Brief Meeting Summary: "CDC Expert Consultation on the Effect of Antiretroviral Therapy on Risk of Sexual Transmission of HIV Infection and Superinfection"

Treatment of HIV infection has seen dramatic developments since the start of the epidemic over thirty-five years ago. Since the advent of highly active antiretroviral therapy (HAART), HIV infection has gone from being a terminal illness with the inevitable development of AIDS to a now-treatable chronic condition with infected individuals living a ‘normal’ and healthy lifestyle when tested early and engaged in care. Antiretroviral therapy (ART) has become simpler with minimal pill burden and fewer side effects. In the UK ART can only be prescribed by a HIV specialist ensuring the patient is engaged in care and under regular monitoring and follow up. HIV infection affects the immune system through depletion of CD4 T-lymphocytes. There are several goals and aims of treating HIV infection. The main function of ART is to prevent HIV viral replication, which in turn reduces viral load (VL) and depletion of CD4 cells thereby preventing the development of AIDS and eventual mortality. HIV infection induces a pro-inflammatory state, which is associated with several conditions especially in late presenters. Common conditions include cardiovascular disease including cardiomyopathy, increased risk of venous thromboembolism due to a hypercoagulable state, HIV-associated nephropathy, disorders of the central nervous system, bone disorders, various dermatological conditions, and acceleration of ageing. Timely initiation of ART can help reduce and reverse such conditions. Studies demonstrate early initiation of ART and maintaining a suppressed VL minimizes the risk of onward sexual transmission of HIV. Though barrier protection is always advised in serodiscordant couples, recent studies support the reduced risk of transmission in virologically suppressed serodiscordant sexual couples, which has led to changes in post-and pre-exposure prophylaxis guidelines and enabling serodiscordant couples to conceive naturally. All HIV positive women should be initiated on ART and virologically suppressed ideally prior to conception. It is now routine practice in the UK and many parts of the world to perform HIV testing during pregnancy. If tested positive during pregnancy ART should be initiated and, depending on the stage of pregnancy and the VL, a Caesarean section may be necessary and the neonate may require prophylactic ART.

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Antiretroviral therapy and the risk of sexual transmission of HIV: a systematic review and meta‐analysis

HIV Medicine ◽

10.1111/hiv.12841 ◽

2020 ◽

Vol 21 (6) ◽

pp. 349-357

Author(s):

M Davari ◽

HB Giwa ◽

A Nabizade ◽

F Taheri ◽

A Giwa

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Meta Analysis ◽

Sexual Transmission ◽

Sexual Transmission Of Hiv

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The actuality of the problem co-infection of HIV and tuberculosis in current epidemiological conditions

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40932 ◽

2016 ◽

Vol 21 (6) ◽

pp. 304-312

Author(s):

G. V Chumachenko ◽

Irina Yu. Babaeva ◽

M. G Avdeeva

Keyword(s):

Hiv Infection ◽

Secondary Infection ◽

Sexual Transmission ◽

Hiv Patients ◽

Sexually Transmitted ◽

Quality Of Medical Care ◽

Sexual Transmission Of Hiv ◽

Long Term Observation ◽

And Control

The aim of the study. The analysis of clinical and epidemiological peculiarities of tuberculosis associated with HIV infection (TB+HIV), in the Tula region for 16 years from 1995 to 2012 to determine priority directions of the prevention and improvement of the quality of medical care. Materials and methods. There was executed the retrospective analysis of 818 inpatient medical records of TB+HIV patients and 645 outpatient medical cards (Tula regional antitubercular dispensary N1). Patients were observed and examined also in the Center for Prevention and Control ofAIDS and Infectious diseases. A study of HIV-associated TB was performed in 7 scientific and practical directions: clinical, radiological, immunological, microbiological, postmortem, statistical. Results and discussion. In the structure of TB+ HIV patients men (73.3%) prevailed, urban residents accounted for 76.76%, there is an increase in the dynamics of the proportion of women from 20.0% (2002) to 34.6% (2011), 83.38% ofpatients were aged of 21-40 years. Social portrait of the patient: the secondary (37.94%) or secondary special (32.65%) education and the lack of constant work (71.32%), 40.88% of the patients had previously been in prison. Two-thirds of patients (66.18%) were HIV infected due to the intravenous use of narcotics, however, during last 6 years of observation (from 2006 to 2012) the proportion of sexual transmission of HIV increased from 18.2% to 39.4%. The sexually transmitted HIV-infected cases most commonly occur in persons older than 41 years as well as in women. In most HIV cases TB appeared to be secondary infection, the average timespan between the onsets of these diseases was 6.3±2.77 years. In examined patients older 50 years HIV and tuberculosis were diagnosed simultaneously at the advanced stage of HIV infection. In 96.18% of cases (654 patients) tuberculosis had pulmonary localization, in most (67.1% of cases, 439patients) it was disseminated, including milliarytuberculosis, followed by infiltrative tuberculosis - 171 patients (26.1% ofpulmonary form cases). In long-term observation there was noted an increase in the proportion of infiltrative tuberculosis in the structure ofpulmonary forms. Conclusion. With taking in consideration the unfavorable epidemic situation, it is quite advisable to perform a comprehensive monitoring of social, medical and other factors, characterizing the patients suffered from TB associated with HIV infection.

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DYNAMICS OF MANIFESTATIONS OF THE EPIDEMIC PROCESS OF HIV INFECTION IN RELATION WITH THE EPIDEMIOLOGICAL SITUATION FOR ADDICTION (IN THE REPUBLIC OF TATARSTAN)

HIV Infection and Immunosuppressive Disorders ◽

10.22328/2077-9828-2019-11-2-58-66 ◽

2019 ◽

Vol 11 (2) ◽

pp. 58-66 ◽

Cited By ~ 2

Author(s):

G. R. Khasanova ◽

C. T. Agliullina ◽

R. F. Haeva ◽

F. I. Nagimova

Keyword(s):

Hiv Infection ◽

Drug Addiction ◽

Drug Users ◽

Statistical Data ◽

Sexual Transmission ◽

Sexually Transmitted ◽

Epidemic Process ◽

The Republic ◽

Sexual Transmission Of Hiv ◽

Epidemiological Situation

The aim of the study is to characterize the trends in the development of the epidemic process of HIV infection in connection with the epidemiological situation of drug addiction in the Republic of Tatarstan.Materials and methods. The official statistical data on the incidence of HIV infection and drug addiction in the Republic of Tatarstan for the period 1987–2016, the data on the prevalence for 2001 and 2016 are analyzed.Results. Direct correlation of the prevalence of HIV infection and prevalence of drug addiction in the different territories of the Republic of Tatarstan were identified for 2001 data (r=0,81, p<0,001) and for 2016 (r=0,82, p<0,001). A statistically significant increase in the incidence of HIV infection in the population against the background of a decrease in the incidence of drug addiction was demonstrated. In the early stages of the epidemic in the region HIV infection spread mainly through injecting drug use and, in recent years, HIV has been sexually transmitted mainly through heterosexual contact.Conclusion. The output of infection outside the population of injecting drug users and the prevalence of sexual transmission of HIV in recent yearsare a reflection of adverse trends in the direction of generalization of the epidemic of HIV infection.

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Safety Assessment of Microbicide 2P23 on the Rectal and Vaginal Microbiota and Its Antiviral Activity on HIV Infection

Frontiers in Immunology ◽

10.3389/fimmu.2021.702172 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zhengqin Gao ◽

Rui Fu ◽

Xiaobo Li ◽

Ji Wang ◽

Yuxian He

Keyword(s):

Antiviral Activity ◽

Hiv Infection ◽

Inflammatory Cytokines ◽

Hiv Transmission ◽

Sexual Transmission ◽

Aids Pandemic ◽

Gel Treatment ◽

Sexual Transmission Of Hiv ◽

Hiv Microbicide

Containment of the AIDS pandemic requires reducing HIV transmission. HIV infection is initiated by the fusion of the membrane between the virus and the cell membrane of the host. 2P23 is an effective HIV membrane fusion inhibitor that may be a good entry inhibitor microbicide candidate. This study evaluated the potential of using gel-formulated 2P23 as a topical microbicide to prevent sexual transmission of HIV in the rectum and vagina. Our data revealed that 2P23 formulated in gel is effective against HIV. There was no change in antiviral activity at 25°C for 4 months or 60°C for 1 week. In addition, we demonstrated that the 2P23 gel was stable and fully functional at pH 4.0–8.0 and under different concentrations of H2O2. Finally, the 2P23 gel exhibited no cytotoxicity or antimicrobial activity and did not induce inflammatory changes in the rectal or vaginal mucosal epithelium in New Zealand rabbits after 20 mg/day daily rectovaginal application for 14 consecutive days. Despite repeated tissue sampling and 2P23 gel treatment, the inflammatory cytokines and microbiota of the rectum and vagina remained stable. These results add to general knowledge on the in vivo evaluation of anti-HIV microbicide application concerning inflammatory cytokines and microbiota changes in the rectum and vagina. These findings suggest that the 2P23 gel is an excellent candidate for further development as a safe and effective pre-exposure prophylactic microbicide for the prevention of HIV transmission.

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PSC-RANTES Blocks R5 Human Immunodeficiency Virus Infection of Langerhans Cells Isolated from Individuals with a Variety of CCR5 Diplotypes

Journal of Virology ◽

10.1128/jvi.78.14.7602-7609.2004 ◽

2004 ◽

Vol 78 (14) ◽

pp. 7602-7609 ◽

Cited By ~ 49

Author(s):

Tatsuyoshi Kawamura ◽

Shannon E. Bruce ◽

Awet Abraha ◽

Makoto Sugaya ◽

Oliver Hartley ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Langerhans Cells ◽

Mononuclear Cells ◽

Sexual Transmission ◽

Dependent Manner ◽

Peripheral Blood Mononuclear ◽

Immunodeficiency Virus ◽

Sexual Transmission Of Hiv

ABSTRACT Topical microbicides that effectively block interactions between CCR5+ immature Langerhans cells (LC) residing within genital epithelia and R5 human immunodeficiency virus (HIV) may decrease sexual transmission of HIV. Here, we investigated the ability of synthetic RANTES analogues (AOP-, NNY-, and PSC-RANTES) to block R5 HIV infection of human immature LC by using a skin explant model. In initial experiments using activated peripheral blood mononuclear cells, each analogue compound demonstrated marked antiviral activity against two R5 HIV isolates. Next, we found that 20-min preincubation of skin explants with each RANTES analogue blocked R5 HIV infection of LC in a dose-dependent manner (1 to 100 nM) and that PSC-RANTES was the most potent of these compounds. Similarly, preincubation of LC with each analogue was able to block LC-mediated infection of cocultured CD4+ T cells. Competition experiments between primary R5 and X4 HIV isolates showed blocking of R5 HIV by PSC-RANTES and no evidence of increased propagation of X4 HIV, data that are consistent with the specificity of PSC-RANTES for CCR5 and the CCR5+ CXCR4− phenotype of immature LC. Finally, when CCR5 genetic polymorphism data were integrated with results from the in vitro LC infection studies, PSC-RANTES was found to be equally effective in inhibiting R5 HIV in LC isolated from individuals with CCR5 diplotypes known to be associated with low, intermediate, and high cell surface levels of CCR5. In summary, PSC-RANTES is a potent inhibitor of R5 HIV infection in immature LC, suggesting that it may be useful as a topical microbicide to block sexual transmission of HIV.

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Debate about male circumcision and risk of sexual transmission of HIV infection

Reproductive Health Matters ◽

10.1016/s0968-8080(00)90030-2 ◽

2000 ◽

Vol 8 (15) ◽

pp. 169-170

Keyword(s):

Hiv Infection ◽

Male Circumcision ◽

Sexual Transmission ◽

Sexual Transmission Of Hiv

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