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Current Opinion in HIV and AIDS

Hsin-Yun Sun, Sui-Yuan Chang, Chien-Ching Hung
PURPOSE OF REVIEW: With prolonged life expectancy in HIV-positive patients on combination antiretroviral therapy, the quest for reducing lifelong drug exposure and minimizing or avoiding the toxicities of combination antiretroviral therapy while maintaining viral suppression has emerged when coformulations of antiretroviral agents with improved convenience, and better tolerability and efficacy became available. This review aims to update the current experience with the novel two-drug combination of dolutegravir (DTG) and rilpivirine (RPV) and elucidate the possible applications and limitations of coformulated DTG-RPV in the future...
March 16, 2018: Current Opinion in HIV and AIDS
Thomas Joshua Pasvol, Caroline Foster, Sarah Fidler
PURPOSE OF REVIEW: Successful roll-out of paediatric antiretroviral therapy (ART) has led to a significant increase in survival of adolescents and young people growing up with HIV. Those on suppressive ART since childhood represent a unique group particularly well positioned to interrupt ART and achieve post-treatment control (PTC), or HIV remission. This maybe a consequence of early and sustained treatment since infancy, the small size of the HIV reservoir, the presence of a functioning thymus and a more 'flexible' immune system better able to respond to novel immune therapeutic interventions when compared with adults who acquired HIV at a time of immunological maturity and thymic involution...
March 14, 2018: Current Opinion in HIV and AIDS
Muge Cevik, Chloe Orkin
PURPOSE OF REVIEW: In an era when virological efficacy approaches 100%, novel antiretroviral (ARV) therapies must deliver better tolerability, safety, and convenient coformulated regimens. We review the phase II and III clinical data on the fixed dose combination (FDC) darunavir (DRV) 800mg / cobicistat (COBI/C) 150 mg / emtricitabine (F/FTC) 200 mg / tenofovir alafenamide fumarate (TAF) 10mg (D/C/F/TAF) for the treatment of HIV-1 infection. RECENT FINDINGS: In an exploratory phase II study, D/C/F/TAF FDC demonstrated similar virological efficacy to darunavir/cobicistat FDC + F /tenofovir disoproxil fumarate (TDF) FDC in treatment-naive HIV-1-infected individuals with favorable bone and renal outcomes...
March 9, 2018: Current Opinion in HIV and AIDS
Ali Judd, Mary-Ann Davies
PURPOSE OF REVIEW: To summarize evidence for health outcomes among adolescents and young people living with HIV (AYLHIV) who have transitioned to adult care/adulthood, views of AYLHIV and providers on the transition process, and the effect of adolescent and youth friendly services (AYFS) on outcomes. RECENT FINDINGS: A total of 43 studies were identified [n = 13 high-income countries (HICs), n = 30 low-/middle-income countries (LMICs)]. In HICs, around 75% of patients were retained in care at approximately 4 years posttransition...
March 9, 2018: Current Opinion in HIV and AIDS
Audrey Pettifor, Marie Stoner, Carey Pike, Linda-Gail Bekker
PURPOSE OF REVIEW: Many of the almost 2 million HIV infections that occurred globally in the last year occurred among adolescents and young people, particularly those from East and Southern Africa and within key populations. Global HIV epidemic control will require that new infections among these youth populations be curtailed. This review examines the most effective prevention approaches to reach these adolescent populations in the next 5 years. RECENT FINDINGS: Adolescents are in transition and are developmentally unique...
March 9, 2018: Current Opinion in HIV and AIDS
Mary-Ann Davies, Elizabeth Hamlyn
No abstract text is available yet for this article.
March 6, 2018: Current Opinion in HIV and AIDS
Lisa Hamzah, Elizabeth Hamlyn
PURPOSE OF REVIEW: This review aims to summarize data in the last 18 months on the sexual and reproductive health of perinatally and horizontally infected adolescents and young people living with HIV (age 13-25 years) and to highlight some key issues faced by this group of adolescents as they reach puberty and sexual debut. RECENT FINDINGS: Adolescents and young people living with HIV are a growing cohort worldwide and a significant proportion engage in high-risk sexual activity, pose risk of onward HIV transmission, yet have poor access to sexual and reproductive health (SRH) services and lack the knowledge and support to advocate for their needs...
February 15, 2018: Current Opinion in HIV and AIDS
Julia Bohlius, Caroline Foster, Gita Naidu, Mazvita Sengayi, Anna Turkova
PURPOSE OF REVIEW: Adults living with HIV have an increased risk of malignancy yet there is little data for adolescents and young adults. We reviewed recently published cancer epidemiology, treatment, and outcome data for adolescents and young adults living with HIV (AYALHIV) aged 10 to less than 25 years between 2016 and 2017. RECENT FINDINGS: AYALHIV are at increased risk of developing cancer compared to their uninfected peers. Kaposi sarcoma and non-Hodgkin lymphoma occur most frequently with variation by geographical region...
February 15, 2018: Current Opinion in HIV and AIDS
Désiré Dahourou, Jean-Philippe Raynaud, Valériane Leroy
PURPOSE OF REVIEW: Improved access to antiretroviral therapy has resulted in an emerging population of adolescents living with HIV (ALHIV) mainly in sub-Saharan Africa. Full disclosure of an HIV diagnosis includes naming HIV/AIDS and is an important step in coping with HIV. We reviewed the recent trends in the rates of children/adolescents who have been informed of their HIV infection according to age groups, the barriers and the evaluated interventions aimed at improving the HIV disclosure process to ALHIV in sub-Saharan Africa...
February 15, 2018: Current Opinion in HIV and AIDS
Lindsey K Reif, Margaret L McNairy, Matthew R Lamb, Ruby Fayorsey, Batya Elul
PURPOSE OF REVIEW: Outcomes among young people living with HIV (YPLWH) remain disturbingly poor. We summarize recent research on youth-friendly services (YFS) and adolescent-specific differentiated care models, which may improve outcomes across the HIV care continuum for this vulnerable population. We further emphasize unique complexities that characterize the transition from childhood through adolescence to adulthood which must be considered when caring for YPLWH. RECENT FINDINGS: Studies suggest that YFS may improve outcomes in some but not all steps of the HIV care continuum...
February 9, 2018: Current Opinion in HIV and AIDS
Morna Cornell, Kathryn Dovel
PURPOSE OF REVIEW: Adolescents and young people who fit within key populations face some of the greatest barriers to HIV care, but are frequently overlooked. We review the recent literature on these young, vulnerable populations including HIV risk factors, barriers to care, and strategies for engagement. RECENT FINDINGS: Common risk factors include age, risky sexual practices, poor education, and high levels of alcohol and drug abuse. Barriers to care include limited data, criminalization, and high levels of stigma...
February 9, 2018: Current Opinion in HIV and AIDS
Paige L Williams, Julie Jesson
PURPOSE OF REVIEW: We present an overview of recent research in the inter-related areas of growth and pubertal development among adolescents with HIV. Growth deficits early in childhood can lead to delayed puberty, with subsequent effects on pubertal growth spurts and bone health. RECENT FINDINGS: Impaired growth remains a critical concern, particularly in low-resource settings, where stunting, wasting and underweight remain pervasive. Antiretroviral treatment (ART) initiation results in improved growth, with greatest growth recovery in the first years and more improvement in weight than in height...
February 9, 2018: Current Opinion in HIV and AIDS
Amy L Slogrove, Annette H Sohn
PURPOSE OF REVIEW: The aim of this study was to summarize recent evidence on the global epidemiology of adolescents (age 10-19 years) living with HIV (ALHIV), the burden of HIV on the health of adolescents and HIV-associated mortality. RECENT FINDINGS: In 2016, there were an estimated 2.1 million (uncertainty bound 1.4-2.7 million) ALHIV; 770 000 younger (age 10-14 years) and 1.03 million older (age 15-19 years) ALHIV, 84% living in sub-Saharan Africa. The population of ALHIV is increasing, as more peri/postnatally infected ALHIV survive into older ages; an estimated 35% of older female ALHIV were peri/postnatally infected, compared with 57% of older male ALHIV...
February 9, 2018: Current Opinion in HIV and AIDS
Steve Innes, Kunjal Patel
PURPOSE OF REVIEW: Perinatally HIV-infected adolescents may be at increased risk of noninfectious comorbidities later in life. This review summarizes recent advances in the understanding of noncommunicable diseases (NCD) among HIV-infected adolescents in high-income and lower middle-income countries, and identifies key questions that remain unanswered. We review atherosclerotic vascular disease (AVD), chronic bone disease (CBD), chronic kidney disease (CKD), and chronic lung disease (CLD)...
February 8, 2018: Current Opinion in HIV and AIDS
Chido D Chikwari, Stefanie Dringus, Rashida A Ferrand
PURPOSE OF REVIEW: HIV/AIDS is one of the leading causes of death among adolescents in sub-Saharan Africa and 40% of new HIV infections worldwide occur in this group. HIV testing and counselling (HTC) is the critical first step to accessing HIV treatment. The prevalence of undiagnosed HIV infection is substantially higher in adolescents compared with adults. We review barriers to HTC for adolescents and emerging HTC strategies appropriate to adolescents in sub-Saharan Africa. RECENT FINDINGS: There are substantial individual, health system and legal barriers to HTC among adolescents, and stigma by providers and communities remains an important obstacle...
February 3, 2018: Current Opinion in HIV and AIDS
Michael Evangeli
PURPOSE OF REVIEW: Adolescents with HIV include both those infected perinatally and behaviourally. This population is confronted by normative challenges and HIV stressors as they move towards becoming increasingly independent adults. This review focuses on mental health and substance use in adolescents with HIV. These are important issues in their own right as well as having implications for antiretroviral therapy (ART) adherence and HIV management. RECENT FINDINGS: Sixteen articles, published from 1 January 2016 to 1 September 2017, were included from 13 distinct studies, mostly from the United States and Africa...
February 3, 2018: Current Opinion in HIV and AIDS
Nabila Seddiki, Yves Lévy
PURPOSE OF REVIEW: The purpose is to recall some of the key immunological elements that are at the crossroad and need to be combined for developing a potent therapeutic HIV-1 vaccine. RECENT FINDINGS: Therapeutic vaccines and cytokines have been commonly used to enhance and/or recall preexisting HIV-1 specific cell-mediated immune responses aiming to suppress virus replication. While the vaccine is important to stimulate HIV-1 specific T-cell responses, the cytokine may support the expansion of the stimulated virus-specific T cells...
January 10, 2018: Current Opinion in HIV and AIDS
Hsiao-Hsuan Kuo, Mathias Lichterfeld
PURPOSE OF REVIEW: Reservoirs of HIV-1-infected cells persist long-term despite highly effective antiretroviral suppression therapy and represent the main barrier against a cure for HIV-1. This review summarizes recent advances in understanding the complexity and diversity of viral reservoir cells. RECENT FINDINGS: Latently infected memory CD4 T cells are the predominant cell compartment responsible for viral persistence, but some studies suggest that myeloid cells, and possibly hematopoietic progenitors, can also serve as long-term viral reservoirs...
March 2018: Current Opinion in HIV and AIDS
Eirini Moysi, Kartika Padhan, Giulia Fabozzi, Constantinos Petrovas
PURPOSE OF REVIEW: To describe recent findings on the effect of HIV/SIV infection on lymph node viral and T-cell dynamics using imaging-based methodologies. RECENT FINDINGS: Chronic infection, particularly HIV/SIV, alters dramatically the microenvironment, immune cell frequency, distribution, function and tissue organization of secondary lymphoid tissues. These changes are not always reversible. Over the past few years, the implementation of advanced imaging protocols on human lymph node biopsies as well as on longitudinal lymphoid tissues samples from nonhuman primates (NHP) have provided a wealth of information on how local immune responses evolve over time in response to a persisting retroviral pathogen...
March 2018: Current Opinion in HIV and AIDS
Jori Symons, Paul U Cameron, Sharon R Lewin
PURPOSE OF REVIEW: To provide an overview of recent research of how HIV integration relates to productive and latent infection and implications for cure strategies. RECENT FINDINGS: How and where HIV integrates provides new insights into how HIV persists on antiretroviral therapy (ART). Clonal expansion of infected cells with the same integration site demonstrates that T-cell proliferation is an important factor in HIV persistence, however, the driver of proliferation remains unclear...
March 2018: Current Opinion in HIV and AIDS
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