Prevention of heart failure, tachyarrhythmias and sudden cardiac death in HIV
Purpose of review
To summarize the state-of-the-art literature on the epidemiology, disease progression, and mediators of heart failure, tachyarrhythmias, and sudden cardiac death in people living with HIV (PLWH) to inform prevention strategies.
Recent findings
Recent studies corroborate the role of HIV as a risk enhancer for heart failure and arrhythmias, which persists despite adjustment for cardiovascular risk factors and unhealthy behaviors. Immune activation and inflammation contribute to the risk. Heart failure occurs more frequently at younger ages, and among women and ethnic minorities living with HIV, h...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CARDIOVASCULAR DISEASE: Edited by Virginia A. Triant Source Type: research
Editorial: HIV and cardiovascular disease: recognizing and reducing disparities
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CARDIOVASCULAR DISEASE: Edited by Virginia A. Triant Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research
Broadly neutralizing antibodies for treatment and prevention of HIV-1 infection
Purpose of review
Anti-HIV-1 broadly neutralizing antibodies (bNAbs) are promising agents in the fight against the AIDS epidemic. Multiple bNAbs have been already evaluated in clinical trials with encouraging results. This review discusses the use of bNAbs for the prevention and treatment of HIV-1 infection, focusing on manufactured products that have been evaluated in clinical settings.
Recent findings
More than 17 bNAbs have been evaluated for safety and pharmacokinetics in humans. The vast majority presented a well tolerated profile and were generally well tolerated. Serum half-life varied from 12 to 73.5 d...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: SPECIAL COMMENTARIES Source Type: research
Role of islatravir in HIV treatment and prevention: an update
Purpose of review
To summarize recent updates on the potential role of islatravir for HIV treatment and prevention.
Recent findings
Islatravir is an investigational antiretroviral agent with unique pharmacologic properties that facilitate flexible dosing regimens. Islatravir has demonstrated potent antiviral activity and a high barrier to resistance when combined with doravirine and lamivudine. A simplified two-drug HIV treatment regimen of islatravir combined with doravirine has also demonstrated comparable efficacy to standard of care three-drug regimens. The long half-life and high potency of islatravir's act...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: SPECIAL COMMENTARIES Source Type: research
Epidemiology of HIV drug resistance in low- and middle-income countries and WHO global strategy to monitor its emergence
Purpose of review
This review summarises the latest information of the epidemiology of HIV drug resistance (HIVDR) in low- and middle-income countries and the updated WHO global strategy for HIVDR surveillance and monitoring.
Recent findings
Finding from recent national-representative surveys show a rise in pretreatment drug resistance (PDR) to reverse transcriptase inhibitors and especially to the class of nonnucleoside reverse transcriptase inhibitors. Levels of PDR are especially high in infants (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: HIV DRUG RESISTANCE: CURRENT KNOWLEDGE AND EXISTING GAPS: Edited by Mike Kozal and Rami Kantor Source Type: research
Technologies for HIV-1 drug resistance testing: inventory and needs
Purpose of review
HIV-1 drug resistance (HIV DR) testing is routinely performed by genotyping plasma viruses using Sanger population sequencing. Next-generation sequencing (NGS) is increasingly replacing standardized Sanger sequencing. This opens up new opportunities, but also brings challenges.
Recent findings
The number of NGS applications and protocols for HIV DR testing is increasing. All of them are noninferior to Sanger sequencing when comparing NGS-derived consensus sequences to Sanger sequencing-derived sequences. In addition, NGS enables high-throughput sequencing of near full-length HIV-1 genomes and d...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: HIV DRUG RESISTANCE: CURRENT KNOWLEDGE AND EXISTING GAPS: Edited by Mike Kozal and Rami Kantor Source Type: research
How could HIV-1 drug resistance impact preexposure prophylaxis for HIV prevention?
Purpose of review
To review current laboratory and clinical data on the frequency and relative risk of drug resistance and range of mutations selected from approved and investigational antiretroviral agents used for preexposure prophylaxis (PrEP) of HIV-1 infection, including tenofovir disproxil fumarate (TDF)-based oral PrEP, dapivirine ring, injectable cabotegravir (CAB), islatravir, lenacapavir and broadly neutralizing antibodies (bNAbs).
Recent findings
The greatest risk of HIV-1 resistance from PrEP with oral TDF/emtricitabine (FTC) or injectable CAB is from starting or continuing PrEP after undiagnosed acu...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: HIV DRUG RESISTANCE: CURRENT KNOWLEDGE AND EXISTING GAPS: Edited by Mike Kozal and Rami Kantor Source Type: research
HIV drug resistance in various body compartments
Purpose of review
HIV drug resistance testing using blood plasma or dried blood spots forms part of international guidelines. However, as the clinical utility of assessing drug resistance in other body compartments is less well established, we review this for blood cells and samples from other body compartments.
Recent evidence
Although clinical benefit is not clear, drug resistance testing in blood cells is often performed when patients with suppressed plasma viral loads require a treatment substitution. In patients with HIV neurocognitive disease, cerebral spinal fluid (CSF) drug resistance is rarely discordan...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: HIV DRUG RESISTANCE: CURRENT KNOWLEDGE AND EXISTING GAPS: Edited by Mike Kozal and Rami Kantor Source Type: research
Safety of oral tenofovir disoproxil - emtricitabine for HIV preexposure prophylaxis in adults
Purpose of review
This review focuses on the safety of oral tenofovir disoproxil and emtricitabine (FTC) combination for HIV preexposure prophylaxis (PrEP) in adults.
Recent findings
Gastrointestinal adverse events are common after treatment initiation but usually resolve within weeks. Although clinical trials did not report an increased risk of serious renal adverse events or tubulopathy, meta-analyses suggest that tenofovir disoproxil -FTC is associated with a slight but non-clinically relevant decline in estimated glomerular filtration rate (eGFR). A decline to less than 60 mL/min remains a rare event, whic...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: PREP (PRE-EXPOSURE PROPHYLAXIS): Edited by Jean-Michel Molina Source Type: research
The future of long-acting agents for preexposure prophylaxis
Purpose of review
The main reason for the failure of oral preexposure prophylaxis (PrEP) regimens for HIV is poor adherence. Intramuscular cabotegravir was recently approved for PrEP, and a number of other long-acting antiretroviral formulations and products are currently in clinical development. This includes subcutaneous and intravenous injections, implants, and microarray (microneedle) patches, as well as extended duration oral drugs. The success and future uptake of these products will depend on a variety of factors.
Recent findings
Long-acting delivery of antiretroviral agents for PrEP confers significant a...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: PREP (PRE-EXPOSURE PROPHYLAXIS): Edited by Jean-Michel Molina Source Type: research
Promises and challenges: cabotegravir for preexposure prophylaxis
Purpose of review
Tenofovir-based oral PrEP has been effective in reducing population-level HIV incidence in multiple settings, although disparities remain. Injectable cabotegravir-based PrEP is an alternative that may be attractive to individuals with adherence challenges or who do not desire to take a daily medication. We review promises and challenges of cabotegravir-based PrEP.
Recent findings
Cabotegravir has demonstrated higher effectiveness than oral PrEP in two randomized trials, with a hazard ratio of 0.31 for HIV incidence among MSM and transgender women across multiple settings [95% confidence interva...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: PREP (PRE-EXPOSURE PROPHYLAXIS): Edited by Jean-Michel Molina Source Type: research
The predictive value of macaque models of preexposure prophylaxis for HIV prevention
Purpose of review
We review macaque models for preexposure prophylaxis (PrEP) for HIV prevention and highlight their role in advancing currently approved and novel PrEP agents.
Recent findings
The development of the repeat low dose simian HIV (SHIV) challenge models represented a significant advancement in preclinical PrEP modeling that has allowed the investigation of PrEP under conditions that better mimic HIV exposures in humans. These models incorporate relevant drug pharmacology to inform drug correlates of PrEP protection. Models of rectal, vaginal, and penile infection are now available and have been foun...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: PREP (PRE-EXPOSURE PROPHYLAXIS): Edited by Jean-Michel Molina Source Type: research
Scaling up preexposure prophylaxis to maximize HIV prevention impact
Purpose of review
Ten years since the first regulatory approval of oral HIV preexposure prophylaxis (PrEP), this review summarizes PrEP uptake, the role of ambitious PrEP targets, emerging evidence of impact on the HIV epidemic and innovative approaches to increasing PrEP uptake.
Recent findings
PrEP uptake among people at risk of HIV has been slow, but has accelerated in recent years, particularly in gay and bisexual men in a limited number of high-income settings and recently in heterosexuals at risk of HIV in sub-Saharan Africa. However, UNAIDS 2020 PrEP targets and HIV prevention targets were missed by large...
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: PREP (PRE-EXPOSURE PROPHYLAXIS): Edited by Jean-Michel Molina Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - July 1, 2022 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research
