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  • Shortening HIV vaccine regimens to achieve high coverage
    Lancet HIV (IF 14.753) Pub Date : 2020-02-17
    Maria Blasi; Genevieve G Fouda

    An international commission of global experts convened by the International AIDS Society and The Lancet in 2018 advised that to eliminate HIV, global treatment efforts should be complemented by a robust scale-up in primary HIV prevention, including the development of a preventive vaccine. To date, only one HIV vaccine trial has shown moderate efficacy of the vaccine. This trial done in Thailand used an ALVAC-HIV prime, followed by two boosts of ALVAC-HIV plus AIDSVAX B/E Alum adjuvanted protein. A follow-up trial (HVTN 702) done in South Africa that used an adapted HIV subtype C vaccine adjuvanted with MF-59 was recently discontinued in February, 2020, because of lack of efficacy, highlighting the need for novel vaccine approaches.

    更新日期:2020-02-17
  • Comparison of shortened mosaic HIV-1 vaccine schedules: a randomised, double-blind, placebo-controlled phase 1 trial (IPCAVD010/HPX1002) and a preclinical study in rhesus monkeys (NHP 17–22)
    Lancet HIV (IF 14.753) Pub Date : 2020-02-17
    Kathryn E Stephenson; Frank Wegmann; Frank Tomaka; Stephen R Walsh; C Sabrina Tan; Ludo Lavreys; Jessica L Ansel; Diane G Kanjilal; Kate Jaegle; Joseph P Nkolola; Lauren Peter; Rachel Fogel; Connor Bradshaw; Anna Tyler; Tatenda Makoni; Lisa Howe; Darla Quijada; Abishek Chandrashekar; Esther A Bondzie; Erica N Borducchi; Katherine E Yanosick; Jenny Hendriks; Steven Nijs; Carla Truyers; Jeroen Tolboom; Roland C Zahn; Michael S Seaman; Galit Alter; Daniel J Stieh; Maria Grazia Pau; Hanneke Schuitemaker; Dan H Barouch
    更新日期:2020-02-17
  • HIV transmission and source–sink dynamics in sub-Saharan Africa
    Lancet HIV (IF 14.753) Pub Date : 2020-02-14
    Justin T Okano; Katie Sharp; Eugenio Valdano; Laurence Palk; Sally Blower
    更新日期:2020-02-17
  • How universal does universal test and treat have to be?
    Lancet HIV (IF 14.753) Pub Date : 2020-02-13
    Rebecca F Baggaley; T Déirdre Hollingsworth
    更新日期:2020-02-14
  • The effect of 90-90-90 on HIV-1 incidence and mortality in eSwatini: a mathematical modelling study
    Lancet HIV (IF 14.753) Pub Date : 2020-02-13
    Adam Akullian; Michelle Morrison; Geoffrey P Garnett; Zandile Mnisi; Nomthandazo Lukhele; Daniel Bridenbecker; Anna Bershteyn
    更新日期:2020-02-14
  • Novel approach to scale integrated depression and HIV care
    Lancet HIV (IF 14.753) Pub Date : 2020-02-11
    Jerome T Galea; Stephanie Marhefka; Elena Cyrus; Carmen Contreras; Brandon Brown

    Depression is recognised as a major factor leading to poor outcomes among people living with HIV. Left untreated, people with HIV and depression face a two-fold increased risk of mortality, lower uptake and adherence to medical care, ,  and increases in viral loads even with high adherence to antiretroviral therapy. But despite the high co-prevalence of HIV and depression, simultaneous management of the two diseases by the same health-care team is uncommon, constituting a mental health and HIV service gap.

    更新日期:2020-02-12
  • Vaccine boosts: balancing response magnitude and character
    Lancet HIV (IF 14.753) Pub Date : 2020-02-06
    Andrew R Crowley; Margaret E Ackerman
    更新日期:2020-02-07
  • Correction to Lancet HIV 2020; published online Jan 14. https://doi.org/10.1016/S2352-3018(19)30378-9
    Lancet HIV (IF 14.753) Pub Date : 2020-02-06

    Ratmann O, Kagaayi J, Hall M, et al. Quantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Uganda. Lancet HIV 2020; published online Jan 14. https:/doi.org/10.1016/S2352-3018(19)30378-9—In figure 2B of this Article, the key and the legend were incorrect and have been updated. Figure 3A has also been updated and the axis labels in figure 4B have been corrected. These corrections were made as of Feb 6, 2020.

    更新日期:2020-02-07
  • Late boosting of the RV144 regimen with AIDSVAX B/E and ALVAC-HIV in HIV-uninfected Thai volunteers: a double-blind, randomised controlled trial
    Lancet HIV (IF 14.753) Pub Date : 2020-02-06
    Punnee Pitisuttithum; Sorachai Nitayaphan; Suwat Chariyalertsak; Jaranit Kaewkungwal; Peter Dawson; Jittima Dhitavat; Benjaluck Phonrat; Siriwat Akapirat; Nicos Karasavvas; Lindsay Wieczorek; Victoria Polonis; Michael A Eller; Poonam Pegu; Dohoon Kim; Alexandra Schuetz; Surat Jongrakthaitae; Yingjun Zhou; Faruk Sinangil; Sanjay Phogat; Carlos A Diazgranados; James Tartaglia; Elizabeth Heger; Kirsten Smith; Nelson L Michael; Jean-Louis Excler; Merlin L Robb; Jerome H Kim; Robert J O'Connell; Sandhya Vasan; Arom Pitisuthitham; Yupa Sabmee; Narongrid Sirisopana; Chirapa Eamsila; Prapaporn Savaraj; Wanlaya Labwech; Siriluck Teerachia; Nuntisa Chotirosniramit; Taweewat Supindham; Boonlure Pruenglampoo; Patcharaphan Sugandhavesa; Natthapol Kosashunhanan; Oranitcha Kaewthip; Piyathida Sroysuwan; Pawinee Jarujareet; Silvia Ratto-Kim; Sebastian Molnar; Jesse Schoen; Nampueng Churikanont; Saowanit Getchalarat; Nongluck Sangnoi; Bessara Nuntapinit; Anant Phramtong; Pornsuk V. Grandin; Sirinan Madnote; Surawach Rittiroongrad; Boot Kaewboon; Rapee Trichavaroj; Jiraporn Puangkaew; Somsak Chantakulkij; Phiromrat Rakyat; Pornchanok Panjapornsuk; Nipattra Tragonlugsana; Weerawan Chuenarom; Mark de Souza; Viseth Ngauy; Nittaya Phanuphak; Nitiya Chomchey; Puttachard Saengtawan; Nipat Teeratakulpisarn; Rungsun Rerknimitr; Eugene Kroon; Carter A. Lee; Suchada Chinaworapong
    更新日期:2020-02-07
  • The syndemic threat of food insecurity and HIV
    Lancet HIV (IF 14.753) Pub Date : 2020-02-01
    The Lancet HIV

    According to the 2019 UN Food and Agriculture Organization State of Food Security and Nutrition in the World , more than 820 million people were undernourished globally in 2018, and 704 million were severely food insecure. Food insecurity and undernourishment affect people in all regions, but the problem is particularly acute in sub-Saharan Africa, where the burden of HIV disease is also greatest. From 2015 to 2018 the region had a consistent rise in food insecurity and undernourishment. And in 2018, an estimated 258 million people (24·6% of the population) were severely food insecure with 605·8 million (57·7%) being moderately or severely food insecure.

    更新日期:2020-02-04
  • Influenza vaccine in pregnant women with HIV: are we there?
    Lancet HIV (IF 14.753) Pub Date : 2020-01-03
    Sharon Nachman

    In The Lancet HIV, Marta Nunes and colleagues report their clinical trial assessing three different approaches to influenza vaccination in pregnant women with HIV in South Africa. Recognising that the standard vaccine, while licensed, might not be the best approach, they compared the safety and immunogenicity of a double dose of a seasonal vaccine to a booster dose of the vaccine with the standard dose of the same influenza vaccine. Their reasons for choosing these different approaches was because immune responses to standard vaccination in this population are poor, with downstream concerns for risk for influenza disease in both mother and baby. Unfortunately, they did not find that these alternative approaches offered any additional protection.

    更新日期:2020-02-04
  • Circulating resistance to first-line HIV drug regimens
    Lancet HIV (IF 14.753) Pub Date : 2019-12-06
    Collins C Iwuji; Mark J Siedner

    Pretreatment HIV drug resistance (PDR) is increasing in sub-Saharan Africa, driven by increasing resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. This has led WHO to recommend that countries with a population prevalence of NNRTIs resistance greater than 10% adopt alternative first-line regimens, or consider PDR testing to guide selection of antiretroviral therapy (ART). ,  In response, many countries in sub-Saharan Africa are now rolling out dolutegravir-based first-line ART. These recommendations rely on the theoretical basis that efavirenz efficacy is significantly curtailed in the presence of NNRTI resistance and that drug resistance testing before initiation of efavirenz-based ART enables selection of more efficacious regimens.

    更新日期:2020-02-04
  • On-demand PrEP efficacy: forgiveness or timely dosing
    Lancet HIV (IF 14.753) Pub Date : 2019-11-26
    Jean-Jacques Parienti
    更新日期:2020-02-04
  • No excuses left to delay opioid agonist treatment roll-out
    Lancet HIV (IF 14.753) Pub Date : 2019-12-23
    Ruslan Malyuta; Reinhard M Krausz

    Eastern Europe is a long way off achieving targets of the 2016 Political Declaration on HIV and AIDS. The epidemic keeps growing, with no indication of a decline, even after introduction of effective prevention and treatment, including pre-exposure prophylaxis among key populations, as has been seen in western Europe. Most new HIV cases in eastern Europe and central Asia are in Russia and Ukraine, with key populations, including people who inject drugs, remaining the hardest hit.

    更新日期:2020-02-04
  • What do we say about condoms in 2019?
    Lancet HIV (IF 14.753) Pub Date : 2019-08-28
    Kevin L Ard; Douglas S Krakower; Alex S Keuroghlian

    How, and if, clinicians caring for gay, bisexual, and other men who have sex with men (MSM) counsel about condoms in the era of HIV pre-exposure prophylaxis (PrEP) and treatment-as-prevention (TasP) is unknown. When we talk to primary care clinicians across the USA in our role as LGBTQ health educators, we hear uncertainty about how to discuss condoms with MSM who are at risk for HIV and sexually transmitted infections (STIs). We propose four approaches to discussing condom counselling with clinicians; these approaches strive to reflect the best available evidence and support clinicians' and patients' experiences.

    更新日期:2020-02-04
  • Antiretroviral resistance and management after pre-exposure to prophylaxis
    Lancet HIV (IF 14.753) Pub Date : 2020-02-01
    Victoria Tittle; Marta Boffito; Alan McOwan; Gary Whitlock

    HIV pre-treatment genotypic resistance has been reported in less than 0·1% of users of pre-exposure prophylaxis (PrEP) because of the effectiveness of PrEP in preventing HIV transmission. However, in the subgroup of PrEP users that do acquire HIV, genotypic resistance in 20 (29%) of 68 patients has been documented, and data on how to manage this group are in short supply. In this Correspondence, we present real-life, baseline resistance data comparing previous users of PrEP (tenofovir disoproxil fumarate and emtricitabine) and non-PrEP users, which were obtained from patients with newly diagnosed HIV at a sexual health and HIV clinic in central London, UK. We also describe the management and outcomes of these patients.

    更新日期:2020-02-04
  • Conditional economic incentives to improve HIV prevention
    Lancet HIV (IF 14.753) Pub Date : 2020-02-01
    Mark K U Pasayan; Adeyinka A Alabi; Douglas F Nixon

    We read with interest the Review by Omar Galárraga and Sandra Sosa-Rubí that paradoxically appeared in The Lancet HIV at the same time as the California Senate Bill 159, which authorised dispensation of pre-exposure prophylaxis (PrEP) without prescription. We agree that incentives for PrEP should be urgently studied.

    更新日期:2020-02-04
  • PrEP use falling short in African American and Hispanic MSM
    Lancet HIV (IF 14.753) Pub Date : 2020-02-01
    Tony Kirby
    更新日期:2020-02-04
  • Positive Impact Health Centres—Atlanta, GA, USA
    Lancet HIV (IF 14.753) Pub Date : 2020-02-01
    Tony Kirby

    The southern states of the USA are not as well served as others in terms of HIV treatment or prevention services. Thus, the team at Positive Impact Health Centers (PIHC), Atlanta, GA, USA, sees a continuous and ever-increasing demand for their services across their three sites—including pre-exposure prophylaxis (PrEP), screening for sexually transmitted infection (STIs), and treatment for HIV.

    更新日期:2020-02-04
  • A life in balance
    Lancet HIV (IF 14.753) Pub Date : 2019-10-10
    Robert Stirrups
    更新日期:2020-02-04
  • You'll never forget your first time
    Lancet HIV (IF 14.753) Pub Date : 2019-09-16
    Peter Ranscombe
    更新日期:2020-02-04
  • Immunogenicity and safety of different dosing schedules of trivalent inactivated influenza vaccine in pregnant women with HIV: a randomised controlled trial
    Lancet HIV (IF 14.753) Pub Date : 2020-01-03
    Marta C Nunes; Clare L Cutland; Andrew Moultrie; Stephanie Jones; Justin R Ortiz; Kathleen M Neuzil; Keith P Klugman; Eric A F Simões; Adriana Weinberg; Shabir A Madhi; A Hugo; P Sithole; L-A Stoltenkamp; Y Abdoola; N van Niekerk; F Treurnicht
    更新日期:2020-02-04
  • Evaluation of the management of pretreatment HIV drug resistance by oligonucleotide ligation assay: a randomised controlled trial
    Lancet HIV (IF 14.753) Pub Date : 2019-12-06
    Michael H Chung; Christine J McGrath; Ingrid A Beck; Molly Levine; Ross S Milne; Isaac So; Nina Andersen; Sandra Dross; Robert W Coombs; Bhavna Chohan; Nelly Yatich; Catherine Kiptinness; Samah R Sakr; James N Kiarie; Lisa M Frenkel
    更新日期:2020-02-04
  • On-demand pre-exposure prophylaxis with tenofovir disoproxil fumarate plus emtricitabine among men who have sex with men with less frequent sexual intercourse: a post-hoc analysis of the ANRS IPERGAY trial
    Lancet HIV (IF 14.753) Pub Date : 2019-11-26
    Guillemette Antoni; Cécile Tremblay; Constance Delaugerre; Isabelle Charreau; Eric Cua; Daniela Rojas Castro; François Raffi; Julie Chas; Thomas Huleux; Bruno Spire; Catherine Capitant; Laurent Cotte; Laurence Meyer; Jean-Michel Molina; Jean-Pierre Aboulker; Nathalie Bajos; Jean-Guy Baril; Michel Besnier; Johan Binesse; Diane Carette; Grégoire Cattin; Antoine Chéret; Christian Chidiac; Elias Choucair; Jean-François Delfraissy; Baptiste Demoulin; Alpha Diallo; Isabelle Durant-Zaleski; Véronique Doré; Nicolas Etien; Françoise Euphrasie; Julien Fonsart; Valérie Foubert; Séverine Gibowski; Gabriel Girard; Brigitte Guillon; Soizic Le Mestre; France Lert; Nicolas Leturque; Nicolas Lorente; Anaïs Mennecier; Michel Morin; Emmanuelle Netzer; Joanne Otis; Armelle Pasquet; Gilles Peytavin; Gilles Pialoux; Marie Préau; Cécile Rabian; Willy Rozenbaum; Luis Sagaon-Teyssier; Yacine Saïdi; Marine Saouzanet; Marie-Christine Simon; Marie Suzan-Monti; David Thompson; Julie Timsit; Benoît Trottier; Mark Wainberg
    更新日期:2020-02-04
  • Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: a modelling study
    Lancet HIV (IF 14.753) Pub Date : 2019-12-23
    Jiale Tan; Frederick L Altice; Lynn M Madden; Alexei Zelenev
    更新日期:2020-02-04
  • Stigma reduction interventions in people living with HIV to improve health-related quality of life
    Lancet HIV (IF 14.753) Pub Date : 2019-11-24
    Galit Zeluf Andersson; Maria Reinius; Lars E Eriksson; Veronica Svedhem; Farhad Mazi Esfahani; Keshab Deuba; Deepa Rao; Goodluck Willey Lyatuu; Danielle Giovenco; Anna Mia Ekström

    As the UNAIDS 90-90-90 targets for people living with HIV are increasingly being reached in many contexts, health-related quality of life, the so-called fourth 90, warrants special attention. HIV-related stigma and discrimination are major barriers for overall health-related quality of life despite impressive clinical and virological improvements in HIV care. There is a scarcity of well designed intervention studies that document stigma reduction in people living with HIV and few studies that specifically assess the effect of stigma on health-related quality of life. Further, few interventions target discrimination from providers outside of HIV-specific care or involve people living with HIV in both the design and implementation. Lastly, evidence on methods to reduce stigma in several underepresented key populations and geographical regions is insufficient and research on intersectional stigma (ie, the convergence of multiple stigmatised identities) needs further attention.

    更新日期:2020-02-04
  • HIV immunoprophylaxis: preparing the pathway from proof of concept to policy decision and use
    Lancet HIV (IF 14.753) Pub Date : 2019-11-27
    Johan Vekemans; William Snow; Patricia E Fast; Rachel Baggaley; Kundai Chinyenze; Martin H Friede; Peter Godfrey-Faussett; David C Kaslow; Helen Rees

    Various long-awaited efficacy studies of vaccines and broadly neutralising antibodies for prevention of HIV are now well underway in highly endemic settings. One broadly neutralising monoclonal antibody is being assessed for proof of concept, and combinations are in the pipeline. Two multicomponent prime-and-boost vaccine regimens are being evaluated, one of which is designed for global coverage. These multicomponent vaccines present a new level of complexity that will challenge health delivery systems. We recommend that while awaiting the results, which will appear in 2020–22, the target product profiles and full public value proposition for both categories of products should be defined, and the regulatory, policy, and implementation pathways should be prepared. Economic and health benefits, cost of goods, administrative complexity, and user perspectives will be key considerations for the roll-out of effective products. Investments in manufacturing capacity and public-sector delivery systems will be needed to prepare for product introduction and scale-up. We propose a prioritisation of activities on the basis of a broad stakeholder consultation organised by WHO and UNAIDS.

    更新日期:2020-02-04
  • Novel metric for evaluating pre-exposure prophylaxis programme effectiveness in real-world settings
    Lancet HIV (IF 14.753) Pub Date : 2020-01-31
    Cheryl Hendrickson; Lawrence Long; David van de Vijver; Charles Boucher; Heidi O'Bra; Cassidy W Claassen; Mwansa Njelesani; Crispin Moyo; Daliso B Mumba; Hasina Subedar; Lloyd Mulenga; Sydney Rosen; Brooke E Nichols

    Although large-scale provision of HIV pre-exposure prophylaxis (PrEP) is gaining momentum, no systematic method to evaluate or compare the effectiveness of different scale-up strategies in real-world settings exists. To date, estimating the effectiveness of PrEP has relied on clinical trials or mathematical models. We propose a novel and pragmatic metric to evaluate and compare programme effectiveness using routine implementation data. Using South African and Zambian PrEP guidelines, we provide two examples of how to consistently measure PrEP-programme effectiveness with routinely collected data. PrEP effectiveness should account for HIV seroconversion, the variable risk of HIV infection (seasons of risk) estimated with routine risk assessment at each clinic visit (when available), and the persistence of PrEP use. Three criteria should be met in order to be considered a successful outcome: first, a person who initiates PrEP must not seroconvert; second, there should be no more than one period at high risk of HIV infection during the follow-up period when not taking PrEP; and finally, an individual must continue to attend health-care visits or discontinue prophylaxis in consultation with a health-care provider within a specified follow-up period. The number of PrEP successes could then be compared with the total number of people initiating PrEP to establish a success ratio. This outcome is a useful and easily interpretable metric to monitor effectiveness of PrEP programmes with routinely collected clinical data and can be used in cost-effectiveness analyses. These measurements allow for comparisons of scale-up strategies for PrEP programmes and, if widely adopted, will allow comparative studies of different approaches for PrEP service delivery.

    更新日期:2020-02-03
  • Correction to Lancet HIV 2019; 6: e71–72
    Lancet HIV (IF 14.753) Pub Date : 2020-01-28

    Kerr SJ, Puthanakit T. Barriers to paediatric switching to second-line ART. Lancet HIV 2019; 6: e71–72—this Comment has been made Open Access. This correction was made on Jan 28, 2020.

    更新日期:2020-01-29
  • Correction to Lancet HIV 2019; 6: e105–15
    Lancet HIV (IF 14.753) Pub Date : 2020-01-28

    The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration. Incidence of switching to second-line antiretroviral therapy and associated factors in children with HIV: an international cohort collaboration. Lancet HIV 2019; 6: e105–15—The Summary Funding line has been revised to include UK Medical Research Council and this Article has been made Open Access. These corrections were made on Jan 28, 2020.

    更新日期:2020-01-29
  • Responding to expanding HIV epidemics in Cebu, Philippines
    Lancet HIV (IF 14.753) Pub Date : 2020-01-16
    Nicholas A Medland; Peter Banys; Van Phillip Baton; Johann Nadela; Lisa Maher; Ilya Tac-An
    更新日期:2020-01-17
  • Quantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Uganda
    Lancet HIV (IF 14.753) Pub Date : 2020-01-14
    Oliver Ratmann; Joseph Kagaayi; Matthew Hall; Tanya Golubchick; Godfrey Kigozi; Xiaoyue Xi; Chris Wymant; Gertrude Nakigozi; Lucie Abeler-Dörner; David Bonsall; Astrid Gall; Anne Hoppe; Paul Kellam; Jeremiah Bazaale; Sarah Kalibbala; Oliver Laeyendecker; Justin Lessler; Fred Nalugoda; Larry W Chang; Tulio de Oliveira; Deenan Pillay; Thomas C Quinn; Steven J Reynolds; Simon E F Spencer; Robert Ssekubugu; David Serwadda; Maria J Wawer; Ronald H Gray; Christophe Fraser; M Kate Grabowski; Helen Ayles; Rory Bowden; Vincent Calvez; Myron Cohen; Anne Dennis; Max Essex; Sarah Fidler; Dan Frampton; Richard Hayes; Josh Herbeck; Pontiano Kaleebu; Cissy Kityo; Jairam Lingappa; Vladimir Novitsky; Nick Paton; Andrew Rambaut; Janet Seeley; Deogratius Ssemwanga; Frank Tanser; Tom Lutalo; Ronald Galiwango; Fred Makumbi; Nelson K. Sewankambo; Dorean Nabukalu; Anthony Ndyanabo; Joseph Ssekasanvu; Hadijja Nakawooya; Jessica Nakukumba; Grace N. Kigozi; Betty S. Nantume; Nampijja Resty; Jedidah Kambasu; Margaret Nalugemwa; Regina Nakabuye; Lawrence Ssebanobe; Justine Nankinga; Adrian Kayiira; Gorreth Nanfuka; Ruth Ahimbisibwe; Stephen Tomusange; Ronald M. Galiwango; Margaret Nakalanzi; Joseph O. Otobi; Denis Ankunda; Joseph L. Ssembatya; John B. Ssemanda; Emmanuel Kato; Robert Kairania; Alice Kisakye; James Batte; James Ludigo; Abisagi Nampijja; Steven Watya; Kighoma Nehemia; Sr. Margaret Anyokot; Joshua Mwinike; George Kibumba; Paschal Ssebowa; George Mondo; Francis Wasswa; Agnes Nantongo; Rebecca Kakembo; Josephine Galiwango; Geoffrey Ssemango; Andrew D. Redd; John Santelli; Caitlin E. Kennedy; Jennifer Wagman; Aaron Tobian
    更新日期:2020-01-15
  • Time, population mobility, and HIV transmission
    Lancet HIV (IF 14.753) Pub Date : 2020-01-14
    Susan Cassels

    Population mobility is an intrinsic human condition. People have always moved over space and time, and always will. Yet mobility can be hard to define and measure, and thus it is challenging to understand the effects of mobility on the spread of HIV. In The Lancet HIV, Oliver Ratmann and colleagues combined social and demographic data with phylogenetic data in an innovative way to measure whether migration led to the spread of HIV from high HIV prevalence fishing communities along Lake Victoria to neighbouring inland communities in south-central Uganda. They asked this important question because HIV prevention efforts and treatment interventions are often prioritised to geographical hotspots, with the implicit assumption that these interventions will also have indirect benefits in neighbouring areas due to infections disseminating from the hotspot. They did not find frequent cross-community HIV transmission between Lake Victoria hotspots and nearby inland populations based on 293 source–recipient pairs with support for epidemiological linkage and direction of transmission. They concluded that, in this particular setting, targeted control of HIV in the lakeside hotspots would have a minimal effect on the epidemic elsewhere.

    更新日期:2020-01-15
  • Correction to Lancet HIV 2019; 6: e737–49
    Lancet HIV (IF 14.753) Pub Date : 2020-01-09

    Pantaleo G, Janes H, Karuna S, et al. Safety and immunogenicity of a multivalent HIV vaccine comprising envelope protein with either DNA or NYVAC vectors (HVTN 096): a phase 1b, double-blind, placebo-controlled trial. Lancet HIV 2019; 6: e737–49—In this Article, the label and data for the study group T4 in the right hand panel of figure 3C were presented incorrectly. This correction was made on Jan 9, 2020.

    更新日期:2020-01-10
  • HIV-related stigma among health-care workers in the MENA region
    Lancet HIV (IF 14.753) Pub Date : 2020-01-09
    Tala Ballouz; Nour Gebara; Nesrine Rizk

    In its commitment to end the HIV epidemic by 2030, UNAIDS set the 90-90-90 targets for testing, retention, and viral suppression. In 2016, a new and fourth 90 target—namely, that 90% of people living with HIV should have a good health-related quality of life—was advocated to be equally important. Although health-related quality of life is influenced by various factors, one highly important determinant is exposure to stigma and discrimination.

    更新日期:2020-01-10
  • People have the power
    Lancet HIV (IF 14.753) Pub Date : 2020-01-01
    The Lancet HIV

    The inexorable progress of time once again brings us to a new year, which inevitably invites reflection, especially at the start of a new decade. A year ago, in our , we commented on the state of play at UNAIDS—the global face of the fight against HIV/AIDS—at that point mired in controversy surrounding allegations of sexual misconduct and bullying. We expressed hope that, with a change of leadership, UNAIDS could rehabilitate itself, and in doing so would reflect on the values of the diverse and inclusive global community that it serves. The early signs from Winnie Byanyima's tenure as Executive Director are encouraging.

    更新日期:2020-01-07
  • Are 96-week data enough for doravirine to DRIVE FORWARD?
    Lancet HIV (IF 14.753) Pub Date : 2019-11-15
    Christoph D Spinner; Tristan John Barber

    In The Lancet HIV, Jean-Michel Molina and colleagues present 96-week data on doravirine (100 mg), a novel non-nucleoside reverse transcriptase inhibitor (NNRTI), versus darunavir (800 mg) boosted with ritonavir (100 mg) once daily, both in combination with investigator-selected nucleoside reverse transcriptase inhibitors (NRTIs)—emtricitabine and tenofovir disoproxil fumarate or abacavir and lamivudine—for initial treatment of HIV-1 infection. Interestingly, the authors compared doravirine with a boosted protease inhibitor in patients who were treatment naive, although highly effective and potent integrase strand inhibitors were a recommended first-line option in many guidelines by the time of trial commencement in 2014. , 

    更新日期:2020-01-07
  • Empirical tuberculosis therapy in advanced HIV disease
    Lancet HIV (IF 14.753) Pub Date : 2019-11-11
    Yukari C Manabe; Mark W Tenforde

    In The Lancet HIV, Alison Grant and colleagues report on the TB Fast Track cluster-randomised trial done in 24 South African primary health-care clinics. This pragmatic trial was designed to assess a nurse-led algorithm to stratify patients with advanced HIV disease (CD4 count <150 cells per μL) who were being evaluated for antiretroviral therapy (ART) to receive empirical tuberculosis treatment. The assessment was based on tuberculosis symptoms, body-mass index, point-of-care haemoglobin concentrations, and urine tuberculosis lipoarabinomannan assays. The algorithm was used to stratify patients into three categories on the basis of probability of tuberculosis (high, medium, and low).

    更新日期:2020-01-07
  • PrEP implementation in pregnant and post-partum women
    Lancet HIV (IF 14.753) Pub Date : 2019-12-05
    Dvora Joseph Davey; Landon Myer; Thomas Coates

    HIV acquisition during pregnancy presents a serious threat to maternal and child health. WHO recommends pre-exposure prophylaxis (PrEP) for HIV prevention among pregnant women living in communities with high HIV incidence. ,  However, there are few studies of the implementation of PrEP during pregnancy and the post-partum period in settings with a high HIV burden. PrEP delivery to pregnant women under regular clinical conditions needs to be documented urgently.

    更新日期:2020-01-07
  • Efavirenz in pregnancy
    Lancet HIV (IF 14.753) Pub Date : 2019-11-15
    Stanzi Maria le Roux; Elaine J Abrams

    Peripartum antiretroviral use has prevented almost 2 million paediatric HIV infections since 2010. Preventing perinatal HIV transmission is the first step towards optimisation of health outcomes for the rapidly expanding global population of children born to women living with HIV. However, the child health benefits of maternal antiretroviral therapy (ART) extend further, as improved health and survival allows women living with HIV to provide and to care for their families.

    更新日期:2020-01-07
  • Improving HIV-related care through eHealth
    Lancet HIV (IF 14.753) Pub Date : 2019-11-24
    Guido E L van den Berk; M C Leoni; Georg M N Behrens; Jantjie Taljaard; Joop E Arends

    WHO defines electronic health (eHealth) as “the use of information and communication technologies (ICT) for health”. eHealth interventions can be effective in HIV care (eg, aiding prevention, retention in care, and treatment adherence).

    更新日期:2020-01-07
  • Women in Kenya face challenges to adherence
    Lancet HIV (IF 14.753) Pub Date : 2020-01-01
    Christabel Ligami
    更新日期:2020-01-07
  • Highlights of the 17th European AIDS Conference
    Lancet HIV (IF 14.753) Pub Date : 2020-01-01
    Philippa Harris

    Antiretroviral-associated weight gain and models of care for those ageing with HIV were big topics at the conference held in Basel, Switzerland, November 6–9.

    更新日期:2020-01-07
  • WOFAK — support and advocacy for women in Kenya
    Lancet HIV (IF 14.753) Pub Date : 2020-01-01
    Christabel Ligami

    Women Fighting AIDS in Kenya (WOFAK) is a non-governmental organisation founded over two decades ago by a group of women living with HIV across Kenya. The organisation's aims are to support HIV-positive women and to empower them against discrimination and stigma.

    更新日期:2020-01-07
  • Living life freely but at a price
    Lancet HIV (IF 14.753) Pub Date : 2019-05-10
    Talha Burki
    更新日期:2020-01-07
  • Doravirine versus ritonavir-boosted darunavir in antiretroviral-naive adults with HIV-1 (DRIVE-FORWARD): 96-week results of a randomised, double-blind, non-inferiority, phase 3 trial
    Lancet HIV (IF 14.753) Pub Date : 2019-11-15
    Jean-Michel Molina; Kathleen Squires; Paul E Sax; Pedro Cahn; Johan Lombaard; Edwin DeJesus; Ming-Tain Lai; Anthony Rodgers; Lisa Lupinacci; Sushma Kumar; Peter Sklar; George J Hanna; Carey Hwang; Elizabeth Anne Martin; Debbie P. Hagins; Olayemi O. Osiyemi; David James Prelutsky; Moti N. Ramgopal; Anthony John Scarsella; Robin Dretler; Edwin DeJesus; Christopher J. Bettacchi; James Sims; Patrick G. Clay; Nicholaos C. Bellos; Melanie A. Thompson; Jose Montero; Cheryl K. McDonald; Catherine Creticos; David Shamblaw; Miguel Mogyoros; Antonio E. Terrelonge; Martin Valdes; Karen T. Tashima; William J. Robbins; Franco Antonio Felizarta; Richard A. Elion; Jihad Slim; Sandra S. Win; Sujata N. Lalla-Reddy; Peter Jerome Ruane; Anthony Mills; Jerry L. Cade; Craig A. Dietz; David Scott Rubin; Cynthia Mayer; Juan Carlos Rondon; Paul P. Cook; Eric Daar; Princy N. Kumar; Susan Swindells; Jose Guillermo Castro; Ivan Melendez-Rivera; Javier O. Morales-Ramirez; Lizette Santiago; Jorge L. Santana-Bagur; Marcelo Martins; Pedro Enrique Cahn; Gustavo D. Lopardo; Norma Porteiro; Mark Theo Bloch; David Alfred Baker; Norman Roth; Richard James Moore; Robert James Finlayson; James McMahon; Armin Rieger; Alexander Zoufaly; Sylvia Hartl; Robert Zangerle; Fiona Smaill; Sharon L. Walmsley; Brian Conway; Anita Rachlis; Graham H.R. Smith; Carlos Perez; Alejandro Afani; Maria Isabel Campos; Carolina Eugenia Chahin; Marcelo Wolff Reyes; Jan Gerstoft; Nina Weis; Alex Lund Laursen; Jean-Michel Molina; Yazdan Yazdanpanah; Laurent Cotte; Francois Raffi; Philippe Morlat; Pierre-Marie Girard; Christine Katlama; Juergen K. Rockstroh; Keikawus Arasteh; Stefan Esser; Albrecht Stoehr; Hans-Juergen Stellbrink; Matthias Stoll; Dirk Schuermann; Gerd Faetkenheuer; Johannes Bogner; Thomas Lutz; Axel Baumgarten; Hans Jaeger; Andrea Gori; Gabriel Coltan; Felicia Constandis; Simona Manuela Erscoiu; Liviu-Jany Prisacariu; Sorin Rugina; Adrian Streinu-Cercel; Vadim Valentinovich Pokrovsky; Natalia V. Zakharova; Andrey Anatolyevich Shuldyakov; Elena Pavlovna Ryamova; Valeriy Viktorovich Kulagin; Olga Aleksandrovna Tsybakova; Elena Orlova-Morozova; Firaya Nagimova; Evgeniy Voronin; Tatyana Evgenyevna Shimonova; Oleg Anatolyevich Kozyrev; Catherine Orrell; Johannes Jurgens Lombaard; Marleen de Jager; Joaquin Portilla Segorb; Josep Mallolas; Maria Jesus Perez Elias; Josep M. Gatell; Jose Ramon Arribas Lopez; Eugenia Negredo Puigmal; Daniel Podzamczer Palter; Federico Pulido Ortega; Jesus Troya Garcia; Ignacio De los Santos Gil; Juan Berenguer Berenguer; Ian G. Williams; Margaret A. Johnson; Gabriel Schembri; Amanda Clarke; Mark Gompels; Julie Meriel Fox; Steven John Taylor; David Harold Dockrell; Stephen Kegg
    更新日期:2020-01-07
  • Algorithm-guided empirical tuberculosis treatment for people with advanced HIV (TB Fast Track): an open-label, cluster-randomised trial
    Lancet HIV (IF 14.753) Pub Date : 2019-11-11
    Alison D Grant; Salome Charalambous; Mpho Tlali; Aaron S Karat; Susan E Dorman; Christopher J Hoffmann; Suzanne Johnson; Anna Vassall; Gavin J Churchyard; Katherine L Fielding
    更新日期:2020-01-07
  • Pre-exposure prophylaxis uptake and early continuation among pregnant and post-partum women within maternal and child health clinics in Kenya: results from an implementation programme
    Lancet HIV (IF 14.753) Pub Date : 2019-12-05
    John Kinuthia; Jillian Pintye; Felix Abuna; Kenneth K Mugwanya; Harison Lagat; Dickens Onyango; Emily Begnel; Julia Dettinger; Jared M Baeten; Grace John-Stewart; Ajode C Aquino; Steve J Ochieng; Alice M Lipesa; Ambia L Naidu; Anastacia Kamau; Anne W Njoroge; Bernard O Okeah; Cecilia B Makabwa; Celestine C Atieno; Christine K Ireri; Diana A Ojowi; Elizabeth S Lubembe; Emma Mukenyi; Emma J A Kephas; Esther N Bundi; Eunita I A Akim; Fredrick O Otieno; George R Owiti; Irene Cherotich; Irene A Ouma; Jacqueline Q Adhiambo; Joel A Otieno; Joseph M Mwendwa; Joyness B Kemunto; Magdalene C Rono; Martin C Ndung'u; Mary I A Osama; Maurine A Odhiambo; Melvin A Kiche; Meridah M Mwania; Neera Bhatt; Osama M Auma; Paskal O Otieno; Pauline Achieng; Peris W Muthoni; Rose K Chiira; Serede M Mmbukane; Sila J Mwania; Steve J Ochieng; Titus Kipyegon; Tonny O Ochieng; Valarie A Kemunto; Veronica A Odede; Vivian A Obote; Winnie N Mituga; Yvonne F Fondo

    Background Pregnant women in settings with high HIV prevalence are at increased risk of HIV acquisition and subsequent vertical transmission. We implemented and evaluated a novel programme to provide pre-exposure prophylaxis (PrEP) in maternal and child health clinics in Kenya. Methods In collaboration with Kisumu County Department of Health, we integrated PrEP delivery within 16 maternal and child health clinics in Kisumu County (Kenya). Women and girls older than 15 years seeking maternal and child health services who tested HIV negative at that visit or within a month and were willing to receive PrEP counselling were interviewed to assess for HIV behavioural risk factors and offered PrEP. Correlates of PrEP initiation and continuation were assessed using Poisson regression in univariate and multivariate analyses. Potential correlates included in our analyses were age, marital status, marriage type, whether pregnant or post partum, gestational age (if pregnant), and HIV risk factors in the previous 6 months. Reasons for the decision to discontinue after having decided to initiate PrEP were evaluated. Women who initiated PrEP were followed up 1 month, 3 months, and 6 months after initiation. Findings Between Nov 20, 2017, and June 13, 2018, 9376 pregnant and post-partum women were assessed for behavioural risk factors and willingness to initiate PrEP. Overall, 2030 (21·7%) initiated PrEP, and 2027 had the status of their partner captured (153 [79·3%] of 193 women with partners living with HIV, 1178 [37·2%] of 3165 women with partners of unknown HIV status, and 696 [11·6%] of 5997 women with HIV-negative partners). Predictors of PrEP initiation in the multivariate analysis were: being younger than 24 years (adjusted prevalence ratio 1·14, 95% CI 1·02–1·28); having a partner living with HIV (6·96, 5·46–8·89) or of unknown HIV status (3·08, 2·50–3·81); gestational age of less than 26 weeks (1·22, 1·02–1·47); having been diagnosed or treated for a sexually transmitted infection (1·57, 1·20–2·06); having been forced to have sex (1·82, 1·38–2·42); having experienced intimate partner violence during the previous 6 months (1·65, 1·10–2·48); having shared needles while engaging in injection drug use (2·43, 1·69–3·50); and recurrent use of post-exposure prophylaxis (1·96, 1·36–2·82). Overall, 786 (38·7%) of 2030 women who initiated PrEP continued use after the first month, with 104 (68·0%) of 153 women who had a partner living with HIV continuing use. Having a partner living with HIV was the only predictor of PrEP continuation at 1 month in the multivariable model (1·98, 1·54–2·55). Frequent reasons for discontinuation were side effects and low HIV risk perception. No incident HIV infection was reported among women on PrEP. Interpretation Many women attending maternal and child health clinics had risk factors for HIV and elected to use PrEP, indicating that routinely accessed maternal and child health clinics can be an effective platform for PrEP delivery for young women. As PrEP awareness rises, PrEP provision in routine clinical settings such as maternal and child health facilities might contribute to decreased HIV incidence among young women. Funding US Department of State.

    更新日期:2020-01-07
  • Association of maternal antiretroviral use with microcephaly in children who are HIV-exposed but uninfected (SMARTT): a prospective cohort study
    Lancet HIV (IF 14.753) Pub Date : 2019-11-15
    Paige L Williams; Cenk Yildirim; Ellen G Chadwick; Russell B Van Dyke; Renee Smith; Katharine F Correia; Alexandria DiPerna; George R Seage; Rohan Hazra; Claudia S Crowell
    更新日期:2020-01-07
  • Patient-reported outcomes to enhance person-centred HIV care
    Lancet HIV (IF 14.753) Pub Date : 2019-11-24
    Meaghan Kall; Fabienne Marcellin; Richard Harding; Jeffrey V Lazarus; Patrizia Carrieri

    Quality of life has been proposed as the fourth 90 to complement the UNAIDS 90-90-90 targets to monitor the global HIV response, highlighting a need to address the holistic needs of people living with HIV beyond viral suppression. This proposal has instigated a wider discussion about the use of patient-reported outcomes (PROs) to improve the treatment and care of an ageing HIV population with increasing comorbidities and a disproportionate burden of social problems. PROs can provide a first-hand assessment of the impact of HIV treatment and care on patients' quality of life, including symptoms. The field of PRO measures is rapidly expanding but still no gold standard exists, raising concerns about tool selection. Challenges also remain in the collection, interpretation, and use of PRO data to improve the performance of the health system. An emerging concern is how to adapt PROs to different sociocultural and geographical settings.

    更新日期:2020-01-07
  • Key populations and power: people-centred social innovation in Asian HIV services
    Lancet HIV (IF 14.753) Pub Date : 2019-12-06
    Fan Yang; Rena Janamnuaysook; Mark A Boyd; Nittaya Phanuphak; Joseph D Tucker

    Key populations increasingly lead the design, implementation, and evaluation of HIV services, which provides an opportunity to make them more people-centred. Despite many challenges, a strong argument that these populations must have a greater role in HIV service planning, development, and delivery worldwide exists. This Viewpoint focuses on Asia, where key populations have advocated for legal reform, engaged vulnerable groups to decrease stigma, co-created innovative HIV services, and developed new key population-led health services. Further research on key populations and their roles in HIV implementation and sustainable scale-up is needed in Asia and beyond.

    更新日期:2020-01-07
  • Tough requirements for new antiretroviral drugs
    Lancet HIV (IF 14.753) Pub Date : 2020-01-03
    Carmen de Mendoza; Vicente Soriano

    Medical and social attention to HIV infection has declined globally and is increasingly focused on developing regions, where the epidemic is still largely uncontrolled. In North America and western Europe, AIDS is rarely in newspaper headlines or mentioned in television news. The success of antiretroviral therapy largely explains this change in the perception of HIV/AIDS, which was once a life-threatening disease but is now, more many, viewed as a chronic illness. Indeed, individuals on treatment currently benefit from life expectancies close to those of people who are HIV negative.

    更新日期:2020-01-04
  • Safety, pharmacokinetics, and antiretroviral activity of islatravir (ISL, MK-8591), a novel nucleoside reverse transcriptase translocation inhibitor, following single-dose administration to treatment-naive adults infected with HIV-1: an open-label, phase 1b, consecutive-panel trial
    Lancet HIV (IF 14.753) Pub Date : 2020-01-03
    Dirk Schürmann; Deanne Jackson Rudd; Saijuan Zhang; Inge De Lepeleire; Martine Robberechts; Evan Friedman; Christian Keicher; Andreas Hüser; Jörg Hofmann; Jay A Grobler; S Aubrey Stoch; Marian Iwamoto; Randolph P Matthews
    更新日期:2020-01-04
  • Adherence among post-partum women living with HIV
    Lancet HIV (IF 14.753) Pub Date : 2019-12-20
    Rachel K Scott

    Antiretroviral therapy (ART) adherence and retention in care are crucial and poorly understood challenges to the care of women living with HIV in the USA, particularly in women with perinatally acquired HIV. Children with perinatally acquired HIV now survive to adulthood and have pregnancies of their own, but not without both medical and behavioural health consequences. ,  ,  In addition to the medical co-morbidities of chronic HIV infection, adolescents and young adults who have grown up with perinatally acquired HIV often have virological resistance from inconsistent long-term ART use. These young people face a lifetime of chronic disease, as well as the associated stigma and resulting behavioural consequences and health comorbidities. This patient population also tends toward more high-risk sexual behaviour, mental illness, and substance abuse than both HIV-exposed but uninfected peers, and peers with behaviourally-acquired HIV. ,  Pregnancy and pregnancy-associated adverse outcomes remain understudied in these patients, as does post-partum adherence and retention in medical care.

    更新日期:2019-12-21
  • Addressing the global burden of hepatitis B virus while developing long-acting injectables for the prevention and treatment of HIV
    Lancet HIV (IF 14.753) Pub Date : 2019-12-20
    Robert C Bollinger; Chloe L Thio; Mark S Sulkowski; Jane McKenzie-White; David L Thomas; Charles Flexner
    更新日期:2019-12-21
  • Trends in post-partum viral load among women living with perinatal HIV infection in the USA: a prospective cohort study
    Lancet HIV (IF 14.753) Pub Date : 2019-12-20
    Kunjal Patel; Brad Karalius; Kathleen Powis; Deborah Kacanek; Claire Berman; Anna-Barbara Moscicki; Mary Paul; Katherine Tassiopoulos; George R Seage
    更新日期:2019-12-21
  • Living well with HIV
    Lancet HIV (IF 14.753) Pub Date : 2019-11-24
    The Lancet HIV

    37·9 million people are estimated to be living with HIV, and those on successful antiretroviral therapy (ART) can expect to live a normal lifespan. In 2018 global progress towards the UNAIDS 90-90-90 targets (for 90% of those living with HIV to know their status, 90% of these to be on ART, and 90% of these to be virally supressed) stood at 79-78-86. Although much work remains to identify those living with undiagnosed HIV and to roll-out treatment to all, health services must also evolve to incorporate the complex, diverse, and changing health-care needs of people living with HIV. Viral suppression remains an essential goal, but it is not the sole endpoint of HIV care. In recognising the importance of looking at the health and wellbeing of people with HIV we are delighted to introduce a Series, HIV Outcomes Beyond Viral Suppression, published in The Lancet HIV, the first paper of which is included in this issue.

    更新日期:2019-12-03
  • Tesamorelin, liver fat, and NAFLD in the setting of HIV
    Lancet HIV (IF 14.753) Pub Date : 2019-10-11
    Jennifer Audsley, Joe Sasadeusz, Sharon R Lewin
    更新日期:2019-12-03
  • The global burden of HIV and prospects for control
    Lancet HIV (IF 14.753) Pub Date : 2019-08-19
    Abhishek Pandey, Alison P Galvani

    HIV/AIDS continues to have devastating health effects globally, with over 39 million HIV/AIDS-related deaths to date and more than 36 million people living with HIV currently.,  Despite great advancements in antiretroviral therapy (ART) and worldwide progress towards implementation of treatment-as-prevention programmes, approximately 2 million people become newly infected with HIV every year.,  Retrospectively, evaluations of the HIV burden are integral to the assessment of control approaches. Prospectively, projections of future HIV burdens are instrumental to guide resource allocation and policy optimisation. In The Lancet HIV, the GBD 2017 HIV Collaborators assess trends in HIV incidence, prevalence, mortality, and treatment coverage for 195 countries and territories from 1980 to 2017. Furthermore, they use these trends to forecast the course of country-specific HIV trends in the context of achieving UNAIDS goals. The aspirational 90-90-90 goal of UNAIDS aims to globally diagnose 90% of people living with HIV, provide treatment to 90% of people diagnosed, and achieve viral suppression in 90% of people on treatment by 2020. A subsequent 95-95-95 goal is set for 2030. The global HIV care continuum stands today at 75-79-81, corresponding to viral suppression in 48% of people living with HIV.

    更新日期:2019-12-03
  • Time to change cardiovascular prevention in people with HIV
    Lancet HIV (IF 14.753) Pub Date : 2019-10-18
    Esteban Martinez

    Today, people with HIV live longer because of antiretroviral therapy (ART) but experience a higher risk of comorbidities, including atherosclerotic cardiovascular disease. Increased risk of cardiovascular disease might be due to not only classic risk factors, which are over-represented in the HIV-positive population, but also additional factors not present in the general population. These factors include chronic inflammation associated with HIV infection (even if successfully treated) and the use of some antiretroviral drugs, through mechanisms that are poorly understood. Because cardiovascular events are rare, assessment of subclinical atherosclerosis measured by carotid artery intima-media thickness (cIMT) has been used as a surrogate marker of cardiovascular disease. cIMT reliably predicts cardiovascular events in the general population. However, the prognostic value of cIMT in people with HIV is not proven and comparisons of cIMT between HIV-positive and HIV-negative adults have shown discordant data. , 

    更新日期:2019-12-03
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