Mpox and HIV —Collision of Two Diseases
AbstractPurpose of ReviewThe global outbreak of mpox has brought renewed attention to a previously neglected disease which is particularly severe in people with underlying untreated HIV co-infection. For this population, the disease is progressive, severe, and often lethal. In this review, we examine the pathogenesis of mpox disease and its collision with co-existent HIV infection and discuss key considerations for management as well as emerging clinical dilemmas and areas for future research.Recent FindingsCo-existent untreated HIV infection characterized by severe immunocompromise potentiates the nefarious effects of mon...
Source: Current HIV/AIDS Reports - November 23, 2023 Category: Infectious Diseases Source Type: research

Overamped: Stimulant Use and HIV Pathogenesis
AbstractPurpose of ReviewIn the era of HIV treatment as prevention (TasP), more clarity is needed regarding whether people with HIV who use stimulants (i.e., methamphetamine, powder cocaine, and crack cocaine) display elevated HIV viral load and greater immune dysregulation.Recent FindingsAlthough rates of viral suppression have improved in the TasP era, stimulant use was independently associated with elevated viral load in 23 of 28 studies included in our review. In the 12 studies examining other HIV disease markers, there was preliminary evidence for stimulant-associated alterations in gut-immune dysfunction and cellular...
Source: Current HIV/AIDS Reports - November 16, 2023 Category: Infectious Diseases Source Type: research

Learning from Persistent Viremia: Mechanisms and Implications for Clinical Care and HIV-1 Cure
AbstractPurpose of ReviewIn this review, we discuss what persistent viremia has taught us about the biology of the HIV-1 reservoir during antiretroviral therapy (ART). We will also discuss the implications of this phenomenon for HIV-1 cure research and its clinical management.Recent FindingsWhile residual viremia (RV, 1 –3 HIV-1 RNA copies/ml) can be detected in most of people on ART, some individuals experience non-suppressible viremia (NSV, >  20–50 copies/mL) despite optimal adherence. When issues of drug resistance and pharmacokinetics are ruled out, this persistent virus in plasma is the reflection of virus...
Source: Current HIV/AIDS Reports - November 13, 2023 Category: Infectious Diseases Source Type: research

Update on Central Nervous System Effects of the Intersection of HIV-1 and SARS-CoV-2
AbstractPurpose of ReviewResearch has shown myriad neurologic and mental health manifestations during the acute and subsequent stages of COVID-19 in people with HIV (PWH). This review summarizes the updates on central nervous system (CNS) outcomes following SARS-CoV-2 infection in PWH and highlight the existing knowledge gaps in this area.Recent FindingsStudies leveraging electronic record systems have highlighted the excess risk of developing acute and lingering neurological complications of COVID-19 in PWH compared to people without HIV (PWoH). However, there is a notable scarcity of neuroimaging as well as blood and cer...
Source: Current HIV/AIDS Reports - November 11, 2023 Category: Infectious Diseases Source Type: research

Advancing Diagnosis and Treatment in People Living with HIV and Tuberculosis Meningitis
AbstractPurpose of reviewTuberculous meningitis (TBM) is the most severe form of tuberculosis. Inadequate diagnostic testing and treatment regimens adapted from pulmonary tuberculosis without consideration of the unique nature of TBM are among the potential drivers. This review focuses on the progress being made in relation to both diagnosis and treatment of TBM, emphasizing promising future directions.Recent findingsThe molecular assay GeneXpert MTB/Rif Ultra has improved sensitivity but has inadequate negative predictive value to “rule-out” TBM. Evaluations of tests focused on the host response and bacterial componen...
Source: Current HIV/AIDS Reports - November 10, 2023 Category: Infectious Diseases Source Type: research

Genomic Exploration of the Brain in People Infected with HIV —Recent Progress and the Road Ahead
AbstractPurpose of ReviewThe adult human brain harbors billions of microglia and other myeloid and lymphoid cells highly susceptible to HIV infection and retroviral insertion into the nuclear DNA. HIV infection of the brain is important because the brain is a potentially large reservoir site that may be a barrier to HIV cure strategies and because infection can lead to the development of HIV-associated neurocognitive disorder. To better understand both the central nervous system (CNS) reservoir and how it can cause neurologic dysfunction, novel genomic, epigenomic, transcriptomic, and proteomic approaches need to be employ...
Source: Current HIV/AIDS Reports - November 10, 2023 Category: Infectious Diseases Source Type: research

Advancing Diagnosis and Treatment in People Living with HIV and Tuberculosis Meningitis
AbstractPurpose of reviewTuberculous meningitis (TBM) is the most severe form of tuberculosis. Inadequate diagnostic testing and treatment regimens adapted from pulmonary tuberculosis without consideration of the unique nature of TBM are among the potential drivers. This review focuses on the progress being made in relation to both diagnosis and treatment of TBM, emphasizing promising future directions.Recent findingsThe molecular assay GeneXpert MTB/Rif Ultra has improved sensitivity but has inadequate negative predictive value to “rule-out” TBM. Evaluations of tests focused on the host response and bacterial componen...
Source: Current HIV/AIDS Reports - November 10, 2023 Category: Infectious Diseases Source Type: research

Genomic Exploration of the Brain in People Infected with HIV —Recent Progress and the Road Ahead
AbstractPurpose of ReviewThe adult human brain harbors billions of microglia and other myeloid and lymphoid cells highly susceptible to HIV infection and retroviral insertion into the nuclear DNA. HIV infection of the brain is important because the brain is a potentially large reservoir site that may be a barrier to HIV cure strategies and because infection can lead to the development of HIV-associated neurocognitive disorder. To better understand both the central nervous system (CNS) reservoir and how it can cause neurologic dysfunction, novel genomic, epigenomic, transcriptomic, and proteomic approaches need to be employ...
Source: Current HIV/AIDS Reports - November 10, 2023 Category: Infectious Diseases Source Type: research

Paradata: Measuring Engagement in Digital HIV Interventions for Sexual and Gender Minorities
AbstractPurpose of ReviewThe goal of this review was to examine online engagement usingparadata (i.e., intervention usage metrics) as part of the reporting of online behavioral HIV prevention and care interventions ’ findings. We underscore the importance of these data in examining intervention engagement and effectiveness.Recent FindingsWe focused on studies indexed in PubMed and published between April 1, 2017, and June 30, 2023, that reported the development and testing of online behavioral interventions for HIV prevention and/or care. Of the 689 extracted citations, 19 met the study criteria and provided engagement d...
Source: Current HIV/AIDS Reports - November 6, 2023 Category: Infectious Diseases Source Type: research

Digital Adaptive Behavioral Interventions to Improve HIV Prevention and Care: Innovations in Intervention Approach and Experimental Design
AbstractPurpose of ReviewRecent advances in digital technologies can be leveraged to adapt HIV prevention and treatment services to the rapidly changing needs of individuals in everyday life. However, to fully take advantage of these technologies, it is critical to effectively integrate them with human-delivered components. Here, we introduce a new experimental approach for optimizing the integration and adaptation of digital and human-delivered behavioral intervention components for HIV prevention and treatment.Recent FindingsTypically, human-delivered components can be adapted on a relatively slow timescale (e.g., every ...
Source: Current HIV/AIDS Reports - November 4, 2023 Category: Infectious Diseases Source Type: research