{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:55:05Z","timestamp":1789473305564,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with human immunodeficiency virus (HIV, PWH) exhibit increased cardiovascular disease (CVD) risk and accelerated biological aging. REPRIEVE demonstrated that pitavastatin reduced major adverse cardiovascular events (MACE) in antiretroviral therapy (ART)-treated PWH with low-to-moderate traditional cardiovascular risk. It remains unknown whether statin therapy can modulate epigenetic aging in PWH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We assessed epigenetic aging biomarkers using DNA methylation profiles from peripheral blood mononuclear cells (PBMCs) in a subset of 99 randomly selected US REPRIEVE participants (65 pitavastatin, 34 placebo) at baseline and 24 months. The primary outcomes were changes in second- and third-generation epigenetic clocks PCGrimAge (trained on mortality risk) and DunedinPACE (trained on rate of age-related multi-organ decline).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median chronological age was 57.0 (Q1, Q3: 56, 58) years and 100% of participants demonstrated epigenetic age acceleration, measured by the difference in PCGrimAge and chronological age (median difference 7.08 years [Q1, Q3: 4.69, 9.64]) at entry. Over 24 months, PCGrimAge remained accelerated with no significant differences between treatment arms (P = .89). However, the median pace of aging by the DunedinPACE increased in the placebo arm (0.036, Q1, Q3 [\u22120.018, 0.10], P = .021) but not in the pitavastatin arm (0.001, Q1, Q3 [\u22120.031, 0.036], [P = .77]), treatment group difference (P = .049).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this pilot study of REPRIEVE, epigenetic age acceleration was demonstrated at trial entry. The biological pace of aging increased over 24 months in the placebo group as compared to the statin group. These preliminary findings suggest pitavastatin may prevent an increase in the pace of biological aging in PWH and support further research into statin therapy as a potential intervention to mitigate accelerated aging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>NCT02344290 (date of initial registration: 22 January 2015).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf247","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T08:55:50Z","timestamp":1747817750000},"page":"e560-e567","source":"Crossref","is-referenced-by-count":9,"title":["Effect of Pitavastatin on Epigenetic Aging Biomarkers in People With HIV: Pilot Substudy of the REPRIEVE Trial"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8957-7153","authenticated-orcid":false,"given":"Michael J","family":"Corley","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6677-7355","authenticated-orcid":false,"given":"Alina P S","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun B","family":"Dwaraka","sequence":"additional","affiliation":[{"name":"TruDiagnostic , Lexington, Kentucky ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7362-8753","authenticated-orcid":false,"given":"Ryan","family":"Smith","sequence":"additional","affiliation":[{"name":"TruDiagnostic , Lexington, Kentucky ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadzanai","family":"Samaneka","sequence":"additional","affiliation":[{"name":"University of Zimbabwe Clinical Trials Research Centre , Harare ,","place":["Zimbabwe"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2644-0760","authenticated-orcid":false,"given":"Sarah","family":"Henn","sequence":"additional","affiliation":[{"name":"Whitman Walker Health , Washington D.C. ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7493-9163","authenticated-orcid":false,"given":"Sonal","family":"Munsiff","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Rochester School of Medicine and Dentistry , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Saumoy","sequence":"additional","affiliation":[{"name":"HIV and STD Unit, Bellvitge University Hospital, Bellvitge Biomedical Research Institute, Hospitalet de Llobregat , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0289-1295","authenticated-orcid":false,"given":"Sara","family":"McCallum","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0541-3707","authenticated-orcid":false,"given":"Kathleen V","family":"Fitch","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M","family":"Chu","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa R","family":"Diggs","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8162-0284","authenticated-orcid":false,"given":"Judith A","family":"Aberg","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3156-2965","authenticated-orcid":false,"given":"Carlos D","family":"Malvestutto","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Ohio State University Medical Center , Columbus, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6778-7253","authenticated-orcid":false,"given":"Carl J","family":"Fichtenbaum","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Cincinnati College of Medicine , Cincinnati, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4279-4737","authenticated-orcid":false,"given":"Judith S","family":"Currier","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markella V","family":"Zanni","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9876-4049","authenticated-orcid":false,"given":"Pamela S","family":"Douglas","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T","family":"Lu","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan L","family":"Landay","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Texas Medical Center , Galveston, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0808-6729","authenticated-orcid":false,"given":"Kristine M","family":"Erlandson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Colorado\u2013Anschutz Medical Campus , Aurora, Colorado ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0394-3990","authenticated-orcid":false,"given":"Heather J","family":"Ribaudo","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6338-000X","authenticated-orcid":false,"given":"Steven K","family":"Grinspoon","sequence":"additional","affiliation":[{"name":"Metabolism Unit, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"2026020907375996300_ciaf247-B1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/jgs.18611","article-title":"Accelerated aging mediates the associations of unhealthy lifestyles with cardiovascular disease, cancer, and mortality","volume":"72","author":"Li","year":"2024","journal-title":"J Am Geriatr Soc"},{"key":"2026020907375996300_ciaf247-B2","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1161\/CIRCRESAHA.121.318965","article-title":"Epigenetic age acceleration reflects long-term cardiovascular health","volume":"129","author":"Joyce","year":"2021","journal-title":"Circ Res"},{"key":"2026020907375996300_ciaf247-B3","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1161\/CIRCULATIONAHA.121.056456","article-title":"Epigenetic age and the risk of incident atrial fibrillation","volume":"144","author":"Roberts","year":"2021","journal-title":"Circulation"},{"key":"2026020907375996300_ciaf247-B4","doi-asserted-by":"crossref","first-page":"573","DOI":"10.18632\/aging.101414","article-title":"An epigenetic biomarker of aging for lifespan and healthspan","volume":"10","author":"Levine","year":"2018","journal-title":"Aging"},{"key":"2026020907375996300_ciaf247-B5","doi-asserted-by":"crossref","first-page":"R115","DOI":"10.1186\/gb-2013-14-10-r115","article-title":"DNA methylation age of human tissues and cell types","volume":"14","author":"Horvath","year":"2013","journal-title":"Genome Biol"},{"key":"2026020907375996300_ciaf247-B6","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.molcel.2012.10.016","article-title":"Genome-wide methylation profiles reveal quantitative views of human aging rates","volume":"49","author":"Hannum","year":"2013","journal-title":"Mol Cell"},{"key":"2026020907375996300_ciaf247-B7","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1038\/s41576-018-0004-3","article-title":"DNA methylation-based biomarkers and the epigenetic clock theory of ageing","volume":"19","author":"Horvath","year":"2018","journal-title":"Nat Rev Genet"},{"key":"2026020907375996300_ciaf247-B8","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1186\/s13059-019-1824-y","article-title":"DNA methylation aging clocks: challenges and recommendations","volume":"20","author":"Bell","year":"2019","journal-title":"Genome Biol"},{"key":"2026020907375996300_ciaf247-B9","doi-asserted-by":"crossref","first-page":"e14821","DOI":"10.1371\/journal.pone.0014821","article-title":"Epigenetic predictor of age","volume":"6","author":"Bocklandt","year":"2011","journal-title":"PLoS One"},{"key":"2026020907375996300_ciaf247-B10","doi-asserted-by":"crossref","first-page":"303","DOI":"10.18632\/aging.101684","article-title":"DNA methylation GrimAge strongly predicts lifespan and healthspan","volume":"11","author":"Lu","year":"2019","journal-title":"Aging"},{"key":"2026020907375996300_ciaf247-B11","doi-asserted-by":"crossref","first-page":"e73420","DOI":"10.7554\/eLife.73420","article-title":"DunedinPACE, a DNA methylation biomarker of the pace of aging","volume":"11","author":"Belsky","year":"2022","journal-title":"Elife"},{"key":"2026020907375996300_ciaf247-B12","doi-asserted-by":"crossref","first-page":"101348","DOI":"10.1016\/j.arr.2021.101348","article-title":"A systematic review of biological, social and environmental factors associated with epigenetic clock acceleration","volume":"69","author":"Oblak","year":"2021","journal-title":"Ageing Res Rev"},{"key":"2026020907375996300_ciaf247-B13","doi-asserted-by":"crossref","first-page":"104488","DOI":"10.1016\/j.isci.2022.104488","article-title":"Accelerated aging with HIV begins at the time of initial HIV infection","volume":"25","author":"Breen","year":"2022","journal-title":"iScience"},{"key":"2026020907375996300_ciaf247-B14","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1093\/infdis\/jiv277","article-title":"HIV-1 infection accelerates age according to the epigenetic clock","volume":"212","author":"Horvath","year":"2015","journal-title":"J Infect Dis"},{"key":"2026020907375996300_ciaf247-B15","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.molcel.2016.04.008","article-title":"An epigenetic clock measures accelerated aging in treated HIV infection","volume":"62","author":"Boulias","year":"2016","journal-title":"Mol Cell"},{"key":"2026020907375996300_ciaf247-B16","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1093\/infdis\/jiaa599","article-title":"Accelerated epigenetic aging and methylation disruptions occur in human immunodeficiency virus infection prior to antiretroviral therapy","volume":"223","author":"Yang","year":"2020","journal-title":"J Infect Dis"},{"key":"2026020907375996300_ciaf247-B17","doi-asserted-by":"crossref","first-page":"e1009785","DOI":"10.1371\/journal.ppat.1009785","article-title":"Abrupt and altered cell-type specific DNA methylation profiles in blood during acute HIV infection persists despite prompt initiation of ART","volume":"17","author":"Corley","year":"2021","journal-title":"PLoS Pathog"},{"key":"2026020907375996300_ciaf247-B18","doi-asserted-by":"crossref","first-page":"e197","DOI":"10.1016\/S2352-3018(21)00006-0","article-title":"Epigenetic age acceleration changes 2 years after antiretroviral therapy initiation in adults with HIV: a substudy of the NEAT001\/ANRS143 randomised trial","volume":"8","author":"Esteban-Cantos","year":"2021","journal-title":"Lancet HIV"},{"key":"2026020907375996300_ciaf247-B19","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1056\/NEJMoa2304146","article-title":"Pitavastatin to prevent cardiovascular disease in HIV infection","volume":"389","author":"Grinspoon","year":"2023","journal-title":"N Engl J Med"},{"key":"2026020907375996300_ciaf247-B20","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1056\/NEJMc2400870","article-title":"Trial update of pitavastatin to prevent cardiovascular events in HIV infection","volume":"390","author":"Grinspoon","year":"2024","journal-title":"N Engl J Med"},{"key":"2026020907375996300_ciaf247-B21","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1111\/hiv.13703","article-title":"What have we learned from the REPRIEVE trial and where do we go from here?","volume":"25","author":"Grinspoon","year":"2024","journal-title":"HIV Med"},{"key":"2026020907375996300_ciaf247-B22","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1001\/jamacardio.2023.5661","article-title":"Effects of pitavastatin on coronary artery disease and inflammatory biomarkers in HIV: mechanistic substudy of the REPRIEVE randomized clinical trial: mechanistic substudy of the REPRIEVE randomized clinical trial","volume":"9","author":"Lu","year":"2024","journal-title":"JAMA Cardiol"},{"key":"2026020907375996300_ciaf247-B23","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1001\/jamacardio.2024.4115","article-title":"Pitavastatin, procollagen pathways, and plaque stabilization in patients with HIV: a secondary analysis of the REPRIEVE randomized clinical trial","volume":"10","author":"Kolossv\u00e1ry","year":"2024","journal-title":"JAMA Cardiol"},{"key":"2026020907375996300_ciaf247-B24","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ahj.2018.12.016","article-title":"Rationale and design of the randomized trial to prevent vascular events in HIV (REPRIEVE)","volume":"212","author":"Grinspoon","year":"2019","journal-title":"Am Heart J"},{"key":"2026020907375996300_ciaf247-B25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ahj.2019.02.011","article-title":"Rationale and design of the mechanistic substudy of the randomized trial to prevent vascular events in HIV (REPRIEVE): effects of pitavastatin on coronary artery disease and inflammatory biomarkers","volume":"212","author":"Hoffmann","year":"2019","journal-title":"Am Heart J"},{"key":"2026020907375996300_ciaf247-B26","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1093\/bioinformatics\/btu049","article-title":"Minfi: a flexible and comprehensive bioconductor package for the analysis of infinium DNA methylation microarrays","volume":"30","author":"Aryee","year":"2014","journal-title":"Bioinformatics"},{"key":"2026020907375996300_ciaf247-B27","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1093\/nar\/gkv907","article-title":"ENmix: a novel background correction method for illumina HumanMethylation450 BeadChip","volume":"44","author":"Xu","year":"2016","journal-title":"Nucleic Acids Res"},{"key":"2026020907375996300_ciaf247-B28","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1038\/s43587-022-00248-2","article-title":"A computational solution for bolstering reliability of epigenetic clocks: implications for clinical trials and longitudinal tracking","volume":"2","author":"Higgins-Chen","year":"2022","journal-title":"Nat Aging"},{"key":"2026020907375996300_ciaf247-B29","doi-asserted-by":"crossref","first-page":"291","DOI":"10.20411\/pai.v5i1.376","article-title":"The effects of anti-retroviral therapy on epigenetic age acceleration observed in HIV-1-infected adults","volume":"5","author":"Sehl","year":"2020","journal-title":"Pathog Immun"},{"key":"2026020907375996300_ciaf247-B30","doi-asserted-by":"crossref","first-page":"796547","DOI":"10.3389\/fgene.2021.796547","article-title":"Increased rate of epigenetic aging in men living with HIV prior to treatment","volume":"12","author":"Sehl","year":"2021","journal-title":"Front Genet"},{"key":"2026020907375996300_ciaf247-B31","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.molcel.2016.03.019","article-title":"Methylome-wide analysis of chronic HIV infection reveals five-year increase in biological age and epigenetic targeting of HLA","volume":"62","author":"Gross","year":"2016","journal-title":"Mol Cell"},{"key":"2026020907375996300_ciaf247-B32","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1186\/s12920-024-01914-7","article-title":"Epigenetic age acceleration is associated with blood lipid levels in a multi-ancestry sample of older U.S. adults","volume":"17","author":"Lin","year":"2024","journal-title":"BMC Med Genomics"},{"key":"2026020907375996300_ciaf247-B33","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s13148-022-01286-8","article-title":"Lifetime exposure to smoking, epigenetic aging, and morbidity and mortality in older adults","volume":"14","author":"Klopack","year":"2022","journal-title":"Clin Epigenetics"},{"key":"2026020907375996300_ciaf247-B34","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1186\/s13148-019-0777-z","article-title":"Effect of tobacco smoking on the epigenetic age of human respiratory organs","volume":"11","author":"Wu","year":"2019","journal-title":"Clin Epigenetics"},{"key":"2026020907375996300_ciaf247-B35","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1186\/s13148-018-0591-z","article-title":"Machine learning selected smoking-associated DNA methylation signatures that predict HIV prognosis and mortality","volume":"10","author":"Zhang","year":"2018","journal-title":"Clin Epigenetics"},{"key":"2026020907375996300_ciaf247-B36","doi-asserted-by":"crossref","first-page":"335","DOI":"10.7326\/M14-0954","article-title":"Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys: cross-sectional surveys","volume":"162","author":"Mdodo","year":"2015","journal-title":"Ann Intern Med"},{"key":"2026020907375996300_ciaf247-B37","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1038\/s43587-023-00432-y","article-title":"Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial","volume":"3","author":"Waziry","year":"2023","journal-title":"Nat Aging"},{"key":"2026020907375996300_ciaf247-B38","author":"Baker"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf247\/63513375\/ciaf247.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/81\/6\/e560\/63513375\/ciaf247.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/81\/6\/e560\/63513375\/ciaf247.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T12:38:14Z","timestamp":1770640694000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/81\/6\/e560\/8166545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,18]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,18]]},"published-print":{"date-parts":[[2026,2,4]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf247","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12,15]]},"published":{"date-parts":[[2025,6,18]]}}}