Current HIV/AIDS Reports最新文献

{"title":"Epidemiological Evolution of HIV in Pakistan (1987-2026): From High-risk Populations to Emerging Pediatric Cases.","authors":"Akash John, Tallat Anwar Faridi, Neelam Iqbal","doi":"10.1007/s11904-026-00800-4","DOIUrl":"https://doi.org/10.1007/s11904-026-00800-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>This narrative review examines the evolving epidemiology of HIV in Pakistan from 1987 to 2026, focusing on temporal trends among key populations, geographic hotspots, emerging pediatric infections, and health-system gaps affecting epidemic control.</p><p><strong>Recent findings: </strong>Evidence indicates a persistent concentrated epidemic, with the highest burden among people who inject drugs and continuing transmission among sex workers, transgender populations, and prisoners. HIV transmission remains geographically heterogeneous, with major urban hotspots in Karachi and cities across Punjab. Recent pediatric outbreaks have introduced an important healthcare-associated dimension, with unsafe medical practices and weaknesses in infection prevention and control emerging as major concerns. Pakistan's HIV epidemic remains concentrated but is becoming increasingly complex. Persistent transmission among key populations, geographic expansion, pediatric infections, and substantial gaps in diagnosis, treatment, and viral suppression highlight the need for strengthened surveillance, prevention, infection control, and continuity of HIV care.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central Nervous System Reservoirs and HIV Cure: Therapeutic Opportunities and Challenges.","authors":"Thomas A Angelovich, Michael Roche, Paul R Gorry, Melissa J Churchill","doi":"10.1007/s11904-026-00798-9","DOIUrl":"10.1007/s11904-026-00798-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite viral suppression with antiretroviral therapy, people with HIV (PWH) remain at increased risk of neurocognitive impairment, neuroinflammation, and potential viral rebound following therapy interruption. Although the central nervous system (CNS) is a recognised HIV reservoir, it is often not fully considered in cure approaches.</p><p><strong>Recent findings: </strong>HIV DNA and ongoing viral transcription persist in the CNS of ART-suppressed PWH, potentially contributing to neuroinflammation and neurocognitive dysfunction. HIV cure strategies, including latency-reversing/promoting agents, broadly neutralising antibodies and other approaches have varying degrees of CNS penetration, efficacy and potential neurotoxicity. Therefore, interventions aimed at silencing or eradicating HIV reservoirs require monitoring of both reservoir-targeting efficacy and neurological adverse effects. Greater consideration of CNS penetration, efficacy in targeting CNS reservoirs, and neurotoxicity is required in HIV cure studies. Developing CNS-inclusive strategies that minimise adverse neurological effects may be an important step in achieving HIV cure.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Cardiovascular Prevention in People Living With HIV: Rethinking Statin Therapy in the Post-REPRIEVE Era.","authors":"Paolo Fusco, Francesco De Maria, Bruno Tassone, Alessandro Russo","doi":"10.1007/s11904-026-00797-w","DOIUrl":"10.1007/s11904-026-00797-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines approaches to primary cardiovascular prevention in people with HIV (PWH), focusing on the implications of the REPRIEVE trial and the 2026 ACC/AHA multisociety dyslipidemia guideline. We discuss cardiovascular risk mechanisms, limitations of conventional prediction tools, selection and monitoring of statin therapy, and the potential roles of imaging and non-statin lipid-lowering agents.</p><p><strong>Recent findings: </strong>REPRIEVE demonstrated that pitavastatin reduced major adverse cardiovascular events in PWH aged 40-75 years receiving antiretroviral therapy and at low-to-moderate estimated cardiovascular risk. Absolute benefit varied substantially according to baseline risk. Current US guidance recommends statin therapy for primary prevention in PWH aged 40-75 years receiving stable combination antiretroviral therapy, while quantitative risk assessment remains important for communicating expected benefit and informing treatment intensity. REPRIEVE did not directly study PWH younger than 40 years or older than 75 years; however, cohort data suggest a higher HIV-attributable relative cardiovascular risk at younger ages despite low absolute event rates, whereas general-population evidence supports statin efficacy and acceptable tolerability in older adults. Conventional risk models show variable performance in PWH, and high-quality evidence supporting imaging-guided prevention or non-statin cardiovascular outcome reduction specifically in this population remains limited. Statin therapy is an evidence-based component of primary cardiovascular prevention in PWH aged 40-75 years, but guideline-level eligibility does not imply uniform absolute benefit. Outside the REPRIEVE age range, decisions should integrate the distinct balance of relative and absolute risk, general-population evidence, comorbidity, frailty, drug-drug interactions, treatment burden, and individual preferences rather than rely on age alone.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV Infection HIV/AIDS in Türkiye: Current Challenges and Strategic Solutions.","authors":"Tuğçe Başarı Omak, Aytan Seydaliyeva, Bahar Madran, Uğur Önal, Buket Ertürk Şengel, Elif Tükenmez Tigen, Selda Sayın Kutlu, Janet M Turan, Bülent Turan, Asuman Inan, Halis Akalın, Volkan Korten, Deniz Gökengin, Önder Ergönül","doi":"10.1007/s11904-026-00796-x","DOIUrl":"10.1007/s11904-026-00796-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to present the current status of the HIV epidemic in Türkiye, to identify the barriers to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets, and to propose strategies to overcome these challenges.</p><p><strong>Recent findings: </strong>In Türkiye, HIV-related diagnostic and treatment services are integrated into the general health insurance system, and most contemporary antiretroviral therapy (ART) are available.Treatment initiation and virological suppression rates that approach international targets. However, challenges remain in early diagnosis and prevention, particularly among key populations. Recent epidemiological data also indicate a marked increase in HIV diagnosesamong women and young people while stigma, discrimination, limited access to testing, and low awareness among both the public and healthcare professionals continue to hinder progress. Controlling the HIV epidemic in Türkiye requires strengthening early diagnosis, ensuring equitable access to ART, expanding prevention strategies such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and implementing multisectoral approaches to reduce stigma and discrimination. Coordinated actions among policymakers, healthcare providers, and community stakeholders will be critical for achieving national and global HIV targets.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps in Testing for HIV in Individuals with Neurological Conditions: Implementation Strategies to Improve HIV Screening and Early Diagnosis.","authors":"Nathania Nathania, Carla Y Kim, Biniyam Ayele, Luisa A Rodriguez, Rabel Ventura, Gerome B Vallejos, Kiran T Thakur, Kathryn B Holroyd","doi":"10.1007/s11904-026-00794-z","DOIUrl":"10.1007/s11904-026-00794-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Neurological conditions remain common among people living with HIV (PLWH) and contribute substantially to morbidity and mortality. Neurological presentations represent a critical opportunity to optimize HIV care pathways. However, HIV testing guidance remains limited for common neurological conditions such as ischemic stroke and cognitive impairment. The absence of clear, neurology-specific testing recommendations leads to missed opportunities for early HIV diagnosis and timely treatment.</p><p><strong>Recent findings: </strong>Strengthening diagnostic and laboratory infrastructure, particularly in high-burden and resource-limited settings, is essential to support systematic HIV screening among patients presenting with neurological symptoms. Policy-level interventions are also needed to reduce stigma and improve access to care. These include integrating HIV testing into national and specialty guidelines, developing consent strategies that address the complexities of impaired mental status, training neurologists to recognize HIV-associated neurological presentations, and implementing patient-centered education initiatives. These approaches may support more standardized HIV testing within neurological practice, facilitate earlier diagnosis and treatment initiation, and improve long-term neurological outcomes for PLWH.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating Low-Barrier Use of Long-Acting Antiretroviral Therapy to Maximize Impact in People with HIV and Viremia or Adherence Challenges.","authors":"Lauren F Collins, Casey Chmura, Morgan M Philbin, Jonathan A Colasanti","doi":"10.1007/s11904-026-00795-y","DOIUrl":"10.1007/s11904-026-00795-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Long-acting (LA) antiretroviral therapy (ART) is rapidly revolutionizing the landscape of HIV treatment. Clinical trials for injectable cabotegravir/rilpivirine (CAB/RPV) only included certain populations, limiting FDA approval to a subset of people with HIV; frontline medical staff and community members (inclusive of PWH) employed resourcefulness, collaboration, and advocacy to maximize access. However, significant implementation hurdles have constrained uptake, and research about clinical outcomes in PWH who initiate LA-ART with viremia or adherence challenges is nascent.</p><p><strong>Recent findings: </strong>PWH who initiate LAI-ART with viremia, including those with adherence challenges, achieve and maintain viral suppression (VS) at rates similar to PWH who initiate with VS. LAI-ART, in combination with appropriate support and programming, can increase access to ART in PWH with viremia and/or adherence challenges. The overall cost, in terms of dollars and person-time, makes implementation challenging. Additional funding mechanisms are needed, alongside innovative research regarding effective programs and care delivery models, to maximize implementation.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HSV, HIV, and Pregnancy: Epidemiology, Viral Interactions, Management, and Prevention.","authors":"Sheliza Halani, Mark H Yudin, Darrell H S Tan","doi":"10.1007/s11904-026-00793-0","DOIUrl":"10.1007/s11904-026-00793-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>We summarize the epidemiology, biology, management and prevention of HSV-2 and HIV in pregnancy.</p><p><strong>Recent findings: </strong>The seroprevalence of HSV-2 is higher in people living with HIV than in HIV-negative people, and 75% of women with recurrent genital herpes may have a recurrence during pregnancy. Those with a history of recurrent genital HSV infection should be offered acyclovir/valacyclovir at 36 weeks gestation to decrease need for C-section. The most important intervention for reducing HIV vertical transmission is maternal antiretroviral therapy (ART) to suppress HIV replication. Maternal ART also reduces HSV-2 cervicovaginal shedding and thus, HSV-2 vertical transmission. HSV-2 viral shedding is incompletely suppressed with acyclovir/valacyclovir, and newer drugs such as the helicase-primase inhibitors show promise but have not been studied in pregnancy. Safe options also exist for preventing HIV acquisition in pregnancy but remain in development for HSV-2. Safe, effective HSV-2/HIV management strategies exist in pregnancy.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Inflammation as a Modulator of FcRn-dependent IgG Pharmacokinetics: Implications for Broadly Neutralising Antibody Efficacy in HIV Prevention.","authors":"Andile Khumalo, Sanjali Pillay, Jivanka Mohan, Sharana Mahomed, Derseree Archary","doi":"10.1007/s11904-026-00791-2","DOIUrl":"10.1007/s11904-026-00791-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Broadly neutralising antibodies (bNAbs) represent a promising long-acting modality for HIV prevention. However, substantial interindividual pharmacokinetic variability poses a threat to real-world efficacy. This review investigates the impact of systemic inflammation, driven by the high prevalence of sexually transmitted infections (STIs), co-endemic pathogens, and metabolic activation, on bNAb persistence, particularly within the vulnerable demographic of women in sub-Saharan Africa. We aim to bridge the gap between neonatal fragment crystallisable receptor (FcRn) biology and clinical pharmacokinetic observations to identify why certain individuals clear bNAbs faster than others.</p><p><strong>Recent findings: </strong>Synthesis of recent clinical trial data and cross-therapeutic PK evidence indicates that systemic inflammatory biomarkers are strong predictors of accelerated monoclonal antibody clearance. Recent evidence suggests that chronic inflammation modulates bNAb half-life through the transcriptional downregulation of the FCGRT gene, which encodes FcRn, and the competitive saturation of FcRn recycling pathways. These findings suggest that bNAbs' standard dosing does not account for the inflammatory burden that characterises many real-world populations, potentially leading to sub-therapeutic concentrations and an increased risk of breakthrough HIV infection. The host's inflammation status is a primary and currently overlooked determinant of antibody pharmacokinetics. This review provides a roadmap to overcoming the pharmacokinetic heterogeneity modulated by systemic inflammation through establishing the link between inflammation and increased antibody clearance. Bridging these insights paves the way for effective bNAbs with promising implications for prospective HIV prevention and cure strategies that are not only effective in controlled clinical trials but also protective in real-world settings.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Leap Forward in Vaccination - the Epigenetic Silencing of HIV by cVacc.","authors":"Jielin Zhang, Philip Askenase, Clyde Crumpacker","doi":"10.1007/s11904-026-00792-1","DOIUrl":"10.1007/s11904-026-00792-1","url":null,"abstract":"<p><strong>Purpose: </strong>More than four decades of HIV/AIDS studies reveal that generation of effective vaccines against HIV infection requires understanding of a host immunity that protects our DNA against the HIV infection. An effective vaccine can elicit the host immunity to stop HIV RNA expression despite the viral DNA integrated into the host DNA.</p><p><strong>Recent findings: </strong>Vaccination is one of the most successful public health interventions of all time. Recent studies show that humans have an intrinsic immunity against foreign nucleotide gene expression, and we have named this the epigenetic immunity. We propose that chromatin vaccine (cVacc), a foreign DNA in chromatin format, is capable of triggering the immunity of host DNA, the epigenetic immunity, to silence the viral gene expression at its RNA transcription level. We discuss these advances in the field of host - virus interaction, specifically host immunity against the retroviral infections by silencing its gene expression, ranging from nucleotide sensors that distinguish self-nonself to the chromatin features that constrict the HIV reservoir. Bolstered by the progress in the fields of virology, immunology and epigenetics, we propose to maneuver cutting edge technologies to develop next-generation vaccines like cVacc, not only silencing the foreign gene expression, but assimilating it to improve our DNA function as well.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IAS 2025: Why Can't I Breastfeed My Baby When Evidence and Lived Experience Say I Can? A Call for Policy Equity for Mothers Living with HIV.","authors":"Ifeanyi Ngwoke, Boluwatife Owoyemi, Fisayo Alao-Amiola","doi":"10.1007/s11904-026-00787-y","DOIUrl":"10.1007/s11904-026-00787-y","url":null,"abstract":"","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"23 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}