Highlights from the Tenth International Workshop on HIV Persistence during Therapy, December 13-16, 2022, Miami, Florida-USA.

The International Workshop on HIV Persistence during Therapy provides a forum in which HIV/AIDS researchers gather to share the latest research findings related to viral reservoirs and cure. The Tenth Workshop, which was attended by over 400 delegates, extended over 4 days and comprised eight sessions covering topics from the basic science of viral persistence to therapeutic approaches to HIV cure. Furthermore, satellite sessions on the first day of the Conference featuring cure research endeavours being pursued by the Bill and Melinda Gates Foundation as well as those being coordinated under the National Institutes of Health Martin Delaney Collaboratory program, provided important updates on research advances being made in these initiatives.

Impact of Antibiotic Treatment on the Gut Microbiome and its Resistome in Hematopoietic Stem Cell Transplant Recipients.

Antibiotic-resistant bacterial infections are increasingly an issue in allogenic hematopoietic stem cell transplant patients. How antibiotic treatment impacts antibiotic resistance in the human gut microbiome remains poorly understood in vivo. Here, a total of 577 fecal samples from 233 heavily antibiotic-treated transplant patients were examined using high-resolution prescription data and shotgun metagenomics.

Pre-Transplant Prediction of Acute Graft-versus-Host Disease Using the Gut Microbiome.

Gut microbiota is thought to influence host responses to allogeneic hematopoietic stem cell transplantation (aHSCT). Recent evidence points to this post-transplant for acute graft-versus-host disease (aGvHD). We asked whether any such association might be found pre-transplant and conducted a metagenome-wide association study (MWAS) to explore.

Low-Abundance Drug-Resistant HIV-1 Variants in Antiretroviral Drug-Naive Individuals: A Systematic Review of Detection Methods, Prevalence, and Clinical Impact.

Background: The presence of high-abundance drug-resistant HIV-1 jeopardizes success of antiretroviral therapy (ART). Despite numerous investigations, the clinical impact of low-abundance drug-resistant HIV-1 variants (LA-DRVs) at levels <15%-25% of the virus population in antiretroviral (ARV) drug-naive individuals remains controversial.

Methods: We systematically reviewed 103 studies assessing prevalence, detection methods, technical and clinical detection cutoffs, and clinical significance of LA-DRVs in antiretroviral drug-naive adults.

Rapid HIV progression during acute HIV-1 subtype C infection in a Mozambican patient with atypical seroconversion.

Acute human immunodeficiency virus (HIV) infection (AHI) refers to the period between viral transmission and development of an adaptive immune response to HIV antigens (seroconversion) usually lasting 6-8 weeks. Rare cases have been described in which HIV-infected patients fail to seroconvert and instead, develop rapid HIV-mediated clinical decline. We report the case of a Mozambican woman with AHI and malaria coinfection who showed atypical seroconversion and experienced rapid deterioration and death within 14 weeks of diagnosis with AHI.

RECall for automated genotypic tropism testing.

Standardization of sequence chromatogram analysis is required for consistent genotypic tropism determination across laboratories. A freely available, fast, and automated chromatogram analysis tool (RECall) provided tropism interpretations equivalent to those of manual sequence editing of 521 V3 loop HIV-1 population sequences, suggesting that RECall can be useful in standardizing genotypic tropism testing across laboratories.

Trends in the population prevalence of people who inject drugs in US metropolitan areas 1992-2007.

Background: People who inject drugs (PWID) have increased risk of morbidity and mortality. We update and present estimates and trends of the prevalence of current PWID and PWID subpopulations in 96 US metropolitan statistical areas (MSAs) for 1992-2007. Current estimates of PWID and PWID subpopulations will help target services and help to understand long-term health trends among PWID populations.

Network Firewall Dynamics and the Subsaturation Stabilization of HIV.

In 2001, Friedman et al. conjectured the existence of a "firewall effect" in which individuals who are infected with HIV, but remain in a state of low infectiousness, serve to prevent the virus from spreading. To evaluate this historical conjecture, we develop a new graph-theoretic measure that quantifies the extent to which Friedman's firewall hypothesis(FH)holds in a risk network.

Resilience among IDUs: planning strategies to help injection drug users to protect themselves and others from HIV/HCV infections.

Many long-term injection drug users (IDUs) engage in planning strategies. In this pilot study, we examine the relation of one planning strategy to IDUs' engaging in safer injection practices. Sixty-eight IDUs were recruited in 2010 from a New York City (NYC) needle exchange program and referrals to participate in an innovative Staying Safe Intervention that teaches strategies to stay HIV/HCV uninfected.

The initiation of homeless youth into the street economy.

Homeless youth (HY) who lack employment in the formal economy typically turn to the street economy (e.g., prostitution, drug selling) for survival.

Estimating the prevalence of injection drug users in the U.S. and in large U.S. metropolitan areas from 1992 to 2002.

This paper estimates the prevalence of current injection drug users (IDUs) in 96 large U.S. metropolitan statistical areas (MSAs) annually from 1992 to 2002.

Resilience Among Young Men Who Have Sex With Men in New York City.

This article describes a study of resilience among young men who have sex with men (YMSM). Resilience is defined as positive adaptation in the context of hardship. Using targeted sampling to capture the diversity and range of this hidden population, we recruited 569 YMSM ages 17-28 years old and examined a subset of 134 YMSM who had experienced severe childhood adversity, as indicated by placement in foster care.

Maternal substance use and HIV status: adolescent risk and resilience.

We examined the risk and protective factors and mental health problems of 105 low SES, urban adolescents whose mothers were coping with alcohol abuse and other drug problems. Approximately half of the mothers were also HIV-infected. As hypothesized, there were few differences between adolescents of HIV-infected and HIV-uninfected mothers in background characteristics, mental health issues and current substance use risk behaviors.

Physical and mental health functioning of urban HIV-infected and uninfected mothers with problem drinking.

Problem drinking is of great concern for mothers, especially those who are HIV-infected. We compared background characteristics, co-occurring drug use, and physical and mental health functioning of urban HIV-infected and uninfected mothers with problem drinking who were raising adolescents. Mothers in both groups reported similarly high levels of lifetime and current alcohol and drug use and poor physical and mental health.

Absent reduction by HIV protease inhibitors of Candida albicans adhesion to endothelial cells.

Highly active antiretroviral therapy including HIV protease inhibitors has led to a marked reduction of clinically relevant mucosal candidiasis. We have previously shown that HIV protease inhibitors directly inhibit adhesion of Candida albicans to epithelial cells at concentrations that are reached in vivo during antiretroviral therapy. The aim of this study was to establish whether HIV protease inhibitors also inhibit adhesion of Candida to endothelial cells, which play a major role in systemic fungal disease.

Tracing complement-retroviral interactions from mucosal surfaces to the lymphatic tissue.

During (nearly) all steps in retroviral pathogenesis, viruses are confronted with complement and complement receptor (CR)-positive cells. As all of the retroviruses tested so far activate the complement system, members of this virus family have adapted different protection mechanisms to keep complement activation under the threshold necessary to avoid complement-mediated lysis. As a consequence of complement activation, retroviruses are covered with complement proteins and thus provide additional ligands to interact with CR-expressing cells.

Immune response to retroviral infections of the brain.

Various neurological manifestations of retroviral infections have been reported, including peripheral neuropathy, encephalopathy and neuronal degeneration. After penetration into the central nervous system (CNS) the invading retroviruses meet a unique immunological situation that differs significantly from that in the periphery. Due to the blood-brain barrier with its general access restrictions peripheral T-cells, monocytes and B-cells are only "guests" in the brain; instead the immune balance is shifted in favour of the local innate immunity with microglia, astrocytes, cytokines/chemokines and complement forming the dominating defence network.

Vitamin C and E suppress mitogen-stimulated peripheral blood mononuclear cells in vitro.

Background/aims: The antioxidant properties of vitamin C and E are considered to be important for their anti-inflammatory activity. Recently, antioxidant resveratrol was found to suppress neopterin production and tryptophan degradation in mitogen-treated human peripheral blood mononuclear cells.

Methods: In this study, the effects of vitamin C and E were investigated in unstimulated peripheral blood mononuclear cells and in cells stimulated with the mitogens phytohaemagglutinin and concanavalin A in vitro.

"I thought there was no hope for me": a behavioral intervention for urban mothers with problem drinking.

In this article, the authors evaluate the effects of a behavioral intervention for mothers with problem drinking who were infected with, or at risk for, HIV. They randomly selected 25 mothers from a larger longitudinal randomized controlled intervention trial for a qualitative interview. The authors found that mothers' participation in the program was facilitated by the development of a strong therapeutic alliance with the intervention facilitator and the use of a harm reduction approach toward alcohol and/or drug abuse.

Gender differences in attitudes toward AIDS clinical trials among urban HIV-infected individuals from racial and ethnic minority backgrounds.

Racial/ethnic minorities and women are under-represented in AIDS clinical trials (ACTs). We examined gender differences in willingness to participate in ACTs among urban HIV-infected individuals (N = 286). Sixty percent of participants were male, and most were from racial/ethnic minority backgrounds (55% African-American, 34% Latino/Hispanic, 11% White/other).

[Transplantation-associated infections].

Transplantation-associated infections are caused by an infected transplanted organ or the endogenic or exogenic environment of the recipient in a state of induced immunodeficiency. The best therapy would be to reconstitute the immunodeficiency, but this is usually impossible as it endangers the transplanted organ. Thus, a specific, standardised anti-infectious therapy is needed even in the absence of clearly identified micro-organisms [bacteria (in two thirds gram-positive rods), parasites (in central Europe predominantly Toxoplasma), fungi (especially Candida spp.

Bariatric surgery cannot prevent tryptophan depletion due to chronic immune activation in morbidly obese patients.

Background: Increased activity of the immuno-modulatory enzyme indoleamine-2,3-dioxygenase (IDO) during immune activation, results in tryptophan depletion. Tryptophan metabolic changes reduce serotonin production and cause mood disturbances, depression, and impaired satiety, ultimately leading to increased food intake and obesity. Bariatric surgery significantly diminishes immune mediators by substantial weight reduction.

The impact of syringe deregulation on sources of syringes for injection drug users: preliminary findings.

In 2001, New York State enacted legislation to allow the provision of syringes by pharmacies and healthcare providers without prescription (ESAP, the Expanded Syringe Access Demonstration Program). A longitudinal study of IDUs (n=130) found that pre-ESAP, about half used only the safest source (needle exchange programs [NEPs]). Post-ESAP implementation, ESAP sources were initiated by 14%.

Gender differences in traumatic events and rates of post-traumatic stress disorder among homeless youth.

In the present report we describe patterns of traumatic events and Post-traumatic Stress Disorder (PTSD), both partial and full, among homeless youth and those at risk for homelessness, with an emphasis on gender differences. Participants were 85 homeless and at-risk youth (49% female) recruited from a drop-in center in New York City in 2000. Youth completed a structured interview lasting 1.

C-type lectin-independent interaction of complement opsonized HIV with monocyte-derived dendritic cells.

HIV directly activates the complement cascade and is, therefore, opsonized with C3-cleavage products in vivo. This cloud of C3 fragments on the viral surface may impair the interaction of the HIV envelope glycoproteins gp120/gp41 with C-type lectins expressed on immature dendritic cells (iDC). Therefore, we determined the accessibility of gp120 after opsonization and compared the interaction of DC with non-opsonized or complement-opsonized HIV.