived miRNAs were significantly upregulated in PLWH: miR-7-5p, miR-9-5p, and miR-519d-3p (all p ≤ 0.030). Stratified correlation analysis showed that the miRNA–TGF-β/Smad correlation structure was reorganized in PLWH relative to controls, with Smad2-anchored miRNA networks predominating in PLWH and Smad3-anchored networks in controls. Age- and sex-adjusted regression indicated that miR-519d-3p was inversely associated with TGF-β1 (p = 0.044), and that lower Smad3 and TGFβ-R2 levels were linked to elevated CRP (β = −0.54; p = 0.020 and β = −0.61; p = 0.027). Four PBMC-derived miRNAs (miR-519d-3p, miR-7-5p, miR-103a-3p, miR-9-5p) were positively associated with sCD14 (β = 0.11–0.13; all p ≤ 0.019) in the full analytical sample. In PLWH-only multivariable sensitivity models, the TGFβ-R2–CRP association persisted (β = −0.94; p = 0.015), whereas the sCD14–miRNA associations were attenuated. Coordinated PBMC-derived miRNA dysregulation was associated with two hypothesis-generating inflammatory patterns in the full analytical sample: TGF-β/Smad attenuation linked to CRP elevation, with PLWH-only multivariable support for the TGFβ-R2–CRP association, and PBMC-derived miRNA associations with monocyte activation (sCD14) that require further validation. These findings warrant validation in larger longitudinal cohorts with comprehensive clinical metadata and cell-type-resolved functional assays.
Antiretroviral therapy (ART) has revolutionized the management of HIV/AIDS, yet the emergence of drug resistance mutations remains a significant concern. This study aimed to characterize drug resistance mutations among patients failing first-line antiretroviral treatment in Ethiopia. A total of 52 HIV-infected patients who experienced first-line ART failure were recruited between March 2020 - March 2021 from selected hospitals of Amhara and Oromiya regions. The viral load was measured by Abbott Real-Time HIV-1 automated extraction and detection m2000 system platform (Abbott Molecular Inc., Des Plaines, IL, USA). The partial pol gene region of HIV-1 was amplified and sequenced using an in-house HIV − 1 drug resistance assay. The Stanford HIVDB v9.0 algorithm, and the Calibrated Population Resistance (CPR) Tool and the IAS-USA mutation lists were used to identify mutations conferring resistance. A total of 52 HIV-positive individuals met the study’s inclusion criteria. Genotypic analysis revealed a diverse spectrum of resistance mutations, with the prevalence of potential drug resistance (PDR) reaching 46.2
An estimated 40.8 million people of all ages worldwide were living with human immunodeficiency virus (HIV) as of the end of 2024. The conduct and advancement of HIV vaccine trials is contingent upon successful participant recruitment and messaging. This study examined the current recruitment landscape and communication strategies for a future HIV vaccine using first-hand accounts of recruitment staff at various HIV Vaccine Trials Network (HVTN) sites in the United States. We conducted key informant in-depth interviews with eleven researchers at various HVTN sites between September 2024 and January 2025. We analyzed the qualitative data using Rapid Assessment Procedures to efficiently identify content and gaps in data, and comparison of similarities and differences across participants. We identified emergent themes after the iterative process and extracted salient quotes to illustrate each theme. Analyses revealed that effective recruitment entails: (1) multifaceted and layered approaches, including in-person and digital outreach approaches, across different broadcast mediums, venues, and online sites; (2) tailoring of strategies to specific cultural and identity groups, and (3) building trust in the community about the research. However, recruitment is hindered by HIV stigma and vaccine misconceptions. Researchers highlighted the importance of using plain language to describe a future HIV vaccine and recommend positioning vaccine campaigns as universal prevention initiatives to emphasize that HIV prevention is relevant to all individuals, rather than being associated with specific demographic groups. Insights from researchers’ recruitment experiences can strengthen HIV vaccine trials and be used to craft compelling messages that position the vaccine as part of a comprehensive set of HIV prevention strategies.
The population of people living with HIV (PLHIV) aged ≥ 50 years is rapidly increasing worldwide, accompanied by a growing burden of chronic comorbidities. This study explored multimorbidity patterns and associated factors among older PLHIV according to HIV transmission category in China. A cross-sectional survey was conducted among PLHIV aged ≥ 50 years receiving antiretroviral therapy (ART) in Chongqing and Jiamusi, China, between April and September 2023. Demographic characteristics, HIV-related factors, and 16 predefined comorbidities were collected. Logistic regression, association rule mining, and network analysis were used to identify factors associated with multimorbidity and characterize comorbidity clustering patterns. Among 504 participants, 205 (40.7
A significant proportion of HIV infections in infants results from vertical transmission, largely due to inadequate maternal knowledge of mother-to-child transmission (MTCT) and its prevention. Although several global studies have assessed women’s MTCT knowledge, nationally representative evidence from Somalia remains limited. This study addresses this gap by examining factors associated with comprehensive knowledge of MTCT of HIV among currently married women aged 15–49 years in Somalia. Multivariable logistic regression was used to examine the association between comprehensive MTCT knowledge of HIV and sociodemographic factors using data from the 2018–2019 SDHS. Overall, 66.67
With the widespread use of antiretroviral therapy (ART), HIV infection has gradually become a chronic condition requiring long-term management. Patient activation plays an important role in promoting effective self-management and improving health outcomes among people living with HIV. However, limited evidence exists regarding patient activation and its psychosocial determinants among men who have sex with men (MSM) living with HIV in China. This study aimed to investigate the level of patient activation and explore its associated psychosocial factors in this population. A single-center cross-sectional study was conducted using convenience sampling. A total of 303 MSM living with HIV attending the Department of Infectious Diseases at the Second Hospital of Nanjing between December 2025 and February 2026 were recruited. Data were collected using a General Information Questionnaire, the Patient Activation Measure-13 (PAM-13), the Berger HIV Stigma Scale-12 (BHSS-12), the Connor–Davidson Resilience Scale (CD-RISC), and the Social Support Rating Scale (SSRS). Pearson correlation analysis, univariate analysis, and hierarchical multiple linear regression analysis were performed to examine factors associated with patient activation. The mean patient activation score among MSM living with HIV was 55.68 ± 9.62, corresponding to Level 3, and indicating a moderate-to-high level of activation. Pearson correlation analysis showed that patient activation was negatively correlated with HIV-related stigma (r = − 0.553, P < 0.01) and positively correlated with psychological resilience (r = 0.495, P < 0.01) and social support (r = 0.544, P < 0.01). Hierarchical multiple linear regression analysis indicated that duration since HIV diagnosis, number of comorbidities, disclosure of HIV status to others, HIV-related stigma, psychological resilience, and social support were significantly associated with patient activation (all P < 0.05). The final model explained 60.5
Tuberculosis (TB) remains the most common opportunistic infection among people living with HIV (PLWH). Dysregulated cytokine responses during HIV/TB co-infection may contribute to immune dysfunction and disease progression. However, the longitudinal dynamics of cytokine profiles and their associations with clinical indicators during treatment remain incompletely understood. In this prospective exploratory longitudinal study, we enrolled 24 patients with HIV/TB co-infection, 24 patients with HIV monoinfection, and 24 healthy controls. Serum concentrations of seven cytokines, including IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, and IFN-γ, as well as routine clinical indicators, were measured at baseline and on days 7, 14, 21, 30, 60, 90, and 180 after treatment initiation. Longitudinal changes were analyzed using linear mixed-effects models, and associations between cytokines and clinical indicators were assessed using exploratory Spearman’s rank correlation analysis. At baseline, patients with HIV/TB co-infection showed evidence of immune and inflammatory alterations, with higher NEUT, NEUT
Hyperuricemia is an emerging metabolic complication among people living with HIV in the era of antiretroviral therapy (ART), yet evidence from sub-Saharan Africa remains limited. A cross-sectional study was conducted at the LRRH Infectious Disease Centre between December 2024 and March 2025. A total of 385 adults living with HIV were selected using systematic sampling. Data were collected on sociodemographic, clinical, behavioral, and biochemical variables through interviews, physical examination, and laboratory testing. Serum uric acid, lipid profile, creatinine, and blood pressure were measured. Hyperuricemia was defined as serum uric acid > 7.0 mg/dL in males and > 6.0 mg/dL in females. Logistic regression was used to identify associated factors. Cardiovascular risk was assessed using the Framingham Risk Score (FRS). The prevalence of hyperuricemia was 21.8
The scale-up of antiretroviral therapy (ART) in China has increased concern regarding HIV-1 pretreatment drug resistance (PDR), particularly in Guangxi due to high subtype diversity and population mobility. However, the epidemiology and transmission dynamics of PDR in the region remain insufficiently characterized. We assessed PDR prevalence, subtype distribution, and transmission dynamics among ART-naïve individuals in central Guangxi. Between 2018 and 2023, 1,226 newly diagnosed individuals were screened, of whom 1,214 were included after quality control. Drug resistance mutations and subtypes were determined using the Stanford HIV Drug Resistance Database. Molecular transmission networks were constructed using the TN93 model with a genetic distance threshold of < 1.5
As antiretroviral therapy (ART) coverage has matured in sub-Saharan Africa, the clinical profile of people living with HIV has shifted from acute opportunistic disease toward chronic neuropsychiatric morbidity. Few high-volume African HIV programmes have systematically described the full neuropsychiatric diagnostic architecture captured in their routine electronic records. We characterised the neuropsychiatric diagnoses recorded at Mildmay Uganda, an urban HIV centre serving approximately 14,500 active patients. We conducted a descriptive analysis of routinely collected, de-identified electronic health-record data extracted from the ClinicMaster electronic medical record on 25 April 2026. Records with at least one ICD-10-coded neuropsychiatric diagnosis between 31 October 2017 and 23 April 2026 were grouped into nine clinically defined diagnostic categories using a pre-specified code list (Supplementary Table S1). Analyses were conducted at two levels: a record level (all 1,137 records) and a patient-index level (one earliest record per patient, n = 581). The design was cross-sectional and descriptive; no longitudinal follow-up, incidence or time-to-event analyses were undertaken. Proportions are reported with 95
Data on bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with both HIV-1 and HBV are limited, particularly for treatment-experienced people. ALLIANCE was a randomized, double-blind, active-controlled, phase 3 study of B/F/TAF versus dolutegravir (DTG) + emtricitabine/tenofovir disoproxil fumarate (F/TDF) in treatment-naïve adults with HIV-1 RNA ≥ 500 copies/mL and HBV DNA ≥ 2000 IU/mL. Participants received continuous B/F/TAF through 144 weeks (≥ 96 weeks of blinded treatment plus 48-week optional open-label extension [OLE]) or switched to B/F/TAF after ≥ 96 weeks of DTG + F/TDF through 48 weeks of OLE. Here we report outcomes from the OLE. 121 participants were included in the continuous B/F/TAF group; 89 in the switch group. Median B/F/TAF exposure was 186.4 and 48 weeks, respectively. HIV-1 and HBV suppression rates (missing = excluded) were maintained in both groups (B/F/TAF Week 144: 99.0
Boosted atazanavir (ATV/r) is associated with clinical jaundice, which may affect ART adherence. However, the prevalence of clinical jaundice among people on ATV/r and its association with ART adherence is unknown in Uganda. We conducted a cross-sectional study among 236 adult patients on ATV/r at the Infectious Disease Institute. Clinical jaundice was assessed by self-report and observation; ART adherence was measured using the 8-item Morisky scale. Period prevalence of clinical jaundice was 31.8
The contribution of lifestyle factors compared with HIV infection and antiretroviral therapy (ART)-related determinants to Metabolic Syndrome (MetS) in Women with HIV (WWH) remains uncertain. To evaluate the prevalence and determinants of MetS in the era of Integrase Strand Transfer Inhibitors (INSTI). Monocentric retrospective cohort study. We analyzed 297 WWH to assess the prevalence of MetS and its association with HIV-related and lifestyle factors. MetS was diagnosed in 80 women (26
We evaluated the magnitude and function of antibody responses to seasonal influenza vaccination in individuals with HIV receiving ART compared with individuals without HIV. In a prospective cohort of 78 adults, influenza strain-specific IgG levels were measured up to one-year post-vaccination. Linear mixed-effects models assessed longitudinal trends. IgG levels peaked at two weeks and declined gradually in both groups. HIV status did not significantly influence antibody magnitude or neutralizing activity, and H1N1 antibody levels correlated with neutralization titers. These findings demonstrate robust, durable, and functional humoral response in well-controlled HIV, supporting the effectiveness of annual influenza vaccination in this population.
Hypertension is a frequent comorbidity among people living with HIV (PLHIV) in sub-Saharan Africa, but analytical data from routine HIV clinics in Cameroon remain limited. This study assessed factors associated with prevalent hypertension among adults receiving antiretroviral therapy (ART) at an urban HIV clinic in Yaounde, Cameroon. We conducted a cross-sectional study at the Day Hospital of Yaounde Central Hospital between January and March 2024. The analytical dataset included 460 adults living with HIV receiving ART. Prevalent hypertension was coded as a binary outcome. Robust Poisson regression was used to estimate prevalence ratios (PRs) and adjusted prevalence ratios (aPRs) because hypertension was common. Sensitivity models were fitted to clarify the interpretation of cumulative ART duration in relation to current age. Among 460 participants, 199 (43.3
Despite effective antiretroviral therapy (ART), a subset of people living with HIV(PLWH)experiences low-level viremia(LLV), yet its impact on subsequent virologic failure (VF) and immunologic failure (IF) remains unclear. This study aims to elucidate the effect of LLV on the risk of VF and IF. This retrospective cohort study included PLWH aged ≥ 18 years who initiated ART in Qinzhou City, Guangxi, China, from 2005 to 2023. Participants were categorized into mutually exclusive viral load categories: undetectable viral load (≤ 50 copies/mL) and LLV (51–999 copies/mL). Time-updated Cox proportional hazards models were used to evaluate the association between LLV and the risk of VF and IF. A total of 4,274 participants were followed for 12,288.35 person-years, with a median follow-up of 3.03 years. Among these participants, 11.16
Although antiretroviral therapy (ART) has improved life expectancy in people living with HIV (PWH), sustained HIV care remains a critical challenge. The Newly Admitted Patients Program (NAPP), a local Patient-Centered Care (PCC) intervention, was implemented for patients admitted via the HIV clinic. We aimed to evaluate clinical outcomes (loss to follow-up (LTFU), hospitalization, treatment discontinuation (TD), virologic failure, and mortality) among participants in NAPP versus non-participants (No-NAPP). We conducted a retrospective cohort study at a single tertiary-care center, including PWH from January 2015 to December 2023. Participants were followed from enrollment in the HIV clinic to their last visit. Clinical, demographic, and laboratory variables were analyzed, and adjusted logistic regression was used to identify factors associated with clinical outcomes. We included 758 participants: 387 (51.1
While India’s HIV epidemic discloses substantial inter-state heterogeneity, Tamil Nadu (TN) achieved one of the country’s earliest and most sustained reversals in transmission. Once a high-burden state, TN successfully decoupled its trajectory from other high-prevalence southern regions. This review examines the ‘Tamil Nadu Model,’ benchmarking its performance against West Bengal and global high-performers to identify specific drivers of success while comparing it with Karnataka, Maharashtra, and undivided Andhra Pradesh. We synthesized longitudinal data (2000–2024) from HIV Sentinel Surveillance (HSS), IBBS, NACO Spectrum estimates, and NFHS reports. Using a Strategic Blueprints (SB) framework, we analyzed 13 key epidemiological and health-system indicators, including TB-HIV collaborative care. We compared Tamil Nadu’s performance with Karnataka, Maharashtra, undivided Andhra Pradesh, and West Bengal, as well as international benchmarks including Thailand, New South Wales, and KwaZulu-Natal. Tamil Nadu recorded a 94
Caribbean countries are among the most heavily burdened by both human immunodeficiency virus (HIV) and cancer, with prevalent stigmatization of both illnesses. This novel pilot study responds to the need to examine and understand both cancer- and HIV-related stigma among cancer survivors living with HIV (CSLWH). Data were collected via quantitative surveys and administered in person in Trinidad and Tobago. The survey used in this pilot study included an HIV stigma scale and a cancer stigma scale. Descriptive analyses were conducted using IBM SPSS Statistics 29.0.0. For most stigma items, HIV stigma is higher than cancer stigma, especially for personal and relational self-stigma: 95
