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Journal of Acquired Immune Deficiency... Aug 2018The Accelerating Children's HIV/AIDS Treatment (ACT) Initiative was an ambitious joint donor initiative to increase the number of HIV-positive children and adolescents... (Review)
Review
The Accelerating Children's HIV/AIDS Treatment (ACT) Initiative was an ambitious joint donor initiative to increase the number of HIV-positive children and adolescents on treatment over a 2-year period from 2014 to 2016. The funding was provided by the US Government's President's Emergency Plan for AIDS Relief (PEPFAR) and the private Children's Investment Fund Foundation (CIFF). Great gains were achieved across the 9 ACT focus countries in pediatric treatment coverage. This article assesses the status of sustainability in the ACT countries after the pediatric treatment surge using PEPFAR sustainability data and a CIFF independent evaluation of sustainability. Although a focus on treatment is critical for pediatric HIV and HIV broadly, there is also a need to support the host country ability to maintain the progress gained once donor funds and initiatives transition. It uses the case of the ACT Initiative to argue that although surge activities are successful in rapidly scaling treatment results, there are concerns related to the health system's ability to maintain the progress along the full cascade. It shares important lessons for planning for and management of transition to support future donor efforts in pediatric HIV, overall HIV programming, and broader global health initiatives.
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Child; Global Health; Government Programs; HIV; HIV Infections; Humans; National Health Programs; Public-Private Sector Partnerships; United States
PubMed: 29994837
DOI: 10.1097/QAI.0000000000001734 -
Current HIV/AIDS Reports Aug 2019We reviewed literature across multiple disciplines to describe issues with the measurement of population mobility in HIV research and to summarize evidence of causal... (Review)
Review
PURPOSE OF REVIEW
We reviewed literature across multiple disciplines to describe issues with the measurement of population mobility in HIV research and to summarize evidence of causal pathways linking mobility to HIV acquisition risks and treatment engagement, with a focus on sub-Saharan Africa.
RECENT FINDINGS
While the literature on mobility and HIV remains hampered by problems and inconsistency in measures of mobility, the recent research reveals a turn towards a greater attentiveness to measurement and gender. Theoretical and heuristic models for the study of mobility and HIV acquisition and treatment outcomes have been published, but few studies have used longitudinal designs with clear ascertainment of exposures and outcomes for measurement of causal pathways. Notwithstanding these limitations, evidence continues to accumulate that mobility is linked to higher HIV incidence, and that it challenges optimal treatment engagement. Gender continues to be important: while men are more mobile than women, women's mobility particularly heightens their HIV acquisition risks. Recent large-scale efforts to find, test, and treat the individuals in communities who are most at risk of sustaining local HIV transmission have been severely challenged by mobility. Novel interventions, policies, and health systems improvements are urgently needed to fully engage mobile individuals in HIV care and prevention. Interventions targeting the HIV prevention and care needs of mobile populations remain few in number and urgently needed.
Topics: Acquired Immunodeficiency Syndrome; Africa South of the Sahara; Female; Gender Identity; Human Migration; Humans; Male; Population Dynamics
PubMed: 31256348
DOI: 10.1007/s11904-019-00457-2 -
Gene Therapy Jul 2017Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) remains a major health hazard despite significant advances in prevention and treatment of... (Review)
Review
Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) remains a major health hazard despite significant advances in prevention and treatment of HIV infection. The major reason for the persistence of HIV/AIDS is the inability of existing treatments to clear or eradicate the multiple HIV reservoirs that exist in the human body. To suppress the virus replication and rebound, HIV/AIDS patients must take life-long antiviral medications. The clustered regularly interspaced palindromic repeats (CRISPR)/CRISPR-associated nuclease 9 (Cas9) system is an emerging gene-editing technique with the potential to eliminate or disrupt HIV-integrated genomes or HIV-infected cells from multiple HIV reservoirs, which could result in the complete cure of HIV/AIDS. Encouraging progress has already been reported for the application of the CRISPR/Cas9 technique to HIV/AIDS treatment and prevention, both in vitro in human patient cells and in vivo in animal model experiments. In this review, we will summarize the most recent progress in the application of the CRISPR/Cas9 gene-editing technique to HIV/AIDS therapy and elimination. Future directions and trends of such applications are also discussed.
Topics: Acquired Immunodeficiency Syndrome; Animals; CRISPR-Cas Systems; Genetic Therapy; Humans
PubMed: 28471431
DOI: 10.1038/gt.2017.35 -
Lancet (London, England) Jul 2015
Review
Topics: Acquired Immunodeficiency Syndrome; Biomedical Research; Epidemics; Evidence-Based Medicine; Global Health; Health Care Costs; Humans; Patient Participation
PubMed: 26117719
DOI: 10.1016/S0140-6736(15)60658-4 -
African Journal of AIDS Research : AJAR Jul 2022
Topics: Acquired Immunodeficiency Syndrome; COVID-19; HIV Infections; Humans; SARS-CoV-2
PubMed: 35901306
DOI: 10.2989/16085906.2022.2106064 -
African Journal of AIDS Research : AJAR Mar 2019In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to...
In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to HIV/AIDS is prevalent and contributes to low testing rates and under-diagnosis of the virus. Identifying factors that contribute to stigma, such as insufficient or inaccurate knowledge of HIV/AIDS, may be critical in increasing early identification and treatment. This cross-sectional study used nationally representative data from the 2013 Botswana AIDS Impact Survey (BAIS) IV to examine the relationship between HIV/AIDS knowledge and stigmatising attitudes toward people living with HIV/AIDS (PLWHA). The mean (standard error) for stigma towards PLWHA score and HIV/AIDS knowledge score were 0.99 (0.02) and 5.90 (0.03) respectively. HIV/AIDS knowledge score and stigma towards PLWHA score were strongly positively correlated r (4,4045) = 0.415, p < 0.001). After adjusting for potential confounders, HIV/AIDS knowledge score significantly predicted stigma towards PLWHA score [coefficient β (95% CI)] [-0.25 (-0.29, -0.20), p < 0.001]. These findings imply that programmes and interventions that increase HIV/AIDS knowledge may reduce the pervasive apprehension, blame, and stigmatising attitude held towards PLWHA in Botswana.
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Botswana; Cross-Sectional Studies; Female; HIV; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Prevalence; Social Stigma; Stereotyping; Surveys and Questionnaires; Unsafe Sex; Young Adult
PubMed: 30880585
DOI: 10.2989/16085906.2018.1552879 -
Medicine Oct 2023Kaposi sarcoma (KS) is the most common cancer in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS). In 1994, Chang and Moore...
Kaposi sarcoma (KS) is the most common cancer in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS). In 1994, Chang and Moore discovered Kaposi sarcoma associated herpesvirus for the first time in KS lesions in AIDS patients. KS is a low-grade mesenchymal neoplasm of blood and lymphatic vessels that primarily affects the skin, although the disease may become disseminated to the lymphatic system, lungs, airways, or abdominal viscera. In this research, clinical characteristics and treatment of patients of Kaposi sarcoma were retrospectively analyzed in Hotan District, Xinjiang China. We look into the clinical traits, prognosis, and therapy of Kaposi sarcoma. From May 2017 to August 2022, 32 patients were treated in the People's Hospital of Hotan District, Xinjiang Uygur Autonomous Region, China. Twenty-two of these were classic Kaposi sarcomas (cKS), and 10 of these were Kaposi sarcomas linked to AIDS (AIDS-KS). The majority of KS patients were Uyghur. In terms of age at onset, AIDS-KS patients were younger than cKS patients. cKS and AIDS-KS are most frequently manifested in the feet and lower limbs. Ten patients with AIDS-KS have treated with combination antiretroviral therapy (combination antiretroviral therapy) combination chemotherapy, 5 of 10 patients had a complete response, 2 patients achieved partial response, the overall effective rate was 70%, and CD4 + T cells were greater than before. For cKS and AIDS-KS, the median overall survival was 56 and 50.8 months, respectively (P > .05). As a result, antiviral combination chemotherapy can also improve the prognosis of AIDS-KS patients.
Topics: Humans; Sarcoma, Kaposi; Retrospective Studies; Acquired Immunodeficiency Syndrome; Skin Neoplasms; Herpesvirus 8, Human
PubMed: 37832074
DOI: 10.1097/MD.0000000000035552 -
American Journal of Public Health Jul 2021
Topics: AIDS-Related Opportunistic Infections; Acquired Immunodeficiency Syndrome; Anti-Retroviral Agents; Epidemics; Humans; New York City; Safe Sex; Sexually Transmitted Diseases
PubMed: 34110912
DOI: 10.2105/AJPH.2021.306291 -
AIDS Research and Therapy Aug 2019Brazil is a low-and-middle income country (LMIC) that, despite having a large population and continental dimensions, has been able to successfully fight HIV/AIDS through... (Review)
Review
Brazil is a low-and-middle income country (LMIC) that, despite having a large population and continental dimensions, has been able to successfully fight HIV/AIDS through a number of governmental and societal measures. These included an early response to the epidemic, the development of a universal and free public health system, incisive discussions with pharmaceutical companies to reduce antiretroviral (ARV) drug prices, investments towards the development of generic drugs and compulsory licensing of ARVs. Through such measures, Brazil is among the leading LMIC towards achieving the 90-90-90 UNAIDS goals in the years to come. In this review, we analyze Brazil's progress throughout the HIV/AIDS epidemic to achieve state-of-the-art ARV treatment and to reduce AIDS mortality in the country. The top-quality HIV/AIDS research in Brazil towards HIV prophylactic and functional cure, the next step towards the economic sustainability of the battle against HIV, is also discussed.
Topics: Acquired Immunodeficiency Syndrome; Anti-Retroviral Agents; Brazil; Delivery of Health Care; Health Policy; Health Services Accessibility; Humans; Research
PubMed: 31412889
DOI: 10.1186/s12981-019-0234-2 -
Biochimica Et Biophysica Acta.... Sep 2017Lipids play a central role in many infectious diseases. AIDS (Acquired Immune Deficiency Syndrome) and tuberculosis are two of the deadliest infectious diseases to have... (Review)
Review
Lipids play a central role in many infectious diseases. AIDS (Acquired Immune Deficiency Syndrome) and tuberculosis are two of the deadliest infectious diseases to have struck mankind. The pathogens responsible for these diseases, Human Immunodeficiency Virus-1 and Mycobacterium tuberculosis, rely on lipids and on lipid membrane properties to gain access to their host cells, to persist in them and ultimately to egress from their hosts. In this Review, we discuss the life cycles of these pathogens and the roles played by lipids and membranes. We then give an overview of therapies that target lipid metabolism, modulate host membrane properties or implement lipid-based drug delivery systems. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá.
Topics: Acquired Immunodeficiency Syndrome; Drug Delivery Systems; Humans; Lipid Metabolism; Membrane Fluidity; Membrane Lipids; Phagocytosis; Tuberculosis; Virus Assembly; Virus Internalization
PubMed: 28535936
DOI: 10.1016/j.bbamem.2017.05.007