Episodic disability framework in the context of Long COVID: Findings from a community-engaged international qualitative study.

Background: Increasing numbers of adults are living with the health-related consequences of Long COVID. The Episodic Disability Framework (EDF), derived from perspectives of adults living with HIV, characterizes the multi-dimensional and episodic nature of health-related challenges (disability) experienced by an individual. Our aim was to determine the applicability of the Episodic Disability Framework to conceptualize the health-related challenges experienced among adults living with Long COVID.

Selecting Appropriate Clinical Trial Endpoints for Geroscience Trials: A Path Towards Consensus.

Using a modified Delphi process, we engaged 28 experts in clinical trials, geriatrics, and research translation to determine if there were consensus around what clinical endpoints should be used for trials evaluating the efficacy of interventions to prevent or treat multiple age-related conditions. Four focus groups developed themes. Statements related to those themes were circulated back to participants in a survey.

Sex Differences in Long COVID.

Importance: A substantial number of individuals worldwide experience long COVID, or post-COVID condition. Other postviral and autoimmune conditions have a female predominance, but whether the same is true for long COVID, especially within different subgroups, is uncertain.

Objective: To evaluate sex differences in the risk of developing long COVID among adults with SARS-CoV-2 infection.

Healthy Aging and the Gut Microbiome in People With and Without HIV.

Background: Aging-related comorbidities are more common in people with human immunodeficiency virus (HIV) compared to people without HIV. The gut microbiome may play a role in healthy aging; however, this relationship remains unexplored in the context of HIV.

Methods: 16S rRNA gene sequencing was conducted on stool from 1409 women (69% with HIV; 2304 samples) and 990 men (54% with HIV; 1008 samples) in the MACS/WIHS Combined Cohort Study.

What Motivates Older Sedentary People Living With HIV in the United States to Participate in an Exercise Trial? A Qualitative Study.

Although exercise supports the physical function and health of older people living with HIV (PLWH), less than half of PLWH globally achieve recommended levels of activity. A qualitative descriptive design was used to determine what motivates sedentary PLWH, 50 years and older, to participate in an exercise trial. Interviews were conducted with PLWH who participated in an exercise trial ( n = 30) and PLWH who declined enrollment in the same exercise trial ( n = 4).

2024 Update of the RECOVER-Adult Long COVID Research Index.

Importance: Classification of persons with long COVID (LC) or post-COVID-19 condition must encompass the complexity and heterogeneity of the condition. Iterative refinement of the classification index for research is needed to incorporate newly available data as the field rapidly evolves.

Objective: To update the 2023 research index for adults with LC using additional participant data from the Researching COVID to Enhance Recovery (RECOVER-Adult) study and an expanded symptom list based on input from patient communities.

Evaluation of a Cohort-Based Healthy Aging With HIV Wellness Pilot Intervention: "People Aging and Thriving With HIV" in Colorado.

The aging population of people living with HIV (PLWH) face unique health and social challenges. We piloted a community-based wellness program, People Aging and Thriving with HIV (PATH2Wellness), aiming to improve health outcomes through physical activity, nutritional counseling, and social support within Colorado Health Network, a statewide AIDS service organization. Participants ages 50+ were recruited into three cohorts between September 2020 and December 2021.

Predictors of frailty trajectories among people with HIV.

Objective: This study aimed to estimate the latent frailty trajectories and identify corresponding predictors (sociodemographic, HIV-related, comorbidities, and behavioral) among a cohort of people with HIV (PWH).

Design: Longitudinal observational study using latent class growth modeling.

Methods: Nine hundred and seventy-six PWH aged 40 years and older with frailty measured from at least two visits within the ACTG HAILO cohort were included.

Area-Level Social Deprivation and Cytomegalovirus Seropositivity at the Time of Solid Organ Transplant.

Importance: Cytomegalovirus (CMV) is associated with significant morbidity and mortality in solid organ transplant (SOT) recipients. The risk factors for CMV seropositivity in SOT recipients, including area-level social deprivation in the US, have not been fully characterized.

Objective: To (1) evaluate CMV seroprevalence, (2) assess the recipient characteristics associated with CMV seropositivity, and (3) assess the association of area-level social deprivation index (SDI) scores with pretransplant CMV serostatus.

Frailty, Physical Function Impairment and Pulmonary Function in Aging Men with and without HIV from the Multicenter AIDS Cohort Study (MACS).

Background: People aging with HIV (PAWH) experience greater impairment in physical and pulmonary function than individuals aging without HIV. We examined whether baseline physical function was associated with subsequent pulmonary impairments.

Methods: Associations of frailty and physical function (gait speed [m/sec], grip strength [kg]) with pulmonary function (< 80% predicted diffusing capacity for carbon monoxide [DL] and forced expiratory volume [FEV]) 3 years later were modeled; age, HIV status, and smoking were assessed as effect modifiers.

Muscle Quality and Physical Function in Men With and Without HIV.

Background: People with HIV (PWH) experience faster physical decline than those without HIV (PWoH), despite antiretroviral therapy. We compared skeletal muscle density and area and their relationship with physical function among PWH and PWoH.

Methods: Quantitative computed tomography scans were performed at the L4-L5 spinal region and the thigh to evaluate muscle groups in Multicenter AIDS Cohort Study participants at baseline.

Relationships Between Hepatic Steatosis and Frailty Differ by HIV Serostatus.

Background: Frailty is associated with obesity-related comorbidities, but the relationship with nonalcoholic fatty liver disease (NAFLD) in people with HIV has been incompletely described. Our objective was to assess the associations between NAFLD and frailty.

Methods: Cross-sectional and longitudinal analysis of men in the Multicenter AIDS Cohort Study.

Pitavastatin Is Well-Tolerated With no Detrimental Effects on Physical Function.

Background: Little is known about the potential benefits or harms of statins on physical function among people with human immunodeficiency virus (PWH).

Methods: REPRIEVE was a double-blind randomized controlled trial evaluating pitavastatin for primary prevention of major adverse cardiovascular events in PWH. Time to complete 10 chair rises, 4-m gait speed, grip strength, and a modified short physical performance test were assessed annually for up to 5 years in the ancillary study PREPARE and analyzed using linear mixed models.

Effects of Semaglutide on Muscle Structure and Function in the SLIM LIVER Study.

Background: Semaglutide is highly effective for decreasing weight. Concomitant loss of muscle mass often accompanies weight loss and may have consequences on muscle function.

Methods: This is a secondary analysis from the SLIM LIVER (Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections, ACTG A5371) study, a single-arm study of semaglutide in people with human immunodeficiency virus (HIV, PWH) with metabolic dysfunction-associated steatotic liver diseases (MASLD).

Area Deprivation Index and Frailty Among Older People With HIV.

We evaluated the relationship between neighborhood disadvantage (measured by the Area Deprivation Index [ADI]) and frailty. We performed a secondary analysis, pooling cross-sectional data collected from 209 people with HIV (PWH) aged ≥50 years enrolled in studies in Colorado (CO) and Missouri (MO). MO participants ( = 137) had a higher ADI (µ= 70, ơ = 25) compared to CO (µ= 32, ơ = 15; < .

Postural Stability as a Measure of Fall Risk in Older People with and without HIV.

As the number of older people with HIV (PWH) grows, accidental falls and their associated negative health outcomes are of increasing concern. Fall risk can be measured using novel screening tools such as evaluating postural stability using force plate technology. The aims of this study were to test this technology to assess fall risk among older PWH.

Risk factors for progression from prediabetes to diabetes among older people with HIV.

Objective: Risk factors for progression from prediabetes mellitus (pre-DM) to diabetes mellitus (DM) among people with HIV (PWH) receiving modern antiretroviral therapy (ART) require better characterization.

Design: AIDS Clinical Trials Group (ACTG) A5322 (HAILO) was an observational cohort study of PWH ≥40 years old. Participants initiated ART through ACTG randomized clinical trials.

Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors.

Objective: Tesamorelin is the only FDA-approved therapy to treat abdominal fat accumulation in people with HIV (PWH). Phase III clinical trials were conducted prior to the introduction of integrase inhibitors (INSTIs), which are now a mainstay of HIV antiretroviral therapy.

Design: We leveraged a randomized double-blind trial of 61 PWH and metabolic dysfunction-associated steatotic liver disease to evaluate the efficacy and safety of tesamorelin 2 mg once daily vs.

Weight change with antiretroviral switch from integrase inhibitor or tenofovir alafenamide-based to Doravirine-Based regimens in people with HIV.

Background: Weight gain has been well-described with integrase strand transfer inhibitors (INSTIs) and tenofovir alafenamide (TAF). Doravirine (DOR) has been identified as a relatively "weight-neutral" drug; however, there is little data describing its effect on weight change in routine clinical practice.

Methods: We conducted a retrospective chart review of weight change among people with HIV changing from an INSTI- to a non-INSTI regimen with DOR.