Current opinion in HIV and AIDS最新文献

{"title":"Genomic and spatial epidemiology: lessons learned from SARS-CoV-2 pandemic.","authors":"Yangji Choi, David De Ridder, Gilbert Greub","doi":"10.1097/COH.0000000000000936","DOIUrl":"10.1097/COH.0000000000000936","url":null,"abstract":"<p><strong>Purpose of review: </strong>The SARS-CoV-2 pandemic presented unprecedented challenges, particularly in understanding its complex spatial transmission patterns. The high transmissibility of the virus led to frequent super-spreading events. These events demonstrated clear spatial clustering patterns, often tied to specific events that facilitated transmission. The uneven geographic distribution of medical resources and varying access to care amplified the impact of SARS-CoV-2. Asymptomatic cases further complicated the situation, as infected individuals could silently spread the virus before being identified.Thus, this review examines how genomic and spatial epidemiology approaches can be integrated to answer some of the above-mentioned challenges. We first describe the methodological foundations of genomics and spatial epidemiology, detailing opportunities of their applications during the SARS-CoV-2 pandemic. We then present a novel interdisciplinary framework that combines these approaches to better guide public health interventions.</p><p><strong>Recent findings: </strong>During the pandemic, the genomic and spatial approaches were used to address key questions, including \"how does the pathogen evolve and diversify?\" and \"how does the pathogen spread geographically?\". Genomic epidemiology allows researchers to identify viral lineages and new variants. Conversely, spatial epidemiology focused on geographic distribution of infections, analyzing how the virus spread. However, despite their complementary nature, these approaches were largely applied independently during the pandemic. This separation limited our collective ability to fully understand the complex relationships between viral evolution and geographic spread.</p><p><strong>Summary: </strong>While phylogeography has traditionally combined phylogenetic and geographic data to understand long-term evolutionary patterns across large areas, events such as the recent SARS-CoV-2 pandemic demand frameworks that can inform public health interventions through joint analysis of genomic and local-scale spatial data.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"287-293"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766226","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":"Editorial introductions.","authors":"","doi":"10.1097/COH.0000000000000934","DOIUrl":"https://doi.org/10.1097/COH.0000000000000934","url":null,"abstract":"","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 3","pages":"v-vi"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775280","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":"Epigenetic reprogramming of the host immune system during acute HIV.","authors":"Alina P S Pang, Michael J Corley","doi":"10.1097/COH.0000000000000935","DOIUrl":"https://doi.org/10.1097/COH.0000000000000935","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review explores the epigenetic mechanisms driving immune dysregulation during acute HIV, focusing on how early HIV exploits host epigenetic machinery to establish viral persistence and evade immune clearance.</p><p><strong>Recent findings: </strong>Epigenetic reprogramming during acute HIV plays a pivotal role in shaping immune responses, establishing viral reservoirs, and driving persistent immune dysfunction. Recent studies leveraging genome-wide DNA methylation profiling, single-cell transcriptomics, and chromatin accessibility assays are elucidating key mechanisms through which HIV exploits the host epigenome to evade immune surveillance and promote viral persistence.</p><p><strong>Summary: </strong>Epigenetic reprogramming during acute HIV is a critical determinant of viral persistence and immune dysfunction. Understanding these mechanisms offers new avenues for therapeutic strategies aimed at modulating the epigenome to disrupt reservoir formation, enhance immune responses, and advance HIV cure efforts.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 3","pages":"209-217"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775281","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":"Stepping stones to cure in children with HIV.","authors":"Louise Kuhn","doi":"10.1097/COH.0000000000000925","DOIUrl":"https://doi.org/10.1097/COH.0000000000000925","url":null,"abstract":"","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 3","pages":"247-248"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775282","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":"Acute retroviral syndrome.","authors":"Javier R Lama, Rachel A Bender Ignacio, Ann Duerr","doi":"10.1097/COH.0000000000000933","DOIUrl":"10.1097/COH.0000000000000933","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the most important recent literature on the definition, epidemiology, clinical presentation, pathogenesis and treatment of the acute retroviral syndrome (ARS), a constellation of nonspecific symptoms and transient illness occuring in at least 50% of persons shortly after HIV acquisition. ARS is driven by initial rapid HIV viral replication and dissemination after acquisition, followed by immune activation and massive systemic inflammation. A more detailed understanding of ARS is important for the implementation of early detection efforts, treatment and public health strategies to control HIV.</p><p><strong>Recent findings: </strong>Recent research has provided deeper insights into ARS. Key findings include associations of ARS with heightened immune activation and elevated levels of IFNγ and multiple other cytokines, particularly IP-10, as well as with higher viral load and more severe CD4 + depletion during acute infection. These negative impacts can be mitigated by early antiretroviral therapy initiation and long-term outcomes are generally similar in treated individals with or without ARS.</p><p><strong>Summary: </strong>Current findings underscore the importance of early detection and intervention in ARS to mitigate long-term health impacts and inform the development of targeted therapeutic strategies.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"186-192"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660032","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":"Human models that inform antiretroviral therapy-free remission with perinatally acquired HIV infection.","authors":"Caroline T Tiemessen","doi":"10.1097/COH.0000000000000918","DOIUrl":"10.1097/COH.0000000000000918","url":null,"abstract":"<p><strong>Purpose of review: </strong>Rare persons who achieve disease-control despite high viral loads (viraemic nonprogressors) or maintain virologic control in the absence of antiretroviral therapy (ART) (elite controllers) or following ART interruption (posttreatment controllers) possess protective factors that can be harnessed for interventions to achieve ART-free remission. This review broadly summarizes these phenotypes in adults and children, and updates on findings important in informing strategies for ART-free remission in children with HIV.</p><p><strong>Recent findings: </strong>To date, only a few individual cases of posttreatment control have been described in children. Smaller HIV reservoir size with very early ART initiation in neonates with in-utero acquired HIV associates with improved virological and immunological outcomes. Nine new cases of ART-free remission in children were recently described - 4 from the P1115 trial, and 5 males from the Ucwaningo Lwabantwana study in South Africa. A striking reduction in the decay of intact proviruses was observed over three decades on suppressive ART in two early-treated twins with HIV.</p><p><strong>Summary: </strong>The unique environment of perinatal HIV infection favours effective restriction and decay of the HIV-1 reservoir with suppressive ART initiated very early. Sex and population differences require consideration in ongoing studies to inform ART-free remission.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"249-256"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416474","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":"Mpox and the impact on people with HIV.","authors":"Mauricio Teixeira Lima, Erna Geessien Kroon, Marco Antônio Campos","doi":"10.1097/COH.0000000000000922","DOIUrl":"10.1097/COH.0000000000000922","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review explores the intersection of Mpox and HIV, highlighting clinical manifestations, immune evasion mechanisms, epidemiological challenges, and prevention strategies. People with HIV (PWH), particularly those with low CD4 + cell count, face severe Mpox outcomes. Prevention relies on education, vaccination, and early detection. Integrating Mpox management into HIV care systems is vital.</p><p><strong>Recent findings: </strong>Since May 2022, Mpox caused by Orthopoxvirus monkeypox (MPV) Clade IIb, has affected 126 countries. In 2024, Clade Ib emerged in the Democratic Republic of Congo, leading to its declaration as a Public Health Emergency of International Concern (PHEIC). Research on MPV-HIV co-infections has provided genomic insights and protective strategies for PWH. Antivirals like tecovirimat show promise despite emerging resistance concerns.</p><p><strong>Summary: </strong>The global Mpox outbreak caused by Clade IIb and the emergence of Clade Ib underscores its growing threat. Mpox disproportionately impacts PWH, leading to severe outcomes and higher fatality rates. This review emphasizes clinical challenges, genomic advances, and prevention strategies. Enhanced surveillance, vaccination, and tailored therapies are essential to addressing this evolving health crisis.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"310-317"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525530","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":"New developments in antiretroviral therapy strategies to improve clinical management of neonates and young infants with HIV.","authors":"Lisa Jane Frigati, Shaun Barnabas, Adrie Bekker","doi":"10.1097/COH.0000000000000928","DOIUrl":"10.1097/COH.0000000000000928","url":null,"abstract":"<p><strong>Purpose of review: </strong>Clinical and virological outcomes in early-treated cohorts of children living with HIV have been sub-optimal. This is in part due to the demands on the caregiver of adhering to twice a day antiretroviral treatment (ART) for their newborn infants. Administering ART to neonates can be challenging and frequently requires separate drugs in liquid formulations and multiple dose adjustments. We reviewed literature from 01 January 2015 to 31 December 2024 on infant outcomes, antiretroviral drugs, updated dosing recommendations, new formulations and potential strategies to enhance adherence when ART is started in the neonatal and young infant period.</p><p><strong>Recent findings: </strong>There are now pharmacokinetic (PK) data to inform the use of abacavir and lamivudine in liquid and solid formulations in the neonatal period and to support the use of lamivudine and nevirapine in preterm infants. A dosing strategy for dolutegravir in the first month of life has been informed by recent studies.</p><p><strong>Summary: </strong>Studies are ongoing with regards to dolutegravir in various formulations. Long-acting antiretroviral therapy and broadly neutralizing antibodies are currently being studied in neonates and young infants. Addressing maternal clinical and psychosocial health and is a key factor in ensuring infants achieve viral suppression and decreased morbidity.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"257-264"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574843","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":"Immune signatures and biomarkers of viral control in early-treated children with HIV: insights informing intervention.","authors":"Benjamin Bone, Lesley de Armas, Rajendra Pahwa, Savita Pahwa","doi":"10.1097/COH.0000000000000929","DOIUrl":"10.1097/COH.0000000000000929","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review concentrates on the immune signatures in infants with perinatally acquired HIV (PAH) and in later life to assess their utility in predicting the likelihood of HIV remission following discontinuation of antiretroviral therapy.</p><p><strong>Recent findings: </strong>Distinct immune signatures are identifiable in early treated infants with PAH in whom reservoirs are markedly restricted, with high CD4 + /CD8 + ratios, decreased immune activation and exhaustion, and a rapid transition of CD8 + T cells from naïve to a terminally differentiated state. The natural killer (NK) cell compartments manifest downregulated inhibitory markers and exhibit cytokine producing NK phenotypes. Immune signatures observed in adolescent/adult cohorts with PAH, and associated with reduced or absent replication competent HIV reservoir included HIV-specific T cell proliferative responses and NK cells expressing the activation markers NKG2D and NKp46.</p><p><strong>Summary: </strong>Immune signatures of functional T cell and NK cell compartments are identifiable in early treated infants and adolescents with PAH, and are associated with limited replication competent reservoirs. Such findings are also observed in post treatment controllers and could be predictors of ART-free remission.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"265-270"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766159","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":"Nonpharmacologic interventions to improve quality of life of older adults with HIV.","authors":"Carmen M Cano de Luque, Matilde Sánchez-Conde, Fátima Brañas","doi":"10.1097/COH.0000000000000937","DOIUrl":"https://doi.org/10.1097/COH.0000000000000937","url":null,"abstract":"<p><strong>Purpose of review: </strong>Ensuring optimal quality of life (QOL) in older adults with HIV (OAWH) should be a priority. Comprehensive strategies are needed not only to assess QOL but also to implement targeted interventions that enhance it across multiple dimensions. This review aims to examine the robust scientific evidence supporting the effectiveness of nonpharmacological interventions, such as exercise, socialization, and psychological support.</p><p><strong>Recent findings: </strong>Physical activity and structured exercise programs have been shown to improve functional capacity, reduce frailty, alleviate depressive symptoms, and enhance psychological well being in OAWH. Studies indicate that interventions such as home-based exercise programs, community-based support, and digital health initiatives can help mitigate isolation, reduce depressive symptoms, and improve socialization.</p><p><strong>Summary: </strong>There remains a gap between the scientific evidence demonstrating the benefits of nonpharmacological interventions and their implementation in clinical practice. A shift from disease-centered to person-centered medicine is necessary to adequately address the real needs of OAWH. From a healthcare policy perspective, a fundamental change in approach is essential, with greater investment in evidence-based strategies - such as exercise, socialization, and psychological support - even if it requires rethinking the current care model.</p>","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766179","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}