Developments in Neuroprotection for HIV-Associated Neurocognitive Disorders (HAND)
AbstractPurpose of ReviewReducing the risk of HIV-associated neurocognitive disorders (HAND) is an elusive treatment goal for people living with HIV. Combination antiretroviral therapy (cART) has reduced the prevalence of HIV-associated dementia, but milder, disabling HAND is an unmet challenge. As newer cART regimens that more consistently suppress central nervous system (CNS) HIV replication are developed, the testing of adjunctive neuroprotective therapies must accelerate.Recent FindingsSuccesses in modifying cART regimens for CNS efficacy (penetrance, chemokine receptor targeting) and delivery (nanoformulations) in pil...
Source: Current HIV/AIDS Reports - July 22, 2022 Category: Infectious Diseases Source Type: research
HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis
AbstractPurpose of ReviewImproving HIV testing uptake is essential to ending the HIV pandemic. HIV testing approaches can be opt-in, opt-out or risk-based. This systematic review examines and compares the uptake of HIV testing in opt-in, opt-out and risk-based testing approaches.Recent FindingsThere remain missed opportunities for HIV testing in a variety of settings using different approaches: opt-in (a person actively accepts to be tested for HIV), opt-out (a person is informed that HIV testing is routine/standard of care, and they actively decline if they do not wish to be tested for HIV) or risk-based (using risk-based...
Source: Current HIV/AIDS Reports - July 13, 2022 Category: Infectious Diseases Source Type: research
Peer Approaches to Improve HIV Care Cascade Outcomes: a Scoping Review Focused on Peer Behavioral Mechanisms
AbstractPurpose of ReviewThere are three main components of peer-based approaches regardless of type: education, social support, and social norms. The purpose of this scoping review was to examine evidence in the literature among peer-based interventions and programs of components and behavioral mechanisms utilized to improve HIV care cascade outcomes.Recent FindingsOf 522 articles found, 40 studies were included for data abstraction. The study outcomes represented the entire HIV care cascade from HIV testing to viral suppression. Most were patient navigator models and 8 of the studies included all three components. Social...
Source: Current HIV/AIDS Reports - July 7, 2022 Category: Infectious Diseases Source Type: research
Status-Neutral Interventions to Support Health Equity for Black Sexual Minority Men
AbstractPurpose of ReviewStatus-neutral care, a person-centered approach to healthcare not predicated on HIV serostatus, may improve health equity among Black sexual minority men (BSMM). We reviewed current status-neutral, HIV, and Pre-Exposure Prophylaxis (PrEP) interventions, and coded each for social-ecological focus and use of six approaches: (1) person-centered, (2) anti-stigma, (3) social support, (4) the social determinants of health (SDOH), (5) community engagement, and (6) multi-sectoral partnerships.Recent FindingsWe reviewed 25 studies, of which 3 were status-neutral. Nineteen studies utilized person-centered ap...
Source: Current HIV/AIDS Reports - July 6, 2022 Category: Infectious Diseases Source Type: research
Bone Quality in Relation to HIV and Antiretroviral Drugs
AbstractPurpose of ReviewPeople living with HIV (PLWH) are at an increased risk for osteoporosis, a disease defined by the loss of bone mineral density (BMD) and deterioration of bone quality, both of which independently contribute to an increased risk of skeletal fractures. While there is an emerging body of literature focusing on the factors that contribute to BMD loss in PLWH, the contribution of these factors to bone quality changes are less understood. The current review summarizes and critically reviews the data describing the effects of HIV, HIV disease-related factors, and antiretroviral drugs (ARVs) on bone qualit...
Source: Current HIV/AIDS Reports - June 20, 2022 Category: Infectious Diseases Source Type: research
Running with Scissors: a Systematic Review of Substance Use and the Pre-exposure Prophylaxis Care Continuum Among Sexual Minority Men
AbstractPurpose of ReviewPatterns of sexualized drug use, including stimulants (e.g., methamphetamine) and chemsex drugs, are key drivers of HIV incidence among sexual minority men (SMM). Although pre-exposure prophylaxis (PrEP) mitigates HIV risk, there is no consensus regarding the associations of substance use with the PrEP care continuum.Recent FindingsSMM who use substances are as likely or more likely to use PrEP. Although SMM who use stimulants experience greater difficulties with daily oral PrEP adherence, some evidence shows that SMM who use stimulants or chemsex drugs may achieve better adherence in the context o...
Source: Current HIV/AIDS Reports - June 14, 2022 Category: Infectious Diseases Source Type: research
Interventions Designed to Improve HIV Continuum of Care Outcomes for Persons with HIV in Contact with the Carceral System in the USA
AbstractPurpose of ReviewTo describe existing evidence and identify future directions for intervention research related to improving HIV care outcomes for persons with HIV involved in the carceral system in the USA, a population with high unmet HIV care needs.Recent FindingsFew recent intervention studies focus on improving HIV care outcomes for this population. Successful strategies to improve care outcomes include patient navigation, substance use treatment, and incentivizing HIV care outcomes. Technology-supported interventions are underutilized in this population. Notable gaps in the existing literature include interve...
Source: Current HIV/AIDS Reports - June 8, 2022 Category: Infectious Diseases Source Type: research
HIV Compartmentalization in the CNS and Its Impact in Treatment Outcomes and Cure Strategies
AbstractPurpose of ReviewThis review focuses on the cerebrospinal fluid (CSF) findings in connection to the central nervous system (CNS) reservoir in treatment-na ïve and virally suppressed PLWH, followed by the findings in CSF HIV-1 escape and analytical treatment interruption studies.Recent FindingsCompared to chronic infection, initiating antiretroviral therapy (ART) during acute HIV-1 infection results in more homogeneous longitudinal benefits in the CNS. Viral variants in CSF HIV-1 escape are independently linked to infected cells from the systemic reservoir and in the CNS, highlighting the phenomenon as a consequenc...
Source: Current HIV/AIDS Reports - May 10, 2022 Category: Infectious Diseases Source Type: research
Interventions to Increase HIV Testing Uptake in Global Settings
AbstractPurpose of ReviewHIV testing is the critical first step to direct people living with HIV (PLWH) to treatment. However, progress is still being made towards the UNAIDS benchmark of 95% of PLWH knowing their status by 2030. Here, we discuss recent interventions to improve HIV testing uptake in global settings.Recent FindingsSuccessful facility-based HIV testing interventions involve couples and index testing, partner notification, and offering of incentives. Community-based interventions such as home-based self-testing, mobile outreach, and hybrid approaches have improved HIV testing in low-resource settings and amon...
Source: Current HIV/AIDS Reports - April 20, 2022 Category: Infectious Diseases Source Type: research
Viral and Host Biomarkers of HIV Remission Post Treatment Interruption
AbstractPurpose of ReviewHIV rebound/remission after antiretroviral therapy (ART) interruption is likely influenced by (a) the size of the inducible replication-competent HIV reservoir and (b) factors in the host environment that influence immunological pressures on this reservoir. Identifying viral and/or host biomarkers of HIV rebound after ART cessation may improve the safety of treatment interruptions and our understanding of how the viral-host interplay results in post-treatment control. Here we review the predictive and functional significance of recently suggested viral and host biomarkers of time to viral rebound a...
Source: Current HIV/AIDS Reports - April 19, 2022 Category: Infectious Diseases Source Type: research
HIV-1 Reservoir Persistence and Decay: Implications for Cure Strategies
AbstractPurpose of ReviewDespite suppressive antiretroviral therapy (ART), a viral reservoir persists in individuals living with HIV that can reignite systemic replication should treatment be interrupted. Understanding how HIV-1 persists through effective ART is essential to develop cure strategies to induce ART-free virus remission.Recent FindingsThe HIV-1 reservoir resides in a pool of CD4-expressing cells as a range of viral species, a subset of which is genetically intact. Recent studies suggest that the reservoir on ART is highly dynamic, with expansion and contraction of virus-infected cells over time. Overall, the i...
Source: Current HIV/AIDS Reports - April 11, 2022 Category: Infectious Diseases Source Type: research
COVID-19 Clinical Presentation Among HIV-Infected Persons in China: A Systematic Review
AbstractPurpose of ReviewThe impact of HIV infection on the natural history of COVID-19 is unknown, given the recency of the human spread of SARS-CoV-2 (CoV). We reviewed published case series/reports of CoV-HIV coinfections to clarify epidemiologic and clinical features in China, the first nation with pandemic experience.Recent FindingsAssuming that HIV-infected persons were at average risk of CoV infection in Wuhan, we estimated HIV-CoV coinfected persons to number 412 (95%CI: 381-442); our review encompassed an estimated 16.7% (69/412) of Wuhan. Men (many of whom reported sex with other men) accounted for 71.1% (54/76) ...
Source: Current HIV/AIDS Reports - April 8, 2022 Category: Infectious Diseases Source Type: research
