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Current Opinion in HIV and AIDS

Barbara L Shacklett, April L Ferre, Brenna E Kiniry
PURPOSE OF REVIEW: This review summarizes our current understanding of HIV-1-specific T-cell responses in mucosal tissues, emphasizing recent work and specifically highlighting papers published over the past 18 months. RECENT FINDINGS: Recent work has improved the standardization of tissue sampling approaches and provided new insights on the abundance, phenotype and distribution of HIV-1-specific T-cell populations in mucosal tissues. In addition, it has recently been established that some lymphocytes exist in tissues as "permanent resident" memory cells that differ from their counterparts in blood...
December 28, 2018: Current Opinion in HIV and AIDS
Claudia Cicala, James Arthos, Anthony S Fauci
PURPOSE OF REVIEW: Trafficking of lymphocytes into and between gut inductive and effector sites of the gut tissues is regulated by integrin α4β7. Recent findings that describe the central role of α4β7 CD4 T cells in HIV pathogenesis, and the possibility of targeting these cells to prevent or treat HIV infection will be reviewed. RECENT FINDINGS: Recent reports indicate that the frequency of α4β7 CD4 T cells is directly correlated with the risk of HIV acquisition and CD4 T-cell decline post infection...
December 28, 2018: Current Opinion in HIV and AIDS
Jennifer A Juno, Chansavath Phetsouphanh, Paul Klenerman, Stephen J Kent
PURPOSE OF REVIEW: To analyze the possible role that the 'unconventional' T-cell populations mucosal-associated invariant T cell (MAIT) and iNKT cells play during HIV infection and following antiretroviral therapy (ART) treatment. RECENT FINDINGS: A substantial body of evidence now demonstrates that both MAIT and iNKT cells are depleted in blood during HIV infection. The depletion and dysfunction of MAIT and iNKT cells are only partially restored by suppressive ART, potentially contributing to HIV-related comorbidities...
December 24, 2018: Current Opinion in HIV and AIDS
Marco Vitoria, Ajay Rangaraj, Nathan Ford, Meg Doherty
PURPOSE OF REVIEW: To summarize global efforts to accelerate access to simpler, safer and more affordable antiretroviral drugs and how this has shaped HIV treatment policy over the last decade, and outline future priorities. Several expert consultations aimed at aligning opportunities for optimization of antiretroviral drugs have been convened by WHO in partnership with academic institutions, international agencies, innovators and manufacturers. The increased access to lifelong treatment for people living with HIV also brings about new challenges in the long-term use of antiretrovirals (ARVs)...
December 17, 2018: Current Opinion in HIV and AIDS
Maria Abad-Fernandez, Nilu Goonetilleke
PURPOSE OF REVIEW: CMV-vectored vaccines expressing SIV antigens have mediated unprecedented levels of virus control following SIV challenge in rhesus macaques. Remarkably, protection was dependent on nonclassically restricted CD8 T cells. Here, we review the latest research in CMV-vectored vaccines in both humans and nonhuman primates as well as recent advances in the understanding nonclassically restricted T cells, particularly MHC-E-restricted CD8 T cells. RECENT FINDINGS: Recent studies have investigated human translation of CMV-vectored vaccines including studies to ensure vaccine vector safety...
December 17, 2018: Current Opinion in HIV and AIDS
Delphine Planas, Jean-Pierre Routy, Petronela Ancuta
PURPOSE OF THE REVIEW: This review highlights current knowledge on the dichotomous role played by T helper 17 cells (Th17)-polarized CD4 T cells in maintaining mucosal immunity homeostasis versus fueling HIV/simian immunodeficiency virus (SIV) replication/persistence during antiretroviral therapy (ART), with a focus on molecular mechanisms underlying these processes. RECENT FINDING: Th17 cells bridge innate and adaptive immunity against pathogens at mucosal barrier surfaces...
December 12, 2018: Current Opinion in HIV and AIDS
Katherine M Bruner, Lillian B Cohn
PURPOSE OF REVIEW: To provide a summary of the recent data examining infected CD4+ T cell dynamics during ART and implications for cure strategies. RECENT FINDINGS: HIV-1 cure is a worldwide unmet medical need. Although combination antiretroviral therapies effectively suppress HIV-1 replication in vivo, viral rebound occurs shortly after therapy cessation. The major barrier to HIV-1 cure is a pool of latently infected CD4+ T cells, called the latent reservoir, which is established early during infection, has a long half-life in vivo, and is not eliminated by treatment...
December 10, 2018: Current Opinion in HIV and AIDS
Marcus Buggert, Alberto Sada Japp, Michael R Betts
PURPOSE OF REVIEW: To introduce emerging concepts in tissue resident CD8 T cell immunosurveillance and their relevance to control HIV infection. RECENT FINDINGS: It is well appreciated that HIV preferentially infects and persists in CD4 T cells located in gut and in lymphoid tissue, yet the majority of known immunological correlates of HIV control are derived from peripheral blood. Instead, tissue-based immunological surveillance likely dictates the course of infection...
December 4, 2018: Current Opinion in HIV and AIDS
Chantelle L Ahlenstiel, Stuart G Turville
PURPOSE OF REVIEW: The utilization of genetically modified T cells to therapeutically target to various previously incurable diseases such, as cancer, has expanded exponentially in recent years. This success now provides the motivating force in applying the same technology for incurable infectious diseases including HIV. The common bottleneck in gene therapy continues to be at the level of gene delivery. Although present approaches adapt the cell to the delivery technology, emerging techniques now focus on leaving cells in their phenotypically resting state...
March 2019: Current Opinion in HIV and AIDS
Timothy N Hoang, Mirko Paiardini
PURPOSE OF REVIEW: The current article describes the current status of the use of cytokines and immune-checkpoint inhibitors as therapeutic strategies toward HIV remission. RECENT FINDINGS: Clinical trials using IL-2 and IL-7 showed increased levels of circulating T cells, although no reduction to the viral reservoir was observed. Studies in nonhuman primates (NHP) demonstrated that experimental IL-15 administration increased proliferation and cytotoxicity of simian immunodeficiency virus (SIV)-specific CD8 T cells, and promoted their localization to the lymph node (LN) B cell follicles...
March 2019: Current Opinion in HIV and AIDS
Yin Xu, Matthew T Ollerton, Elizabeth Connick
PURPOSE OF REVIEW: T cells within B-cell follicles of secondary lymphoid tissues play key roles in HIV immunopathogenesis. This review highlights recent findings and identifies gaps in current knowledge. RECENT FINDINGS: B-cell follicles are major sites of virus replication and demonstrate significant impairments in the generation of humoral immunity in HIV infection. Follicular T helper cells (Tfh), follicular T regulatory cells (Tfr) and follicular CD8 T cells (fCD8) play key roles in HIV immunopathogenesis...
March 2019: Current Opinion in HIV and AIDS
Rafail Mehdiyev, Natavan Alikhanova, Elmira Gurbanova
PURPOSE OF REVIEW: The tide of HIV, hepatitis C virus (HCV) and drug-resistant tuberculosis (TB) is a challenge for the penitentiary system in Eastern Europe Central Asia (EECA) region. We have analyzed the existing services for incarcerated individuals with HIV, HCV and TB to assess the current situation in the EECA region. RECENT FINDINGS: Because of the current criminal-legal system, key risk population with strong linkage to the blood-borne and airborne infections has a high proportion among prisoners...
January 2019: Current Opinion in HIV and AIDS
Asia Russell, Maureen Luba, Kenneth Mwehonge, Richard Lusimbo, Maureen Milanga, Matthew M Kavanagh
PURPOSE OF REVIEW: Civil society demand for accountability has long been a critical component of the AIDS response. In the age of 90-90-90 HIV treatment goals, civil society advocacy has continued, but often in new forms. In particular, civil society accountability at the intersection of national policy and global health financing has taken on increasing importance, but has not been well documented. RECENT FINDINGS: Civil society demand for accountability is a key to addressing both the insufficient progress toward '90-90-90' HIV treatment goals and the gap in democracy in HIV policymaking particularly prevalent in the context of internationally financed HIV programming...
January 2019: Current Opinion in HIV and AIDS
Giten Khwairakpam, Jessica Burry
PURPOSE OF REVIEW: With increasing availability of generic direct-acting antivirals (DAAs) and associated price reductions, various governments, multilateral institutions, and donors have started providing testing and treatment for hepatitis C virus (HCV) infection. More data on the quality of these generic medicines and on cost-effectiveness of their use are becoming widely available. This review seeks to describe some of the treatment programs for HCV that are evolving in Cambodia, India, Indonesia, Malaysia, Myanmar, and Thailand...
January 2019: Current Opinion in HIV and AIDS
Solange L Baptiste, Trisa B Taro, Helen M Etya'ale
PURPOSE OF REVIEW: Since the beginning of the HIV epidemic, informed communities have demanded and fought for access to life-saving treatment. The last several years have seen interesting developments in this area - particularly with respect to the switch to dolutegravir (DTG)-based regimens and scale-up of routine viral load testing (RVLT), and how these directly and indirectly impact issues of treatment optimization, HIV drug resistance, and sexual and reproductive health. In this review, we present recent advances in antiretroviral treatment and monitoring in the context of how treatment education and community demand for them...
January 2019: Current Opinion in HIV and AIDS
Justine Fargher, Anja Reuter, Jennifer Furin
PURPOSE OF REVIEW: More than two billion people are infected with Mycobacterium tuberculosis and few of them are ever offered therapy in spite of such treatment being associated with reduced rates of morbidity and mortality. This article reviews the current recommendations on the diagnosis and treatment of TB infection (or what is commonly referred to as 'prophylaxis' or 'preventive therapy' of latent TB) and discusses barriers to implementation that have led to low demand for this life-saving therapeutic intervention...
January 2019: Current Opinion in HIV and AIDS
Emily MacLean, Kavitha Saravu, Madhukar Pai
PURPOSE OF REVIEW: Diagnosis of tuberculosis (TB) in people living with HIV (PLHIV) remains a challenge, despite it being the most common comorbidity in this group. In this review, we provide an overview of tests for active TB, and their diagnostic performance in PLHIV. RECENT FINDINGS: New and updated diagnostic tests have better performance than traditional bacterial culture or smear microscopy in PLHIV. Recent developments in molecular tests have improved the sensitivity at which TB and drug susceptibility can be detected in PLHIV...
January 2019: Current Opinion in HIV and AIDS
Emily Bass, Laura Fitch, Anabel Gomez, Rebecca Loar
PURPOSE OF REVIEW: At a moment when UNAIDS (Joint United Nations Programme on HIV/AIDS) has acknowledged a 'prevention crisis,' and multiple countries and implementers are emphasizing 'user-centered' and/or differentiated models of delivering HIV treatment and prevention, it is essential to understand and act on best practices from all relevant interventions to create effective oral preexposure prophylaxis (PrEP) programs. RECENT FINDINGS: It is possible to adapt private sector approaches to understanding and segmenting the preferences and mindsets of potential consumers to primary HIV prevention programs, as demonstrated by a voluntary medical male circumcision (VMMC)-focused intervention that successfully trained and supported counselors to identify and deliver tailored messages to men potentially undergoing VMMC...
November 15, 2018: Current Opinion in HIV and AIDS
Ilesh V Jani, Caroline De Schacht
PURPOSE OF REVIEW: This article aims at examining the key recent advances in the field of EID, as well as at discussing approaches for resolving the major bottlenecks faced by health systems in the identification and linkage to care of HIV-infected infants. RECENT FINDINGS: Programmatic experience in South Africa and research in other high-burden countries showed that birth HIV testing is accurate, feasible and has the potential to decrease infant mortality. Substantial evidence has mounted on the accuracy of point-of-care testing for EID, including for birth testing...
November 1, 2018: Current Opinion in HIV and AIDS
Charles Flexner, David L Thomas, Susan Swindells
PURPOSE OF REVIEW: Long-acting parenteral drug delivery is an established and widely accepted solution to the problem of poor adherence when daily oral medications are used to treat or prevent chronic medical conditions. Poor adherence to oral formulations remains a major barrier to successfully treating or preventing HIV, tuberculosis (TB), and viral hepatitis. The uptake of long-acting formulations developed for these infections is uncertain, despite their promise. This review addresses the current state of development of long-acting and extended-release approaches to HIV, TB, and viral hepatitis in the context of creating market demand for such products...
November 1, 2018: Current Opinion in HIV and AIDS
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