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 older pa...
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
