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Pharmacological and Behavioral Interventions to Mitigate Premature Aging in Patients with HIV. 减轻HIV患者过早衰老的药理学和行为干预。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1007/s11904-023-00677-7
Roxane Rohani, Jacob Malakismail, Emmanuel Njoku

Purpose of review: We sought to review pharmacological and behavioral interventions that have been publicly presented, published, or are currently ongoing to prevent or mitigate the effect of premature HIV-associated comorbidities.

Recent findings: Multiple studies have been conducted in hopes of finding an effective intervention. While the choice of antiretroviral regimen influences recovery of immune function, several drugs used as adjunct treatments have proven effective to mitigate premature aging. Additionally, few behavioral interventions have exhibited some efficacy. Statins, angiotensin-receptor blockers, and anti-hyperglycemic agents as well as optimal adherence, exercise, and intermittent fasting among others have had beneficial impact on markers of immune activation and levels of inflammatory biomarkers. However, several investigations had inconclusive outcomes so further studies with larger sample sizes are warranted.

综述目的:我们试图综述已经公开提出、发表或目前正在进行的药物和行为干预措施,以预防或减轻过早HIV相关合并症的影响。最近的发现:已经进行了多项研究,希望找到一种有效的干预措施。虽然抗逆转录病毒疗法的选择会影响免疫功能的恢复,但一些用作辅助治疗的药物已被证明能有效缓解过早衰老。此外,很少有行为干预措施显示出一定的疗效。他汀类药物、血管紧张素受体阻滞剂、抗高血糖药物以及最佳依从性、运动和间歇性禁食等对免疫激活标志物和炎症生物标志物水平产生了有益影响。然而,几项调查没有得出结论,因此有必要对更大样本量进行进一步研究。
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引用次数: 0
Genomic Exploration of the Brain in People Infected with HIV-Recent Progress and the Road Ahead. HIV感染者大脑基因组学研究的最新进展和未来之路。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-01 Epub Date: 2023-11-10 DOI: 10.1007/s11904-023-00675-9
Amara Plaza-Jennings, Schahram Akbarian

Purpose of review: The adult human brain harbors billions of microglia and other myeloid and lymphoid cells highly susceptible to HIV infection and retroviral insertion into the nuclear DNA. HIV infection of the brain is important because the brain is a potentially large reservoir site that may be a barrier to HIV cure strategies and because infection can lead to the development of HIV-associated neurocognitive disorder. To better understand both the central nervous system (CNS) reservoir and how it can cause neurologic dysfunction, novel genomic, epigenomic, transcriptomic, and proteomic approaches need to be employed. Several characteristics of the reservoir are important to learn, including where the virus integrates, whether integrated proviruses are intact or defective, whether integrated proviruses can be reactivated from a latent state to seed ongoing infection, and how this all impacts brain function.

Recent findings: Here, we discuss similarities and differences of viral integration sites between brain and blood and discuss evidence for and against the hypothesis that in the absence of susceptible T-lymphocytes in the periphery, the virus housing in the infected brain is not able to sustain a systemic infection. Moreover, microglia from HIV + brains across a wide range of disease severity appear to share one type of common alteration, which is defined by downregulated expression, and repressive chromosomal compartmentalization, for microglial genes regulating synaptic connectivity. Therefore, viral infection of the brain, including in immunocompetent cases with near-normal levels of CD4 blood lymphocytes, could be associated with an early disruption in microglia-dependent neuronal support functions, contributing to cognitive and neurological deficits in people living with HIV.

综述目的:成年人脑中含有数十亿小胶质细胞和其他骨髓和淋巴细胞,这些细胞对HIV感染和逆转录病毒插入细胞核DNA高度敏感。大脑中的HIV感染很重要,因为大脑是一个潜在的大储存部位,可能是HIV治疗策略的障碍,而且感染会导致HIV相关神经认知障碍的发展。为了更好地了解中枢神经系统(CNS)库及其如何导致神经功能障碍,需要采用新的基因组、表观基因组、转录组和蛋白质组学方法。宿主的几个特征很重要,包括病毒在哪里整合,整合的前病毒是完整的还是有缺陷的,整合的原病毒是否可以从潜伏状态重新激活以引发持续的感染,以及这一切如何影响大脑功能。最近的发现:在这里,我们讨论了大脑和血液之间病毒整合位点的异同,并讨论了支持和反对以下假设的证据:在外周缺乏易感T淋巴细胞的情况下,感染大脑中的病毒外壳无法维持系统性感染。此外,来自HIV的小胶质细胞 + 不同疾病严重程度的大脑似乎都有一种常见的改变,即调节突触连接的小胶质细胞基因表达下调和染色体区室化抑制。因此,大脑的病毒感染,包括CD4血淋巴细胞水平接近正常的免疫活性病例,可能与小胶质细胞依赖性神经元支持功能的早期破坏有关,导致HIV感染者的认知和神经功能缺陷。
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引用次数: 0
Mpox and HIV-Collision of Two Diseases. 麻疹和hiv两种疾病的碰撞。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-01 Epub Date: 2023-11-23 DOI: 10.1007/s11904-023-00682-w
Jason Zucker, Aniruddha Hazra, Boghuma K Titanji

Purpose of review: The global outbreak of mpox has brought renewed attention to a previously neglected disease which is particularly severe in people with underlying untreated HIV co-infection. For this population, the disease is progressive, severe, and often lethal. In this review, we examine the pathogenesis of mpox disease and its collision with co-existent HIV infection and discuss key considerations for management as well as emerging clinical dilemmas and areas for future research.

Recent findings: Co-existent untreated HIV infection characterized by severe immunocompromise potentiates the nefarious effects of monkeypox virus infection leading to severe manifestations of mpox. Treating mpox in the context of HIV requires mpox-directed therapies, supportive care, and HIV-specific treatment to restore immune function. Preventative measures for PWH are like those in healthy individuals, but the effectiveness and durability of protection conferred by existing vaccines in PWH remain to be fully characterized. Mpox is an important opportunistic infection in PWH. Clinicians should be aware of the unique features of the disease in this population and approaches to care and management of mpox in PWH.

审查目的:mpox的全球暴发使人们重新关注以前被忽视的一种疾病,这种疾病在未经治疗的潜在艾滋病毒合并感染患者中尤为严重。对于这一人群,这种疾病是进行性的,严重的,而且往往是致命的。在这篇综述中,我们探讨了m痘病的发病机制及其与共存的HIV感染的冲突,并讨论了管理的关键注意事项以及新出现的临床困境和未来研究的领域。最近的发现:共存的未经治疗的HIV感染以严重的免疫功能低下为特征,增强了猴痘病毒感染的邪恶影响,导致严重的m痘表现。在艾滋病毒背景下治疗m痘需要针对m痘的治疗、支持性护理和艾滋病毒特异性治疗,以恢复免疫功能。PWH的预防措施与健康人的预防措施类似,但现有疫苗在PWH中所赋予的保护的有效性和持久性仍有待充分研究。Mpox是PWH中一种重要的机会性感染。临床医生应该意识到该疾病在这一人群中的独特特征以及在PWH中护理和管理m痘的方法。
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引用次数: 0
Challenges and Solutions to STI Control in the Era of HIV and STI Prophylaxis. 艾滋病毒和性传播感染预防时代性传播感染控制的挑战和解决方案。
IF 3.7 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-10-01 Epub Date: 2023-09-26 DOI: 10.1007/s11904-023-00666-w
Felix Ong'era Mogaka, Jenell Stewart, Victor Omollo, Elizabeth Bukusi

Purpose of review: This article reviews current efforts to control bacterial sexually transmitted infections (STIs) among HIV pre-exposure prophylaxis (PrEP) users and outlines the opportunities and challenges to controlling STIs within HIV PrEP programs.

Recent findings: The incidence of STIs continues to rise globally especially among HIV PrEP users, with an estimated 1 in 4 PrEP users having a curable bacterial STI. STIs and HIV comprise a syndemic needing dual interventions. The majority of STIs are asymptomatic, and when testing is available, many STIs occur in extragenital sites that are missed when relying on urine testing or genital swabs. Optimal testing and treatment, including testing for antimicrobial resistance, pose difficulties in high income countries and is essentially non-existent in most low- and middle-income countries. Novel STI primary prevention strategies, like doxycycline post-exposure prophylaxis (PEP) for STI prevention, have proven to be highly efficacious in some populations. A few jurisdictions have issued normative guidelines and position statements for doxycycline PEP; however, clinical standards for implementation and data on public health impact are limited. STI incidence rates are high and rising in sexually active populations. Sexual health programs should leverage the expansion of HIV PrEP delivery services to integrate STI testing, surveillance, and novel STI prevention services.

综述目的:本文综述了目前在HIV暴露前预防(PrEP)使用者中控制细菌性传播感染(STIs)的努力,并概述了在HIV PrEP计划中控制STIs的机会和挑战。最近的发现:全球性传播感染的发病率持续上升,尤其是在艾滋病毒PrEP使用者中,估计每4名PrEP使用者就有1人患有可治愈的细菌性传播感染。性传播感染和艾滋病毒是一种需要双重干预的综合征。大多数性传播感染是无症状的,当可以进行检测时,许多性传播感染发生在生殖器外部位,而在依赖尿液检测或生殖器拭子时,这些部位被遗漏了。最佳检测和治疗,包括抗微生物耐药性检测,在高收入国家造成了困难,在大多数中低收入国家基本上不存在。新的STI初级预防策略,如用于预防STI的多西环素暴露后预防(PEP),已被证明在某些人群中非常有效。一些司法管辖区发布了多西环素PEP的规范性指南和立场声明;然而,实施的临床标准和关于公共卫生影响的数据是有限的。性行为活跃人群的性传播感染发病率很高,而且还在上升。性健康项目应利用扩大HIV PrEP提供服务,将STI检测、监测和新型STI预防服务结合起来。
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引用次数: 0
Integrated Care Models: HIV and Substance Use. 综合护理模式:艾滋病毒和药物使用。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-10-01 Epub Date: 2023-09-12 DOI: 10.1007/s11904-023-00667-9
Katherine Hill, Irene Kuo, Sheela V Shenoi, Mahalia S Desruisseaux, Sandra A Springer

Purpose of review: Behaviors and practices associated with substance use contribute to lack of HIV virologic suppression and onward transmission. In the USA, many recent HIV outbreaks have been connected with substance use. Evidence-based strategies for integrating care of those at risk for and living with HIV and who use substances continue to evolve. This review, based on scientific and medical literature through March 2023, provides an overview and evaluation of initiatives for integrated care aimed to serve patients at risk for and with HIV and a substance use disorder.

Recent findings: Integrated care services can improve health outcomes for patients at risk for and with HIV and a substance use disorder; for instance, treatment for an opioid use disorder can help improve HIV viral suppression. Brick-and-mortar facilities can provide successful care integration with appropriate clinic leadership to support multidisciplinary care teams, up-to-date provider training, and sufficient pharmacy stock for substance use treatment. Delivering healthcare services to communities (e.g., mobile healthcare clinics and pharmacies, telehealth) may prove to be an effective way to provide integrated services for those with or at risk of HIV and substance use disorders. Incorporating technology (e.g., mobile phone applications) may facilitate integrated care. Other venues, including harm reduction programs and carceral settings, should be targets for integrated services. Venues providing healthcare should invest in integrated care and support legislation that increases access to services related to HIV and substance use.

综述目的:与药物使用相关的行为和实践导致缺乏HIV病毒抑制和进一步传播。在美国,最近的许多艾滋病疫情都与药物使用有关。基于证据的综合护理艾滋病毒感染者和感染者以及使用药物者的战略仍在发展。这篇综述基于截至2023年3月的科学和医学文献,概述和评估了旨在为有艾滋病毒和药物使用障碍风险的患者提供服务的综合护理举措。最近的研究结果:综合护理服务可以改善有感染艾滋病毒和药物使用障碍风险的患者的健康状况;例如,阿片类药物使用障碍的治疗可以帮助改善HIV病毒的抑制。实体设施可以提供成功的护理整合,适当的诊所领导可以支持多学科护理团队、最新的提供者培训以及足够的药物使用治疗库存。向社区提供医疗服务(例如,移动医疗诊所和药店、远程医疗)可能被证明是为艾滋病毒和药物使用障碍患者或有风险的患者提供综合服务的有效方式。结合技术(例如,移动电话应用程序)可以促进综合护理。其他场所,包括减少伤害项目和尸体环境,应该成为综合服务的目标。提供医疗保健的场所应投资于综合护理和支持立法,以增加获得与艾滋病毒和药物使用有关的服务的机会。
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引用次数: 0
Intervention Approaches to Address Intimate Partner Violence and HIV: a Scoping Review of Recent Research. 应对亲密伴侣暴力和艾滋病毒的干预方法:最近研究的范围综述。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-10-01 Epub Date: 2023-09-28 DOI: 10.1007/s11904-023-00668-8
Kamila A Alexander, Gloria Mpundu, Brenice Duroseau, Nkemakolem Osian, Shadae Chambers, DaJaneil McCree, Karin E Tobin, Tiara C Willie

Purpose of review: Intimate partner violence (IPV) remains a critical challenge to HIV prevention and treatment efforts across the globe. We examined recently published (January 9, 2017-January 9, 2023) integrated behavioral interventions designed to address IPV and HIV across the care continuum.

Recent findings: Fifteen studies (involving n = 10,947 participants) met the inclusion criteria for this review. Majority (n = 13) of studies focused on IPV and HIV prevention whereas two studies addressed IPV and HIV care engagement among women living with HIV. Ten studies were conducted on the African continent representing 5 countries. Most interventions (n = 11) focused on individual-level outcomes among cisgender women although two involved male partners. About half of the interventions reviewed (n = 8) showed effectiveness on both IPV and HIV outcomes compared to control groups. Integrated HIV/IPV interventions are needed to address the synergistic nature of these epidemics among marginalized populations. Future studies should focus on developing and implementing strength-based interventions among people living with HIV, men, transgender people, and Black women in the USA. Additionally, researchers and program managers should consider addressing structural and internalized stigma as potential behavioral mechanisms for improving health among people simultaneously experiencing or at-risk for HIV and IPV.

审查目的:亲密伴侣暴力仍然是全球艾滋病毒预防和治疗工作面临的重大挑战。我们研究了最近发表的(2017年1月9日至2023年1月09日)综合行为干预措施,旨在解决整个护理过程中的IPV和HIV问题。最近的发现:15项研究(涉及10947名参与者)符合本综述的纳入标准。大多数(n=13)研究侧重于IPV和艾滋病毒预防,而两项研究涉及艾滋病毒感染妇女的IPV和艾滋病护理参与。代表5个国家在非洲大陆进行了10项研究。大多数干预措施(n=11)侧重于顺性别女性的个人层面结果,尽管有两项涉及男性伴侣。与对照组相比,大约一半的受访干预措施(n=8)对IPV和HIV结果均显示出有效性。需要采取综合的艾滋病毒/IPV干预措施,以解决这些流行病在边缘化人群中的协同作用。未来的研究应侧重于在美国的艾滋病毒感染者、男性、跨性别者和黑人女性中制定和实施基于力量的干预措施。此外,研究人员和项目经理应该考虑解决结构性和内化的污名,将其作为改善同时经历或面临艾滋病毒和IPV风险的人群健康的潜在行为机制。
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引用次数: 0
The New Era of Long-Acting Antiretroviral Therapy: When and Why to Make the Switch. 长效抗逆转录病毒疗法的新时代:何时以及为什么要做出改变。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-10-01 Epub Date: 2023-09-21 DOI: 10.1007/s11904-023-00665-x
Melanie C Goebel, Emmanuel Guajardo, Thomas P Giordano, Shital M Patel

Purpose of review: Despite the availability of safe and effective oral combination antiretroviral therapy, barriers to maintaining viral suppression remain a challenge to ending the HIV epidemic. Long-acting injectable antiretroviral therapy was developed as an alternative to daily oral therapy. This review summarizes the current literature on the efficacy of long-acting cabotegravir plus rilpivirine for the treatment of HIV-1, reasons to switch to injectable therapy, and barriers to switching.

Recent findings: Long-acting cabotegravir plus rilpivirine is safe and effective in maintaining HIV-1 virologic suppression. Ideal candidates for switching to long-acting cabotegravir plus rilpivirine are virologically suppressed on oral regimens with good adherence and no history of virologic failure or baseline resistance. Indications to switch to injectable therapy include patient preference, the potential for improved adherence, and avoidance of adverse effects. Implementation research is needed to assess and overcome system barriers. Long-acting cabotegravir plus rilpivirine is a novel alternative to oral antiretrovirals, with the potential to improve adherence and quality of life in people with HIV.

审查目的:尽管有安全有效的口服联合抗逆转录病毒疗法,但维持病毒抑制的障碍仍然是结束艾滋病毒流行的挑战。开发了长效注射抗逆转录病毒疗法,作为日常口服疗法的替代方案。这篇综述总结了目前关于长效卡博替拉韦联合利匹韦林治疗HIV-1的疗效、改用注射疗法的原因以及改用的障碍的文献。最近的发现:长效卡博韦加利匹韦林在维持HIV-1病毒抑制方面是安全有效的。改用长效卡博韦加利匹韦林的理想候选者在口服方案中受到病毒学抑制,具有良好的依从性,没有病毒学失败或基线耐药性史。转向注射治疗的适应症包括患者偏好、改善依从性的潜力以及避免不良反应。需要进行实施研究,以评估和克服系统障碍。长效卡博替拉韦加利匹韦林是口服抗逆转录病毒药物的一种新替代品,有可能改善艾滋病毒感染者的依从性和生活质量。
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引用次数: 0
A Review of Serious Gaming as an Intervention for HIV Prevention. 将严肃游戏作为艾滋病预防干预措施的综述。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-08-01 Epub Date: 2023-05-22 DOI: 10.1007/s11904-023-00659-9
Ariel U Smith, Gabriella M Khawly, Janna Jann, Ana Paola Mata Zetina, Janeth Padilla, Rebecca Schnall

Purposeof review: Young people face the highest number of new HIV infections globally. With today's increasing access to smartphones, serious games have been viewed as an effective means of improving knowledge and behavioral outcomes. This systematic review describes current HIV prevention serious games and their relationship with HIV-related knowledge and behavioral outcomes.

Recent findings: A search of HIV prevention serious games was conducted using PubMed, CINAL, IEEE, Web of Science, and Google Scholar. A total of 31 papers were identified, which consist of 20 studies and 11 protocols. Results for knowledge, attitudes, intentions, and behaviors were mixed. Two interventions reported improvement in PrEP usage and optimal dosing. Gaming appears to be a viable and engaging method to improve knowledge, attitudes, and behavioral outcomes to promote HIV prevention among diverse groups of adolescents and young adults globally. However, additional research is needed to understand how to implement this modality effectively.

审查目的:在全球范围内,年轻人是新感染艾滋病毒人数最多的群体。随着智能手机的普及,严肃游戏被视为提高知识和行为结果的有效手段。本系统综述介绍了当前的艾滋病预防严肃游戏及其与艾滋病相关知识和行为结果之间的关系:我们使用 PubMed、CINAL、IEEE、Web of Science 和 Google Scholar 对艾滋病预防严肃游戏进行了检索。共发现了 31 篇论文,其中包括 20 项研究和 11 项协议。关于知识、态度、意向和行为的研究结果不一。有两项干预报告称,PrEP 的使用率和最佳剂量有所提高。游戏似乎是一种可行的、吸引人的方法,可以改善知识、态度和行为结果,从而促进全球不同青少年群体的艾滋病预防工作。然而,还需要开展更多的研究来了解如何有效地实施这种方式。
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引用次数: 0
Spiraling Risk: Visualizing the multilevel factors that socially pattern HIV risk among gay, bisexual & other men who have sex with men using Complex Systems Theory. 螺旋式风险:利用复杂系统理论可视化在同性恋、双性恋和其他男男性行为者中社会模式HIV风险的多层次因素。
IF 4.6 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-08-01 DOI: 10.1007/s11904-023-00664-y
K Stojanovski, E J King, S O'Connell, K S Gallagher, K P Theall, A T Geronimus

Purpose of review: Global disparities in HIV infection, particularly among gay, bisexual, and other men who have sex with men (GBMSM), indicate the importance of exploring the multi-level processes that shape HIV's spread. We used Complex Systems Theory and the PRISMA guidelines to conduct a systematic review of 63 global reviews to understand how HIV is socially patterned among GBMSM. The purpose was to conduct a thematic analysis of the reviews to (1) synthesize the multi-level risk factors of HIV risk, (2) categorize risk across the socioecological model, and (3) develop a conceptual model that visualizes the interrelated factors that shape GBMSMS's HIV "risk."

Recent findings: We included 49 studies of high and moderate quality studies. Results indicated that GBMSM's HIV risk stems from the individual, interpersonal, and structural levels of the socioecological model. We identified a few themes that shape GBMSM's risk of HIV infection related to biomedical prevention methods; sexual and sex-seeking behaviors; behavioral prevention methods; individual-level characteristics and syndemic infections; lived experiences and interpersonal relationships; country-level income; country-level HIV prevalence; and structural stigma. The multi-level factors, in tandem, serve to perpetuate GBMSM's risk of HIV infection globally. The amalgamation of our thematic analyses from our systematic reviews of reviews suggests that the risk of HIV infection operates in an emergent, dynamic, and complex nature across multiple levels of the socioecological model. Applying complex systems theory indicates how multilevel factors create a dynamic and reinforcing system of HIV risk among GBMSM.

综述目的:艾滋病毒感染的全球差异,特别是同性恋、双性恋和其他男男性行为者(GBMSM)之间的差异,表明探索影响艾滋病毒传播的多层次过程的重要性。我们使用复杂系统理论和PRISMA指南对63项全球综述进行了系统综述,以了解HIV在GBMSM中的社会模式。目的是对综述进行专题分析,以(1)综合艾滋病毒风险的多层次风险因素,(2)跨社会生态模型对风险进行分类,(3)建立一个概念性模型,将影响GBMSMS艾滋病毒风险的相关因素可视化。“最近的发现:我们纳入了49项高质量和中等质量的研究。结果表明,GBMSM的HIV风险来自社会生态模型的个体、人际和结构层面。我们确定了几个与生物医学预防方法有关的影响GBMSM感染艾滋病毒风险的主题;性和寻求性的行为;行为预防方法;个体水平特征与合并症感染;生活经历和人际关系;国家层面的收入;国家一级的艾滋病毒流行情况;以及结构性的病耻感。这些多层次的因素串联在一起,使gbsm在全球范围内感染艾滋病毒的风险持续存在。我们对综述的系统综述的主题分析的合并表明,艾滋病毒感染的风险在社会生态模型的多个层面上以一种紧急的、动态的和复杂的性质运作。运用复杂系统理论揭示了多重因素如何形成一个动态强化的GBMSM HIV风险系统。
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引用次数: 0
Mpox and HIV: a Narrative Review. Mpox 与 HIV:叙述性综述。
IF 3.7 2区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2023-08-01 Epub Date: 2023-05-13 DOI: 10.1007/s11904-023-00661-1
Carlos S Saldana, Colleen F Kelley, Bruce M Aldred, Valeria D Cantos

Purpose of review: We reviewed the available literature on mpox in People with HIV (PWH). We highlight special considerations of mpox infection related to epidemiology, clinical presentation, diagnostic and treatment considerations, prevention, and public health messaging in PWH.

Recent findings: During the 2022 mpox outbreak, PWH were disproportionally impacted worldwide. Recent reports suggest that the disease presentation, management, and prognosis of these patients, especially those with advanced HIV disease, can widely differ from those without HIV-associated immunodeficiency. Mpox can often be mild and resolve on its own in PWH with controlled viremia and higher CD4 counts. However, it can be severe, with necrotic skin lesions and protracted healing; anogenital, rectal, and other mucosal lesions; and disseminated organ systems involvement. Higher rates of healthcare utilization are seen in PWH. Supportive, symptomatic care and single or combination mpox-directed antiviral drugs are commonly used in PWH with severe mpox disease. Data from randomized clinical control trials on the efficacy of therapeutic and preventive tools against mpox among PWH are needed to better guide clinical decisions.

综述目的:我们回顾了有关艾滋病病毒感染者(PWH)水痘的现有文献。我们强调了感染天花的流行病学、临床表现、诊断和治疗注意事项、预防以及针对艾滋病感染者的公共卫生信息等方面的特殊考虑:在 2022 年麻风腮疫情爆发期间,全世界感染麻风腮疫情的威尔士和威尔士族人数不成比例。最新报告显示,这些患者(尤其是晚期艾滋病患者)的疾病表现、管理和预后可能与未患艾滋病相关免疫缺陷的患者大不相同。在病毒血症得到控制、CD4 细胞计数较高的感染者中,麻疹通常是轻微的,并可自行缓解。然而,它也可能很严重,出现皮肤坏死和长期愈合;肛门、直肠和其他粘膜病变;以及器官系统受累。公共卫生人员的医疗保健使用率较高。对于患有严重水痘的威斯康星人,通常采用支持性对症治疗和单一或联合水痘导向抗病毒药物。为了更好地指导临床决策,需要从随机临床对照试验中获得有关治疗和预防水痘工具在威尔士人中疗效的数据。
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引用次数: 0
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