AIDS research and human retroviruses最新文献

Monitoring HIV viral rebound (VR) is crucial, as it indicates an increased risk of infection, transmission, disease progression, and drug resistance. This study aims to identify the association between dynamic VR and historical viral load (VL)/CD4 count measures. Fifteen-year South Carolina population-based electronic health record data were used for the study. VR was defined as the return of detectable levels of VL (>200 copies/mL) after stable viral suppression (VS) (two consecutive VS, i.e., VL ≤200 copies/mL). A generalized linear mixed model was used to evaluate the association between dynamic VR and historical time-dependent predictors, such as nadir CD4 count and comorbidities, within a year prior to each VR. Subgroup analysis for men who have sex with men (MSM) was also conducted. Among 8,185 people with HIV (PWH), 1,173 (14.3%) had a history of VR. Lower nadir CD4 count (≥500 vs. <200 cells/µL; adjusted odds ratio [aOR]: 0.51, 95% confidence interval [CI]: [0.43, 0.60]), younger age (>60 years old vs. 18-30 years old; aOR: 0.43, 95% CI: [0.29, 0.63]), and being Black (Black vs. White; aOR: 1.58, 95% CI: [1.34, 1.85]) were associated with a higher risk of VR, while MSM (MSM vs. heterosexual; aOR: 0.81, 95% CI: [0.67, 0.96]) were associated with decreased VR risk. The rate of VR among PWH in South Carolina is significant. Within-1-year VL/CD4 test is critical for identifying PWH at risk for VR. Tailored interventions are needed for PWH at risk for VR to achieve sustained suppression and better health outcomes.

Infection with human immunodeficiency virus (HIV) shows a higher risk of infection by human papillomavirus (HPV). We aim to provide evidence about the effect of a Coriolus versicolor-based vaginal gel (Papilocare®) for treating HPV in women with HIV. Women ≥25 years coinfected by endocervical HPV and with low-grade abnormal cervicovaginal cytology were treated for 6 months with Papilocare in this observational, prospective, noncontrolled pilot study. Cytology, colposcopy, biopsy, hybrid capture test, and 5-point Likert scale were assessed to evaluate cervical lesions repair, HPV clearance, and changes in cervical reepithelization, respectively, at 6 months. Fifteen patients (25-54 years) were included. Overall HPV clearance and cytological normalization rates were 73.3% and 80.0%, respectively, and 55.6% of the abnormal colposcopies were normalized. Reepithelialization index improved in 66.7% of cases. Papilocare may be effective for managing endocervical HPV infection in patients living with HIV.

Chronic pain can be complicated by problematic opioid use, which may decrease engagement in care and HIV medication adherence. Pain-related anxiety and catastrophic thinking augment pain severity and interference while driving increased substance use. The acceptability and effect of a music-based smartphone application on negative affect and catastrophic thinking were evaluated in a mixed-methods study among persons living with HIV (PWH) with problematic opioid use and chronic pain. Participants (N = 16) completed a 10-min music listening session, quantitative assessment, and qualitative interview. Paired sample t-tests compared pre- and post-test scores of negative affect (Profile of Mood States-Short Form) and pain catastrophizing (Situational Pain Catastrophizing Scale) before and after music. Qualitative data were analyzed using within-case, across-case analysis. Negative affect significantly decreased after the music listening session (pre 8.3 ± 6.7 vs. post 1.8 ± 2.6; p = .0003), as did pain catastrophizing (pre 8.5 ± 4.3 vs. post 2.5 ± 3.4; p < .0001). Qualitatively, participants (n = 14) viewed the app-based music listening session as acceptable and potentially useful as an intervention or adjuvant for pain management and reduction of opioid use. Overall, a brief exposure to a novel music app produced significant improvements in negative affect and pain-related catastrophic thoughts among PWH with problematic opioid use and chronic pain. Future work should further explore the effects of music on pain and the use of illicit substances more broadly in this population.

Current trials toward an HIV cure involve combination strategies aimed at achieving durable antiretroviral treatment (ART)-free viral control or HIV elimination, many relying on analytical treatment interruptions (ATIs) to evaluate efficacy. Given the physical, psychosocial, and interpersonal risks associated with ATIs, it is critical to monitor participants' experiences so that support can be provided when needed. While qualitative approaches have been used in similar settings, we designed and implemented a series of short, closed-ended participant surveys in the University of California, San Francisco-amfAR trial, a single-arm multi-intervention HIV cure-related trial with an extended ATI. Surveys were administered at relevant trial timepoints to capture participants' (n = 10) perspectives and experiences. These included their understanding of the trial, motivations, expectations, perceived risks, benefits, and burdens of trial participation, as well as their perspectives on restarting ART and partner protections. We describe these data using descriptive statistics and summarize lessons learned from implementing quantitative surveys in this complex trial. Our data indicate that all respondents understood the scientific goals and requirements of participating in the trial. Most were motivated to help advance research but many expressed anxiety about participating. During the trial, respondents had limited side effects, discomfort, and trial burnout. Those who completed surveys at ART restart reported mixed (positive and negative) feelings and challenges (e.g., missed doses) when restarting ART. Participants offered various methods for partner protection during ATIs and at ART restart. Many respondents expressed future willingness to participate in a similar HIV cure trial. While the number of respondents was small, these findings are consistent with concerns identified in guidance regarding these types of trials as well as qualitative findings from earlier studies. Moreover, we demonstrated that it is feasible to implement quantitative evaluations of participants' experiences. Such approaches should be implemented in future HIV cure trials to optimize human-centered research implementation.

Recombination contributes substantially to the genetic diversity of HIV-1. Here we reported a novel HIV-1 recombinant detected from a Chinese labor who had been to Uganda as an immigrant worker using nanopore sequencing. Near full-length genome (NFLG) phylogenetic analysis showed that the novel HIV-1 recombinant HIV-sd1801 stood in a distinct branch between the CRF130_A1B/CRF131_A1B and CRF50_A1D/CRF84_A1D reference sequences. Recombinant analysis showed that the NFLG of HIV-sd1801 was composed of subtypes A1, D, and K, with 19 recombinant breakpoints observed in the gag, pol, tat, rev, vpu, env, and nef regions. This is the first detection of a novel HIV-1 recombinant (A1/D/K) in immigrant workers in China, which indicated the continuous evolution of HIV-1 among this population and underscored the importance of continuous surveillance of the dynamic changes of HIV-1.

Many new circulating recombinant forms (CRFs) and unique recombinant forms (URFs) of human immunodeficiency virus type-1 (HIV-1) have been discovered in populations with multiple circulating HIV-1 genotypes. In this study, we report two novel URFs derived from two individuals who were HIV-1 positive in Hebei, China, who were infected through homosexual (BDD142) and heterosexual (BDD154) contact. Phylogenetic and recombinant analyses of the two NFLG revealed that they are second-generation recombinant strains originating from the CRF01_AE cluster 4/B and CRF01_AE cluster 5/B strains. The BDD142 viral genome consists of a subtype B fragment inserted into a CRF01_AE backbone, whereas the BDD154 virus genome consists of two subtype B fragments inserted into a CRF01_AE backbone. Prompt monitoring of molecular epidemiological shifts of HIV-1 within sexually transmitted populations and enhanced behavioral interventions targeting this group are imperative to mitigate the spread of HIV-1 effectively.

This study focuses on women of childbearing age infected with HIV-1 in Liangshan Prefecture and analyses their HIV-1 RNA and HIV-1 DNA genotypic drug resistance to provide a theoretical basis and technical support for monitoring the spread of resistant strains and formulating and optimizing antiretroviral therapy regimens. The study subjects were women of childbearing age infected with HIV-1 who were followed up in the county of Liangshan Prefecture from January to September 2023. Peripheral venous blood samples were collected from each subject. The samples were centrifuged to separate the plasma and blood cells for HIV-1 RNA quantitative testing and HIV-1 genotypic drug resistance testing. A total of 47 participants were included in this study. When HIV-1 RNA were <50 copies/mL and between 50 and 1,000 copies/mL, the success rate of HIV-1 DNA pol gene amplification was significantly higher than that of HIV-1 RNA pol gene amplification. Among the 47 subjects, 17 (17/47, 36.17%) indicated successfully amplified HIV-1 RNA and HIV-1 DNA genotypic drug resistance in each region simultaneously, and 9 (9/17, 52.94%) developed any degree of resistance. Among these nine cases, five had consistent resistance, while four indicated inconsistent resistance. Among the five cases with identical drug resistance, there were three cases with inconsistent drug resistance mutations (DRMs). Among the four cases with inconsistent drug resistance results, one had DRMs at the HIV-1 DNA level but no DRMs at the HIV-1 RNA level, while the other three had more DRMs at the HIV-1 RNA level than at the HIV-1 DNA level. The combination of HIV-1 RNA and HIV-1 DNA genotypic drug resistance testing can improve the drawbacks of current single HIV-1 RNA genotypic drug resistance testing, especially when HIV-1 RNA is ≤1,000 copies/mL, and significantly improve the efficiency of HIV-1 genotypic drug resistance testing.

In 2023, we published a case study involving a 10-year-old child infected with HIV-1 with low-level viremia (LLV). We showed that this child patient achieved successful viral suppression by modifying the antiretroviral therapy (ART) regimen according to the HIV-1 DNA genotypic drug resistance testing. In this study, we aimed to address whether HIV-1 DNA genotypic drug resistance testing could direct successfully virological suppression in patients infected with HIV-1 experiencing persistent LLV based on evidence from a cohort study. The subjects of this study were all people living with HIV-1 who received ART and followed in the Yuexi County (Liangshan, China) from December 2010 to February 2024. From June 2021 to February 2024, a total of 10 mL of peripheral blood was collected from each subject at each follow-up and separated. HIV-1 RNA and HIV-1 DNA were quantified, followed by HIV-1 genotypic drug resistance testing. ART regimens were accordingly adjusted, while follow-up tests were performed in terms of HIV-1 RNA and DNA measurements. The prevalent HIV-1 DNA drug resistance mutations (DRMs) included M184V, K103N, K101E/P, and V108I. The primary resistance mutations observed for nucleoside reverse transcriptase inhibitor (NRTI) were against abacavir, lamivudine, and emtricitabine. For non-NRTI, the primary DRMs were associated with efavirenz and nevirapine. Five out of the six patients were subjected to regimen adjustments according to HIV-1 DNA DRMs, while one patient was continuously treated with unchanged regimen. Viral suppression was achieved in all five ART-changed cases, with observation of remarkable of HIV-1 DNA decline. The ART-unchanged case showed progressive treatment failure with drastic increase of plasma HIV-1 RNA and whole blood HIV-1 DNA. For patients with LLV, HIV-1 DNA genotypic drug resistance testing directed ART regimen considerations are highly recommended for achieving viral suppression.

Molecular transmission networks are being used with increasing frequency to study HIV-1 transmission patterns and to develop precise intervention strategies for high-risk populations. Here, we analyzed the molecular transmission networks of newly diagnosed patients with HIV-1 in Hefei City, Anhui Province, from 2017 to 2022. Of the 1,413 newly diagnosed HIV-1 Pol sequences, the major genotypes in Hefei were CRF07_BC (600, 42.5%) and CRF01_AE (530, 37.5%). Molecular transmission network analysis identified 146 clusters and 9 large propagation clusters, including four CRF01_AE clusters, four CRF07_BC clusters, and one CRF55_01B cluster. This study highlights the pattern of local HIV-1 transmission in Hefei City, with notable rapid transmission of CRF55_01B. It suggests that the implementation of focused strategies for the identified key transmission clusters is essential for effective control of the HIV-1 epidemic.

There has been significant controversy surrounding the use of HIV sequence data to identify outbreaks of HIV transmission since the initiation of molecular HIV surveillance (MHS) in the US. The current approach to MHS is comprehensive cluster detection and response (CDR), in which clusters of related infections are identified and used as the basis for cluster-based or population-based interventions. With CDR, there are ethical and stigma concerns around the impingement of individual privacy, as well as legal concerns around the inference of transmission in regions where HIV criminalization laws and statutes exist. Here we propose an alternative approach to the analysis of HIV sequence and public health data that focuses on regions and populations rather than clusters, and still provides useful data for public health agencies.