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 - February 25, 2021 Category: Infectious Diseases Source Type: research
The Impact of COVID-19 on HIV Care Provided via Telemedicine —Past, Present, and Future
AbstractPurpose of ReviewThis review summarizes HIV care delivered via telemedicine before and during the COVID-19 pandemic and highlights areas of study to inform optimal usage of telemedicine in HIV clinical practice in the future.Recent FindingsTo address barriers to care created by the COVID-19 pandemic, regulatory agencies and payors waived longstanding restrictions, which enabled rapid expansion of telemedicine across the country. Preliminary data show that providers and persons with HIV (PWH) view telemedicine favorably. Some data suggest telemedicine has facilitated retention in care, but other studies have found i...
Source: Current HIV/AIDS Reports - February 22, 2021 Category: Infectious Diseases Source Type: research
Undernutrition and HIV Infection in Sub-Saharan Africa: Health Outcomes and Therapeutic Interventions
AbstractPurpose of ReviewSub-Saharan Africa (SSA) is disproportionately burdened by the twin epidemics of food insecurity and HIV infection, and protein-calorie undernutrition is common among persons with HIV (PWH) initiating antiretroviral therapy (ART) in the region. In this review, we discuss the intersection of HIV infection and undernutrition, health outcomes among undernourished PWH starting ART, and the demonstrated and potential benefits of therapeutic interventions such as micro/macronutrient supplementation and pharmacological agents.Recent FindingsA low body mass index (BMI), used as a general indicator of poor ...
Source: Current HIV/AIDS Reports - February 19, 2021 Category: Infectious Diseases Source Type: research
Impact of Antiretroviral Therapy on Cancer Treatment Outcomes among People Living with HIV in Low- and Middle-Income Countries: a Systematic Review
AbstractPurpose of ReviewThe relationship between antiretroviral therapy (ART) and cancer treatment outcomes among people living with HIV (PLWH) in low- and middle-income countries (LMICs) is complex and poorly understood for many cancers. We aimed to summarize existing evidence from LMICs regarding the benefit of ART on cancer treatment –related outcomes.Recent FindingsWe included twelve observational studies that reported associations between ART status and cancer treatment outcomes among HIV-positive patients in LMICs. Most confirmed ART was associated with improved cancer treatment outcomes. Heterogeneity in cancers ...
Source: Current HIV/AIDS Reports - February 2, 2021 Category: Infectious Diseases Source Type: research
Gastrointestinal Dysfunction and HIV Comorbidities
AbstractPurpose of ReviewGut dysfunction and resulting chronic low-grade inflammation have been linked to metabolic and chronic diseases in the general population. In this review, we present recently published studies of HIV-associated gut dysfunction and comorbidities including obesity, diabetes, cardiovascular disease, liver disease, and neurocognitive disease.Recent FindingsBiomarkers of microbial translocation, dysbiosis, or intestinal epithelial integrity have been used to investigate relationships between HIV-associated gut dysfunction and metabolic, cardiovascular, and neurologic complications. Many studies point to...
Source: Current HIV/AIDS Reports - January 19, 2021 Category: Infectious Diseases Source Type: research
Immune Dysregulation in Myocardial Fibrosis, Steatosis, and Heart Failure: Current Insights from HIV and the General Population
AbstractPurpose of ReviewHIV is an independent risk factor for heartfailure (HF). Cardiac imaging studies in people with HIV (PWH) have identified myocardial pathologies, namely fibrosis and steatosis, that likely contribute to the higher risk of HF. In this review, we survey existing epidemiological, clinical, and mechanistic literature to identify potential pathways that may contribute to the burden of myocardial fibrosis and steatosis among PWH.Recent FindingsMultiple cohort studies over the past 20 years have demonstrated a roughly 2-fold higher risk of incident HF in PWH, as well as a disproportionate burden of myoc...
Source: Current HIV/AIDS Reports - January 12, 2021 Category: Infectious Diseases Source Type: research
Latency Reversal 2.0: Giving the Immune System a Seat at the Table
AbstractPurpose of ReviewFor most people living with HIV (PLWH), treatment with effective antiretroviral therapy (ART) results in suppression of viremia below the limit of detection of clinical assays, immune reconstitution, reduced immune activation, avoidance of opportunistic infections, and progression to AIDS. However, ART alone is not curative, and HIV persists in a non-replicating, latent form. In this review, we provide a historical perspective on non-specific latency reversal approaches (LRA 1.0) and summarize recent advances in latency reversal strategies that target specific signaling pathways within CD4+ T cells...
Source: Current HIV/AIDS Reports - January 12, 2021 Category: Infectious Diseases Source Type: research
Patient-Led Decision-Making for HIV Preexposure Prophylaxis
AbstractPurpose of ReviewShared decision-making is a process that involves bidirectional exchange of information between patients and providers to support patients in making individualized, evidence-based decisions about their healthcare. We review the evidence on patient-led decision-making, a form of shared decision-making that maximizes patient autonomy, as a framework for decisions about HIV preexposure prophylaxis (PrEP). We also assess the likelihood that patient-led decision-making occurs for PrEP and describe interventions to facilitate this process.Recent FindingsPatient-led decision-making is likely to be uncommo...
Source: Current HIV/AIDS Reports - January 8, 2021 Category: Infectious Diseases Source Type: research
Non-communicable Diseases in Pregnant and Postpartum Women Living with HIV: Implications for Health Throughout the Life Course
AbstractPurpose of ReviewThe development of non-communicable diseases (NCDs) in pregnant women living with HIV can be a harbinger of future NCD-related morbidity and mortality. This review focuses on the NCDs that complicate pregnancy and the postpartum period, including hypertensive complications, hyperglycemic disorders, excessive gestational weight gain, and bone mineral density losses. For each disease process, we explore the role of HIV as a possible driver of excess risk, the immediate consequences of these complications on pregnancy outcomes and maternal and infant health, and possible implications for long-term wom...
Source: Current HIV/AIDS Reports - January 5, 2021 Category: Infectious Diseases Source Type: research
Aging with HIV in Latin America and the Caribbean: a Systematic Review
AbstractPurpose of ReviewWith the establishment of antiretroviral treatment (ART) programs in low- and middle-income countries, people with HIV (PWH) in Latin America and the Caribbean (LAC) are living longer, subsequently developing chronic non-communicable diseases (NCDs). Few studies focus on the impact of aging among older LAC PWH. This systematic review aims to fill this information gap and understand the burden of aging with HIV in LAC. We identified peer-reviewed literature published in English, Spanish, or Portuguese from several databases to assess currently available evidence on the burden of aging with HIV in LA...
Source: Current HIV/AIDS Reports - January 5, 2021 Category: Infectious Diseases Source Type: research
Recruitment of US Adolescents and Young Adults (AYA) into Human Immunodeficiency Virus (HIV) –Related Behavioral Research Studies: A Scoping Review
The objective of this scoping review was to examine the range of published evidence on recruitment approaches and outcomes of US adolescents and young adults (AYA) ages (18 –29 years) into human immunodeficiency virus (HIV)–related behavioral research studies during the past 10 years.Recent FindingsImplementation of effective behavioral research strategies among HIV at-risk and infected AYA is key to ending the HIV epidemic and necessitates successful recruitment strategies.SummaryA comprehensive search was executed across four electronic databases. Of the 1697 identified studies, seven met inclusion criteria with si...
Source: Current HIV/AIDS Reports - November 12, 2020 Category: Infectious Diseases Source Type: research
Utility of Short Message Service (SMS) for Remote Data Collection for HIV in Low- and Middle-Income Countries
AbstractPurpose of ReviewShort message system (SMS) communication is widespread in low- and middle-income countries (LMICs), and may be a viable approach to address challenges with in-person data collection for HIV-related research and monitoring and evaluation. We reviewed the literature to characterize potential benefits and challenges with using SMS for remote data capture, including examples from HIV and sexual and reproductive health.Recent FindingsIn our review, we found that studies that have used SMS to capture sensitive, self-reported data found this was an acceptable and feasible strategy, and may reduce social d...
Source: Current HIV/AIDS Reports - October 2, 2020 Category: Infectious Diseases Source Type: research
NASH in HIV
AbstractPurpose of ReviewAging-related comorbidities, including liver disease, represent the main drivers of morbidity and mortality in people with HIV (PWH). Nonalcoholic fatty liver disease (NAFLD) seems a frequent comorbidity in aging PWH nowadays. NAFLD results from a fat deposition into the liver parenchyma that may evolve to nonalcoholic steatohepatitis (NASH), a state of hepatocellular inflammation and injury in response to the accumulated fat leading to liver fibrosis and cirrhosis. We here review the current status of knowledge regarding this emerging comorbidity in PWH.Recent FindingsRecent studies suggest that P...
Source: Current HIV/AIDS Reports - September 27, 2020 Category: Infectious Diseases Source Type: research
Understanding, Contextualizing, and Addressing PrEP Stigma to Enhance PrEP Implementation
AbstractPurpose of ReviewHIV pre-exposure prophylaxis (PrEP) is a safe and effective preventive intervention that could play a central role in ending the HIV epidemic. However, low uptake in general, and among certain social groups in particular, underscores the need to identify and address barriers to PrEP use. PrEP stigma has emerged as a key factor interfering with PrEP interest, uptake, and continuation. The purpose of this article is to describe and contextualize PrEP stigma and to offer recommendations on how to address it in future PrEP implementation initiatives.Recent FindingsPrEP users are commonly stereotyped as...
Source: Current HIV/AIDS Reports - September 22, 2020 Category: Infectious Diseases Source Type: research
A Review of HIV Pre-exposure Prophylaxis Streamlining Strategies
AbstractPurpose of ReviewStandard care for HIV pre-exposure prophylaxis (PrEP) in the USA creates substantial burdens for patients, clinicians, and the healthcare system; to optimize uptake, there is a need for innovative strategies to streamline its provision.Recent FindingsOur review, structured by the expanded chronic care model, identified eleven promising strategies to streamline PrEP care. Approaches ranged widely in mechanism of action. Using text messages to support care was the only strategy with clinical trial evidence supporting its use. Other modalities such as patient navigation, telemedicine PrEP models, alte...
Source: Current HIV/AIDS Reports - September 12, 2020 Category: Infectious Diseases Source Type: research
