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 HBsAg lo...
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 issues in...
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
