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

Is reaching 90–90–90 enough to end AIDS? Lessons from Amsterdam
Purpose of review Although cities present opportunities for infectious pathogens such as HIV to spread, public health infrastructure within these cities also provides opportunities to design effective approaches to eliminate transmission of these pathogens. The HIV Transmission Elimination AMsterdam (H-TEAM) Initiative, a consortium of relevant stakeholders involved in HIV prevention and care, designed an integrated approach to curb the HIV epidemic in Amsterdam, including providing preexposure prophylaxis (PrEP), increasing awareness of acute HIV infection, offering same-day test and treat, and improving indicator disea...
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 90–90–90 in rural communities in East Africa: lessons from the Sustainable East Africa Research in Community Health Trial
Purpose of review There is an urgent need to understand new population-level approaches that achieve high levels of treatment and viral suppression for persons living with HIV. Recent findings The SEARCH Universal test and treat (UTT) trial conducted in Kenya and Uganda aimed to reduce HIV incidence and improve community health. SEARCH offered HIV and multidisease testing at health fairs followed by home testing for nonparticipants in 32 communities, each with approximately 10 000 persons. In the 16 intervention communities, UNAIDS 90–90–90 targets were achieved within 3 years, reaching ‘92–9...
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 90–90–90 in Botswana
Purpose of review Botswana, a small country in southern Africa, has had a very high prevalence of HIV since about 1995. It seems important to analyze the response of this country to help us understand how it became one of the first nations to achieve the 90–90–90 targets. Recent findings Botswana began a national program for treatment of HIV/AIDS with ARVs in 2002. Initially established in the four largest population centers, it expanded to more than 30 sites throughout the country by 2004. Also in 2004, an ‘opt out’ system for HIV testing was introduced. The government-sponsored ARV regimen fo...
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

Editorial: Can we end HIV as a public health problem globally? Progress towards achieving the UNAIDS 90–90–90 goals
No abstract available (Source: Current Opinion in HIV and AIDS)
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

Editorial introduction
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - October 7, 2019 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTION Source Type: research

Universal health coverage and key populations
Purpose of review There is renewed focus at global and national level to adopt commitments to ensure universal access to health services. The present study highlights key considerations to ensure that the commitment to ‘leave no one behind’ includes key populations, recognizing the specific impact of marginalization, stigma, discrimination, and criminalization on their access to health. Recent findings Universal health coverage (UHC) means that all people can use the promotive, preventive, curative, rehabilitative, and palliative health services they need, of sufficient quality to be effective, while also ...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Comprehensive HIV risk reduction interventions for 2020 and beyond: product choices and effective service-delivery platforms for individual needs and population-level impact
Purpose of review This review summarizes key HIV prevention strategies in the 2020 toolkit and discusses opportunities to maximize the public health impact of these prevention interventions at a population level. Recent findings HIV prevention has relied on counseling, HIV testing, and condom distribution for the past three decades. Recent exciting work has provided evidence on effective HIV prevention interventions, including antiretroviral therapy for HIV prevention, expanding preexposure prophylaxis modalities, and voluntary medical male circumcision which all reduce individual-level HIV risk. Efficient service-del...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Prisons: ignore them at our peril
Purpose of review People with HIV and HCV are concentrated within criminal justice settings globally, primarily related to criminalization of drug use. This review examines updated prevention and treatment strategies for HIV and HCV within prison with a focus on people who inject drugs and the challenges associated with the provision of these services within prisons and other closed settings and transition to the community. Recent findings The prevalence of HIV and HCV are several-fold higher in the criminal justice system than within the broader community particularly in regions with high prevalence of injecting drug...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Transforming lives and empowering communities: evidence, harm reduction and a holistic approach to people who use drugs
We describe the current environment and review recent innovations and responses, including peer distribution of naloxone, low dead space syringes, drug consumption rooms and drug-checking services. However, despite efforts by people who use drugs and supporting partners to sustain harm reduction services and to develop and implement novel interventions, programmes are often under-scaled and under-resourced and people who use drugs continue to face significant barriers to accessing services. Summary There is an urgent need to bring existing harm reduction programmes to scale and to broaden their scope, as well to complem...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Strategies to promote the meaningful involvement of sex workers in HIV prevention and care
Purpose of review We review the recent evidence regarding strategies for engaging sex workers in HIV prevention and care programs. We searched Pub Med on 19 March 2019 using terms ‘Sex Work’ And ‘HIV infections’. Our search was limited to articles published since 2017. Recent findings Community empowerment approaches where sex workers work collaboratively to address their specific priorities and concerns, including those beyond HIV, are those most likely to meaningfully engage sex workers. Community-driven programs that combine structural, behavioral and biomedical approaches can facilitate imp...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Strategies for engaging transgender populations in HIV prevention and care
Purpose of review Transgender (trans) populations are heavily impacted by HIV, yet face structural, social, and individual barriers to engagement in HIV prevention and care. In this review, we summarize the data on barriers and facilitators and discuss evidence-informed strategies to facilitate access to and engagement in HIV prevention and care by trans communities. Recent findings Intersectional stigma and discrimination at structural, community, individual levels present substantial impediments to HIV prevention and optimal care. Access to gender-affirming health care is a priority for trans communities. Where tran...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Strategies to improve access for MSM in low-income and middle-income countries
Purpose of review HIV prevention and treatment interventions for MSM are not well studied or reported from low-income and middle-income countries (LMIC) in comparison to those targeting gender-conforming populations. Some evidence-based strategies to engage MSM in appropriate healthcare have recently reported on their experiences and impact. Novel recruitment strategies have been developed for treatment and preexposure prophylaxis (PrEP) for MSM, leveraging new community engagement strategies and social media technologies. Recent findings Despite publication of several new guidelines, there is little recent evidence a...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Getting to grips with the HIV epidemic in Russia
Purpose of review In contrast to global patterns, the HIV epidemic in the Russian Federation continues to expand. The epidemic remains largely concentrated among key populations and their sexual partners but has the potential of affecting the general population. We have focused our analysis on legislative, policy-related, structural, and cultural obstacles that the country faces in confronting its epidemic. Recent findings The Russian Federation has the largest HIV epidemic in Europe. Recent epidemiological analyses have shown a decrease in the annual growth of new reported infections. However, stigma and discriminati...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Optimizing HIV prevention and treatment outcomes for persons with substance use in Central Asia: what will it take?
Purpose of review To summarize the status of HIV and substance use in Central Asia and discuss potential ways to move forward to effective epidemic control among people who inject drugs (PWID) in the region and beyond. Recent findings PWID and their partners remain the population most affected by HIV in Central Asia. Lack of effective substance use prevention and treatment options and limited involvement of PWID-led community-based organizations in HIV programs, combined with the requirement for official registration, stigma and discrimination of PWID, and criminalization of drug use remain key barriers to effective H...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

The HIV epidemic in Latin America: accomplishments and challenges on treatment and prevention
In conclusion, accomplishments have been made though challenges for fully addressing the HIV epidemic persist. The impact of both treatment and PrEP will be limited by the availability and prompt use of all services, including HIV testing. (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

The arc of HIV epidemics in sub-Saharan Africa: new challenges with concentrating epidemics in the era of 90–90–90
Purpose of review The aim of this review is to examine the emerging results from the HIV universal test and treat (UTT) cluster-randomized trials in sub-Saharan Africa, discuss how expanding access to HIV clinical services is likely to reshape the arc of HIV epidemics, and consider implications for HIV prevention and control strategies in the coming decade. Recent findings The effect of universal HIV testing followed by immediate antiretroviral treatment (ART) on community-level HIV incidence remains unclear upon completion of five randomized trials. Only two of the four trials that measured HIV incidence found signif...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Evolving HIV epidemics: the urgent need to refocus on populations with risk
Purpose of review To explore the comparative importance of HIV infections among key populations and their intimate partners as HIV epidemics evolve, and to review implications for guiding responses. Recent findings Even as concentrated epidemics evolve, new infections among current and former key population members and their intimate partners dominate new infections. Prevalent infections in the general population grow primarily because of key population turnover and infections among their intimate partners. In generalized epidemic settings, data and analysis on key populations are often inadequate to assess the impact...
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

Editorial: Concentrated epidemics: time for a rethink
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - August 5, 2019 Category: Infectious Diseases Tags: CONCENTRATED EPIDEMICS: Edited by Sheena McCormack, Rachel Baggaley and Kevin M. DeCock Source Type: research

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

Vaccinal effect of HIV-1 antibody therapy
Purpose of review The review recalls recent findings regarding the induction of vaccinal effects by HIV-1 broadly neutralizing antibodies (bNAbs) and highlights potential therapeutic strategies to exploit such immunomodulatory properties. Recent findings Studies in different animal models have shown that mAbs can generate long-lasting protective immunity. Induction of this vaccinal effect by HIV-1 bNAbs has also been more recently reported in animal models of HIV-1 infection. Notably, bNAbs treatment of macaques infected with the chimeric simian-human immunodeficiency virus (SHIV) improved both humoral and cellular ad...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Neutralizing antibodies for HIV-1 prevention
Purpose of review In the absence of a protective vaccine against HIV-1, passive immunization using novel broadly neutralizing antibodies (bNAbs) is an attractive concept for HIV-1 prevention. Here, we summarize the results of preclinical and clinical studies of bNAbs, discuss strategies for optimizing bNAb efficacy and lay out current pathways for the development of bNAbs as prophylaxis. Recent findings Passive transfer of second-generation bNAbs results inpotent protection against infection in preclinical animal models. Furthermore, multiple bNAbs targeting different epitopes on the HIV-1 envelope trimer are in clini...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Vaccine-induced V1V2-specific antibodies control and or protect against infection with HIV, SIV and SHIV
Purpose of review In humans, only one independent immunologic correlate of reduced risk of HIV infection has been identified: a robust antibody (Ab) response to the V1V2 domain of the gp120 envelope (Env) protein. In recent years, the presence and level of V1V2-specific Abs has also been correlated with protection from SIV and SHIV infections. Here, we review the multitude of studies showing the in-vivo protective effects of V1V2 Abs and review their immunologic characteristics and antiviral functions. Recent findings Structural and immunologic studies have defined four epitope families in the V1V2 domain: one epitope...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Presentation of HIV-1 envelope glycoprotein trimers on diverse nanoparticle platforms
Purpose of review We will discuss recent advances in the development of nanoparticle vaccines presenting HIV-1 envelope trimer vaccines and the immunological mechanisms by which they act. Recent findings The multivalent presentation of Env trimers on nanoparticles is a promising strategy to increase Env immunogenicity. Recent studies have shed light on how Env nanoparticles increase lymph node trafficking and germinal center formation by using the lectin-mediated complement pathway and enhancing the interaction with naïve B cells. Meanwhile, research on different nanoparticle platforms has resulted in improved de...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Targeting broadly neutralizing antibody precursors: a naïve approach to vaccine design
Purpose of review It is believed that broadly neutralizing antibodies (bNAbs) will be an important component of an effective HIV-1 vaccine. Several immunogens have been designed that can target specific precursor B cells as a first step in a vaccine strategy to elicit bNAbs. Recent findings Germline-targeting immunogens have been developed that specifically engage precursors of reproducible classes of anti-HIV antibodies, such as VRC01-class and apex-directed bNAbs. However, these precursors represent only a small portion of the immune repertoire and any antigen will inherently present off-target epitopes to the immun...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Coevolution of HIV-1 and broadly neutralizing antibodies
Purpose of review Exploring the molecular details of the coevolution of HIV-1 Envelope with broadly neutralizing antibodies (bNAbs) in infected individuals over time provides insights for vaccine design. Since mid-2017, the number of individuals described in such publications has nearly tripled. New publications have extended such studies to new epitopes on Env and provided more detail on previously known sites. Recent findings Studies of two donors – one of them an infant, the other with three lineages targeting the same site – has deepened our understanding of V3-glycan-directed lineages. A V2-apex-direc...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Correlates of broadly neutralizing antibody development
Purpose of review Broadly neutralizing antibodies (bnAbs) are considered a key component of an effective HIV-1 vaccine, but despite intensive efforts, induction of bnAbs by vaccination has thus far not been possible. Potent bnAb activity is rare in natural infection and a deeper understanding of factors that promote or limit bnAb evolution is critical to guide bnAb vaccine development. This review reflects on recent key discoveries on correlates of bnAb development and discusses what further insights are needed to move forward. Recent findings An increasing number of parameters have been implicated to influence bnAb d...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

HIV-1 antibodies in prevention of transmission
Purpose of review To present the data that suggest that antibodies to HIV may prevent HIV-1 infection. Recent findings Many human monoclonal broadly neutralizing antibodies (bnAbs) have been isolated over the last decade. Numerous experiments of passive immunization in nonhuman primate models have allowed to accumulate strong evidences that bnAbs, opposed to nonneutralizing antibodies, are the best candidates to prevent HIV-1 infection. bnAbs counteract HIV-1 by both blocking the virus at the portal of entry and clearing rapidly viral foci established at distance after dissemination of the virus following infection. C...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

A role for antibodies in natural HIV control
Purpose of review Rare patients naturally control HIV replication without antiretroviral therapy. Understanding the mechanisms implicated in natural HIV control will inform the development of immunotherapies against HIV. Elite controllers are known for developing efficient antiviral T-cell responses, but recent findings suggest that antibody responses also play a significant role in HIV control. We review the key studies that uncovered a potent memory B-cell response and highly functional anti-HIV antibodies in elite controllers, and explore the mechanisms that may account for the distinct properties of their humoral res...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Systems serology for decoding infection and vaccine-induced antibody responses to HIV-1
Purpose of review Experimental and analytical advances have enabled systematic, high-resolution studies of humoral immune responses, and are beginning to define mechanisms of immunity to HIV. Recent findings High-throughput, information-rich experimental and analytical methods, whether genomic, proteomic, or transcriptomic, have firmly established their value across a diversity of fields. Consideration of these tools as trawlers in ‘fishing expeditions’ has faded as ‘data-driven discovery’ has come to be valued as an irreplaceable means to develop fundamental understanding of biological systems...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Germinal centers B-cell reaction and T follicular helper cells in response to HIV-1 infection
Purpose of review This review aims to summarize the recent findings on germinal center B-cell reaction and Tfh cells in HIV-1 infection, with particular emphasis on the spatial organization of the germinal center, follicular cell regulation, and cellular alterations resulting from HIV infection. Recent findings HIV-specific bNAbs are generated by iterative cycles of B-cell maturation supported by GC environment. Recent observations underline that germinal center structural alterations at the earliest stages of HIV infection could impact Tfh cell and germinal center B-cell homeostasis, thus preventing the rise of effic...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

B-cell abnormalities in HIV-1 infection: roles for IgG3 and T-bet
Purpose of review Numerous B-cell abnormalities in HIV-1 infection have been described over the past three decades yet have remained poorly defined mechanistically. We review recent studies that describe mechanisms of B-cell dysregulation in chronic HIV-1 infection associated with IgG3 and T-bet. Recent findings HIV-1 infection causes hypergammaglobulinemia and dysregulation of B-cell populations, including the expansion during chronic viremia of functionally impaired tissue-like memory (TLM) B cells. TLM B cells and B cells in other conditions of chronic activation and inflammation with similar phenotypes are charact...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

The antibody response in HIV-1-infected donors
Purpose of review Although the goal of preventive HIV vaccine design is primarily the induction of broadly neutralizing antibodies (bNAbs), recent evidence suggests that a protective response will also benefit from Fc effector functions. Here, we provide an update on the antibody response to HIV infection, including both Fab and Fc-mediated antibody responses. We also highlight recent studies showing the interplay between these functions, focusing primarily on studies published in the last year. Recent findings Identification and characterization of bNAb donors continues to provide insights into viral factors that are...
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: BROAD NEUTRALISING AND NON-NEUTRALISING ANTIBODIES: Edited by Hugo Mouquet and Olivier Schwartz Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - June 3, 2019 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

HIV-1 phylogenetics and vaccines
We describe the vaccine regimens that are currently tested in two vaccine efficacy trials and recent research highlighting HIV-1 genetic features that were associated with the development of broadly neutralizing antibodies. Summary Compared with how widely HIV-1 diversity is recognized as a critical issue for vaccine research, relatively few genetically informed vaccine solutions have been compared, in part because the lack of correlates of protection against HIV-1 limits the ability to develop and test multiple vaccine candidates in a fully rational manner. Yet, recent findings have provided a better understanding of t...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

Ethical issues in HIV phylogenetics and molecular epidemiology
Purpose of review HIV phylogenetic and molecular epidemiology analyses are increasingly being performed with a goal of improving HIV prevention efforts. However, ethical, legal and social issues are associated with these analyses, and should be considered when performed. Recent findings Several working groups have recently outlined the major issues surrounding the use of molecular epidemiology for HIV prevention. First, the benefits of HIV molecular epidemiology remain unclear, and further work is needed to quantitatively demonstrate the benefits that can be expected. Second, privacy loss is an important risk, with im...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

Comparative analysis of HIV sequences in real time for public health
Purpose of review The purpose of this study is to summarize recent advances in public health applications of comparative methods for HIV-1 sequence analysis in real time, including genetic clustering methods. Recent findings Over the past 2 years, several groups have reported the deployment of established genetic clustering methods to guide public health decisions for HIV prevention in ‘near real time’. However, it remains unresolved how well the readouts of comparative methods like clusters translate to events that are actionable for public health. A small number of recent studies have begun to elucidate ...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

Understanding disclosed and cryptic HIV transmission risk via genetic analysis: what are we missing and when does it matter?
Purpose of review To discuss the recent HIV phylogenetic analyses examining HIV transmission patterns among and within risk groups. Recent findings Phylodynamic analysis has recently been applied to multiple HIV outbreaks among people who inject drugs to determine whether HIV transmission is ongoing. Large-scale analyses of datasets of HIV sequences collected for drug-resistance testing provide population-level insights into transmission patterns. One focus across world regions has been to investigate whether age-disparity is a driver of HIV transmission. In sub-Saharan Africa, researchers have examined transmission b...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

Clinical and evolutionary consequences of HIV adaptation to HLA: implications for vaccine and cure
Purpose of review The purpose of this review is to summarize recent advances in our understanding of HIV adaptation to human leukocyte antigen (HLA)-associated immune pressures and its relevance to HIV prevention and cure research. Recent findings Recent research has confirmed that HLA is a major driver of individual and population-level HIV evolution, that HIV strains are adapting to the immunogenetic profiles of the different human ethnic groups in which they circulate, and that HIV adaptation has substantial clinical and immunologic consequences. As such, adaptation represents a major challenge to HIV prevention an...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

Review: HIV-1 phylogeny during suppressive antiretroviral therapy
This article reviews methods for interrogating intrahost HIV-1 diversity, addresses the ongoing debate regarding HIV-1 compartmentalization and replication during ART, and summarizes recent findings on the effects of curative strategies on HIV-1 populations. Recent findings HIV-1 replication in the blood is virtually halted upon the initiation of ART. However, proliferation of cells infected prior to ART provides a self-renewing reservoir for infection during ART. Current evidence supports that proliferation of infected cells is a mechanism for HIV-1 persistence in both the blood and the tissues. However, more studies a...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

Phylogenetics in HIV transmission: taking within-host diversity into account
Purpose of review Within-host diversity complicates transmission models because it recognizes that between-host virus phylogenies are not identical to the transmission history among the infected hosts. This review presents the biological and theoretical foundations for recent development in this field, and shows that modern phylodynamic methods are capable of inferring realistic transmission histories from HIV sequence data. Recent findings Transmission of single or multiple genetic variants from a donor's HIV population results in donor-recipient phylogenies with combinations of monophyletic, paraphyletic, and polyph...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

PANGEA-HIV 2: Phylogenetics And Networks for Generalised Epidemics in Africa
Purpose of review The HIV epidemic in sub-Saharan Africa is far from being under control and the ambitious UNAIDS targets are unlikely to be met by 2020 as declines in per-capita incidence being largely offset by demographic trends. There is an increasing number of proven and specific HIV prevention tools, but little consensus on how best to deploy them. Recent findings Traditionally, phylogenetics has been used in HIV research to reconstruct the history of the epidemic and date zoonotic infections, whereas more recent publications focus on HIV diversity and drug resistance. However, it is also the most powerful metho...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research

Factors influencing HIV-1 phylogenetic clustering
Purpose of review A major goal of public health in relation to HIV/AIDS is to prevent new transmissions in communities. Phylogenetic techniques have improved our understanding of the structure and dynamics of HIV transmissions. However, there is still no consensus about phylogenetic methodology, sampling coverage, gene target and/or minimum fragment size. Recent findings Several studies use a combined methodology, which includes both a genetic or patristic distance cut-off and a branching support threshold to identify phylogenetic clusters. However, the choice about these thresholds remains an inherently subjective pr...
Source: Current Opinion in HIV and AIDS - April 6, 2019 Category: Infectious Diseases Tags: PHYLOGENETICS IN HIV TRANSMISSION: Edited by Morgane Rolland and Josh Herbeck Source Type: research