Special Issue "Diagnosis and Management of HIV Infection"

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 30 September 2021.

Special Issue Editor

Dr. Massimiliano Fabbiani
E-Mail Website
Guest Editor
Infectious and Tropical Diseases Unit, Siena University Hospital, 53100 Siena, Italy
Interests: diagnosis and treatment of HIV infection; viral hepatitis and other viral diseases; infections in immunocompromised patients

Special Issue Information

Dear Colleagues,

Despite the availability of effective combination antiretroviral therapy (ART), HIV infection is still a major global health threat. The UNAIDS 90–90–90 target (which means diagnosing 90% of all people living with HIV (PLWH), providing ART to 90% of those diagnosed, and achieving viral suppression for 90% of those on ART), advocated to end the AIDS epidemic, is unlikely to be met soon in many areas. Crucial factors that need to be addressed to reach this goal are scaling up HIV testing, improving access to ART, optimizing ART based on resistance monitoring, reducing loss to follow-up for those on ART, and optimally diagnosing and managing comorbidities that could impact ART adherence and final prognosis.  Moreover, patients achieving viral suppression and adequate immune reconstitution on ART represent a challenging population. Accelerated aging and an increased prevalence of non-AIDS-related comorbidities (e.g., cancers, neurocognitive, cardiovascular, hepatic, renal and bone diseases) make PLWH a difficult-to-treat population. Both HIV-specific expertise and internal medicine/primary care knowledge are required to optimally manage PLWH. On this basis, further research is needed to better understand the complex aspects of HIV infection and to optimize strategies for its diagnosis and management.

The aim of this Special Issue is to publish high-quality research on any aspect of diagnosis and management of HIV infection and its related comorbidities. Original research articles and reviews summarizing the state of ART of HIV medicine are welcome.

Dr. Massimiliano Fabbiani
Guest Editor

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 papers will be 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. Diagnostics 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 1600 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-1
  • HIV-2
  • HIV testing
  • HIV-RNA
  • HIV-DNA
  • HIV viral load
  • genotypic resistance test
  • phenotypic resistance test
  • antiretroviral therapy
  • opportunistic infections
  • non-AIDS-related comorbidities

Published Papers (2 papers)

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Research

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Open AccessArticle
Blood–Brain Barrier Impairment in Patients Living with HIV: Predictors and Associated Biomarkers
Diagnostics 2021, 11(5), 867; https://doi.org/10.3390/diagnostics11050867 - 12 May 2021
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Abstract
Despite the substantial changes resulting from the introduction of combination antiretroviral therapy (cART), the prevalence of HIV-associated neurocognitive disorders (HAND) remains substantial. Blood–brain barrier impairment (BBBi) is a frequent feature in people living with HIV (PLWH) and it may persist despite effective antiretroviral [...] Read more.
Despite the substantial changes resulting from the introduction of combination antiretroviral therapy (cART), the prevalence of HIV-associated neurocognitive disorders (HAND) remains substantial. Blood–brain barrier impairment (BBBi) is a frequent feature in people living with HIV (PLWH) and it may persist despite effective antiretroviral treatment. A cross-sectional study was performed in PLWH who underwent lumbar puncture for clinical reasons or research protocols and several cerebrospinal fluid biomarkers were studied. BBBi was defined as cerebrospinal fluid-to-serum albumin ratio (CSAR) >6.5 (<40 years) or >8 (>40 years). We included 464 participants: 147 cART-naïve and 317 on cART. Male sex was prevalent in both groups (72.1% and 72.2% respectively); median age was 44 (38–52) years in naïve and 49 (43–57) years in treated subjects. BBBi was observed in 35.4% naïve and in 22.7% treated participants; the use of integrase inhibitors was associated with a lower prevalence (18.3 vs. 30.9%, p = 0.050). At multivariate binary logistic regression (including age and sex) nadir CD4 cell count (p = 0.034), presence of central nervous system (CNS) opportunistic infections (p = 0.024) and cerebrospinal fluid (CSF) HIV RNA (p = 0.002) in naïve participants and male sex (p = 0.021), a history of CNS opportunistic infections (p = 0.001) and CSF HIV RNA (p = 0.034) in treated patients were independently associated with BBBi. CSF cells and neopterin were significantly higher in participants with BBBi. BBBi was prevalent in naïve and treated PLWH and it was associated with CSF HIV RNA and neopterin. Systemic control of viral replication seems to be essential for BBB integrity while sex and treatment influence need further studies. Full article
(This article belongs to the Special Issue Diagnosis and Management of HIV Infection)
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Review

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Open AccessReview
Dolutegravir Plus Lamivudine Two-Drug Regimen: Safety, Efficacy and Diagnostic Considerations for Its Use in Real-Life Clinical Practice—A Refined Approach in the COVID-19 Era
Diagnostics 2021, 11(5), 809; https://doi.org/10.3390/diagnostics11050809 - 29 Apr 2021
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Abstract
The diagnostic and therapeutic management of the Coronavirus Disease 2019 (COVID-19) pandemic in the HIV population brought some known criticalities (and opportunities) to the forefront, for both those who are facing their first therapeutic line today, and for those already well viro-suppressed. The [...] Read more.
The diagnostic and therapeutic management of the Coronavirus Disease 2019 (COVID-19) pandemic in the HIV population brought some known criticalities (and opportunities) to the forefront, for both those who are facing their first therapeutic line today, and for those already well viro-suppressed. The clinical, socioeconomic, and psychological impact of the COVID-19 pandemic should not affect the long-term care of people living with HIV, which creates an urgent need to optimize the diagnostic and treatment approach to the first-line or switch regimens. The use of dolutegravir plus a lamivudine two-drug regimen is one of the most promising solutions to ease the management of HIV treatment in this difficult period. In this review, we report the most salient features related to the use of this regimen from real-life cohorts, meta-analyses, randomized clinical trials, and studies presented at international conferences up to March 2021. We focused on the diagnostic and clinical-management implications of its use in real life, and how these comply with the contingent historical situation. The issue of the timing and type of diagnostic procedures and the relevance of classical diagnostic tests (such as genotype for resistance detection) is also discussed. According to the currently available results, dolutegravir plus a lamivudine two-drug regimen represents an outstanding tool, whose expected advantages fulfill the current requirements for optimal daily care of our HIV patients. Full article
(This article belongs to the Special Issue Diagnosis and Management of HIV Infection)
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