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Emerging Infectious Diseases Jun 2021June 2021 marks the 40th anniversary of the first description of AIDS. On the 30th anniversary, we defined priorities as improving use of existing interventions,... (Review)
Review
June 2021 marks the 40th anniversary of the first description of AIDS. On the 30th anniversary, we defined priorities as improving use of existing interventions, clarifying optimal use of HIV testing and antiretroviral therapy for prevention and treatment, continuing research, and ensuring sustainability of the response. Despite scientific and programmatic progress, the end of AIDS is not in sight. Other major epidemics over the past decade have included Ebola, arbovirus infections, and coronavirus disease (COVID-19). A benchmark against which to compare other global interventions is the HIV/AIDS response in terms of funding, coordination, and solidarity. Lessons from Ebola and HIV/AIDS are pertinent to the COVID-19 response. The fifth decade of AIDS will have to position HIV/AIDS in the context of enhanced preparedness and capacity to respond to other potential pandemics and transnational health threats.
Topics: Acquired Immunodeficiency Syndrome; COVID-19; HIV Infections; Hemorrhagic Fever, Ebola; Humans; Pandemics; SARS-CoV-2
PubMed: 34013858
DOI: 10.3201/eid2706.210284 -
International Journal of Molecular... Jan 2023Human immunodeficiency virus (HIV) infections and HIV-induced acquired immunodeficiency syndrome (AIDS) continue to represent a global health burden. There is currently... (Review)
Review
Human immunodeficiency virus (HIV) infections and HIV-induced acquired immunodeficiency syndrome (AIDS) continue to represent a global health burden. There is currently no effective vaccine, nor any cure, for HIV infections; existing antiretroviral therapy can suppress viral replication, but only as long as antiviral drugs are taken. HIV infects cells of the host immune system, and it can establish a long-lived viral reservoir, which can be targeted and edited through gene therapy. Gene editing platforms based on the clustered regularly interspaced palindromic repeat-Cas system (CRISPR-Cas) have been recognized as promising tools in the development of gene therapies for HIV infections. In this review, we evaluate the current landscape of CRISPR-Cas-based therapies against HIV, with an emphasis on the infection biology of the virus as well as the activity of host restriction factors. We discuss the potential of a combined CRISPR-Cas approach that targets host and viral genes to activate antiviral host factors and inhibit viral replication simultaneously. Lastly, we focus on the challenges and potential solutions of CRISPR-Cas gene editing approaches in achieving an HIV cure.
Topics: Humans; Acquired Immunodeficiency Syndrome; CRISPR-Cas Systems; HIV Infections; Gene Editing; Viruses; Antiviral Agents
PubMed: 36675077
DOI: 10.3390/ijms24021563 -
Journal of Leukocyte Biology Apr 2020The morbidity and mortality of HIV type-1 (HIV-1)-related diseases were dramatically diminished by the grounds of the introduction of potent antiretroviral therapy,... (Review)
Review
The morbidity and mortality of HIV type-1 (HIV-1)-related diseases were dramatically diminished by the grounds of the introduction of potent antiretroviral therapy, which induces persistent suppression of HIV-1 replication and gradual recovery of CD4 T-cell counts. However, ∼10-40% of HIV-1-infected individuals fail to achieve normalization of CD4 T-cell counts despite persistent virological suppression. These patients are referred to as "inadequate immunological responders," "immunodiscordant responders," or "immunological non-responders (INRs)" who show severe immunological dysfunction. Indeed, INRs are at an increased risk of clinical progression to AIDS and non-AIDS events and present higher rates of mortality than HIV-1-infected individuals with adequate immune reconstitution. To date, the underlying mechanism of incomplete immune reconstitution in HIV-1-infected patients has not been fully elucidated. In light of this limitation, it is of substantial practical significance to deeply understand the mechanism of immune reconstitution and design effective individualized treatment strategies. Therefore, in this review, we aim to highlight the mechanism and risk factors of incomplete immune reconstitution and strategies to intervene.
Topics: Acquired Immunodeficiency Syndrome; Antiretroviral Therapy, Highly Active; Gastrointestinal Microbiome; Humans; Immune Reconstitution
PubMed: 31965635
DOI: 10.1002/JLB.4MR1019-189R -
Cell Oct 2020The human immunodeficiency virus, the lentivirus that causes AIDS, is responsible for the most prevalent epidemic in the history of mankind. Here in this Timeline, we...
The human immunodeficiency virus, the lentivirus that causes AIDS, is responsible for the most prevalent epidemic in the history of mankind. Here in this Timeline, we have attempted to illustrate a short history of HIV-1, from its identification in landmark papers published by Robert Gallo, Myron Essex, and Luc Montagnier, to the numerous drug and vaccine trials as well as the stride toward a possible cure. Even today, a vaccine and cure against HIV-1 remains elusive. In spite of this, in the space of 30 years, from the time when being HIV positive meant an instant death sentence, to today where millions of HIV positive people are living normal lives, the progress we have made in such a short period of time should be celebrated. To view this Timeline, open or download the PDF.
Topics: Acquired Immunodeficiency Syndrome; HIV Infections; HIV-1; History, 20th Century; History, 21st Century; Humans
PubMed: 33064990
DOI: 10.1016/j.cell.2020.09.004 -
Current HIV/AIDS Reports Feb 2020The introduction of the National Free Antiretroviral Therapy Program (NFATP) in 2003 by the China National Center for AIDS/STD Control and Prevention has led to dramatic... (Review)
Review
PURPOSE OF REVIEW
The introduction of the National Free Antiretroviral Therapy Program (NFATP) in 2003 by the China National Center for AIDS/STD Control and Prevention has led to dramatic increases in antiretroviral therapy (ART) coverage among HIV-infected Chinese patients. Despite limitations in the number of available free antiretroviral drugs, the overall mortality associated with HIV/AIDS has dropped from 39.3 per 100 person-years in 2002 to 3.1 in 2014. In this review, we summarize the challenges, responses, and achievements of antiretroviral therapy (ART) in China over the past 20 years.
RECENT FINDINGS
Continuous optimization of the Chinese National Guidelines for HIV/AIDS Diagnosis and Treatment has been guided by data from serial domestic multi-center studies aimed at evaluating efficacy and toxicity of available ART regimens among Chinese patients with HIV, with the goal of maximizing adherence, access, and efficacy. In addition, increasing attention has been focused on the importance of continuity in the HIV care cascade to promote linkage to care, and address the multidisciplinary chronic care needs HIV/AIDS patients on lifelong ART. Great progress has been achieved in the past 20 years in terms of access to and optimization of antiretroviral treatment in China. As the number of patients receiving long-term ART continues to grow, the focus of HIV/AIDS treatment has gradually transitioned from urgent care to the management of non-AIDS-related chronic complications and control of chronic inflammation.
Topics: Acquired Immunodeficiency Syndrome; Adult; Anti-Retroviral Agents; Antiretroviral Therapy, Highly Active; China; Continuity of Patient Care; Female; HIV; Humans; Male; National Health Programs; Patient Compliance
PubMed: 31939111
DOI: 10.1007/s11904-019-00478-x -
Advances in Experimental Medicine and... 2020Physical exercise is a common type of planned physical activity in order to enhance or maintain a person's physical fitness. Physical exercise may act as an effective... (Review)
Review
Physical exercise is a common type of planned physical activity in order to enhance or maintain a person's physical fitness. Physical exercise may act as an effective strategy to take control of certain conditions associated with HIV-1 infection. HIV infection and its related treatments not only affect the immune system but also cause several musculoskeletal disorders including pre-sarcopenia or sarcopenia, myalgia, and low bone mineral density. Moderate- to high-intensity aerobic exercise, progressive resistance exercise, or a combination of both is considered as a complementary part of medical care and treatment of HIV-infected individuals. In the present chapter, the results of recent investigations regarding the effects of physical activity on muscle strength and function, mental health, and immune system of HIV infected individuals will be discussed.
Topics: Acquired Immunodeficiency Syndrome; Exercise; HIV; HIV Infections; Humans; Mental Health; Quality of Life
PubMed: 32342474
DOI: 10.1007/978-981-15-1792-1_28 -
Journal of the Neurological Sciences Dec 2022Progressive multifocal leukoencephalopathy (PML) is a subacute CNS inflammatory disease seen primarily among immunocompromised patients. It is caused by the JC virus... (Review)
Review
Progressive multifocal leukoencephalopathy (PML) is a subacute CNS inflammatory disease seen primarily among immunocompromised patients. It is caused by the JC virus (JCV), a polyomavirus that otherwise induces an insidious, latent infection in the general population. This reactivated disease is characterized by cognitive and behavioral changes, language disturbances, motor weakness, or visual deficits. Median survival in patients with AIDS is approximately 2-4 months, and mortality is high (around 4% in untreated AIDS). Recent scientific developments indicate that PML can also be associated with the increased utilization of monoclonal antibody (mAb) immunotherapy. In fact, PML has been witnessed with several mAbs, including natalizumab in multiple sclerosis, rituximab for lymphoma or lupus, efalizumab for psoriasis, and ofatumumab in leukemia; this leads us to the risk reassessment of PML due to treatment-induced immunosuppression. The range of clinical presentations of JCV-related disease has transformed over time and can pose significant challenges to the current diagnostic criteria. Most cases with PML suffer from persistent and irreversible neurological conditions, and some with chronic, low-level viral replication in the CNS. With the expanded use of mAbs for various autoimmune and lymphoproliferative disorders, we are now seeing this infection in non-HIV patients on drugs such as natalizumab, rituximab, and other recently approved therapies. This article aims to review the relationship between the incidence of PML and all four mAbs used in the treatment of MS. Currently, at least 18 FDA-approved medications carry label warnings for PML;to this date, no treatment has been convincingly effective.
Topics: Humans; Leukoencephalopathy, Progressive Multifocal; Natalizumab; Rituximab; Acquired Immunodeficiency Syndrome; JC Virus; Antibodies, Monoclonal; Multiple Sclerosis; Immunotherapy
PubMed: 36283150
DOI: 10.1016/j.jns.2022.120459 -
Chinese Medical Journal Nov 2021In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world...
In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.
Topics: Acquired Immunodeficiency Syndrome; China; Disease Outbreaks; HIV Infections; Humans; Prevalence
PubMed: 34759226
DOI: 10.1097/CM9.0000000000001842 -
African Journal of AIDS Research : AJAR Jul 2022
Topics: Acquired Immunodeficiency Syndrome; COVID-19; HIV Infections; Humans; Socioeconomic Factors
PubMed: 35901307
DOI: 10.2989/16085906.2022.2106066 -
Cells Dec 2023The treatment of human immunodeficiency virus (HIV-1) has evolved since the establishment of combination antiretroviral therapy (ART) in the 1990s, providing... (Review)
Review
The treatment of human immunodeficiency virus (HIV-1) has evolved since the establishment of combination antiretroviral therapy (ART) in the 1990s, providing HIV-infected individuals with approaches that suppress viral replication, prevent acquired immunodeficiency syndrome (AIDS) throughout their lifetime with continuous therapy, and halt HIV transmission. However, despite the success of these regimens, the global HIV epidemic persists, prompting a comprehensive exploration of potential strategies for an HIV cure. Here, we offer a consolidated overview of cell-based therapies for HIV-1, focusing on CAR-T cell approaches, gene editing, and immune modulation. Persistent challenges, including CAR-T cell susceptibility to HIV infection, stability, and viral reservoir control, underscore the need for continued research. This review synthesizes current knowledge, highlighting the potential of cellular therapies to address persistent challenges in the pursuit of an HIV cure.
Topics: Humans; HIV Infections; HIV; Acquired Immunodeficiency Syndrome; Antiretroviral Therapy, Highly Active; Cell- and Tissue-Based Therapy
PubMed: 38201268
DOI: 10.3390/cells13010064