The clinical implications of HIV infection and aging

Exploring socio-economic dimensions in HIV research: a comprehensive bibliometric analysis (1992-2024)

The socio-economic burden of HIV infection remains a critical global health concern. This study was conducted to perform a comprehensive bibliometric analysis of the socio-economic burden of HIV infection, highlighting research trends, collaboration networks, and the evolving focus on social determinants of health over the past 32 years. A systematic search was conducted in Scopus and Web of Science Core Collection databases, covering publications from 1992 to 2024. The analysis was performed using RStudio and Biblioshiny, focusing on 1,054 studies from 422 publications. This study revealed a steady annual growth rate of 16.72% in publications on the socio-economic burden of HIV from 1992 to 2024, with the USA and Canada leading in contributions. The University of Toronto emerged as the top institution, while 'social determinants of health' and 'HIV infections' were identified as pivotal research themes. Collaboration networks were predominantly among high-income countries, with limited engagement from high-burden regions like sub-Saharan Africa. Key journals, such as AIDS and Behavior, were identified as central to advancing the field. Thematic analysis highlighted a shift from biomedical to socio-economic factors, emphasizing the need for equitable global collaboration and research addressing disparities in HIV management. This comprehensive analysis provides valuable insights into the evolving landscape of HIV socio-economic burden research, emphasizing the need for increased collaboration with high-burden regions and a continued focus on addressing social determinants of health in HIV management.

Síndrome da fragilidade, capacidade pulmonar e funcional em pacientes infectados pelo HIV/AIDS

RESUMO O objetivo deste estudo foi avaliar a prevalência da síndrome da fragilidade e a sua relação com a função pulmonar, a capacidade funcional e as variáveis relacionadas à pacientes infectados pelo vírus HIV. Trata-se de um estudo transversal e descritivo, com análises quantitativas de dados. A amostra foi composta por indivíduos diagnosticados com HIV/AIDS e sem limitações prévias de locomoção. A síndrome da fragilidade foi avaliada pela aplicação do fenótipo da fragilidade, pontuado nos seguintes itens: perda de peso não intencional, fadiga, redução da velocidade da marcha, redução do nível de atividade física e redução da força de preensão palmar. A função pulmonar e a força muscular ventilatória foram avaliadas por meio de espirometria e manovacuometria. A capacidade funcional foi mensurada pelo teste de caminhada de seis minutos (TC6). A análise dos dados foi realizada com testes estatísticos de comparação, adotando-se o nível de significância de 5%. Todos os pacientes incluídos neste estudo encontravam-se dentro dos critérios de fragilidade. Destes, 70% eram frágeis e 30% pré-frágeis. Verificou-se uma relação entre o comprometimento da capacidade funcional, a prevalência de distúrbio ventilatório restritivo e a presença de comorbidades na população frágil comparado com a pré-frágil. Os achados deste estudo permitem a conclusão de que a síndrome da fragilidade impacta a saúde de indivíduos com HIV/AIDS, com comprometimento da espirometria, redução da capacidade funcional e presença de comorbidades.

Growing challenges for HIV programmes in Asia: clinic population trends, 2003-2013

The scale-up of antiretroviral therapy (ART) has led to a substantial change in the clinical population of HIV-positive patients receiving care. We describe the temporal trends in the demographic and clinical characteristics of HIV-positive patients initiating ART in 2003-13 within an Asian regional cohort. All HIV-positive adult patients that initiated ART between 2003 and 2013 were included. We summarized ART regimen use, age, CD4 cell count, HIV viral load, and HIV-related laboratory monitoring rates during follow-up by calendar year. A total of 16 962 patients were included in the analysis. Patients in active follow-up increased from 695 patients at four sites in 2003 to 11,137 patients at eight sites in 2013. The proportion of patients receiving their second or third ART regimen increased over time (5% in 2003 to 29% in 2013) along with patients aged ≥50 years (8% in 2003 to 18% in 2013). Concurrently, CD4 monitoring has remained stable in recent years, whereas HIV viral load monitoring, although varied among the sites, is increasing. There have been substantial changes in the clinical and demographic characteristics of HIV-positive patients receiving ART in Asia. HIV programmes will need to anticipate the clinical care needs for their aging populations, expanded viral load monitoring, and, the eventual increase in second and third ART regimens that will lead to higher costs and more complex drug procurement needs.