Current opinion in HIV and AIDS最新文献_第5页

HIV-1 reservoir landscape of post-treatment control. 治疗后控制的 HIV-1 病毒库状况。

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-10-21 DOI: 10.1097/COH.0000000000000891

Caroline Charre, Yanis Merad, Véronique Avettand-Fenoel

{"title":"HIV-1 reservoir landscape of post-treatment control.","authors":"Caroline Charre, Yanis Merad, Véronique Avettand-Fenoel","doi":"10.1097/COH.0000000000000891","DOIUrl":"10.1097/COH.0000000000000891","url":null,"abstract":"Purpose of review: This review explores the viral reservoir landscape in individuals who control viral replication after treatment interruption (TI), designated as post-treatment controllers (PTCs). Identifying their virologic features is crucial to inform drug-free HIV remission strategies.Recent findings: Traditionally characterized as small, likely due to early treatment, the viral reservoir of PTCs, after TI, exhibits limited transcriptional activity, residual viral replication and subsequent proviral diversity. Intact proviruses are found to be restricted. In nonhuman primate PTCs, this depletion of intact proviruses is already observed in lymph nodes before TI, suggesting that control mechanisms begin during antiretroviral therapy. Furthermore, recent studies suggest immune-driven proviral deep latency associated with repressive epigenetic features and integration sites in PTCs. While molecular mapping of virological features of PTCs is increasingly precise and coupled with in-depth immunologic assays, robust predictive biomarkers of PTCs are still lacking.Summary: Despite limited sample sizes and heterogeneous definitions, common virologic features of PTCs include restricted reservoir size and transcriptional activity, fewer intact proviruses and deep proviral latency. Ongoing research using innovative technologies will further elucidate the mechanisms underlying post-treatment control, paving the way for successful HIV cure interventions.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"99-108"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559839","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

Long-acting preexposure prophylaxis: early data on roll-out in the United States. 长效暴露前预防：美国推出的早期数据。

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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782211","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

Use of long-acting injectable cabotegravir/rilpivirine in people with HIV and adherence challenges. 长效注射卡波特韦/利匹韦林在艾滋病毒感染者中的使用和依从性挑战。

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}

引用次数: 0

Soluble markers of viral rebound and post-treatment HIV control. 病毒反弹和治疗后艾滋病毒控制的可溶性标志物。

Current opinion in HIV and AIDS Pub Date : 2025-01-01 Epub Date: 2024-09-25 DOI: 10.1097/COH.0000000000000889

Leila B Giron, Alexander O Pasternak, Mohamed Abdel-Mohsen

{"title":"Soluble markers of viral rebound and post-treatment HIV control.","authors":"Leila B Giron, Alexander O Pasternak, Mohamed Abdel-Mohsen","doi":"10.1097/COH.0000000000000889","DOIUrl":"10.1097/COH.0000000000000889","url":null,"abstract":"Purpose of review: We focus on the different classes of biological molecules measurable in easily accessible bodily fluids that have the potential to serve as biomarkers for the HIV post-treatment controller (PTC) phenotype and/or the timing of viral rebound after stopping antiretroviral therapy (ART).Recent findings: Various viral components and host factors measurable in body fluids can play crucial roles in understanding and predicting the PTC phenotype. We review recent findings linking viral components, the quantitative and qualitative features of antibodies (including autologous HIV-specific antibodies), markers of inflammation and tissue damage, other host proteins (including hormones such as sex hormones), as well as metabolites, extracellular vesicles, and cell-free DNA to HIV control post-ART interruption. Several of these molecules can or have the potential to predict the time and probability of viral rebound after stopping ART and are biologically active molecules that can directly or indirectly (by modulating immune pressures) impact the size and activity of HIV reservoirs during and post-ART interruption.Summary: A comprehensive model combining multiple markers is needed to predict the PTC phenotype. This model can be leveraged to predict and understand the PTC phenotype, which can guide novel curative interventions to replicate this phenotype in post-treatment non-controllers.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"61-69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402442","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

Editorial introductions. 编辑介绍。

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

引用次数: 0

Advances in the mathematical modeling of posttreatment control of HIV-1. HIV-1治疗后控制数学模型的研究进展。

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. HIV-1治疗后控制者的体液免疫

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}

引用次数: 0

Long-acting antiretroviral therapy in the context of viral suppression. 在病毒抑制的背景下长效抗逆转录病毒治疗。

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

Effective preexposure prophylaxis in young women and girls, a key population for HIV prevention. 年轻妇女和女孩是预防艾滋病毒的关键人群，对她们进行有效的接触前预防。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-08-26 DOI: 10.1097/COH.0000000000000885

Elzette Rousseau, Fiona Bennin, Linda-Gail Bekker

{"title":"Effective preexposure prophylaxis in young women and girls, a key population for HIV prevention.","authors":"Elzette Rousseau, Fiona Bennin, Linda-Gail Bekker","doi":"10.1097/COH.0000000000000885","DOIUrl":"10.1097/COH.0000000000000885","url":null,"abstract":"Purpose of review: Although there is substantial momentum to scale up preexposure prophylaxis (PrEP) for HIV prevention in adolescent girls and young women (AGYW) at risk of HIV acquisition, this key population has demonstrated difficulty in sustained PrEP use. Despite being a user-controlled and discreet prevention option, effective oral PrEP use requires a series of complex daily decisions in the life of the PrEP user. In this review, we describe how the number of decisions AGYW have to execute for effective and continued PrEP use may potentially be reduced by providing simplified, integrated, differentiated sexual and reproductive health services that include PrEP, and introducing a choice of PrEP products, including less frequently dosed, longer acting and/or multipurpose prevention technology (MPT) products.Recent findings: PrEP uptake and effective use are enhanced when AGYW experience PrEP service delivery channels as convenient, integrated with their other sexual and reproductive health needs and matching their experiences (including limited autonomy) and lifestyle. Longer acting or less frequently dosed PrEP products or MPTs may reduce the cognitive burden associated with prevention decision-making and is, therefore, likely more suitable for the majority of AGYW who struggle with daily pill adherence.Summary: In the scaling up of HIV prevention for AGYW, implementers are encouraged to consider both PrEP products and PrEP delivery outlet preferences. Understanding and responding to AGYW's different needs will allow for preferred PrEP delivery outlets and choice in PrEP products, leading to a greater likelihood of effective PrEP use in this key population.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"19 6","pages":"287-292"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607573","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