AIDS reviews最新文献

The risk of developing non-AIDS events (NAEs) remains higher in persons living with HIV-1 (PLWH) compared to the general population despite progress made in the treatment by antiretroviral (ARV). Particular attention is therefore given to the management of risk factors associated with NAEs during the follow-up of PLWH, including overweight. Factors associated with weight gain in PLWH are multifactorial and include demographics, HIV disease-related, lifestyle, cultural, and antiretroviral therapy (ART)-associated factors. All these confounding factors make it difficult to interpret the potential link between ARVs and weight gain. In antiretroviral treatment- experienced PLWH, confounding factors such as the return to normal health or the advanced stage of disease can be ruled out compared to naïve patients which somewhat facilitates the interpretation of weight gain. Weight gain after ART switch is modest, not generally a big concern in clinical practice in this population and correlated more strongly with baseline regimen, especially after the stop of TDF or EFV, than with sex-, race-, or HIV-related factors. It remains uncertain whether this is due to the loss of a weight suppressive effect of prior regimens with older agent such as TDF or EFV or a weight gain effect of the newer regimens especially TAF and/or INSTI, or both. The mechanisms linked to weight gain attributed to the new ARVs as well as its possible reversibility are not yet elucidated. Clinicians who switched ARV regimen of experienced PLWH should be aware of this side effect and of this potentially consequences on the global health.

There is a widespread practice of using 'sex' and 'gender' interchangeably. The World Health Organization considers that they are not. It defines sex as a set of chromosome-dependent biological variables that show unique hormone profiles and anatomy. Conversely, gender refers to socially constructed sex attributions with differential roles, behavioral expressions, identity, etc. Researchers and institutions have proposed guidelines to ensure that good science is not compromised by ideologies, media or social pressures, morality, religion or economic interests. Sex differences are immune to any ideology or socio-cultural interest, because they are governed by biologically determined genetic parameters. Considering men and women to be alike is very valuable from a moral or social perspective, but ignoring differences could be wrong and unacceptable from a biomedical perspective. The organization of health and/or research systems that does not consider the different morbidity, evolution or treatment response depending on sex would generate biases and mistakes. To work on medical innovation with a gender perspective should need to take sex differences into account and integrate them properly, recognizing diversity. The controversy is not just about sex or gender, but about sex and gender and how they may influence each other. Maintaining a scientific and academic approach will help both to advance science and enrich laws and/or ideologies.

Around 10% of adults infected with SARS-CoV-2 that survive a first episode of COVID-19 appear to experience long-term clinical manifestations. The signs and symptoms of this post-acute COVID-19 syndrome (PACS) include fatigue, dyspnea, joint pain, myalgia, chest pain, cough, anosmia, dysgeusia, headache, depression, anxiety, memory loss, concentration difficulties, and insomnia. These sequelae remind the constellation of clinical manifestations previously recognized as myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). This condition has been described following distinct infectious events, mostly acute viral illnesses. In this way, the pathophysiology of PACS might overlap with mechanisms involved in other post-infectious fatigue syndromes. The risk of PACS is more frequent in women than men. Additional host genetic factors could be involved. There is a dysregulation of multiple body organs and systems, involving the immune system, the coagulation cascade, endocrine organs, autonomic nervous system, microbiota-gut-brain axis, hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-thyroid axis, etc. Hypothetically, an abnormal response to certain infectious agents could trigger the development of postinfectious fatigue syndromes.

The aim of this review is to know the current status of sarcopenia in people living with acquired immunodeficiency virus, as well as predictors, prevalence, and associated factors. Searches were done in PubMed, Scielo, and ScienceDirect databases (January 2010 to August 2021), using predefined search terms. Prevalence, intervention, and meta-analysis studies investigating sarcopenia or muscle mass and function in people living with Human immunodeficiency virus (PLHIV) were selected. We identified reports of high prevalence and increased risk for sarcopenia due to factors such as prolonged exposure to antiretroviral drugs, lack of physical activity, central obesity, drug use, and other sociodemographic factors, as well as disease duration. HIV should be considered a risk factor for sarcopenia, and evaluation of sarcopenia should be included as part of the comprehensive medical care of PLHIV. Forceful actions are required to prevent muscle weakness, especially in stages before old age with actions aimed at preserving strength and function.

Although the world is currently focused on the COVID-19 pandemic, HIV/AIDS remains a significant threat to public health. To date, the HIV/AIDS pandemic has claimed the lives of over 36 million people, while nearly 38 million people are currently living with the virus. Despite the undeniable success of antiretroviral therapy (ART) in controlling HIV, the medications are not curative. Soon after initial infection, HIV integrates into the genome of infected cells as a provirus, primarily, within CD4+ T lymphocytes and tissue macrophages. When not actively transcribed, the provirus is referred to as a latent reservoir because it is hidden to the immune system and ART. Following ART discontinuation, HIV may emerge from the replication-competent proviruses and resumes the infection of healthy cells. Thus, these latent reservoirs are a major obstacle to an HIV cure, and their removal remains a priority. A vital aspect in the development of curative therapies is the demonstration of efficacy in an animal model, such as the humanized mouse model. Therefore, optimization, standardization, and validation of the humanized mouse model are a priority. The purpose of this review article is to provide an update on existing humanized mouse models, highlighting the advantages and disadvantages of each as they pertain to HIV cure studies and to review the approaches to curative therapies that are under investigation.