Current opinion in HIV and AIDS最新文献_第6页

Children who are HIV exposed-uninfected: does maternal ART regimen matter? 暴露于艾滋病病毒但未感染的儿童：母体抗逆转录病毒疗法是否重要？

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-08-29 DOI: 10.1097/COH.0000000000000883

Richard Patrick Ellis, Ceri Evans, Catherine J Wedderburn, Andrew J Prendergast

{"title":"Children who are HIV exposed-uninfected: does maternal ART regimen matter?","authors":"Richard Patrick Ellis, Ceri Evans, Catherine J Wedderburn, Andrew J Prendergast","doi":"10.1097/COH.0000000000000883","DOIUrl":"10.1097/COH.0000000000000883","url":null,"abstract":"Purpose of review: Differences in health outcomes between children who are HIV-exposed but uninfected (CHEU) compared to children who are HIV-unexposed (CHU) have been reported both before and since the availability of antiretroviral therapy (ART) during pregnancy and breastfeeding. This review highlights recent studies investigating the impact of ART on the health, growth and development of CHEU.Recent findings: Several meta-analyses confirm higher rates of adverse birth outcomes among pregnant women with HIV compared to pregnant women without HIV. The highest risk of adverse birth outcomes is among women with HIV not receiving ART, and generally studies indicate that more time on ART is associated with lower risk of adverse birth outcomes; however, most data are from observational cohorts. Where studies have compared historic regimens, prior to dolutegravir use, adverse birth outcomes are more commonly associated with exposure to protease inhibitors. Recent population-based studies have not demonstrated an association between neural tube defects and dolutegravir exposure. In a recent, multisite randomized trial, infants born to mothers receiving dolutegravir vs. efavirenz had lower neonatal mortality, possibly mediated through reductions in small-for-gestational age and preterm birth. Neurodevelopment, neuroimaging and growth studies suggest a protective effect of earlier maternal ART initiation.Summary: Dolutegravir continues to appear safe in pregnancy. Randomized trials of specific regimens during pregnancy and breastfeeding, including long-acting and newer ART drugs with long-term follow-up of children, are critical to understand the contribution of ART exposure to CHEU outcomes.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"19 6","pages":"316-322"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607647","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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Editorial introduction. 编辑介绍。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-10-03 DOI: 10.1097/COH.0000000000000888

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Challenges towards an AIDS-free generation in Africa and Asia. 非洲和亚洲实现无艾滋病一代的挑战。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-07-16 DOI: 10.1097/COH.0000000000000878

Wipaporn Natalie Songtaweesin, Grace Miriam Ahimbisibwe, Thanyawee Puthanakit, Philippa Musoke

{"title":"Challenges towards an AIDS-free generation in Africa and Asia.","authors":"Wipaporn Natalie Songtaweesin, Grace Miriam Ahimbisibwe, Thanyawee Puthanakit, Philippa Musoke","doi":"10.1097/COH.0000000000000878","DOIUrl":"10.1097/COH.0000000000000878","url":null,"abstract":"Purpose of review: To review the latest data on prevention of HIV vertical transmission in Asia and Africa and discuss strategic directions to achieve an AIDS free generation by 2030.Recent findings: Progress in vertical transmission elimination efforts in Africa and Asia have stalled in the last decade, with 130 000 new infections in 2022. Main causes of vertical transmissions vary; in Asia-Pacific due to its low-burden, thus low testing coverage, but high overall vertical transmission rates, in South and East Africa due to new HIV infections during pregnancy and breast/chestfeeding, whereas in Western and Central Africa due to low antiretroviral therapy (ART) coverage. Long-acting injectable ART and neutralizing antibodies for treatment and prevention show promise in supporting efforts to further reduce vertical transmissions. Integrated and more accessible pre- and postnatal care is needed to achieve an AIDS-free generation.Summary: Much can be implemented to address existing HIV service gaps; including strengthening of HIV prevention services for youth and women of childbearing age and pregnant people, early detection and treatment, and the delivery of integrated services that can reach and retain pregnant and postpartum people living with HIV in care.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"280-286"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984176","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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HIV-associated tuberculosis in infants, children, and adolescents younger than 15 years: an update on the epidemiology, diagnosis, prevention, and treatment. 婴儿、儿童和 15 岁以下青少年中与艾滋病毒相关的结核病：流行病学、诊断、预防和治疗方面的最新情况。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-07-30 DOI: 10.1097/COH.0000000000000879

Juanita Lishman, Lisa J Frigati, Helena Rabie

{"title":"HIV-associated tuberculosis in infants, children, and adolescents younger than 15 years: an update on the epidemiology, diagnosis, prevention, and treatment.","authors":"Juanita Lishman, Lisa J Frigati, Helena Rabie","doi":"10.1097/COH.0000000000000879","DOIUrl":"10.1097/COH.0000000000000879","url":null,"abstract":"Purpose of review: HIV-associated tuberculosis (TB) remains a major driver of morbidity and mortality in children and adolescents younger than 15 years (CLWH). The purpose of this review is to highlight recent findings in the areas of prevention, diagnosis, and treatment of HIV-associated TB in CLWH and to highlight knowledge and implementation gaps.Recent findings: We found that despite access to antiretroviral therapy (ART), high rates of HIV-associated TB are still reported, and with an unacceptably high mortality. There are no advances in screening for TB, but shorter courses of rifapentine-based TB preventive therapy are becoming available. The use of algorithms in TB diagnosis can potentially simplify the therapeutic decision making. There are more data supporting the use of dolutegravir (DTG) with rifampicin and a need to study unadjusted DTG especially in the youngest children. Short course therapy for nonsevere pulmonary TB is currently implemented and programmatic outcome should be studied in CLWH. Low uptake of ART and poor suppression remains an important driver of HIV-associated TB.Summary: Although screening and diagnosis remains challenging, there are several advances in the prevention and treatment of HIV-associated TB. Effective implementation of these strategies is needed to advance the outcomes of CLWH.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"330-337"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984178","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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Cardiovascular health in people with perinatally acquired HIV - where do we stand? 围产期感染艾滋病毒者的心血管健康--我们的现状如何？

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-06-26 DOI: 10.1097/COH.0000000000000872

Edith D Majonga, Merle Henderson, Rashida A Ferrand

{"title":"Cardiovascular health in people with perinatally acquired HIV - where do we stand?","authors":"Edith D Majonga, Merle Henderson, Rashida A Ferrand","doi":"10.1097/COH.0000000000000872","DOIUrl":"10.1097/COH.0000000000000872","url":null,"abstract":"Purpose of review: HIV-associated cardiac disease was well recognized in the preantiretroviral (ART) era among children with perinatally-acquired HIV infection (PHIV). While ART has dramatically improved survival, it has become increasingly apparent that individuals with PHIV continue to experience multisystem co-morbidities. We review the cardiac and vascular manifestations in people growing up with PHIV in the ART era.Recent findings: ART has resulted in a drop in incidence of serious cardiac morbidity. However, there is a substantial body of evidence that demonstrates that cardiac and vascular structural and functional abnormalities, mostly subclinical, are common in people with PHIV taking ART. Studies have considerable heterogeneity with respect to types of cardiovascular assessments used. HIV-mediated chronic inflammation and potentially effects of ART contribute to these abnormalities. The long-term clinical significance of these abnormalities remains unknown as studies have mainly been cross-sectional, but it is likely that the burden of cardiovascular disease will grow as individuals with PHIV age and the prevalence of traditional risk factors increases.Summary: Understanding the pathogenesis of cardiovascular disease in PHIV, is critical to inform screening and interventional strategies. Longitudinal studies are also needed to understand the natural history of cardiovascular abnormalities and incidence of clinical outcomes.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"348-354"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461339","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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Current opinion: antiretrovirals during pregnancy and breastfeeding. 当前观点：孕期和哺乳期抗逆转录病毒药物。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-09-20 DOI: 10.1097/COH.0000000000000884

Laura Nijboer, Lena van der Wekken-Pas, Karoline Aebi-Popp, Elisabeth van Leeuwen, Angela Colbers

{"title":"Current opinion: antiretrovirals during pregnancy and breastfeeding.","authors":"Laura Nijboer, Lena van der Wekken-Pas, Karoline Aebi-Popp, Elisabeth van Leeuwen, Angela Colbers","doi":"10.1097/COH.0000000000000884","DOIUrl":"10.1097/COH.0000000000000884","url":null,"abstract":"Purpose of review: To review the most important literature from the past 2 years on the pharmacokinetics of antiretrovirals in pregnancy, placental transfer, and breastmilk.Recent findings: Concentrations of antiretrovirals frequently used in pregnancy and their placental transfer are described, together with infant exposure through breastmilk. Also, applications of ex-vivo and in-silico studies, such as placenta perfusion studies and PBPK models, are discussed.Summary: Great efforts were made in the past 2 years to accelerate the availability of data on antiretrovirals during pregnancy and lactation. Bictegravir showed decreased but still sufficient concentrations during pregnancy, leading to a label change by the FDA. In-silico and clinical studies on long-acting cabotegravir and rilpivirine generated information leading to cautious use of these formulations in pregnancy. Low infant exposure to antiretrovirals through breastmilk is expected for most compounds. Despite the impact of these studies, more incentives are needed for earlier implementation, for instance, during the developmental phase of drugs, to provide women antenatally with proper information on their drugs.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":"19 6","pages":"305-315"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607570","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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Bridging the gaps in perinatal HIV: treatment and prevention. 缩小围产期艾滋病毒的差距：治疗和预防。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-10-03 DOI: 10.1097/COH.0000000000000886

Caroline Foster

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Human papillomavirus infection among adolescents living with HIV: a focus on prevention. 感染艾滋病毒的青少年中的人类乳头瘤病毒感染：预防重点。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-06-19 DOI: 10.1097/COH.0000000000000868

Vita W Jongen, Nicola van Dongen, Annette H Sohn

{"title":"Human papillomavirus infection among adolescents living with HIV: a focus on prevention.","authors":"Vita W Jongen, Nicola van Dongen, Annette H Sohn","doi":"10.1097/COH.0000000000000868","DOIUrl":"10.1097/COH.0000000000000868","url":null,"abstract":"Purpose of review: To highlight recent data on HPV infection and cervical precancerous lesions in adolescents with HIV, and priorities for primary and secondary HPV prevention.Recent findings: Incident and persistent high-risk HPV infections and cervical abnormalities are higher among young women with perinatally acquired HIV compared to their HIV-negative peers; data on HPV among males with perinatally acquired HIV are scarce. HPV vaccination is highly effective in preventing HPV-related disease, but antibody titers may decline in people with HIV. It remains unclear if emerging recommendations to reduce vaccine schedules from three doses to two or one dose are appropriate for children and adolescents with perinatally acquired HIV. Due to higher risks of HPV-related cancers, screening guidelines for cervical cancer differ in their frequency and age at initiation for women with HIV, but there are no recommendations for women with perinatally acquired HIV; nor for anal cancer screening for men with perinatally acquired HIV.Summary: Data on the effectiveness of reduced HPV vaccine schedules in children and adolescents with HIV are needed. Implementation research to guide strategies for vaccination, screening, and treatment should include children, adolescents, and young adults with perinatally acquired HIV to ensure they are not left behind.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"361-367"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461340","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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Hepatitis co-infection in paediatric HIV: progressing treatment and prevention. 儿科艾滋病病毒合并肝炎感染：治疗和预防的进展。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-07-26 DOI: 10.1097/COH.0000000000000882

Chiara Rubino, Mariangela Stinco, Giuseppe Indolfi

{"title":"Hepatitis co-infection in paediatric HIV: progressing treatment and prevention.","authors":"Chiara Rubino, Mariangela Stinco, Giuseppe Indolfi","doi":"10.1097/COH.0000000000000882","DOIUrl":"10.1097/COH.0000000000000882","url":null,"abstract":"Purpose of review: To analyse the main evidence and recommendations for the management of hepatitis co-infection in children living with HIV.Recent findings: We analysed available data pertaining to the natural history of liver disease and treatment of co-infected children.Summary: Viral hepatitis co-infection in people living with HIV (PLHIV) is a global problem owing to the shared routes of transmission, particularly in areas of high endemicity for the three viruses. Viral hepatitis co-infection can accelerate liver disease progression and increase morbidity and mortality, even in patients on suppressive antiretroviral treatment (ART). Viral hepatitis should be routinely screened in PLHIV and, once diagnosed with viral hepatitis, PLHIV should be closely monitored for liver disease progression and complications. Children living with HIV-HBV co-infection should be treated with ART containing agents which are active against both viruses. Children living with HIV-HCV co-infection should receive directly acting antivirals (DAA) to eradicate HCV infection. Prevention measures to reduce vertical and horizontal transmission of HBV and HCV (anti-HBV vaccination and immunoglobulins, anti-HBV treatment in pregnancy, anti-HCV DAAs in people of childbearing age, avoiding blood contact, sexual barrier precautions) should be adopted and encouraged, particularly in high endemicity countries.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"338-347"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984177","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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Preventing perinatal HIV acquisition; current gaps and future perspectives. 预防围产期感染艾滋病毒；当前差距与未来展望。

Current opinion in HIV and AIDS Pub Date : 2024-11-01 Epub Date: 2024-08-21 DOI: 10.1097/COH.0000000000000881

Beatrice Cockbain, Sarah Fidler, Hermione Lyall

{"title":"Preventing perinatal HIV acquisition; current gaps and future perspectives.","authors":"Beatrice Cockbain, Sarah Fidler, Hermione Lyall","doi":"10.1097/COH.0000000000000881","DOIUrl":"10.1097/COH.0000000000000881","url":null,"abstract":"Purpose of review: Although current treatment could eradicate vertical transmission, in 2022, 130 000 infants acquired HIV globally. HIV suppression with antiretroviral therapy (ART) transforms survival for people living with HIV (PLWH), and prevents transmission, including vertical. International guidelines recommend lifelong ART for PLWH, consequently perinatal HIV acquisition reflects implementation gaps in the HIV care cascade. We summarize these gaps, exploring potential novel approaches and therapeutic innovations towards eliminating vertical HIV transmission.Recent findings: Multifactorial challenges continue to underpin gaps in the HIV care cascade, including accessibility, availability and sustainability of HIV testing, prevention and treatment, alongside stigma, gender-based violence and poverty. Long-acting ART may be important in preventing perinatal HIV acquisition, with early data demonstrating tolerability and efficacy of injectable ART throughout pregnancy, both as HIV treatment and prevention. Carefully selected long-acting broadly neutralizing antibodies (bNAbs) matching circulating, exposing viral envelope sequences have demonstrated safety, clinical trials are ongoing to demonstrate efficacy.Summary: Emerging clinical studies should prioritize pregnant/lactating people and infants to ensure such therapies are well tolerated and efficacious. Alongside therapeutic innovation, programmatic strategies must address social and economic challenges, ensuring sustainable HIV treatment/prevention programmes and facilitating global elimination of blood-borne viruses.","PeriodicalId":93966,"journal":{"name":"Current opinion in HIV and AIDS","volume":" ","pages":"293-304"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082902","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