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HIV and Co-infections: Updates and Insights

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A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 21683

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Dr. Francesco Di Gennaro

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Guest Editor

Clinic of Infectious Diseases, University of Bari, 70121 Bari, Italy
Interests: HIV; tuberculosis; NTM; malaria; antimicrobial resistance; HCV; HBV; SARS CoV2; COVID-19; infectious diseases
Special Issues, Collections and Topics in MDPI journals

Dr. Alessandra Vergori

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Guest Editor

HIV/AIDS Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
Interests: HIV; AIDS; antiretroviral therapy; SARS-CoV-2; COVID-19

Dr. Davide Fiore Bavaro

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Guest Editor

Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Unit of Infectious Diseases, University of Bari "A. Moro", Polyclinic Hospital, Bari, Italy
Interests: clinical microbiology; difficult-to-treat infections; multidrug-resistant infections; implant-associated infection; viral infections; Mycobacterial infection
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

Co-infections are frequent in HIV patients; some of them may be AIDS-defining, while others share the same underlying virus mechanism. Some may be asymptomatic, causing or influencing HIV illness in a minor way. HIV co-infections with bacterial, viral, or parasitic microorganisms, on the other hand, may affect the natural history of HIV infection and vice versa.

This call for papers on this issue aims to provide new insights into viral, bacterial, and parasitical co-infections in patients living with HIV, in addition to their features, the interactions between the co-infecting agents, and the effect of co-infections on the natural history and host immune response. In addition, fresh epidemiological data on such diseases are also of interest, as are unique ways to improve the management of infected individuals. In addition, manuscripts covering the following areas of interest are welcome:

Sexually transmitted co-infections in HIV patients;
Tuberculosis and nontuberculous mycobacteria (NTM) in HIV patients;
Viral pneumonia and SARS-CoV-2 interstitial pneumonia in HIV patients;
HIV and Malaria;
Hepatitis and HIV;
New therapeutics findings;
Drug-drug interaction;
HIV pre-exposure prophylaxis.

Dr. Francesco Di Gennaro
Dr. Alessandra Vergori
Dr. Davide Fiore Bavaro
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

HIV
co-infection
TB
HCV
HBV
AIDS

Related Special Issue

HIV and Co-infections: Updates and Insights, 2nd Edition in Viruses (7 articles)

Published Papers (12 papers)

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Editorial

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3 pages, 170 KiB

Open AccessEditorial

HIV and Co-Infections: Updates and Insights

by Francesco Di Gennaro, Alessandra Vergori and Davide Fiore Bavaro

Viruses 2023, 15(5), 1097; https://doi.org/10.3390/v15051097 - 29 Apr 2023

Cited by 1 | Viewed by 1008

Abstract

Co-infections are frequent in HIV patients; some of them may be AIDS-defining, while others share the same underlying virus mechanism [...] Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

Research

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11 pages, 859 KiB

Open AccessArticle

Occurrence and Molecular Characterization of Cryptosporidium Infection in HIV/Aids Patients in Algeria

by Malika Semmani, Damien Costa, Nassima Achour, Meriem Cherchar, Hanifa Ziane, Abdelmounaim Mouhajir, Venceslas Villier, Haiet Adjmi Hamoudi, Loic Favennec and Romy Razakandrainibe

Viruses 2023, 15(2), 362; https://doi.org/10.3390/v15020362 - 27 Jan 2023

Cited by 2 | Viewed by 1773

Abstract

The estimated prevalence rate of adults living with HIV infection in MENA is one of the lowest in the world. To date, no data on the genetic characteristics of Cryptosporidium isolates from HIV/AIDS patients in Algeria were available. This study aimed to identify Cryptosporidium species and subtype families prevalent in Algerian HIV-infected patients and contribute to the molecular epidemiology mapping of Cryptosporidium in the MENA region. A total of 350 faecal specimens from HIV/AIDS patients were analysed using microscopy, and a Cryptosporidium infection was identified from 33 samples, with 22 isolates successfully sequencing and confirming species and subtypes. Based on sequence analysis, 15 isolates were identified as C. parvum with family subtypes IIa (n = 7) and IId (n = 8), while five were identified as C. hominis (family subtypes Ia (n = 2) and Ib (n = 3)) and two as C. felis. The C. parvum subtype families IIa and IId predominated, suggesting potential zoonotic transmission. More extensive sampling of both humans and farm animals, especially sheep, goats and calves, as well as a collection of epidemiological data are needed for a better understanding of the sources of human C. parvum infections in Algeria. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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12 pages, 299 KiB

Open AccessArticle

HIV-HCV Incidence in Low-Wage Agricultural Migrant Workers Living in Ghettos in Apulia Region, Italy: A Multicenter Cross Sectional Study

by Valentina Totaro, Giulia Patti, Francesco Vladimiro Segala, Renato Laforgia, Lucia Raho, Carmine Falanga, Marcella Schiavone, Luísa Frallonardo, Gianfranco Giorgio Panico, Vito Spada, Laura De Santis, Carmen Pellegrino, Roberta Papagni, Angelo D’Argenio, Roberta Novara, Claudia Marotta, Nicole Laforgia, Davide Fiore Bavaro, Giovanni Putoto, Annalisa Saracino and Francesco Di Gennaro Show full author list Hide full author list

Viruses 2023, 15(1), 249; https://doi.org/10.3390/v15010249 - 15 Jan 2023

Cited by 2 | Viewed by 1704

Abstract

Migrant populations are more susceptible to viral hepatitis and HIV due to the epidemiology from their country of origin or their social vulnerability when they arrive in Europe. The aims of the study are to explore the incidence of HIV and HCV in low-wage agricultural migrant workers and their knowledge, attitude, and practice with regard to HIV and HCV, as well as their sexual behaviour and risk factors. As part of the mobile clinic services, we performed a screening campaign for HIV-HCV involving migrants living in three Apulian establishments. Results: Between January 2020 and April 2021, 309 migrants (n. 272, 88% male, mean age 28.5 years) were enrolled in the study. Most of the migrants interviewed (n = 297, 96%) reported a stopover in Libya during their trip to Italy. Only 0.9% (n. 3) of migrants reported having been tested for HCV, while 30.7% (n. 95) reported being tested for HIV. Furthermore, screening tests found four migrants (1.3%) to be HIV positive and nine (2.9%) to be HCV positive. The median knowledge score was 1 (IQR 0-3; maximum score: 6 points) for HCV and 3 (IQR 1-4; maximum score: 7 points) for HIV and low use of condoms was 5% (n. 16), while more than 95% show an attitude score of 5 (IQR 5-6; maximum score:6 points) on HIV-HCV education campaigns. In a multivariate analysis, being male (OR = 1.72; 95% CI 1.28–1.92), being single (OR = 1.63; 95% CI 1.20–2.03), being of low educational status (OR = 2.09; 95% CI 1.29–2.21), living in shantytowns for >12 months (OR = 1.95; 95% CI 1.25–2.55), and originating from the African continent (OR = 1.43; 95% CI 1.28–2.01) are significant predictors of poor knowledge on HCV. Our data show low knowledge, especially of HCV, confirming migrants as a population with a higher risk of infection. To develop education programmes, integrated care and screening among migrants could be an effective strategy, considering the high attitude toward these items shown in our study. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

11 pages, 611 KiB

Open AccessArticle

Role of HBcAb Positivity in Increase of HIV-RNA Detectability after Switching to a Two-Drug Regimen Lamivudine-Based (2DR-3TC-Based) Treatment: Months 48 Results of a Multicenter Italian Cohort

by Vincenzo Malagnino, Romina Salpini, Elisabetta Teti, Mirko Compagno, Ludovica Ferrari, Tiziana Mulas, Valentina Svicher, Marta Zordan, Monica Basso, Giuliana Battagin, Sandro Panese, Maria Cristina Rossi, Renzo Scaggiante, Daniela Zago, Marco Iannetta, Saverio Giuseppe Parisi, Massimo Andreoni and Loredana Sarmati

Viruses 2023, 15(1), 193; https://doi.org/10.3390/v15010193 - 10 Jan 2023

Cited by 4 | Viewed by 1438

Abstract

The aim of this study was to evaluate whether the presence of anti-hepatitis B (HBV) c antibodies (HBcAb positivity) could influence the control of HIV viremia in patients living with HIV (PLWH) who switch to two-drug antiretroviral therapy (2DR) containing lamivudine (3TC) (2DR-3TC-based). A retrospective multicentre observational study was conducted on 160 PLWH switching to the 2DR-3TC-based regimen: 51 HBcAb-positive and 109 HBcAb-negative patients. The HBcAb-positive PLWH group demonstrated a significantly lower percentage of subjects with HIV viral suppression with target not detected (TND) at all time points after switching (24th month: 64.7% vs. 87.8%, p < 0.0001; 36th month 62.7% vs. 86.8%, p = 0.011; 48th month 57.2% vs. 86.1%, p = 0.021 of the HBcAb-positive and HBcAb-negative groups, respectively). Logistic regression analysis showed that the presence of HBcAb positivity (OR 7.46 [95% CI 2.35–14.77], p = 0.004) could favour the emergence of HIV viral rebound by nearly 54% during the entire study follow-up after switching to 2DR-3TC. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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8 pages, 438 KiB

Open AccessArticle

Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals

by Stephanie Popping, Lize Cuypers, Mark A. A. Claassen, Guido E. van den Berk, Anja De Weggheleire, Joop E. Arends, Anne Boerekamps, Richard Molenkamp, Marion P. G. Koopmans, Annelies Verbon, Charles A. B. Boucher, Bart Rijnders and David A. M. C. van de Vijver

Viruses 2022, 14(9), 1953; https://doi.org/10.3390/v14091953 - 2 Sep 2022

Cited by 4 | Viewed by 1576

Abstract

Background: In the Netherlands, unrestricted access to direct-acting antivirals (DAAs) halved the incidence of acute hepatitis C virus (HCV) infections among HIV-infected men who have sex with men (MSM). To develop strategies that can further reduce the spread of HCV, it is important to understand the transmission dynamics of HCV. We used phylogenetic analysis of a dense sample of MSM to provide insight into the impact of unrestricted access to DAAs on HCV transmission in the Netherlands and in Belgium. Methods: We included 89 MSM that were recently infected with HCV genotype 1a in ten Dutch and one Belgian HIV treatment centers. Sequences were generated using next gene sequencing and Sanger sequencing. Maximum likelihood phylogenetic analysis (general time reversible model) was performed on concatenated NS5A and NS5B sequences and a reference set of 389 highly similar control sequences selected from GenBank. A cluster was based on a minimum bootstrap support of 90% and a 3% genetic distance threshold. Results: We found that 78 (88%) of individuals were part of seven major clusters. All clusters included individuals from across the study region, however, different cities were part of different clusters. In three clusters, HIV-negative MSM clustered with sequences from HIV-positive MSM. All clusters that were observed before the introduction of DAAs persisted after unrestricted access to DAAs became available. Conclusion: Recently acquired HCV infections among MSM in the Netherlands and Belgium are strongly clustered and therefore highly suitable for targeted prevention strategies, such as contact tracing and partner notification. Importantly, despite an HCV incidence reduction after high DAA uptake and continuously monitoring, HCV transmission persisted in the same clusters. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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12 pages, 688 KiB

Open AccessArticle

CMV and EBV Co-Infection in HIV-Infected Children: Infection Rates and Analysis of Differential Expression of Cytokines in HIV Mono- and HIV–CMV–EBV Co-Infected Groups

by Fizza Nazim, Hammad Afzal Kayani, Apsara Ali Nathwani, Fatima Mir and Syed Hani Abidi

Viruses 2022, 14(8), 1823; https://doi.org/10.3390/v14081823 - 19 Aug 2022

Cited by 7 | Viewed by 2548

Abstract

(1) Background: CMV and EBV co-infections can affect the HIV disease progression by modulating the immune system. The disease dynamics can differ in HIV-positive adults and children. In Pakistan, HIV is rapidly expanding, especially in children; however, the prevalence of CMV and EBV co-infection and the effect on immune modulation in HIV-positive children are not known. This study aimed to bridge this gap by estimating the rate of active CMV and EBV co-infection in HIV-positive children, followed by the analysis of differential expression of cytokines in HIV mono- and HIV/CMV/EBV co-infected children. (2) Methods: DNA samples from 319 HIV-positive children, previously recruited as part of a study to investigate the HIV outbreak in Larkana, Pakistan, in 2019, were screened for CMV and EBV through qPCR. Subsequently, differences in HIV viral loads and CD4 counts were analyzed between the HIV mono- and HIV/CMV/EBV co-infected groups. The RNA samples were used to determine the differential expression of both pro- and anti-inflammatory cytokines in the mono- and co-infected groups using RT-qPCR, while unpaired T-test and Pearson correlation test were applied to, respectively, analyze the differential cytokine expression and correlation between cytokine in the two groups. (3) Results: Of 319 samples, the rate of active EBV and CMV co-infection in HIV-positive children was observed in 79.9% and 38.9%, respectively. A significant difference was observed in HIV viral load between HIV mono- and co-infected groups. IFN-γ expression was found to be lower in the HIV mono-infected group, while higher in all other three co-infected groups. Meanwhile, mRNA expression of TGF-β1 was found to be lower in HIV mono- and HIV–CMV–EBV co-infected groups, while higher in HIV–CMV and HIV–EBV co-infected groups. IFN-γ and IL-2 exhibited a significant positive correlation in all except HIV–CMV co-infected group. (4) Conclusions: The study suggests that the presence of EBV/CMV co-infection can affect the HIV viral loads and expression of certain cytokines (IFN-γ and TGF-β1), which may affect the HIV disease dynamics in infected children. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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14 pages, 5284 KiB

Open AccessArticle

Characterization of the Intestinal Fungal Microbiome in HIV and HCV Mono-Infected or Co-Infected Patients

by Yue Yin, Maermaer Tuohutaerbieke, Chengjie Feng, Xinjie Li, Yuqi Zhang, Qiang Xu, Jing Tu, Ence Yang, Qinghua Zou and Tao Shen

Viruses 2022, 14(8), 1811; https://doi.org/10.3390/v14081811 - 18 Aug 2022

Cited by 5 | Viewed by 1530

Abstract

Intestinal mycobiome dysbiosis plays an important role in the advancement of HIV- and HCV-infected patients. Co-infection with HCV is an important risk factor for exacerbating immune activation in HIV-infected patients, and gut fungal microbial dysbiosis plays an important role. However, no systematic study has been conducted on the intestinal fungal microbiome of HIV/HCV co-infected patients to date. Patients infected with HIV and HCV, either alone or in combination, and healthy volunteers were included. Stool samples were collected for fungal ITS sequencing and for further mycobiome statistical analysis. We found that the abundance of fungal species significantly decreased in the HIV/HCV co-infection group compared to in the healthy control group, while no significant differences were found in the mono-infection groups. Low-CD4 + T-cell patients in the HIV group and high-ALT-level patients in the HCV group were discovered to have a more chaotic fungal community. Furthermore, the opportunistic pathogenic fungal profiles and fungal inter-correlations in the co-infection group became less characteristic but more complicated than those in the mono-infection groups. Intestinal fungal dysregulation occurs in HIV- and HCV-infected patients, and this dysregulation is further complicated in HIV/HCV co-infected patients. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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10 pages, 2542 KiB

Open AccessArticle

Impact of HIV-1 Infection on the Natural Progress of an Anti-HCV Positive Population in an Impoverished Village in China from 2009 to 2017

by Xinjie Li, Yuantao Li, Yuqi Zhang, Yue Yin, Jing Tu, Qiang Xu, Hua Liang and Tao Shen

Viruses 2022, 14(8), 1621; https://doi.org/10.3390/v14081621 - 26 Jul 2022

Cited by 1 | Viewed by 1355

Abstract

Our study aimed to determine the impact of HIV coinfection on the natural progression of liver disease in treatment-naive HCV-infected patients. From 2009 to 2017, we tracked non-invasive markers of liver fibrosis and end-stage liver disease (ESLD)-associated mortality among HCV mono-infected and HIV/HCV coinfected patients in an impoverished village in China. The study cohort consisted of 355 HBsAg-negative and anti-HCV (+) or anti-HIV (+) patients recruited in July 2009, 164 of whom were diagnosed with HIV-1 infection. The surviving patients were re-evaluated in August 2017. During the follow-up, the disease status, liver biochemical, and non-invasive indicators of liver fibrosis (APRI and FIB-4) were measured. The transaminases ALT and AST were significantly higher in HIV-positive HCV resolvers (HIV+ HCVr) than in HIV-negative HCV resolvers (HCVr) (p = 0.019 and p < 0.0001, respectively). APRI and FIB-4 scores of HIV-positive chronic HCV carriers (HIV+ HCVc) were significantly higher than in HIV-negative chronic HCV carriers (HCVc) (p < 0.001). Similarly, APRI and FIB-4 scores were higher in the HIV+ HCVr group than in the HCVr group (p_s < 0.001). From 2009 to 2017, the levels of ALT (p = 0.006), AST (p = 0.003), APRI (p = 0.015), and FIB-4 (p = 0.025) were significantly elevated in the HIV/HCV coinfected patients with CD4+ T counts below 500 cells/l. ESLD-related mortality was significantly greater in HIV/HCV-infected cases than in HCV mono-infected patients (73.3% vs. 31.3%, p = 0.009) among patients (n = 45) who died between 2009 and 2017 during follow-up. These findings suggest a higher risk of ESLD-related death and rapid progression of liver fibrosis in HIV/HCV coinfected individuals compared with HCV mono-infected patients. During HIV/HCV coinfection, HIV infection may aggravate HCV-associated liver injury. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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11 pages, 1108 KiB

Open AccessArticle

SARS-CoV-2 Specific Immune Response and Inflammatory Profile in Advanced HIV-Infected Persons during a COVID-19 Outbreak

by Alessandra Vergori, Antonio Boschini, Stefania Notari, Patrizia Lorenzini, Concetta Castilletti, Francesca Colavita, Giulia Matusali, Eleonora Tartaglia, Roberta Gagliardini, Andrea Boschi, Eleonora Cimini, Markus Maeurer, Pierluca Piselli, Leila Angeli, Andrea Antinori, Chiara Agrati and Enrico Girardi

Viruses 2022, 14(7), 1575; https://doi.org/10.3390/v14071575 - 20 Jul 2022

Cited by 9 | Viewed by 2001

Abstract

The main aim of this study was to describe the clinical and immunological outcomes, as well as the inflammatory profile, of patients with advanced HIV in an assisted-living facility in which an outbreak of SARS-CoV-2 occurred. SARS-CoV-2 humoral and specific T-cell response were analyzed in patients with HIV infection and COVID-19; as a secondary objective of the analysis, levels of the inflammatory markers (IL-1β, IL-6, IL-8, and TNFα) were tested in the HIV/COVID-19 group, in HIV-positive patients without COVID-19, and in HIV-negative patients with mild/moderate COVID-19. Antibody kinetics and ability to neutralize SARS-CoV-2 were evaluated by ELISA assay, as well as the inflammatory cytokines; SARS-CoV-2 specific T-cell response was quantified by ELISpot assay. Mann–Whitney or Kruskal–Wallis tests were used for comparisons. Thirty patients were included with the following demographics: age, 57 years old (IQR, 53–62); 76% male; median HIV duration of infection, 18 years (15–29); nadir of CD4, 57/mmc (23–100) current CD4 count, 348/mmc (186–565). Furthermore, 83% had at least one comorbidity. The severity of COVID-19 was mild/moderate, and the overall mortality rate was 10% (3/30). Additionally, 90% of patients showed positive antibody titers and neutralizing activity, with a 100% positive SARS-CoV-2 specific T-cell response over time, suggesting the ability to induce an effective specific immunity. Significantly higher levels of IL-6, IL-8, and TNF-α in COVID-19 without HIV vs. HIV/COVID-19 patients (p < 0.05) were observed. HIV infection did not seem to negatively impact COVID-19-related inflammatory state and immunity. Further data are mandatory to evaluate the persistence of these immunity and its ability to expand after exposure and/or vaccination. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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The Presence of Either Typical or Atypical Radiological Changes Predicts Poor COVID-19 Outcomes in HIV-Positive Patients from a Multinational Observational Study: Data from Euroguidelines in Central and Eastern Europe Network Group

by Justyna D. Kowalska, Carlo Bieńkowski, Lukáš Fleischhans, Sergii Antoniak, Agata Skrzat-Klapaczyńska, Magdalena Suchacz, Nikolina Bogdanic, Deniz Gokengin, Cristiana Oprea, Igor Karpov, Kerstin Kase, Raimonda Matulionyte, Antonios Papadopoulos, Nino Rukhadze, Arjan Harxhi, David Jilich, Botond Lakatos, Dalibor Sedlacek, Gordana Dragovic, Marta Vasylyev, Antonia Verhaz, Nina Yancheva, Josip Begovac and Andrzej Horban Show full author list Hide full author list

Viruses 2022, 14(5), 972; https://doi.org/10.3390/v14050972 - 5 May 2022

Cited by 5 | Viewed by 2016

Abstract

HIV-positive patients may present lungs with multiple infections, which may hinder differential diagnoses and the choice of treatment in the course of COVID-19, especially in countries with limited access to high-standard healthcare. Here, we aim to investigate the association between radiological changes and poor COVID-19 outcomes among HIV-positive patients from Central and Eastern Europe. Between November 2020 and May 2021, the Euroguidelines in Central and Eastern Europe Network Group started collecting observational data on HIV and COVID-19 co-infections. In total, 16 countries from Central and Eastern European submitted data (eCRF) on 557 HIV-positive patients. The current analyses included patients who had a radiological examination performed. Logistic regression models were used to identify the factors associated with death, ICU admission, and partial recovery (poor COVID-19 outcomes). Factors that were significant in the univariate models (p < 0.1) were included in the multivariate model. Radiological data were available for 224 (40.2%) patients, 108 (48.2%) had computed tomography, and 116 (51.8%) had a chest X-ray. Of these, 211 (94.2%) were diagnosed using RT-PCR tests, 212 (94.6%) were symptomatic, 123 (55.6%) were hospitalized, 37 (16.6%) required oxygen therapy, and 28 (13.1%) either died, were admitted to ICU, or only partially recovered. From the radiologist’s description, 138 (61.6%) patients had typical radiological changes, 18 (8.0%) atypical changes, and 68 (30.4%) no changes. In the univariate models, CD4 count (OR = 0.86 [95% CI: 0.76–0.98]), having a comorbidity (2.33 [1.43–3.80]), HCV and/or HBV co-infection (3.17 [1.32–7.60]), being currently employed (0.31 [0.13–0.70]), being on antiretroviral therapy (0.22 [0.08–0.63]), and having typical (3.90 [1.12–13.65]) or atypical (10.8 [2.23–52.5]) radiological changes were all significantly associated with poor COVID-19 outcomes. In the multivariate model, being on antiretroviral therapy (OR = 0.20 [95% CI:0.05–0.80]) decreased the odds of poor COVID-19 outcomes, while having a comorbidity (2.12 [1.20–3.72]) or either typical (4.23 [1.05–17.0]) or atypical (6.39 [1.03–39.7]) radiological changes (vs. no changes) increased the odds of poor COVID-19 outcomes. Among HIV patients diagnosed with symptomatic SARS-CoV-2 infection, the presence of either typical or atypical radiological COVID-19 changes independently predicted poorer outcomes. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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10 pages, 2850 KiB

Open AccessArticle

Use of Pembrolizumab for Treatment of Progressive Multifocal Leukoencephalopathy in People Living with HIV

by Carmela Pinnetti, Eleonora Cimini, Alessandra Vergori, Valentina Mazzotta, Germana Grassi, Annalisa Mondi, Federica Forbici, Alessandra Amendola, Susanna Grisetti, Francesco Baldini, Caterina Candela, Rita Casetti, Paolo Campioni, Maria Rosaria Capobianchi, Chiara Agrati and Andrea Antinori

Viruses 2022, 14(5), 970; https://doi.org/10.3390/v14050970 - 5 May 2022

Cited by 4 | Viewed by 1915

Abstract

Progressive Multifocal Leukoencephalopathy (PML) is a demyelinating disease occurring in advanced HIV infection, caused by the reactivation of poliomavirus JC (JCV). The use of pembrolizumab for treatment is based on the inhibition of programmed cell death protein 1 (PD-1), potentially improving the anti JCV-specific response. We used pembrolizumab with combined antiretroviral treatment (cART) on a compassionate-use basis. At each administration, clinical evaluation, MRI and laboratory testing, including CD3, CD4, CD8, PD-1 markers, HIV-RNA and JCV-DNA in cerebrospinal fluid (CSF)/plasma pairs, were performed. The JCV-specific T cell response was analysed by Elispot assay. This study included five HIV patients: four male, median age 43 years (29–52), median CD4 and CD8 count 150 (15–158) and 973 (354–1250) cell/mm³, respectively; median JCV-DNA and HIV-RNA in CSF/plasma pairs 9.540/1.503 cps/mL and 2.230/619 cp/mL, respectively. Overall, patients received between two and seven doses of pembrolizumab. After treatment, we observed JCV-DNA reduction and PD-1 down-regulation both in CSF and in plasma (high in circulating CD4 and CD8 at baseline), which remained stable at low levels in all patients. Three out of five patients showed stability of clinical picture and neuroimaging, while two others died. More data are needed in order to identify predictors of response to therapy. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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9 pages, 1266 KiB

Open AccessArticle

Inflammatory Markers after Switching to a Dual Drug Regimen in HIV-Infected Subjects: A Two-Year Follow-Up

by Matteo Vassallo, Jacques Durant, Roxane Fabre, Laurene Lotte, Audrey Sindt, Annick Puchois, Anne De Monte, Renaud Cezar, Pierre Corbeau and Christian Pradier

Viruses 2022, 14(5), 927; https://doi.org/10.3390/v14050927 - 28 Apr 2022

Cited by 2 | Viewed by 1453

Abstract

Objective: Immunadapt is a study evaluating the impact of combination antiretroviral treatment (cART) simplification on immune activation. We previously showed that switching to dual therapies could be associated six months later with macrophage activation. Followup continued up to 24 months after treatment simplification. Materials and Methods: Immunadapt is a prospective single arm study of successfully treated subjects simplifying cART from triple to dual regimens. Before cART change, at 6 months, and between 18 and 24 months following the switch, we measured IP-10, MCP-1, soluble CD14 (sCD14), soluble CD163 (sCD163), and lipopolysaccharide binding protein. Patients were stratified according to lower or greater likelihood of immune activation (CD4 nadir < 200, previous AIDS-defining event or very-low-level viremia during follow-up). Variables were compared using matched Wilcoxon tests. Results: From April 2019 to September 2021, 14 subjects were included (mean age 60 years, 12 men, 26 years since HIV infection, CD4 nadir 302 cells/mm³, 18 years on cART, 53 months on last cART). Twenty-one months following the switch, all but one subject maintained their viral load < 50 cp/mL. One subject had two viral blips. For the entire population, the sCD163 values increased significantly from baseline (+36%, p = 0.003) and from 6 months after the switch. The other markers did not change. After 6 months, the sCD163 increase was more pronounced in subjects with greater likelihood of immune activation (+53% vs. +19%, p = 0.026) Conclusions: cART simplification to dual therapy was associated with macrophage activation despite successful virological control after almost two years’ follow-up. This was more pronounced in those at risk of immune activation. Full article

(This article belongs to the Special Issue HIV and Co-infections: Updates and Insights)

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