Tyrosine Kinase Inhibition: a New Perspective in the Fight against HIV
AbstractPurpose of ReviewHIV-1 infection is incurable due to the existence of latent reservoirs that persist in the face of cART. In this review, we describe the existence of multiple HIV-1 reservoirs, the mechanisms that support their persistence, and the potential use of tyrosine kinase inhibitors (TKIs) to block several pathogenic processes secondary to HIV-1 infection.Recent FindingsDasatinib interferes in vitro with HIV-1 persistence by two independent mechanisms. First, dasatinib blocks infection and potential expansion of the latent reservoir by interfering with the inactivating phosphorylation of SAMHD1. Secondly, ...
Source: Current HIV/AIDS Reports - September 11, 2019 Category: Infectious Diseases Source Type: research

Impact of Direct Acting Antiviral Agent Therapy upon Extrahepatic Manifestations of Hepatitis C Virus Infection
AbstractPurpose of ReviewDirect acting antiviral agents (DAAs) have emerged as simple, short, safe, and effective treatments for chronic hepatitis C (CHC) infection. CHC is a systemic disease with frequent and multiple extrahepatic manifestations. The beneficial effects of DAA treatment regimens extend beyond improvement in liver-related outcomes to amelioration of extra hepatic manifestations and are likely to have economic implications. The purpose of this review is to evaluate the effect of DAAs on extra hepatic manifestations of CHC virus infection.Recent FindingsRecent studies indicate that DAAs are associated with re...
Source: Current HIV/AIDS Reports - September 4, 2019 Category: Infectious Diseases Source Type: research

HIV and Solid Organ Transplantation: Where Are we Now
AbstractPurpose of ReviewWe review the international evolution of HIV and solid organ transplantation over 30  years. We emphasise recent developments in solid organ transplantation from HIV-infected to HIV-uninfected individuals, and their implications.Recent FindingsIn 2017, Johannesburg, South Africa, a life-saving partial liver transplant from an HIV-infected mother to her HIV-uninfected child was performed. This procedure laid the foundation not only for consideration of HIV-infected individuals as living donors, but also for the possibility that HIV-uninfected individuals could receive organs from HIV-infected...
Source: Current HIV/AIDS Reports - September 4, 2019 Category: Infectious Diseases Source Type: research

Heart Failure among People with HIV: Evolving Risks, Mechanisms, and Preventive Considerations
AbstractPurposePeople with HIV (PHIV) with access to modern antiretroviral therapy (ART) face a two-fold increased risk of heart failure as compared with non-HIV-infected individuals. The purpose of this review is to consider evolving risks, mechanisms, and preventive considerations pertaining to heart failure among PHIV.Recent FindingsWhile unchecked HIV/AIDS has been documented to precipitate heart failure characterized by overtly reduced cardiac contractile function, ART-treated HIV may be associated with either heart failure with reduced ejection fraction (HFrEF) or with heart failure with preserved ejection fraction (...
Source: Current HIV/AIDS Reports - September 3, 2019 Category: Infectious Diseases Source Type: research

The Opioid Epidemic: Impact on Inflammation and Cardiovascular Disease Risk in HIV
AbstractPurpose of ReviewPeople infected with HIV through injection drug use are more likely to experience progression to AIDS, death due to AIDS, and all-cause mortality even when controlling for access to care and antiretroviral therapy. While high-risk behavior and concurrent infections most certainly are contributors, chronic immune activation, downstream metabolic comorbidities may play an important role.Recent FindingsAltered intestinal integrity plays a major role in HIV-related immune activation and microbial translocation markers are heightened in active heroin users. Additionally, greater injection frequency driv...
Source: Current HIV/AIDS Reports - August 31, 2019 Category: Infectious Diseases Source Type: research

Hepatitis B Vaccination and Waning Hepatitis B Immunity in Persons Living with HIV
AbstractPurpose of ReviewPersons with HIV are at a higher risk for acquiring HBV (hepatitis B virus) than the general population due to shared modes of transmission and are significantly more likely to develop and die from sequelae of chronic HBV infection. Early vaccination is key to achieving HBV protective immunity, but response rates are still much lower than in the general population, ranging from 35 to 70%. Individuals with HIV also experience more rapidly waning immunity than those without HIV. Strategies to augment initial response and improve long-term immunity in individuals with HIV include alterations in dose, ...
Source: Current HIV/AIDS Reports - August 29, 2019 Category: Infectious Diseases Source Type: research

How to Evolve the Response to the Global HIV Epidemic With New Metrics and Targets Based on Pre-Treatment CD4 Counts
AbstractPurpose of the ReviewEarly diagnosis and treatment of HIV following seroconversion improves individual and population health. Using published data on pre-treatment CD4 cell counts, we benchmarked the level of immunodeficiency at HIV diagnosis and ART initiation in the “real world” against those of the treatment and control arms of landmark controlled trials that successfully reduced HIV-related deaths (INSIGHT/START) and onward HIV transmission (HPTN 052).Recent FindingsThe median CD4 count in the treatment vs. control arms of the INSIGHT/START trial and HPTN 052 were 650 vs. 408 cells/ μL and 442 vs...
Source: Current HIV/AIDS Reports - July 5, 2019 Category: Infectious Diseases Source Type: research

Obstructive Lung Disease in HIV —Phenotypes and Pathogenesis
AbstractPurpose of ReviewIn the antiretroviral therapy era, people living with HIV (PLWH) are surviving to older ages. Chronic illnesses such as chronic obstructive pulmonary disease (COPD) occur more frequently. COPD is often described as a single entity, yet multiple manifestations may be considered phenotypes. HIV is an independent risk factor for certain COPD phenotypes, and mechanisms underlying pathogenesis of these phenotypes may differ and impact response to therapy.Recent FindingsImpaired diffusing capacity, airflow obstruction, and radiographic emphysema occur in PLWH and are associated with increased mortality. ...
Source: Current HIV/AIDS Reports - June 29, 2019 Category: Infectious Diseases Source Type: research

Mobility and its Effects on HIV Acquisition and Treatment Engagement: Recent Theoretical and Empirical Advances
AbstractPurpose of ReviewWe reviewed literature across multiple disciplines to describe issues with the measurement of population mobility in HIV research and to summarize evidence of causal pathways linking mobility to HIV acquisition risks and treatment engagement, with a focus on sub-Saharan Africa.Recent FindingsWhile the literature on mobility and HIV remains hampered by problems and inconsistency in measures of mobility, the recent research reveals a turn towards a greater attentiveness to measurement and gender. Theoretical and heuristic models for the study of mobility and HIV acquisition and treatment outcomes hav...
Source: Current HIV/AIDS Reports - June 29, 2019 Category: Infectious Diseases Source Type: research

Design Considerations for Implementing eHealth Behavioral Interventions for HIV Prevention in Evolving Sociotechnical Landscapes
We present a checklist of critical implementation questions to address during intervention development.SummaryIn the absence of a clear path forward for eHealth implementation, deliberate design of an eHealth intervention ’s service and technological components in tandem with their implementation plans is critical to mitigating barriers to widespread use. The design considerations presented can be used by developers, evaluators, reviewers, and funders to prioritize the pragmatic scalability of eHealth interventions in research. (Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - June 27, 2019 Category: Infectious Diseases Source Type: research

A Review of Differentiated Service Delivery for HIV Treatment: Effectiveness, Mechanisms, Targeting, and Scale
AbstractPurpose of ReviewDifferentiated service delivery (DSD) models were initially developed as a means to combat suboptimal long-term retention in HIV care, and to better titrate limited health systems resources to patient needs, primarily in low-income countries. The models themselves are designed to streamline care along the HIV care cascade and range from individual to group-based care and facility to community-based health delivery systems. However, much remains to be understood about how well and for whom DSD models work and whether these models can be scaled, are sustainable, and can reach vulnerable and high-risk...
Source: Current HIV/AIDS Reports - June 22, 2019 Category: Infectious Diseases Source Type: research

Current and Future PrEP Medications and Modalities: On-demand, Injectables, and Topicals
AbstractPurpose of ReviewPre-exposure prophylaxis (PrEP) is a potent HIV prevention strategy, but uptake of daily oral PrEP remains low. This review covers PrEP agents currently available and agents and modalities under investigation.Recent FindingsInjectable ARV preparations have high acceptability among users but are likely to require adherence to 8-week interval injections. Topical microbicide gels and vaginal rings have underperformed by intention-to-treat analyses in efficacy studies, at least in large part due to challenges with adherence and/or sustained use. However, daily oral TDF-FTC also underperformed in random...
Source: Current HIV/AIDS Reports - June 20, 2019 Category: Infectious Diseases Source Type: research

Interventions to Improve Linkage to HIV Care in the Era of “Treat All” in Sub-Saharan Africa: a Systematic Review
AbstractPurpose of the ReviewIn 2015, antiretroviral therapy (ART) was recommended for all people living with HIV (PLHIV) regardless of CD4 count ( “Treat All”). To better understand how to improve linkage to care under these new guidelines, we conducted a systematic review of studies evaluating linkage interventions in Sub-Saharan Africa under Treat All.Recent FindingsWe identified 14 eligible articles and qualitatively analyzed the effectiveness of the interventions. Increases in linkage were reported by supply-side and counseling interventions. Mobile testing and economic incentives did not increase linkage....
Source: Current HIV/AIDS Reports - June 14, 2019 Category: Infectious Diseases Source Type: research

Making Smarter Decisions Faster: Systems Engineering to Improve the Global Public Health Response to HIV
AbstractPurpose of ReviewThis review offers an operational definition of systems engineering (SE) as applied to public health, reviews applications of SE in the field of HIV, and identifies opportunities and challenges of broader application of SE in global health.Recent FindingsSE involves the deliberate sequencing of three steps: diagnosing a problem, evaluating options using modeling or optimization, and providing actionable recommendations. SE includes diverse tools (from process improvement to mathematical modeling) applied to decisions at various levels (from local staffing decisions to planning national-level roll-o...
Source: Current HIV/AIDS Reports - June 13, 2019 Category: Infectious Diseases Source Type: research

Confronting Rising STIs in the Era of PrEP and Treatment as Prevention
This study aims to review the epidemiology of sexually transmitted infections (STIs) among men who have sex with men (MSM) and suggest control measures.Recent FindingsDespite declines in new HIV diagnosis, bacterial STIs among MSM have dramatically risen since the late 1990s. This increase occurred concurrent with introduction of effective antiretroviral therapy, the advent of electronic mechanisms for meeting sex partners and population-level changes in sexual behavior, including decreased condom use. HIV pre-exposure prophylaxis (PrEP) is now further diminishing condom use, though its impact on STIs is uncertain. A plan ...
Source: Current HIV/AIDS Reports - June 10, 2019 Category: Infectious Diseases Source Type: research

Implementation Strategies to Increase PrEP Uptake in the South
AbstractPurpose of ReviewSeven years after TDF/FTC was approved for pre-exposure prophylaxis to reduce risks of HIV infection, there have been large increases in the number of persons using PrEP in the USA. However, recent data on pre-exposure prophylaxis (PrEP) use at the state level indicate that people living in the Southern United States are underserved by PrEP relative to their epidemic need. We sought to review possible reasons for inequitable uptake of PrEP in the South and identify implementation approaches to increase PrEP uptake in the South.Recent FindingsPublished literature, data on the locations of PrEP servi...
Source: Current HIV/AIDS Reports - June 8, 2019 Category: Infectious Diseases Source Type: research

Neurocognitive Phenotyping of HIV in the Era of Antiretroviral Therapy
AbstractPurpose of ReviewThis paper examines the theoretical and empirical basis for neurocognitive phenotyping of HIV.Recent FindingsThe pattern of neurocognitive symptoms associated with HIV has traditionally been referred to as a “subcortical” phenotype. Recent concern has been raised that the neurocognitive phenotype in the post-ART era has changed to reflect the addition of cortical features, suggestive of synergistic age-related neurodegeneration. Empirical evidence reviewed in this paper suggests that, when present, HIV-related neurocognitive impairment in the post-ART era remains subcortical in nature, ...
Source: Current HIV/AIDS Reports - June 6, 2019 Category: Infectious Diseases Source Type: research

Crowdsourcing to Improve HIV and Sexual Health Outcomes: a Scoping Review
AbstractPurpose of ReviewThis review synthesizes evidence on the use of crowdsourcing to improve HIV/sexual health outcomes.Recent FindingsWe identified 15 studies, including four completed randomized controlled trials (RCTs), one planned RCT, nine completed observational studies, and one planned observational study. Three of the four RCTs suggested that crowdsourcing is an effective, low-cost approach for improving HIV testing and condom use among key populations. Results from the observational studies revealed diverse applications of crowdsourcing to inform policy, research, and intervention development related to HIV/se...
Source: Current HIV/AIDS Reports - June 3, 2019 Category: Infectious Diseases Source Type: research

Innate Lymphoid Cells: Their Contributions to Gastrointestinal Tissue Homeostasis and HIV/SIV Disease Pathology
AbstractPurpose of ReviewThe discovery of innate lymphoid cells (ILCs) over the past decade has reformed principles that were once thought to be exclusive to adaptive immunity. Here, we describe ILC nomenclature and function, and provide a survey of studies examining these cells in the context of HIV/SIV infections. Particular emphasis is placed on the ILC3 subset, important for proper functioning of the gastrointestinal tract barrier.Recent FindingsStudies in both humans and nonhuman primates have found ILCs to be rapidly and durably depleted in untreated HIV/SIV infections. Their depletion is most likely due to a number ...
Source: Current HIV/AIDS Reports - May 18, 2019 Category: Infectious Diseases Source Type: research

Solid Organ Transplantation in HIV-Infected Recipients: History, Progress, and Frontiers
AbstractPurpose of ReviewEnd-stage organ disease prevalence is increasing among HIV-infected (HIV+) individuals. Trial and registry data confirm that solid organ transplantation (SOT) is efficacious in this population. Optimizing access to transplant and decreasing complications represent active frontiers.Recent FindingsHIV+ recipients historically experienced 2 –4-fold higher rejection. Integrase strand transferase inhibitors (INSTIs) minimize drug interactions and may reduce rejection along with lymphodepleting induction immunosuppression. Hepatitis C virus (HCV) coinfection has been associated with inferior outcom...
Source: Current HIV/AIDS Reports - May 16, 2019 Category: Infectious Diseases Source Type: research

Role of T Lymphocytes in HIV Neuropathogenesis
AbstractPurpose of ReviewThe purpose of this review is to summarize the current knowledge on the role of CD4+ T lymphocytes leading to HIV assault and persistence in the central nervous system (CNS) and the elimination of HIV-infected CNS resident cells by CD8+ T lymphocytes.Recent FindingsHIV targets the CNS early in infection, and HIV-infected individuals suffer from mild forms of neurological impairments even under antiretroviral therapy (ART). CD4+ T cells and monocytes mediate HIV entry into the brain and constitute a source for HIV persistence and neuronal damage. HIV-specific CD8+ T cells are also massively recruite...
Source: Current HIV/AIDS Reports - May 6, 2019 Category: Infectious Diseases Source Type: research

Pathogenic Role of Type I Interferons in HIV-Induced Immune Impairments in Humanized Mice
AbstractPurpose of ReviewRecent findings on the critical pathogenic role of type 1 interferons (IFN-I) in HIV-1 persistence in humanized mice suggest that inhibiting IFN-I signaling transiently will reverse HIV-induced inflammatory diseases and rescue anti-HIV immunity to control HIV-1 reservoirs.Recent FindingsIn both humanized mice and in monkeys, IFN-I signaling is functionally defined to play an important role in suppressing early HIV-1 and SIV infection. During persistent infection in humanized mice, however, IFN-I signaling is revealed to induce T cell depletion and impairment. Interestingly, in HIV-infected mice wit...
Source: Current HIV/AIDS Reports - May 4, 2019 Category: Infectious Diseases Source Type: research

HIV and the Gut Microbiota: Composition, Consequences, and Avenues for Amelioration
AbstractPurpose of ReviewWe discuss recent advances in understanding of gut bacterial microbiota composition in HIV-infected subjects and comment on controversies. We discuss the putative effects of microbiota shifts on systemic inflammation and HIV disease progression and potential mechanisms, as well as ongoing strategies being developed to modulate the gut microbiota in humans for amelioration of infectious and inflammatory diseases.Recent FindingsLifestyle and behavioral factors relevant to HIV infection studies have independent effects on the microbiota. Microbial metabolism of immunomodulatory compounds and direct im...
Source: Current HIV/AIDS Reports - April 29, 2019 Category: Infectious Diseases Source Type: research

Correction to: Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?
The article"Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?", written by Gabrielle O ’Malley, Gena Barnabee and Kenneth Mugwanya, was originally published electronically on the publisher’s internet portal. (Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - April 22, 2019 Category: Infectious Diseases Source Type: research

Lipidome Abnormalities and Cardiovascular Disease Risk in HIV Infection
AbstractPurpose of ReviewHuman immunodeficiency virus (HIV) infection and its treatment with antiretroviral therapy (ART) are associated with lipid abnormalities that may enhance cardiovascular disease risk (CVD).Recent FindingsChronic inflammation persists in HIV+ individuals, and complex relationships exist among lipids and inflammation, as immune activation may be both a cause and a consequence of lipid abnormalities in HIV infection. Advances in mass spectrometry-based techniques now allow for detailed measurements of individual lipid species; improved lipid measurement might better evaluate CVD risk compared with the ...
Source: Current HIV/AIDS Reports - April 16, 2019 Category: Infectious Diseases Source Type: research

The Antibodiome —Mapping the Humoral Immune Response to HIV
AbstractPurpose of ReviewThe design of an HIV vaccine remains an elusive but top priority. Data from the non-human primate model and the first moderately protective HIV vaccine trial (RV144) point to a role for qualitative changes in humoral immune functions in protection from infection. Here, we review the current understanding of the antibody response throughout HIV infection, the known correlates of protection, and current strategies to manipulate antibodies to put an end to the epidemic.Recent FindingsRecent studies point to innate immune-recruiting antibody function in preventing infection as well as controlling virem...
Source: Current HIV/AIDS Reports - March 22, 2019 Category: Infectious Diseases Source Type: research

Impact of Myeloid Reservoirs in HIV Cure Trials
AbstractPurpose of ReviewGallant efforts are ongoing to achieve sustained antiretroviral therapy (ART) –free HIV remission in the HIV-infected person; however, most, if not all, current human clinical studies have primarily focused these efforts on targeting viral persistence in CD4 T cells in blood and tissue sanctuaries. The lack of myeloid centered HIV clinical trials, either as primary or secon dary end points, has hindered our understanding of the contribution of myeloid cells in unsuccessful trials but may also guide successes in future HIV eradication clinical strategies.Recent FindingsRecent advances have hig...
Source: Current HIV/AIDS Reports - March 5, 2019 Category: Infectious Diseases Source Type: research

Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?
AbstractPurpose of ReviewClinical trials have found that PrEP is highly effective in reducing risk of HIV acquisition across types of exposure, gender, PrEP regimens, and dosing schemes. Evidence is urgently needed to inform scale-up of PrEP to meet the ambitious WHO/UNAIDS prevention target of 3,000,000 individuals on PrEP by 2020.Recent FindingsSuccessful models of delivering HIV services at scale evolved from years of formal research and programmatic evidence. These efforts produced lessons-learned relevant for scaling-up PrEP delivery, including the importance of streamlining laboratory tests, expanding prescription an...
Source: Current HIV/AIDS Reports - February 22, 2019 Category: Infectious Diseases Source Type: research

Brain PET Imaging: Value for Understanding the Pathophysiology of HIV-associated Neurocognitive Disorder (HAND)
AbstractPurpose of ReviewThe purpose of this review is to summarize recent developments in PET imaging of neuropathologies underlying HIV-associated neurocognitive dysfunction (HAND). We concentrate on the recent post antiretroviral era (ART), highlighting clinical and preclinical brain PET imaging studies.Recent FindingsIn the post ART era, PET imaging has been used to better understand perturbations of glucose metabolism, neuroinflammation, the function of neurotransmitter systems, and amyloid/tau protein deposition in the brains of HIV-infected patients and HIV animal models. Preclinical and translational findings from ...
Source: Current HIV/AIDS Reports - February 18, 2019 Category: Infectious Diseases Source Type: research

Physiological Changes from Violence-Induced Stress and Trauma Enhance HIV Susceptibility Among Women
AbstractPurpose of ReviewThis theoretical review identifies physiological mechanisms by which violence against women (VAW) may increase women ’s susceptibility to HIV through trauma, stress, and immune dysfunction.Recent FindingsResearch documents systemic and local immune responses are related to stress and trauma from abuse across the life course (i.e., childhood, IPV, adulthood re-victimization). Findings are interpreted within a theoretical framework grounded in the Social Stress Theory and the concept of toxic stress, and highlight the current state of the science connecting: (1) VAW to the physiological stress ...
Source: Current HIV/AIDS Reports - February 14, 2019 Category: Infectious Diseases Source Type: research

Interventions to Reduce Drug Use Among Methamphetamine Users at Risk for HIV
AbstractPurpose of ReviewThis paper reports on the results of a study comparing two behavioral treatments for methamphetamine users. The outcome was the effectiveness of the interventions in reducing meth use. The interventions were contingency management (CM) and contingency management plus strengths-based case management (CM/SBCM).Recent FindingsCM/SBCM was found to be associated with attending more sessions for people who reported being in a couple. Also, participants who earned more money in the first part of the study were more likely to have more clean urinalysis in the second part of the study. Latent class analysis...
Source: Current HIV/AIDS Reports - February 14, 2019 Category: Infectious Diseases Source Type: research

The Impact of ACA and Medicaid Expansion on Progress Toward UNAIDS 90-90-90 Goals
AbstractPurpose of ReviewPassage of the Affordable Care Act (ACA) in 2010 and subsequent Medicaid expansion has influenced access to HIV treatment and care in the USA. This review aims to evaluate whether the implementation of these policies has impacted progress toward UNAIDS 90-90-90 goals.Recent FindingsPreliminary evidence has emerged suggesting that the ACA and Medicaid expansion has increased the likelihood of HIV testing and diagnosis, reduced the number of people unaware of HIV infection, and increased the number of people on antiretroviral therapy (ART) who are virally suppressed.SummaryWhile the ACA is associated...
Source: Current HIV/AIDS Reports - February 14, 2019 Category: Infectious Diseases Source Type: research

Substance Use Screening in HIV Care Settings: a Review and Critique of the Literature
AbstractPurpose of ReviewPeople living with human immunodeficiency virus/AIDS (PLWHA) experience high prevalence of substance use disorders (SUD). HIV care settings represent a unique opportunity to identify possible SUD, to provide SUD interventions, and to improve linkage to SUD treatment. The aims of this paper are to (a) review and critique the extant literature examining substance use screening approaches among PLWHA in HIV care settings and (b) provide recommendations for future clinical practice.Recent FindingsTwenty-one peer-reviewed articles that examined substance screening approaches employed in HIV and other pr...
Source: Current HIV/AIDS Reports - February 12, 2019 Category: Infectious Diseases Source Type: research

HIV Eradication Strategies: Implications for the Central Nervous System
AbstractPurpose of ReviewIn addition to preventive protocols and antiretroviral therapy, HIV-1 eradication has been considered as an additional strategy to help fight the AIDS epidemic. With the support of multiple funding agencies, research groups worldwide have been developing protocols to achieve either a sterilizing or a functional cure for HIV-infection.Recent FindingsMost of the studies focus on the elimination or suppression of circulating CD4+ T cells, the best characterized HIV-1 latent reservoir. The role of the central nervous system (CNS) as a latent reservoir is still controversial. Although brain macrophages ...
Source: Current HIV/AIDS Reports - February 8, 2019 Category: Infectious Diseases Source Type: research

Substance Use and HIV Among Justice-Involved Youth: Intersecting Risks
AbstractPurpose of ReviewThis review discusses recent advances in research on the intersection of HIV prevention and substance use among youth involved with the justice system. We discuss current themes of recent findings and provide guidance for researchers, policymakers, and clinicians on the next steps in advancing work in this nascent area.Recent FindingsOf the 46 studies that measured HIV risk and substance use among justice-involved youth, 56% were cross-sectional designs, 22% were intervention trials, and 22% were longitudinal designs. Cross-sectional studies suggested that substance use is highly associated with HI...
Source: Current HIV/AIDS Reports - February 8, 2019 Category: Infectious Diseases Source Type: research

Breaking the Glyco-Code of HIV Persistence and Immunopathogenesis
AbstractPurpose of reviewGlycoimmunology is an emerging field focused on understanding how immune responses are mediated by glycans (carbohydrates) and their interaction with glycan-binding proteins called lectins. How glycans influence immunological functions is increasingly well understood. In a parallel way, in the HIV field, it is increasingly understood how the host immune system controls HIV persistence and immunopathogenesis. However, what has mostly been overlooked, despite its potential for therapeutic applications, is the role that the host glycosylation machinery plays in modulating the persistence and immunopat...
Source: Current HIV/AIDS Reports - February 1, 2019 Category: Infectious Diseases Source Type: research

HIV Prevention Interventions for Adolescents
AbstractPurpose of ReviewThe goal of this paper is to review recent data on biomedical, behavioral, and structural HIV prevention interventions for adolescents and young adults.Recent FindingsWhile it is accepted that HIV prevention interventions must take an integrated approach to achieve maximum effectiveness, to date, there have been limited, rigorously evaluated combination prevention interventions for adolescents. There are currently a range of effective biomedical, behavioral, and structural approaches that can be integrated into prevention packages to address the prevention needs of adolescents, including oral PrEP,...
Source: Current HIV/AIDS Reports - February 1, 2019 Category: Infectious Diseases Source Type: research

A Review of Telehealth Innovations for HIV Pre-Exposure Prophylaxis (PrEP)
AbstractPurpose of ReviewThis review summarizes novel interventions that employ technology to improve HIV pre-exposure prophylaxis (PrEP) availability, uptake, and adherence.Recent FindingsSeveral notable technology-based programs are increasing access to PrEP in unique ways. We identified multiple models for using telehealth to bolster PrEP dissemination and adherence, such as mobile applications that offer PrEP prescribing without an in-person visit, longitudinal distance telementoring for community provider PrEP education and clinical guidance, and electronic consults for PrEP specialist support in the primary care sett...
Source: Current HIV/AIDS Reports - January 30, 2019 Category: Infectious Diseases Source Type: research

Medications for Treatment of Opioid Use Disorder among Persons Living with HIV
AbstractPurpose of ReviewRecent HIV outbreaks have occurred as a result of the current US opioid epidemic. Providing medications for opioid use disorder (MOUD) with methadone, buprenorphine, and extended-release naltrexone is essential to achieving optimal HIV treatment outcomes including viral suppression and retention in treatment. This review describes the pharmacology of MOUD with specific attention to interactions with antiretroviral therapy, and to the effect of MOUD on HIV treatment outcomes.Recent FindingsMethadone and buprenorphine both improve HIV viral suppression, adherence to antiretroviral therapy, and overal...
Source: Current HIV/AIDS Reports - January 25, 2019 Category: Infectious Diseases Source Type: research

The Association Between Marijuana Use and HIV Continuum of Care Outcomes: a Systematic Review
AbstractPurpose of ReviewApproximately 77% of HIV-infected adults report lifetime marijuana use. Given the high rates and social acceptability of marijuana use among HIV-infected individuals, it is important to gain a stronger understanding of if, and how, marijuana impacts HIV care cascade outcomes. The purpose of this study is to systematically review recent articles that assess the relationship between marijuana use and HIV continuum of care outcomes.Recent FindingsOne hundred and ninety articles from PubMed were considered for inclusion, and 15 were included in the review. The studies focus on marijuana use among HIV-i...
Source: Current HIV/AIDS Reports - January 22, 2019 Category: Infectious Diseases Source Type: research

HIV, Depression, and Cognitive Impairment in the Era of Effective Antiretroviral Therapy
AbstractPurpose of ReviewMental health disorders, especially depression, are prevalent among people living with HIV (PLWH) and are associated with cognitive impairment (CI) among HIV-uninfected (HIV −) individuals. We conducted a comprehensive review of the link between depression and cognition among PLWH.Recent FindingsStudies examining depression and cognition in PLWH report high rates of current (median  = 24%) and lifetime depression (42%). There is reliable evidence that depression is associated with overall CI among PLWH, and in the cognitive domains of processing speed, executive function, learni...
Source: Current HIV/AIDS Reports - January 19, 2019 Category: Infectious Diseases Source Type: research

Social Networks of Substance-Using Populations: Key Issues and Promising New Approaches for HIV
AbstractPurpose of ReviewThis paper presents recent literature on substance using networks and HIV, highlighting renewed and emerging themes in the field. The goal is to draw attention to research that holds considerable promise for advancing our understanding of the role of networks in shaping behaviors, while also providing critical information for the development of interventions, programs, and policies to reduce HIV and other drug-related harms.Recent FindingsRecent research advances our understanding of networks and HIV, including among understudied populations, and provides new insight into how risk environments shap...
Source: Current HIV/AIDS Reports - January 18, 2019 Category: Infectious Diseases Source Type: research

Cerebrospinal Fluid Concentrations of the Synaptic Marker Neurogranin in Neuro-HIV and Other Neurological Disorders
AbstractPurpose of ReviewThe aim of this study was to examine the synaptic biomarker neurogranin in cerebrospinal fluid (CSF) in different stages of HIV infection and in relation to what is known about CSF neurogranin in other neurodegenerative diseases.Recent FindingsCSF concentrations of neurogranin are increased in Alzheimer ’s disease, but not in other neurodegenerative disorder such as Parkinson’s disease, frontotemporal dementia, and Lewy body dementia. Adults with HIV-associated dementia have been found to have decreased levels of neurogranin in the frontal cortex, which at least to some extent, may be m...
Source: Current HIV/AIDS Reports - January 16, 2019 Category: Infectious Diseases Source Type: research

Health Behavior Theory to Enhance eHealth Intervention Research in HIV: Rationale and Review
AbstractPurpose of ReviewOptimal design and evaluation of eHealth interventions requires the specification of behavioral targets and hypothesized mechanisms of action —both of which can be enhanced with the use of established health behavior theories (HBTs). In this paper, we describe the major HBTs and examine their use in studies of eHealth interventions for HIV prevention and treatment and assess the contribution of HBT in developing and evaluating eHealth i nterventions.Recent FindingsBased on our review of the literature, we argue the field can benefit from more systematic selection, application, and reporting o...
Source: Current HIV/AIDS Reports - December 3, 2018 Category: Infectious Diseases Source Type: research

Inflammation and Metabolic Complications in HIV
AbstractPurpose of ReviewWe aim to provide an in-depth review of recent literature highlighting the role of inflammation involving the adipose tissue, liver, skeletal muscles, and gastrointestinal tract in the development of metabolic complications among persons living with HIV (PLWH).Recent FindingsRecent studies in PLWH have demonstrated a significant association between circulating inflammatory markers and development of insulin resistance and metabolic complications. In adipose tissue, pro-inflammatory cytokine expression inhibits adipocyte insulin signaling, which alters lipid and glucose homeostasis. Increased lipoly...
Source: Current HIV/AIDS Reports - October 1, 2018 Category: Infectious Diseases Source Type: research

Actionable Adherence Monitoring: Technological Methods to Monitor and Support Adherence to Antiretroviral Therapy
AbstractPurpose of ReviewCurrent digital technologies are being used for “actionable adherence monitoring”; that is, technologies that can be used to identify episodes of non-adherence to ART in a timely manner such that tailored interventions based on adherence data can be provided when and where they are needed most.Recent FindingsCurrent digital communication technologies used to monitor ART adherence include electronic adherence monitors (EAMs), digital ingestion monitors, cellular phones, and electronic pharmacy refill tracking systems.SummaryCurrently available real-time adherence monitoring approaches ba...
Source: Current HIV/AIDS Reports - October 1, 2018 Category: Infectious Diseases Source Type: research

A Dissemination and Implementation Science Approach to the Epidemic of Opioid Use Disorder in the United States
AbstractPurpose of ReviewThis review aims to (1) conceptualize the complexity of the opioid use disorder epidemic using a conceptual model grounded in the disease continuum and corresponding levels of prevention and (2) summarize a select set of interventions for the prevention and treatment of opioid use disorder.Recent FindingsEpidemiologic data indicate non-medical prescription and illicit opioid use have reached unprecedented levels, fueling an opioid use disorder epidemic in the USA. A problem of this magnitude is rooted in multiple supply- and demand-side drivers, the combined effect of which outweighs current preven...
Source: Current HIV/AIDS Reports - October 1, 2018 Category: Infectious Diseases Source Type: research

CNS Persistence of HIV-1 in Children: the Untapped Reservoir
AbstractPurpose of ReviewThe central nervous system (CNS) represents a potential HIV-1 reservoir that may need to be specifically targeted by remission strategies. Perinatally HIV-1-infected children and youth are exposed to HIV-1 at a critical period of brain development. This review summarizes the current literature regarding HIV-1 and the CNS in perinatal infection.Recent FindingsHIV-1-associated encephalopathy is prevalent with perinatal infection and neurocognitive impairment persists even following antiretroviral treatment (ART)-mediated suppression of viremia. Compartmentalization of HIV-1 between plasma and CSF of ...
Source: Current HIV/AIDS Reports - October 1, 2018 Category: Infectious Diseases Source Type: research

A Missing Link: HIV-/AIDS-Related mHealth Interventions for Health Workers in Low- and Middle-Income Countries
AbstractPurpose of ReviewThrough a review of the peer-reviewed and gray literature on HIV mobile health (mHealth) tools for health workers and in-depth interviews with mHealth leaders in the field, we provide a synthesis of current work and propose mHealth research priorities for HIV prevention, care, and treatment.Recent FindingsSignificant investment in implementation research and bringing together researchers capable of identifying drivers of successful implementation and industry leaders capable of bringing efficacious tools to scale are needed to move this area forward.SummaryEffective and appropriate technologies to ...
Source: Current HIV/AIDS Reports - September 26, 2018 Category: Infectious Diseases Source Type: research