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AIDS Reviews

Joaquin Burgos, Esteban Ribera, Vicenç Falcó
Advanced HIV disease, defined as a CD4 cell count below 200 cells/μl or the presence of an AIDS-defining illness, remains common among HIV-infected individuals who first present for medical care. In developed countries, nearly 30% of new HIV diagnoses occurred at advanced stages of the disease, and it is important because advanced HIV disease has been associated with worse clinical outcomes, including lower rates of virological response, higher morbidity, and higher mortality. However, there are scarce data regarding which is the best antiretroviral regimen in these patients...
January 25, 2018: AIDS Reviews
Vicente Soriano, Benjamin Young, Nancy Reau
The International Conference on Viral Hepatitis 2017 brought exciting news on the treatment of viral hepatitis. The most recent estimates of the burden for hepatitis B virus and hepatitis C virus (HCV) infections were presented. The current gaps and prospects for regional and global eradication of viral hepatitis were discussed on the light of the WHO roadmap until 2030. Debates focused on hepatitis C and expectations using the new approved HCV pan-genotypic, once daily, oral direct-acting antivirals (DAAs), glecaprevir-pibrentasvir, and sofosbuvir-velpatasvir-voxilaprevir...
January 25, 2018: AIDS Reviews
Carmen de Mendoza
The latest estimate from the WHO is of nearly 37 million people living with HIV worldwide by the end of 2016. Roughly 20 million are receiving antiretroviral therapy. Despite this progress in diagnosis and treatment, nearly 2 million new HIV infections continue to occur annually. Whereas men having sex with men (MSM) represent the major risk population for incident cases in North America and the European Union, infection of heterosexual women is the major group in Sub-Saharan Africa. Injection drug use is a leading mechanism of HIV acquisition in Asia, including Russia and the former Soviet republics...
October 2017: AIDS Reviews
José Vicente Fernández-Montero, Esther J Aspinall, James E Burns
Long-term experience in the treatment of HIV-infected individuals has shown indirect benefits of early initiation of antiretroviral therapy, particularly in preventing HIV transmission. With the advent of direct-acting antivirals for the treatment of hepatitis C, the strategy of treatment-as-prevention has become feasible. However, economic, clinical, ethical, and public health issues arise from the concept of using therapeutic interventions only as prevention strategies.
October 2017: AIDS Reviews
Mohamed H Ahmed, Nazik Elmalaika Husain, Akif Malik, Clare Woodward, Dushyant Mital
With the advent and subsequent success of antiretroviral therapy, HIV infection has largely become a chronic condition and is increasingly seen alongside metabolic disorders such as dyslipidemia and insulin resistance. Furthermore, the administration of antiretroviral therapy itself is associated with an increase in the incidence of metabolic risk factors, namely insulin resistance, lipoatrophy, dyslipidemia, and abnormalities of fat distribution, in HIV patients. Thus, further challenges in the management of HIV patients include the management of diabetes and the metabolic syndrome, non-alcoholic fatty liver disease...
October 2017: AIDS Reviews
Pompeyo Viciana
During the past 30 years of antiretroviral therapy, continuous improvements in drug discovery have provided increasingly potent and safer antivirals that have transformed HIV infection in a chronic illness, rarely fatal. Non-nucleoside reverse-transcriptase inhibitors (NNRTIs) are frequently used as part of any antiretroviral combination therapy. Side effects and low resistance barrier of fi rst-generation NNRTIs (e.g., nevirapine and efavirenz) have been overcome with rilpivirine (RPV), and the last NNRTI approved for the treatment of HIV infection...
October 2017: AIDS Reviews
George A Yendewa, Robert A Salata
The introduction of combination antiretroviral therapy (ART) in the 1990s has fundamentally transformed the landscape of HIV medicine, greatly improved disease morbidity and mortality, and reduced transmission rates across all demographic groups. Central to this success was the idea that to achieve best disease outcomes and minimize the development of drug resistance, at least three antiretroviral agents should be used for HIV treatment. This therapeutic strategy is a core tenet of HIV medicine, backed by incontrovertible scientific evidence, and made easy to deploy by the high compliance levels with once-daily coformulations, which have generally been well tolerated...
October 2017: AIDS Reviews
Vicente Soriano
The huge success of current antiretroviral therapy is mediated by a triple effect: (i) Halting progression to AIDS in infected persons; (ii) reducing the risk of transmission to contacts (treatment as prevention); and (iii) minimizing the risk of HIV acquisition treating uninfected persons at risk (pre-exposure prophylaxis). However, UNAIDS has estimated that only 70% of infected people globally are diagnosed, only 53% are treated, and overall 44% have undetectable viral load, which is the necessary request for ensuring any antiretroviral benefit...
October 2017: AIDS Reviews
Eva Poveda, Michael L Freeman
Exosomes are nanovesicles that can be released into the extracellular medium by different cell types and are considered an important system of intercellular communication. In some instances, on secretion, exosomes break down and release their content into the extracellular space. Alternatively, intact exosomes can interact with other cells and discharge their content directly into the target cell cytoplasm. Exosomes are rich in endosome-associated proteins (i.e., the tetraspanin family) but also carry different molecules in their lumen including proteins, RNAs (i...
October 2017: AIDS Reviews
Anne C Spaulding, Emeli J Anderson, Mohammed A Khan, Cesar A Taborda-Vidarte, Jennifer A Phillips
Screening and treating correctional populations for HIV and HCV infections is essential to successfully addressing both epidemics in the USA. The prevalence of HIV and HCV infection is high in prisons and jails due to increased rates of incarceration among disproportionately affected groups such as injection drug users. Through a search of the published and grey literature and surveying persons overseeing health programs in prisons, we collected data on efforts to determine prevalence first for HIV and then for HCV...
October 2017: AIDS Reviews
Claudio Ucciferri, Katia Falasca, Jacopo Vecchiet
Hypertension is among the leading risk factors for cardiovascular disease and accounts for 6% of adult deaths worldwide. It is estimated that in 2013, hypertension was responsible for at least 45% of deaths due to heart disease and 51% of deaths due to stroke. Accordingly, management of hypertension and its long-term complications in HIV-infected subjects is a significant component of routine care. The choice of an effective anti-hypertensive therapy in HIV-infected patients is important and must be made carefully in order to prevent cardiovascular mortality and morbidity in these patients...
October 2017: AIDS Reviews
Dario Cattaneo, Alessandro Fossati, Chiara Resnati, Massimo Galli, Cristina Gervasoni
The treatment of hepatitis C virus in monoinfected and HIV-coinfected patients has greatly changed over recent years as a result of the introduction of direct-acting antiviral agents (DAAs), which have revolutionized clinical outcomes and led to sustained virological response rates above 90-95%. The discovery of new molecules and the subsequent competition between pharmaceutical companies, together with the negotiated price policies pursued by many national health systems, have led to a gradual reduction in the cost of DAAs, and expand their use to an increasing number of patients, including those with mild liver damage...
September 19, 2017: AIDS Reviews
Theofilos Chrysanthidis, Georgia Loli, Simeon Metallidis, Georgios Germanidis
Although there is evidence that HCV progresses rapidly in HIV/HCV coinfected patients in comparison with HCV monoinfected, the HIV-, HCV- and host/genetic-related factors, as well as the exact mechanisms implicated in this process are not fully elucidated. Furthermore, cure of HCV in those coinfected seems possible with the new antiviral drugs, but high cost as well as insufficient identification, linkage with care and treatment hamper the achievement of this goal. Research on the subject, could reveal an important prognostic marker for the effectiveness of persuasion of patients with HIV/HCV coinfection with a predicted accelerated fibrosis course, in order to facilitate and prioritize, not in terms of guidelines but in the real life situation, their treatment with a medically just framework...
September 19, 2017: AIDS Reviews
Valentina Svicher, Giulia Marchetti, Adrianna Ammassari, Francesca Ceccherini-Silberstein, Loredana Sarmati
The high potency and tolerability of the currently available antiretroviral drugs has modified HIV-1 infection from a life-threatening disease to a chronic illness. Nevertheless, some issues still remain open to optimize the management of HIV-1 infected patients in term of maintenance of virological suppression over time, identifying patients that could benefit from simplification therapy, and reducing co-mordibities driven by chronic inflammation. The availability of robust and affordable virological and immunological markers can help in solving these issues by providing information on the burden of HIV-1 reservoir in all the anatomical compartments in which the virus replicates as well as on persistent inflammation, immune activation and senescence despite successful virological suppression...
September 19, 2017: AIDS Reviews
José A Fernández-Caballero, Natalia Chueca, Eva Poveda, Federico García
Next-generation sequencing prototypes for the routine diagnosis of resistance to antiretrovirals approved for the treatment of HIV infection are now being used in many clinical diagnostic laboratories. As some of the next-generation sequencing platforms may be a source of errors, it is necessary to improve the currently available protocols and implement bioinformatic tools that may help to correctly identify the presence of resistance mutations with clinical impact. Several studies have addressed these issues in recent years...
May 23, 2017: AIDS Reviews
Joanna Smoleń-Dzirba, Magdalena Rosińska, Janusz Janiec, Marek Beniowski, Mariusz Cycoń, Jolanta Bratosiewicz-Wąsik, Tomasz J Wąsik
CC-chemokine receptor 5 serves as the coreceptor for the HIV-1 R5 strains, which are responsible for the majority of HIV transmissions. A deletion of 32 nucleotides in the gene encoding this receptor (termed CCR5-Δ32) leads to the suppression of CC-chemokine receptor 5 presentation at the cell surface, thus impeding process of HIV entry into the cell. Individuals homozygous for the CCR5-Δ32 allele are resistant to infection with HIV-1 R5 strains, and are extremely rare among HIV-1-infected individuals. We have described a case of person homozygous for CCR5-Δ32, who was infected with subtype B HIV-1...
May 23, 2017: AIDS Reviews
Philippe Halfon, Vicente Soriano
No abstract text is available yet for this article.
April 2017: AIDS Reviews
Josep Mallolas
Current antiretroviral therapy reaches and maintains viral suppression over the years in more than 90% of treated HIV-infected individuals. Although integrase inhibitors are the preferred third agent in antiretroviral therapy in the current guidelines, rilpivirine, a non-nucleoside reverse transcrip- tase inhibitor, and darunavir (DRV), a second-generation protease inhibitor, are the preferred third companion to be used along with a backbone of two nucleos(t)ide reverse transcriptase inhibitors as first-line triple HIV combination treatment...
April 2017: AIDS Reviews
Pablo Barreiro, Vicente Soriano
Hepatitis A virus (HAV) is a small RNA, non-enveloped agent predominantly transmitted via the fecal/oral route through person-to-person contact or contaminated food and water. The mean incubation period is 28 days (range: 15-50). Acute hepatitis A is always self-limited and very rarely fatal. Moreover, it never progresses to chronicity. Acutely infected persons are most likely to transmit HAV before the onset of jaundice, when viral particle concentration in stool is highest.
April 2017: AIDS Reviews
Eva Poveda, Manuelo Crespo
Several strategies to reduce and control the HIV reservoir are being evaluating to achieve the great challenge of HIV remission or functional cure. Some of these are based on immune and gene therapy, or in the use of agents with latency reversing properties. Moreover, acute HIV infection and the impact of early antiretroviral treatment (ART) initiation is another key issue of current research. It has been demonstrated that ART initiation during acute HIV infection minimizes the establishment of the latent HIV reservoir...
April 2017: AIDS Reviews
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