Current opinion in HIV and AIDS最新文献_第2页

Reframing obesity in aging people with HIV: sarcopenic obesity, muscle quality, and frailty. 重新定义老年艾滋病患者的肥胖：肌肉减少型肥胖、肌肉质量和虚弱。

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Current opinion in HIV and AIDS Pub Date : 2026-11-01 Epub Date: 2026-09-01 DOI: 10.1097/COH.0000000000001067

Vitor H F Oliveira, Todd T Brown, Kristine M Erlandson

{"title":"Reframing obesity in aging people with HIV: sarcopenic obesity, muscle quality, and frailty.","authors":"Vitor H F Oliveira, Todd T Brown, Kristine M Erlandson","doi":"10.1097/COH.0000000000001067","DOIUrl":"10.1097/COH.0000000000001067","url":null,"abstract":"Purpose of review: As people with HIV (PWH) age, obesity is increasingly prevalent, yet body weight alone inadequately captures the functional and metabolic consequences of adverse body composition remodeling. This review examines emerging evidence supporting a shift from weight-centric approaches toward a framework centered on sarcopenic obesity, muscle quality, and frailty in aging PWH.Recent findings: Weight gain in the contemporary antiretroviral therapy era often reflects increased visceral and ectopic adiposity. Sarcopenic obesity is a clinically relevant phenotype characterized by the coexistence of excess adiposity and impaired muscle mass or function, with important implications for healthy aging. Emerging evidence highlights myosteatosis and impaired muscle quality as potential mechanistic links between adiposity and functional decline. Exercise-based interventions, particularly those incorporating resistance training, demonstrate promise for preserving physical function, reducing frailty, and improving body composition. In contrast, pharmacologic weight loss may raise concerns regarding lean tissue preservation if implemented without a concurrent focus on muscle health.Summary: Obesity in aging PWH should be reframed as a body composition and functional health problem rather than simply excess body weight. Clinical and research priorities should emphasize early identification of vulnerability, preservation of muscle health, and interventions that support long-term physical resilience and independence.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"473-479"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876799","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}

引用次数: 0

Population health and epidemiologic trends in weight gain among people with HIV. 艾滋病毒感染者体重增加的人口健康和流行病学趋势。

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Current opinion in HIV and AIDS Pub Date : 2026-11-01 Epub Date: 2026-09-07 DOI: 10.1097/COH.0000000000001072

Kassem Bourgi

{"title":"Population health and epidemiologic trends in weight gain among people with HIV.","authors":"Kassem Bourgi","doi":"10.1097/COH.0000000000001072","DOIUrl":"10.1097/COH.0000000000001072","url":null,"abstract":"Purpose of review: The epidemiology of weight among people with HIV (PWH) has shifted from wasting to overweight and obesity. This review summarizes population trends in weight, antiretroviral therapy (ART)-associated weight trajectories, subgroup heterogeneity, and cardiometabolic consequences of weight gain among PWH.Recent findings: Weight gain after ART initiation is common and occurs against a background of secular increases in obesity prevalence. Greater gains are often observed with contemporary integrase strand transfer inhibitor (INSTI)-containing and tenofovir alafenamide (TAF)-containing regimens, although interpretation is complicated by return-to-health and the weight-suppressive effects of older regimens (efavirenz and tenofovir disoproxil fumarate). Weight changes after ART switch are usually modest, and discontinuing INSTI or TAF rarely reverses established gain. Black women and individuals with advanced HIV disease experience greater gains, and substantial early increases in weight have been associated with diabetes, metabolic syndrome, hypertension, and dyslipidemia.Summary: Weight gain among PWH is heterogeneous and should be interpreted in the context of baseline nutritional status, ART exposure, and population setting. Future studies should identify which patterns of weight gain predict adverse clinical outcomes and evaluate interventions that reduce metabolic risk.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"453-459"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019196","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}

引用次数: 0

Beyond weight gain toward healthy cardiometabolic aging in people with HIV. 艾滋病毒感染者的健康心脏代谢衰老

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Current opinion in HIV and AIDS Pub Date : 2026-11-01 Epub Date: 2026-10-01 DOI: 10.1097/COH.0000000000001073

Celestine N Wanjalla

引用次数: 0

The interaction of comorbidities, aging, and HIV persistence in tissues. 合并症、衰老和HIV在组织中持续存在的相互作用。

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Current opinion in HIV and AIDS Pub Date : 2026-10-09 DOI: 10.1097/COH.0000000000001077

Katelyn A O'Hare, Michael L Freeman, Kristine M Erlandson

{"title":"The interaction of comorbidities, aging, and HIV persistence in tissues.","authors":"Katelyn A O'Hare, Michael L Freeman, Kristine M Erlandson","doi":"10.1097/COH.0000000000001077","DOIUrl":"https://doi.org/10.1097/COH.0000000000001077","url":null,"abstract":"Purpose of review: The review examines the how the HIV reservoir and its tissue distribution intersect with aging and comorbidity development in people with HIV (PWH) on suppressive antiretroviral therapy (ART) and considers implications for cure-directed research in an aging population.Recent findings: PWH on ART carry a disproportionate and accelerating comorbidity burden, with multimorbidity projected to rise from 63 to 70% by 2030. Neurocognitive disorders, liver disease, lung disease, cardiovascular disease, and frailty are all elevated, and linked to the viral reservoir through chronic inflammation and direct viral mechanisms. Coinfections (HCV, HBV, CMV) compound this issue by amplifying the reservoir while independently driving the same comorbidities, particularly liver disease, and cardiovascular and frailty outcomes.Summary: Reservoir persistence and comorbidity burden in aging PWH are mechanistically intertwined, with chronic inflammation as a common driver. These findings underscore the need for longitudinal, tissue-resolved studies spanning the lifespan, as well as inclusion of aged and comorbid individuals in cure-directed trials, given that immune-engagement-dependent cure strategies may exhibit differential efficacy in this growing population.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140014","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}

引用次数: 0

Quiet but not silent: assessing the impact of intact and defective HIV proviral DNA in the brain. 安静但不沉默：评估大脑中完整和有缺陷的HIV前病毒DNA的影响。

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Current opinion in HIV and AIDS Pub Date : 2026-09-01 Epub Date: 2026-08-06 DOI: 10.1097/COH.0000000000001054

Emily K Chalmers, Janna Jamal Eddine, Liam Yucel, Melissa J Churchill, Thomas A Angelovich

{"title":"Quiet but not silent: assessing the impact of intact and defective HIV proviral DNA in the brain.","authors":"Emily K Chalmers, Janna Jamal Eddine, Liam Yucel, Melissa J Churchill, Thomas A Angelovich","doi":"10.1097/COH.0000000000001054","DOIUrl":"https://doi.org/10.1097/COH.0000000000001054","url":null,"abstract":"Purpose of review: People with HIV (PWH) require lifelong antiretroviral therapy (ART) to maintain viral suppression, yet integrated HIV DNA persists in long-lived cellular reservoirs in blood and tissues. Most integrated proviruses are defective, meaning they contain deletions, hypermutation, packaging-signal defects, splice defects, or other defects that prevent production of replication-competent viruses. However, these genomes are not necessarily biologically inert as many remain capable of transcription and, in some cases, translation of viral proteins.Recent findings: Recent evidence has demonstrated that the brain is a stable reservoir of both intact and defective HIV despite viral suppression with ART. Whilst intact replication capable proviruses are known to induce cell activation and pathology, recent studies suggest that defective proviruses with large internal deletions and hypermutation can remain transcriptionally, and in some cases, translationally active and have now been linked with persistent immune activation during ART. Therefore, transcriptionally active defective proviral DNA may be a contributor to underlying neuropathogenesis in ART-suppressed PWH.Summary: Defective HIV proviruses make up the majority of the proviral reservoir across blood and tissue compartments. Although they are replication-incompetent, many remain transcriptionally and translationally competent and may contribute to chronic inflammation, antigen persistence, and neuropathology in ART-suppressed PWH.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"21 5","pages":"372-378"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681476","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}

引用次数: 0

Implications of HIV persistence and pathogenesis in microglia. HIV在小胶质细胞中的持久性和发病机制的意义。

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Current opinion in HIV and AIDS Pub Date : 2026-09-01 Epub Date: 2026-06-24 DOI: 10.1097/COH.0000000000001044

Nanouk Zuidmeer, Jori Symons, Monique Nijhuis

{"title":"Implications of HIV persistence and pathogenesis in microglia.","authors":"Nanouk Zuidmeer, Jori Symons, Monique Nijhuis","doi":"10.1097/COH.0000000000001044","DOIUrl":"10.1097/COH.0000000000001044","url":null,"abstract":"Purpose of the review: This review summarizes recent advances in understanding HIV infection of the brain, focusing on viral persistence in microglia and associated pathogenesis during viremia and viral suppression. We highlight key findings in microglial research that inform the next steps toward therapeutic strategies and cure approaches addressing the brain as a viral reservoir.Recent findings: Microglia can contain intact, replication-competent inducible proviruses, even during antiretroviral therapy (ART). The microglial chromatin context and HIV integration site landscape during HIV infection are reportedly distinct from peripheral lymphocytes. Upon infection, both infected and bystander microglia exhibit pro-inflammatory and senescent phenotypes that closely resemble those observed in aging microglia and play a central role in neuropathogenesis. ART mitigates these effects but does not fully restore to levels observed in HIV-uninfected conditions.Summary: Microglial HIV infection and persistence of this reservoir play a central and detrimental role in HIV pathogenesis in the brain. Given their role in neurodegeneration during HIV infection, closer characterization of the microglial (latent) reservoir and careful monitoring of neurodegeneration during treatment and cure interventions are essential. Treatment and cure strategies should prioritize minimizing viral transcription and protein expression within the brain reservoir to mitigate neuroinflammation and neuropathogenesis.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"386-392"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321337","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}

引用次数: 0

Rethinking aging biomarkers in HIV: from measures to meaning. 重新思考HIV中的衰老生物标志物：从措施到意义。

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Current opinion in HIV and AIDS Pub Date : 2026-09-01 Epub Date: 2026-07-16 DOI: 10.1097/COH.0000000000001057

Ekta Singh, Alan L Landay, Matthew L Mendoza

{"title":"Rethinking aging biomarkers in HIV: from measures to meaning.","authors":"Ekta Singh, Alan L Landay, Matthew L Mendoza","doi":"10.1097/COH.0000000000001057","DOIUrl":"10.1097/COH.0000000000001057","url":null,"abstract":"Purpose of review: People with HIV (PWH) on effective antiretroviral therapy continue to experience a disproportionate burden of age-related comorbidities and multimorbidity. This review explores HIV-associated aging as a systems-level dysregulation and loss of resilience and evaluates emerging biomarker strategies for capturing its biological and clinical heterogeneity.Recent findings: Recent evidence indicates that aging in HIV is driven by interacting immune, metabolic, regenerative, structural, and inter-organ pathways that generate measurable signatures across biological scales. Composite biomarker approaches integrating molecular, physiological, and functional measures are increasingly being applied to cardiovascular, neurocognitive, physical, and co-infection-related outcomes. Large cohort studies, risk prediction models, and intervention trials support their clinical relevance, while emerging gerotherapeutic studies suggest that biologic aging markers may serve as responsive treatment endpoints.Summary: No single biomarker adequately captures HIV-associated aging. Future progress will depend on multimodal, outcome-anchored composites that integrate biological and functional domains and are coupled with artificial intelligence- and machine learning-based approaches to improve risk stratification, therapeutic monitoring, and evaluation of geroscience-informed interventions in PWH.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"347-354"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474900","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}

引用次数: 0

Pathogenesis of HIV in the brain. 艾滋病毒在大脑中的发病机制。

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Current opinion in HIV and AIDS Pub Date : 2026-09-01 Epub Date: 2026-08-06 DOI: 10.1097/COH.0000000000001055

Melissa Churchill

引用次数: 0

Measuring neurocognitive impairment in virally suppressed HIV: HIV-associated neurocognitive disorders, HIV-associated brain injury problems and solutions. 测量病毒抑制HIV的神经认知障碍：HIV相关的神经认知障碍，HIV相关的脑损伤问题和解决方案。

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Current opinion in HIV and AIDS Pub Date : 2026-09-01 Epub Date: 2026-07-06 DOI: 10.1097/COH.0000000000001053

Bruce J Brew, Lucette A Cysique

{"title":"Measuring neurocognitive impairment in virally suppressed HIV: HIV-associated neurocognitive disorders, HIV-associated brain injury problems and solutions.","authors":"Bruce J Brew, Lucette A Cysique","doi":"10.1097/COH.0000000000001053","DOIUrl":"10.1097/COH.0000000000001053","url":null,"abstract":"Purpose of review: To discuss neurocognition measurement in view of current controversies in HIV-associated neurocognitive disorders (HAND).Recent findings: The HAND criteria have been criticised for several reasons with some proposing alternative criteria and terminology, HIV-associated brain injury (HABI). The following concerns have been raised: the legacy effect from past ineffective therapy is not included, the adoption of an asymptomatic neurocognitive impairment (ANI) stage, including liberal neuropsychological test cut-offs overestimate neurocognitive impairment (NCI), and that NCI with viral suppression is still related to HIV rather than the effect of either legacy and/or comorbidities. However, the legacy effect cannot be easily identified, the HAND criteria have been inappropriately used, and there is increasing evidence that low level HIV replication is important in virally suppressed HAND, though likely mitigated in some by resilience factors. Potential solutions to addressing these within the HAND framework will be proposed.Summary: The HAND framework is still useful but it must be put in clinical context. ANI should be considered a research category pending further clarification of its clinical utility. Further work is needed to identify and quantify the legacy effect/ongoing NCI, as well as the nature of resilience.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"379-385"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400326","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}

引用次数: 0

Learned young: HIV-1 germline-targeting vaccination in infants. 年轻有为：婴儿的HIV-1种系靶向疫苗接种。

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Current opinion in HIV and AIDS Pub Date : 2026-09-01 Epub Date: 2026-07-06 DOI: 10.1097/COH.0000000000001051

Rogier W Sanders, Tom G Caniels, John P Moore, Sallie R Permar

{"title":"Learned young: HIV-1 germline-targeting vaccination in infants.","authors":"Rogier W Sanders, Tom G Caniels, John P Moore, Sallie R Permar","doi":"10.1097/COH.0000000000001051","DOIUrl":"10.1097/COH.0000000000001051","url":null,"abstract":"Purpose of review: It is standard practice to protect infants against viruses that they are exposed to early in life, during childhood, or as adults. While HIV-1 is only rarely a risk in the period between the end of breast-feeding and the onset of sexual maturity, there are good immunological and practical arguments for assessing whether vaccination of young children might be beneficial.Recent findings: Studies of HIV-1-infected individuals suggest that the characteristics of the developing immune system may favor the evolution of B cells that produce broadly neutralizing antibodies (bNAbs), when compared to the same processes in adults. One way to exploit these properties of the infant immune system is targeting the germline precursors of B cells that can, over time and with the right sequential antigenic stimuli, mature into bNAb-producing plasma cells. Multidose immunization over time is standard practice within global childhood vaccine frameworks.Summary: We discuss strategies to accomplish the goal of inducing bNAbs, based on the use of specifically designed envelope glycoprotein immunogens. We also summarize how bNAbs may be used for passive protection of infants and combined with active vaccination.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"393-400"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400221","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}

引用次数: 0