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

Update on neurological complications of HIV. 艾滋病毒神经系统并发症的最新情况。

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Current opinion in HIV and AIDS Pub Date : 2025-07-01 Epub Date: 2025-05-16 DOI: 10.1097/COH.0000000000000951

Monica M Diaz

{"title":"Update on neurological complications of HIV.","authors":"Monica M Diaz","doi":"10.1097/COH.0000000000000951","DOIUrl":"10.1097/COH.0000000000000951","url":null,"abstract":"Purpose of review: The prevalence of neurological complications among people with HIV (PWH) is expected to increase as PWH live longer due to increased access to antiretroviral treatment (ART). This review provides updates to the understanding of the neurological sequelae, including neurocognitive impairment, neuropathy, neurological opportunistic infections, and others, which are crucial for improving care and outcomes of PWH.Recent findings: Recent literature highlights several key themes: the pathophysiology of HIV-related neuronal damage involving HIV proteins (gp120, Nef) and neuroinflammation; the role of aging in exacerbating neurological complications; the high prevalence of HIV-associated neurocognitive disorders (HAND) and Alzheimer's disease-related dementias (AD/ADRD) among PWH; the importance of neurocognitive screening tools like IHDS and MoCA; and the identification of biomarkers and neuroimaging techniques for early detection and monitoring of HAND.Summary: The findings highlight the need for comprehensive healthcare strategies to manage neurological complications in PWH, including targeted interventions for high-risk groups, improved diagnostic tools, and tailored treatments. It is important for clinicians and researchers to develop effective approaches to mitigate the impact of HIV on brain health and improve quality of life for PWH.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"337-343"},"PeriodicalIF":4.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121735","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

Understanding residual risk of cardiovascular disease in people with HIV. 了解艾滋病毒感染者心血管疾病的剩余风险。

Current opinion in HIV and AIDS Pub Date : 2025-07-01 Epub Date: 2025-05-16 DOI: 10.1097/COH.0000000000000953

Laventa M Obare, Victoria R Stephens, Celestine N Wanjalla

{"title":"Understanding residual risk of cardiovascular disease in people with HIV.","authors":"Laventa M Obare, Victoria R Stephens, Celestine N Wanjalla","doi":"10.1097/COH.0000000000000953","DOIUrl":"10.1097/COH.0000000000000953","url":null,"abstract":"Purpose of review: Traditional cardiovascular risk factors, combined with persistent systemic inflammation, contribute to the increased prevalence of atherosclerotic cardiovascular disease (ASCVD) in people with HIV (PWH). This review highlights key findings from the REPRIEVE trial on statin-based primary prevention of major adverse cardiovascular events in PWH. It explores HIV-specific immune mechanisms contributing to residual cardiovascular risk.Recent findings: In REPRIEVE, statin therapy used for primary prevention of major adverse cardiovascular events in PWH decreased the plasma lipoprotein-associated phospholipase A2, oxidized low-density lipoprotein, and high-sensitivity C-reactive protein (hs-CRP). However, several inflammatory markers including soluble CD14 (sCD14), sCD163, interleukin (IL)-1β, interleukin (IL)-6, IL-10, and caspase 1 did not change. The HIV reservoir, dysfunctional CD4 + T cells, immunoglobulin G N-glycans, antiapolipoprotein A1 autoantibodies, trained immunity, and clonal hematopoiesis of indeterminate potential may contribute to residual inflammation.Summary: Despite antiretroviral and statin therapy, residual ASCVD risk in PWH underscores the need for targeted interventions. Anti-inflammatory therapies, including IL-6 and IL-1β inhibitors, CCR5 antagonists (e.g., maraviroc, cenicriviroc mesylate), and immunomodulatory agents like methotrexate and colchicine, are being explored. Understanding HIV-driven immune dysregulation may lead to novel strategies to mitigate cardiovascular risk in this population.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"319-330"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121727","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

Caring for people aging with HIV. 照顾携带艾滋病毒的老年人。

Current opinion in HIV and AIDS Pub Date : 2025-07-01 Epub Date: 2025-06-05 DOI: 10.1097/COH.0000000000000945

Eugenia L Siegler

引用次数: 0

The utility of nonhuman primate models for understanding acute HIV-1 infection. 非人类灵长类动物模型对理解急性HIV-1感染的效用。

Current opinion in HIV and AIDS Pub Date : 2025-05-01 Epub Date: 2025-03-27 DOI: 10.1097/COH.0000000000000920

Matthew S Parsons, Diane L Bolton

{"title":"The utility of nonhuman primate models for understanding acute HIV-1 infection.","authors":"Matthew S Parsons, Diane L Bolton","doi":"10.1097/COH.0000000000000920","DOIUrl":"10.1097/COH.0000000000000920","url":null,"abstract":"Purpose of review: Nonhuman primate (NHP) models of HIV-1 infection provide complementary experimental pathways for assessing aspects of acute HIV-1 infection (AHI) that cannot be addressed in humans. This article reviews acute infection studies in SIV-infected or SHIV-infected macaque species over the previous 18 months.Recent findings: Reviewed studies examined the dynamics of replication-competent viral reservoir establishment during early infection, reservoir maintenance throughout therapy, and factors influencing viral rebound after treatment cessation. Also discussed are acute infection events in the central nervous system and liver and potential links between these events and manifestations of comorbidities during chronic infection. Additional studies addressed how occurrences during acute infection impact the development of natural viral control or posttreatment control. Another report evaluated treatment during acute infection with broadly neutralizing antibodies with enhanced ability to engage innate immune cells, highlighting the ability of this early intervention to shape innate and adaptive antiviral responses.Summary: NHP models of HIV-1 infection are a fundamental research tool for investigating AHI events. These models enable detailed pathogenesis characterization and the testing of hypothesis-driven strategies for altering disease courses through interventions during AHI, including targeting viral persistence and comorbidities that persist throughout chronic infection.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"218-227"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660037","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

HIV diagnosis during acute infection: implications of long-acting preexposure prophylaxis and other evolving challenges. 急性感染期间的艾滋病毒诊断：长效暴露前预防措施的影响及其他不断变化的挑战。

Current opinion in HIV and AIDS Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI: 10.1097/COH.0000000000000919

Tamara Elliott, Daniel Bradshaw, Sarah Fidler

{"title":"HIV diagnosis during acute infection: implications of long-acting preexposure prophylaxis and other evolving challenges.","authors":"Tamara Elliott, Daniel Bradshaw, Sarah Fidler","doi":"10.1097/COH.0000000000000919","DOIUrl":"10.1097/COH.0000000000000919","url":null,"abstract":"Purpose of review: Tests for HIV may perform differently in some circumstances such as with preexposure prophylaxis (PrEP) or other HIV prevention agents. Testing algorithms may not account for this, with a risk of false negative or positive HIV results. In this review we have explored the challenges of HIV testing in these special circumstances.Recent findings: Long-acting injectable PrEP using cabotegravir or lenacapavir has been studied in large randomized controlled trials (HPTN083/084 and PURPOSE1/2 respectively). Injectable PrEP was significantly more efficacious than oral PrEP, but infections still occurred risking the emergence of HIV drug-resistance. HIV diagnostic test results were atypical in those receiving injectable PrEP, with low or undetectable HIV viral loads, delayed or diminished antibody, and HIV detection assays reverting from reactive to unreactive; so-called long acting early viral inhibition (LEVI) syndrome. In these cases, missed or delayed HIV diagnoses could be reduced with the use of HIV nucleic acid amplification tests in addition to routine testing, but this remains unfeasible in many settings.Summary: Finding HIV testing strategies that are affordable and practical in low- and middle-income countries that can accurately diagnose HIV in the context of HIV prevention is of high importance, but more research is needed in this area.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"228-235"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443049","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

Mucosal immunity in acute HIV: a review of recent work. 急性艾滋病病毒的粘膜免疫：最新研究综述。

Current opinion in HIV and AIDS Pub Date : 2025-05-01 Epub Date: 2025-01-24 DOI: 10.1097/COH.0000000000000917

Barbara L Shacklett

{"title":"Mucosal immunity in acute HIV: a review of recent work.","authors":"Barbara L Shacklett","doi":"10.1097/COH.0000000000000917","DOIUrl":"10.1097/COH.0000000000000917","url":null,"abstract":"Purpose of review: This review summarizes recent research literature relevant to mucosal immunity and acute/early HIV infection.Recent findings: Recent findings include new insights on the HIV transmission \"bottleneck\" at mucosal surfaces, the impact of acute HIV on germinal centers and mucosal B-cell function, the expression of cytotoxic effector molecules by mucosal CD8 + T-cells, and an enhanced understanding of the impact of acute HIV on innate cell-mediated defenses including mucosa-associated invariant T-cells invarant natural killer T-cells and natural killer cells.Summary: Now more than 40 years since the beginning of the HIV/AIDS pandemic, extensive research has elucidated the dynamics of HIV replication and the corresponding host response. However, the vast majority of HIV-related immunopathogenesis studies have focused on innate and adaptive immune responses in peripheral blood. Mucosal tissues serve as the primary portals of entry for HIV and house the majority of the body's lymphocytes. Innate and adaptive immune responses in mucosal tissues are of particular relevance during the acute phase of HIV disease, as successful defenses can both limit viral dissemination within the host and prevent transmission to a new host, yet until recently these responses were poorly understood.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"193-198"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191428","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

Public health implications of diagnosing and treating acute HIV. 诊断和治疗急性艾滋病毒对公共卫生的影响。

Current opinion in HIV and AIDS Pub Date : 2025-05-01 Epub Date: 2025-02-19 DOI: 10.1097/COH.0000000000000921

Sarah E Rutstein, Laura Limarzi-Klyn, William C Miller, Kimberly A Powers

{"title":"Public health implications of diagnosing and treating acute HIV.","authors":"Sarah E Rutstein, Laura Limarzi-Klyn, William C Miller, Kimberly A Powers","doi":"10.1097/COH.0000000000000921","DOIUrl":"10.1097/COH.0000000000000921","url":null,"abstract":"Purpose of review: The earliest months of HIV infection are characterized by high viral loads and elevated transmissibility, particularly during the acute (preseroconversion) phase. Transmission prevention during early HIV requires diagnostic tools that narrow the window between viral acquisition and reactive test, followed by rapid linkage to effective antiretroviral therapy (ART). Here, we review recent advances related to diagnosing and treating persons during early HIV, with a particular focus on acute HIV infection (AHI).Recent findings: Point-of-care (POC) fourth-generation antigen/antibody tests have mixed performance, often dependent on the pretest probability of early infection within the screened population. Risk score algorithms demonstrate the potential for prioritizing resource-intensive tests, such as POC HIV RNA, to those most likely to have AHI, but their predictive performance varies across populations, complicating implementation. Emerging and re-emerging infections, including SARS-CoV-2 and mpox, present opportunities for and challenges to symptom-driven AHI screening. Daily oral ART with standard first-line regimens quickly suppresses viremia during AHI, but long-acting injectable drugs are yet to be explored for this indication.Summary: Few practice-changing results related to diagnosing or treating persons with early HIV have been released in the last 18 months. Accurate POC HIV RNA tests could leapfrog fourth-generation POC assays, but they remain unavailable for routine use. Implementation science approaches are needed to guide use of evidence-based strategies for early HIV screening, and additional research on same-day ART linkage, including injectable ART, could produce dramatic impacts on forward transmission during this period.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"236-246"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451244","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

Autovaccination revisited: potential to boost antiviral immunity and facilitate HIV-1 cure/remission in children. 重新审视自身疫苗接种：增强抗病毒免疫和促进儿童HIV-1治愈/缓解的潜力

Current opinion in HIV and AIDS Pub Date : 2025-05-01 Epub Date: 2025-03-19 DOI: 10.1097/COH.0000000000000924

Harriet R Parker, Julia E Edgar, Philip J R Goulder

{"title":"Autovaccination revisited: potential to boost antiviral immunity and facilitate HIV-1 cure/remission in children.","authors":"Harriet R Parker, Julia E Edgar, Philip J R Goulder","doi":"10.1097/COH.0000000000000924","DOIUrl":"10.1097/COH.0000000000000924","url":null,"abstract":"Purpose of review: To review the concept of autovaccination as a strategy to boost anti-HIV-1 immunity and improve immune control, especially as a means to facilitate cure/remission in paediatric HIV-1 infection, where effective interventions in clinical testing remain limited compared to adults.Recent findings: Early autovaccination studies, conducted 15-25 years ago, suggested potential immunological benefits from exposure to autologous virus in both children and adults, specifically when antiretroviral therapy (ART) was initiated during acute infection. More recent work in nonhuman primates (NHPs) has shown that early ART initiation can significantly reduce the viral setpoint following treatment interruption, primarily through CD8 + T-cell responses, and prevent early immune escape - a phenomenon commonly observed in ART-naive acute infections. Additionally, NHP studies indicate that multiple, short analytical treatment interruptions (ATIs) can delay viral rebound and further lower the viral setpoint via enhanced CD8 + T-cell responses.Summary: Recent studies in NHP support the potential for autovaccination via short ATIs to enhance antiviral immunity and improve immune control of HIV-1. With well tolerated, well monitored ATI protocols, autovaccination could be a valuable approach to facilitating cure/remission in children living with HIV (LWH), in whom very early-ART initiation and early-life immunity are associated with low viral reservoirs and high cure/remission potential.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"271-278"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660034","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

Syndromic approaches for sexually transmitted infections: added value of molecular diagnosis. 性传播感染的综合征方法：分子诊断的附加价值。

Current opinion in HIV and AIDS Pub Date : 2025-05-01 Epub Date: 2025-04-01 DOI: 10.1097/COH.0000000000000932

Onya Opota, Gilbert Greub

{"title":"Syndromic approaches for sexually transmitted infections: added value of molecular diagnosis.","authors":"Onya Opota, Gilbert Greub","doi":"10.1097/COH.0000000000000932","DOIUrl":"10.1097/COH.0000000000000932","url":null,"abstract":"Purpose of review: Sexually transmitted infections (STIs) are a significant global health concern, with many cases going undiagnosed due to asymptomatic infections. Traditional diagnostic methods, such as culture and serology, have limitations in sensitivity, specificity, and turnaround time. Molecular diagnostics, particularly PCR-based approaches, offer significant advantages, including improved detection rates and the potential for syndromic testing. This review examines the role of syndromic PCR diagnostics in improving STI detection and management.Recent findings: Recent studies highlight the utility in detecting common STIs, such as Chlamydia trachomatis , Neisseria gonorrhoeae , and Trichomonas vaginalis , as well as emerging pathogens. PCR-based syndromic panels allow for the simultaneous detection of multiple pathogens from a single sample, improving diagnostic accuracy and efficiency. Syndromic PCR approaches streamline diagnosis, aid in early detection, and support efficient treatment, addressing both common and emerging infections.Summary: Syndromic PCR diagnostics streamline STI detection, addressing the limitations of conventional methods. They enable faster, more accurate, and comprehensive diagnosis, leading to targeted treatment and improved patient outcomes. Expanding syndromic panels to include emerging pathogens and ensuring cost-effective implementation remain key areas for future research.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"303-309"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766202","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

"Let's start at the very beginning": studies of acute HIV inform prevention, diagnosis, and treatment. “让我们从头开始”：对急性艾滋病毒的研究为预防、诊断和治疗提供信息。

Current opinion in HIV and AIDS Pub Date : 2025-05-01 Epub Date: 2025-04-03 DOI: 10.1097/COH.0000000000000930

Trevor A Crowell

引用次数: 0