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Search Results (899)

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Keywords = people living with HIV

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11 pages, 377 KiB  
Article
Coronary Artery Disease in People Living with HIV May Reflect Their Sensitivity to Inflammation Associated with Cytomegalovirus
by Luna-faye Veld, Shelley Waters, Silvia Lee, Anna C. Hearps, Janine Trevillyan, Ari S. Mushin, Damien Foo, Jennifer Hoy and Patricia Price
Pathogens 2025, 14(8), 822; https://doi.org/10.3390/pathogens14080822 (registering DOI) - 20 Aug 2025
Abstract
Cytomegalovirus (CMV) is implicated in cardiovascular disease in healthy adults and after transplantation, but analyses in people living with HIV (PLWH) are difficult as almost all have CMV co-infections. Here, we address whether coronary artery disease (CAD) is associated with levels of CMV-reactive [...] Read more.
Cytomegalovirus (CMV) is implicated in cardiovascular disease in healthy adults and after transplantation, but analyses in people living with HIV (PLWH) are difficult as almost all have CMV co-infections. Here, we address whether coronary artery disease (CAD) is associated with levels of CMV-reactive antibodies or with sensitivity to inflammation associated with CMV. PLWH stable on antiretroviral therapy (ART) with a recent diagnosis of CAD were matched with PLWH without CAD. Plasma samples stored at the time of the CAD event and 6, 12, 24 or 36 months earlier (n = 34–55 per group) were used for analyses. Antibodies reactive with a lysate from CMV infected cells were quantitated using an in-house ELISA, and inflammatory biomarkers were assessed using commercial kits. Bivariate analyses demonstrated similar levels of CMV antibodies in PLWH with and without CAD at all time points (p > 0.5). However, in PLWH with CAD, levels of CMV antibody correlated directly with plasma sCD14, LBP, CXCL10 and/or IL-6 at the earlier points. These correlations were not impacted by detectable plasma HIV RNA. Our findings suggest that individual differences in sensitivity to the inflammatory effects of CMV impact upon the development of CAD. Full article
(This article belongs to the Special Issue Immune Pathways and Mechanisms Involved in Viral Infections)
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10 pages, 257 KiB  
Article
Prevalence and Factors Associated with HIV Testing Among Men Aged 15–54 Years in Kenya—Evidence from the 2022 Demographic and Health Survey
by Ipeleng Caroline Victoria Melato, Alfred Musekiwa and Siphesihle Robin Nxele
Int. J. Environ. Res. Public Health 2025, 22(8), 1291; https://doi.org/10.3390/ijerph22081291 - 18 Aug 2025
Abstract
Sub-Saharan Africa bears the heaviest burden of HIV/AIDS. Kenya alone has an estimated 1.4 million people living with HIV. Therefore, this study determined HIV testing prevalence and associated factors among men aged 15–54 years in Kenya. The study is a secondary data analysis [...] Read more.
Sub-Saharan Africa bears the heaviest burden of HIV/AIDS. Kenya alone has an estimated 1.4 million people living with HIV. Therefore, this study determined HIV testing prevalence and associated factors among men aged 15–54 years in Kenya. The study is a secondary data analysis of the 2022 Kenya Demographic and Health Survey, a nationally representative population-based cross-sectional survey. A multivariable logistic regression model was used to determine factors associated with HIV testing. Survey weights were used to adjust analyses for unequal sampling probabilities. Out of 14,453 men included in the study, the prevalence of self-reported HIV testing was 73.5%, which was higher among men aged 30–34 years old compared to the 15–19 years (90.2% vs. 33.3%), married or living with a partner (89.1% vs. 55.5%), residing in urban areas (82.5% vs. 67.8%), with higher education (90.6% vs. 58.4%), employed (80.5% vs. 43.1%), richest (83.8% vs. 60.4%), and those with three or more sexual partners (81.7% vs. 68.0%) groups. Targeted interventions to encourage more men to participate in regular HIV testing are needed. This can be achieved by bringing HIV testing sites closer to males through HIV self-testing and community testing, particularly home-based testing. Full article
(This article belongs to the Special Issue Progress Toward the UNAIDS 95-95-95 Targets for HIV Care Cascade)
19 pages, 2719 KiB  
Article
Next-Generation Sequencing Analysis for HIV-1 Genotyping and Drug Resistance Mutations Mapping in Sicily, Italy
by Luca Pipitò, Sara Cannella, Chiara Mascarella, Domenico Graceffa, Marcello Trizzino, Chiara Iaria, Pietro Colletti, Giovanni Mazzola, Giovanni M. Giammanco, Antonio Cascio, Celestino Bonura and Sicilian GRT Working Group
Viruses 2025, 17(8), 1129; https://doi.org/10.3390/v17081129 - 18 Aug 2025
Viewed by 53
Abstract
Background: The advent and continuous improvement in antiretroviral therapy (ART) have profoundly altered the clinical course of HIV infection, shifting the focus from AIDS-related complications to the management of age-related comorbidities and non-AIDS-related hospitalizations. In this evolving context, optimizing ART is essential, with [...] Read more.
Background: The advent and continuous improvement in antiretroviral therapy (ART) have profoundly altered the clinical course of HIV infection, shifting the focus from AIDS-related complications to the management of age-related comorbidities and non-AIDS-related hospitalizations. In this evolving context, optimizing ART is essential, with genotypic resistance testing (GRT), particularly through next-generation sequencing (NGS), playing a pivotal role. Methods: This multicenter, retrospective cross-sectional study investigated HIV-1 subtypes, resistance mutations, and drug resistance profiles among 367 people living with HIV (PLWH) in Sicily, based on 384 GRTs performed at the Microbiology Laboratory of the University Hospital of Palermo. Results: Subtype B was the most prevalent (50%), followed by circulating recombinant forms (30%). Among treatment-naïve individuals, resistance-associated mutations were infrequent, with prevalence rates of 0.4% for NRTIs, 5.5% for NNRTIs, 1.3% for PIs, and 0.8% for INIs. Conversely, treatment-experienced individuals showed significantly higher resistance rates, especially to NRTIs (16.3%), NNRTIs (10.6%), and INIs (9.6%). No significant differences in resistance patterns were observed between B and non-B subtypes. Conclusions: This study provides the first regional overview of HIV drug resistance across Sicily. Despite the detection of resistance-associated mutations, the overall prevalence of clinically relevant resistance, particularly to currently recommended therapies, remains low, especially among treatment-naïve individuals. Full article
(This article belongs to the Special Issue Antiviral Resistance Mutations)
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16 pages, 1000 KiB  
Article
Immune Response to Childhood Vaccination in Vertically Infected People Living with HIV: A Long-Term Evaluation
by Annachiara Zin, Elisa Barbieri, Giulia Brigadoi, Andrea Berlese, Lorenzo Chiusaroli, Daniele Mengato, Andrea Francavilla, Carlo Giaquinto, Daniele Donà and Osvalda Rampon
Vaccines 2025, 13(8), 871; https://doi.org/10.3390/vaccines13080871 - 16 Aug 2025
Viewed by 232
Abstract
Background: Despite virological suppression through antiretroviral therapy (ART), people living with HIV (PLHIV) may exhibit inadequate immune responses to vaccination, placing them at continued risk for preventable infectious diseases. Evidence regarding the durability of vaccine-induced immunity in PLHIV with vertically acquired infection remains [...] Read more.
Background: Despite virological suppression through antiretroviral therapy (ART), people living with HIV (PLHIV) may exhibit inadequate immune responses to vaccination, placing them at continued risk for preventable infectious diseases. Evidence regarding the durability of vaccine-induced immunity in PLHIV with vertically acquired infection remains limited. Methods: We conducted a cross-sectional observational study to evaluate humoral immunity to routine childhood vaccines in a cohort of PLHIV with perinatally acquired infection. Antibody titers against diphtheria, tetanus, measles, mumps, rubella, varicella, and hepatitis B (HBV) were retrospectively assessed via serological testing and review of medical records. Seroprotection rates were analyzed at predefined intervals following the completion of the primary immunization schedule. Multivariate analysis was used to explore potential predictors of long-term immune response. Results: A total of 85 individuals were included. Two years after completing the primary vaccination series, seroprotection rates were as follows: diphtheria 71%, tetanus 79%, measles 79%, mumps 67%, rubella 87%, and varicella 54%. Five years post-vaccination, 50–70% of participants maintained protective antibody levels, declining further to 50–58% after ten years. By twenty years, protective immunity dropped below 30% for all antigens except rubella (47%). HBV vaccine responses were notably poor, with only 60%, 37%, 24%, and 7.5% retaining protective anti-HBs titers at 2, 5, 10, and 20 years post-immunization, respectively. Time elapsed since vaccination was the sole significant predictor of seroprotection across all vaccines. Conclusions: In this cohort of vertically infected PLHIV, vaccine-induced immunity was suboptimal and declined markedly over time compared to the general population. These findings highlight the need for tailored immunization strategies, including timely boosters and regular serological monitoring, to maintain long-term protection in this high-risk group. Full article
(This article belongs to the Special Issue Effectiveness and Safety of Vaccines in Special Populations)
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13 pages, 298 KiB  
Article
Socioeconomic, Behavioural, and Protective Factors Influences on the Combined Prevention of HIV Infection Among Brazilian Amazon Men Who Have Sex with Men: A Cross-Sectional Study
by Thiago Vilhena Silva, Iaron Leal Seabra, Glenda Roberta Oliveira Naiff Ferreira, João Gabriel Alves da Luz, Cecília Conceição Viana, Lucas Barros de Paiva, Glauber Weder dos Santos Silva, Caio Lacerda dos Santos, Luiz Fernando Almeida Machado and Eliã Pinheiro Botelho
Trop. Med. Infect. Dis. 2025, 10(8), 231; https://doi.org/10.3390/tropicalmed10080231 - 16 Aug 2025
Viewed by 184
Abstract
We analysed the socioeconomic, behavioural, and protection factors (PFs) influences on the HIV combined prevention (CP) strategy among Brazilian Amazonian men who have sex with men (MSMs). PFs are resources that reduce the effect of adversity and help people maintain their well-being. Methods: [...] Read more.
We analysed the socioeconomic, behavioural, and protection factors (PFs) influences on the HIV combined prevention (CP) strategy among Brazilian Amazonian men who have sex with men (MSMs). PFs are resources that reduce the effect of adversity and help people maintain their well-being. Methods: Cross-sectional study employing a convenient sample of MSMs living in the metropolitan region of Belém. A questionnaire containing socioeconomic, behavioural, PFs, and behaviour/knowledge concerning CP questions was used. “Behaviour/knowledge concerning CP” was defined as a dependent variable and received a maximum score of 16 points. The Mann–Whitney and Kruskal–Wallis tests and multiple linear regression were employed. Results: Our sample comprised 384 MSMs scoring an average of 7.83 points (±1.9). Contributing to lower scores were “not talking about sex life with confidants”, “not talking with work colleagues about personal life and sexually transmissible infections”, and “not participating in non-governmental organisations.” On the other hand, “not being happy in the neighbourhood of residency” contributed to higher scores. Conclusion: Peer support and social inclusion are essential for increasing MSMs’ access to CP. Full article
16 pages, 1636 KiB  
Article
Cardiovascular Risk in People Living with HIV: A Preliminary Case Study from Romania
by Manuela Arbune, Alina Plesea-Condratovici, Anca-Adriana Arbune, Geanina Andronache, Catalin Plesea-Condratovici and Cristian Gutu
Medicina 2025, 61(8), 1468; https://doi.org/10.3390/medicina61081468 - 15 Aug 2025
Viewed by 196
Abstract
Background and Objectives: AIDS-related mortality has significantly decreased due to antiretroviral therapy (ART), leading to a substantial increase in average lifespan. Consequently, cardiovascular diseases have become a growing concern among people living with HIV (PLWH). This study aimed to assess the cardiovascular risk [...] Read more.
Background and Objectives: AIDS-related mortality has significantly decreased due to antiretroviral therapy (ART), leading to a substantial increase in average lifespan. Consequently, cardiovascular diseases have become a growing concern among people living with HIV (PLWH). This study aimed to assess the cardiovascular risk profile of people living with HIV receiving ART and to explore the association between traditional and HIV-related factors with increased cardiovascular risk. Materials and Methods: We conducted a case study involving 112 PLWH receiving ART at a specialized clinic in southeastern Romania to estimate cardiovascular risk (CVR) using the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D®) score. For participants aged 40 and above, the SCORE2 algorithm was additionally applied. Results: Most participants were male and under 40 years of age, including 34 individuals from Romania’s distinct pediatric HIV cohort. We observed a substantial cardiovascular risk burden: abdominal obesity was present in 24.1% of participants, active smoking was reported by 55.4%, and over 70% had low physical activity levels. Among participants aged 40 and above, the D:A:D® and SCORE2 scores were strongly correlated, with an average cardiovascular age exceeding chronological age by a mean of 7.5 years. Although CVR remained similarly low among subgroups of PLWH under 40, the prevalence of metabolic syndrome was higher in patients from the pediatric cohort compared to those diagnosed later. Traditional risk factors—such as age, obesity, hypertension, dyslipidemia, smoking, and alcohol use—as well as elevated C-reactive protein levels, were significantly associated with increased CVR. Conclusions: Residual inflammation in PLWH, despite complete viral suppression in combination with metabolic syndrome, is associated with increased cardiovascular risk even in younger and clinically stable populations. Routine integration of metabolic and cardiovascular risk screening into HIV care may support timely prevention and personalized management strategies starting at an early age. Full article
(This article belongs to the Special Issue Updates on Risk Factors and Prevention of Coronary Artery Disease)
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35 pages, 1649 KiB  
Review
Candidemia: An Update on Epidemiology, Risk Factors, Diagnosis, Susceptibility, and Treatment
by Juan Pablo Cabrera-Guerrero, Eduardo García-Salazar, Graciela Hernandez Silva, Alberto Chinney Herrera, Erick Martínez-Herrera, Rodolfo Pinto-Almazán, María Guadalupe Frías-De-León and Carlos Alberto Castro-Fuentes
Pathogens 2025, 14(8), 806; https://doi.org/10.3390/pathogens14080806 - 14 Aug 2025
Viewed by 526
Abstract
Candidemia is a highly prevalent invasive fungal infection caused primarily by C. albicans, C. parapsilosis, C. glabrata (currently Nakaseomyces glabratus), C. tropicalis, and C. krusei (currently Pichia kudriavzevii). Risk factors for the development of candidemia include steroid-induced immunosuppression [...] Read more.
Candidemia is a highly prevalent invasive fungal infection caused primarily by C. albicans, C. parapsilosis, C. glabrata (currently Nakaseomyces glabratus), C. tropicalis, and C. krusei (currently Pichia kudriavzevii). Risk factors for the development of candidemia include steroid-induced immunosuppression used in solid organ or hematopoietic transplantation, and neutropenia secondary to infectious or tumorous processes. Alterations in the gut microbiota in people living with HIV, caused by antiretroviral therapy, increase the possibility of colonization by C. albicans. Likewise, the presence of a central venous catheter, parenteral nutrition, and abdominal surgery stand out as the main risk factors for the development of candidemia. New diagnostic tools have been developed for the diagnosis of this mycosis that allow the identification of the main species, from improvements in conventional stains such as calcofluor white, which increases sensitivity, as well as technologies such as T2 Candida, MoiM assay, biomarker panel (1,3 β-D-glucan, C-reactive protein, presepsin, and procalcitonin), and, more recently, the development of biosensors for the identification of Candida spp. Regarding treatment, the use of micafungin and anidulafungin in patients with obesity defined by a BMI > 30 kg/m2 has shown higher survival rates and therapeutic success. Meanwhile, newer antifungals such as rezafungin and fosmanogepix have demonstrated excellent results in the treatment of these patients. Therefore, this review aims to update the epidemiology and risk factors of candidemia, as well as analyze the diagnostic tools and treatments currently available. Full article
(This article belongs to the Special Issue An Update on Fungal Infections)
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11 pages, 416 KiB  
Article
Hepatitis B Virus PreS-Mutated Strains in People Living with HIV: Long-Term Hepatic Outcomes Following ART Initiation
by Xianglong Lan, Yurou Wang, Min Liao, Linghua Li and Fengyu Hu
Viruses 2025, 17(8), 1102; https://doi.org/10.3390/v17081102 - 11 Aug 2025
Viewed by 291
Abstract
In the modern era of HIV treatment, people co-infected with HIV and HBV still face poor liver outcomes, including liver fibrosis, liver cirrhosis, and hepatocellular carcinoma. We investigated baseline characteristics and long-term liver function outcomes in 435 people living with HIV and HBV [...] Read more.
In the modern era of HIV treatment, people co-infected with HIV and HBV still face poor liver outcomes, including liver fibrosis, liver cirrhosis, and hepatocellular carcinoma. We investigated baseline characteristics and long-term liver function outcomes in 435 people living with HIV and HBV co-infection, focusing on HCC-associated point mutations (PMs) and PreS region deletion mutations. PMs were present in 72.9% of participants and were associated with male predominance, lower HBV genotype C prevalence, reduced HBV DNA and HBeAg levels, and higher HBsAg and HBeAb positivity. However, PMs did not significantly impact liver function or fibrosis progression over six years of ART follow-up. In contrast, PreS deletions were found in 21.8% of cases and stratified into PreS1, PreS2, and PreS1+2 deletions. PreS2 and PreS1+2 deletions were linked to older age, higher HBsAg and AFP levels, elevated liver enzymes, and lower platelet counts. These groups also exhibited significantly worse liver fibrosis markers (APRI and FIB-4), with PreS2 deletions consistently showing the highest values throughout the follow-up. Despite the initial improvement with ART, patients with PreS2 and PreS1+2 deletions maintained higher fibrosis and cirrhosis risks over six years. In summary, while PMs were not predictive of liver disease progression, PreS deletion mutations (especially in the PreS2 region) were associated with poorer liver outcomes, indicating their potential as biomarkers for fibrosis risk in co-infected individuals with long-term ART. Full article
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22 pages, 2782 KiB  
Article
Mycobacterium tuberculosis Modulates the Expansion of Terminally Exhausted CD4+ and CD8+ T-Cells in Individuals with HIV-TB Co-Infection
by Komal Sharma, Aman Sharma and Sunil K. Arora
Pathogens 2025, 14(8), 802; https://doi.org/10.3390/pathogens14080802 - 11 Aug 2025
Viewed by 439
Abstract
Introduction: Mycobacterium tuberculosis (Mtb), the most common co-infection among people living with HIV (PLWH), aggravates the associated morbidity and mortality in these individuals; however, the immune-modulatory role of Mtb in the pathogenesis of HIV infection remains incompletely understood. Methods: We investigated the role [...] Read more.
Introduction: Mycobacterium tuberculosis (Mtb), the most common co-infection among people living with HIV (PLWH), aggravates the associated morbidity and mortality in these individuals; however, the immune-modulatory role of Mtb in the pathogenesis of HIV infection remains incompletely understood. Methods: We investigated the role of Mtb infection in regulating adaptive immune responses with reference to the expression of five immune checkpoint molecules (ICMs) in co-infected individuals in a cross-sectional study conducted on treatment-naïve human cohorts from North India, including PLWH, people with Mtb infection, people with HIV-Mtb co-infection, and healthy volunteers as controls. Results: The data revealed a significantly increased gene expression of TIM-3 (p = 0.0058), LAG-3 (p < 0.0001), PD-1 (p = 0.0090), and CTLA-4 (p = 0.0008). It also revealed a higher frequency of CD4+ and CD8+ T-cells surface-expressing TIM-3+, CTLA-4+, LAG-3+. Finally, it showed cells co-expressing two ICMs together (p < 0.05) in individuals with HIV–Mtb co-infection as compared to HIV mono-infected ones. Interestingly, the frequency of these cells correlated inversely with the absolute CD4+ T-cell count and positively with the plasma viral load (p < 0.05), indicating direct association with HIV disease progression. Conclusions: These findings suggest that Mtb co-infection exacerbates immune exhaustion in co-infected individuals. Targeting ICMs with pharmacological immune checkpoint inhibitors (ICIs) offers a promising approach for better clinical management of co-infected individuals. Full article
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12 pages, 443 KiB  
Review
Comprehensive Communication for a Syndemic Approach to HIV Care: A Framework for Enhancing Health Communication Messages for People Living with HIV
by Sarah E. Sheff, Vanessa Boudewyns, Jocelyn Coleman Taylor, Hannah Getachew-Smith, Nivedita L. Bhushan and Jennifer D. Uhrig
Int. J. Environ. Res. Public Health 2025, 22(8), 1231; https://doi.org/10.3390/ijerph22081231 - 7 Aug 2025
Viewed by 249
Abstract
Despite the increasing adoption of a syndemic approach in HIV research, few health communication campaigns have used a syndemic approach in messaging to improve health outcomes for persons living with HIV (PWH). This paper introduces a framework for practitioners and researchers developing health [...] Read more.
Despite the increasing adoption of a syndemic approach in HIV research, few health communication campaigns have used a syndemic approach in messaging to improve health outcomes for persons living with HIV (PWH). This paper introduces a framework for practitioners and researchers developing health communication messages in support of a syndemic approach to HIV care for PWH in the United States. Grounded in insights from a review of counseling and psychosocial interventions that demonstrated significant positive effects on HIV clinical outcomes, the C4H Framework emphasizes four components: compassion, comprehensive messaging, capacity-building, and coordination. Compassion ensures that messages resonate with individuals experiencing the intertwined challenges of HIV, substance abuse, and mental health issues. Comprehensive messaging integrates a holistic view of the barriers faced by PWH. Capacity-building empowers individuals to effectively engage with and act upon health information. Coordination promotes alignment between stakeholders and resources to ensure consistent and supportive messaging. The C4H Framework bridges the gap between research and practice, offering a foundation for crafting effective communication messages that resonate with individuals facing the complex challenges inherent in HIV syndemics. Future research should explicitly test the effectiveness and acceptability of messages developed using the C4H Framework with people living with HIV. Full article
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11 pages, 443 KiB  
Article
Cognitive Screening with the Italian International HIV Dementia Scale in People Living with HIV: A Cross-Sectional Study in the cART Era
by Maristella Belfiori, Francesco Salis, Sergio Angioni, Claudia Bonalumi, Diva Cabeccia, Camilla Onnis, Nicola Pirisi, Francesco Ortu, Paola Piano, Stefano Del Giacco and Antonella Mandas
Infect. Dis. Rep. 2025, 17(4), 95; https://doi.org/10.3390/idr17040095 - 6 Aug 2025
Viewed by 179
Abstract
Background: HIV-associated neurocognitive disorders (HANDs) continue to be a significant concern, despite the advancements in prognosis achieved through Combination Antiretroviral Therapy (cART). Neuropsychological assessment, recommended by international guidelines for HANDs diagnosis, can be resource-intensive. Brief screening tools, like the International HIV Dementia [...] Read more.
Background: HIV-associated neurocognitive disorders (HANDs) continue to be a significant concern, despite the advancements in prognosis achieved through Combination Antiretroviral Therapy (cART). Neuropsychological assessment, recommended by international guidelines for HANDs diagnosis, can be resource-intensive. Brief screening tools, like the International HIV Dementia Scale (IHDS) and the Montreal Cognitive Assessment (MoCA), are crucial in facilitating initial evaluations. This study aims to assess the Italian IHDS (IHDS-IT) and evaluate its sensitivity and specificity in detecting cognitive impairment in HIV patients. Methods: This cross-sectional study involved 294 patients aged ≥30 years, evaluated at the Immunology Unit of the University of Cagliari. Cognitive function was assessed using the MoCA and IHDS. Laboratory parameters, such as CD4 nadir, current CD4 count, and HIV-RNA levels, were also collected. Statistical analyses included Spearman’s correlation, Receiver Operating Characteristic analysis, and the Youden J statistic to identify the optimal IHDS-IT cut-off for cognitive impairment detection. Results: The IHDS and MoCA scores showed a moderate positive correlation (Spearman’s rho = 0.411, p < 0.0001). ROC analysis identified an IHDS-IT cut-off of ≤9, yielding an Area Under the Curve (AUC) of 0.76, sensitivity of 71.7%, and specificity of 67.2%. At this threshold, 73.1% of patients with MoCA scores below 23 also presented abnormal IHDS scores, highlighting the complementary utility of both cognitive assessment instruments. Conclusions: The IHDS-IT exhibited fair diagnostic accuracy for intercepting cognitive impairment, with a lower optimal cut-off than previously reported. The observed differences may reflect this study cohort’s demographic and clinical characteristics, including advanced age and long-lasting HIV infection. Further, longitudinal studies are necessary to validate these findings and to confirm the proposed IHDS cut-off over extended periods. Full article
(This article belongs to the Section HIV-AIDS)
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14 pages, 290 KiB  
Article
Patterns of Reverse Transcriptase Inhibitor Resistance Mutations in People Living with Human Immunodeficiency Virus in Libreville, Gabon
by Guy Francis Nzengui-Nzengui, Gaël Mourembou, Euloge Ibinga, Ayawa Claudine Kombila-Koumavor, Hervé M’boyis-Kamdem, Edmery Muriel Mpouho-Ntsougha, Alain Mombo-Mombo and Angélique Ndjoyi-Mbiguino
Trop. Med. Infect. Dis. 2025, 10(8), 216; https://doi.org/10.3390/tropicalmed10080216 - 30 Jul 2025
Viewed by 336
Abstract
Objective: To characterize the profiles of resistance mutations to HIV reverse transcriptase inhibitors in Gabon. Design: Cross-sectional study conducted over 37 months, from October 2019 to October 2022, at the IST/HIV/AIDS Reference Laboratory, a reference center for the biological monitoring of people living [...] Read more.
Objective: To characterize the profiles of resistance mutations to HIV reverse transcriptase inhibitors in Gabon. Design: Cross-sectional study conducted over 37 months, from October 2019 to October 2022, at the IST/HIV/AIDS Reference Laboratory, a reference center for the biological monitoring of people living with the human immunodeficiency virus (PWHIV) in Gabon. Methods: Plasma from 666 PWHIV receiving antiretroviral treatment was collected, followed by RNA extraction, amplification, and reverse transcriptase gene sequencing. Statistical analyses were performed using Stata® 14.0 software (USA). Results: Six hundred and sixty-six (666) PWHIV plasma collected from 252 male and 414 female patients were analyzed and 1654 mutations were detected in 388 patients, including 849 (51.3%) associated with nucleoside reverse transcriptase inhibitors (NRTIs) and 805 (48.7%) with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Three of the most prescribed treatment regimens were associated to the appearance of both NRTIs and NNRTIs resistance mutations: TDF + 3TC + EFV (24.02%; 160/666); TDF + FTC + EFV) (17.2%; 114/666) and AZT + 3TC + EFV (14.6%; 97/666). Additionally, stage 3 of CD4 T-lymphocyte deficiency, the higher viral load, and treatment duration are risk factors influencing the appearance of virus mutations. Also, treatment containing TDF-3TC + DTG is more protective against mutations. Conclusions: Drug resistance mutations are common in Gabon and compromise the efficacy of ART. Further study must search for other causes of therapeutic failure in Gabon in PWHIV. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)
14 pages, 866 KiB  
Article
Switching to Long-Acting Cabotegravir and Rilpivirine in Turkey: Perspectives from People Living with HIV in a Setting of Increasing HIV Incidence
by Rıdvan Dumlu, Yeliz Çiçek, Mahir Kapmaz, Okan Derin, Halis Akalın, Uğur Önal, Egemen Özdemir, Çiğdem Ataman Hatipoğlu, Günay Tuncer Ertem, Alper Şener, Leyla Akgül, Yeşim Çağlar, Derya Tuna Ecer, Mustafa Kemal Çelen, Nur Bahar Oğuz, Figen Yıldırım, Deniz Borcak, Sevtap Şenoğlu, Eyüp Arslan, Sinan Çetin, Meryem Balcı and Ali Mertadd Show full author list remove Hide full author list
Medicina 2025, 61(8), 1373; https://doi.org/10.3390/medicina61081373 - 29 Jul 2025
Viewed by 607
Abstract
Background and Objectives: Long-acting cabotegravir and rilpivirine (LA-CAB/RPV) offers an alternative to daily oral antiretroviral therapy (ART) for people living with HIV (PLWH). Although LA-CAB/RPV has been approved in Turkey, the country remains in the pre-rollout period, and national data on patient [...] Read more.
Background and Objectives: Long-acting cabotegravir and rilpivirine (LA-CAB/RPV) offers an alternative to daily oral antiretroviral therapy (ART) for people living with HIV (PLWH). Although LA-CAB/RPV has been approved in Turkey, the country remains in the pre-rollout period, and national data on patient perspectives are lacking. This is the first nationwide study from Turkey, a setting of increasing HIV incidence, assessing PLWH perspectives on switching to LA-CAB/RPV and the influence of motivational factors on treatment preferences. Materials and Methods: A prospective, multicenter, cross-sectional study was conducted across 11 HIV treatment centers representing all regions of Turkey. Virologically suppressed PLWH meeting current eligibility criteria for LA-CAB/RPV were included. Treatment preferences (switch to LA-CAB/RPV or remain on oral ART) and five anticipated motivational domains, namely perceived efficacy, safety, convenience, privacy, and cost, were systematically assessed through structured, face-to-face interviews. Results: Among 200 eligible participants, 86% (n = 172) preferred switching to LA-CAB/RPV. In all subgroups, LA-CAB/RPV was preferred over oral ART, except for those with no formal literacy. Prior awareness of LA-CAB/RPV was significantly associated with the switching preference (p < 0.001), with healthcare providers being the most common source of information, at 45.5% (n = 172) (p < 0.001). Residential proximity to the healthcare center (p = 0.018) and all motivational factors significantly influenced the preference (p < 0.05). Notably, when participants who initially chose to remain on oral ART were asked whether they would reconsider switching if injections were administered every six months, overall preference for long-acting therapy increased from 86% to 98%. Conclusions: High clinical eligibility and strong acceptability for LA-CAB/RPV were observed among Turkish PLWH. Our findings demonstrate that structured motivational factors significantly influence the treatment preference. Addressing these patient-centered factors and logistical barriers may support the successful integration of long-acting therapies into routine HIV care. Future longer-interval agents may improve patient-centered acceptability. Full article
(This article belongs to the Section Infectious Disease)
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15 pages, 2095 KiB  
Article
T-Lymphocyte Phenotypic and Mitochondrial Parameters as Markers of Incomplete Immune Restoration in People Living with HIV+ on Long-Term cART
by Damian Vangelov, Radoslava Emilova, Yana Todorova, Nina Yancheva, Reneta Dimitrova, Lyubomira Grigorova, Ivailo Alexiev and Maria Nikolova
Biomedicines 2025, 13(8), 1839; https://doi.org/10.3390/biomedicines13081839 - 28 Jul 2025
Viewed by 491
Abstract
Background/Objectives: Restored CD4 absolute counts (CD4AC) and CD4/CD8 ratio in the setting of continuous antiretroviral treatment (ART) do not exclude a low-level immune activation associated with HIV reservoirs, microbial translocation, or the side effects of ART itself, which accelerates the aging of [...] Read more.
Background/Objectives: Restored CD4 absolute counts (CD4AC) and CD4/CD8 ratio in the setting of continuous antiretroviral treatment (ART) do not exclude a low-level immune activation associated with HIV reservoirs, microbial translocation, or the side effects of ART itself, which accelerates the aging of people living with HIV (PLHIV). To delineate biomarkers of incomplete immune restoration in PLHIV on successful ART, we evaluated T-lymphocyte mitochondrial parameters in relation to phenotypic markers of immune exhaustion and senescence. Methods: PLHIV with sustained viral suppression, CD4AC > 500 and CD4/CD8 ratio >0.9 on ART (n = 39) were compared to age-matched ART-naïve donors (n = 27) and HIV(–) healthy controls (HC, n = 35). CD4 and CD8 differentiation and effector subsets (CCR7/CD45RA and CD27/CD28), activation, exhaustion, and senescence markers (CD38, CD39 Treg, CD57, TIGIT, and PD-1) were determined by flow cytometry. Mitochondrial mass (MM) and membrane potential (MMP) of CD8 and CD4 T cells were evaluated with MitoTracker Green and Red flow cytometry dyes. Results: ART+PLHIV differed from HC by increased CD4 TEMRA (5.3 (2.1–8.8) vs. 3.2 (1.6–4.4), p < 0.05), persistent TIGIT+CD57–CD27+CD28– CD8+ subset (53.9 (45.5–68.9) vs. 40.1 (26.7–58.5), p < 0.05), and expanding preapoptotic TIGIT–CD57+CD8+ effectors (9.2 (4.3–21.8) vs. 3.0 (1.5–7.3), p < 0.01) in correlation with increased CD8+ MMP (2527 (1675–4080) vs.1477 (1280–1691), p < 0.01). These aberrations were independent of age, time to ART, or ART duration, and were combined with increasing CD4 T cell MMP and MM. Conclusions: In spite of recovered CD4AC and CD4/CD8 ratio, the increased CD8+ MMP, combined with elevated markers of exhaustion and senescence in ART+PLHIV, signals a malfunction of the CD8 effector pool that may compromise viral reservoir latency. Full article
(This article belongs to the Special Issue Emerging Insights into HIV)
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20 pages, 1399 KiB  
Article
The Impact of COVID-19 on People Living with HIV: A Network Science Perspective
by Jared Christopher, Aiden Nelson, Paris Somerville, Simran Patel and John Matta
COVID 2025, 5(8), 119; https://doi.org/10.3390/covid5080119 - 28 Jul 2025
Viewed by 243
Abstract
People living with HIV (PLWH) faced diverse challenges during the COVID-19 pandemic, including disruptions to care, housing instability, emotional distress, and economic hardship. This study used graph-based clustering methods to analyze pandemic-era experiences of PLWH in a national sample from the NIH’s All [...] Read more.
People living with HIV (PLWH) faced diverse challenges during the COVID-19 pandemic, including disruptions to care, housing instability, emotional distress, and economic hardship. This study used graph-based clustering methods to analyze pandemic-era experiences of PLWH in a national sample from the NIH’s All of Us dataset (n = 242). Across three graph configurations we identified consistent subgroups shaped by social connectedness, housing stability, emotional well-being, and engagement with preventive behaviors. Comparison with an earlier local study of PLWH in Illinois confirmed recurring patterns of vulnerability and resilience while also revealing additional national-level subgroups not observed in the smaller sample. Subgroups with strong social or institutional ties were associated with greater emotional stability and proactive engagement with COVID-19 preventive behaviors, while those facing isolation and structural hardship exhibited elevated distress and limited engagement with COVID-19 preventive measures. These findings underscore the importance of precision public health strategies that reflect the heterogeneity of PLWH and suggest that strengthening social support networks, promoting housing stability, and leveraging institutional connections may enhance pandemic preparedness and HIV care in future public health crises. Full article
(This article belongs to the Section COVID Public Health and Epidemiology)
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