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Recent HIV infection

Gabriel Mosquera Klinger, Andrea Holguín-Cardona
Surgical management has been the main approach for enteral fistulae. This approach is usually complex due to comorbidities, a wasted nutritional state and anatomical difficulties related to prior multiple interventions. Therefore, endoscopic methods such as clips, self-expanding metal stent (SEMS) and recently, the over scope clip (OTSC®) are increasing in popularity and use. Herein, we present the case of a patient with a HIV infection who was admitted due to respiratory symptoms. Radiological and microbiological studies documented a tracheoesophageal fistula due to tuberculosis (TB) and cytomegalovirus (CMV) infection...
June 22, 2018: Revista Española de Enfermedades Digestivas
Vijayakumar Velu, Geetha Mylvaganam, Chris Ibegbu, Rama Rao Amara
T follicular helper CD4 cells (Tfh) are essential for the development and maintenance of germinal center (GC) reactions, a critical process that promotes the generation of long-lived high affinity humoral immunity. It is becoming increasingly evident that GC-Tfh cells are heterogeneous in nature with some cellular characteristics associated with a Th1, Th2, and Th17 phenotype. Emerging studies suggest that GC-Tfh cells are directed to differentiate into distinct phenotypes during chronic HIV/SIV infection and these changes in GC-Tfh cells can greatly impact the B cell response and subclass of antibodies generated...
2018: Frontiers in Immunology
Chui Ching Wong, Siew Hoon Lim, Chai Teng Tan, Sook Yin Lui, Yee Leng Lee, Kwai Peng Chan
In view of recent revised recommendations for human immunodeficiency virus (HIV) confirmatory testing, the performance of 3 HIV confirmatory assays was compared. Using the HIV Blot 2.2 (MP-WB), the INNO-LIA HIV I/II Score (INNO), and the Geenius HIV 1/2 Confirmatory Assay (Geenius), we tested 199 HIV-1 positive, 161 HIV negative, 65 HIV western blot indeterminate, 26 HIV seroconversion, 34 early HIV infection and 4 HIV-2 positive archived specimens. We show that all 3 assays had comparable test sensitivity in the detection of HIV-1 positive cases...
2018: PloS One
Marc A Pitasi, Kevin P Delaney, Emeka Oraka, Heather Bradley, Elizabeth A DiNenno, John T Brooks, Joseph Prejean
Since 2006, CDC has recommended routine screening of all persons aged 13-64 years for human immunodeficiency virus (HIV) and at least annual rescreening of persons at higher risk (1). However, national surveillance data indicate that many persons at higher risk for HIV infection are not screened annually, and delays in diagnosis persist (2). CDC analyzed 2006-2016 data from the General Social Survey (GSS)* and estimated that only 39.6% of noninstitutionalized U.S. adults had ever tested for HIV. Among persons ever tested, the estimated median interval since last test was 1,080 days or almost 3 years...
June 22, 2018: MMWR. Morbidity and Mortality Weekly Report
Karen Champenois, Rémonie Seng, Anne Persoz, Asma Essat, Catherine Gaud, Didier Laureillard, Olivier Robineau, Claudine Duvivier, Yazdan Yazdanpanah, Cécile Goujard, Laurence Meyer
BACKGROUND: With the advent of treatment as prevention of HIV infection (TasP), we assessed trends in sexual behaviours between 2000 and 2017 among HIV-infected MSM enrolled in the French ANRS PRIMO cohort. METHODS: At each cohort visit, a clinical questionnaire including laboratory values was completed and a self-administered questionnaire was used to collect sexual behaviours, that is, the number, type (steady/casual) and HIV status (positive or negative/unknown) of partners, and condom use...
June 20, 2018: AIDS
Andrea A Kim, Thomas Rehle
BACKGROUND: A recent infection testing algorithm (RITA) that includes a test for recent HIV infection and a viral load (VL) test is the recommended strategy to estimate population-level HIV incidence, reducing false-recent misclassification to <1%. The inclusion of information on exposure to antiretroviral therapy (ART), as a supplement to VL testing, could improve RITA performance by further lowering false-recent misclassification of true long-term infection. METHODS: In 2012, Kenya and South Africa conducted national population-based surveys that collected information on HIV recency (i...
June 21, 2018: AIDS Research and Human Retroviruses
Bin Xu, Qinghua Pan, Chen Liang
Type I interferon inhibits viruses through inducing the expression of antiviral proteins, including the myxovirus resistance (Mx) proteins. Compared to human MxA protein that inhibits a wide range of viruses, the MxB protein has been reported to specifically inhibit primate lentiviruses including HIV-1, and herpesviruses. Further, the role of endogenous MxB in interferon-α mediated inhibition of HIV-1 infection was questioned by a recent study showing that MxB knockout did not increase the infection of HIV-1 which carried the G protein of vesicular stomatitis virus (VSV), and thus was able to infect CD4-negative HT1080 cells...
June 20, 2018: Journal of Virology
Carmen H Logie, Kathleen S Kenny, Ashley Lacombe-Duncan, Ying Wang, Kandasi Levermore, Nicolette Jones, Tyrone Ellis, Annecka Marshall
BACKGROUND: Men who have sex with men (MSM) are at elevated risk for sexually transmissible infection (STI) acquisition globally. Yet, limited research has explored STI testing practices among MSM in contexts where same-sex practices are criminalised, such as in Jamaica. METHODS: A cross-sectional, tablet-based survey with MSM in Kingston, Ocho Rios and Montego Bay, Jamaica, was conducted. Multivariable logistic regression analyses were conducted to determine the adjusted risk ratio for lifetime STI testing and lifetime STI diagnosis...
June 21, 2018: Sexual Health
I F T Viana, D F Coêlho, M L Palma, E J M Nascimento, G Gu, L F O Lima, L Foti, M A Krieger, C Pilcher, C E Calzavara-Silva, R B Mailliard, C R Rinaldo, R Dhalia, E T A Marques
Reducing the risk of human immunodeficiency virus type 1 (HIV-1) transmission is still a public health priority. The development of effective control strategies relies on the quantification of the effects of prophylactic and therapeutic measures in disease incidence. Although several assays can be used to estimate HIV incidence, these estimates are limited by the poor performance of these assays in distinguishing recent from long-standing infections. To address such limitation, we have developed an assay to titrate p24-specific IgG3 antibodies as a marker of recent infection...
June 21, 2018: Epidemiology and Infection
Adamma Aghaizu, Jennifer Tosswill, Daniela De Angelis, Helen Ward, Gwenda Hughes, Gary Murphy, Valerie Delpech
INTRODUCTION: The HIV epidemic in England is largely concentrated among heterosexuals who are predominately black African and men who have sex with men (MSM). We present for the first time trends in annual HIV incidence for adults attending sexual health clinics, where 80% of all HIV diagnoses are made. METHODS: We identified newly diagnosed incident HIV using a recent infection testing algorithm (RITA) consisting of a biomarker (AxSYM assay, modified to determine antibody avidity), epidemiological and clinical information...
2018: PloS One
Vincent C Allen, Lara A Ray, Hector F Myers
BACKGROUND: Black men who have sex with men (MSM) are disproportionately affected by HIV infection. Efforts are needed to understand correlates of HIV risk among this group. Alcohol consumption may have a role in HIV transmission given its association with condomless sex. This study aimed to examine the association between alcohol consumption (i.e., drinking before/during sex and levels of alcohol use problems) and condom use during lifetime, past 6 months, and the event (i.e., a specific sexual episode) level...
June 20, 2018: Alcoholism, Clinical and Experimental Research
A E Brown, S Nash, N Connor, P D Kirwan, D Ogaz, S Croxford, D De Angelis, V C Delpech
OBJECTIVES: Our objective was to present recent trends in the UK HIV epidemic (2007-2016) and the public health response. METHODS: HIV diagnoses and clinical markers were extracted from the HIV and AIDS Reporting System; HIV testing data in sexual health services (SHS) were taken from GUMCAD STI Surveillance System. HIV data were modelled to estimate the incidence in men who have sex with men (MSM) and post-migration HIV acquisition in heterosexuals. Office for National Statistics (ONS) data enabled mortality rates to be calculated...
June 20, 2018: HIV Medicine
X Mao, Z Wang, Q Hu, C Huang, H Yan, Z Wang, L Lu, M Zhuang, X Chen, J Fu, W Geng, Y Jiang, H Shang, J Xu
OBJECTIVES: The HIV epidemic is worsening among men who have sex with men (MSM) in China, especially among those who are younger than 25 years old [younger MSM (YMSM)]. The aim of the study was to compare the prevalences of HIV incidence and recent HIV infection as well as factors associated with recent HIV infection in YMSM and older MSM (OMSM). METHODS: A multicentre cross-sectional survey was conducted among 4496 MSM recruited from seven Chinese cities. YMSM were defined as those aged < 25 years...
June 19, 2018: HIV Medicine
Julia Niessl, Daniel E Kaufmann
Passive administration of broadly neutralizing antibodies (bNAbs) capable of recognizing a broad range of viral strains to non-human primates has led to protection from infection with chimeric SIV/HIV virus (SHIV). This data suggests that generating protective antibody responses could be an effective strategy for an HIV vaccine. However, classic vaccine approaches have failed so far to induce such protective antibodies in HIV vaccine trials. HIV-specific bNAbs identified in natural infection show high levels of somatic hypermutations, demonstrating that they underwent extensive affinity maturation...
June 19, 2018: Viruses
Sixtine Coindre, Nicolas Tchitchek, Lamine Alaoui, Bruno Vaslin, Christine Bourgeois, Cecile Goujard, Veronique Avettand-Fenoel, Camille Lecuroux, Pierre Bruhns, Roger Le Grand, Anne-Sophie Beignon, Olivier Lambotte, Benoit Favier
CD32a has been proposed as a specific marker of latently HIV-infected CD4+ T cells. However, CD32a was recently found to be expressed on CD4+ T cells of healthy donors, leading to controversy on the relevance of this marker in HIV persistence. Here, we used mass cytometry to characterize the landscape and variation in the abundance of CD32a+ CD4+ T cells during HIV infection. To this end, we analyzed CD32a+ CD4+ T cells in primary HIV infection before and after effective combination antiretroviral therapy (cART) and in healthy donors...
2018: Frontiers in Immunology
Vincenzo Spagnuolo, Antonella Castagna, Adriano Lazzarin
Darunavir (DRV) was the last approved protease inhibitor (PI) and has been extensively used for the treatment of HIV in both naïve and experienced subjects due to its high genetic barrier and efficacy. The introduction in clinical practice of integrase strand transfer inhibitors limited its role in the management of naïve subjects and in antiretroviral treatment simplification strategies. However, recent data from trials that have investigated the new DRV/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) combination showed an excellent efficacy and tolerability of this coformulation both in naïve patients and in those with viral suppression, making D/C/F/TAF a new option for the treatment of HIV infection...
June 18, 2018: Expert Opinion on Pharmacotherapy
Matthew S Parsons, Roger Le Grand, Stephen J Kent
Improved vaccine-mediated protection against HIV-1 requires a thorough understanding of the mode of HIV-1 transmission and how various immune responses control transmission. Cell-associated HIV-1 is infectious and contributes to HIV-1 transmission in humans. Non-human primate models of cell-associated SIV infection demonstrate that cell-associated SIV is more infectious than cell-free SIV. In a recently described chimeric simian⁻human immunodeficiency virus (SHIV) macaque model, it was demonstrated that an occult infection with cell-associated SHIV can be established that evades passive protection with a broadly neutralizing antibody (bnAb)...
June 18, 2018: Viruses
Tanja Engel, Marieke Raffenberg, Catia Marzolini, Matthias Cavassini, Helen Kovari, Barbara Hasse, Philip E Tarr
Ever since the introduction of highly active antiretroviral therapy (ART) in 1995, HIV infection has been linked to "metabolic" complications (insulin resistance, dyslipidemia, osteoporosis, and others). Studies suggested increased rates of myocardial infarction, renal insufficiency, neurocognitive dysfunction, and fractures in HIV-postitive patients. Even long-term suppression of HIV seemed to be accompanied by an excess of deleterious inflammation that could promote these complications. The aims of this viewpoint paper are to summarize recent data and to examine the possibility that the problem of aging-related morbidity in HIV might not be as dramatic as previously believed...
June 15, 2018: Gerontology
Linden Lalley-Chareczko, Devon Clark, S Caitlin Conyngham, Athena Zuppa, Ganesh Moorthy, Karam Mounzer, Helen Koenig
BACKGROUND: Pre-exposure prophylaxis(PrEP) for HIV prevention with daily TDF/FTC is effective when taken consistently. Currently, there is no objective way to monitor PrEP adherence. Urine has been shown to be highly correlated with plasma tenofovir levels, with urine tenofovir levels >1000ng/mL demonstrating recent(1-2 days) adherence to PrEP. SETTING: The present study was conducted at an urban community health center in Philadelphia, Pennsylvania. METHODS: PrEP was administered to 50 young men who have sex with men and transgender women of color using weekly, biweekly, and/or monthly dispensation schedules...
June 12, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Juliana Flemming, Lisa Wiesen, Alon Herschhorn
The human immunodeficiency virus type 1 (HIV-1) envelope glycoproteins (Env) mediate virus entry and are the target of neutralizing antibodies. Binding of the metastable HIV-1 Env trimer to the CD4 receptor triggers structural rearrangements that mediate Env conformational transitions from a closed conformation to a more open state through an intermediate step. Recent studies have revealed new insights on the dynamics, regulation and molecular mechanisms of Env transitions along the entry pathway. Here we provide an overview of the current knowledge on Env conformational dynamics and the relationship between Env conformational states and neutralization selectivity of the broadly neutralizing antibodies (bNAbs) that develop in 10-20% of infected individuals and may provide guidance for the development of an effective HIV-1 vaccine...
June 15, 2018: AIDS Research and Human Retroviruses
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