Topics in antiviral medicine最新文献

{"title":"COVID-19 treatments: current options and therapies under investigation.","authors":"Skye Opsteen, Nathaniel Erdmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The COVID-19 pandemic has contributed to more than 7 million deaths globally and has triggered a variety of postacute sequelae, now commonly referred to as long COVID, in millions more. Early efforts during the pandemic resulted in several therapies to mitigate the severity and mortality of acute COVID-19. However, despite effective therapies and accumulated immunity through vaccination and natural infection reducing disease severity, COVID-19 continues to contribute to hospitalizations and mortality. Long COVID encompasses several distinct yet overlapping clinical syndromes, and evidence suggests that these manifestations are mediated by numerous underlying mechanisms. There are currently no approved therapies for the treatment of long COVID, driven in part by its heterogeneity in presentation and etiology. This review will outline the current guidelines for treating acute COVID-19 and summarize information on the mechanistic rationale behind various published and ongoing clinical trials investigating potential long COVID therapeutic agents.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 Ahead of Issue","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight gain and obesity management in people with HIV: pathophysiology, antiretroviral therapy effects, and clinical strategies.","authors":"Danna Kashlan, Zoobia Chaudhry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Obesity is a chronic, relapsing disease that is defended by complex biologic regulatory mechanisms, and is defined by excessive or abnormal adipose tissue that impairs health. Among people with HIV (PWH), the epidemiology of body weight has shifted dramatically in the modern antiretroviral therapy (ART) era, with obesity now replacing wasting and lipodystrophy as dominant body-composition phenotypes. Excess adiposity in PWH arises from overlapping influences: persistent immune activation, ART-specific effects on adipose tissue, and the same environmental factors driving the global obesity epidemic. The consequences include insulin resistance, dyslipidemia, cardiovascular disease, and fatty liver disease, which now constitute the leading causes of morbidity and mortality in this population. This review summarizes the pathophysiology, epidemiology, and management of obesity in PWH, emphasizing mechanisms that link ART exposure to altered adipose biology and metabolic risk. Effective care requires an integrated approach combining behavioral, pharmacologic, and procedural strategies within multidisciplinary HIV programs. Recognizing obesity as a chronic, treatable disease reframes management away from lifestyle blame toward durable metabolic control. In contemporary HIV care, the goal extends beyond viral suppression to encompass the prevention of cardiometabolic disease and preservation of long-term health.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 3","pages":"533-544"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selected highlights from the 26th International Workshop on Clinical Pharmacology of HIV, Hepatitis, and Other Antiviral Drugs.","authors":"Kimberly K Scarsi, Catia Marzolini, Fiona Marra, Alice L Tseng","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinical pharmacology plays a crucial role in the successful treatment and prevention of HIV and other viral infections. Information from the field of clinical pharmacology leads to the development of novel antiviral treatments, supports the evaluation of efficacy and safety of antiviral therapies, informs the management of drug-drug interactions, and defines the optimal dosing and drug selection for special populations. The International Workshop on Clinical Pharmacology of HIV, Hepatitis, and Other Antiviral Drugs recently held its 26th meeting. This review focuses on selected abstracts presented at the 2025 workshop and provides insights to assist clinicians in applying this new knowledge to clinical practice.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 3","pages":"545-553"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention-deficit/hyperactivity disorder, autism spectrum disorder, and HIV: implications for risk, outcomes, and care for neurodivergent people.","authors":"Heather M Relyea Ashley, Sara K Stuart, Ellen F Eaton","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neurodivergence, including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), is increasingly recognized as an important factor influencing health across the lifespan. Although ASD and ADHD are diagnosed categorically using standardized criteria based on the Diagnostic and Statistical Manual of Mental Disorders, the traits that define these conditions exist dimensionally across the population and are expressed with wide variability in support needs. Global ASD prevalence is approximately 1% to 2%, and emerging data suggest higher rates of autistic traits among some populations affected by HIV; however, estimates vary substantially based on methodology and diagnostic approach. ADHD affects approximately 2.5% of adults worldwide, although adult prevalence in people with HIV is not well characterized and likely underrecognized. Neurodevelopmental differences in executive function, reward processing, sensory regulation, and social communication may influence HIV acquisition risk, engagement in care, and long-term outcomes. Health care systems designed primarily for neurotypical individuals may inadvertently create barriers for neurodivergent patients. This review outlines a conceptual framework for understanding neurodivergence in the context of HIV, summarizes available epidemiologic and outcomes data, and provides practical strategies for delivering neurodiversity- affirming, accessible care.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 3","pages":"561-572"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current evidence on islatravir drug resistance and implications for future HIV treatment.","authors":"Annemarie M Wensing, Vincent Calvez, Francesca Ceccherini-Silberstein, Charlotte Charpentier, Huldrych F Günthard, Roger Paredes, Robert W Shafer, Douglas D Richman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Islatravir (ISL; MK-8591; 4'-ethynyl-2-fluoro-2'-deoxyadenosine; EFdA) is the first antiviral drug that acts as a nucleoside reverse transcriptase translocation inhibitor (NRTTI). Unlike classic nucleoside and nucleotide analogue reverse transcriptase inhibitors (nRTIs) that terminate viral DNA chain extension upon incorporation because they lack the 3'-hydroxyl group, ISL primarily interferes with reverse transcriptase (RT) translocation. After ISL-triphosphate (ISL-TP) is incorporated into viral DNA, RT has a reduced ability to shift along the template to effectively position the subsequent nucleotide for incorporation, thereby inhibiting further DNA synthesis. In addition, ISL is frequently misincorporated by RT, leading to mismatched primer termini that further reduces productive DNA elongation. ISL has highly potent antiviral activity against both wildtype HIV-1 (50% effective concentration [EC₅₀], ∼0.07-0.20 nM) and a broad panel of nRTI-resistant clinical isolates in vitro. It is also active against HIV-2, with an EC50 on average 4.8-fold more potent than observed for HIV-1. In late 2025, a fixed-dose combination of the nonnucleoside reverse transcriptase inhibitor (NNRTI) doravirine (DOR) and ISL (DOR/ISL 100/0.25 mg once daily) was filed with the US Food and Drug Administration for therapy in adults with HIV who are virologically suppressed on their antiretroviral (ARV) regimens and have no known resistance to either drug. In parallel, a once-weekly oral regimen combining ISL with the capsid inhibitor lenacapavir is currently undergoing phase III clinical investigation as maintenance therapy for people with HIV-1 who are virologically suppressed. People with HIV who are expected to be eligible for combinations with ISL may have been previously exposed to ARV therapy or preexposure prophylaxis, during which resistance mutations may have emerged. In addition, some individuals may have acquired virus containing resistance mutations through the transmission of a resistant strain.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 3","pages":"527-532"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions and opportunities to enhance aging among people with HIV: a focus on frailty, sarcopenia, and intrinsic capacity.","authors":"Evelyn Iriarte, Kristine M Erlandson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Antiretroviral therapy has transformed HIV into a chronic condition, resulting in a growing population of older people with HIV (PWH). This shift has been accompanied by an increased burden of age-related conditions, including frailty and sarcopenia, that compromise physical function and quality of life. Frailty and sarcopenia arise from complex biologic processes, many of which may be amplified in PWH. Recent conceptual advances emphasize intrinsic capacity (the composite of physical and mental capacities that determine functional ability) as a framework for understanding aging-related vulnerability. Emerging evidence suggests that social and structural determinants influence trajectories of intrinsic capacity and contribute to disparities in frailty risk. Geriatric-informed care models, including comprehensive geriatric assessment and the Integrated Care for Older People framework set forth by the World Health Organization, offer structured approaches to identify early declines in intrinsic capacity and guide individualized interventions. Exercise, nutrition optimization, and multidisciplinary care remain foundational strategies to mitigate frailty and sarcopenia, and emerging pharmacologic approaches targeting inflammation and metabolic dysfunction may influence aging trajectories. Integrating intrinsic capacity into HIV care may improve risk stratification and support interventions aimed at preserving function and healthy aging among PWH.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 3","pages":"554-560"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CROI 2026: Basic Science Highlights From the 2026 Conference on Retroviruses and Opportunistic Infections.","authors":"Mario Stevenson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The 2026 Conference on Retroviruses and Opportunistic Infections in Denver, Colorado, showcased major advances in our understanding of HIV replication, viral persistence, host-virus interactions, and innate immune sensing. Basic science presentations emphasized the remarkable complexity of the HIV replication cycle and highlighted how structural virology, systems biology, and genome-wide screening approaches are transforming the field. A consistent highlight of the conference is the Scott M. Hammer workshop for new investigators and trainees in which scientific experts help orient trainees to thematic areas being covered in the conference. This underscores the conference's dedication to the mentoring and training of early career investigators new to the field of HIV/AIDS research.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 2","pages":"437-448"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CROI 2026: Global Epidemiology and Prevention of HIV and Other Sexually Transmitted Diseases.","authors":"Susan P Buchbinder, Albert Y Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>At the 2026 Conference on Retroviruses and Opportunistic Infections (CROI), investigators presented updates on the global HIV epidemic. HIV incidence remains high among key populations, including female sex workers, men who have sex with men, people who inject drugs, and transgender women. Testing for recent infections can guide targeted HIV prevention services to interrupt ongoing transmission. In a cohort study of serodifferent couples in Africa, low-level viremia was associated with reduced but nonnegligible risk of HIV transmission. Sociostructural risk factors play a substantial role in driving new HIV transmissions. Several studies described the use of molecular epidemiology to characterize HIV transmission patterns and identify hot spots. Innovative strategies to increase HIV testing are being evaluated. In an oral preexposure prophylaxis (PrEP) study offering choice between daily and on-demand PrEP, HIV incidence was very low with either regimen. Follow-up data from 2 injectable lenacapavir PrEP trials demonstrated continued high efficacy with very rare breakthrough infections. Although awareness of long-acting PrEP is increasing, use remains low across various cohorts. Several studies reported on the use of PrEP in pregnancy, including a pharmacokinetic study showing no dose adjustment needed for long-acting injectable cabotegravir. Interventions to increase PrEP uptake and persistence show promise. A randomized clinical trial of the meningococcal vaccine did not show efficacy in preventing gonorrhea acquisition. Although doxycycline postexposure prophylaxis (doxy-PEP) use is increasing, it remained low among male veterans with a history of a sexually transmitted infection. Several studies reported on the impact of doxy-PEP on antibiotic use.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 2","pages":"501-523"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CROI 2026: Tuberculosis and Other Infectious Complications in People With HIV.","authors":"Andrew D Kerkhoff, Jason Zucker, Diane V Havlir","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The 2026 Conference on Retroviruses and Opportunistic Infections (CROI) featured numerous studies on tuberculosis and other opportunistic infections in people with HIV. High mortality rate among people with HIV hospitalized with disseminated tuberculosis (TB) and among those treated for drug-resistant TB represents a major clinical challenge. Intensified TB treatment in one trial and adjunctive prednisone in another failed to reduce mortality in hospitalized people with HIV with disseminated TB. In addition, a novel higher-dose linezolid dosing strategy did not improve culture conversion in drug-resistant TB. Recommended options for TB prevention are increasing, and include 1-month daily (1HP) and 3-month weekly (3HP) isoniazid-rifapentine regimens. Two head-to-head trials comparing 1HP and 3HP found comparable efficacy, although 1HP was associated with lower treatment completion rate and greater treatment intolerance. These and other key findings from TB, mpox, and other opportunistic infection-related studies are summarized herein.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 2","pages":"470-480"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CROI 2026: HIV Comorbidities.","authors":"Sudipa Sarkar, Todd T Brown","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aging-related comorbid conditions have major effects on the health, quality of life, and survival of people with HIV (PWH). The 2026 Conference on Retroviruses and Opportunistic Infections (CROI) featured a number of studies about various comorbid diseases in PWH. Cardiovascular diseases and hypertension were important topics at CROI, with ancillary analyses from the REPRIEVE (Pitavastatin to Prevent Cardiovascular Disease in HIV Infection) trial and studies from lower- and middle-income countries. Metabolic dysfunction-associated fatty liver disease was highlighted in a themed discussion and studies on glucagon-like protein-1 receptor agonists in PWH and antiretroviral-related weight gain were featured prominently in other sessions. Research focusing on aging in PWH was presented, including numerous studies examining the effects of exercise and physical activity and important studies documenting the high prevalence of osteoporosis and frailty in PWH in sub-Saharan Africa. This review focuses on the abstracts presented at CROI 2026 in these areas, highlighting those with the most clinical impact.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":"34 2","pages":"486-493"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}