The field of HIV medicine has changed rapidly in the last two decades since effective and tolerable antiretroviral treatment became available. As a result, although classical opportunistic infections of the brain have become less common, clinicians need to be aware of a wider range of acute and chronic complications of HIV and its treatment. In this article, we summarise major opportunistic infections, immune reconstitution inflammatory syndrome, HIV-associated neurocognitive disorders, and cerebrovascular disease in HIV positive patients. We also emphasise the preventability and reversibility of most of the central nervous system complications of HIV, and hence the importance of early diagnosis of HIV and involvement of clinicians with special expertise in HIV medicine.
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http://dx.doi.org/10.7861/clinmedicine.13-6-s24 | DOI Listing |
AIDS Care
January 2025
Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA.
Violence experience, interpersonal and community-level, is commonly reported by people living with HIV (PLWH). Understanding the impact of the various forms of violence on HIV outcomes is critical for prioritizing violence screening and support resources in care settings. From February 2021 to December 2022, among 285 PLWH purposively sampled to attain diversity by gender, race/ethnicity, and HIV care retention status in Atlanta, Georgia, we examined interpersonal and community violence experiences and proxy measures of violence (post-traumatic stress disorder (PTSD), anxiety, depression) and their associations with HIV outcomes (engagement and retention in care and HIV viral suppression) using multivariable analysis.
View Article and Find Full Text PDFMicrobiome
January 2025
Department of Medicine, University of Toronto, Toronto, Canada.
Background: Genital inflammation increases HIV susceptibility and is associated with the density of pro-inflammatory anaerobes in the vagina and coronal sulcus. The penile urethra is a critical site of HIV acquisition, although correlates of urethral HIV acquisition are largely unknown. While Streptococcus mitis is a consistent component of the urethral flora, the presence of Gardnerella vaginalis has been linked with prior penile-vaginal sex and urethral inflammation.
View Article and Find Full Text PDFBMC Infect Dis
January 2025
Department of Family Medicine, Epidemiology & Community Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya.
Background: HIV and HBV remain significant public health challenges characterized by high prevalence, morbidity, and mortality, especially among women of reproductive age in Uganda. Patients with HBV do not receive routine counselling and education, and there are limited resources for laboratory investigation coupled with a high loss to follow-up. This study set out to assess barriers and facilitators of integrated viral hepatitis B C and HIV care model to optimize screening uptake among mothers and newborns at health facilities in Koboko District, west Nile sub-region, Uganda.
View Article and Find Full Text PDFNat Commun
January 2025
Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, USA.
Early investigation revealed a reduced risk of SARS-CoV-2 infection among social contacts of COVID-19 vaccinated individuals, referred to as indirect protection. However, indirect protection from SARS-CoV-2 infection-acquired immunity and its comparative strength and durability to vaccine-derived indirect protection in the current epidemiologic context of high levels of vaccination, prior infection, and novel variants are not well characterized. Here, we show that both vaccine-derived and infection-acquired immunity independently yield indirect protection to close social contacts with key differences in their strength and waning.
View Article and Find Full Text PDFAIDS Behav
January 2025
Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, USA.
Pre-exposure prophylaxis (PrEP), an effective biomedical prevention intervention, is not sufficiently reaching populations experiencing high HIV incidence. Behavioral health (BH) treatment addressing mental health and substance use similarly requires increased reach to HIV-affected populations. HIV testing is an opportunity to refer individuals to PrEP and BH treatment.
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