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CD300a is differentially expressed among B cell subsets, although its expression in immunoglobulin (Ig)M+ B cells is not well known. We identified a B cell subset expressing CD300a and high levels of IgM (IgMhiCD300a+). The results showed that IgMhiCD300a+ B cells were CD10−CD27+CD25+IgDloCD21hiCD23−CD38loCD1chi, suggesting that they are circulating marginal zone (MZ) IgM memory B cells. Regarding the immunoglobulin repertoire, IgMhiCD300a+ B cells exhibited a higher mutation rate and usage of the IgH-VDJ genes than the IgM+CD300a− counterpart. Moreover, the shorter complementarity-determining region 3 (CDR3) amino acid (AA) length from IgMhiCD300a+ B cells together with the predicted antigen experience repertoire indicates that this B cell subset has a memory phenotype. IgM memory B cells are important in T cell-independent responses. Accordingly, we demonstrate that this particular subset secretes higher amounts of IgM after stimulation with pneumococcal polysaccharides or a toll-like receptor 9 (TLR9) agonist than IgM+CD300a− cells. Finally, the frequency of IgMhiCD300a+ B cells was lower in people living with HIV-1 (PLWH) and it was inversely correlated with the years with HIV infection. Altogether, these data help to identify a memory B cell subset that contributes to T cell-independent responses to pneumococcal infections and may explain the increase in severe pneumococcal infections and the impaired responses to pneumococcal vaccination in PLWH. [ABSTRACT FROM AUTHOR]

Objectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID‐19 with [people with HIV (PWH)] and without (non‐PWH) HIV co‐infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active‐follow‐up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non‐PWH of the same age and sex randomly selected from COVID‐19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID‐19. The main outcome was all‐cause in‐hospital mortality. Results: Forty‐five PWH with PCR‐confirmed COVID‐19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex‐matched controls were selected from the COVID‐19@Spain cohort. The median age in both groups was 53 (Q1–Q3, 46–56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV‐RNA < 50 copies/mL, and the median (Q1–Q3) CD4 count was 595 (349–798) cells/μL. No statistically significant differences were found between PWH and non‐PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non‐PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non‐PWH (P = 0.800). Conclusions: Our findings suggest that well‐controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID‐19 hospitalization. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the long-term effectiveness, persistence and tolerability of dolutegravir (DTG)/lamivudine (3TC), compared with the most frequently prescribed first-line treatment regimens, among antiretroviral-naive people with HIV from CoRIS, a multicentre cohort in Spain, in 2018-23., Methods: We used multivariable regression models to compare viral suppression (VS) (HIV RNA viral load <50 copies/mL), change in CD4 cell counts, persistence and treatment discontinuations due to adverse events (AEs), at 96 (±24) weeks after treatment initiation., Results: Of 2359 participants, DTG/3TC was prescribed in 472 (20.0%), bictegravir/tenofovir alafenamide (TAF)/emtricitabine (FTC) in 1134 (48.1%), DTG + tenofovir disoproxil fumarate/FTC in 300 (12.7%), DTG/abacavir/3TC in 273 (11.6%) and darunavir/cobicistat/TAF/FTC in 180 (7.6%). At 96 weeks from treatment initiation, 94.0% of participants initiating with DTG/3TC achieved VS, and the mean increase in CD4 cell counts was 295.5 cells/μL (95% CI: 269.9-321.1). During the first 96 weeks after DTG/3TC initiation, 9.8% and 1.3% discontinued their initial regimen, overall and due to AEs, respectively. In multivariable analyses, we did not find significant differences in VS or increase in CD4 cell counts among participants initiating with DTG/3TC compared with other regimens. Initiating ART with a regimen other than DTG/3TC was associated with a higher risk of treatment discontinuation, overall and due to AEs., Conclusions: Among treatment-naive people with HIV from this large multicentre cohort, DTG/3TC had similar effectiveness and better persistence and tolerability than those of the most frequently prescribed first-line regimens at 96 weeks., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Background: Tenofovir alafenamide (TAF) has replaced tenofovir disoproxil fumarate (TDF) in many clinical settings. However, concerns remain about potential metabolic complications of TAF. We aimed to evaluate changes in weight, laboratory markers, and metabolic-related clinical events after replacing TDF with TAF., Methods: Multicenter prospective cohort study in the Spanish CoRIS cohort. We included virologically suppressed adults with human immunodeficiency virus (HIV) receiving TDF for more than 12 months who either switched to TAF or maintained TDF, with no changes in the core agent. Participants were matched by propensity score. We fitted generalized equation models to assess changes in weight, blood lipids, and hepatic steatosis index, and to compare the incidence of diabetes, hypertension, and lipid-lowering drug use after 144 weeks., Results: In total, 1446 participants were matched in each group. Median age was 38 years, 85% were male, mean weight at baseline was 73 kg. Participants who switched to TAF had a mean weight increase of +0.5 kg at 144 weeks over those who maintained TDF, with no difference in the occurrence of overweight or obesity. Individuals who switched to TAF had a significant increase in total cholesterol (+7.9 mg/dL) and triglycerides (+11.2 mg/dL), with no differences in the total cholesterol-high-density lipoprotein (HDL) ratio. However, no increased incidence of diabetes, hypertension, or lipid-lowering drug use was observed after the follow-up period., Conclusions: Switching from TDF to TAF is associated with modest weight gain and increases in total cholesterol and triglycerides, without an impact on the incidence of obesity or metabolic-related clinical events, in this Spanish cohort with a majority White male population., Competing Interests: Potential conflicts of interest. J. M.-S. reports personal fees and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from ViiV Healthcare, Janssen Cilag, Gilead Sciences, and Merck Sharp & Dohme (MSD) and non-financial support from ViiV Healthcare, Jannsen Cilag, and Gilead Sciences, including support for attending meetings and/or travel, outside the submitted work. A. M. d. C. reports personal fees and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from ViiV Healthcare, Janssen Cilag, Gilead Sciences, and MSD and non-financial support from Jannsen Cilag and Gilead Sciences, including support for attending meetings and/or travel. S. M. reports grants, personal fees, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, participation on a Data Safety Monitoring Board or Advisory Board, support for attending meetings and/or travel, and non-financial support from ViiV Healthcare; personal fees, grants or contracts, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, participation on a Data Safety Monitoring Board or Advisory Board, support for attending meetings and/or travel and non-financial support from Janssen; grants, personal fees, participation on a Data Safety Monitoring Board or Advisory Board and non-financial support including support for attending meetings and/or travel from MSD; grants, personal fees, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, support for attending meetings and/or travel, participation on a Data Safety Monitoring Board or Advisory Board and non-financial support from Gilead, outside the submitted work, and grants or contracts from the Instituto de Salud Carlos III. S. S.-V. reports grants or contracts from Instituto de Salud Carlos III (ICI20/00058, COV20/00349, PI21/00041) and from Merck (IISP 60257, IISP 59181); personal fees from Gilead Sciences; as well as non-financial support from ViiV Healthcare, Merck and Gilead Sciences; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Gilead Sciences; support for attending meetings and/or travel from ViiV and Gilead; patents planned, issued or pending (EP19382159, “Anal bacterial biomarkers for the diagnosis of anal precancerous lesions” and EP21382486, “Biomarker and methods to predict susceptibility to SARS-CoV-2 and COVID19 severity”), and research grants from MSD, outside the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)