A high proportion of individuals with HIV infection currently are diagnosed at an advanced stage of disease (late presenters), increasing their risk for immune reconstitution inflammatory syndrome (IRIS). IRIS typically occurs within 6 months of initiation of antiretroviral therapy (ART) in patients with low CD4+ cell counts and can occur before any marked elevation in CD4+ count is achieved on ART. In addition to low CD4+ count at ART initiation, 2 other major clinical predictors of IRIS are preexisting opportunistic infection (including subclinical infection) and shorter treatment period for opportunistic infection prior to starting ART. Mycobacterial infection-associated IRIS, including tuberculosis (TB)-associated IRIS, and cryptococcal infection-associated IRIS are the most common forms of the syndrome. Corticosteroid prophylaxis and early treatment can be effective in reducing incidence of TB-IRIS and severity of symptoms in select patients. Sterilization of the cerebrospinal fluid should be achieved prior to starting ART in patients with TB meningitis and cryptococcal meningitis. This article summarizes a presentation by Irini Sereti, MD, MHS, at the International Antiviral Society-USA (IAS-USA) continuing education program held in Washington, DC, in April 2019.
{"title":"Immune reconstruction inflammatory syndrome in HIV infection: beyond what meets the eye.","authors":"Irini Sereti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A high proportion of individuals with HIV infection currently are diagnosed at an advanced stage of disease (late presenters), increasing their risk for immune reconstitution inflammatory syndrome (IRIS). IRIS typically occurs within 6 months of initiation of antiretroviral therapy (ART) in patients with low CD4+ cell counts and can occur before any marked elevation in CD4+ count is achieved on ART. In addition to low CD4+ count at ART initiation, 2 other major clinical predictors of IRIS are preexisting opportunistic infection (including subclinical infection) and shorter treatment period for opportunistic infection prior to starting ART. Mycobacterial infection-associated IRIS, including tuberculosis (TB)-associated IRIS, and cryptococcal infection-associated IRIS are the most common forms of the syndrome. Corticosteroid prophylaxis and early treatment can be effective in reducing incidence of TB-IRIS and severity of symptoms in select patients. Sterilization of the cerebrospinal fluid should be achieved prior to starting ART in patients with TB meningitis and cryptococcal meningitis. This article summarizes a presentation by Irini Sereti, MD, MHS, at the International Antiviral Society-USA (IAS-USA) continuing education program held in Washington, DC, in April 2019.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162680/pdf/tam-27-106.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37781613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Effective antiretroviral therapy has extended life expectancy for individuals with HIV. Estimates from 2015 indicate that 47% of persons with HIV in the US were older than 50 years of age and 16% were older than 65 years. These older patients are at increased risk of age-related diseases and conditions. Further, there is substantial evidence that patients with HIV infection accumulate age-related conditions earlier than do those in the general population. There is risk for increased comorbidities and polypharmacy in the aging HIV-infected population. Specific measures for assessing and reducing the risk of cardiovascular disease and other age-related conditions in the aging HIV population are needed. This article summarizes a presentation by Judith A. Aberg, MD, at the International Antiviral Society-USA (IAS-USA) annual continuing education program held in Chicago, Illinois, in May 2019.
有效的抗逆转录病毒治疗延长了艾滋病毒感染者的预期寿命。2015年的估计表明,美国47%的艾滋病毒感染者年龄在50岁以上,16%的人年龄在65岁以上。这些老年患者患与年龄有关的疾病和病症的风险增加。此外,有大量证据表明,艾滋病毒感染患者比一般人群更早积累与年龄相关的疾病。老年艾滋病毒感染人群的合并症和多重用药风险增加。需要采取具体措施,评估和减少老年艾滋病毒感染者患心血管疾病和其他与年龄有关的疾病的风险。本文总结了Judith a . Aberg医学博士在2019年5月在伊利诺伊州芝加哥举行的美国国际抗病毒学会(IAS-USA)年度继续教育项目上的演讲。
{"title":"Aging and HIV infection: focus on cardiovascular disease risk.","authors":"Judith A Aberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Effective antiretroviral therapy has extended life expectancy for individuals with HIV. Estimates from 2015 indicate that 47% of persons with HIV in the US were older than 50 years of age and 16% were older than 65 years. These older patients are at increased risk of age-related diseases and conditions. Further, there is substantial evidence that patients with HIV infection accumulate age-related conditions earlier than do those in the general population. There is risk for increased comorbidities and polypharmacy in the aging HIV-infected population. Specific measures for assessing and reducing the risk of cardiovascular disease and other age-related conditions in the aging HIV population are needed. This article summarizes a presentation by Judith A. Aberg, MD, at the International Antiviral Society-USA (IAS-USA) annual continuing education program held in Chicago, Illinois, in May 2019.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162677/pdf/tam-27-102.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37781612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Achieving a cure for HIV remains a priority in HIV research. Two cases of 'sterilizing cure' have been observed-in Timothy Ray Brown and the "London" patient; both patients received allogeneic hematopoietic stem cell transplantation (HSCT) from donors homozygous for the CCR5-delta 32 deletion, which impairs function of an HIV coreceptor on host cells. Other strategies that have been evaluated for achieving sterilizing cure or functional cure--ie, sustained virologic remission in the absence of antiretroviral therapy (ART)-include: HSCT with wild-type CC chemokine receptor (CCR5); early ART to limit size of the HIV latent reservoir; shock and kill strategies using latency reversing agents and/or anti-HIV broadly neutralizing antibodies; and gene therapy, including attempts to modify CCR5 genes, HIV proviruses in autologous host cells, or enhanced T cells. This article summarizes a presentation by Jonathan Li, MD, MMSc, at the International Antiviral Society-USA (IAS-USA) continuing education program held in Atlanta, Georgia, in March 2019.
治愈艾滋病毒仍然是艾滋病毒研究的一个优先事项。已经观察到两个“绝育治疗”的案例——蒂莫西·雷·布朗和“伦敦”病人;这两名患者都接受了来自供体的同种异体造血干细胞移植(HSCT),这些供体的ccr5 - δ 32缺失纯合子会损害宿主细胞上HIV辅助受体的功能。其他已被评估用于实现绝育治愈或功能性治愈的策略(即在没有抗逆转录病毒治疗(ART)的情况下持续病毒学缓解)包括:使用野生型CC趋化因子受体(CCR5)的HSCT;早期抗逆转录病毒治疗以限制艾滋病毒潜伏库的大小;使用潜伏期逆转剂和/或抗艾滋病毒广泛中和抗体的休克和杀伤策略;以及基因治疗,包括尝试修改CCR5基因、自体宿主细胞中的HIV前病毒或增强型T细胞。本文总结了2019年3月在乔治亚州亚特兰大举行的美国国际抗病毒学会(IAS-USA)继续教育项目上,医学博士、MMSc Jonathan Li的演讲。
{"title":"Advances toward a cure for HIV: getting beyond n=2.","authors":"Jonathan Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Achieving a cure for HIV remains a priority in HIV research. Two cases of 'sterilizing cure' have been observed-in Timothy Ray Brown and the \"London\" patient; both patients received allogeneic hematopoietic stem cell transplantation (HSCT) from donors homozygous for the CCR5-delta 32 deletion, which impairs function of an HIV coreceptor on host cells. Other strategies that have been evaluated for achieving sterilizing cure or functional cure--ie, sustained virologic remission in the absence of antiretroviral therapy (ART)-include: HSCT with wild-type CC chemokine receptor (CCR5); early ART to limit size of the HIV latent reservoir; shock and kill strategies using latency reversing agents and/or anti-HIV broadly neutralizing antibodies; and gene therapy, including attempts to modify CCR5 genes, HIV proviruses in autologous host cells, or enhanced T cells. This article summarizes a presentation by Jonathan Li, MD, MMSc, at the International Antiviral Society-USA (IAS-USA) continuing education program held in Atlanta, Georgia, in March 2019.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162679/pdf/tam-27-091.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37781179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annemarie M Wensing, Vincent Calvez, Francesca Ceccherini-Silberstein, Charlotte Charpentier, Huldrych F Günthard, Roger Paredes, Robert W Shafer, Douglas D Richman
The 2019 edition of the IAS-USA drug resistance mutations list updates the Figure last published in January 2017. The mutations listed are those that have been identified by specific criteria for evidence and drugs described. The Figure is designed to assist practitioners in identifying key mutations associated with resistance to antiretroviral drugs, and therefore, in making clinical decisions regarding antiretroviral therapy.
{"title":"2019 update of the drug resistance mutations in HIV-1.","authors":"Annemarie M Wensing, Vincent Calvez, Francesca Ceccherini-Silberstein, Charlotte Charpentier, Huldrych F Günthard, Roger Paredes, Robert W Shafer, Douglas D Richman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The 2019 edition of the IAS-USA drug resistance mutations list updates the Figure last published in January 2017. The mutations listed are those that have been identified by specific criteria for evidence and drugs described. The Figure is designed to assist practitioners in identifying key mutations associated with resistance to antiretroviral drugs, and therefore, in making clinical decisions regarding antiretroviral therapy.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Available data indicate that 55% of women and 20% of men living with HIV infection experience intimate parter violence (IPV) and that 24% of women experience abuse by their partners after disclosing their HIV serostatus. IPV increases the risk of HIV acquisition and often interferes with victims' engagement in and adherence to HIV care. The processes of integrating IPV screening as part of a health-centered approach in the HIV clinic are discussed. This article is based on a presentation by Tami P. Sullivan, PhD, at the 2018 Clinical Conference at the National Ryan White Conference on HIV Care and Treatment in December 2018.
现有数据表明,55%感染艾滋病毒的妇女和20%感染艾滋病毒的男子遭受亲密伴侣暴力,24%的妇女在披露其艾滋病毒抗体状况后遭受伴侣虐待。IPV增加了感染艾滋病毒的风险,并经常干扰受害者参与和坚持艾滋病毒护理。将IPV筛查作为艾滋病毒诊所以健康为中心的方法的一部分的过程进行了讨论。本文基于Tami P. Sullivan博士在2018年12月全国Ryan White艾滋病护理和治疗会议2018年临床会议上的演讲。
{"title":"The intersection of intimate partner violence and HIV: detection, disclosure, discussion, and implications for treatment adherence.","authors":"Tami P Sullivan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Available data indicate that 55% of women and 20% of men living with HIV infection experience intimate parter violence (IPV) and that 24% of women experience abuse by their partners after disclosing their HIV serostatus. IPV increases the risk of HIV acquisition and often interferes with victims' engagement in and adherence to HIV care. The processes of integrating IPV screening as part of a health-centered approach in the HIV clinic are discussed. This article is based on a presentation by Tami P. Sullivan, PhD, at the 2018 Clinical Conference at the National Ryan White Conference on HIV Care and Treatment in December 2018.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550354/pdf/tam-27-084.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37281845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rates of syphilis and other sexually transmitted infections are on the rise in the United States. The lesions of early syphilis can be mistaken for those of other infections and conditions, and syphilis should be suspected in all sexually active patients presenting with a new skin rash or an oral or genital lesion. Rapid diagnosis and treatment of syphilis as well as rapid identification and treatment of sexual contacts are needed to reverse the trend of increasing incidence. Available data indicate success in reducing acquisition of syphilis with doxycyclinepre- and postexposure prophylaxis. This article is based on a presentation by Jeffrey D. Klausner, MD, MPH, at the 2018 Clinical Conference at the National Ryan White Conference on HIV Care and Treatment in December 2018.
在美国,梅毒和其他性传播疾病的发病率正在上升。早期梅毒的病变可能被误认为是其他感染和疾病的病变,所有出现新皮疹或口腔或生殖器病变的性活跃患者都应怀疑是梅毒。需要快速诊断和治疗梅毒以及快速识别和治疗性接触,以扭转发病率上升的趋势。现有数据表明,多西环素暴露前和暴露后预防可以成功地减少梅毒的感染。本文基于Jeffrey D. Klausner医学博士和公共卫生硕士在2018年12月全国瑞安·怀特艾滋病护理和治疗会议的2018年临床会议上的演讲。
{"title":"The great imitator revealed: syphilis.","authors":"Jeffrey D Klausner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rates of syphilis and other sexually transmitted infections are on the rise in the United States. The lesions of early syphilis can be mistaken for those of other infections and conditions, and syphilis should be suspected in all sexually active patients presenting with a new skin rash or an oral or genital lesion. Rapid diagnosis and treatment of syphilis as well as rapid identification and treatment of sexual contacts are needed to reverse the trend of increasing incidence. Available data indicate success in reducing acquisition of syphilis with doxycyclinepre- and postexposure prophylaxis. This article is based on a presentation by Jeffrey D. Klausner, MD, MPH, at the 2018 Clinical Conference at the National Ryan White Conference on HIV Care and Treatment in December 2018.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550356/pdf/tam-27-071.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37281844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The leading cause of non-HIV-related mortality is liver disease. Fatty liver disease can be characterized as alcoholic or nonalcoholic in nature. Alcohol use is prevalent among individuals with HIV infection and can lead to medication nonadherence, lower CD4+ cell count, inadequate viral suppression, and disease progression. The pathogenesis of nonalcoholic fatty liver disease (NAFLD) in individuals with HIV infection includes metabolic syndrome, hyperuricemia, HIV-related lipodystrophy, genetic polymorphisms, medications, HIV itself, and the gut microbiome. The prevalence of NAFLD in persons with HIV infection ranges from 30% to 65% depending on the modality of diagnosis. Individuals with HIV infection and NAFLD are at higher risk of cardiovascular disease; however, there is a dearth of longitudinal outcomes studies on this topic. Current therapies for NAFLD, such as vitamin E and pioglitazone, have not been studied in persons with HIV infection. There are several drugs in phase II and III clinical trials that specifically target NAFLD in HIV, including CC chemokine receptor 5 inhibitors, growth hormone-releasing factor agonists, and stearoyl-CoA desaturase inhibitors. Persons with HIV should be screened for NAFLD while pursuing aggressive risk factor modification and lifestyle changes, given the increased risk of cardiovascular mortality.
{"title":"Fatty liver disease in persons with HIV infection.","authors":"Aradhna Seth, Kenneth E Sherman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The leading cause of non-HIV-related mortality is liver disease. Fatty liver disease can be characterized as alcoholic or nonalcoholic in nature. Alcohol use is prevalent among individuals with HIV infection and can lead to medication nonadherence, lower CD4+ cell count, inadequate viral suppression, and disease progression. The pathogenesis of nonalcoholic fatty liver disease (NAFLD) in individuals with HIV infection includes metabolic syndrome, hyperuricemia, HIV-related lipodystrophy, genetic polymorphisms, medications, HIV itself, and the gut microbiome. The prevalence of NAFLD in persons with HIV infection ranges from 30% to 65% depending on the modality of diagnosis. Individuals with HIV infection and NAFLD are at higher risk of cardiovascular disease; however, there is a dearth of longitudinal outcomes studies on this topic. Current therapies for NAFLD, such as vitamin E and pioglitazone, have not been studied in persons with HIV infection. There are several drugs in phase II and III clinical trials that specifically target NAFLD in HIV, including CC chemokine receptor 5 inhibitors, growth hormone-releasing factor agonists, and stearoyl-CoA desaturase inhibitors. Persons with HIV should be screened for NAFLD while pursuing aggressive risk factor modification and lifestyle changes, given the increased risk of cardiovascular mortality.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550355/pdf/tam-27-075.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37281846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), a plan for ending the HIV epidemic in the United States was presented. More rapid HIV diagnosis and treatment is a key component needed nationwide. In international settings, substantial scale up of HIV testing and treatment has led to substantial declines in HIV incidence. U=U (undetectable equals untransmittable) is a powerful concept that can reduce stigma and encourage engagement in testing and care, but raises a number of clinical questions. HIV testing remains a gateway to HIV prevention and treatment, and innovative testing strategies, including HIV self-testing, show promise. Opioid overdose deaths are on the rise, highlighting the need for comprehensive prevention efforts. Molecular data are being used to identify rapidly growing clusters of infections for intervention. Rates of sexually transmitted infections have increased substantially in recent years. A new preexposure prophylaxis (PrEP) combination, tenofovir alafenamide/emtricitabine (FTC), was demonstrated to be non inferior to tenofovir disoproxil fumarate/FTC, with improved bone and renal safety. PrEP uptake is increasing globally, but use is lower in several populations, including African Americans, cis- and transgender women, and youth. Same-day PrEP initiations are a promising approach to increasing access, but PrEP discontinuations remain a challenge.
{"title":"CROI 2019: advances in HIV prevention and plans to end the epidemic.","authors":"Susan P Buchbinder, Albert Y Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>At the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), a plan for ending the HIV epidemic in the United States was presented. More rapid HIV diagnosis and treatment is a key component needed nationwide. In international settings, substantial scale up of HIV testing and treatment has led to substantial declines in HIV incidence. U=U (undetectable equals untransmittable) is a powerful concept that can reduce stigma and encourage engagement in testing and care, but raises a number of clinical questions. HIV testing remains a gateway to HIV prevention and treatment, and innovative testing strategies, including HIV self-testing, show promise. Opioid overdose deaths are on the rise, highlighting the need for comprehensive prevention efforts. Molecular data are being used to identify rapidly growing clusters of infections for intervention. Rates of sexually transmitted infections have increased substantially in recent years. A new preexposure prophylaxis (PrEP) combination, tenofovir alafenamide/emtricitabine (FTC), was demonstrated to be non inferior to tenofovir disoproxil fumarate/FTC, with improved bone and renal safety. PrEP uptake is increasing globally, but use is lower in several populations, including African Americans, cis- and transgender women, and youth. Same-day PrEP initiations are a promising approach to increasing access, but PrEP discontinuations remain a challenge.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550360/pdf/tam-27-008.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37281848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), there was a major focus on hepatitis C virus (HCV) elimination and improving each component of the hepatitis C care cascade. Many interventions showed promising improvements in diagnosis and linkage to care. Settings with robust access to direct-acting antivirals (DAAs) continue to demonstrate the role of HCV treatment as prevention. However, substantial barriers to accessing curative therapy remain. Reinfection after treatment presents an important barrier to elimination, particularly in some populations of men who have sex with men (MSM). MSM without HIV infection are at an elevated risk for sexual acquisition of HCV, and several studies reported HCV rates that were as high as those seen in MSM living with HIV. There was also a focus on HCV and HBV in pregnant women. Rates of HCV infection in women of child-bearing potential have increased, making prenatal diagnosis a priority. In the first study of HCV treatment during pregnancy, sofosbuvir/ledipasvir started at 28 weeks of gestation led to cure in 8 pregnant women. Hepatitis B virus (HBV)-active antiretrovirals are generally effective in suppressing HBV but have low rates of surface antigen loss despite long term treatment. Initial results from novel laboratory assessments of intrahepatic HBV viral infection events were presented, hopefully paving the way for more effective HBV treatment strategies to control and potentially cure HBV.
{"title":"CROI 2019: highlights of viral hepatitis.","authors":"Anne F Luetkemeyer, David L Wyles","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>At the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), there was a major focus on hepatitis C virus (HCV) elimination and improving each component of the hepatitis C care cascade. Many interventions showed promising improvements in diagnosis and linkage to care. Settings with robust access to direct-acting antivirals (DAAs) continue to demonstrate the role of HCV treatment as prevention. However, substantial barriers to accessing curative therapy remain. Reinfection after treatment presents an important barrier to elimination, particularly in some populations of men who have sex with men (MSM). MSM without HIV infection are at an elevated risk for sexual acquisition of HCV, and several studies reported HCV rates that were as high as those seen in MSM living with HIV. There was also a focus on HCV and HBV in pregnant women. Rates of HCV infection in women of child-bearing potential have increased, making prenatal diagnosis a priority. In the first study of HCV treatment during pregnancy, sofosbuvir/ledipasvir started at 28 weeks of gestation led to cure in 8 pregnant women. Hepatitis B virus (HBV)-active antiretrovirals are generally effective in suppressing HBV but have low rates of surface antigen loss despite long term treatment. Initial results from novel laboratory assessments of intrahepatic HBV viral infection events were presented, hopefully paving the way for more effective HBV treatment strategies to control and potentially cure HBV.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550361/pdf/tam-27-041.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37284747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The annual Conference on Retroviruses and Opportunistic Infections remains the preeminent venue for the sharing and dissemination of research advances in the field of HIV and AIDS research. The 26th conference in Seattle featured highlights including news of additional individuals who experienced long-term virologic remission following a bone marrow transplant. The factors driving reservoir persistence gathered a lot of interest, as well as data presented on new factors involved in regulating HIV-1 latency. The effectiveness of the conference in disseminating new findings is further enhanced through themed discussions that focus the attention of participants on abstracts with a common theme. In addition, the Program Committee workshops provide an outstanding venue, directed to new investigators, fellows, and students, to receive updates on different aspects of HIV and AIDS research. These sessions add to the information-sharing environment provided by the conference.
{"title":"CROI 2019: advances in basic science understanding of HIV.","authors":"Mario Stevenson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The annual Conference on Retroviruses and Opportunistic Infections remains the preeminent venue for the sharing and dissemination of research advances in the field of HIV and AIDS research. The 26th conference in Seattle featured highlights including news of additional individuals who experienced long-term virologic remission following a bone marrow transplant. The factors driving reservoir persistence gathered a lot of interest, as well as data presented on new factors involved in regulating HIV-1 latency. The effectiveness of the conference in disseminating new findings is further enhanced through themed discussions that focus the attention of participants on abstracts with a common theme. In addition, the Program Committee workshops provide an outstanding venue, directed to new investigators, fellows, and students, to receive updates on different aspects of HIV and AIDS research. These sessions add to the information-sharing environment provided by the conference.</p>","PeriodicalId":38738,"journal":{"name":"Topics in antiviral medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550362/pdf/tam-27-002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37281847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}