AIDS reviews最新文献

The human being is sexed, as there are men and women. The presence of two complementary sexes provides a biological mechanism for evolution and adaptation to changing environments through reproduction with the admixture of distinct genetic traits. Ultimately, this reproductive meaning of sex provides its most important biological foundation. In humans, sexuality also plays a significant role in interpersonal relationships and affection, uniquely contributing to personhood, well-being, and flourishing. In this way, both meanings of human sexuality, reproductive and affective, can be challenged in certain scenarios, such as when there are intersex states of biological basis, nowadays referred to as disorders or differences of sex development (DSD), same-sex orientation, or gender dysphoria. Following the approach taken for DSD, same-sex attraction and transgender identity could be categorized medically as differences in sexual orientation and self-identity, respectively. This could provide a respectful framework for conducting research about sexuality. Herein, we examine the spectrum of differences in the sexual sphere and update on major determinants. Whereas biological factors lead to DSD, psychological and sociocultural variables largely contribute to same-sex orientation and transgender identity. Inclusive efforts for persons with atypical sexuality must be encouraged to avoid discrimination. However, these conditions should not be overlooked medically. Denying their relevance might discourage research that would ultimately benefit these individuals.

HIV affects over 39 million people globally and remains a challenge in oral health care despite advances in antiretroviral therapy (ART). The oral cavity often reflects immune status and serves as a site for opportunistic infections, making dental care essential in HIV management. This review explores four main aspects of dental care for people living with HIV (PLHIV): HIV pathophysiology, transmission risk during dental procedures, infection control strategies, and pre-treatment clinical assessment. Using the population-concept-context framework, literature was reviewed from PubMed, Scopus, and Web of Science spanning 2000-2025. Oral conditions such as candidiasis, Kaposi's sarcoma, and periodontal disease remain prevalent in PLHIV and are closely linked to HIV progression. The risk of HIV transmission in dental settings is very low (< 0.3% for percutaneous exposure) when standard precautions are followed, though stigma among providers persists. Effective infection control includes personal protective equipment, sterilization, and aerosol reduction. Pre-procedural evaluation (CD4 count, viral load, and hematological status) is vital for safe care. In cases of neutropenia, antibiotic prophylaxis may be needed, and elective procedures should be deferred. Dental treatment for PLHIV is safe when guided by evidence-based protocols. Integrating infection control, risk assessment, and personalized planning strengthens the role of dentistry in comprehensive HIV care.

Same-day initiation of antiretroviral therapy (ART), known as same-day ART, has been endorsed by the World Health Organization since 2017 as a strategy to improve treatment coverage, reduce HIV transmission, and increase the survival of people living with HIV. This approach aims to minimize loss to follow-up (LTFU) and strengthen engagement in care, particularly in high-prevalence settings such as South Africa. This review aims to synthesize available data on the benefits, challenges, and impacts of same-day ART, with a particular focus on resource-limited settings. A literature review was conducted on published studies that addressed the effectiveness, adherence, retention in care, and clinical outcomes associated with same-day ART. The studies indicate that same-day ART is associated with a significant improvement in treatment initiation and reduced delays in therapy. However, its success depends on several factors, including patient acceptability, healthcare system capacity, and the quality of psychosocial support. Increased risks of long-term LTFU have also been reported among certain vulnerable populations. Same-day ART represents a major advancement in the fight against HIV, but its implementation requires a contextualized approach, adequate training of healthcare providers, and strengthened psychosocial support to ensure long-term retention in care.

Despite advances in antiretroviral therapy, developing an effective human immunodeficiency virus (HIV) vaccine remains pivotal for epidemic control. Through a scientometric analysis of 19,863 publications from the Web of Science Core Collection (1989-2023) using CiteSpace, this study delineates evolving trends and emerging frontiers in HIV vaccine research. The United States dominated contributions, with institutions like the National Institutes of Health and Harvard leading productivity. Clustering revealed two interconnected research trajectories, which are broad neutralizing antibody development, broad neutralizing antibody precursors, and immune mechanism exploration. Despite efficacy trials not resulting in licensed HIV vaccine advancements in antigen design and adjuvant strategies, they show promise. Key findings indicated structural biology, germinal center (GC) dynamics, antibody-dependent cellular cytotoxicity, and glycosylation shielding as pivotal research domains. Critical barriers include generating a specific immune response to new epitopes and glycosylation-mediated immune evasion. Future efforts should prioritize GC optimization to enhance B-cell affinity maturation, structure-guided epitope targeting through cryo-electron microscopy, and advances in antigen delivery. In addition, engineering vaccines to expand CXCR5+ T follicular helper cell populations may improve durable humoral immunity. This analysis underscores the necessity of multidisciplinary approaches to overcome HIV vaccine hurdles.

HIV-1 infection can easily cause CD4(+) T cell depletion. To investigate the impact of CD4(+) T cell depletion on the health of people living with HIV-1 (PLWH), we collected and analyzed baseline data from 5139 volunteers who had never received any treatment. The results showed that as CD4(+) T cells were depleted, the volunteers were more likely to suffer from anemia, liver and kidney dysfunction, and blood glucose abnormalities, which were more pronounced in elderly PLWHs. In addition, there was a low correlation between dyslipidemia and CD4(+) depletion. CD4(+) T cell depletion increases the likelihood of HIV-1 carriers developing anemia, liver and kidney dysfunction, and blood glucose abnormalities, making elderly PLWHs more susceptible to these effects. Relatively speaking, the correlation between dyslipidemia and CD4(+) depletion is low.

Highly pathogenic avian influenza viruses (HPAIVs) have undergone ecological and evolutionary shifts in recent years, broadening both their host range and geographic distribution. This manuscript explores the emergence and dissemination of HPAIVs, tracing their origins from wild waterfowl reservoirs to domestic poultry, and examining their increasing ability to infect mammalian species, including swine and humans. We detail the molecular transition insights from low pathogenic avian influenza to highly pathogenic avian influenza (HPAI) within poultry populations as drivers of adaptation and enhanced virulence. Key zoonotic episodes involving human and other hosts are reviewed, with attention to the role of viral reassortment and adaptation. Current risk assessments are analyzed, suggesting measures to mitigate the impact of HPAI from a One Health perspective, including public health interventions, coordinated international surveillance, early warning and containment systems, as well as prophylactic and therapeutic options.

The growing use of antiretroviral therapy (ART) has transformed HIV infection into a chronic, manageable disease, yet the emergence of drug resistance continues to threaten global progress. Morocco, located at the crossroads of Sub-Saharan Africa and Europe, offers a unique context for understanding the molecular evolution of HIV in the Middle East and North Africa. This systematic review synthesizes all available data on HIV-1 genotyping and resistance mutations in Morocco from 2009 to 2024, providing the first national overview of molecular resistance patterns. Six studies comprising 673 individuals met the inclusion criteria, spanning 2004-2015. Subtype B predominated (73.8%), followed by CRF02_AG (17.6%), reflecting increasing viral diversification linked to cross-regional transmission. Among ART-experienced patients, acquired drug resistance reached 19.5% at the population level and 53.3% among successfully sequenced samples, with NRTI (48.9%) and PI (22.2%) mutations predominating. The most frequent mutations were M184V (44%), K103N (8.9%), and V82A/L (13.3%). In ART-naïve individuals, transmitted resistance remained limited (1.55%), with no major integrase strand-transfer inhibitor mutations detected, though accessory polymorphisms such as L74M/I and E157Q were present in 3-5% of cases. CD4 counts and viral load suppression improved in later cohorts. These findings underline the critical need to re-establish molecular surveillance in Morocco to capture post-2019 resistance dynamics under dolutegravir-based therapy. Strengthening genotypic monitoring and integrating resistance testing into clinical care will be pivotal to preserving long-term ART efficacy and achieving the UNAIDS 95-95-95 and HIV elimination targets by 2030.

HIV remains a major global public health challenge, and pre-exposure prophylaxis (PrEP) has established itself as a pivotal evidence-based strategy for HIV prevention. While research on PrEP has expanded rapidly, a comprehensive synthesis of the existing literature is lacking. This review systematically analyzes trends, collaborative networks, and research hotspots in PrEP through a bibliometric approach to consolidate current knowledge and inform future directions. A total of 5,273 PrEPrelated publications (1992-2025) from the Web of Science Core Collection were included, showing a 15.99% annual growth rate. The field is dominated by contributions from the United States (2,969 publications), with the University of Washington as a core institutional contributor and the Journal of Acquired Immune Deficiency Syndromes as the most prolific journal; Baeten JM emerges as a key collaborative figure. Key research hotspots include PrEP implementation, HIV prevention in men who have sex with men, adherence issues, and the development of long-acting agents (e.g., cabotegravir). Emerging trends highlight growing focus on long-acting formulations, awareness promotion, and multi-sectoral collaboration. This synthesis underscores the expanding significance of PrEP research, offering critical insights for clinicians, researchers, and policymakers. Future efforts should prioritize advancing long-acting PrEP applications, addressing barriers such as limited awareness and economic burdens, and strengthening cross-sector collaboration to maximize PrEP's role in global HIV control.