Anti-HIV Therapy: Current and Future Directions

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Viral Immunology, Vaccines, and Antivirals".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 6150

Special Issue Editor


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Guest Editor
Department of Molecular Medicine, University of Padova, Padova, Italy
Interests: HIV infection; antiretroviral therapy; immunoactivation; HCV infection; virus-related cancers
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Special Issue Information

Dear Colleagues,

Human immunodeficiency virus (HIV) infection is still a significant public health problem despite the dramatic reductions in HIV-related morbidity and mortality due to the global expansion of access to antiretroviral therapy (ART).

At present, persons living with HIV (PLWH) have a life expectancy similar to patients without HIV, and consequently the research approach in real life settings should take into account the concept of “long-term”. Furthermore, most, not all, PLWH treated according to updated guidelines achieved optimal response to ART. Known criteria for assessing successful response to ART as CD4+ cell count increase and plasma RNA-HIV suppression could be analyzed with a non-conventional approach: for example, virological suppression is defined by a plasma HIV RNA level <50 copies/ml, but many commercial assays can quantify lower copy levels. Chronic drug toxicity and adherence to treatment are crucial to achieve the therapeutic success and, moreover, they are interplayed and may need a tailored response. Besides these clinical parameters, there is a growing interest in testing plasma levels of soluble markers of immune activation, which is a well-known predictor of clinical events and mortality, in order to identify patients who could benefit of specific therapeutical approaches.

This Special Issue will accept all kinds of manuscripts (original research, short communications and reviews) describing response to first-line ART or to ART simplification, with a special interest in studies including the elaboration of a score or the relationships between soluble markers of immune activation and clinical parameters.

Dr. Monica Basso
Guest Editor

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Keywords

  •  HIV
  •  naïve
  •  first-line therapy
  •  simplification
  •  soluble markers
  •  immune activation
  •  residual HIV VIREMIA
  •  long-term
  •  score

Published Papers (2 papers)

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Research

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11 pages, 970 KiB  
Article
Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model
by Ezechiel Ngoufack Jagni Semengue, Joseph Fokam, Naomi-Karell Etame, Evariste Molimbou, Collins Ambe Chenwi, Désiré Takou, Leonella Mossiang, Alain P. Meledie, Bouba Yagai, Alex Durand Nka, Beatrice Dambaya, Georges Teto, Aude Christelle Ka’e, Grâce Angong Beloumou, Sandrine Claire Djupsa Ndjeyep, Aissatou Abba, Aurelie Minelle Ngueko Kengni, Michel Carlos Tommo Tchouaket, Nounouce Pamen Bouba, Serge-Clotaire Billong, Samuel Martin Sosso, Vittorio Colizzi, Carlo-Federico Perno, Charles Kouanfack, Anne-Cecile Zoung-Kanyi Bissek, Emmanuel Eben-Moussi, Maria Mercedes Santoro, Francesca Ceccherini-Silberstein and Alexis Ndjoloadd Show full author list remove Hide full author list
Viruses 2023, 15(1), 18; https://doi.org/10.3390/v15010018 - 21 Dec 2022
Cited by 6 | Viewed by 2231
Abstract
To ensure optimal prescribing practices in the dolutegravir-era in Cameroon, we compared first-line virological response (VR) under tenofovir + lamivudine + dolutegravir (TLD) according to prior exposure to tenofovir + lamivudine + efavirenz (TLE). A facility-based survey was conducted among patients initiating antiretroviral [...] Read more.
To ensure optimal prescribing practices in the dolutegravir-era in Cameroon, we compared first-line virological response (VR) under tenofovir + lamivudine + dolutegravir (TLD) according to prior exposure to tenofovir + lamivudine + efavirenz (TLE). A facility-based survey was conducted among patients initiating antiretroviral therapy (ART) with TLD (I-TLD) versus those transitioning from TLE to TLD (T-TLD). HIV viral load was performed and unsuppressed participants (VL > 1000 copies/mL) had genotyping performed by Sanger sequencing. Of the 12,093 patients followed, 310 (mean-age: 41 ± 11 years; 52.26% female) complied with study criteria (171 I-TLD vs. 139 T-TLD). The median ART-duration was 14 (12–17) months among I-TLDs versus 28 (24.5–31) months among T-TLDs (15 (11–19) on TLE and 14 (9–15) on TLD), and 83.15% (148/178) were at WHO clinical stages I/II. The viral suppression rate (<1000 copies/mL) was 96.45%, with 97.08% among I-TLDs versus 95.68% among T-TLDs (p = 0.55). VR was similar in I-TLD versus T-TLD at <400 copies/mL (94.15% versus 94.42%) and age, gender, residence, ART-duration, and WHO stages were not associated with VR (p > 0.05). Genotyping was successful for 72.7% (8/11), with no major mutations to integrase inhibitors found. VR is optimal under first-line TLD after 14 months, even among TLE-exposed, thus confirming the effectiveness of transitioning from TLE to TLD in similar settings, supported by strong pharmacological potency and genetic barrier of dolutegravir. Full article
(This article belongs to the Special Issue Anti-HIV Therapy: Current and Future Directions)
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Review

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30 pages, 6492 KiB  
Review
The Effect of Treatment-Associated Mutations on HIV Replication and Transmission Cycles
by Madison M. Johnson, Carson Everest Jones and Daniel N. Clark
Viruses 2023, 15(1), 107; https://doi.org/10.3390/v15010107 - 30 Dec 2022
Cited by 3 | Viewed by 3579
Abstract
HIV/AIDS mortality has been decreasing over the last decade. While promising, this decrease correlated directly with increased use of antiretroviral drugs. As a natural consequence of its high mutation rate, treatments provide selection pressure that promotes the natural selection of escape mutants. Individuals [...] Read more.
HIV/AIDS mortality has been decreasing over the last decade. While promising, this decrease correlated directly with increased use of antiretroviral drugs. As a natural consequence of its high mutation rate, treatments provide selection pressure that promotes the natural selection of escape mutants. Individuals may acquire drug-naive strains, or those that have already mutated due to treatment. Even within a host, mutation affects HIV tropism, where initial infection begins with R5-tropic virus, but the clinical transition to AIDS correlates with mutations that lead to an X4-tropic switch. Furthermore, the high mutation rate of HIV has spelled failure for all attempts at an effective vaccine. Pre-exposure drugs are currently the most effective drug-based preventatives, but their effectiveness is also threatened by viral mutation. From attachment and entry to assembly and release, the steps in the replication cycle are also discussed to describe the drug mechanisms and mutations that arise due to those drugs. Revealing the patterns of HIV-1 mutations, their effects, and the coordinated attempt to understand and control them will lead to effective use of current preventative measures and treatment options, as well as the development of new ones. Full article
(This article belongs to the Special Issue Anti-HIV Therapy: Current and Future Directions)
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