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

Editorial introductions.

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.1097/COH.0000000000000903

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Long-acting preexposure prophylaxis: early data on roll-out in the United States.

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-11-05 DOI: 10.1097/COH.0000000000000894

Catherine A Koss, Urvi M Parikh

{"title":"Long-acting preexposure prophylaxis: early data on roll-out in the United States.","authors":"Catherine A Koss, Urvi M Parikh","doi":"10.1097/COH.0000000000000894","DOIUrl":"10.1097/COH.0000000000000894","url":null,"abstract":"Purpose of review: Long-acting preexposure prophylaxis (LA-PrEP), including cabotegravir (CAB-LA) and lenacapavir, could expand biomedical prevention coverage and reduce HIV incidence. This review describes LA-PrEP rollout in the United States, early clinical innovations in delivery, as well as opportunities and challenges for future delivery.Recent findings: Although CAB-LA is approved in numerous countries, availability is limited outside of implementation studies. Data on CAB-LA rollout in routine care are mainly limited to the U.S at present. Early data indicate that oral PrEP far exceeds CAB-LA use and gaps exist between prescription and receipt of CAB-LA, with barriers including insurance coverage. Successful early clinic models include multidisciplinary staffing for benefits navigation, medication procurement, and injection provision, scheduling, and monitoring. Innovative models are being explored for community health worker delivery, low-barrier care for persons with psychosocial barriers, and telehealth and community-based models. Given persistent disparities in HIV diagnoses and oral PrEP use, there is a critical need for equitable implementation of CAB-LA and forthcoming products, including long-acting lenacapavir.Summary: Gaps exist between the promise of LA-PrEP and actual use in US settings. To achieve population-level impact with LA-PrEP, there is an urgent need for greatly expanded access, clinical systems prepared for delivery, and a focus on LA-PrEP equity.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 1","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782211","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}

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Use of long-acting injectable cabotegravir/rilpivirine in people with HIV and adherence challenges.

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-11-08 DOI: 10.1097/COH.0000000000000904

Katerina A Christopoulos, Matthew D Hickey, Aadia Rana

{"title":"Use of long-acting injectable cabotegravir/rilpivirine in people with HIV and adherence challenges.","authors":"Katerina A Christopoulos, Matthew D Hickey, Aadia Rana","doi":"10.1097/COH.0000000000000904","DOIUrl":"10.1097/COH.0000000000000904","url":null,"abstract":"Purpose of review: Recent changes in US Department of Health and Human Services and International AIDS Society USA guidelines now endorse use of long-acting injectable cabotegravir and rilpivirine (LA-CAB/RPV) in people with HIV (PWH) who have adherence challenges, including those with viremia. We sought to summarize clinical trial and real-world study data on outcomes and implementation strategies, highlight key unanswered questions, and provide recommendations for best practices.Recent findings: Studies of LA-CAB/RPV in PWH with adherence challenges demonstrate excellent virologic outcomes, although the rate of virologic failure is higher than that in registrational trials conducted in PWH with stable viral suppression. However, viral suppression is attainable on alternate antiretroviral regimen, including those that employ lenacapavir, another long-acting injectable antiretroviral drug, even after virologic failure on LA-CAB/RPV. Successful implementation strategies for long-acting programs include centralized multidisciplinary clinic teams (ideally with pharmacist/pharmacy technician involvement), small incentives to promote patient retention on injections, allowing for drop-in injections, outreach after late injections, and partnerships with home nursing, street medicine, and harm reduction sites.Summary: Creating programs that can support PWH with adherence challenges, their providers, and their clinics to use LA-CAB/RPV in service of sustained viral suppression is an urgent priority, particularly for PWH with CD4+ cell count <200 cells/mm3.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 1","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782212","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}

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Advances in the mathematical modeling of posttreatment control of HIV-1.

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-11-07 DOI: 10.1097/COH.0000000000000896

Bharadwaj Vemparala, Jérémie Guedj, Narendra M Dixit

{"title":"Advances in the mathematical modeling of posttreatment control of HIV-1.","authors":"Bharadwaj Vemparala, Jérémie Guedj, Narendra M Dixit","doi":"10.1097/COH.0000000000000896","DOIUrl":"10.1097/COH.0000000000000896","url":null,"abstract":"Purpose of review: Several new intervention strategies have shown significant improvements over antiretroviral therapy (ART) in eliciting lasting posttreatment control (PTC) of HIV-1. Advances in mathematical modelling have offered mechanistic insights into PTC and the workings of these interventions. We review these advances.Recent findings: Broadly neutralizing antibody (bNAb)-based therapies have shown large increases over ART in the frequency and the duration of PTC elicited. Early viral dynamics models of PTC with ART have been advanced to elucidate the underlying mechanisms, including the role of CD8+ T cells. These models characterize PTC as an alternative set-point, with low viral load, and predict routes to achieving it. Large-scale omic datasets have offered new insights into viral and host factors associated with PTC. Correspondingly, new classes of models, including those using learning techniques, have helped exploit these datasets and deduce causal links underlying the associations. Models have also offered insights into therapies that either target the proviral reservoir, modulate immune responses, or both, assessing their translatability.Summary: Advances in mathematical modeling have helped better characterize PTC, elucidated and quantified mechanisms with which interventions elicit it, and informed translational efforts.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 1","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782199","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

Humoral immunity in HIV-1 post-treatment controllers.

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-11-07 DOI: 10.1097/COH.0000000000000893

Hugo Mouquet

{"title":"Humoral immunity in HIV-1 post-treatment controllers.","authors":"Hugo Mouquet","doi":"10.1097/COH.0000000000000893","DOIUrl":"10.1097/COH.0000000000000893","url":null,"abstract":"Purpose of review: Decoding the HIV-1 immune response, including its humoral arm, in post-treatment controllers (PTCs) is paramount to unveil immune correlates of viral control, which could help developing novel strategies towards HIV-1 remission. Here, we review novel findings on the humoral response to HIV-1 in PTCs.Recent findings: New data reveal the heterogeneity of humoral immune profiles in PTCs, principally influenced by viral exposure and dynamics. Stably aviremic PTCs, akin early ART-treated individuals, show minimal antibody B-cell response. Conversely, virally exposed PTCs develop functionally coordinated and effective humoral responses to HIV-1. They can produce antibodies cross-neutralizing heterologous HIV-1 viruses, including broadly neutralizing antibodies (bNAbs) exerting selective immune pressure. PTCs also elicit neutralizing antibodies against contemporaneous autologous viruses presumed to play a major role in sustaining viral suppression.Summary: The immune mechanisms underlying virologic control in PTCs likely involve various immune effectors. Notably, functional HIV-1 humoral responses can generate bNAbs and autologous neutralizing antibodies; however, their exact contribution to maintaining long-term control of plasma viremia and the precise mechanisms driving their induction require further investigation.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 1","pages":"80-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782201","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}

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Long-acting antiretroviral therapy in the context of viral suppression.

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-11-05 DOI: 10.1097/COH.0000000000000897

Kyle Ring, Chloe Orkin

{"title":"Long-acting antiretroviral therapy in the context of viral suppression.","authors":"Kyle Ring, Chloe Orkin","doi":"10.1097/COH.0000000000000897","DOIUrl":"10.1097/COH.0000000000000897","url":null,"abstract":"Purpose of review: Long-acting antiretroviral therapy (ART), such as with cabotegravir and rilpivirine, is a new and exciting paradigm shift that could change the face of HIV treatment if it were universally available to all who want it. In countries where there is access, uptake has been slow - partly because of capacity issues and partly because of hesitancy around remaining clinical questions. We summarized clinical trial data and emerging real-world evidence to shed light on these questions.Recent findings: Phase 2b/3/3b clinical trials have shown CAB+RPV injections to be both well tolerated and efficacious. Real-world cohort (RWC) studies with larger numbers of people demonstrate high levels of adherence and persistence, and low rates of virological failure in clinical practice.Summary: Although the risk of virological failure in the context of CAB+RPV is low, it remains a pertinent issue because of the high risk of developing two-class resistance. The use of multiple definitions of virological failure in RWC studies currently makes understanding the available evidence difficult and could have deleterious effects on clinical decision-making. Longer term real-world evidence in diverse populations is needed to better understand the durability of CAB+RPV and its suitability in different contexts.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"20 1","pages":"4-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782202","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

Stem cell transplantation and allogeneic immunity: post treatment control or HIV cure? 干细胞移植和异体免疫：治疗后控制还是治愈艾滋病毒？

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-11-25 DOI: 10.1097/COH.0000000000000892

Megan Cleary, Lishomwa C Ndhlovu, Jonah B Sacha

{"title":"Stem cell transplantation and allogeneic immunity: post treatment control or HIV cure?","authors":"Megan Cleary, Lishomwa C Ndhlovu, Jonah B Sacha","doi":"10.1097/COH.0000000000000892","DOIUrl":"10.1097/COH.0000000000000892","url":null,"abstract":"Purpose of review: Long-lasting HIV remission has been reported in a small group of people with HIV (PWH) following allogenic hematopoietic stem cell transplants (HSCT) for the treatment of hematologic malignancies. While the mechanisms of HIV remission following release from antiretroviral therapy (ART) were not initially known, subsequent findings from clinical cases and preclinical nonhuman primate studies have implicated mechanisms of clearance. Here, we review the six currently published human cases of long-term ART-free HIV remission.Recent findings: Since the first report of ART-free HIV remission following HSCT, five subsequent cases of HSCT-induced sustained HIV remission have been published. While the pre- and posttransplant treatment conditions vary greatly, all but one received cells from donors homozygous for a 32 bp deletion in the gene that encodes CCR5 ( ccr5Δ32 ), the major HIV coreceptor. Studies in nonhuman primates and the newest published individual suggest that while CCR5 deficiency can protect donor cells from infection early posttransplant, it is not required for long term remission, as ablation of the viral reservoir is likely due to allogeneic immunity mediating a graft-versus-reservoir response.Summary: Studies of HSCT in PLWH and simian immunodeficiency virus (SIV)-infected monkeys show that those with durable remission are likely cured, demonstrated by complete ablation of the replication-competent HIV reservoir, gradual loss of anti-HIV immunity, and greater than 5 years of aviremia.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559840","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

Emerging role of natural killer cells in non-AIDS comorbidities during suppressive antiretroviral therapy.

Current opinion in HIV and AIDS Pub Date : 2024-12-27 DOI: 10.1097/COH.0000000000000913

Mario Alles, Thorsten Demberg, Namal P M Liyanage

{"title":"Emerging role of natural killer cells in non-AIDS comorbidities during suppressive antiretroviral therapy.","authors":"Mario Alles, Thorsten Demberg, Namal P M Liyanage","doi":"10.1097/COH.0000000000000913","DOIUrl":"https://doi.org/10.1097/COH.0000000000000913","url":null,"abstract":"Purpose of review: Despite decades of insights about the role of natural killer (NK) cells in HIV infection, their persistent dysregulation despite antiretroviral therapy (ART) and its pathological consequences have been incompletely delineated. In this review, we highlight recent findings on the immunophenotypic and functional alterations of NK cells during virally suppressed HIV infection and explore their potential impact on promoting non-AIDS related comorbidities among people living with HIV (PLWH).Recent findings: Of note are the apparent persistent activated profiles of NK cells and pathophysiological events such as endoplasmic reticulum (ER) stress in potentially driving NK cell derived inflammation and tissue destruction. Additionally, recent interest in trained immunity is discussed as a potential mediator of ongoing NK cell dysregulation, contributing to comorbidities such as cardiovascular disease and neurocognitive disorders, both with an inflammatory etiology.Summary: Clinical and mechanistic evidence suggests persistent activation and dysregulation of the innate immune system are major drivers of non-AIDS comorbidities during virally suppressed HIV infection. Delineating the mechanistic role of specific components of innate immunity such as NK cells in inducing these pathologies will lead to the identification of novel therapeutic/prophylactic strategies to improve the overall health of PLWH.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960691","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}

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Monocytes across life span in hiv infection: lights and shadows.

Current opinion in HIV and AIDS Pub Date : 2024-12-20 DOI: 10.1097/COH.0000000000000910

Alessia Neri, Giulio Olivieri, Chiara Pighi, Donato Amodio, Nicola Cotugno, Paolo Palma

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Innate lymphoid cells in HIV pathogenesis and in the human female genital tract.

Current opinion in HIV and AIDS Pub Date : 2024-12-20 DOI: 10.1097/COH.0000000000000908

Alexandra Werner, Aleah Holmes, Genna Moldovan, Marta Rodriguez-Garcia

{"title":"Innate lymphoid cells in HIV pathogenesis and in the human female genital tract.","authors":"Alexandra Werner, Aleah Holmes, Genna Moldovan, Marta Rodriguez-Garcia","doi":"10.1097/COH.0000000000000908","DOIUrl":"https://doi.org/10.1097/COH.0000000000000908","url":null,"abstract":"Purpose of review: Women are underrepresented in HIV infection and prevention research despite making up half of people living with HIV. The female genital tract (FGT) serves as a primary site of HIV acquisition, but gaps in knowledge remain regarding protective innate immune mechanisms. Innate lymphoid cells are tissue-resident cells involved in mucosal barrier maintenance and protection, and innate lymphoid cells (ILCs) are altered during chronic HIV infection. However, ILCs role in mucosal HIV pathogenesis is unclear and they are poorly characterized in the FGT.Recent findings: Human ILCs differ from their mouse counterparts and plastically adjust to their tissue of residency. Human ILC characterization is difficult due to tissue-specific adaptations and transition between subsets. While evidence for ILC involvement in antiviral activity and barrier maintenance is provided in mouse models, human ILC role in mucosal immunity remain understudied, particularly in the FGT. In chronic HIV/simian immunodeficiency virus (SIV) infection, ILCs are altered in a tissue-specific manner, and SIV models indicate potential for antiviral responses.Summary: ILCs are tissue-resident plastic cells that provide barrier protection at mucosal surfaces and display antiviral capacity. Considering that HIV is primarily transmitted through mucosal exposure, more research is needed to understand ILC contribution to HIV pathogenesis in human mucosal surfaces relevant for HIV acquisition.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960692","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