Valganciclovir as Add-On Therapy Modifies the Frequency of NK and NKT Cell Subpopulations in Disseminated Kaposi Sarcoma Patients

Human herpesvirus-8 infection (HHV-8) is the causative agent of Kaposi sarcoma (KS) and is highly prevalent among people living with HIV (KS/HIV). It has been reported that valganciclovir (VGC) reduces HHV-8 replication in KS/HIV patients. However, currently it is unclear if VGC modifies the frequency and induces changes in markers of immune regulation of immune cells necessary to eliminate HHV8-infected cells, such as Natural Killer (NK) and NK T cells (NKT). This study evaluated the effect of VGC used as antiviral HHV8 therapy in KS patients on the frequency of NK and NKT subpopulations based on the CD27 and CD57 expression, and the immunosenescence markers, PD-1 and KLRG1. Twenty KS/HIV patients were followed-up at baseline (W0), 4 (W4), and 12 weeks (W12) of the study protocol. Among them, 10 patients received a conventional treatment scheme (CT), solely antiretroviral therapy (ART), and 10 patients received a modified treatment regime (MT), including VGC plus ART. In both groups, bleomycin/vincristine was administrated according to the treating physician’s decision. The soluble levels of IL-15, PD-L1, PD-L2, and E-cadherin were quantified across the follow-up. Our results showed that the higher IL-15 levels and lower NK frequencies cells in KS/HIV patients reach almost normal values with both treatments regimes at W12. CD27+ NK and NKT cell frequencies increased since W4 on KS/HIV patients with MT. Furthermore, PD-1 expression decreased while KLRG1 increased on NK and NKT subpopulations at W12, and it is accompanied by increased PD-L1 plasma level since W4. Our study highlights the disruption of NK and NKT subpopulations in patients with KS/HIV and explores VGC treatment’s contribution to immune reconstitution during the first weeks of treatment.

Development of Droplet Digital PCR-Based Assays to Quantify HIV Proviral and Integrated DNA in Brain Tissues from Viremic Individuals with Encephalitis and Virally Suppressed Aviremic Individuals

We developed ddPCR assays to quantitatively measure HIV DNA and used this ddPCR assays to detect and quantitatively measure HIV DNA in the archived brain tissues from HIV patients. The tissue viral loads assessed by ddPCR was highly correlative with those assessed by qPCR.

Raltegravir Inclusion Decreases CD4 T-Cells Intra-Cellular Viral Load and Increases CD4 and CD28 Positive T-Cells in Selected HIV Patients

Raltegravir (RLT) prevents the integration of HIV DNA in the nucleus, but published studies remain controversial, suggesting that it does not decrease proviral DNA. However, there are only a few studies focused on virus-targeted cells. We aimed our study on the impact of RLT inclusion on total intra-cellular viral DNA (TID) in cellular subsets and immune effects in patients with newly acquired undetectable plasmatic viral load (UVL). Six patients having UVL using an antiretroviral combination for 6 months and CD4 T-cells > 350/mL and <500/mL were selected to receive RLT for 3 months from M0 to M3. Patients had 7 sequential viro-immunological determinations from M-1 to M5. Immune phenotypes were determined by flow cytometry and TID quantification was performed using PCR assay on purified cells. TID (median values) at the initiation of RLT in CD4 T-cells was 117 copies/millions of cells, decreased to 27.5 on M3, and remained thereafter permanently under the cut-off (<10 copies/millions of cells) in 4 out of 6 patients. This was associated with an increase of CD4 and CD4 + CD28+ T-cells and a decrease of HLA-DR expression and apoptosis of CD4 T-cells. RLT inclusion led to decreases in the viral load along with positive immune reconstitution, mainly for CD4 T-cells in HIV patients.

Elevated Cerebrospinal Fluid Anti-CD4 Autoantibody Levels in HIV Associate with Neuroinflammation

This study reports that an autoantibody presents in the CNS of HIV patients and that its levels in the CSF correlate with some markers of neuroinflammation.

Acceptance of COVID-19 Vaccination and its Related Factors Among HIV/AIDS Patients in Guangxi, China: A Cross-Sectional Survey.

Background Vaccination is the most effective approach against the coronavirus disease 2019 (COVID-2019) pandemic. This study aimed to investigate acceptance and the predominant influential factors of COVID-19 vaccination among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Methods A cross-sectional survey was carried out in five cities in Guangxi from 7 May to 1 June 2021. Questionnaires on the acceptance of COVID-19 vaccination and the influential factors were conducted among HIV/AIDS patients recruited by random cluster sampling. We performed univariate and multivariate logistic regression analysis to identify factors associated with acceptance of COVID-19 vaccination among HIV/AIDS patients. Results Of all the participants (n = 903), 72.9% (n = 658) were willing to accept the COVID-19 vaccine and there was no statistically significant difference between CD4+T cell count and willingness to vaccinate using stratified analysis (P > 0.05). The main reason for willingness to accept the COVID-19 vaccine was fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (76.0%), whereas patients who were reluctant to receive the vaccine were mainly concerned about the safety of the vaccine (54.7%) and whether it would impact anti-retroviral therapy(ART) efficacy (50.6%). The most significant factors influencing vaccination were concerns that the vaccine was unsafe in HIV patients (OR=0.082, 95%CI = 0.024–0.282) and that it would be less effective in preventing SARS-CoV-2 infection in HIV patients (OR = 0.093, 95%CI = 0.030–0.287). Other factors associated with acceptance of the COVID-19 vaccine included Zhuang ethnicity (OR=1.653, 95%CI=1.109–2.465), the highest education level of middle school and high school or above (OR=1.747, 95%CI=1.170–2.608; OR=2.492, 95%CI=1.326–4.682), unknown vaccination type (OR=0.487, 95%CI=0.305–0.776) and little vaccine influence on ART efficacy (OR=2.889, 95%CI=1.378-6.059). Conclusions Acceptance of the COVID-19 vaccination is high among HIV/AIDS patients, although some patients refused vaccination because of vaccine safety and influence on ART efficacy. More research is needed to investigate the impact of the COVID-19 vaccine on the efficacy of ART and to evaluate its effectiveness in preventing SARS-CoV-2 infection in HIV patients so that concerns about COVID-19 vaccination issues can be addressed in HIV patients.

New Jersey FQHC Process Improvement Increases Oral Health Access for HIV Patients

Introduction: Patients living with HIV/AIDS (PLWHA) have more unmet oral health care needs than the general population, outpacing unmet medical needs [1]. Poor oral health can impact a person’s confidence and ability to speak, eat, work, sleep, and socialize [2]. Lack of access to dental care is a national issue for HIV patients; providing access is a challenge faced by many health centers and practices, including Zufall Health in New Jersey, a federally qualified health center (FQHC). In collaboration with Northeast/Caribbean AIDS Education and Training Center (NECA AETC), Zufall embarked on an initiative to improve access to quality dental care for PLWHA. AETC is the training component of the Ryan White Program, a federally funded program that provides medical care, support services, and medications for PLWHA who are low income, uninsured, or underserved [3-5]. Materials and Methods: In 2019, Zufall Health launched a quality improvement project to increase oral health access and services for Ryan White patients by integrating all partners involved in providing health care: medical, dental, psychological, behavioral, and HIV/AIDS providers and case managers. The project goal was to increase the number of patients receiving dental care to improve oral and overall health. Results/Observations: As a result of the project, there were significant quantitative and qualitative improvements in the oral health and quality of life of PLWHA: more dental encounters, a higher percentage of patients with a dental home, and the surpassing of the project goal of a 10% increase in dental referrals.