Journal of AIDS and HIV treatment最新文献

Artificial intelligence (AI) has become an indispensable ally in virology, enabling the analysis of enormous datasets that extend from viral genomes to behavioral and clinical information. HIV-1, a rapidly evolving retrovirus with extraordinary genetic diversity and a persistent latent reservoir, poses unique computational challenges that are now approachable through data-driven models. Modern machine-learning and deep-learning architectures can decode viral sequences, predict drug resistance and co-receptor usage, simulate evolutionary trajectories under therapy, and integrate multi-omics information to identify molecular determinants of persistence. In parallel, AI-assisted chemoinformatic shortens drug-discovery cycles, while network and language models enhance epidemiological surveillance and individualized care. The convergence of AI with organoid technologies, single-cell systems biology, and population informatics is redefining HIV research from static observation to dynamic prediction. Ethical transparency, algorithmic fairness, and equitable access remain central to ensuring that these innovations accelerate-not distort-the path toward durable remission and cure.

Background: Frailty is increasingly recognized in older people living with HIV (PLWH), but optimal diagnostics are yet to be determined. Frailty indices (FI) represent an accumulation of health deficits shown to correlate better with mortality and adverse effects of aging than the frailty phenotype or chronological age.

Methods: This is a retrospective cohort study of frailty assessments in PLWH aged ≥ 50 years in a multidisciplinary urban HIV clinic. Frailty was assessed using Frailty Phenotype (FP) and a new 40-variable clinical composite FI derived from routine clinical and laboratory data (CCFI). CCFI scores were categorized into robust (≤ 0.15), pre-frail (>0.15-0.4), and frail (>0.4). CCFI frailty and its association with frailty-related factors were analyzed using logistic regression.

Results: The 165 participants were mostly black (94%) and male (56%), with median age 59 years (IQR 55-63), CD4 count 606 cells/μl (IQR 393-873), and 78% had HIV viral load ≤ 40 copies/ml. 70% had multimorbidity, 38% falls, 25% poor cognition, and 24% polypharmacy. By FP, 2% were frail, 65% prefrail, and 33% robust. By CCFI, 26% were frail, 67% prefrail, and 7% robust (range 0.08-0.57; mean 0.34 ±0.11). For FP categorized as robust, prefrail and frail, the mean CCFI was 0.31 ± 0.1, 0.35 ± 0.11 and 0.38 ± 0.08 respectively (P=0.06). Cognition (OR 3.64, p=0.003), falls (OR 5.09, p<0.001), polypharmacy of 6-9 medications (OR 3.07, p=0.03) and ≥ 10 medications (OR 4.25, p=0.009) and >3 comorbidities (OR 3.06, p=0.03) were associated with CCFI frailty, adjusted for age and sex.

Conclusion: The majority of older PLWH were pre-frail or frail. The CCFI identified more patients as frail and had significant clinical associations compared to FP.

HIV programs worldwide have achieved remarkable gains toward viral suppression, transforming HIV from a fatal illness into a chronic condition for many. Despite these successes, a substantial proportion of people living with HIV (PLWH) continue to face poor health outcomes that extend well beyond viral control. Persistent social determinants of health and structural barriers, including poverty, stigma, discrimination, and disrupted health systems, limit access to prevention, treatment, and retention in care. At the same time, demographic shifts have created new challenges, with more than half of PLWH in high-income countries now aged ≥50 years, facing accelerated aging, multi-morbidity, and neurocognitive decline. Emerging drug resistance, both pretreatment and transmitted, threatens the durability of existing regimens, particularly in low- and middle-income countries where routine resistance testing remains limited. In reproductive health, women of childbearing age remain disproportionately affected, with ongoing complexities around antiretroviral selection, adverse pregnancy outcomes, and the long-term health of HIV-exposed but uninfected (HEU) infants. This narrative review synthesizes evidence from peer-reviewed studies, global guidelines, and major clinical trials published up until September 2025 to explore these converging issues. By highlighting gaps and opportunities across aging, structural barriers to care, social determinants of health, therapeutic innovation, and reproductive health, we underscore the need for inclusive, multidisciplinary, and evidence-based HIV care models for the next decade.

This review underscores the important role of nutrition in enhancing the management of Human Immunodeficiency Virus type 1 (HIV-1). Highlighting the efficacy of dietary interventions, including, the importance of omega-3 fatty acids, vitamins D and B-12, and the Mediterranean diet, we delineate how these beneficial nutritional strategies can improve the effectiveness of combined antiretroviral therapy (cART), mitigate its side effects, and ameliorate metabolic disorders in people living with HIV-1 (PLWH). Our review advocates for the integration and implementation of personalized nutritional assessments into the care plan for PLWH, proposing actionable strategies for healthcare providers in HIV-1 field. Summarizing the current standing of the relevance of the nutritional and well-planned diet recommended for the PLWH and emphasizing on the future research directions, this review establishes a foundation for nutrition as a cornerstone in comprehensive HIV-1 management. Our review aims to improve patients' health outcomes and overall quality of life for PLWH.