Search Results (2,064)

Background/Objectives: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with ischemic stroke, systemic thromboembolism, heart failure, and mortality. Although oral anticoagulation (OAC) remains the cornerstone of stroke prevention, long-term therapy may be limited by bleeding risk, contraindications, intolerance, nonadherence, or thromboembolic events despite treatment. Left atrial appendage closure (LAAC) has therefore emerged as a non-pharmacological alternative for selected patients with nonvalvular AF. This review aimed to synthesize current evidence on LAAC, focusing on comparative efficacy versus OAC, device evolution, imaging-guided strategies, antithrombotic management, procedural optimization, unresolved challenges, and emerging technologies. Methods: This state-of-the-art narrative review was informed by targeted, non-systematic searches of PubMed and Scopus for publications from January 2009 to June 2026. Evidence was selected purposively to represent clinically relevant guidelines, randomized trials, registries, comparative observational studies, systematic reviews, meta-analyses, imaging studies, device-comparison studies, and reports of emerging technologies. The selected evidence was synthesized narratively; no exhaustive screening process, PRISMA flow diagram, formal risk-of-bias assessment, or quantitative synthesis was performed. Results: Randomized evidence was context dependent. OPTION supported LAAC as an alternative to oral anticoagulation in selected anticoagulation-eligible patients undergoing atrial fibrillation ablation. CHAMPION-AF established noninferiority of Watchman FLX to non–vitamin K antagonist oral anticoagulants for its composite efficacy endpoint in a predominantly moderate-risk, anticoagulation-eligible population and demonstrated less non-procedural bleeding, although ischemic stroke occurred numerically more often after LAAC. In contrast, CLOSURE-AF did not establish noninferiority of LAAC to physician-directed medical therapy in an older population at high risks of both stroke and bleeding. These findings indicate that the comparative value of LAAC depends strongly on patient selection, comparator therapy, endpoint composition, procedural risk, and trial design. Observational, registry, and emerging evidence was considered supportive or hypothesis-generating rather than equivalent to randomized evidence. OPTION enrolled only patients undergoing or recently undergoing AF ablation who were suitable for anticoagulation. CHAMPION-AF included 3000 anticoagulation-eligible patients but had relatively low baseline bleeding risk, while CLOSURE-AF studied 912 substantially older, higher-risk patients and did not meet its noninferiority criterion. Conclusions: LAAC has evolved into a precision-guided intervention integrating patient risk, left atrial appendage anatomy, device choice, imaging, antithrombotic therapy, and structured surveillance. Further studies are needed to optimize patient selection, standardize post-procedural therapy, and clarify its long-term role compared with contemporary direct oral anticoagulant therapy. Full article

Human immunodeficiency virus (HIV) is an enveloped virus with a remarkable capacity for genetic diversification, enabling rapid escape from host immune responses and therapeutic interventions. Despite extensive global efforts, the development of an effective vaccine has remained elusive owing to the virus’s high genetic variability and antigenic diversity. Consequently, considerable effort has been directed toward the development of therapeutic agents targeting viral entry, reverse transcriptase, integrase, protease, and more recently, capsid. Although antiretroviral therapy (ART) remains the cornerstone of HIV treatment, it is associated with challenges including drug resistance, adverse side effects, and limitations in access and affordability. Targeting viral entry offers distinct advantages by blocking infection at the earliest stage of the viral life cycle and enabling the neutralization of free virions, as well as Fc-mediated elimination of HIV-infected cells in some cases. This review highlights promising protein-based HIV entry inhibitors that have demonstrated efficacy in preclinical studies, and discusses ongoing efforts to optimize their valency, avidity, specificity, serum half-life, effector functions, and production platforms to improve their therapeutic potential and economic feasibility. Full article

Background: Despite Rwanda’s achievement of the UNAIDS 95–95–95 targets, national evidence on virological failure (VF) and mortality after transition to second- or third-line antiretroviral therapy (ART) remains limited. We estimated the incidence of these outcomes and examined associated factors among people living with HIV (PLWH) transitioned to second- or third-line ART in Rwanda between 2019 and 2025. Methods: We conducted a retrospective cohort study using Rwanda’s national HIV case-based surveillance (CBS) system. PLWH aged ≥15 years who transitioned to second- or third-line ART between 1 January 2019 and 31 December 2025 were followed from transition until the first recorded outcome, last clinical contact, or administrative censoring. The primary operational VF endpoint was the first viral load >1000 copies/mL recorded ≥180 days after transition; a prespecified sensitivity analysis required two consecutive measurements >1000 copies/mL. We used Kaplan–Meier estimation and facility-clustered Cox regression for the composite outcome of VF or death, and Aalen–Johansen cumulative incidence functions and Fine–Gray regression for VF with death treated as a competing event. Results: Among 778 PLWH followed for 3564 person-years (median follow-up, 60.0 months), 81 (10.4%) met the primary operational VF endpoint, and 13 (1.7%) had death recorded as the first event. The composite incidence rate was 2.64 per 100 person-years (95% CI 2.10–3.17). In adjusted Cox regression, a PI-based regimen (adjusted hazard ratio [aHR] 2.14, 95% CI 1.37–3.36), WHO stage III (aHR 1.92, 95% CI 1.10–3.34), and WHO stage IV (aHR 3.59, 95% CI 1.61–8.02) were associated with the composite outcome. In Fine–Gray analysis, a PI-based regimen (subdistribution hazard ratio [sHR] 3.37, 95% CI 1.96–5.78) and WHO stage IV (sHR 4.44, 95% CI 1.91–10.4) were associated with VF. Conclusions: PI-based regimen use and advanced WHO clinical stage were associated with poorer outcomes after ART line transition. These findings support intensified viral load monitoring, adherence and resistance assessment, and individualized regimen review for patients receiving PI-based therapy, together with systematic implementation of the WHO advanced HIV disease package for patients with stage III or IV disease. Full article

The identification of valid biomarkers for ischemic stroke would greatly benefit not only diagnostic and prognostic assessment but also the development of new therapies. The development of omics technologies has made it possible to explore various perspectives of the pathophysiology of ischemic stroke, in particular genomics, transcriptomics, proteomics and metabolomics, and well-known clinical variables, such as hypertension, diabetes, heart diseases, and many others. Omics-based research has produced a mass of data evidencing candidate biomarkers at different stages in the disease process. However, further scientific evidence must be presented and affordable, and rapid detection techniques developed before these technologies can be usefully applied to the clinical setting of stroke. Here, we aim to provide stroke clinicians with an updated overview of the contribution of these emerging technologies in the individuation of diagnostic and prognostic biomarkers and the development of specifically targeted therapies. Cross-fertilization (translation and reverse translation) between preclinical and clinical research is of particular relevance in the identification of stroke biomarkers. We believe it is useful to provide, in parallel, an updated review of omics investigations using stroke rodent models. This review presents a detailed discussion of the state of the art, focusing on the strengths and limitations of the individual technologies and an outline of the promising, most recent results of both clinical and preclinical research in this field related to stroke. Full article

Background/Objectives: Tenofovir disoproxil fumarate (TDF)-containing regimens remain the cornerstone of first-line antiretroviral therapy (ART) in many low- and middle-income countries. However, concerns regarding treatment failure and antiretroviral resistance highlight the need to evaluate the effectiveness of treatments under routine clinical conditions. This study evaluated the virologic outcomes of treatment-naïve individuals living with HIV who received predominantly TDF-based first-line ART in Davao City, Philippines. Methods: A retrospective observational study was conducted among treatment-naïve HIV patients who initiated ART between 2016 and 2020. Demographic and clinical characteristics, ART regimens, HIV surveillance stage classifications, and viral load results were extracted from routinely collected medical records. Virologic suppression was defined as an HIV RNA viral load of <1000 copies/mL and virologic failure as ≥1000 copies/mL. The availability of viral load monitoring and the interval between ART initiation and the latest viral load measurement were also evaluated. Results: A total of 494 treatment-naïve patients with HIV were included. Most patients were male (97.8%) and received TDF-containing regimens (99.0%), predominantly TDF + 3TC + EFV (95.1%). Viral load results eligible for outcompe analysis were available for 174 (35.2%) patients. Among these patients, 165 achieved virologic suppression, corresponding to a suppression rate of 94.8% (95% CI: 90.5–97.3), whereas virologic failure was observed in nine patients (5.2%; 95p% CI: 2.7–9.5). Viral load availability declined substantially among patients initiating ART in recent years, reflecting shorter follow-up durations and fewer opportunities for routine viral load monitoring. High levels of virologic suppression were observed across the demographic and clinical subgroups. Conclusions: Predominantly TDF-based first-line ART demonstrated high virologic effectiveness among treatment-naïve HIV patients with evaluable viral load measurements, with nearly 95% of patients achieving virologic suppression. However, incomplete viral load monitoring, particularly among patients initiating ART in later years, limits the evaluation of treatment outcomes at the program level. Strengthening routine viral load monitoring and long-term follow-up will improve the future real-world evaluation of ART effectiveness. Full article

Background/Objectives: Human immunodeficiency virus (HIV) infection is characterized by chronic systemic inflammation. Antiretroviral therapy (ART) can reduce persistent inflammation, as measured by C-reactive protein (CRP). The CRP methylation risk score (MRS_CRP) acts as proxy for plasma CRP, but longitudinal changes in this score for people with HIV (PWH) before and after initiating ART have not been described. Methods: We evaluated a previously published MRS_CRP in the Emory Twin Study (N = 352), testing its correlation with plasma CRP and CRP-responsive biomarkers, as well as associations with cardiometabolic traits using generalized estimating equations (GEEs). We then applied MRS_CRP in the HIV AIDS Drug Resistance Surveillance Study (ADReSS) cohort (N = 440) to assess longitudinal changes before and after ART, using paired t-tests and linear mixed-effects models. Results: MRS_CRP showed moderate correlation with CRP (r = 0.38) and other inflammatory biomarkers (r = 0.25–0.34). MRS_CRP was associated with hypertension, type 2 diabetes, coronary artery disease, and obesity, and remained independently associated with obesity (odds ratio = 1.49) after adjusting for measured CRP. Z-score-standardized MRS_CRP decreased by 0.254 standard deviation units between baseline and follow-up among PWH receiving ART, confirmed by linear mixed-effects models. Conclusions: MRS_CRP showed associations with chronic inflammation and cardiometabolic diseases. The observed decline in MRS_CRP following ART initiation may reflect changes in inflammatory status among PWH. These findings highlight the potential of MRS_CRP as a marker of inflammation-related changes and comorbidity risk in PWH. Full article

Background/Objectives: People living with HIV (PLWH) who undergo prolonged antiretroviral therapy (ART) may experience weight gain as a potential side effect. Many of these individuals are prescribed glucagon-like peptide 1 (GLP-1) receptor agonists (RAs), or dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) RAs, which are known for their weight-reducing effects and positive impact on metabolic health. However, studies investigating their effects on PLWH are limited. Methods: We conducted a retrospective study at a public hospital in the Bronx, New York, among PLWH with obesity and/or type 2 diabetes mellitus (T2DM) prescribed GLP-1 or dual GLP-1/GIP RAs between August 2020 to March 2024. We collected baseline measurements of weight, body mass index (BMI), glycated hemoglobin (HbA1c), and lipid panel, before and after initiation of treatment, to assess the potential metabolic changes associated with the therapy. Logistic regression was used to analyze the factors associated with reductions in HbA1c and weight. Results: A total of 202 patients were included in the final study, with a mean duration of 24.2 months of GLP-1 or GLP-1/GIP RA therapy. A mean HbA1c reduction of 1.0% (p < 0.001), a mean BMI reduction of 0.7 kg/m² (p < 0.001), and an average mean weight loss of 3.55% were observed. In the univariate analysis, the duration of GLP-1 or GLP-1/GIP RA use was the only factor independently associated with HbA1c reduction greater than 1% (p = 0.027). However, no correlation was found between the duration of their use and the percentage of weight loss (p = 0.126). Insulin use was associated with less weight loss (p = 0.048), while younger age was associated with greater weight loss (p = 0.048). No significant differences in weight loss were observed when the population was stratified by sex, race, comorbidities, type of GLP-1 RA therapy, or other antidiabetic or ART regimens. Conclusions: Use of GLP-1 RAs among PLWH with obesity and/or T2DM is associated with reductions in HbA1c and BMI. In this diverse cohort, which predominantly consists of Black and Hispanic individuals, longer duration of treatment was associated with reductions in HbA1c greater than 1%. These findings encourage GLP-1 RA-related treatment for PLWH with obesity and/or T2DM. Further prospective studies with larger cohorts are needed to confirm these benefits and better define their effects on long-term metabolic health. Full article

Background/Objectives: Mindfulness-based interventions show promise for reducing stress in people living with dementia, but rigorous evidence against active control conditions remains limited, and little is known about how to adapt mindfulness for the specific needs of this population. MindArt is an innovative eight-week art-based mindfulness programme developed specifically for people living with dementia and their care partners, which uses repetitive mark-making to facilitate present-moment engagement through doing rather than requiring abstract meditation practice. Methods: This randomised crossover trial compared MindArt with Memory Café, an active social control for people living with dementia and their care partners. Thirty-two dyads were randomly allocated to MindArt followed by Memory Café, or Memory Café followed by MindArt, with a 10-week washout period separating the two eight-week intervention periods. Twenty-six dyads completed the trial. The primary outcome was perceived stress, measured using the Perceived Stress Scale (PSS-10). Secondary outcomes included wellbeing, quality of life, cognitive function, and care partner burden and positive caregiving experiences. Linear mixed-effects models were used to analyse treatment effects. Results: MindArt produced a significantly greater reduction in perceived stress for people living with dementia compared to Memory Café (GES = 0.16, p = 0.032), representing a large effect size. The marginal mean change was −2.43 points for MindArt (95% CI: −4.28, −0.59) versus 0.21 points for Memory Café (95% CI: −1.62, 2.04). No significant between-intervention differences were found for secondary outcomes for people living with dementia or for any outcome for care partners. Structured observations indicated that people living with dementia were engaged in 96% of MindArt sessions, with positive affect recorded in 74% of observations. Conclusions: MindArt offers an accessible and enjoyable pathway to stress reduction for people living with dementia, with effects extending beyond the non-specific benefits of social participation alone, supporting its potential as a community-based post-diagnostic support option. Full article

Violent crime is a widely recognized public health concern. According to emotion regulation theory, aggressive behavior in violent offenders is linked to maladaptive emotion regulation strategies. However, few studies have explored interventions targeting emotional factors to reduce aggression in this population. Expressive arts therapy (EAT), which facilitates emotional expression and release, has shown therapeutic potential, but its effectiveness for violent offenders remains understudied. This randomized controlled trial examined the effects of an 8-week EAT program on emotion regulation and aggressive behavior in male violent offenders from a prison in China. Participants were assigned to either the intervention group (n = 31) or the control group (n = 34). Outcomes were assessed using cognitive reappraisal tasks, the Implicit Association Test, visual analogue mood scales, and the Emotion Regulation Strategies for Artistic Creative Activities Scale. Key findings revealed that, after 4 weeks of intervention, the experimental group demonstrated significantly improved cognitive reappraisal abilities and weakened “violence-positive” implicit associations, suggesting that enhanced cognitive reappraisal may be one key mechanism through which EAT operates. These results suggest that EAT effectively fosters positive psychological resources (i.e., cognitive reappraisal) and promotes non-violent implicit attitudes among violent offenders. This study provides initial quantitative evidence for EAT as a promising intervention for reducing aggression-related cognitive and implicit processes. Future research should further investigate its long-term effects and underlying mechanisms. Full article

Background and Clinical Significance: Iatrogenic atrophy following intralesional corticosteroid injections represents a rare but potentially disfiguring complication, particularly when administered in the facial region for the treatment of inflammatory acne. Unlike conventional post-acne atrophic scarring, corticosteroid-induced tissue loss involves both dermal and subcutaneous compartments, resulting in a clinically distinct presentation that poses significant therapeutic challenges, with no established consensus on optimal management. Case Presentation: We report the case of a 26-year-old Caucasian female (Fitzpatrick phototype III) presenting with severe iatrogenic facial atrophy of the left cheek, resulting from multiple intralesional corticosteroid injections performed by a previous physician for papulo-pustular acne. The condition had been clinically stable for approximately two years at first evaluation. The patient underwent a stepwise multimodal protocol delivered over approximately 18 months (November 2023 to April 2025), combining non-ablative fractional laser remodelling (LightScan—Eufoton), Autologous Regenerative Therapy (ART, Seffiller technique, Seffiline srl), hyperdiluted calcium hydroxylapatite (CaHA—Radiesse, Merz Aesthetics) biostimulation, and additional non-ablative fractional photothermolysis sessions, supported by a topical cosmeceutical protocol. Documented follow-up extended to December 2024, 13 months after the initiation of treatment at our centre. Clinician-assessed severity of the post-acne atrophic scarring component improved from Goodman & Baron Grade 3 to Grade 2. Global aesthetic improvement of the treated area was rated as +2 (“much improved”) on the GAIS, with a patient satisfaction score of 5/5. No validated grading instrument was applied to the subcutaneous volume deficit itself, for which no such instrument is currently available. Conclusions: This case documents the clinical management and favourable outcome of a patient with severe iatrogenic steroid-induced facial atrophy treated with a personalised multimodal protocol. While the observed improvement is encouraging, the single-case design does not permit conclusions regarding the efficacy, reproducibility, or generalisability of this approach. Future controlled studies are needed to determine the therapeutic value of this multimodal strategy for this rare condition. Full article

Antiretroviral therapy (ART) is essential for preventing HIV transmission and improving the health outcomes of people living with HIV (PLHIV). However, many barriers limit PLHIV from starting and adhering to ART, which explains why HIV responses in many settings, including Indonesia, have produced limited gains. This qualitative phenomenological study explored multilevel barriers to ART adherence in urban Yogyakarta (locally known as Jogja) and rural Belu, Indonesia, from the perspectives of PLHIV and healthcare professionals (HCPs). Data were collected through one-on-one in-depth interviews with 92 PLHIV and 20 HCPs. Participants were recruited using the snowball sampling technique. Data were analysed using framework analysis informed by the Access to Healthcare Framework. The findings showed that PLHIV in Belu and Jogja had different experiences in terms of the provision of and ability to access and adhere to ART or HIV treatment. In rural Belu, ART was less available and visible, harder to approach, often unaffordable, less aligned with patients’ needs, and strongly influenced by the widespread use of traditional medicine. PLHIV in Belu also reported a more limited ability to perceive the need for ART, reach services, pay costs, engage in care, and seek ART than those in urban Jogja. Personal, psychological, and social barriers were also reported to hinder PLHIV’s ART adherence in both settings. These findings highlight the need for HIV policies that promote the equitable distribution of ART services and targeted interventions to improve understanding and acceptance of HIV care among PLHIV and the wider community. Full article

Fibrosis is driven by persistent fibroblast activation, oxidative stress, myofibroblast differentiation, and extracellular matrix remodeling, yet available antifibrotic therapies remain limited. This study evaluated whether artemisinin (ART), dihydroartemisinin (DHA), and traditional tea infusions of Artemisia annua and A. afra differentially regulate fibrosis-associated responses in human dermal fibroblasts. Neonatal and adult human dermal fibroblasts were cultured under pre-fibrotic or TGF-β/ascorbic acid-stimulated pro-fibrotic conditions and assessed for intracellular ROS, scratch-wound closure, collagen gel contraction, fibrosis-associated gene expression, and α-SMA protein abundance. Artemisia teas produced greater ROS reduction than purified ART or DHA, with A. afra showing the strongest antioxidant effect despite lacking detectable artemisinin. DHA and A. annua most consistently suppressed scratch closure, while A. afra produced intermediate inhibition and ART was comparable to vehicle control. Collagen gel contraction was most strongly reduced by A. annua, with DHA and A. afra producing intermediate suppression. Under pro-fibrotic conditions, DHA and A. annua downregulated ACTA2, A. annua suppressed COL1A1, and DHA and A. annua increased matrix-remodeling MMP expression. Reduced levels of α-SMA confirmed the antifibrotic effects. These findings indicate that antifibrotic activity differs among artemisinin-related compounds and whole-plant Artemisia preparations, with DHA and A. annua showing the strongest overall activity. Full article

Hepatitis B virus (HBV) infection remains a major concern among people living with HIV (PLWH), particularly in high-endemic settings such as Vietnam. The study evaluated the serological and molecular characteristics of HBV among PLWH receiving antiretroviral therapy (ART) in southern Vietnam. A cross-sectional study was conducted among 316 HIV-infected patients receiving ART. Serological markers (HBsAg, anti-HBs IgG, and anti-HBc IgG) and HBV DNA were assessed using highly sensitive assays, and the Pre-S1/Pre-S2/S regions were sequenced for genotype and mutation analysis. Associations were evaluated using appropriate statistical methods. HBV DNA was detected in 32.6% of the patients, whereas HBsAg was present in only 16.1%. The most common serological profile was susceptibility (36.4%), followed by occult HBV infection (OBI) (17.4%), including 6.6% with completely seronegative OBI, and chronic HBV (CHB) (15.8%). Males and older individuals showed a significantly higher risk of CHB (adjusted odds ratio [aOR] = 2.58 and aOR = 1.87, respectively). Genotype B predominated (78.4%) overall, but genotype C was significantly more frequent in OBI than in CHB patients (31.5% vs. 8.3%, p = 0.008). Moreover, the burden of surface S gene escape mutations was significantly higher in the OBI group (p = 0.023). The LASSO model showed a moderate discriminatory ability for predicting OBI status (Area Under the Receiver Operating Characteristic [ROC] Curve [AUC] = 0.76). Lamivudine-associated resistance (rtM204I/V) was the most common RT mutation detected in the overlapping RT/S region. HIV-infected individuals in southern Vietnam face a burden of both CHB and OBI, including a high proportion of seronegative OBI. The presence of seronegative OBI further supports the risk of underdiagnosis when relying only on standard serological markers, and reflects the need for integrated strategies combining highly sensitive serological assays with molecular diagnostics to improve HBV detection among high-risk populations. Full article

As critical geopolitical and migratory hubs in Eastern Europe, the Azov and Donbas regions represent an epidemiological melting pot for HIV-1 trafficking, exacerbating the global trend of rising dolutegravir (DTG) resistance through the cross-border dissemination of drug-resistant strains. This study presents a comprehensive molecular epidemiological analysis of HIV-1 in these regions in 2025 (N = 1666), focusing on drug resistance and cross-border transmission networks using phylogenetic and molecular network approaches. The study cohort was predominantly female (53.33%) and had heterosexual transmission (78.77%). Most patients (87.64%) received antiretroviral therapy (ART). Sub-subtype A6 predominated, with the radiation’s origin traced to September 1994. Molecular network analysis identified the study area as a significant node, demonstrating viral exports towards the Russian Federation and Belarus, alongside multiple imports from Ukraine, Poland, and Russia. The overall resistance prevalence was 4.49% to integrase strand transfer inhibitors (INSTIs), 2.49% to protease inhibitors (PIs), 12.19% to nucleoside reverse transcriptase inhibitors (NRTIs), and 16.07% to non-nucleoside reverse transcriptase inhibitors (NNRTIs). Surveillance drug resistance mutations in treatment-naive individuals stood at 0.89% (INSTIs), 4.90% (PIs), 4.90% (NRTIs), and 8.82% (NNRTIs). Crucially, intermediate or high-level DTG resistance and key mutations (G118R, R263K, and Y143R) were detected in individuals without prior DTG exposure. This 4.49% integrase inhibitor resistance cannot be considered low; combined with intense cross-border viral dissemination, it may indicate the formation of a stable pool of resistant variants, potentially posing a risk of dolutegravir-based regimen failure and highlighting the need for enhanced regional molecular surveillance. Full article

Background: Doravirine (DOR) is a new-generation non-nucleoside reverse transcriptase inhibitor, which has emerged as an option for people living with HIV (PLWH) owing to its favorable efficacy and safety profile, unique resistance pathway and limited potential for drug-drug interactions. Methods: This retrospective chart review study aimed to better understand DOR-based treatment use in Greece, PLWH characteristics, and drivers of treatment switch. Eligible individuals were adult PLWH who were switched to a DOR-based regimen based on the physician’s decision. Individuals exposed to DOR at any time prior to switching to the DOR-based regimen were excluded. Results: From 12 July 2023 to 31 October 2023, 110 PLWH were consecutively enrolled across 6 public hospital clinics. At baseline (closest prior to or on the date of first DOR prescription), the mean age of PLWH was 49.3 years, 90.9% were males, 88.2% were asymptomatic, 86.5% were virologically suppressed, 33.6% were suffering from multimorbidity (excluding infections/infestations), 45.5% were receiving comedications for their comorbidities, and 5.5% were co-infected with Hepatitis C virus. Most PLWH (98.2%) were prescribed DOR plus two nucleoside reverse transcriptase inhibitors; 87.3% were prescribed DOR/Lamivudine/Tenofovir Disoproxil Fumarate fixed-dose combination. PLWH started DOR a median of 11.7 years after first-ever antiretroviral therapy initiation, corresponding to 2nd/3rd/≥4th antiretroviral line in 33.6%/33.6%/32.7% of participants, respectively; 60.9% of them were proactively switched to a DOR-based regimen. The most common reasons for switching were ‘regimen simplification’ (42.7%), ‘tolerability’ (26.4%) and ‘prevention of toxicities’ (18.2%). Conclusions: This study highlights the patterns of DOR use in real-life clinical practice in Greece among treatment-experienced PLWH. Physicians switch HIV-1-infected individuals from prior ART to DOR-based regimens to offer a simplified regimen or to avoid or prevent toxicity. Full article