AIDS research and human retroviruses最新文献

Although HIV-1 infection has now become a treatable chronic condition and not the deadly illness it once was, the costs of that treatment are substantial, and each infection prevented saves both financial and other costs. In China, the most predominant subtypes are CRF07_BC, CRF01_AE, and CRF55_01B, and the various second-generation recombinants are produced from the recombination between these subtypes. HIV full-length genome sequences can provide important information on their epidemiology. In this study, we identified two unique recombinant forms (URFs) designated as JLCC230106 and XJWQ230011, which are composed of CRF01_AE/CRF07_BC and CRF07_BC/CRF55_01B, respectively. Phylogenetic and recombinant analyses utilizing near-full-length genome (NFLG) confirmed that these URFs originated from CRF01_AE/CRF07_BC and CRF07_BC/CRF55_01B strains. The emergence of novel recombinants is increasing the genetic diversity of HIV in China. This information can be shared with clinicians, human behavior specialists, or public health policymakers and used as an aid in discovering which methods are best or most cost-effective in combating the spread of HIV.

Kaposi sarcoma (KS) is a common malignancy for people living with HIV (PLWH), despite antiretroviral therapy (ART). Curiously, even with improved CD4⁺ T-cell counts and low viral loads following ART, some PLWH with KS may still experience KS progression or even death and require adjuvant chemotherapy to manage their KS. The factors associated with persistent or unresponsive KS after ART initiation remain poorly characterized, and biomarkers to identify patients at risk of KS progression are needed, particularly in resource-limited areas where access to chemotherapy is limited. Here we analyzed baseline KS tumor biopsies from PLWH with KS who required chemotherapy due to unresolved KS after ART initiation and those who did not require chemotherapy after ART initiation. By examining participant metadata and viral copy number for Kaposi sarcoma-associated herpesvirus (KSHV), HIV, cytomegalovirus, and Epstein-Barr virus and KSHV gene expression in the tumor biopsies prior to ART initiation, we identified a model of factors associated with KS progression after ART initiation, including biological sex, age, and the log ratio of KSHV/HIV copy number in the tumor. We believe that the ratio of KSHV/HIV may be linked to the cell types that each virus infects, and future work exploring the relationship between tumor and immune cells in the baseline tumors is planned. Innovation would be necessary to reduce costs and simplify the viral quantification assays, enabling the translation of these findings into routine clinical care, particularly in resource-limited settings.

Since combined antiretroviral therapy for human immunodeficiency virus-associated neurocognitive dysfunction (HAND) only slows the disease's progression, early identification and timely intervention are crucial for effective therapy. In this article, we review the latest evidence in body fluid biomarkers of HAND, providing an overview of research conducted on cerebrospinal fluid and blood samples to draw conclusions on promising biomarkers. Although the significance of biomarkers such as amyloid metabolites, tau proteins, neurofilament light chain, myelin oligodendrocyte glycoprotein, and brain-derived neurotrophic factor in the early detection of HAND may not be immediately clear, they could potentially play a crucial role in evaluating prognosis and tracking the effectiveness of treatment.

To assess the impact of anemia severity during antiretroviral therapy (ART) on in-hospital mortality among persons living with HIV. We conducted a retrospective cohort study of hospitalized persons living with HIV at the Fourth People's Hospital of Nanning, Guangxi, China, from 2018 to 2020. Kaplan-Meier analysis was used to calculate cumulative mortality rates. The Cox proportional hazards model, 1:1:1 propensity score matching (PSM), and three-group inverse probability of treatment weighting (IPTW) were used to assess the impact of anemia severity on mortality in hospitalized persons living with HIV. A total of 2,217 hospitalized persons living with HIV were included, among whom 409 (18.4%) had anemia: 50 (2.3%) with mild anemia, 174 (7.8%) with moderate anemia, and 185 (8.3%) with severe anemia. Among all AIDS-related complications, patients with severe anemia had a higher mortality rate [20.34/100 person-months, 95% confidence interval (CI): 13.29-27.39], significantly higher than that of persons living with HIV without anemia (7.74/100 person-months, 95% CI: 6.02-9.45); the adjusted hazard ratio (AHR) was 2.422, with a 95% CI of (1.500, 3.913). After PSM and IPTW analyses, results were similar, with PSM (AHR: 4.745, 95% CI: 2.231-10.091) and IPTW (AHR: 1.920, 95% CI: 1.146-3.216). Patients with CD4⁺ T cell counts below 350 per μL and severe anemia had an increased mortality risk. Severe anemia is an independent risk factor for in-hospital death in persons living with HIV in southern China. The importance of timely identification and assessment of anemia severity during ART and prompt treatment to correct anemia, which is crucial for improving anemia burden and prognosis for persons living with HIV.

Extraordinary HIV-1 recombination is occurring in China. Here, a novel second-generation circulating recombinant form (CRF174_0708) was found in Yunnan Province, China. First, Bootscanning revealed a mosaic structure with three subtype B segments inserted into a subtype C backbone. However, phylogenetic analysis showed that subregions 2B (2978-3267) and 4B (6023-6196) were related to CRF07_BC, whereas subregion 6B (8846-8997) was related to CRF08_BC, suggesting that the sequences could be recombined from CRF07_BC and CRF08_BC. Furthermore, Bootscanning-guided partitioning with subregion-specific phylogenetic analysis confirmed that subregions I (790-1902), III (2636-3746), V (4327-5825), VII (6023-6196) and IX (6379-6782) from CRF07_BC, and subregions II (1903-2635), IV (3747-4326), VI (5826-6022), VIII (6197-6378) and XI (7463-9512) from CRF08_BC. Bayesian dating traced the emergence to 2005-2007, consistent with the expansion of the parental strains. This discovery advanced our understanding of HIV-1 evolution.

Since HIV-1 is a retrovirus with a high mutation rate and recombination rate, the virus contains a variety of genotypes and recombinants. The men who have sex with men (MSM) population in Beijing has become the main group of HIV transmission, and the co-transmission of multiple HIV-1 subtypes in the same high-risk group has led to the continuous generation of recombinants between various subtypes. In this study, two unique recombinant forms were identified in the samples from Beijing, and the full-length sequences were amplified and sequenced for analysis. Through the construction of phylogenetic trees and recombination breakpoint analysis, the two recombinants were identified as second-generation recombinants composed of CRF01_AE and CRF07_BC. The emergence of more complex recombinant strains poses new challenges to HIV prevention, and it is necessary to focus on monitoring the epidemic in the MSM population.

Heterosexual transmission (HETE) represents the predominant method of transmission for the human immunodeficiency virus type 1 (HIV-1) in Shijiazhuang, Hebei Province, China. The number of circulating recombinant forms (CRFs) and unique recombinant forms (URFs) continues to increase in this region. In the present study, two novel URFs (TFH010919 and TFH010944) were identified, both derived from HETEs in the Shijiazhuang area. The phylogenetic and recombination breakpoint analyses conducted on the near-full-length genomes of the two novel URFs revealed that the CRF01_AE strains serve as the predominant backbones for both TFH010919 and TFH010944. TFH010919 is a second-generation recombinant form composed of CRF01_AE and CRF07_BC, whereas TFH010944 is formed by the combination of CRF01_AE and CRF68_01B. This finding indicates that HIV-1 prevalence among HETEs remains a significant concern, driven by complex sexual networks that facilitate the spread of diverse recombinant strains, providing more opportunities for the recombination of viruses. The emergence of these new URFs revealed the ongoing evolution of HIV-1 and underscores the critical need for continuous monitoring of viral diversity in Hebei Province and surrounding regions to control HIV-1 transmission within the vulnerable population and beyond.

Despite increased HIV testing and access to treatment in Australia, presentations with advanced disease occur, placing a significant burden on the health system. We sought to describe costs associated with HIV care in the first year post diagnosis in a specialized, tertiary-level HIV service and identify factors predicting increased health care costs. People newly diagnosed with HIV from 2016 to 2020 were included in the study. Data were gathered regarding their demographics (age, gender, birthplace, and first language), HIV parameters (viral load [VL] and CD4 cell count), antiretroviral therapy start date, opportunistic illness history, and health care costs (inpatient, outpatient, and emergency) from 12 months of diagnosis. Multivariable modeling was used to identify factors associated with increased costs. We identified 147 people; median age 38 years, 90% male, median CD4 count at diagnosis 338 cells/µL with median initial cost of care AUD $22,929 (interquartile range $11,902-$39,175). Costs associated with advanced HIV diagnosis (CD4 < 200 cells/µL; n = 52) were more than double an early HIV diagnosis (CD4 ≧ 350 cells/µL; n = 69) (median $46,406 vs. $20,274; p < .001). In univariate analysis, older age, higher VL, low CD4 count, and VL >200 copies/mL after 6 months were associated with increased costs. In multivariate analysis, older age (p = .001) and CD4 count <200 cells/µL (p = .001) were the only factors predicting increased cost in the first year after HIV diagnosis. Prioritizing HIV testing strategies to allow earlier diagnosis of HIV would significantly reduce the financial burden of HIV care.