HIV infection

VISTA as a context-dependent immune checkpoint: Implications for tumor immunity and autoimmune pathogenesis

V-domain Ig suppressor of T cell activation (VISTA) is a recently characterized as immune checkpoint regulator with critical roles in modulating immune responses across pathological contexts. In cancer, VISTA contributes to immune evasion by sustaining an immunosuppressive tumor microenvironment, emerging as a promising target for immunotherapeutic intervention. In contrast, in autoimmune diseases, VISTA preserves peripheral immune tolerance and suppresses aberrant immune activation, thereby preventing tissue destruction. This functional dichotomy reflects the complexity of VISTA-mediated signaling, which is modulated by cellular context, microenvironmental cues, and disease stage. Recent studies have elucidated key aspects of VISTA biology, including its structural features, ligand interactions, and context-dependent expression patterns. VISTA operates as a co-inhibitory molecule in cancer, while exerting co-stimulatory or regulatory effects in autoimmunity. This review provides a comprehensive overview of VISTA's discovery, molecular mechanisms, and dual roles in cancer and autoimmune pathogenesis. Furthermore, the current status of VISTA-targeted therapeutic strategies is critically examined, highlighting the translational challenges posed by discrepancies between preclinical models and clinical trial outcomes. Finally, the potential of targeting VISTA within the broader paradigm of immune checkpoint plasticity is discussed, with emphasis on overcoming compensatory immune resistance to enhance therapeutic efficacy. A deeper mechanistic understanding of VISTA is essential for the rational design of future immunomodulatory therapies tailored to specific disease contexts.

1H, 13C, and 15N resonance assignments of the amyloidogenic peptide SEM2(49-107) by NMR spectroscopy

It has been shown that human seminal fluid is a major factor in enhancing HIV activity. The SEM2(49-107) peptide is a product of cleavage after ejaculation by internal prostheses of the semenogelin 2 protein, expressed in seminal vesicles. It is established that the peptide SEM2(49-107) forms amyloid fibrils, which increase probability of contracting HIV infection. In this nuclear magnetic resonance (NMR) study, we present almost complete (86%) resonance assignments for the 1H 15N and 13C atoms of the backbone and side-chain of the SEM2(49-107) peptide (BioMagResBank accession number 52356). The secondary structure of SEM2(49-107) peptide was estimated by using two approaches, secondary chemical shifts analysis (CSI) and TALOS-N prediction. Analysis of the secondary structure of the SEM2(49-107) peptide using both methods revealed that the peptide contains helical segments at the C-terminus. Also in this work, we used phase-sensitive 2D HSQC 1H- 15N experiments measuring longitudinal T1 and transverse T2 NMR relaxation times to report predicted secondary structure and backbone dynamics of the SEM2(49-107) peptide. This resonance assignment will form the basis of future NMR research, contributing to a better understanding of the peptide structure and internal dynamics of the molecule.

Association between CD4 + cell count, CD4/CD8 ratio, and fragility fractures in people with HIV

BACKGROUND

People with HIV (PWH) often exhibit reduced CD4 + T cell counts and altered CD4/CD8 ratios, but their impact on fragility fractures remains underexplored. This study investigated the association between CD4 + cell count, CD4/CD8 ratio, and fragility fractures in PWH in China.

METHODS

A retrospective cohort study was conducted on PWH treated at Beijing Ditan Hospital from January 2011 to September 2023. Data on demographics, clinical status, and bone mineral density were collected. Fragility fractures were identified through medical records. Multivariate Cox regression was used to assess the relationship between CD4 + cell count, CD4/CD8 ratio, and fracture risk, with restricted cubic splines (RCS) applied to explore potential nonlinear associations. Subgroup analyses evaluated the consistency of these findings.

RESULTS

The study included 1107 participants (median age 37 years, 92.6% male). The median CD4 + cell count was 547 cells/μl, and the median CD4/CD8 ratio was 0.7. Fragility fractures occurred in 185 participants (16.7%). Lower CD4 + cell counts (<200 cells/μl) were associated with a higher risk of fractures [aHR = 2.78; 95% confidence interval (95% CI): 1.66-4.65; P  < 0.001], as were lower CD4/CD8 ratios (<0.5) (aHR = 3.43; 95% CI: 2.16-5.44; P  < 0.001). RCS indicated a curvilinear association, with increased fracture risk at CD4/CD8 ratios below 1.16. Subgroup analyses confirmed the stability of these associations.

CONCLUSION

Lower CD4 + cell counts and CD4/CD8 ratios are linked to an increased risk of fragility fractures in PWH, underscoring the importance of immune function in bone health.

Discovery of miRNAs unique to actively transcribed erythroparvovirus infection in heart failure patients

AIMS

miRNAs, small non-coding RNAs, play key roles in gene regulation, cell differentiation and tissue development. They influence viral infection outcomes by directly interacting with viral genomes or modifying the host microenvironment. This study demonstrates miRNAs' ability to selectively suppress transcriptionally active erythroparvovirus, highlighting their potential in antiviral therapies.

METHODS AND RESULTS

Seventy-five endomyocardial biopsy (EMB) specimens from patients with unexplained heart failure were analysed. The samples included 19 with dilated cardiomyopathy and inflammation (DCMi), 12 with dilated cardiomyopathy (DCM), 25 with inflammation and active erythroparvovirus infection, 13 with active erythroparvovirus infection only and 6 from undiagnosed patients as controls. miRNA expression was measured using TaqMan assays. miR-98, miR-222, miR-106b and miR-197 were significantly upregulated in patients with transcriptionally active erythroparvovirus infection, independent of inflammation (P < 0.005). These miRNAs differentiated these patients from all other groups with over 90% specificity.

CONCLUSIONS

These specific miRNAs offer a novel diagnostic tool for active erythroparvovirus infections and hold promise as therapeutic targets, providing safer alternatives to traditional antiviral treatments.

Powering immunity: mitochondrial dynamics in natural killer cells

Natural killer (NK) cells are innate lymphocytes that are crucial for eliminating malignant and infected cells, and have significant therapeutic potential against cancer and viral infections. However, their functionality is often impaired under pathological conditions. Emerging evidence identifies mitochondria as key regulators of NK cell metabolism, fitness, and fate. This review examines how mitochondrial dysfunction impacts on NK cell activity in cancer, viral infections, and inflammatory disorders. We discuss strategies to target mitochondrial architecture, dynamics, and function as potential therapies to restore NK cell fitness. Finally, we highlight unanswered questions and future directions to better understand mitochondrial regulation in NK cells and its implications for therapeutic development.

Machine Learning-Driven Consensus Modeling for Activity Ranking and Chemical Landscape Analysis of HIV-1 Inhibitors

Background/Objective: This study aimed to develop a predictive model to classify and rank highly active compounds that inhibit HIV-1 integrase (IN). Methods: A total of 2271 potential HIV-1 inhibitors were selected from the ChEMBL database. The most relevant molecular descriptors were identified using a hybrid GA-SVM-RFE approach. Predictive models were built using Random Forest (RF), eXtreme Gradient Boosting (XGBoost), Support Vector Machines (SVM), and Multi-Layer Perceptron (MLP). The models underwent a comprehensive evaluation employing calibration, Y-randomization, and Net Gain methodologies. Results: The four models demonstrated intense calibration, achieving an accuracy greater than 0.88 and an area under the curve (AUC) exceeding 0.90. Net Gain at a high probability threshold indicates that the models are both effective and highly selective, ensuring more reliable predictions with greater confidence. Additionally, we combine the predictions of multiple individual models by using majority voting to determine the final prediction for each compound. The Rank Score (weighted sum) serves as a confidence indicator for the consensus prediction, with the majority of highly active compounds identified through high scores in both the 2D descriptors and ECFP4-based models, highlighting the models' effectiveness in predicting potent inhibitors. Furthermore, cluster analysis identified significant classes associated with vigorous biological activity. Conclusions: Some clusters were found to be enriched in highly potent compounds while maintaining moderate scaffold diversity, making them promising candidates for exploring unique chemical spaces and identifying novel lead compounds. Overall, this study provides valuable insights into predicting integrase binders, thereby enhancing the accuracy of predictive models.

Induction of Regulatory T Cells After Virus Infection and Vaccination

Vaccines have been proven to be one of the safest and most effective ways to prevent and combat diseases. However, the main focus has been on the evaluation of the potency of effector mechanisms and the lack of adverse effects of vaccine candidates. Recently, the importance of induced regulatory mechanisms of the immune system after vaccination has come to light. With the increase in our knowledge about these regulatory mechanisms including the regulatory T cells (Tregs), we have come to understand the significance of this arm of the immune system in controlling immunopathology and/or diminishing the effectiveness of vaccines, especially viral vaccines. Tregs play a dual role during infectious diseases by limiting immune-mediated pathology and also contributing to chronic pathogen persistence by decreasing effector immunity and clearance of infection. Tregs may also affect immune responses after vaccination primarily by inhibiting antigen presenting cell function such as cytokine secretion and co-stimulatory molecule expression as well as effector T (Teff) and B cell function. In this article, we review the current knowledge on the induction of Tregs after several life-threatening virus infections and their available vaccines to bring them to the spotlight and emphasise that studying viral-induced antigen-specific Tregs will help us improve the effectiveness and decrease the immunopathology or side effects of viral vaccines. Trial Registration: ClinicalTrials.gov identifier: NCT04357444.

Epigenetic reprogramming of the host immune system during acute HIV

PURPOSE OF REVIEW

This review explores the epigenetic mechanisms driving immune dysregulation during acute HIV, focusing on how early HIV exploits host epigenetic machinery to establish viral persistence and evade immune clearance.

RECENT FINDINGS

Epigenetic reprogramming during acute HIV plays a pivotal role in shaping immune responses, establishing viral reservoirs, and driving persistent immune dysfunction. Recent studies leveraging genome-wide DNA methylation profiling, single-cell transcriptomics, and chromatin accessibility assays are elucidating key mechanisms through which HIV exploits the host epigenome to evade immune surveillance and promote viral persistence.

SUMMARY

Epigenetic reprogramming during acute HIV is a critical determinant of viral persistence and immune dysfunction. Understanding these mechanisms offers new avenues for therapeutic strategies aimed at modulating the epigenome to disrupt reservoir formation, enhance immune responses, and advance HIV cure efforts.

Efficacy of an Online Self-compassion Group Intervention for Sexual Minority Men Living with HIV: A Pilot Randomized Controlled Trial

Sexual minority men living with HIV face challenges affecting their quality of life and medication adherence. While self-compassion has shown promise in improving quality of life, targeted interventions for this group remain limited. This pilot study evaluated the efficacy of an online self-compassion group intervention on quality of life and medication adherence among sexual minority men living with HIV. A six-week online intervention, adapted from the Mindful Self-Compassion program, was implemented in a two-arm randomized controlled trial with 28 participants, comparing the intervention to a waitlist control group. The primary outcomes were quality of life and self-compassion, with medication adherence as a secondary outcome. Measures were taken at baseline, mid-intervention, post-intervention, and 1-month follow-up. Linear mixed-effects model showed that the intervention significantly improved quality of life and medication adherence at post-intervention. Although self-compassion showed no significant improvement, over-identification, an uncompassionate self-responding component, showed marginal improvement at follow-up. This pilot study provides preliminary evidence that a self-compassion intervention may improve quality of life and medication adherence in sexual minority men living with HIV, warranting further research with larger sample sizes and a focus on the underlying mechanisms.

Acute-phase proteins as biomarkers of inflammation in HIV patients with latent tuberculosis: a prospective study

Introduction

Tuberculosis (TB) remains the primary cause of death among individuals infected with HIV, increasing the risk of contracting TB by up to 26 times. This co-infection complicates the diagnosis and treatment of TB, ultimately affecting outcomes adversely. Acute-phase proteins (APPs), markers of inflammation, are significantly elevated during infections and serve as critical indicators of inflammation resulting from infectious diseases.

Methods

In this prospective study, HIV-positive individuals at antiretroviral therapy (ART) clinics were screened for latent tuberculosis infection (LTBI) before starting isoniazid (INH) prophylaxis. Initially, 101 patients were enrolled, with 71 completing a six-month follow-up on INH prophylaxis. LTBI was diagnosed using QuantiFERON-TB Gold plus, categorizing participants as HIV-positive with LTBI (n=30) and HIV-positive without LTBI (n=71).

Results

Plasma levels of alpha-2-macroglobulin (A2M), C-reactive protein (CRP), serum amyloid P (SAP), haptoglobin, ferritin, soluble transferrin receptor (sTFR), apotransferrin, hepcidin, and S100A8/A9 were assessed using multiplex and quantikine assays.At baseline, levels of A2M, CRP, SAP, ferritin, hepcidin, and S100A9 were significantly elevated in HIV-positive patients with LTBI compared to those without LTBI (A2M, p=0.005; CRP, p<0.001; SAP, p=0.0006; ferritin, p<0.001; hepcidin, p=0.001; S100A9, p=0.001). Following six months of INH prophylaxis, significant reductions in these markers were observed in both groups, suggesting a reduction in inflammation.

Discussion

Our findings indicate that a baseline profile of APPs can effectively reflect the inflammatory status of HIV patients with LTBI. These inflammatory markers tend to decrease following effective INH treatment, underscoring their potential utility in monitoring disease progression and treatment response in this vulnerable population.

Polymeric and lipidic nanoparticles in transforming anti-HIV combinational therapy: can they turn the tide?

The HIV-1 pandemic presents a multifaceted challenge across the globe, standing as the foremost public health crisis today. Global data on HIV-related morbidity and mortality are alarming. Effective HIV management hinges on minimizing transmission through highly active antiretroviral therapy (HAART), which relies on a combination of HAART and has been a cornerstone in HIV management. However, challenges such as low patient adherence, suboptimal drug pharmacokinetics, and side effects, potentially undermine the efficacy of existing treatment. Emerging nanotherapeutics, particularly lipidic and polymeric nanoparticles, have exhibited immense promise in addressing these concerns. These nanocarriers enhance targeted drug delivery, facilitate controlled release, and reduce toxicity. Notably, co-delivery strategies using nanoparticles enable the simultaneous transport of multiple drugs involved in HAART. But the question arises whether the exploration is enough to turn the tide. Hence, through this review, the authors have tried to explore and discuss the obstacles faced by the lipid and polymeric nanoparticles such as stability and encapsulation efficiency, and translating these innovations to clinical practice in detail and discussed the future potential of AI-driven nanomedicine.

The heart of the matter: modeling HIV-associated cardiovascular comorbidities in nonhuman primate models

With the advent of antiretroviral therapy (ART) that effectively suppresses HIV replication, and reduced AIDS progression, the clinical spectrum of HIV infection has dramatically changed. Currently, the people living with HIV (PLWH) who receive ART have a nearly normal prognostic of survival, yet they still experience higher morbidity and mortality than age-matched uninfected subjects. The higher risk of death in PLWH is linked to persistence of residual systemic inflammation and T-cell activation. These factors contribute to accelerated aging and higher incidence of HIV-associated non-AIDS conditions, thereby presenting new diagnostic and therapeutic challenges. This new shifting paradigm of HIV infection associates a higher incidence of cardiovascular disease (CVD), such as stroke, acute myocardial infarction and sudden cardiac death, in stark contrast to the reduced incidence of opportunistic infections. The incidence of acute myocardial infarction and coronary disease is several folds higher in PLWH than in the general population. Study of United States (US) death certificates listing HIV infection shows that the deaths from CVD doubled between 1996 and 2006. CVD will become an even more prominent comorbidity considering that more than 50% of PLWH in the US are over 50 years old, an age that more frequently associates CVD, and cardiovascular complications are more frequent in urban African-Americans and Hispanics, which are disproportionately affected by HIV. Therefore, reducing the overall risk of these complications will become the primary challenge in the management of chronic HIV infection. Not surprisingly, the REPRIEVE trial showed a substantial benefit of statins to PLWH, and the current guidelines include statin administration to PLWH. Nonhuman primate (NHP) models for the cardiovascular comorbidities associated with HIV are currently available and their use for testing new therapeutic approaches aimed at countering the effects of hypercoagulability and CVD is discussed. Their use can be of tremendous help to understand the etiology, pathophysiology, and the determinants of CVD in PLWH, which are currently poorly understood. Use of the NHP models could help in dissecting the relative contribution of the virus, behavioral factors, and ART to cardiovascular risk, having the potential to help us establish new strategic approaches aimed at controlling HIV-related CVD.

Targeting inflammasomes as a therapeutic potential for HIV/AIDS

Human immunodeficiency virus (HIV) infection in humans can cause a variety of symptoms. Among these, acquired immunodeficiency syndrome (AIDS) remains the most severe form. Current treatment of HIV/AIDS with antiretroviral drugs effectively inhibits HIV replication and infection and significantly extends the lifespan of HIV/AIDS patients. However, antiretroviral drugs cannot completely remove HIV from patients due to the high latency of HIV, and they possess side effects and can lead to drug resistance. HIV/AIDS remains to be an incurable disease, and new methods and drugs are still desirable. Inflammasomes were found to be activated during HIV infection and regulate AIDS progression. Previous reviews provide a simple summary of inflammasome activators and inhibitors during HIV infection without distinguishing the specific infection stage, this kind of summary does not provide any clinical target value. Here, we provide a comprehensive review of inflammasomes in HIV/AIDS according to the infection timeline and propose several inflammasome target strategies for clinical HIV/AIDS treatment. We systematacially summarized the activation and function of kinds inflammasomes during the different HIV infection stages, with the aim of providing new therapeutic targets and directions for HIV/AIDS and HIV-associated comorbidities.

Effectiveness of the Hayling and Brixton Tests for Detecting Dementia, Progressive Cognitive Decline, and Mild Cognitive Impairment in Middle to Older Aged Adults: A Systematic Review and Meta-analysis

The aging population is increasing the prevalence of dementia, neurodegenerative disorders, and mild cognitive impairment, which are associated with cognitive declines in executive functioning. In people with these disorders, accurate tests can aid in the early detection of executive functioning decline and facilitate access to interventions. The Hayling and Brixton tests (HBTs) are popular executive functioning tests that assess inhibitory control. The HBTs may be especially effective for detecting people with disorders that are associated with disinhibition, such as behavioral-variant frontotemporal dementia (bvFTD). However, the effectiveness of the HBTs for detecting cognitive decline in dementia, neurodegenerative disorders, and mild cognitive impairment has yet to be collated. A comprehensive search of five databases identified 50 studies that compared the HBTs performances of adults aged 40 years and over with a dementia, neurodegenerative disorder, or mild cognitive impairment (e.g., Parkinson's disease, Alzheimer's dementia, bvFTD) and cognitively-healthy controls. Hedges' g effect sizes compared groups on the five HBTs scores (Inhibition Errors, Inhibition Reaction Time (RT), Automatic RT, Inhibition minus Automatic RT, and Brixton Errors). The disorders (combined) showed negative effects on all HBTs scores (g - 0.37 to - 1.13), with dementia (combined) performing the worst (g - 0.54 to - 1.56). Automatic RT and Inhibition Errors were the most effective scores for detecting cognitive decline in dementia (g - 1.55; g - 1.34). The dementia types performed similar after outliers were removed and only studies with low risk-of-bias were analyzed. Overall, the HBTs are effective for detecting cognitive decline in middle to older aged adults, especially those with dementia. However, no score type can be recommended for differentiating the dementia types, such as AD and bvFTD.

Transcriptomic Analysis Reveals Key Pathways Influenced by HIV-2 Vpx

Viral protein X (Vpx) is a unique accessory protein encoded by the genome of the human immunodeficiency virus type 2 (HIV-2) and lineages of the simian immunodeficiency virus of sooty mangabeys. So far, counteracting the cellular restriction factor SAMHD1 and mediating the efficient translocation of viral pre-integration complex have been recognized as key functions of Vpx; however, a thorough exploration of its effects on the cellular transcriptome and cytokine milieu has not yet been undertaken. In this study, we carried out the transcriptomic analysis of THP-1 cells and determined differential gene expressions induced by HIV-2 Vpx, utilizing vectors coding for the wild-type and K68-R70 functionally restricted proteins. Significantly altered genes were then validated and quantified through real-time quantitative PCR (qPCR); additionally, replication-competent virions were also used to confirm the findings. Moreover, we analyzed the effect of Vpx expression on the secretion of key cytokines in the medium of transfected cells. Our findings revealed that wild-type HIV-2 Vpx can significantly alter the expression of genes coding for helicases, zinc finger proteins, chaperons, transcription factors and proteins involved in DNA methylation. Differentially altered genes were involved in negative regulation of viral processes, the type I interferon-signaling pathway, DNA-template transcription, elongation, the positive regulation of interferon beta production and the negative regulation of innate immune response. Importantly, Vpx was also found to decrease the expression of HIV-1 Tat, possibly through the downregulation of a crucial splicing factor, required for the maturation of Tat. Additionally, studies on cellular cytokine milieu showed that this accessory protein induced key proinflammatory cytokines. Our study provides important information about the complex role played by HIV-2 Vpx in priming and taming the cellular environment to allow for the establishment of the infection.

Factors associated with the interruption of antiretroviral therapy among people living with HIV/AIDS in Brazilian municipalities between 2019 and 2022

OBJECTIVE

To analyze the factors associated with antiretroviral therapy interruption among people living with the human immunodeficiency virus participating in the A Hora é Agora [The Time is Now] project in the municipalities of Campo Grande, Curitiba, and Florianópolis.

METHODS

This is a cross-sectional analytical study using data from the Brazilian Medication Logistics Control System, collected between October 2019 and September 2022. Bivariate analyses were performed to assess associations between sex, age group, race/skin color, and level of education, with the outcomes of treatment interruption and the number of times the treatment was interrupted, using the χ2 test with a 5% significance level.

RESULTS

In Campo Grande, treatment interruption was more frequent among individuals with eight to 11 years of formal education (34.0%). In Curitiba, women (20.4%) showed a higher frequency of treatment interruption, and the age group of 50 years or older had a higher likelihood of treatment interruption (OR: 1.73; 95%CI: 1.12-2.66). In Florianópolis, 31.1% of women experienced treatment interruption, and individuals with up to seven years of formal education had a higher likelihood of treatment interruption (OR: 1.62; 95%CI: 1.15-2.29).

CONCLUSIONS

The interruption of antiretroviral therapy was significantly associated with sex, level of education, and age group, with distinct patterns across the analyzed territorial contexts. These findings highlight the need for targeted interventions aimed at vulnerable groups, considering regional differences and local challenges to improve treatment adherence.

The Application of mRNA Technology for Vaccine Production-Current State of Knowledge

Over the past 20 years, intensive research has been conducted on the development of therapeutic mRNA, leading to numerous discoveries that have enabled its use in therapy. The main achievements in this field include increasing mRNA stability, reducing its immunogenicity (i.e., its ability to trigger an immune response), and solving the challenge of delivering mRNA into cells-all to achieve a therapeutic effect. The aim of this study was to review the scientific literature on the use of mRNA technology in the production of vaccines. Various methods of applying mRNA technology that could potentially be introduced into clinical practice in the future are described. A detailed analysis was conducted on the approved COVID-19 vaccines developed by Pfizer/BioNTech (New York, NY, USA) and Moderna (Kirkland, QC, Canada), as their introduction marked a groundbreaking moment in the advancement of mRNA technology. This study was based on the latest scientific literature from reputable publishers and medical databases such as PubMed and ClinicalTrials. In conclusion, mRNA technology is currently experiencing rapid development, significantly driven by the ongoing COVID-19 pandemic. The application of this technology holds great potential not only for vaccines against infectious diseases but also for cancer treatment. However, further research is necessary to facilitate its broader clinical implementation.

Osteopontin as a potential mediator of inflammation in HIV and comorbid conditions

INTRODUCTION

Approximately 39 million people live with HIV globally, with 1.3 million new infections annually. Despite improved treatment, noncommunicable diseases (NCDs) such as cardiovascular disease (CVD), neurological disorders, chronic kidney disease (CKD), and cancer are now the leading causes of death among people with HIV (PWH). Osteopontin (OPN) has emerged as a notable mediator in the inflammatory response to HIV and related NCDs. Our aim is to review the current understanding of OPN's role in HIV-related inflammatory pathways to highlight potential therapeutic avenues for improved treatment and mitigation of comorbidities.

METHODS

We conducted a systematic review by searching relevant literature using specific keywords related to HIV, osteopontin, cardiovascular disease, inflammation, neurological disorders, cancer, and chronic kidney disease. The collected studies were organized and categorized by key themes, followed by a comprehensive analysis to identify patterns and draw conclusions regarding OPN's role in HIV-associated comorbidities.

RESULTS

The intricate interactions between OPN, its isoforms, and HIV-related illnesses suggest that OPN can exhibit both pro-inflammatory and anti-inflammatory roles, depending on the stage of the disease and the specific cell type involved. Its functions are diverse throughout the progression of HIV and its associated comorbidities, including CVD, CKD, cancer, and neurological disorders.

CONCLUSION

OPN's effects on the disease progression of HIV and related NCDs are highly variable due to its diverse functions. Therefore, further research is essential to fully understand its complex roles before considering OPN as a therapeutic target for HIV and its comorbidities.

Metformin Treatment and Immune Reconstitution in People With HIV and Type 2 Diabetes: A Matched Retrospective Study

Background

Despite effective antiretroviral treatment (ART), HIV infection is associated with immune dysfunction and inflammation. Metformin has shown beneficial immunological and anti-inflammatory effects, including in people with HIV (PWH). We studied the potential association between metformin treatment and immune reconstitution in PWH.

Methods

We conducted a retrospective cohort study set in Stockholm, Sweden. PWH with T2DM who initiated metformin treatment after at least 2 years on effective ART (exposed individuals) and metformin-naïve PWH (controls) were matched in a 1:1 ratio based on age, sex, baseline immune status, and duration of ART. Outcomes included mean values of CD4 cell counts and CD4/CD8 ratios from 1.5 years to 3.5 years after compared with 2 years before the exposed individual started metformin treatment (index date).

Results

Among 1332 PWH, 43 metformin-exposed individuals (median age, 48 years; 11 years since start of ART) with T2DM and 43 nondiabetic controls (median age, 47 years; 11 years since start of ART) were included in the matched analyses. The median (interquartile range) change in CD4 T-cell count was 35 (-21 to 125) cells/μL among exposed individuals and 48 (-18 to 100) cells/μL among controls (P = .96). The corresponding numbers were 0.10 (0.03 to 0.20) and 0.08 (0.02-0.16) for CD4/CD8 ratio (P = .18). No differences were observed in subgroup analyses of PWH with low CD4 T-cell counts and CD4/CD8 ratios.

Conclusions

No significant differences in immune reconstitution were observed between metformin-treated individuals and matched controls over the 2-year follow-up period.

Temporal Trends in HIV-1 Subtypes and Antiretroviral Drug Resistance Mutations in Istanbul, Türkiye (2021-2024): A Next-Generation Sequencing Study

HIV-1 genotyping and drug resistance tests are routinely performed in virology laboratories in some countries, aiding clinical management. In Istanbul, between January 2021 and March 2024, plasma samples from 1029 HIV-1-infected patients were analyzed using the NGS method, and mutation and drug resistance results were retrospectively evaluated alongside demographic data. Subtype B (54.4%) was most frequent in Turkish patients, while Subtype A1 (43.5%) was predominant among foreign nationals. The most common CRFs were CRF02_AG (3.8%) and CRF56_cpx (1.6%). According to the change in detection rates during the study period, Subtype B decreased, and Subtype A increased. The most frequent mutations detected were A62V (38.7%) and M184V (22.4%) for NRTIs; E138A (55.5%) and E138G (11.5%) for NNRTIs; M46I (33.3%) and M46L (25%) for PIs; and E92Q and G for INIs (total rate: 35.2%). Darunavir/ritonavir had the highest sensitivity rate, while resistance rates for NNRTIs and INIs increased over time. We anticipate that this study, in which we evaluate the routine use of an FDA-approved NGS kit alongside integrated bioinformatics data analysis and automated reporting software for the first time in Türkiye, will contribute to both national and international molecular epidemiological data and public health strategies by providing reliable results that align with international standarts.

Targeting HIV-1 conserved regions: An immunoinformatic pathway to vaccine innovation for the Asia

A combination of humoral and cell-mediated immune system stimulation is essential for developing an effective HIV vaccine. Traditional treatment options and the challenges posed by drug resistance necessitate the discovery of a viable vaccine candidate capable of eliciting a robust immunological response. This research aims to develop an HIV vaccine with a multi-epitope component using a unique immunoinformatics approach. A subunit vaccine comprising B-cell, helper T-cell, and cytotoxic T-cell epitopes, along with appropriate adjuvants and linkers, was employed to identify conserved regions in the Pol, Vpr, Gag, Tat, Env, Nef, and Vif proteins. The HIV subunit vaccine demonstrated the potential to activate both cell-mediated and humoral immune responses, indicating its immunogenicity. The application of homology modeling and refinement further enhanced the model's accuracy. Subsequently, the molecular docking procedure utilized the refined model structure to bind to the immunological receptor TLR-3 in lymphocyte cells. Following this, the potential interactions of the subunit vaccine with TLR-3 were investigated using molecular dynamics modeling. The vaccine's stability was improved through a meticulous disulfide engineering technique that involved inserting cysteine residues into highly flexible regions. Finally, in silico cloning was employed to validate the efficacy of translating and producing the vaccine in a microbiological setting. The vaccine shows promising results in terms of population coverage, reaching 82% of the global population, with extraordinary efficacy in Asia, covering up to 95% of the population. Our HIV vaccine candidate is highly stable and elicits a robust immune response against HIV-1.

Machine Learning Reveals Distinct Immunogenic Signatures of Th1 Imprinting in ART-Treated Individuals with HIV Following Repeated SARS-CoV-2 Vaccination

The human immune system is intrinsically variable and remarkably diverse across a population. The immune response to antigens is driven by a complex interplay of time-dependent interdependencies across components of the immune system. After repeated vaccination, the humoral and cellular arms of the immune response display highly heterogeneous dynamics, further complicating the attribution of a phenotypic outcome to specific immune system components. We employ a random forest (RF) approach to classify informative differences in immunogenicity between older people living with HIV (PLWH) on ART and an age-matched control group who received up to five SARS-CoV-2 vaccinations over 104 weeks. RFs identify immunological variables of importance, interpreted as evidence for Th1 imprinting, and suggest novel distinguishing immune features, such as saliva-based antibody screening, as promising diagnostic features towards classifying responses (whereas serum IgG is not). Additionally, we implement supervised and unsupervised Machine Learning methods to produce physiologically accurate synthetic datasets that conform to the statistical distribution of the original immunological data, thus enabling further data-driven hypothesis testing and model validation. Our results highlight the effectiveness of RFs in utilizing informative immune feature interdependencies for classification tasks and suggests broad impacts of ML applications for personalized vaccination strategies among high-risk populations.

Amorphous Solid Dispersion/Salt of Efavirenz: Investigating the Role of Molecular Interactions on Recrystallization and In-vitro Dissolution Performance

Efavirenz (EFZ), a BCS (Biopharmaceutical classification system) class-II/IV drug, suffers from low oral bioavailability (40-50%) and significant inter/intra-individual variability due to its low solubility and poor dissolution properties. The present investigation aimed to prepare a stable amorphous system of EFZ to improve its dissolution using the slurry method with various polymers and examine the nature of the interaction between them and its impact on the stability (recrystallization) of the formed systems and their in-vitro dissolution performance. Differential Scanning Calorimetry (DSC) and Powder X-ray Diffraction (PXRD) studies proved the formation of a complete amorphous system of EFZ with Eudragit® E100, HPMC E5, and HPMCAS-LF up to 50% drug loading. During 90 days accelerated stability studies, amorphous systems prepared using Eudragit® E100 remained stable at 50% drug loading however those prepared with HPMC E5, and HPMCAS-LF only remained stable at 25% drug loading. The ability of Eudragit® E100 based system to stabilize the drug at higher drug loading was attributed to the formation of stronger ionic interaction as revealed by the Fourier-transform infrared spectroscopy (FTIR) study. During in-vitro dissolution study, Eudragit® E100 based amorphous system generated and maintained significantly higher supersaturation compared to those prepared with HPMC E5, and HPMCAS-LF due to the formation of ionic interaction between EFZ and Eudragit® E100 as revealed by solution 1H NMR study.

HIV-1 Vif disrupts phosphatase feedback regulation at the kinetochore, leading to a pronounced pseudo-metaphase arrest

Virion Infectivity Factor (Vif) of the Human Immunodeficiency Virus type 1 (HIV-1) targets and degrades cellular APOBEC3 proteins, key regulators of intrinsic and innate antiretroviral immune responses, thereby facilitating HIV-1 infection. While Vif's role in degrading APOBEC3G is well-studied, Vif is also known to cause cell cycle arrest, but the detailed nature of Vif's effects on the cell cycle has yet to be delineated. In this study, we employed high-temporal resolution single-cell live imaging and super-resolution microscopy to monitor individual cells during Vif-induced cell cycle arrest. Our findings reveal that Vif does not affect the G2/M boundary as previously thought. Instead, Vif triggers a unique and robust pseudo-metaphase arrest, distinct from the mild prometaphase arrest induced by Vpr. During this arrest, chromosomes align properly and form the metaphase plate, but later lose alignment, resulting in polar chromosomes. Notably, Vif, unlike Vpr, significantly reduces the levels of both Protein Phosphatase 1 (PP1) and 2 A (PP2A) at kinetochores, which regulate chromosome-microtubule interactions. These results unveil a novel role for Vif in kinetochore regulation that governs the spatial organization of chromosomes during mitosis.

Transcriptomic Alterations Induced by Tetrahydrocannabinol in SIV/HIV Infection: A Systematic Review

Given the high prevalence of cannabis use among people with HIV (PWH) and its potential to modulate immune responses and reduce inflammation, this systematic review examines preclinical evidence on how tetrahydrocannabinol (THC), a key compound in cannabis, affects gene and micro-RNA expression in simian immunodeficiency virus (SIV)-infected macaques and HIV-infected human cells. Through a comprehensive search, 19 studies were identified, primarily involving SIV-infected macaques, with a pooled sample size of 176, though methodological quality varied across the studies. Pathway analysis of differentially expressed genes (DEGs) and miRNAs associated with THC revealed enrichment in pathways related to inflammation, epithelial cell proliferation, and adhesion. Notably, some DEGs were targets of the differentially expressed miRNAs, suggesting that epigenetic regulation may contribute to THC's effects on gene function. These findings indicate that THC may help mitigate chronic immune activation in HIV infection by altering gene and miRNA expression, suggesting its potential immunomodulatory role. However, the evidence is constrained by small sample sizes and inconsistencies across studies. Further research employing advanced methodologies and larger cohorts is essential to confirm THC's potential as a complementary therapy for PWH and fully elucidate the underlying mechanisms, which could inform targeted interventions to harness its immunomodulatory effects.

Predicting the immunological nonresponse to antiretroviral therapy in people living with HIV: a machine learning-based multicenter large-scale study

Background

Although highly active antiretroviral therapy (HAART) has greatly enhanced the prognosis for people living with HIV (PLWH), some individuals fail to achieve adequate immune reconstitution, known as immunological nonresponse (INR), which is linked to poor prognosis and higher mortality. However, the early prediction and intervention of INR remains challenging in South China.

Methods

This study included 1,577 PLWH who underwent at least two years of HAART and clinical follow-up between 2017 and 2022 at two major tertiary hospitals in South China. We utilized logistic multivariate regression to identify independent predictors of INR and employed restricted cubic splines (RCS) for nonlinear analysis. We also developed several machine-learning models, assessing their performance using internal and external datasets to generate receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The best-performing model was further interpreted using Shapley additive explanations (SHAP) values.

Results

Independent predictors of INR included baseline, 6-month and 12-month CD4+ T cell counts, baseline hemoglobin, and 6-month hemoglobin levels. RCS analysis highlighted significant nonlinear relationships between baseline CD4+ T cells, 12-month CD4+ T cells and baseline hemoglobin with INR. The Random Forest model demonstrated superior predictive accuracy, with ROC areas of 0.866, 0.943, and 0.897 across the datasets. Calibration was robust, with Brier scores of 0.136, 0.102, and 0.126. SHAP values indicated that early CD4+T cell counts and CD4/CD8 ratio were crucial in predicting INR.

Conclusions

This study introduces the random forest model to predict incomplete immune reconstitution in PLWH, which can significantly assist clinicians in the early prediction and intervention of INR among PLWH.

Sensitive Colorimetric Lateral Flow Assays Enabled by Platinum-Group Metal Nanoparticles with Peroxidase-Like Activities

The last several decades have witnessed the success and popularity of colorimetric lateral flow assay (CLFA) in point-of-care testing. Driven by increasing demand, great efforts have been directed toward enhancing the detection sensitivity of CLFA. Recently, platinum-group metal nanoparticles (PGM NPs) with peroxidase-like activities have emerged as a type of promising colorimetric labels for enhancing the sensitivity of CLFA. By incorporating a simple and rapid post-treatment process, the PGM NP-based CLFAs are orders of magnitude more sensitive than conventional gold nanoparticle-based CLFAs. In this perspective, the study begins with introducing the design, synthesis, and characterization of PGM NPs with peroxidase-like activities. The current techniques for surface modification of PGM NPs are then discussed, followed by operation and optimization of PGM NP-based CLFAs. Afterward, opinions are provided on the social impact of PGM NP-based CLFAs. Lastly, this perspective is concluded with an outlook of future research directions in this emerging field, where the challenges and opportunities are discussed.

Breaking barriers: we need a multidisciplinary approach to tackle cancer drug resistance

Most cancer-related deaths result from drug-resistant disease(1,2). However, cancer drug resistance is not a primary focus in drug development. Effectively mitigating and treating drug-resistant cancer will require advancements in multiple fields, including early detection, drug discovery, and our fundamental understanding of cancer biology. Therefore, successfully tackling drug resistance requires an increasingly multidisciplinary approach. A recent workshop on cancer drug resistance, jointly organised by Cancer Research UK, the Rosetrees Trust, and the UKRI-funded Physics of Life Network, brought together experts in cell biology, physical sciences, computational biology, drug discovery, and clinicians to focus on these key challenges and devise interdisciplinary approaches to address them. In this perspective, we review the outcomes of the workshop and highlight unanswered research questions. We outline the emerging hallmarks of drug resistance and discuss lessons from the COVID-19 pandemic and antimicrobial resistance that could help accelerate information sharing and timely adoption of research discoveries into the clinic. We envisage that initiatives that drive greater interdisciplinarity will yield rich dividends in developing new ways to better detect, monitor, and treat drug resistance, thereby improving treatment outcomes for cancer patients.

Composite quantile regression approach to batch effect correction in microbiome data

Background

Batch effects refer to data variations that arise from non-biological factors such as experimental conditions, equipment, and external factors. These effects are considered significant issues in the analysis of biological data since they can compromise data consistency and distort actual biological differences, which can severely skew the results of downstream analyses.

Method

In this study, we introduce a new approach that comprehensively addresses two types of batch effects: "systematic batch effects" which are consistent across all samples in a batch, and "nonsystematic batch effects" which vary depending on the variability of operational taxonomic units (OTUs) within each sample in the same batch. To address systematic batch effects, we apply a negative binomial regression model and correct for consistent batch influences by excluding fixed batch effects. Additionally, to handle nonsystematic batch effects, we employ composite quantile regression. By adjusting the distribution of OTUs to be similar based on a reference batch selected using the Kruskal-Walis test method, we consider the variability at the OTU level.

Results

The performance of the model is evaluated and compared with existing methods using PERMANOVA R-squared values, Principal Coordinates Analysis (PCoA) plots and Average Silhouette Coefficient calculated with diverse distance-based metrics. The model is applied to three real microbiome datasets: Metagenomic urine control data, Human Immunodeficiency Virus Re-analysis Consortium data, and Men and Women Offering Understanding of Throat HPV study data. The results demonstrate that the model effectively corrects for batch effects across all datasets.

Identification of Pathogens in HIV-Infected Patients Using Metagenomic Next-Generation Sequencing (mNGS) as Compared to Conventional Microbiological Tests (CMTs)

Background

The rapid and accurate identification of infectious pathogens in HIV-infected patients remains a challenge. Metagenomic next-generation sequencing (mNGS) is a panpathogen assay for rapid diagnosis of infectious diseases. Here, the diagnostic value of mNGS was evaluated in HIV-infected patients and compared with conventional microbiological tests (CMTs).

Methods

This study was conducted on 216 hIV-infected patients with suspected opportunistic infections. Infectious pathogen detection was done by mNGS and conventional microbiological tests, respectively.

Results

A total of 195 patients (90.2%) were positive for microbial pathogens by mNGS, while 135 patients (62.5%) were positive for microbial pathogens by CMTs. Mixed infection was identified in 92 patients by mNGS, and 41 patients were detected with mixed infection by CMTs. Fungi and virus mixed infection was the most frequent pattern detected by mNGS (32, 14.8%) and CMTs (22, 10.2%). The CD4+ T cell count in patients with mixed pathogens was significantly lower than that in patients infected with a single pathogen. Pathogens were quickly identified by mNGS in 151 patients (69.9%), and appropriate treatments were initiated. In 47 patients antibacterial agents were adjusted based on mNGS results, in 39 patients antifungal agents were changed, and 35 patients had antiviral agents added.

Conclusion

mNGS is a valuable tool and enhances rapid microbiological identification in HIV-infected patients. Combined with CMTs, mNGS may facilitate personalized antimicrobial treatment strategies and increase survival.

Excision of HIV-1 Provirus in Human Primary Cells with Nanocapsuled TALEN Proteins

Despite the tremendous success of combination antiretroviral therapy (ART) to treat human immunodeficiency virus (HIV) infection, the durability and persistence of latent reservoirs of HIV-infected cells in HIV-infected patients remain obstacles to achieving HIV cure. While technically challenging, the most direct means to eradicate latent reservoirs is to destroy the HIV provirus, thus ensuring that HIV virions are not produced while preserving resident cells. Transcription activator-like effector nucleases (TALEN)─a genome editing method with high DNA targeting efficiency─have been investigated as a potential gene therapy by disrupting the HIV-1 coreceptor CCR5 genes in HIV target cells or HIV proviral DNA in infected cells. However, the transduction and editing efficiencies are low in primary cells and vary by cell type. Using a nanotechnology platform, which we term nanocapsules, the TALEN protein can be effectively delivered into primary cells and escape from endosome/lysosome sequestration. We report that TALEN nanocapsules can effectively mutagenize the HIV-1 proviral DNA integrated into two primary HIV-1 reservoir cells─T cells and macrophages, such that replication and/or reactivation from latency is aborted. We envision that this study provides a useful platform to deliver a wide range of DNA-modifying enzymes for effective HIV therapy.

Neuroimaging advances in neurocognitive disorders among HIV-infected individuals

Although combination antiretroviral therapy (cART) has been widely applied and effectively extends the lifespan of patients infected with human immunodeficiency virus (HIV), these patients remain at a substantially increased risk of developing neurocognitive impairment, commonly referred to as HIV-associated neurocognitive disorders (HAND). Magnetic resonance imaging (MRI) has emerged as an indispensable tool for characterizing the brain function and structure. In this review, we focus on the applications of various MRI-based neuroimaging techniques in individuals infected with HIV. Functional MRI, structural MRI, diffusion MRI, and quantitative MRI have all contributed to advancing our comprehension of the neurological alterations caused by HIV. It is hoped that more reliable evidence can be achieved to fully determine the driving factors of cognitive impairment in HIV through the combination of multi-modal MRI and the utilization of more advanced neuroimaging analysis methods.

Extracellular Vesicles as Biomarkers in Infectious Diseases

Extracellular vesicles (EVs) are nanosized vesicles that are secreted by all cells into the extracellular space. EVs are involved in cell-to-cell communication and can be found in different bodily fluids (bronchoalveolar lavage fluid, sputum, and urine), tissues, and in circulation; the composition of EVs reflects the physiological condition of the releasing cell. The ability to use EVs from bodily fluids for minimally invasive detection to monitor diseases makes them an attractive target. EVs carry a snapshot of the releasing cell's internal state, and they can serve as powerful biomarkers for diagnosing diseases. EVs also play a role in the body's immune and pathogen detection responses. Pathogens, such as bacteria and viruses, can exploit EVs to enhance their survival and spread and to evade detection by the immune system. Changes in the number or contents of EVs can signal the presence of an infection, offering a potential avenue for developing new diagnostic methods for infectious diseases. Ongoing research in this area aims to address current challenges and the potential of EVs as biomarkers in diagnosing a range of diseases, including infections and infectious diseases. There is limited literature on the development of EVs as diagnostic biomarkers for infectious diseases using existing molecular biology approaches. We aim to address this gap by reviewing recent EV-related investigations in infectious disease studies.

Inflammatory responses revealed through HIV infection of microglia-containing cerebral organoids

Cerebral organoids (COs) are valuable tools for studying the intricate interplay between glial cells and neurons in brain development and disease, including HIV-associated neuroinflammation. We developed a novel approach to generate microglia containing COs (CO-iMs) by co-culturing hematopoietic progenitors and inducing pluripotent stem cells. This approach allowed for the differentiation of microglia within the organoids concomitantly with the neuronal progenitors. Compared with conventional COs, CO-iMs were more efficient at generating CD45+/CD11b+/Iba-1+ microglia and presented a physiologically relevant proportion of microglia (~ 7%). CO-iMs presented substantially increased expression of microglial homeostatic and sensome markers as well as markers for the complement cascade. CO-iMs are susceptible to HIV infection, resulting in a significant increase in several pro-inflammatory cytokines/chemokines, which are abrogated by the addition of antiretrovirals. Thus, CO-iM is a robust model for deciphering neuropathogenesis, neuroinflammation, and viral infections of brain cells in a 3D culture system.

Merkel Cell Polyomavirus Co-Infection in HIV/AIDS Individuals: Clinical Diagnosis, Consequences and Treatments

Merkel cell polyomavirus (MCV) was named for its role as the causative agent of Merkel cell carcinoma (MCC), which is MCV positive in approximately 80% of cases. MCV is classified as a Group 2A carcinogen, which promotes carcinogenesis by integrating T-antigen into the cell genome. The prevalence of anti-MCV antibodies in the general population can be as high as 90%. MCV typically promotes cancer by integrating T-antigen genes into the host cell genome, and 80% of MCC cases are attributed to MCV activation. In immunocompetent individuals, MCV usually remains latent after infection. However, the incidence of MCC increases significantly in immunocompromised or immunodeficient patients, such as those who have undergone organ transplantation, have chronic lymphocytic leukemia, or are living with human immunodeficiency virus (HIV) infection. Acquired immunodeficiency is a particular feature of people living with HIV. Currently, research on HIV/AIDS patients with MCV infection, clinical outcomes, and treatments is quite limited. This paper reviews previous research and systematically examines the relationship between HIV/AIDS and MCV-associated diseases, with the aim of providing valuable information for the prevention, diagnosis, and treatment of MCV in vulnerable populations.

Severity and Number of Substances Used are Independently Associated with Antiretroviral Therapy Adherence Over Time among People with HIV in the Current Treatment Era

Substance use is associated with decreased antiretroviral therapy (ART) adherence among people with HIV (PWH). Adherence plays a significant role in mediating the negative effects of substance use on HIV suppression and is a principal modifiable patient-level factor in improving HIV suppression and reducing ART drug resistance. Understanding substance use and ART adherence, particularly with rapidly changing substance use epidemiology and ART regimens, is vital to improving HIV care. Among 10,557 PWH (2010-2021) from 8 academic clinical sites nationally we examined longitudinal associations of substance use severity and number of substances used (measured using AUDIT-C and modified ASSIST) with patient-reported ART adherence (visual analog scale). Alcohol (68% any use, 18% unhealthy use [AUDIT-C > 4 men, > 3 women]), marijuana (33%), and methamphetamine (9%) use were most reported. Polysubstance use was common (32%). Both higher severity substance use and higher number of substances used were associated with lower ART adherence. Severity of methamphetamine use had the strongest dose-response association with ART adherence (low severity [ASSIST 1-3]: -3.05%, 95% CI: -4.23%, -1.87%; moderate [ASSIST 4-26]: -6.20%, 95% CI: -7.08%, -5.33%; high [ASSIST > 26]: -10.77%, 95% CI: -12.76%, -8.78%). Severe substance use, especially methamphetamine, and higher number of illicit drugs used were associated with declines in adherence at levels that were likely clinically meaningful in the modern era of ART. Findings support integrating substance use care with HIV care and potential benefits of harm reduction strategies for improving adherence such as encouraging lower levels of substance use and fewer number of substances used.

Modeling the Interplay Between Viral and Immune Dynamics in HIV: A Review and Mrgsolve Implementation and Exploration

Since its initial discovery, HIV has infected more than 70 million individuals globally, leading to the deaths of 35 million. At present, the annual number of deaths has significantly decreased due to 75% of HIV-positive individuals being on antiretroviral therapy. Although there is no cure yet, available treatments extend life expectancy, enhance quality of life, and reduce transmission by maintaining viral load below the detection limit of 50 copies/mL, making the individual's levels undetectable and untransmittable. HIV has attracted considerable attention in the computational modeling area, with various models having been developed with different degrees of complexity in an attempt to explain the viral dynamics of the disease. It is important to note that no single model can fully incorporate and predict all the critical factors influencing the dynamics of the disease and its response to treatments. Since the number of published models is large, the purpose of this article is to review several relevant models found in the literature that describe biologically plausible scenarios of HIV infection, including key features of disease progression with or without treatment. A total of 15 models are described, with some implemented in the mrgsolve package in R Studio and shared for the benefit of the scientific community. The modeling framework concerning HIV infection aids in identifying the most impactful parameters within the system and their implications in the model outcomes. Insights provided by these models may help in confirming targets for current and novel therapies, thereby contributing to the exploration of new strategies.

Integrated Genetic and Cellular Analysis Reveals NLRP1 Activation in CD4+ T Lymphocytes During Chronic HIV Infection

BACKGROUND

Most of the investigations related to inflammasome activation during HIV infection have focused on the receptor NLRP3 and innate immune cells such as monocytes/macrophages. However, during the past years, inflammasome activation has also been explored in lymphocytes, and novel sensors, other than the NLRP3, have been shown to play a role in the biology of these cells. Here, we hypothesized that NLRP1 may be involved in CD4+ T cell dysregulation in people living with HIV (PLWH), therefore contributing to chronic inflammation and to the pathogenesis of non-HIV-associated diseases.

METHODS

The activation of NLRP1 in CD4+ T cells was assessed ex-vivo and in-vitro by the meaning of anti-CD3/anti-CD28 and Talabostat/Val-boroPro (VbP) response.

RESULTS

Our results showed that the NLRP1 inflammasome was activated in PLWH CD4+ T cells, and that the stimulation of CD4+ T cells resulted in increased response to anti-CD3/anti-CD28 and VbP. Functional variants in NLRP1 significantly affected the level of inflammatory dysregulation of CD4+ T cells, therefore explaining at least in part the association with CD4+ T-mediated diseases.

CONCLUSION

PLWH CD4+ T cells are more prone to IL-1β release and pyroptosis, therefore contributing to chronic inflammation.

Genotoxic consequences of viral infections

Viral diseases continually threaten human health as evolving pathogens introduce new risks. These infections can lead to complications across organ systems, with impacts varying by virus type, infection severity, and individual immune response. This review examines the genotoxic stress caused by viral infections and its pathological consequences in humans.

Impact of HIV on HPV-related cancers in men who have sex with men: a review

Co-infection with human immunodeficiency virus (HIV) significantly increases the incidence of human papillomavirus (HPV) infection and HPV-related cancers among men who have sex with men (MSM). Conversely, HPV infection can also influence HIV acquisition rates. HIV-induced immune suppression may affect chromosomal stability, gene expression, protein function and other molecular components in MSM with HPV-related cancers. Additionally, HIV infection also alters cellular mechanisms by compromising immune responses and epithelial integrity. In this review, we reviewed the influence of HIV on specific HPV-related cancers in MSM, including oropharyngeal squamous cell carcinoma, penile cancer, and anal cancer. We integrated epidemiological data from the past five years and discussed diagnosis and treatment strategies. Overall, our review offers crucial insights into the underlying molecular and cellular mechanisms of these co-infection MSM patients. Our review aims to assist future research in developing effective treatment strategies for MSM with HIV/HPV co-infection.

Increases in the susceptibility of human endometrial CD4+ T cells to HIV-1 infection post-menopause are not dependent on greater viral receptor expression frequency

Epidemiological evidence suggests that post-menopausal women are more susceptible to HIV infection following sexual intercourse than are younger cohorts for reasons that remain unclear. Here, we evaluated how menopause-associated changes in CD4+ T cell numbers and subsets as well as HIV coreceptor expression, particularly CCR5, in the endometrium (EM), endocervix (CX), and ectocervix (ECX) may alter HIV infection susceptibility. Using a tissue-specific mixed cell infection model, we demonstrate that while no changes in CD14+ macrophage infection susceptibility were observed, CD4+ T cell HIV-1 infection frequency increases following menopause in the EM, but not CX nor ECX. Unexpectedly, the CD4+ T cell expression of two known correlates of HIV infection susceptibly, CCR5 and integrin-α4β7, increased following menopause across all three tissues despite only being associated with increased infection frequency in EM derived CD4+ T cells. After controlling for changes in the expression of either receptor, both CCR5 and α4β7 expressing CD4+ T cells isolated from the EM of post-menopausal women remained more susceptible to HIV-1 infection than those isolated from pre-menopausal women. Shifts in T helper subset composition, including increases in Th1 frequency and decreases in Th17 and Treg frequency were also observed in the EM only following menopause, but did not correlate with increased infection frequency. Treatment of EM derived CD4+ T cells with 17β-estradiol (E2) prior to viral infection, reduced infection frequency independent of changes in either CCR5 or α4β7 expression frequency. Our results demonstrate that the susceptibility of EM derived CD4+ T cells to HIV-1 infection increases post menopause but is unlikely to be driven by increased expression frequency of either CCR5 or integrin-α4β7. These findings contribute to our understanding of how advanced age alters HIV infection risk which will become increasingly important as the human population continues to age.

CAR-T Therapy Beyond B-Cell Hematological Malignancies

Despite the advances of CAR-T cells in certain hematological malignancies, mostly from B-cell derivations such as non-Hodgkin lymphomas, acute lymphoblastic leukemia and multiple myeloma, a significant portion of other hematological and non-hematological pathologies can benefit from this innovative treatment, as the results of clinical studies are demonstrating. The clinical application of CAR-T in the setting of acute T-lymphoid leukemia, acute myeloid leukemia, solid tumors, autoimmune diseases and infections has encountered limitations that are different from those of hematological B-cell diseases. To overcome these restrictions, strategies based on different molecular engineering platforms have been devised and will be illustrated below. The aim of this manuscript is to provide an overview of the CAR-T application in pathologies other than those currently treated, highlighting both the limits and results obtained with these settings.

Bifurcation and stability analysis of within host HIV dynamics with multiple infections and intracellular delay

Human immunodeficiency virus (HIV) manifests multiple infections in CD4+ T cells, by binding its envelope proteins to CD4 receptors. Understanding these biological processes is crucial for effective interventions against HIV/AIDS. Here, we propose a mathematical model that accounts for the multiple infections of CD4+ T cells and an intracellular delay in the dynamics of HIV infection. We study the model system and establish the conditions under which the disease-free equilibrium point and the endemic equilibrium point are locally and globally asymptotically stable. We further provide the conditions under which these equilibrium points undergo forward or backward transcritical bifurcations for the autonomous model and Hopf bifurcation for both the delay model and autonomous models. Our simulation results show that an increase in the rate of multiple infections of CD4+ T cells stabilizes the endemic equilibrium point through Hopf bifurcation. However, in the presence of an intracellular delay, the model system evinces three types of stability scenarios at the endemic equilibrium point-instability switch, stability switch, and stability invariance and is demonstrated using bi-parameter diagrams. One of the novel aspects of this study is exhibiting all these interesting nonlinear dynamical results within a single model incorporating a single time delay.

Testis Is a Sanctuary Site for HIV-1

In this review, we summarize some recent findings regarding the likely mechanisms by which HIV-1 uses the testis as a sanctuary site for evading the effects of antiviral drugs from reaching the testis, due to the presence of the blood-testis barrier. This discussion also sheds insights into the possibility of eradicating the small viral pool in the testis behind the blood-testis barrier in future functional studies. These findings also bridge the knowledge gap of eradicating viral particles hiding behind the blood-brain barrier in the brain since it is anticipated that the blood-tissue barriers, namely the blood-testis and the blood-brain barriers, are utilizing similar mechanisms to regulate the dynamic nature of their tight junctions.

Amphotericin B Colloidal Dispersion is Efficacious and Safe for the Management of Talaromycosis in HIV-Infected Patients: Results of a Retrospective Cohort Study in China

Background

Amphotericin B deoxycholate (AmB-D) have potential toxic effects in the treatment of talaromycosis, and high-quality, non-generic liposomal AmB (L-AMB) is still inaccessible in many regions of China. As such, the efficacy and safety of alternative drugs warrant further investigation for the management of talaromycosis. This study aimed to compare the efficacy and safety of Amphotericin B Colloidal Dispersion (ABCD) and AmB-D for the treatment of talaromycosis in a retrospective cohort of HIV-infected patients.

Methods

This was a retrospective study and the data of HIV-infected patients with talaromycosis who received ABCD or AmB-D from January 2018 to December 2022, were retrospectively collected and analyzed. We compared the efficacy and safety of the two antifungal drugs.

Results

Overall, 38 patients receiving ABCD and 33 patients receiving AmB-D were included. The conversion rates to fungal negativity at one week post-treatment were 86.84% (33/38) in the ABCD group and 90.09% (30/33) in the AmB-D group, which reached 100.00% in both groups at two weeks post-treatment. A higher symptom remission rate was observed at two weeks in the ABCD group compared with the AmB-D group (94.74% vs 75.76%; p=0.003). Additionally, the serum creatinine level significantly increased from baseline in the AmB-D group, whereas it did not increase significantly in the ABCD group. Furthermore, significantly fewer patients discontinued antifungal treatment due to drug intolerance in the ABCD group, and the incidences of leukopenia and elevated creatinine levels were lower in the ABCD group compared with the AmB-D group.

Conclusion

ABCD has a clinical efficacy comparable to AmB-D, with higher symptom remission rate, lower nephrotoxicity, and lower bone marrow suppression, indicating that ABCD may be an appropriate alternative option for the clinical management of talaromycosis.

Nucleoside Reverse Transcriptase Inhibitor (NRTI)-Induced Neuropathy and Mitochondrial Toxicity: Limitations of the Poly-γ Hypothesis and the Potential Roles of Autophagy and Drug Transport

Nucleoside reverse transcriptase inhibitors (NRTIs) are the backbone of highly active antiretroviral therapy (HAART)-the current standard of care for treating human immunodeficiency virus (HIV) infection. Despite their efficacy, NRTIs cause numerous treatment-limiting adverse effects, including a distinct peripheral neuropathy, called antiretroviral toxic neuropathy (ATN). ATN primarily affects the extremities with shock-like tingling pain, a pins-and-needles prickling sensation, and numbness. Despite its negative impact on patient quality of life, ATN remains poorly understood, which limits treatment options and potential interventions for people living with HIV (PLWH). Elucidating the underlying pathophysiology of NRTI-induced ATN will facilitate the development of effective treatment strategies and improved patient outcomes. In this article, we will comprehensively review ATN in the setting of NRTI treatment for HIV infection.

Dry eye disease caused by viral infection: Past, present and future

Following viral infection, the innate immune system senses viral products, such as viral nucleic acids, to activate innate defence pathways, leading to inflammation and apoptosis, control of cell proliferation, and consequently, threat to the whole body. The ocular surface is exposed to the external environment and extremely vulnerable to viral infection. Several studies have revealed that viral infection can induce inflammation of the ocular surface and reduce tear secretion of the lacrimal gland (LG), consequently triggering ocular morphological and functional changes and resulting in dry eye disease (DED). Understanding the mechanisms of DED caused by viral infection and its potential therapeutic strategies are crucial for clinical interventional advances in DED. This review summarizes the roles of viral infection in the pathogenesis of DED, applicable diagnostic and therapeutic strategies, and potential regions of future studies.

Adherence to antiretroviral therapy and its association with quality of life among people with HIV in the United States

Adherence to antiretroviral therapy (ART) is critical for people with HIV (PWH) to achieve and maintain virologic suppression and minimize drug resistance. This study aimed to use real-world data to characterize ART adherence and its effect on quality of life (QoL) in PWH. Data were drawn from the Adelphi HIV Disease Specific Programme™, a cross-sectional survey of physicians and PWH in the United States, conducted June-October 2021. Demographic and clinical characteristics, ART adherence and treatment satisfaction for PWH were reported by physicians. PWH completed standardized QoL questionnaires. Adherence level was categorized into completely, mostly and less adherent. Regression analysis was used to investigate factors associated with adherence and the association between adherence and QoL measures. Of 578 PWH, 189 (32.7%) were not completely adherent. Having AIDS-defining illnesses, anxiety/depression or being symptomatic was significantly associated with lower adherence. Reasons for poor adherence included forgetting, difficulties integrating into routine and side effects. QoL scores were significantly higher in the completely adherent group. These findings highlight the strong association between suboptimal adherence and QoL among PWH and key factors and PWH reasons that may lead to suboptimal adherence. Interventions aimed at improving the QoL of PWH by understanding these factors are warranted.

HIV-1 exploits LBPA-dependent intraepithelial trafficking for productive infection of human intestinal mucosa

The gastrointestinal tract is a prominent portal of entry for HIV-1 during sexual or perinatal transmission, as well as a major site of HIV-1 persistence and replication. Elucidation of underlying mechanisms of intestinal HIV-1 infection are thus needed for the advancement of HIV-1 curative therapies. Here, we present a human 2D intestinal immuno-organoid system to model HIV-1 disease that recapitulates tissue compartmentalization and epithelial-immune cellular interactions. Our data demonstrate that apical exposure of intestinal epithelium to HIV-1 results in viral internalization, with subsequent basolateral shedding of replication-competent viruses, in a manner that is impervious to antiretroviral treatment. Incorporation of subepithelial dendritic cells resulted in HIV-1 luminal sampling and amplification of residual viral replication of lab-adapted and transmitted-founder (T/F) HIV-1 variants. Markedly, intraepithelial viral capture ensued an altered distribution of specialized endosomal pathways alongside durable sequestration of infectious HIV-1 within lysobisphosphatidic acid (LPBA)-rich vesicles. Therapeutic neutralization of LBPA-dependent trafficking limited productive HIV-1 infection, and thereby demonstrated the pivotal role of intraepithelial multivesicular endosomes as niches for virulent HIV-1 within the intestinal mucosa. Our study showcases the application of primary human 2D immune-competent organoid cultures in uncovering mechanisms of intestinal HIV-1 disease as well as a platform for preclinical antiviral drug discovery.