The efficacy and safety of bictegravir-based antiretroviral therapy in people with HIV and tuberculosis has not been evaluated. We aimed to evaluate the efficacy, safety, and pharmacokinetics of bictegravir-emtricitabine-tenofovir alafenamide twice-daily in people with HIV receiving rifampicin-based tuberculosis treatment.

A combined regimen of tenofovir disoproxil fumarate, lamivudine, and dolutegravir is widely prescribed for people living with HIV in programmes supported by the US President's Emergency Plan for AIDS Relief (PEPFAR). This study aimed to assess long-term virological and drug-resistance outcomes in response to initiation of or switching to the tenofovir-lamivudine-dolutegravir combination among individuals receiving care through such programmes.

Antiretroviral therapy (ART) scale-up in western Europe has reduced the incidence of AIDS-related conditions, increased life expectancies, and led to an ageing population of people with HIV. We aimed to project cause-specific mortality patterns in western Europe by 2050 in the context of changes in demographics and ART use.

There is a high unmet need for effective HIV prevention options, including vaccines, for individuals at high risk of HIV acquisition who choose not to use pre-exposure prophylaxis or other prevention strategies. This study evaluated the efficacy and safety of an HIV-1 vaccine regimen consisting of tetravalent mosaic adenovirus serotype 26-based vaccine (Ad26.Mos4.HIV) and bivalent clade C glycoprotein (gp) 140-mosaic gp140 vaccine, in a population with high seroincidence.

Identifying characteristics associated with functional cure of HIV-1 infection is of pivotal importance. Here, we describe a unique case of functional cure in an exceptional elite controller, comparing immunological, virological, and clinical characteristics with those of other elite controllers.

HIV acquisition risk during pregnancy remains high and additional data supporting pre-exposure prophylaxis (PrEP) in pregnancy are needed. The aim of the MTN-042/DELIVER study was to evaluate the dapivirine vaginal ring (DVR) and daily oral tenofovir disoproxil fumarate plus emtricitabine use as PrEP during pregnancy. We report infant outcomes following confirmed in-utero exposure.

Parkinsonism is increasingly recognised in people who are ageing with virally suppressed HIV, with bradykinesia emerging earlier and more frequently than in idiopathic Parkinson's disease. Despite effective antiretroviral therapy (ART), studies report persistent motor symptoms-such as motor slowing, postural instability, and symmetric postural tremor-and non-motor features, including sleep disturbance, cognitive decline, and autonomic dysfunction. Neuroimaging reveals basal ganglia atrophy, white matter hyperintensities, and reduced dopamine transporter activity, underscoring a pathophysiology distinct from idiopathic Parkinson's disease. Proposed mechanisms include chronic neuroinflammation, cerebrovascular dysfunction, mitochondrial injury, disturbed iron metabolism, and possible ART-induced neurotoxicity, all contributing to basal ganglia dysfunction. Diagnosis is made complex by under-recognition, non-specific assessment tools, and comorbidities. Standardised rating scales, such as the Unified Parkinson's Disease Rating Scale and the HIV Dementia Motor Scale, can support clinical evaluation, but evidence-based management strategies are scarce. Although dopamine replacement therapy and deep brain stimulation show promise in case reports, no established guidelines exist for parkinsonism in people with virally suppressed HIV. As the global population of older adults with HIV grows, parkinsonism is expected to become an increasingly prevalent and underdiagnosed cause of frailty, highlighting the urgent need for targeted epidemiological, mechanistic, and interventional research, particularly in low-income and middle-income settings.

Characterising disparities in HIV infection across populations by gender, age, and HIV risk is key information to guide intervention priorities. We aimed to assess how indicators measuring HIV acquisitions, transmissions, or potential long-term infections influence estimates of the contribution of different populations to new infections, including key populations (including female sex workers, their clients, men who have sex with men).

Women living with HIV have an elevated risk for cervical cancer, present earlier, and have more recurrent human papillomavirus (HPV) infections compared with women without HIV. To update WHO recommendations on screening and treatment to prevent cervical cancer, we aimed to identify whether women living with HIV should be screened for cervical cancer at a specific age, the optimal screening interval following a negative cervical screen, and the screening interval following treatment.

Dolutegravir is not recommended for neonates (age 28 days or younger) due to the absence of dosing guidelines and safety information. We evaluated the multidose pharmacokinetics and safety of two paediatric dolutegravir formulations in neonates: a scored dispersible tablet and a novel oral dispersible film.

A large and rapidly growing percentage of health-care organisations are implementing artificial intelligence (AI; including generative AI), for research, care delivery, and policy. Despite concerns (eg, ethical considerations and data privacy) by HIV stakeholders (eg, providers, patients, government, and community-based organisations), AI-driven tools are already being used in HIV-related areas such as testing, risk prediction, clinical decision making, and HIV interventions. This Viewpoint outlines the use of AI in both HIV and broader public health settings; provides examples across patient, provider, and system-level use cases; and presents crucial AI-related implementation challenges, including health literacy, system readiness, and equitable access. HIV stakeholders need to actively and repeatedly seek out and engage partnerships with industry and technology professionals to ensure that AI safely and effectively supports public care and trust.

HIV programmes globally continue to face two persistent challenges: advanced HIV disease and high HIV incidence. These issues are often viewed separately, with advanced HIV disease viewed as a late-stage clinical failure and high HIV incidence as a failure of early prevention. However, these issues are closely linked at the individual and population level; both reflect the inability of current care models to engage and sustain viral suppression among a sizeable subgroup of people living with HIV who initiate antiretroviral therapy late or cycle in and out of care. In sub-Saharan Africa, where the HIV burden is highest, most individuals with advanced HIV disease are people who have previously initiated antiretroviral therapy and subsequently disengaged, often multiple times. This type of interruption in care has substantial implications for immune decline, viral rebound, and mortality. As donor funding decreases, there is a risk that global HIV responses will revert focus to maintaining aggregate antiretroviral therapy coverage, overlooking harder-to-reach populations with persistent viraemia.