Highlights from HIV and AIDS reviews

We feature here a selection of review articles published recently in AIDS Research & Therapy and other journals, shedding light on fundamental aspects, as well as comparatively less explored issues, in HIV and AIDS research.


The forces driving clonal expansion of the HIV-1 latent reservoir

Authors reviewed here how viral, immunologic and genomic factors contribute to clonal expansion of HIV-1-infected cells, and how clonal expansion shapes the HIV-1 latent reservoir. Targeting clonally expanding HIV-1 latent reservoir without disrupting CD4+ T cell function is a top priority for HIV-1 eradication.

Effects of HIV infection and ART on phenotype and function of circulating monocytes, natural killer, and innate lymphoid cells

HIV infection causes upregulation of markers of inflammation, immune activation and apoptosis of host adaptive, and innate immune cells particularly monocytes, natural killer (NK) and innate lymphoid cells (ILCs). Although antiretroviral therapy (ART) restores CD4 T-cell counts, the persistent aberrant activation of monocytes, NK and ILCs observed likely contributes to the incomplete recovery of T-cell effector functions. This review calls for a better understanding of the effects of HIV infection and ART on the phenotype and function of circulating monocytes, NK, and ILCs, to guide development of novel therapeutic interventions to optimize immune recovery.

Metformin effect on gut microbiota: insights for HIV-related inflammation

Inspired by the effect of metformin on diabetes-related gut dysbiosis, authors provide a critical review of the relevance of metformin to control inflammation in people living with HIV. Metformin may improve gut microbiota composition, in turn reducing inflammation and risk of non-AIDS comorbidities. This review aims to pave the way towards innovative strategies to counteract dysregulated microbiota and improve the lives of people living with HIV.

The role of polymorphonuclear neutrophils during HIV-1 infection

This review provides a summary of the recent research breakthroughs uncovering aspects of the interactions between HIV-1 and polymorphonuclear neutrophils (PMNs). Authors address the impact of HIV-1 infection on PMNs as well as the impact of PMNs on HIV-1 disease progression to better understand the pathophysiology of HIV-1 infection.


Treatment and drugs

A meta-analysis comparing 48-week treatment outcomes of single and multi-tablet antiretroviral regimens for the treatment of people living with HIV

This meta-analysis compared outcomes with single tablet regimens (STR) versus multi-tablet regimens (MTR) for human immunodeficiency virus (HIV) treatment using published data. The findings of this study confirm previously reported preliminary findings of the advantages of STR over MTR for HIV treatment in adherence, therapy continuation, viral suppression, tolerability, quality of life improvement, cost-effectiveness and healthcare resource utilization.

Kidney transplant outcomes in HIV-positive patients: a systematic review and meta-analysis

This systematic review and meta-analysis investigate the published evidence of outcome and risk of kidney transplantation in HIV-positive patients following the PRISMA guidelines.

Contemporary issues and new challenges in chronic kidney disease amongst people living with HIV

This review focuses on chronic kidney disease in people living with HIV. Non-infectious comorbidities are becoming increasingly prevalent as the cohort of people living with HIV ages. People living with HIV are at an increased risk of chronic kidney disease, which is most often related to non-infectious comorbidities, such as diabetes and hypertension. As a consequence, models of care need to evolve to meet the new and changing healthcare needs of this population.


Public health

Systematic review and meta-analysis of HIV, HBV and HCV infection prevalence in Sudan

This systematic review provides pooled seroprevalence estimates of these three viruses in Sudan. Results indicate that there is no evidence for an HIV endemic in the general population of Sudan. However, both HBV and HCV seroprevalence rates are indicating otherwise. Reducing the overall burden of HIV, HBV and HCV infections will require new measures and national strategies and the recognition of the infections as one of the country’s priority issues.

Addressing advanced HIV disease and mortality in global HIV programming

The US President’s Emergency Plan for AIDS Relief (PEPFAR), launched to increase access to antiretroviral treatment among people living with HIV and to prevent new HIV infections globally,  is increasing its efforts to identify advanced HIV disease; to prevent, diagnose, and treat opportunistic infections; and to track mortality in its programs. In this article, authors review ongoing efforts, done in collaboration with other stakeholders, aimed to decrease global mortality among people living with HIV.


Living with HIV

Frailty in people living with HIV

The life expectancy of people living with HIV (PLHIV) has dramatically improved with effective and well-tolerated antiretroviral therapy. This presents a new challenge in caring for this patient population, with up to 28% of older PLHIV being identified as frail. Frail individuals often present with multiple and non-specific health complaints, fluctuating disability, falls and delirium, and are at higher risk for multiple adverse outcomes, post-operative complications, poor responses to vaccination and functional decline. Limited evidence exists to support the reversal of frailty, but epidemiological evidence suggests that interventions to assess and manage co-morbidities, reducing risk factors such as smoking, increasing exercise and optimizing BMI, and improving personal and community resources, are all likely to reduce the risk of frailty. Physicians who care for PLHIV need to recognise and manage frailty in this patient population.

Smoking and HIV: what are the risks and what harm reduction strategies do we have at our disposal?

Rates of current smoking among people living with HIV (PLHIV) are 2–3 times that of the general population, which contributes to the higher incidence of non-AIDS-related morbidity and mortality in PLHIV. Given the benefit of smoking cessation, strategies to assist individuals who smoke to quit should be a primary focus in modern HIV care. However, there is the need for further safety and efficacy data surrounding interventions to assist quitting in the general population, as well as in PLHIV specifically.

Food insecurity and the risk of depression in people living with HIV/AIDS: a systematic review and meta-analysis

The link between food insecurity and depression in people living with HIV/AIDS has been explored in numerous studies; however, the existing evidence is inconclusive due to inconsistent results. Therefore, the objective of this systematic review and meta-analysis is to examine the relationship between food insecurity and depression in people living with HIV/AIDS.

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