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AIDS Reviews

Carmen de Mendoza
Budget constrictions have pushed some researchers to explore whether antiretroviral therapy with one or two drugs instead of the well-established triple-drug regimens may be able to maintain undetectable viremia in HIV-infected individuals, at least used as simplification in patients already with viral suppression under standard triple therapy. With the advent of co-formulations and the improved safety of the newest antiretroviral agents, there is no other reason than cost to justify moving from triple to dual or monotherapy...
October 2016: AIDS Reviews
Vicente Soriano
Two billion people have been exposed to HBV and exhibit serological markers of past infection such as anti-HBc and/or anti-HBs. However, around 240 million suffer from chronic hepatitis B, as defined by the presence of serum HBsAg for longer than six months. In addition, a small proportion of patients exposed to HBV may harbor detectable viremia (serum HBV DNA) in the absence of HBsAg, which is named "occult hepatitis B".
October 2016: AIDS Reviews
Jose V Fernandez-Montero
The increasing use of antiretrovirals for averting HIV infection before potential exposure is under debate. Whereas there is no doubt about the benefit of using Truvada® (tenofovir plus emtricitabine) to reduce HIV acquisition in uninfected persons who have sex with HIV-infected stable partners, concerns are rising about the increasing rate of sexually transmitted infections in subjects engaged in sex with multiple partners, due to misinterpreted self-security.
October 2016: AIDS Reviews
Joe Sasadeusz
Approximately 30% of HIV individuals are coinfected with HCV. It is known that HIV accelerates liver fibrosis progression, even with the use of combination antiretroviral therapy, and HCV is now a leading cause of morbidity and mortality in this patient population. Past HCV therapy with pegylated interferon and ribavirin in this setting has demonstrated poor outcomes, which were inferior to those seen in HCV-monoinfected populations, especially in patients with genotype 1 infections. This and the high rate of adverse events with these agents resulted in very limited uptake of these treatment options...
October 2016: AIDS Reviews
Chidozie U Nduka, Olalekan A Uthman, Peter K Kimani, Saverio Stranges
Although more than one in two HIV-infected persons may develop central fat accumulation soon after commencing antiretroviral therapy, the association between antiretroviral therapy and body fat changes has not been consistent across primary epidemiological studies. We conducted a systematic review with meta-analyses to estimate the pooled effects of antiretroviral therapy on different measures of body fat, and to examine factors that potentially modify these effects. We searched for studies that compared body mass index, waist circumference, combined overweight/obesity, and central obesity between HIV-infected adults naive and exposed to antiretroviral therapy...
October 2016: AIDS Reviews
Ching-Sheng Hsu, Jia-Horng Kao
Both human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection are important global public health problems with shared transmission routes. Although HIV/HCV coinfection is not uncommon, the prevalence rates vary significantly across different studies and regions. In Taiwan, injection drug users have become the major contributors to the HIV/AIDS epidemic since 2005. Because the prevalence of HCV infection is high in injection drug users, this HIV epidemic is also associated with a significant increase of HIV/HCV coinfection in Taiwan...
October 2016: AIDS Reviews
Blandine Aloy, Imane Tazi, Corinne Isnard Bagnis, Marion Gauthier, Nicolas Janus, Vincent Launay-Vacher, Gilbert Deray, Jérôme Tourret
Tenofovir disoproxil fumarate is currently the cornerstone of HIV treatment. Although it shows an overall good safety profile, numerous cases of nephrotoxicity have been reported. Tenofovir alafenamide is a novel tenofovir prodrug that has been developed to improve renal safety. Pharmacokinetic studies suggest a better renal tolerance of tenofovir alafenamide than tenofovir disoproxil fumarate, probably because tenofovir plasma concentrations are lower after tenofovir alafenamide administration. Consistently in clinical trials, renal tolerance seems to be improved in patients treated with tenofovir alafenamide...
October 2016: AIDS Reviews
Pawel Bonczkowski, Marie-Angélique De Scheerder, Ward De Spiegelaere, Linos Vandekerckhove
Due to the scarcity of HIV-1 latently infected cells in patients, in vitro primary latency models are now commonly used to study the HIV-1 reservoir. To this end, a number of experimental systems have been developed. Most of these models differ based on the nature of the primary CD4+ T-cell type, the used HIV strains, activation methods, and latency assessment strategies. Despite these differences, most models share some common characteristics. Here, we provide a systematic review covering the primary HIV latency models that have been used to date with the aim to compare these models and identify minimal requirements for such experiments...
October 2016: AIDS Reviews
Sara de la Fuente, Carmen de Mendoza
Despite the fact that HIV infection can still not be eradicated from carriers, tremendous advances in antiretroviral therapy have led to achieving sustained suppression of HIV replication in most treated individuals. This translates into huge benefits for both patients and their sexual partners. This message was emphasized during the last IAS Conference, held in Durban, South Africa, at the end of July 2016. In parallel with this major AIDS event, two major publications were released: the updated recommendations on HIV therapy and the PARTNER study...
July 2016: AIDS Reviews
Eva Poveda, Manuel Crespo
Highly active antiretroviral therapy (ART) has allowed a long-term control of viral replication and HIV infection has been transformed into a chronic disease. However, ART is not able to eradicate the virus, and high levels of inflammation and immune-activation are observed despite prolonged ART. Consequently, a number of comorbidities, such as cardiovascular diseases and cancer, are gaining relevance in patients living with HIV. Moreover, the toxicities associated with continued exposure to ART cause several metabolic disturbances with clinical relevance, and the cost of treatment is a heavy burden for the national health systems...
July 2016: AIDS Reviews
Jesús Troya, José Bascuñana
Following the introduction of triple combination therapy in 1996, the paradigm of HIV infection has been modified by its transformation into a chronic disease and thereby significantly reducing its morbidity and mortality. The spectrum of drugs in use since then has changed dramatically with the advent of more potent molecules, new classes of drugs aimed at novel therapeutic targets and their optimization and simplification through fixed-dose combinations that are more convenient for patients, and which, taken together, have led to sustained virologic response rates in treatment-naive patients of more than 90%...
July 2016: AIDS Reviews
Wei Zou, Lunli Zhang
In vitro studies have demonstrated that HIV-1 Nef has several important activities, promoting viral replication and pathogenesis. These activities include downregulation of cell surface molecules CD4 and major histocompatibility complex class I, enhancement of viral infectivity, activation of p21-activated kinase 2, and inhibition of immunoglobulin class switching. But how important each in vitro activity is to in vivo Nef function remains elusive. To address this question, several small animal models have been developed in the past two decades, such as Nef transgenic mice, SCID-hu mice, and humanized mice...
July 2016: AIDS Reviews
Adan Rios, Ethan C Pottet, Edward B Siwak, Dallas W Anderson, Qizhi C Yao
There is evidence that the transmission and acute phase of HIV infection triggers an immune response capable of controlling HIV subverted by the process of virus integration, essential to the replicative cycle of retroviruses. We review here two aspects that deserve consideration in light of recent developments concerning HIV transmission and vaccine development: vaccines directed against transmitted/founder viruses, and a reconsideration of inactivation as a viable means to obtain a preventive HIV vaccine...
July 2016: AIDS Reviews
Yanille Scott, Charlene S Dezzutti
Non-antiretroviral microbicide candidates were previously explored as a female-controlled method of preventing sexual transmission of HIV. These products contained non-HIV specific active compounds that were ultimately found to disrupt the vaginal epithelium, cause increased immune activation in the female genital tract, disturb vaginal flora, and/or cause other irritation that precluded their use as vaginal microbicides. Due to the failure of these first-generation candidates, there was a shift in focus to developing HIV pre-exposure prophylaxis and microbicides containing small-molecule antiretrovirals...
July 2016: AIDS Reviews
Álvaro Mena, Héctor Meijide, Pedro J Marcos
The widespread use of HAART for persons living with HIV since 1996 has resulted in a dramatic decline in AIDS-related mortality. However, other comorbidities are increasing, such as metabolic disturbances or cancers, including solid organ malignancies. Among the latest, lung cancer, especially the adenocarcinoma subtype, is on the rise. HIV infection, even controlling for smoking, is an independent risk factor for developing lung cancer. HIV could promote lung cancers through immunosuppression, chronic inflammation, and a direct oncogenic effect...
July 2016: AIDS Reviews
Carmen de Mendoza
Approximately one-third of people living with HIV are coinfected with hepatitis C virus (HCV). Coinfected individuals experience more rapid liver disease progression on average, and in the era of interferon-based therapy they do not respond as well to antiviral treatment. However, recent studies have suggested that this disparity in treatment response does not apply to interferon-free direct-acting anti-viral (DAA) regimens.
April 2016: AIDS Reviews
Pablo Barreiro
Zika virus is an enveloped, single-stranded RNA virus that belongs to the flavivirus genre. As with arbovirus, it is transmitted by arthropods (mosquitoes), both Aedes aegypti (urban) and albopictus (rural). Zika virus was first isolated in 1947 from monkeys in Uganda. The first human cases were reported in 1952 in East Africa. Outbreaks were reported in Micronesia (2007), Polynesia (2013), and Chile (2014). Both diagnostic procedures and therapeutics are poorly developed. Serological tests cross-react with dengue and there are neither specific antivirals nor vaccines...
April 2016: AIDS Reviews
José Luis Casado
The use of tenofovir disoproxil fumarate has been associated with side effects on renal function and bone mineral density, but whether this toxicity is of clinical relevance in the middle or long term is highly debated. Current knowledge supports that the use of and time on tenofovir disoproxil fumarate, modulated by other factors such as age, baseline renal function, or classical risk factors, could led to progressive wasting in the urine of low molecular weight proteins, phosphate, uric acid, or glucose. This "partial" Fanconi syndrome seems to be slowly progressive, with increases in the proportion of patients and in the severity of different tubular abnormalities with the long term use of tenofovir disoproxil fumarate...
April 2016: AIDS Reviews
Thai Nguyen, Ian McNicholl, Joseph M Custodio, Javier Szwarcberg, David Piontkowsky
Cobicistat and ritonavir are structurally distinct compounds that both potently inhibit cytochrome P450 (CYP) 3A, the metabolizing enzyme primarily responsible for the elimination of several antiretroviral medications, and, as such, are pharmacokinetic boosters for antiretroviral agents that require longer dosing intervals. Recently, cobicistat was approved for the treatment of HIV-1 infection in treatment-naive adults as a component of a single-tablet regimen consisting of cobicistat-boosted elvitegravir plus emtricitabine and tenofovir disoproxil fumarate...
April 2016: AIDS Reviews
Vicente Soriano, Benjamin Young, Norah Terrault
The International Conference on Viral Hepatitis 2016 brought exciting news on the treatment of viral hepatitis. The conference was mainly focused on the most recent estimates of burden for HBV and HCV; the current gaps and prospects for regional and global HCV eradication; the use of HCV treatment as prevention; and the management of difficult-to-cure hepatitis C patients, including individuals who fail on direct-acting antivirals, people who inject drugs, and those with decompensated cirrhosis or renal insufficiency...
April 2016: AIDS Reviews
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