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Current Opinion in HIV and AIDS

Naomi F Walker, Cari Stek, Sean Wasserman, Robert J Wilkinson, Graeme Meintjes
PURPOSE OF REVIEW: Antiretroviral therapy (ART) is an essential, life-saving intervention for HIV infection. However, ART initiation is frequently complicated by the tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in TB endemic settings. Here, we summarize the current understanding highlighting the recent evidence. RECENT FINDINGS: The incidence of paradoxical TB-IRIS is estimated at 18% (95% CI 16-21%), higher than previously reported and may be over 50% in high-risk groups...
September 19, 2018: Current Opinion in HIV and AIDS
April C Pettit, Bryan E Shepherd, Timothy R Sterling
PURPOSE OF REVIEW: The present review describes recent advances in the treatment of drug-susceptible tuberculosis (DS-TB) among people living with human immunodeficiency virus (PLWH). RECENT FINDINGS: Higher than standard rifampicin doses (>10 mg/kg/day) are well tolerated and have improved sterilizing activity. Standard pyrazinamide doses may result in low drug exposures; modeling reveals that higher doses (>25 mg/kg/day) may be required to reach target levels, although safety is unknown...
September 14, 2018: Current Opinion in HIV and AIDS
Michael E Herce, Monde Muyoyeta, Stephanie M Topp, German Henostroza, Stewart E Reid
PURPOSE OF REVIEW: To advance a re-conceptualized prevention, treatment, and care continuum (PTCC) for HIV-associated tuberculosis (TB) in prisons, and to make recommendations for strengthening prison health systems and reducing HIV-associated TB morbidity and mortality throughout the cycle of pretrial detention, incarceration, and release. RECENT FINDINGS: Despite evidence of increased HIV-associated TB burden in prisons compared to the general population, prisoners face entrenched barriers to accessing anti-TB therapy, antiretroviral therapy, and evidence-based HIV and TB prevention...
September 14, 2018: Current Opinion in HIV and AIDS
Reuben Granich, Somya Gupta
PURPOSE OF REVIEW: The HIV and Mycobacterium tuberculosis syndemic remains a major global public health threat. HIV and tuberculosis (TB) global targets have been set. Success will depend on achieving combined disease control. We explore current policy, economic investment, and disease control strategies for HIV, TB, and HIV-associated TB. We review published HIV, TB, and HIV-associated TB data for 30 WHO priority countries and propose a comprehensive HIV and TB care continua. RECENT FINDINGS: People living with HIV (PLHIV) on antiretroviral treatment (ART) ranged from 13 to 84%; viral suppression ranged from 21 to 79%...
September 3, 2018: Current Opinion in HIV and AIDS
Susan E Dorman
PURPOSE OF REVIEW: The current review highlights recent advances in tuberculosis (TB) diagnostics that are relevant for clinicians engaged in the care of HIV-positive adults. RECENT FINDINGS: The first section focuses on newly available tools, highlighting recent progress. The second section focuses on new diagnostic approaches that are not yet widely available or implemented, but have considerable potential to improve the management of TB/HIV coinfected persons...
August 14, 2018: Current Opinion in HIV and AIDS
Jeffrey A Tornheim, Kelly E Dooley
PURPOSE OF REVIEW: In the past few years, tuberculosis (TB) has overtaken HIV as the infectious disease with the highest global mortality. Successful management of this syndemic will require improved diagnostic tests, shorter preventive therapies, and more effective treatments, particularly in light of drug-resistant TB. RECENT FINDINGS: Results from several major studies have been published or presented recently, including the development of a more sensitive rapid, molecular assay for TB; several new symptom-based screening tools; use of a 1-month regimen for TB prevention; the results of early vs...
August 4, 2018: Current Opinion in HIV and AIDS
Elisa Nemes, Thomas J Scriba, Mark Hatherill
PURPOSE OF REVIEW: To outline the need for a new tuberculosis (TB) vaccine; challenges for induction of vaccine-mediated protection in HIV-infected persons; and recent advances in clinical development. RECENT FINDINGS: HIV has a detrimental effect on T-cell function, polarization and differentiation of Mycobacterium tuberculosis (Mtb)-specific T cells, Mtb antigen presentation by dendritic cells, and leads to B-cell and antibody-response deficiencies. Previous observations of protection against TB disease in HIV-infected persons by Mycobacterium obuense suggest that an effective vaccine against HIV-related TB is feasible...
August 4, 2018: Current Opinion in HIV and AIDS
Christine Rouzioux, Pauline Trémeaux, Véronique Avettand-Fenoël
PURPOSE OF REVIEW: A number studies are currently underway to develop new drugs aimed at reducing the HIV reservoir or achieving ART-free control of HIV infection. Many markers of HIV reservoirs have been proposed, each one having a different meaning. Total HIV DNA dynamics during the course of HIV infection and its predictive value are now well known. This marker allowed to estimate the size of HIV reservoir at different stages of HIV infection in blood, cell subsets and tissues. Therefore, the purpose of this review is timely and relevant, with the objective to discuss how total HIV DNA might be helpful in the clinical settings...
September 2018: Current Opinion in HIV and AIDS
Nir Eyal, Lisa G Holtzman, Steven G Deeks
PURPOSE OF REVIEW: Several promising experimental pathways exist for long-term control of HIV in the absence of antiretroviral therapy (HIV 'remission') and are now being tested in early clinical studies. These studies can be invasive and pose a host of distinctive risks to participants, as well as to nonparticipants, especially to participants' fetuses, and sexual partners. RECENT FINDINGS: Ethical analyses of these studies have mainly focused on the risks to study participants...
September 2018: Current Opinion in HIV and AIDS
Timothy J Henrich, Jean-Daniel Lelièvre
No abstract text is available yet for this article.
September 2018: Current Opinion in HIV and AIDS
Kathryn E Stephenson
PURPOSE OF REVIEW: This review summarizes the recent landscape of HIV therapeutic vaccine research, emphasizing the results of randomized controlled trials that included analytical treatment interruption (ATI) to assess efficacy. RECENT FINDINGS: Therapeutic vaccines for HIV are designed to re-educate the host immune response in HIV-infected individuals to better control viral replication in the absence of antiretroviral therapy. No therapeutic vaccine has yet to induce long-term HIV remission following ATI in a randomized controlled trial...
September 2018: Current Opinion in HIV and AIDS
Alison L Hill
PURPOSE OF REVIEW: To provide a summary of the contributions of mathematical modeling to understanding of HIV persistence during antiretroviral therapy. RECENT FINDINGS: Although HIV persistence during therapy could be caused by continual viral replication or slow-decaying latent infection, most evidence points toward the latter mechanism. The latent reservoir is maintained by a balance of cell death, proliferation, and reactivation, and new methods to estimate the relative contributions of these rates use a wide range of experimental data...
September 2018: Current Opinion in HIV and AIDS
Maria Pino, Mirko Paiardini, Vincent C Marconi
PURPOSE OF REVIEW: The purpose of the present review is to describe the major barriers to HIV eradication and assess the most promising cure strategies under investigation. RECENT FINDINGS: There are significant challenges to achieve HIV eradication. These include the establishment of persistent latently infected cells, systemic chronic immune activation, and immune dysfunction. Since the announcement of the first HIV cure involving the Berlin patient, several attempts to reproduce these results have failed...
September 2018: Current Opinion in HIV and AIDS
Genevieve E Martin, John Frater
PURPOSE OF REVIEW: The aim of the current review is to explore the evidence around virological remission in ART-treated and untreated individuals living with HIV. With increasing evidence and interest in post-treatment control within the HIV-cure field, it is now increasingly important to agree on definitions to allow different 'controller' phenotypes to be clearly distinguished and mechanisms compared. RECENT FINDINGS: This review explores recent data on potential predictors and mechanisms driving spontaneous and post-treatment control...
September 2018: Current Opinion in HIV and AIDS
Anne-Sophie Kuhlmann, Christopher W Peterson, Hans-Peter Kiem
PURPOSE OF REVIEW: Combination antiretroviral therapy (ART) has enabled tremendous progress in suppressing HIV replication in infected patients. However, ART alone cannot eradicate HIV and its latent, persisting reservoirs. Novel approaches are needed to eradicate the virus or achieve functional cure in the absence of ART. RECENT FINDINGS: Adoptive T-cell therapies were initially tested in HIV-infected individuals with limited efficiency. Benefiting from new and improved methodologies, an increasing array of CAR T-cell therapies has been successfully developed in the cancer immunotherapy field, demonstrating promising new avenues that could be applied to HIV...
September 2018: Current Opinion in HIV and AIDS
Ying Wen, Katharine J Bar, Jonathan Z Li
PURPOSE OF REVIEW: Clinical trials with an antiretroviral therapy (ART) interruption remains indispensable for assessing strategies for ART-free HIV remission. This review highlights the lessons learned from ART interruption studies so far, including the risks to the participants and implications for HIV remission. RECENT FINDINGS: Historically, analytic HIV treatment interruption (ATI) studies were commonly designed with a prolonged duration of ART interruption and with viral load set point as the primary outcome...
September 2018: Current Opinion in HIV and AIDS
Pierre Gantner, Jade Ghosn
PURPOSE OF REVIEW: HIV functional cure requires the elimination or a major reduction of HIV reservoir pool including male and female genital HIV reservoirs. A comprehensive understanding of HIV dynamics in these compartments is mandatory. RECENT FINDINGS: Data from chronically HIV-infected therapy-naïve individuals or fully suppressed on combined antiretroviral therapy (cART) or undergoing ART interruptions are now available. Using paired blood/genital samples, HIV-RNA/DNA quantification and sequencing provide new insights on HIV dynamics in genital reservoirs...
September 2018: Current Opinion in HIV and AIDS
Timothée Bruel, Olivier Schwartz
PURPOSE OF REVIEW: The HIV-1 reservoir is composed of infected cells poised to replicate and spread the virus upon treatment interruption. It constitutes the main obstacle toward an HIV-1 cure. Whether marker(s) may allow the detection of cells that form the reservoir is an outstanding question. Here, we present and discuss recent advances and controversies in the identification and characterization of markers of the HIV-1 reservoir. RECENT FINDINGS: Latently infected T cells that persist under successful therapy do not express viral antigens, making their identification challenging...
September 2018: Current Opinion in HIV and AIDS
(no author information available yet)
No abstract text is available yet for this article.
July 2018: Current Opinion in HIV and AIDS
Francesca Ferretti, Marta Boffito
PURPOSE OF REVIEW: Rilpivirine is a non-nucleoside reverse transcriptase inhibitor approved for the treatment of HIV in combination with other antiretrovirals (ARV). The development of the long-acting formulation of rilpivirine (RPV-LA) and its use in clinical settings is the subject of this review. RECENT FINDINGS: In 2017, the results of the phase IIb study LATTE2 have been published. This study demonstrated that the combination of RPV-LA with a second long-acting agent (cabotegravir) administered intramuscularly every 4--8 weeks was similar in virologic suppression rates to standard of care ARV treatment...
July 2018: Current Opinion in HIV and AIDS
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