AIDS reviews最新文献

HIV emerged silently taking time to spread and become visible only through geographically isolated clusters of life-threatening immunodeficiency, known as AIDS since the early 80s. The clusters of infection expanded, overlapping to evolve into a pandemic that is ongoing and almost as silent. Phylogenetic analysis places the emergence of HIV-1 group M, the subtype responsible for the pandemic, in the human population more than 100 years ago. Once established, the rate and direction of spread of HIV-1 from local, to national, to contemporary pandemic proportions have varied over time and place. The literature presents many theories on the emergence and drivers of the spread of the virus over the past century. Here, historical evidence and phylogenetic models are reviewed to seek clarity on the emergence, geographic spread and key world events that mark the progression of the HIV-1 pandemic. This narrative review places particular focus on: war (both its direct and indirect affects), trade and economic expansion, changes in sexual behaviors, and public health policy. Investigating the impact of major world events and policy on the emergence and spread of HIV-1 may aid better understanding of what influences the viruses transmission dynamic. By identifying multilateral targets that influence transmission, up-scaled efforts to effectively control, if not remove, HIV-1 from the human population become a possibility. Suggestions for revisions in HIV-1 global public health policy are discussed. Refocused efforts to tackle HIV-1 transmission and replace the need to manage the pathology of this terrible disease are both ethically and economically just.

Compared to either HIV or hepatitis B virus (HBV) monoinfected individuals, HIV/HBV-coinfected individuals have a decreased probability of spontaneous HBV clearance and a greater risk of developing chronic liver damage and a faster progression to cirrhosis and hepatocellular carcinoma. This manuscript attempts to provide a comprehensive review of the landscape of current HIV/HBV coinfection research with a focus on the intricate interactions between these two viruses. Our review will help understand the disease dynamics of HIV/HBV coinfection and has important implications for designing public health strategies.

The aim of this study was systematically review the acquired syphilis before and during follow-up of pre-exposure prophylaxis (PrEP) for HIV. We analyzed articles that studied PrEP users with the outcome of acquired syphilis. The eligibility criteria were studies retrieved from the United States National Library of Medicine (Pubmed), Latin American and Caribbean Health Sciences Literature (Lilacs), Embase and Scopus databases, published between 2012 and 2023, in English, Spanish or Portuguese. We performed the descriptive synthesis and quality analysis of selected studies using the Newcastle Ottawa scale or Cochrane scale. We also used random-effects models to generate pooled rate estimates for syphilis before PrEP and during follow-up. A total of 4412 studies were found and 35 were selected, all in English, and almost all with high or satisfactory quality. The review found a PrEP syphilis rate of 6.0%. A summary of three studies estimated a 2.34-fold increased risk of syphilis acquisition during PrEP, with an incidence rate of 8.89 cases/100 person-years. These findings warrant caution due to study heterogeneity. Compared to HIV-positive individuals, PrEP users exhibit potentially higher syphilis rates, particularly among those aged 33-38 years, and factors such as age ≥ 35 years, MSM status, prior sexually-transmitted infections, and longer PrEP duration (every 6 months) are associated. Future research should further investigate these PrEP-related factors contributing to heightened syphilis risk.

Africa hosts the highest burden of esophageal cancer (49%) and HIV (60%) worldwide. It is imperative to investigate the synergistic impact of these two diseases on African populations. This study conducted an exhaustive computerized search of databases, including Medline/PubMed, Embase, Web of Science, Scopus, Cochrane library, and African Journals Online, to identify eligible studies up to October 2023. HIV infection was the exposure, esophageal cancer risk was the outcome, and healthy subjects with no cancer history served as comparators. Study quality was assessed using the Newcastle-Ottawa scale, and potential publication bias was evaluated through funnel plots and the Egger test. Meta-analyses were conducted using Stata 17.0 software and involved a thorough examination of 98,397 studies. Out of these, eight studies originating from Eastern and Southern Africa, recognized as esophageal cancer hotspots on the continent, met the eligibility criteria. The analysis revealed a non-significant association between HIV infection and esophageal cancer risk (odds ratio = 1.34 [95% confidence interval, 0.85-2.12]; with 0.26 as p-value of overall effects). The Egger test yielded a p-value of 0.2413, suggesting the absence of publication bias. In summary, this systematic review and meta-analysis indicate that there is no established causal link between HIV infection and esophageal cancer risk. However, further research is essential to delve into the potential mechanisms underlying this relationship.

Smoking among persons living with HIV infection (PLWH) is estimated to be 2-3 times greater than that in the general population. Data suggest that cigarette smoking is more common among PLWH because of several factors, including lower socioeconomic status, previous, or concurrent illicit drug and alcohol use, younger age, lower education level, and concomitant depressive symptoms. Cigarette smoking among PLWH has been associated with a higher risk of certain cancers and infections as well as lowered response to antiretroviral therapy. Randomized controlled trials on behavioral interventions for tobacco use among smokers with HIV were searched in the PubMed, Cochrane Library, EMBASE, and Web of Science databases. The retrieval period was from the inception of databases to November 2023. Network meta-analysis (NMA) was performed using the Stata 18.0 software with 19 studies (3190 subjects), of which 15 reported 7-day point prevalence abstinence and seven of which reported continuous abstinence. The NMA results showed that compared with general advice plus self-help brochure, text messaging (relative risk [RR] = 4.60, 95% confidence interval [CI], 1.12-18.81) and cell phone counseling (RR = 3.29, 95% CI, 1.71-6.32) were the most effective for 7-day point prevalence abstinence among smokers with HIV infection. Moreover, the meta-analysis showed that compared with smoking counseling and self-help brochures, continuous abstinence was statistically significantly enhanced after behavioral interventions (RR = 2.52, 95% CI, 1.51-4.20). The study revealed very low-to-high-quality evidence that text messaging, telephone counseling, and smoking cessation websites were effective for smokers with HIV infection.

This study was performed to reveal the risk factors associated with mortality in people living with HIV (PLHIV) who were diagnosed with COVID-19. Studies reporting deaths among PLHIV and infected with SARS-CoV-2 were investigated. After protocol setup and registration, the extracted sources were categorized and assessed for quality. This study examined ten articles with a total of 46,136 patients. Patients aged ≥ 60 years (hazard ratio [HR] = 2.22; 95% CI: 1.617, 3.050; p < 0.001), male (HR = 1.668; 95% CI: 1.179, 2.361; p = 0.004), and people with diabetes (risk ratio [RR] = 3.34; 95% CI: 1.45, 7.68; p = 0.005) were at higher risk of death. Adherence to antiretroviral therapy (ART) reduced mortality risk (RR = 0.90; 95% CI: 0.83, 0.98; p = 0.02). Patients in the survival groups showed a statistically significant lower mean of C-reactive protein (mean difference = 114.08; 95% -74.05, 154.10; p < 0.001). Deceased patients showed higher mean levels of interleukin-6 (IL-6). Chronic respiratory disorders, hypertension, oxygen requirement, admission to an intensive care unit, D-dimer levels, and HIV viral load < 50 copies RNA/mL before admission did not show statistically significant differences between the deceased and survival groups. ART therapy reduced mortality risk (RR = 0.90; 95% 0.83, 0.98; p = 0.02). Identifying PLHIV at higher mortality risk could improve the outcomes of COVID-19 by stratifying these patients to the most effective treatment in a timely fashion.

More than two decades after introducing antiretroviral therapy (ART), several challenges still prevail in keeping well people living with HIV, even with "Test and Treat" and/or "Rapid Start of ART" initiatives, as well as the scale-up of ART worldwide to promote access and adherence to treatment. This review examined articles on ART adherence in Africa between 2016 and 2023, published in English and indexed in PubMed. A total of 16 articles out of 2415 were eligible and included for analyses. Overall, good ART adherence rates in sub-Saharan African (SSA) regions ranged from 43% to 84%. Rates in the center of the SSA region ranged from 58% to 80%, in the north from 50% to 83%, in the south from 77% to 84%, in the west from 43% to 60%, and in the east from 69% to 73%. Most African countries use self-reporting to assess treatment adherence, which is frequently unreliable. The main factors with negative influence on ART adherence were comorbidities, lack of motivation, socioeconomic difficulties, or side effects. Conclusion: Adherence to ART is a good indicator for controlling the spread of HIV in a given region. It is important to overcome the barriers that make it difficult to comply with ART and reinforce the factors that facilitate access to medication.

HIV epidemics still exist as a major global public health burden, especially in middle- and low-income countries. Given the lack of approved vaccines, antiretroviral therapy (ART) remains the primary approach to reduce the mortality and morbidity linked to this disease. Effective treatment for HIV-1 requires the simultaneous administration of multiple drugs. However, the virus can show resistance to antiretroviral drugs, resulting in treatment failure. Therefore, this study focused on assessing the prevalence of mutations within the Indian HIV-positive population. After assessing the data, we intended to identify the most effective highly active ART (HAART) regimens for individuals with drug-resistant variants. Furthermore, our analysis revealed a spectrum of HIV mutations, with varying effects on protein stability. The significance of this analysis lies in its potential to optimize HAART selection for HIV-positive individuals by accounting for both prevalence and stability-altering mutations. By considering mutation effects on protein stability, we can modify treatment regimens, increasing the likelihood of therapy success and diminishing the risk of resistance. Moreover, this study contributes to the broader field of drug repurposing, offering insights into the rational design of antiretroviral therapies.