Publications
Results
- Showing results for:
- Reset all filters
Search results
-
Journal articleCassar O, Djuicy DD, Begliomini G, et al., 2026,
HTLV-1 genetic diversity of 52 complete sequences from 14 African countries reveals novel variants and a lack of typical P12/P8 and P30 accessory proteins in HTLV-1b, d, and f genotypes
, Emerging Microbes and Infections, Vol: 15, ISSN: 2222-1751Central Africa is the largest region of human T-cell Leukaemia virus (HTLV-1) endemicity with several million people estimated to be infected. Based on the study of the LTR region, it is also the region with the highest HTLV-1 diversity, with the presence of genotypes a-b and d-g. However, complete genomic sequences are still lacking for Central African genotypes. Here, we report the first large collection of complete HTLV-1 sequences for genotypes b, d and f from Central Africa and neighbouring countries. We identified substantial diversity within the HTLV-1b genotype, including a newly defined clade that we designated HTLV-1b-del. It mainly comprises strains from the Democratic Republic of the Congo (COD) and neighbouring countries and is characterized by a distinctive 12-bp-long deletion. We also generated the complete sequence of the STLV-1 strain from Allenopithecus nigroviridis from the COD. This strain belongs to the PTLV-1b genotype and carries a 12-bp duplication in the pX region. Lastly, we found that, except for HTLV-1a strains, HTLV-1 genomes generally lack open reading frames encoding the canonical accessory protein P12; instead, they encode either shorter versions of the protein or an ORF lacking a start ATG codon. This work substantially expands the genomic landscape of HTLV-1 in Central Africa and provides a critical resource for understanding viral diversity.
-
Journal articleEvangeli M, Gnan G, Musiime V, et al., 2026,
The process of developing an HIV disclosure intervention for youth with perinatally acquired HIV: The HIV Empowering Adults' Decisions to Share - UK/Uganda Project (Heads-Up).
, Glob Public Health, Vol: 21Sharing one's HIV status with others (onward HIV disclosure) for youth with perinatally acquired HIV (PAH) is often difficult but may assist with challenges associated with living with HIV. We describe the development of an intervention to help HIV-sharing decision-making for UK and Ugandan youth with PAH. The methods included : (1) semi-structured interviews with 50 participants (20 with PAH patients aged 18-25 years, 20 friends, family or partners and 10 professionals), (2) a survey of 57 UK participants with PAH patients aged ≥17, (3) the development of an intervention conceptual model, (4) intervention development, including obtaining intervention feedback from 13 youth with PAH. The survey showed that group (23/57; 40%) and mixed individual and group formats (21/57; 37%), mixed gender groups (52/57; 91%) and peer worker involvement (54/57; 95%) were preferred. The interviews highlighted the importance of overcoming feelings of shame and accepting one's status before sharing, having support to feel confident to share, personal values playing a part in sharing decisions and friends and partners explaining that they had not been educated about HIV until someone had shared their status with them. We describe the finalised intervention, and strengths and limitations of the intervention development process are outlined.Trial registration: ISRCTN Registry, ISRCTN31852047, Registered on 21 January 2019.
-
Journal articleDi Gravio C, Guzmàn V, Wu S, et al., 2026,
Long COVID symptom profiles, workforce participation, and working hours among adults in England: a population-based cohort study
, The Lancet Regional Health. Europe, Vol: 68, ISSN: 2666-7762Background. Long COVID, marked by ongoing multi-systemic symptoms following COVID-19 infection, can impair ability to maintain employment. However, its relationship to workforce retention and working hours remains unclear. Methods. Long COVID was defined as symptoms lasting >12 weeks post-infection. We analysed data from a late-2022 follow-up survey involving 45,864 participants of the Real-time Assessment of Community Transmission (REACT) Study in England (median follow-up: 23 months). Hierarchical clustering identified symptom groups. Multivariable regressions examined associations between Long COVID, being in paid work, and changes in working hours. Findings. Of 45,864 participants employed at recruitment, 86% (N = 39,341) remained in paid work at follow-up and 11% (N = 4,877) changed work hours. Approximately 4% (N = 1,967/45,864) had unresolved Long COVID. Compared with participants with no/short (<4 weeks) symptoms, those with unresolved Long COVID had lower odds of being in paid work at follow-up (adjusted odds ratio [aOR]: 0·62, 95% confidence interval [CI]: 0·55,0·70), and higher odds of changing work hours (aOR: 4·34, 95%CI: 3·88,4·85). Three clusters were identified: multisystem severe, fatigue-predominant and anosmia-predominant Long COVID. Compared with the fatigue-predominant cluster, participants with multisystem severe Long COVID had lower odds of paid work (aOR: 0·63, 95%CI: 0·47,0·84) and higher odds of changing work hours (aOR 2·76, 95%CI 2·21,3·46).Interpretations. Unresolved Long COVID was associated with worse employment outcomes. Symptom clusters highlighted the importance of considering heterogeneity in Long COVID when assessing workforce impacts and designing public health responses.Fundings. National Institute for Health and Care Research, UK Research and Innovation.
-
Journal articleWeterings DA, Chiou Yee LL, Watber P, et al., 2026,
Loss of HTLV-1–specific CD8⁺ T-cell immunity in virus-carriers predisposed to adult T-cell leukemia/lymphoma
, Blood Neoplasia, Vol: 3, ISSN: 2950-3280Adult T-cell Leukemia/Lymphoma (ATL) is caused by chronic infection with Human T-lymphotropic virus type-1 (HTLV-1). HTLV-1 contains highly immunogenic CD8+ T-cell epitopes which elicit high frequencies of virus-specific CD8+ T-cells in most virus-carriers. Despite the virus being present in the tumour, HTLV-1-specific CD8+ cells are often undetectable in ATL. To characterise HTLV-1-specific CD8+ T-cells during ATL development, we studied a sub-group of people living with asymptomatic HTLV-1 infection at very high risk of developing ATL. These so- called ‘high-risk’ carriers have suspected premalignant lesions: expanded, HTLV-1-infected ‘ATL-like’ clones circulating in their peripheral blood. Compared to viral antigen-burden matched controls, high-risk carriers had significantly fewer Tax-specific IFN-γ+CD8+ cells in peripheral blood. Furthermore, ex vivo CD8+ T-cells from high-risk carriers did not efficiently kill autologous HTLV-1-infected T-cells, including premalignant ATL-like clones. We stained Tax11–19/HLA-A*0201 pentamer+CD8+ T-cells to test whether the low frequencies of functional CD8+ T-cells resulted from the phenotype or absolute frequency of HTLV-1-specific CD8+ T-cells. Again, high-risk carriers had significantly lower frequencies of Tax11–19/HLA-A*0201 pentamer+CD8+ T-cells than controls, but we observed no difference in effector function, memory phenotype or expression of checkpoint control molecules (PD-1, TIGIT, TIM-3, LAG-3, CTLA-4). In contrast, there was no difference in the frequency of CD8+ T-cells specific for other viruses (CMV, EBV, Flu) between high-risk carriers and controls. This is the first report of HTLV-1-specific immune dysregulation in the premalignant stage of ATL. Low frequencies of HTLV-1-specific CD8+ T-cells may contribute to ATL development, and may be a novel therapeutic target for ATL prevention.
-
Journal articlede Oliveira ACP, Assone T, Haziot ME, et al., 2026,
Asymptomatic is not silent: proposal of HTLV-1-associated multiple inflammatory disorder as an early neuroinflammatory state.
, Expert Rev Anti Infect Ther, Pages: 1-8BACKGROUND: Human T-lymphotropic virus type 1 (HTLV-1) infection is classically categorized as either asymptomatic or associated with HTLV-1-associated myelopathy (HAM). However, accumulating clinical evidence suggests that a proportion of individuals labeled as asymptomatic present early inflammatory and neurological manifestations that do not fulfill HAM diagnostic criteria. RESEARCH DESIGN AND METHODS: We conducted an observational study within a large, long-standing Brazilian HTLV-1 cohort. Between January 2015 and December 2025, adults previously classified as asymptomatic were systematically evaluated during follow-up at an outpatient clinic. Standardized clinical and neurological examinations were newly performed by clinicians not previously involved in their care and assessment. These findings were then integrated with neuropsychological, radiological and laboratory assessments. RESULTS: Among individuals previously considered asymptomatic, 24% fulfilled predefined criteria for an intermediate condition termed HTLV-1-associated multiple inflammatory disorder (HAMID). HAMID was associated with older age, female sex, higher proviral load, markers of chronic immune activation, subtle spinal cord abnormalities, and cognitive impairment, particularly affecting episodic memory. CONCLUSIONS: HTLV-1 infection encompasses an early, biologically active inflammatory disease stage distinct from both asymptomatic infection and overt HAM. Recognition of HAMID refines the clinical spectrum of HTLV-1 infection and provides a framework for earlier diagnosis, improved risk stratification, and clinical surveillance.
-
Journal articlede Melo Silva J, Vasconcelos Mourão EM, Santos EM, et al., 2026,
Emergence of West African Human T-Lymphotropic Virus 1aC Subgroup, Brazilian Amazon.
, Emerg Infect Dis, Vol: 32, Pages: 1207-1211In a cross-sectional survey of 1,397 residents of Manaus, Brazil, we found a seroprevalence of 0.3% for human T-lymphotropic viruses (HTLVs) 1/2 and identified HTLV type 1aC by phylogenetic analysis. Those findings provide evidence of introduction of West African HTLV-1aC into the Brazilian Amazon and highlight regional limitations in genomic surveillance.
-
Journal articleHenderson M, Dutey-Magni P, Herrera C, et al., 2026,
Longitudinal changes in plasma biomarkers of immune activation, neuronal inflammation and injury in persons with HIV initiating ART.
, HIV Med, Vol: 27, Pages: 1132-1143BACKGROUND: Data on changes in biomarkers of brain health, and their associations with cognitive function in adults commencing either dual- or triple-antiretroviral therapy (ART) are sparse. METHODS: Plasma biomarkers (neurofilament light [NfL], glial fibrillary acidic protein [GFAP], sCD14, CXCL10, neopterin and IL-6) were measured at baseline and after 96 weeks on ART in individuals randomized to darunavir/ritonavir and either tenofovir-DF/emtricitabine (triple-ART, n = 119) or raltegravir (dual-ART, n = 119) in NEAT-001/ANRS143. Regression models examined associations of baseline and week-96 biomarker concentrations with HIV clinical parameters, composite cognitive test scores (Standardized neuropsychological test [NPZ], 7-domains) and treatment arm. RESULTS: In 238 individuals, median age was 38 (interquartile range [IQR] 31, 46) years, 87% male and 83% of white ethnicity. Baseline median log10 HIV RNA 4.73 (IQR 4.23, 5.11) copies/mL and CD4 350 (IQR 285, 412) cells/mm3. At baseline, higher biomarker concentrations were associated with lower CD4 (NfL, GFAP, CXCL10; p < 0.03), higher log10 HIV RNA (sCD14, neopterin, CXCL10; p < 0.02) and longer known duration of HIV (sCD14; p = 0.044). At week-96, 94% had plasma HIV <50 copies/mL, and a decline in biomarker concentrations was observed: GFAP -14.4%, sCD14 -6.8%, neopterin -47.4%, CXCL10 -58.8%, IL-6 -29.5% (all p < 0.001) and NfL -4.4% (p = 0.075). NPZ improved by 0.21 mean points. Change in GFAP, CXCL10, sCD14, neopterin and NfL was negatively associated with change in CD4 (all p ≤ 0.002) but not change in NPZ (p > 0.05). A greater decline in neopterin concentration was observed with dual- (-50.2%) versus triple-ART (-44.3%; p = 0.022). CONCLUSIONS: Plasma biomarkers of brain health improved following ART initiation, associated predominantly wi
-
Journal articleSaini R, Fidler S, Boffito M, et al., 2026,
Prior PrEP use and discontinuation in individuals newly diagnosed with HIV.
, HIV MedBACKGROUND: In settings with high uptake of HIV pre-exposure prophylaxis (PrEP), an increasing proportion of individuals newly diagnosed with HIV report prior PrEP exposure. Understanding patterns of PrEP use, discontinuation and adherence in such settings is essential to inform future HIV prevention strategies. METHODS: We conducted a retrospective case-note review of individuals newly diagnosed with HIV at 56 Dean Street, London, UK, between 1 January 2017 and 31 December 2024. Data collected included demographics, prior PrEP use, adherence and reasons for discontinuation and baseline blood results. Individuals with prior PrEP use were compared with those who had never used PrEP. RESULTS: Among 1080 individuals newly diagnosed with HIV, 210 (19.4%) reported prior PrEP use. The annual proportion with prior PrEP use increased from 4.3% in 2017 to 60.5% in 2024. Compared with never-PrEP users, those with prior PrEP use were more likely to have recently acquired HIV (85.7% vs. 58.2%, p < 0.00001), to have previously attended the clinic (70.0% vs. 37.7%, p < 0.00001) and to have undergone more frequent HIV testing. Among prior PrEP users, 36.2% reported PrEP discontinuation, and in those who had not discontinued PrEP at diagnosis, 73.5% reported poor adherence. The most common reasons for discontinuation were lack of PrEP supply, monogamy and gastrointestinal side effects. The only major resistance mutation that showed a significant difference between the two groups was M184I/V: 27 (19.6%) in PrEP-exposed versus 7 (0.8%) in not-PrEP-exposed. CONCLUSIONS: In this high-PrEP-uptake setting, a growing proportion of individuals newly diagnosed with HIV report prior PrEP use, most commonly characterized by discontinuation or suboptimal adherence. These findings highlight an ongoing unmet need for interventions that support PrEP persistence and continuity, including improved access pathways and alternative PrEP formulations.
-
Journal articleSconza R, Taylor GP, Ene L, et al., 2026,
Dosing of ritonavir-boosted darunavir for treatment of HIV in pregnancy.
, AIDS, Vol: 40, Pages: 831-839OBJECTIVE: To assess the effectiveness of once- and twice-daily ritonavir-boosted darunavir (DRV/r)-containing regimens for treating HIV in pregnancy to inform the 2025 World Health Organization antiretroviral treatment guidelines update. DESIGN: Analysis of pooled data from two observational study networks with sites in Romania, Switzerland, and the United Kingdom. METHODS: Pregnancies resulting in a live birth or stillbirth in women receiving 800/100 mg DRV/r once-daily or 600/100 mg twice-daily during pregnancy were included. The primary outcome was viral suppression (<50 copies/ml) near delivery (from 28 days prior to 7 days after delivery). RESULTS: Among 162 women on once-daily DRV/r, 95% were virally suppressed near delivery, with no difference between those on DRV/r from conception (95%, 113/119) and those who started on or switched to DRV/r during pregnancy (95%, 41/43). Among 27 women on twice-daily DRV/r, 78% were virally suppressed near delivery. Most women remained on the same DRV/r regimen until delivery, and there were no vertical transmissions. Darunavir drug concentrations for the limited number of pregnancies with data available fell within the expected ranges. CONCLUSIONS: This analysis provides some reassurance that once-daily DRV/r can be used successfully in pregnancy. However, given the possibility of reduced drug levels in pregnancy with once-daily dosing, viral load monitoring during pregnancy remains essential. Surveillance of pregnancies in women receiving once-daily DRV/r is needed to further support the use of this dosing during pregnancy.
-
Journal articleKarakosta A, Nicholls EJ, Coukan F, et al., 2026,
Missed opportunities to prevent HIV acquisition with pre-exposure prophylaxis: A mixed methods study of people with recently acquired HIV in the United Kingdom.
, HIV Med, Vol: 27, Pages: 979-990OBJECTIVES: To explore missed opportunities for PrEP use among people with recently acquired HIV in the United Kingdom. METHODS: Data were derived from CASCADE, an international, longitudinal, mixed-methods study of adults (≥16 years) with recently acquired HIV (≤12 months). Individuals were recruited from nine UK clinics (08/2022-09/2024) to self-complete a questionnaire; a subset participated in semi-structured interviews (SSIs). RESULTS: 46 questionnaires were completed (39 cisgender men and 7 women, including 2 transgender women) and 11 SSIs (1 cisgender woman). Among men, 22 perceived HIV risk before diagnosis; 21 had ≥5 sexual partners and 17 reported group sex in the 3 months before diagnosis. Thirty (29 men and 1 woman) reported sexualized drug use. Twenty men had ever used PrEP; seven of them had not used it in the 6 months prior to diagnosis. No women had ever used PrEP. Most gay, bisexual and other men who have sex with men (GBMSM) were aware of PrEP; however, risk perception, social meanings of PrEP and concerns about side effects hindered utilization. Among five men using event-based dosing (EBD), three described difficulty predicting sexual activity that led to missed or mistimed pre-/post-sex doses - while others were reluctant to take daily PrEP. For women, the biggest barrier was lack of awareness. CONCLUSIONS: PrEP barriers vary by population. For GBMSM, addressing barriers to uptake/adherence (e.g., EBD challenges) are key, highlighting the potential benefit of long-acting injectables. However, awareness of PrEP remains a key challenge for women to achieve equity in prevention.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.