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The Lancet. HIV Feb 2021Ending the AIDS epidemic by 2030 will require addressing stigma more systematically and at a larger scale than current efforts. Existing global evidence shows that... (Review)
Review
Ending the AIDS epidemic by 2030 will require addressing stigma more systematically and at a larger scale than current efforts. Existing global evidence shows that stigma is a barrier to achieving each of the 90-90-90 targets; it undermines HIV testing, linkage to care, treatment adherence, and viral load suppression. However, findings from both research studies and programmatic experience have helped to inform the growing body of knowledge regarding how to reduce stigma, leading to key principles for HIV stigma reduction. These principles include immediately addressing actionable drivers of stigma, centring groups affected by stigma at the core of the response, and engaging opinion leaders and building partnerships between affected groups and opinion leaders. Although there is still room to strengthen research on stigma measurement and reduction, in particular for intersectional stigma, the proliferation of evidence over the past several decades on how to measure and address stigma provides a solid foundation for immediate and comprehensive action.
Topics: Acquired Immunodeficiency Syndrome; Anti-HIV Agents; Epidemics; Fear; Female; HIV; HIV Testing; Humans; Male; Patient Compliance; Social Isolation; Social Stigma; Treatment Adherence and Compliance; Viral Load
PubMed: 33539757
DOI: 10.1016/S2352-3018(20)30309-X -
International Journal of Molecular... Nov 2020Sexually-transmitted infections (STIs) are a global health concern worldwide as they cause acute diseases, infertility, and significant mortality. Among the bacterial,... (Review)
Review
Sexually-transmitted infections (STIs) are a global health concern worldwide as they cause acute diseases, infertility, and significant mortality. Among the bacterial, viral, and parasitic pathogens that can be sexually transmitted, human immunodeficiency virus (HIV) has caused one of the most important pandemic diseases, which is acquired immune deficiency syndrome (AIDS). 32.7 million people have died from AIDS-related illnesses since the start of the epidemic. Moreover, in 2019, 38 million people were living with HIV worldwide. The need to deal with this viral infection becomes more obvious, because it represents not only a problem for public health, but also a substantial economic problem. In this context, it is necessary to focus efforts on developing methods for prevention, detection and treatment of HIV infections that significantly reduce the number of newly infected people and provide a better quality of life for patients. For several decades, biomedical research has been developed allowing quick solutions through the contribution of effective tools. One of them is the use of polymers as vehicles, drug carrier agents, or as macromolecular prodrugs. Moreover, nanosystems (NSs) play an especially important role in the diagnosis, prevention, and therapy against HIV infection. The purpose of this work is to review recent research into diverse NSs as potential candidates for prevention and treatment of HIV infection. Firstly, this review highlights the advantages of using nanosized structures for these medical applications. Furthermore, we provide an overview of different types of NSs used for preventing or combating HIV infection. Then, we briefly evaluate the most recent developments associated with prevention and treatment alternatives. Additionally, the implications of using different NSs are also addressed.
Topics: Acquired Immunodeficiency Syndrome; Humans; Nanomedicine; Nanostructures
PubMed: 33212766
DOI: 10.3390/ijms21228647 -
Sexual Health Mar 2021The Asia-Pacific region is home to nearly 6 million people living with HIV. Across the region, key populations - men who have sex with men, transgender women, people who...
The Asia-Pacific region is home to nearly 6 million people living with HIV. Across the region, key populations - men who have sex with men, transgender women, people who inject drugs, sex workers, prisoners - and their sexual partners make up the majority of those living with HIV. While significant progress has been made in the past 5 years towards UNAIDS's 90-90-90 goals (90% of people with HIV diagnosed, 90% on antiretroviral therapy, 90% virologically suppressed), significant gaps remain. The papers in this Special Issue address important questions: are we on track to end the AIDS epidemic in the Asia-Pacific region? And can countries in this region reach the new UNAIDS targets for 2030?
Topics: Acquired Immunodeficiency Syndrome; Asia; Female; Homosexuality, Male; Humans; Male; Policy; Sexual and Gender Minorities
PubMed: 33663685
DOI: 10.1071/SH20226 -
Bioscience Trends Jan 2022Since the first edition of the guidelines for the diagnosis and treatment of AIDS was published in 2005, the AIDS Specialists Group of the Society of Infectious Diseases...
Since the first edition of the guidelines for the diagnosis and treatment of AIDS was published in 2005, the AIDS Specialists Group of the Society of Infectious Diseases has updated the guidelines three more times to include more thorough, practical, standardized, and specific content. The latest edition (the 2021 version) has recently been updated in China in accordance with clinical practice nationwide and results of the latest research. Compared to the four previous editions, the 2021 edition references the latest information on the epidemiology of HIV, the prevention of HIV transmission, standardized lab diagnosis, and clinical management. First, the guidelines highlight the concept of "enhancing the combination of early intervention, prevention, and treatment". The guidelines specify more detailed clinical phases (three clinical stages), the clinical staging and progression of AIDS, and patient prognosis. The guidelines also specify diagnostic criteria - HIV antibodies, HIV RNA tests, CD4 cell counts, and the patient's epidemiological history - to use in conjunction with symptoms to confirm an HIV infection. In addition, the guidelines summarize more advanced HIV/AIDS research in China by describing the different circulating recombinant forms (CRFs) and unique recombinant forms (URFs) in Chinese patients, by summarizing the most prevalent strains in the Chinese population, and by comparing disease progression by route of transmission and by the CD4+T cell count. Lastly, this edition describes ways to optimize programs to prevent mother-to-child transmission, strategies for diagnosis and treatment of opportunistic infections, the aging patient population, and specialized ART treatment programs for different populations living with HIV. The guidelines should not only help to prolong the life of people living with HIV and improve their quality of life but also encourage successful collaboration between scientific researchers and physicians in the area of HIV.
Topics: Acquired Immunodeficiency Syndrome; CD4 Lymphocyte Count; China; Female; HIV Infections; Humans; Infectious Disease Transmission, Vertical; Public Health; Quality of Life
PubMed: 34880197
DOI: 10.5582/bst.2021.01514 -
The Lancet. Infectious Diseases Sep 2023
Topics: Humans; Acquired Immunodeficiency Syndrome
PubMed: 37633298
DOI: 10.1016/S1473-3099(22)00684-3 -
Frontiers in Cellular and Infection... 2023Cytomegalovirus retinitis (CMVR) is the most common and sight-threatening opportunistic retinal infection in patients with acquired immunodeficiency syndrome (AIDS) and...
BACKGROUND
Cytomegalovirus retinitis (CMVR) is the most common and sight-threatening opportunistic retinal infection in patients with acquired immunodeficiency syndrome (AIDS) and several controversies remain to be settled. We aimed to summarize the current evidence and clarify the clinical features and prognosis of CMVR in AIDS patients.
METHODS
The databases PubMed, EMBASE, and Ovid from inception to April 2022 were searched to identify the relevant studies. R software version 3.6.3 was used to perform the statistical analyses. Results in proportion with 95% confidence interval (CI) were calculated using the Freeman-Tukey variant of arcsine square transformation.
RESULTS
We finally included 236 studies comprising 20,214 patients. CMVR in AIDS was male-dominated (88%, 95%CI 86%-89%), with 57% (95%CI 55%-60%) aged <41 years and 44% (95%CI 41%-47%) being bilaterally involved. CMVR was preponderant in AIDS patients with the following characteristics: white and non-Hispanic, homosexual, HIV RNA load ≥ 400 copies/mL, and CD4+ T-cells <50 cells/μL. The positivity of CMV-DNA in blood, aqueous humor, and vitreous humor was 66% (95%CI 52%-79%), 87% (95%CI 76%-96%), and 95% (95%CI 85%-100%), respectively. The most common symptoms were blurred vision (55%, 95%CI 46%-65%), followed by asymptomatic, visual field defect, and floaters. CMVR was first diagnosed and regarded as the clue to AIDS diagnosis in 9% (95%CI 6%-13%) of CMVR patients. Approximately 85% (95%CI 76%-93%) of the CMVR patients have received cART. CMVR remission was observed in 72%-92% of patients depending on the specific category of anti-CMV therapy. The general incidence of CMVR-related RD in the entire course was 24% (95%CI 18%-29%), of which most patients received PPV with SO or gas tamponade and the rate of anatomic success was 89% (95%CI 85%-93%).
CONCLUSION
CMVR is a common opportunistic infection with diverse clinical features in AIDS patients, preponderant in those who are male, homosexual, or with CD4+ T-cells <50 cells/μL. Current therapies for CMVR and CMVR-related RD were shown to be effective. Early detection and routine ophthalmic screening should be promoted in AIDS patients.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, identifier CRD42022363105.
Topics: Humans; Male; Female; Cytomegalovirus Retinitis; Acquired Immunodeficiency Syndrome; Opportunistic Infections; CD4-Positive T-Lymphocytes; Retina
PubMed: 37305416
DOI: 10.3389/fcimb.2023.1107237 -
Physical Therapy Mar 2017
Topics: Acquired Immunodeficiency Syndrome; Anti-HIV Agents; Congresses as Topic; Humans; Pandemics; Physical Therapy Modalities; Prevalence; South Africa
PubMed: 28403432
DOI: 10.1093/ptj/pzx003 -
Anatomical Record (Hoboken, N.J. : 2007) Dec 2023HIV/AIDS pandemic remains the world's most severe public health challenge, especially for HIV/AIDS immunological nonresponders (HIV/AIDS-INRs), who tend to have higher...
HIV/AIDS pandemic remains the world's most severe public health challenge, especially for HIV/AIDS immunological nonresponders (HIV/AIDS-INRs), who tend to have higher mortality. Due to the advantages in promoting patients' immune reconstitution, Traditional Chinese medicine (TCM) has become one of the mainstays of complementary treatments for HIV/AIDS-INRs. Given that effective TCM treatments largely depend on precise syndrome differentiation, there is an increasing interest in exploring biological evidence for the classification of TCM syndromes in HIV/AIDS-INRs. In our study, to identify the typical HIV/AIDS-INRs syndrome, an epidemiological survey was first conducted in the Liangshan prefecture (China), a high HIV/AIDS prevalence region. The key TCM syndrome, Yang deficiency of spleen and kidney (YDSK), was evaluated by using a tandem mass tag combined with liquid chromatography-tandem mass spectrometry (TMT-LC-MS/MS). A total of 62 differentially expressed proteins (DEPs) of YDSK syndrome compared with healthy people were screened out. Comparative bioinformatics analyses showed that DEPs in YDSK syndrome were mainly associated with response to wounding and acute inflammatory response in the biological process. The pathway annotation is mainly enriched in complement and coagulation cascades. Finally, the YDSK syndrome-specific DEPs such as HP and S100A9 were verified by ELISA, and confirmed as potential biomarkers for YDSK syndrome. Our study may lay the biological and scientific basis for the specificity of TCM syndromes in HIV/AIDs-INRs, and may provide more opportunities for the deep understanding of TCM syndromes and the developing more effective and stable TCM treatment for HIV/AIDS-INRs.
Topics: Humans; Acquired Immunodeficiency Syndrome; Medicine, Chinese Traditional; Chromatography, Liquid; Proteomics; Tandem Mass Spectrometry
PubMed: 35775967
DOI: 10.1002/ar.25018 -
IAVI Report : Newsletter on... 2016The Centre for the Aids Programme of Research in Sourt Agrica, CAPRISA, has been working to unlock the secrets and weaknesses of HIV and TB for years. With a spate of...
The Centre for the Aids Programme of Research in Sourt Agrica, CAPRISA, has been working to unlock the secrets and weaknesses of HIV and TB for years. With a spate of ongoing and planned trials, researchers hope to soon turn the tables on the deadly diseases.
Topics: Acquired Immunodeficiency Syndrome; Epidemics; HIV Infections; Humans; Research; South Africa; Tuberculosis
PubMed: 29901871
DOI: No ID Found -
Clinical and Experimental Medicine Dec 2023The recommended first-line chemotherapy agents for managing Kaposi sarcoma (KS) in high-income countries are expensive and often unavailable in developing nations such...
The recommended first-line chemotherapy agents for managing Kaposi sarcoma (KS) in high-income countries are expensive and often unavailable in developing nations such as Peru. Limited data exist on whether management practices in these countries affect patient outcomes. We assessed the real-world treatment approaches and outcomes of patients with KS in Peru. We retrospectively reviewed the medical records of patients with acquired immunodeficiency syndrome-related KS (AIDS-related KS; n = 95) and classic KS (CKS; n = 81) diagnosed at a tertiary center between 2000 and 2014 in Lima, Peru. We used the Kaplan-Meier method to estimate overall survival (OS) rates. The median follow-up was 64 months for AIDS-related KS and 88 months for CKS. The median age of patients with AIDS-related KS was 35 years (range 20-63 years) and 70 years (range 33-91 years) for those with CKS. Most individuals had an Eastern Cooperative Oncology Group performance status of ≥ 2 (AIDS-related KS 75%; CKS 85%). Seventy-six percent and 40% of individuals with AIDS-related KS and CKS, respectively, received systemic chemotherapy. The most common first-line drug was paclitaxel, with relatively optimal overall response rates (ORRs) for AIDS-related KS (n = 64/72, 89%; ORR 61%) and CKS (n = 24/32, 75%; ORR 50%). The 5-year OS rates were 71% in the AIDS-related KS cohort and 81% in the CKS cohort. The findings from this real-world study may inform clinical practices and highlight the need for increased access to effective treatments and clinical trials for patients with KS in Peru and other developing countries.
Topics: Humans; Young Adult; Adult; Middle Aged; Sarcoma, Kaposi; Acquired Immunodeficiency Syndrome; Retrospective Studies; Treatment Outcome
PubMed: 37940724
DOI: 10.1007/s10238-023-01246-3