Assessing Cardiovascular Risk in People Living with HIV: Current Tools and Limitations
AbstractPurpose of ReviewTo provide the current state of the development and application of cardiovascular disease (CVD) prediction tools in people living with HIV (PLWH).Recent FindingsSeveral risk prediction models developed on the general population are available to predict CVD risk, the most notable being the US-based pooled cohort equations (PCE), the Framingham risk functions, and the Europe-based SCORE (Systematic COronary Risk Evaluation). In validation studies in cohorts of PLWH, these models generally underestimate CVD risk, especially in individuals who are younger, women, Black race, or predicted to be at low/i...
Source: Current HIV/AIDS Reports - July 11, 2021 Category: Infectious Diseases Source Type: research
Analytical Treatment Interruption in HIV Trials: Statistical and Study Design Considerations
AbstractPurpose of ReviewAnalytical treatment interruption (ATI) remains an essential component in clinical studies investigating novel agents or combination treatment strategies aiming to induce HIV treatment-free remission or long-term viral control. We provide an overview on key study design aspects of ATI trials from the perspective of statisticians.Recent FindingsATI trial designs have evolved towards shorter treatment interruption phases and more frequent viral load monitoring aiming to reduce prolonged viremia risks. Criteria for ART resumption have evolved as well. Common outcome measures in modern ATI trials inclu...
Source: Current HIV/AIDS Reports - July 2, 2021 Category: Infectious Diseases Source Type: research
A Review of Interventions to Enhance HIV Medication Adherence
AbstractPurpose of ReviewAdherence to antiretroviral treatment (ART) is crucial for a successful HIV treatment. Unfortunately, it is estimated that 45% of persons living with HIV (PLWH) have poor adherence to ART. To provide health care professionals and PLWH with effective tools for supporting adherence, researchers have investigated the effectiveness of psychosocial interventions to enhance adherence to ART. In this paper, interventional studies, systematic reviews, and meta-analyses that examine ART adherence interventions for PLWH are reviewed.Recent FindingsDespite a diverse and wide-ranging assortment of ART adherenc...
Source: Current HIV/AIDS Reports - June 21, 2021 Category: Infectious Diseases Source Type: research
Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters
AbstractPurpose of ReviewAlcohol is the most misused substance in the world. For people living with HIV (PLWH), alcohol misuse may impact ART adherence and viral suppression. This review of the most recently published alcohol intervention studies with PLWH examines how these studies considered gender in the samples, design, and analyses.Recent FindingsThree searches were conducted initially, and 13 intervention studies fit our criteria with alcohol outcomes. In general, most studies did not consider gender and had used small samples, and few demonstrated significant efficacy/effectiveness outcomes. Five studies considered ...
Source: Current HIV/AIDS Reports - June 10, 2021 Category: Infectious Diseases Source Type: research
Technology-Delivered Intervention Strategies to Bolster HIV Testing
AbstractSince the beginning of the HIV epidemic, there have been more than 75 million cases. Currently, there about 1.2 million living with HIV in the USA. Despite current testing recommendations, test rates continue to be suboptimal. Investigators have studied the use of digital technology to promote HIV testing, especially among high-risk populations.Purpose of ReviewThis non-systematic review provides an overview of the scientific research between 2015 and 2020 focused on the use of digital technology to bolster HIV testing and suggests novel technologies for exploration.Recent FindingsA total of 40 studies were include...
Source: Current HIV/AIDS Reports - June 9, 2021 Category: Infectious Diseases Source Type: research
HIV and COVID-19: Lessons From HIV and STI Harm Reduction Strategies
AbstractPurpose of ReviewThis review highlights the intersection of the COVID-19, HIV, and STI pandemics and examines how harm reduction strategies can be applied broadly to controlling a pandemic.Recent FindingsSince the onset of the COVID-19 pandemic, remarkable advances in the understanding of COVID-19 prevention, diagnosis, and treatment have been made at a much faster pace than prior pandemics, yet much more still remains to be discovered. Many of the strategies to control the COVID-19 pandemic mirror those employed to stem the HIV pandemic.SummaryHarm reduction principles used in the HIV pandemic can be applied to re...
Source: Current HIV/AIDS Reports - June 8, 2021 Category: Infectious Diseases Source Type: research
The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management
AbstractPurpose of ReviewTo highlight recent trends in the epidemiology of HIV and syphilis, the impact of the COVID epidemic, our approach to care of co-infected patients, and our views on important next steps in advancing the field.Recent FindingsHIV and syphilis co-infection has been on the rise in recent years although since the COVID pandemic there is a decrease in new diagnoses —it remains unclear if this represents a true decline or inadequate testing or under-reporting. Standard HIV care should include regular syphilis serology .Treatment and serological follow-up of syphilis in HIV positive and negative patients...
Source: Current HIV/AIDS Reports - June 6, 2021 Category: Infectious Diseases Source Type: research
Strategies for Successful Clinical Trial Recruitment of People Living with HIV in Low- and Middle-Income Countries: Lessons Learned and Implementation Implications from the Nigeria Renal Risk Reduction (R3) Trial
AbstractPurpose of ReviewClinical trials represent a bedrock for measuring efficacy of interventions in biomedical research, but recruitment into clinical trials remains a challenge. Few data have focused on recruitment strategies from the perspective of clinical trial teams, especially in low- and middle-income countries (LMIC), where HIV is most prevalent.Recent FindingsWe summarized data from the literature and our experience with recruitment for theRenalRiskReduction trial, aimed at reducing risk of kidney complications among people living with HIV in Nigeria. Using an implementation science framework, we identified st...
Source: Current HIV/AIDS Reports - June 4, 2021 Category: Infectious Diseases Source Type: research
Cost-Effectiveness Analysis in Implementation Science: a Research Agenda and Call for Wider Application
We describe examples of how model-based CEA can integrate implementation scientific concepts and evidence to help tailor evaluations to local context. We also propose six distinct domains for methodological advancement in order to enhance the uptake and impact of model-based cost-effectiveness analysis in implementation scientific research. (Source: Current HIV/AIDS Reports)
Source: Current HIV/AIDS Reports - June 1, 2021 Category: Infectious Diseases Source Type: research
Neuroimaging the Neuropathogenesis of HIV
AbstractPurpose of ReviewThis review highlights neuroimaging studies of HIV conducted over the last 2 years and discusses how relevant findings further our knowledge of the neuropathology of HIV. Three major avenues of neuroimaging research are covered with a particular emphasis on inflammation, aging, and substance use in persons living with HIV (PLWH).Recent FindingsNeuroimaging has been a critical tool for understanding the neuropathological underpinnings observed in HIV. Recent studies comparing levels of neuroinflammation in PLWH and HIV-negative controls show inconsistent results but report an association between ele...
Source: Current HIV/AIDS Reports - June 1, 2021 Category: Infectious Diseases Source Type: research
Machine Learning and Clinical Informatics for Improving HIV Care Continuum Outcomes
AbstractPurpose of ReviewThis manuscript reviews the use of electronic medical record (EMR) data for HIV care and research along the HIV care continuum with a specific focus on machine learning methods and clinical informatics interventions.Recent FindingsEMR-based clinical decision support tools and electronic alerts have been effectively utilized to improve HIV care continuum outcomes. Accurate EMR-based machine learning models have been developed to predict HIV diagnosis, retention in care, and viral suppression. Natural language processing (NLP) of clinical notes and data sharing between healthcare systems and public h...
Source: Current HIV/AIDS Reports - June 1, 2021 Category: Infectious Diseases Source Type: research
People living with HIV and the emerging field of chronic pain —what is known about epidemiology, etiology, and management
AbstractPurpose of ReviewChronic pain is common in people living with HIV (PLWH). It causes significant disability and poor HIV outcomes. Despite this, little is understood about its etiology and management.Recent FindingsRecent studies suggest that chronic pain in PLWH is caused by inflammation that persists despite viral load suppression. This coupled with central sensitization and psychosocial factors leads to chronic pain that is difficult to manage. PLWH with chronic pain often feel that their pain is incompletely treated, and yet there are few evidence-based options for the management of chronic pain in PLWH. Recent ...
Source: Current HIV/AIDS Reports - May 27, 2021 Category: Infectious Diseases Source Type: research
Interventions Addressing Depression and HIV-Related Outcomes in People with HIV
AbstractPurpose of ReviewPeople with HIV (PWH) are more likely to experience depression than those without HIV. Depression is not only distressing and interfering in and of itself, but it is also consistently associated with non-adherence to antiretroviral treatment (ART). Accordingly, research and clinical priorities require updated knowledge about interventions that address depression in PWH.Recent FindingsTwenty efficacy trials and nine pilot studies since a 2009 review emerged in the literature review search. Of these, 11 and 6 respectively had a depression-related inclusion criterion. The intervention strategies inclu...
Source: Current HIV/AIDS Reports - May 20, 2021 Category: Infectious Diseases Source Type: research
