Global public health efforts to address HIV and related communicable disease syndemics
Purpose of review To review recent progress in public health efforts to address HIV, and the extent to which key approaches can be applied to three key epidemics that commonly co-occur with HIV: TB, viral hepatitis, and STIs. Recent findings The public health approach to tackling HIV in low-income and middle-income settings relied on standardized treatment regimens and monitoring approaches, task sharing and community involvement, and decentralized and integrated service delivery. These approaches can all be applied to three key epidemics that commonly co-occur with HIV: TB, viral hepatitis, and STIs. Summary HIV, ...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

Let's talk chronic disease: can differentiated service delivery address the syndemics of HIV, hypertension and diabetes?
Purpose of review Differentiated service delivery (DSD) for HIV provides an approach to scaling services that are client-centred and aims to address client challenges whilst reducing the burden on health systems. With access to antiretroviral therapy, people living with HIV are living longer and increasingly present with comorbid conditions, such as hypertension and diabetes. This review presents the syndemic burden of HIV, hypertension and diabetes and highlights opportunities and challenges to leveraging DSD across diseases. Recent findings Prevalence of hypertension and diabetes in the eight highest HIV prevalence ...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

Syndemic theory, structural violence and HIV among African–Americans
Purpose of review This paper will review recent use of syndemic frameworks in HIV research among African–Americans. Recent findings Researchers have used syndemic theory in diverse African–American study populations, including MSM, cis-women, trans-women, heterosexual men and adolescents. These studies have evaluated the associations between syndemic conditions and a variety of outcomes, such as sexual behaviours, HIV and other sexually transmitted infections, HIV testing, adherence to antiretroviral therapy, HIV suppression and preexposure prophylaxis use. The most frequently evaluated syndemic conditions...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

Characterizing the role of intersecting stigmas and sustained inequities in driving HIV syndemics across low-to-middle-income settings
Purpose of review In 2020, key populations around the world still have disproportionate risks for HIV acquisition and experiencing HIV-related syndemics. This review presents current data around HIV-related syndemics among key populations globally, and on the role of intersecting stigmas in producing these syndemics in low-to-middle-income settings. Recent findings Sex workers, sexual and gender minorities, prisoners, and people who use drugs experience high burdens of tuberculosis, sexually transmitted infections, viral hepatitis, and violence linked to heightened HIV-related risks or acquisition. Adverse sexual, rep...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

Identifying and managing infectious disease syndemics in patients with HIV
Purpose of review We will present recent articles focusing on HIV synergistic interactions with other sexually transmitted infections, tuberculosis, and hepatitis, as well as recent advances in the study of social and behavioral determinants that facilitate this clustering of infectious disease. For each synergistic interaction, we highlight evidence-based interventions that clinicians and policymakers should consider to tackle HIV and infectious disease syndemics. Recent findings Significant advances in understanding the behavioral and structural determinants of HIV and other infectious disease synergisms have been m...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

Syndemics of HIV with mental illness and other noncommunicable diseases: a research agenda to address the gap between syndemic theory and current research practice
Purpose of review The aim of this article is to summarize the status of syndemic research on HIV and noncommunicable diseases (NCDs) to identify opportunities for improving research to benefit prevention and treatment of NCDs among persons living with HIV. Recent findings The majority of research on syndemics of HIV and NCDs has been conducted in the United States, with few studies in low and middle-income countries. The substance abuse, violence, and AIDS syndemic model was used by a quarter of the studies, however, most other studies failed to outline a syndemic model for interpreting their findings. Mental illnesse...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

The OATH Syndemic: opioids and other substances, aging, alcohol, tobacco, and HIV
Purpose of review Persons living with HIV (PLWH) are aging, continue to use alcohol and other substances, and experience age-associated adverse effects. We explore a new syndemic: OATH (opioids and other substances, aging, alcohol, tobacco, and HIV). Recent findings Frailty and falls are important problems that affect the health status of PLWH who continue to use alcohol and other substances. HIV, alcohol and other substance use, and aging each contributes to inflammaging. Multimorbidity and polypharmacy are also important pathways as alcohol and other substances interact with prescribed medications resulting in adver...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

What constitutes a syndemic? Methods, contexts, and framing from 2019
Purpose of review The purpose of this review is to describe what methods were used for 60 articles on HIV syndemics in 2019, where they took place, what syndemic clusters emerged, and why this matters. Recent findings Most articles published in 2019 used regression analyses, and fewer used higher level modeling techniques, frequencies and descriptive, longitudinal cohort study, and social network analysis. Some employed ethnography, qualitative interviews, or were simply reviews. Most syndemic co-factors were substance abuse, risky sexual behavior, depression, intimate partner violence, stigma, sexually transmitted in...
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: HIV SYNDEMICS: Edited by Kenneth H. Mayer Source Type: research

Editorial introduction
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - June 9, 2020 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTION Source Type: research

Hepatitis B cure: modeling the economics of a potential cost of a cure
Purpose of review The cure for hepatitis C virus infection has raised hope for a potential hepatitis B virus (HBV) cure, but the high price tag has led to serious questions about the affordability, and thus to access for all. This review discusses cost-effectiveness models, affordability, and access to a potential new cure for chronic HBV infection. Recent findings A cure does not yet exist for HBV, but the antiviral treatments that are currently available help slow down the progression of disease. There is limited research in the area of cost-effectiveness and economic analysis comparing a potential cure. Our prelimi...
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Recent developments with advancing gene therapy to treat chronic infection with hepatitis B virus
Purpose of review The available vaccine and therapies against hepatitis B virus (HBV) rarely eliminate chronic infection with the virus. High mortality resulting from complicating cirrhosis and hepatocellular carcinoma makes improving anti-HBV therapy an important priority. Recent advances with using gene therapy to counter HBV have potential and are the focus of this review. Recent findings The stable replication-competent HBV intermediate comprising covalently closed circular DNA (cccDNA) is the template for expression of all viral genes. Inactivating cccDNA has thus been a focus of research aimed at achieving cure ...
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Challenges and opportunities for hepatitis B cure in the setting of HIV--hepatitis B virus co-infection
Purpose of review To examine issues specific to HIV--HBV co-infection that are relevant to the search for and achieving hepatitis B cure in this the setting Recent findings In HIV--HBV co-infection, high rates of hepatitis B surface antigen (HBsAg) loss early after initiation of HBV-active antiretroviral therapy (ART) have previously been reported. Between 2012 and 2016, HBsAg loss from 2.8 to 23% was reported in numerous studies, including those already on suppressive HBV-active ART. Data published in 2018–2019 show that these rates have remained fairly stable (3.0–13.9%). However, it appears that higher ...
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Challenges for hepatitis B virus cure in resource-limited settings in sub-Saharan Africa
Purpose of review The aim of this article is to highlight the unique challenges for hepatitis B virus (HBV) cure faced in resource-limited settings (RLS) in sub-Saharan Africa (SSA), where access to disease prevention measures, medical testing, and treatment are limited. Recent findings SSA RLS face challenges, which need to be anticipated as HBV cure research advances. There is a paucity of data because of lack of HBV surveillance and limited access to laboratories. Interruption of transfusion-transmitted infections, perinatal mother-to-child-transmissions, and transmission in people-who-infect-drug networks has not ...
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Ethics of HIV and hepatitis B cure research
Purpose of review Achieving a cure for HIV or hepatitis B virus (HBV) is expected to have a range of salutary effects including eliminating the need for continued treatments, minimizing risk to sexual and injecting partners, reducing prevalence, and decreasing stigma. Nevertheless, conducting research to achieve such laudable goals is necessarily associated with a broad set of ethical challenges. This review aims at describing key findings from selected peer-reviewed literature published in the last 2 years (2018–2019) that enhance understanding of some of these issues. Recent findings A variety of ethical issue...
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

In-vitro and in-vivo models for hepatitis B cure research
Purpose of review Antiviral therapy for chronic hepatitis B infection is rarely curative, thus research in HBV cure strategies is a priority. Drug development and testing has been hampered by the lack of robust cell culture systems and small animal models. This review summarizes existing models for HBV cure research and focuses on recent developments since 2017 until today. Recent findings The field has progressed in the development of cell culture and animal models to study HBV. Although early cell culture systems relied on transfection of HBV genomes in hepatoma cell lines, novel models expressing the entry receptor...
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Direct-acting antivirals and viral RNA targeting for hepatitis B cure
This article is designed to summarize the HBV life cycle in order to review the current treatment strategies and compounds targeting different points of the virus life cycle, which are either in preclinical or clinical phases. Recent findings Recently our developed understanding of the HBV life cycle has enabled the development of multiple novel treatment options, all aiming for functional cure. Summary It is likely that combinations of novel treatments will be needed to achieve a functional cure, including those that target the virus itself as well as those that target the immune system. (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Shared immunotherapeutic approaches in HIV and hepatitis B virus: combine and conquer
Purpose of review The aim of this study was to identify similarities, differences and lessons to be shared from recent progress in HIV and hepatitis B virus (HBV) immunotherapeutic approaches. Recent findings Immune dysregulation is a hallmark of both HIV and HBV infection, which have shared routes of transmission, with approximately 10% of HIV-positive patients worldwide being coinfected with HBV. Immune modulation therapies to orchestrate effective innate and adaptive immune responses are currently being sought as potential strategies towards a functional cure in both HIV and HBV infection. These are based on activa...
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Editorial: Strategies and barriers for hepatitis B cure: implications for HIV
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: HIV AND HEPATITIS B CURE: Edited by Sharon R. Lewin and Peter A. Revill Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - April 6, 2020 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

What lessons it might teach us? Community engagement in HIV research
Purpose of review Partnerships between academia and the community led to historic advances in HIV and paved the way for ongoing community engagement in research. Three decades later, we review the state of community engagement in HIV research, discuss best practices as supported by literature, explore innovations, and identify ongoing gaps in knowledge. Recent findings The community of people living with and at risk for HIV remains actively involved in the performance of HIV research. However, the extent of participation is highly variable despite long standing and established principles and guidelines of good partici...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

HIV, aging, and adherence: an update and future directions
Purpose of review To highlight recent data on antiretroviral adherence in older people living with HIV (PLWH), describe the most relevant pharmacokinetic antiretroviral studies, and identify critical research gaps in this population. Recent findings Overall, studies have found that older PLWH are more likely to be adherent to antiretroviral therapy (ART). Although multiple methods to measure adherence are available (self-report, pharmacy refills, electronic device monitors, drug concentrations), there is currently no ‘gold standard’ adherence measure or sufficient evidence to suggest a preferred method in ...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

Polypharmacy in HIV: recent insights and future directions
Purpose of review Update findings regarding polypharmacy among people with HIV (PWH) and consider what research is most needed. Recent findings Among PWH, polypharmacy is common, occurs in middle age, and is predominantly driven by nonantiretroviral (ARV) medications. Many studies have demonstrated strong associations between polypharmacy and receipt of potentially inappropriate medications (PIMS), but few have considered actual adverse events. Falls, delirium, pneumonia, hospitalization, and mortality are associated with polypharmacy among PWH and risks remain after adjustment for severity of illness. Summary Poly...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

Antiretroviral therapy in older people with HIV
Purpose of review The age of people with HIV) continues to rise, and yet older people have tended to be under-represented or excluded from premarketing studies of antiretroviral therapy (ART). In this review, we highlight special considerations for the use of ART in older people with HIV, with a focus on toxicities associated with specific antiretroviral agents or drug classes as well as key research questions moving forward. Recent findings Like all people with HIV, older people with HIV should be started on ART as soon as possible, regardless of CD4 count, and with a regimen that includes an integrase strand transfe...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

Multimorbidity patterns in people with HIV
Purpose of review With the progressive aging of populations of people with HIV (PWH), multimorbidity is increasing. Multimorbidity patterns, that is groups of comorbidities that are likely to co-occur, may suggest shared causes or common risk factors. We review the literature regarding multimorbidity patterns identified with data-driven approaches and discuss the methodology and potential implications of the findings. Recent findings Despite the substantial heterogeneity in the methods used to identify multimorbidity patterns, patterns of mental health problems, cardiovascular diseases, metabolic disorders and musculo...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

Mitochondria and ageing with HIV
Purpose of review Some older people living with HIV (PLWH) exhibit features of unsuccessful ageing, such as frailty. Mitochondrial dysfunction is one of the best characterized ageing mechanisms. There has been recent interest in whether some people ageing with HIV may have an excess of mitochondrial dysfunction. This review aims to address this question through: analogy with ageing and chronic disease; discussion of the key unknowns; suggested ways that measures of mitochondrial dysfunction might be incorporated into HIV research studies. Recent findings Recent data suggest that mitochondrial dysfunction in PLWH may n...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

What is the collective effect of aging and HIV on the gut microbiome?
Purpose of review Aging and HIV share features of intestinal damage and alterations in the communities of enteric bacteria, termed dysbiosis. The purpose of this review is to highlight the various features of the gut microbiome in aging and in people with HIV (PWH) and to discuss how aging and HIV converge to impact the gut microbiome. The term microbiome reflects the combined genetic material of micro-organisms present including bacteria, viruses, bacteriophages, and fungi. To date, the majority of studies investigating the impact of aging and HIV on the gut microbiome have focused on bacteria, and therefore, for the pu...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

Senotherapeutics for HIV and aging
Purpose of review To summarize the state of chronic, treated HIV infection and its contribution to accelerated aging, and to evaluate recent research relevant to the study and treatment of aging and senescence. Recent findings Chronic treated HIV-1 infection is associated with significant risk of end-organ impairment, non-AIDS-associated malignancies, and accelerated physiologic aging. Coupled with the chronologic aging of the HIV-1-positive population, the development of therapies that target these processes is of great clinical importance. Age-related diseases are partly the result of cellular senescence. Both immun...
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

Editorial: Forging new frontiers in HIV and aging
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: HIV AND AGING: Edited by Kristine M. Erlandson Source Type: research

Editorial introduction
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - February 3, 2020 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTION Source Type: research

The only way is up: priorities for implementing long-acting antiretrovirals for HIV prevention and treatment
Purpose of review Long-acting HIV treatment and prevention (LAHTP) can address some of the achievement gaps of daily oral therapy to bring us closer to achieving Joint United Nations Programme on HIV/AIDS Fast-track goals. Implementing these new technologies presents individual-level, population-level, and health systems-level opportunities and challenges. Recent findings To optimize LAHTP implementation and impact, decision-makers should define and gather relevant data to inform their investment case within the existing health systems context. Programmatic observations from scale-up of antiretroviral therapy, oral pr...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Behavioral and social science research to support accelerated and equitable implementation of long-acting preexposure prophylaxis
Purpose of review The sociobehavioral research agenda for HIV prevention urgently needs to progress beyond research on end user preferences to examine how to best support patient access, engagement, and choice in the rollout of long-acting modalities. We outline critical challenges for an era of choice in biomedical prevention that could benefit from the rigorous application of sociobehavioral research methods. Recent findings Research in three areas could accelerate implementation of long-acting antiretrovirals for prevention: integrating dual process models into research on patient decision-making and behavior; iden...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Considerations and challenges in developing novel long-acting antiretrovirals modalities for treatment and prevention of HIV-1 infection: a regulatory perspective
Purpose of review Outline some regulatory considerations and scientific challenges related to the development of long-acting antiretrovirals (ARVs) for the treatment and prevention of HIV-1 infection. Recent findings Poor adherence to oral ARV regimens continues to pose challenges for effective treatment and prevention of HIV-1 infection. The development of long-acting ARV modalities for treatment and prevention of HIV-1 infection is emerging as a promising alternative to the current treatment and prevention paradigm and has gained considerable interest. Summary The development of long-acting ARVs can present some ...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Statistical approaches to accelerate the development of long-acting antiretrovirals for HIV pre-exposure prophylaxis
Purpose of review This review considers statistical issues in the design and analysis of the studies used to develop long-acting formulations of antiretrovirals for pre-exposure prophylaxis (PrEP). Recent finding An abundant pipeline of products is maturing. Accelerating their evaluation as clinical products requires abandonment of noninferiority standards. Randomized trials should be based on the comparison of principled but innovative estimates of background HIV risk and enrich enrollment for those who do not desire current PrEP products. At every stage of testing, innovative analyses can be applied to help inform a...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Broadly neutralizing antibodies for the treatment and prevention of HIV infection
Purpose of review Several anti-HIV-1 broadly neutralizing antibodies (bNAbs) with exceptional breadth and potency, and targeting different HIV-1 envelope epitopes have entered clinical trials. bNAbs are being evaluated for their potential as long-acting alternatives to antiretrovirals in HIV-1 prevention and therapy, and for potential role in strategies aiming at long-term viral remission. Here, we discuss recent findings from bNAb clinical studies. Recent findings bNAbs targeting distinct HIV-1 envelope epitopes have shown, in general, favorable safety profiles, and engineered bNAb variants have demonstrated improved...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Topical delivery of long-acting antiretrovirals to prevent HIV acquisition
Purpose of review Although tremendous successes in HIV treatment and prevention have occurred in the past decade, existing HIV prevention options are inadequate, unacceptable or inaccessible to many. Topical antiretroviral-based preexposure prophylaxis (PrEP) options may offer effective, long-acting prevention to those who do not desire systemic exposure to anti-HIV drugs or who want greater control over their own prevention. Recent findings Among long-acting topical PrEP agents, the dapivirine vaginal ring has advanced the furthest in product development; recent studies have shown high adherence and persistence and e...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Long-acting implants to treat and prevent HIV infection
Purpose of review Subcutaneous implants are a promising technology to enable long-acting parenteral delivery of antiretroviral drugs (ARV) because they may be able to provide protective drugs concentrations for a year or longer following a single implant. The present review covers the current status of preclinical and clinical development of antiretroviral implants. Recent findings Over the past three decades, subcutaneous implants have been widely used for long-acting hormonal contraception and the treatment of hormonally-driven malignancies. They are economical and scalable to manufacture, but require special proced...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Islatravir for the treatment and prevention of infection with the human immunodeficiency virus type 1
Purpose of review To discuss the potential role of islatravir (ISL), a novel reverse transcriptase translocation inhibitor, in the treatment and prevention of human immunodeficiency virus type 1 (HIV-1) infection. Recent findings Islatravir (4′-ethynyl-2-fluoro-2′-deoxyadenosine, MK-8591) is a long-acting first-in-class nucleoside reverse transcriptase translocation inhibitor with the potential for versatile dosing routes and dosing intervals. It demonstrated robust antiviral activity when dosed once daily and once weekly in HIV-1-infected individuals and SIV-infected rhesus macaques. In clinical trials of...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Long-acting injectable cabotegravir for the prevention of HIV infection
Purpose of review This review highlights the development of long-acting injectable cabotegravir (CAB LA) for HIV preexposure prophylaxis (PrEP), with a focus on phase 2 studies and later development. Recent findings Early studies of CAB LA for HIV prevention offered promising pharmacokinetic data and paved the way for phase 2 studies, which have now been completed. On the basis of phase 2 data, dosing of CAB LA at 8-week intervals consistently delivers target trough concentrations in both men and women. Recent studies have shown no required dose adjustments for hepatic or renal disease and minimal drug--drug interacti...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Long-acting injectable therapy: an emerging paradigm for the treatment of HIV infection
Purpose of review Long-acting formulations of antiretrovirals have the potential to reshape the treatment paradigm for HIV infection. Emerging evidence demonstrates efficacy and safety of two drug regimens for the treatment of HIV infection. This review focuses on recent advances with long-acting cabotegravir and rilpivirine administered intramuscularly every 4 weeks for the treatment of HIV infection in virologically suppressed patients. Recent findings Despite the development of complete, orally administered single tablet regimens with improved efficacy, side effects, tolerability, with an improved drug interaction ...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

HIV treatment and prevention 2019: current standards of care
Purpose of review The purpose of this review is to summarize the current standards of care for both HIV treatment and HIV prevention in 2019. Recent findings Current HIV treatment is started as soon as feasible in a person with HIV infection and consists of a three-drug oral daily antiretroviral regimen, consisting of two nucleoside analogue reverse transcriptase inhibitors combined with a third drug, either an integrase inhibitor, a non-nucleoside reverse transcriptase inhibitor, or a protease inhibitor. Present treatment regimens are potent, convenient, generally well tolerated and durable, and lead to a normal life...
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Introduction: long-acting antiretrovirals for the treatment and prevention of HIV-1 infection: the future is now
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: LONG ACTING ART FOR TREATMENT AND PREVENTION: Edited by Martin Markowitz Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - December 5, 2019 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Treatment as prevention trials and ending AIDS: what do we know, when did we know it, and what do we do now?
Purpose of review HIV remains a significant global public health problem. Treatment as prevention of HIV and TB illness, death and transmission was proposed in 2006 as a means to end the HIV epidemic. We review the results of the treatment as prevention trials. Recent findings Some of the trials struggled with delivering services, however, most demonstrate that it is feasible to achieve at least the 90–90–90 target by scaling access to test-and-treat at the community level and by extension at the district or national level. Patients, if offered, will start and stay on immediate treatment even without sympt...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research

The cost of reaching the 90–90–90 targets: are current investments enough?
Purpose of review The 90–90–90 targets were launched with the aim of reaching specific milestones by 2020. To support these targets, modeling has shown that additional resources are needed. This review examines what is known about current investments for HIV in low and middle-income countries, resource needs, and the potential for additional investment. Recent findings Reaching the 90–90–90 targets would place the global community on track to end the AIDS epidemic by 2030, significantly improving health outcomes and reducing future spending needs. Recent analyses indicate, however, that funding...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research

Fast-Track Cities: striving to end urban HIV epidemics by 2030
Purpose of review To provide a summary of progress achieved, lessons learned, and best practices employed in select Fast-Track Cities striving to attain and surpass the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90–90–90 targets. Recent findings The 90–90–90 targets have served as a catalyst to galvanize political, programmatic, and funding support for urban HIV responses, while prompting increased community engagement. More than 300 cities and municipalities have joined the Fast-Track Cities network, pledging to attain and surpass the UNAIDS 90–90–90 targets. One city has ...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research

Reaching the second 90: the strategies for linkage to care and antiretroviral therapy initiation
We present recent literature describing interventions for linkage to HIV care in the era of Universal Test and Treat (UTT) policies. We also provide information for ongoing studies of linkage to care strategies registered with ClinicalTrials.gov. Recent findings Differentiated service delivery for linkage to care involves implementing strategies that simplify and adapt HIV services to better serve individual needs and reduce unnecessary burdens on the health system. Recent strategies have focused not only on clinic-based populations testing for HIV but also emphasize community-based services and HIV self-testing, which ...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research

The first 90: the gateway to prevention and care: opening slowly, but not for all
Purpose of review Knowledge of HIV status is the gateway to HIV treatment and prevention, and optimizing this pillar is essential to bend the curve of the HIV epidemic toward zero new infections. This review will discuss the epidemiology of serostatus awareness, including disparities among key populations, and explore interventions and societal barriers. Recent findings Rates of serostatus awareness have improved overall; however, progress is lagging in many regions, nations and populations, with substantial disparities seen among key populations. These populations and their partners now contribute the majority of new...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research

Harnessing digital data and data science to achieve 90–90–90 goals to end the HIV epidemic
Purpose of review Effective public health interventions depend on timely, accurate surveillance. Harnessing digital data (including internet searches, social media, and online media) and data science is an emerging approach to complement traditional surveillance in public health but has been underutilized in HIV prevention and treatment. Recent findings We highlight recent examples that illustrate how social media data can be applied to HIV surveillance and prevention interventions. Summary To achieve 90–90–90 goals to end the HIV epidemic, we encourage traditional public health researchers to partner w...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research

Challenges of reaching 90–90–90 in the Southern United States
Purpose of review More than half of new HIV diagnoses occur in the Southern United States where the epidemic disproportionately affects persons of color. Although other areas of the country are seeing dramatic declines in the number of new cases, the progress in the South lags behind. This review will examine the reasons for that disparity. Many are unique to the South. Recent findings Despite advances in antiretroviral therapy for HIV, many in the South are not benefiting from these medications, at either a personal or public health level. The reasons are complex and include lack of access to healthcare, lower levels...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research

Can the United States achieve 90–90–90?
Purpose of review To summarize recent trends in knowledge of HIV status, care and viral suppression, and the status of implementation of relevant contextual requirements for the United States to achieve the 90–90–90 goals. Recently, the US government announced a plan to decrease HIV incidence by over 90% by 2030. Reaching this goal may require higher targets than 90–90–90. Recent findings The United States is on course to reach 90–90–90 goals in the near future, with 86% of persons with HIV aware of their infection, 74% of persons with diagnosed infection in care, and 83% of persons...
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: ENDING HIV: PROGRESS TO 90–90–90: Edited by Carlos del Rio Source Type: research