Sign in to use this feature.

Years

Between: -

Subjects

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Journals

Article Types

Countries / Regions

Search Results (50)

Search Parameters:
Keywords = ART-naive individuals

Order results
Result details
Results per page
Select all
Export citation of selected articles as:
14 pages, 1048 KB  
Article
Antiretroviral Adherence and Use of Antihypertensives, Statins, and Antidiabetics Among Elderly People with HIV: A 5-Year Real-World Study in Southern Italy
by Pietro Trisolini, Simona Cammarota, Anna Citarella, Marianna Fogliasecca, Viviana Alicchio, Stefania Antonacci, Romina Giannini, Renato Lombardi, Mariantonietta Piccoli, Francesco Pomarico, Cataldo Procacci, Antonino Siniscalco, Stefania Spennato, Annalisa Saracino and Sergio Lo Caputo
Viruses 2025, 17(9), 1212; https://doi.org/10.3390/v17091212 - 5 Sep 2025
Viewed by 656
Abstract
Modern antiretroviral therapy (ART) has transformed HIV into a chronic, manageable condition. This retrospective analysis of administrative data from Apulia (Southern Italy) covering 2018–2023 evaluated demographic changes, ART regimen trends, adherence, and the use of antihypertensives, statins, and antidiabetics among people with HIV [...] Read more.
Modern antiretroviral therapy (ART) has transformed HIV into a chronic, manageable condition. This retrospective analysis of administrative data from Apulia (Southern Italy) covering 2018–2023 evaluated demographic changes, ART regimen trends, adherence, and the use of antihypertensives, statins, and antidiabetics among people with HIV (PWH). Temporal trends were assessed using compound annual growth rate (CAGR). ART adherence was measured as proportion of days covered (PDC), categorized as <75%, 75–90%, and ≥90%. Over the study period, the proportion of PWH aged 18–54 declined, while those aged 55–64 and ≥65 increased (CAGRs: +10.9%, +14.3%). Use of single-tablet regimens rose from 45.1% to 79.6% (CAGR +12.1%), and integrase-based regimens increased from 52.0% to 69.0%, while protease inhibitor and multi-tablet regimens declined. Antihypertensives were the most prescribed concomitant drugs, followed by statins and antidiabetics (CAGRs: +5.8%, +9.7%, +9.5%). In 2023, 81.9% of subjects achieved PDC ≥ 90%, although lower adherence was observed in women and treatment-naïve individuals. These findings indicate a shift toward simplified, integrase-based regimens and high ART adherence, alongside a growing cardiometabolic burden. Tailored strategies are needed to support adherence, particularly in women and treatment-naïve individuals, and to address cardiovascular risk in aging PWH. Full article
(This article belongs to the Special Issue HIV in the Context of Chronic Disorders and Aging)
Show Figures

Figure 1

19 pages, 2719 KB  
Article
Next-Generation Sequencing Analysis for HIV-1 Genotyping and Drug Resistance Mutations Mapping in Sicily, Italy
by Luca Pipitò, Sara Cannella, Chiara Mascarella, Domenico Graceffa, Marcello Trizzino, Chiara Iaria, Pietro Colletti, Giovanni Mazzola, Giovanni M. Giammanco, Antonio Cascio, Celestino Bonura and Sicilian GRT Working Group
Viruses 2025, 17(8), 1129; https://doi.org/10.3390/v17081129 - 18 Aug 2025
Viewed by 852
Abstract
Background: The advent and continuous improvement in antiretroviral therapy (ART) have profoundly altered the clinical course of HIV infection, shifting the focus from AIDS-related complications to the management of age-related comorbidities and non-AIDS-related hospitalizations. In this evolving context, optimizing ART is essential, with [...] Read more.
Background: The advent and continuous improvement in antiretroviral therapy (ART) have profoundly altered the clinical course of HIV infection, shifting the focus from AIDS-related complications to the management of age-related comorbidities and non-AIDS-related hospitalizations. In this evolving context, optimizing ART is essential, with genotypic resistance testing (GRT), particularly through next-generation sequencing (NGS), playing a pivotal role. Methods: This multicenter, retrospective cross-sectional study investigated HIV-1 subtypes, resistance mutations, and drug resistance profiles among 367 people living with HIV (PLWH) in Sicily, based on 384 GRTs performed at the Microbiology Laboratory of the University Hospital of Palermo. Results: Subtype B was the most prevalent (50%), followed by circulating recombinant forms (30%). Among treatment-naïve individuals, resistance-associated mutations were infrequent, with prevalence rates of 0.4% for NRTIs, 5.5% for NNRTIs, 1.3% for PIs, and 0.8% for INIs. Conversely, treatment-experienced individuals showed significantly higher resistance rates, especially to NRTIs (16.3%), NNRTIs (10.6%), and INIs (9.6%). No significant differences in resistance patterns were observed between B and non-B subtypes. Conclusions: This study provides the first regional overview of HIV drug resistance across Sicily. Despite the detection of resistance-associated mutations, the overall prevalence of clinically relevant resistance, particularly to currently recommended therapies, remains low, especially among treatment-naïve individuals. Full article
(This article belongs to the Special Issue Antiviral Resistance Mutations)
Show Figures

Figure 1

19 pages, 3523 KB  
Systematic Review
HIV Infection and Antiretroviral Therapy Impair Liver Function in People Living with HIV: Systematic Review and Meta-Analysis
by Kay-Lee E. Strauss, Wendy N. Phoswa, Sidney Hanser and Kabelo Mokgalaboni
Pharmaceuticals 2025, 18(7), 955; https://doi.org/10.3390/ph18070955 - 25 Jun 2025
Cited by 1 | Viewed by 1214
Abstract
Background: The use of antiretroviral therapy (ART) has improved the lives of people living with HIV (PLWH). However, its use is associated with secondary complications, notably hepatotoxicity. This systematic review and meta-analysis assess the effects of HIV infection and ART on liver function [...] Read more.
Background: The use of antiretroviral therapy (ART) has improved the lives of people living with HIV (PLWH). However, its use is associated with secondary complications, notably hepatotoxicity. This systematic review and meta-analysis assess the effects of HIV infection and ART on liver function in PLWH. Method: A comprehensive literature search was performed in PubMed, Scopus, and Google Scholar from inception to 12 February 2025. Studies analyzing liver enzymes such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) in PLWH undergoing ART, those who are ART-naïve, and HIV-negative individuals were considered. Data analysis was performed using a meta-analysis web tool, and the results were reported as standardized mean differences (SMDs) and 95% confidence intervals (CIs). Results: Twenty-six studies were included in the meta-analysis. The findings showed an increase in AST, SMD = 1.85 (0.93 to 2.78, p < 0.0001, I2 = 93.8%), and ALT, SMD = 2.65 (1.25 to 4.04, p = 0.0002, I2 = 97.8%) in PLWH who were naïve compared with those who were HIV negative. Additionally, there was a pronounced elevation in AST, SMD = 1.49 (0.48 to 2.50, p = 0.0038, I2 = 98%); ALT, SMD = 2.30 (1.14 to 3.45, p < 0.0001, I2 = 98%); and ALP, SMD = 1.40 (0.55 to 2.26, p < 0.01, I2 = 97%) in PLWH exposed to ART compared with HIV-negative individuals. However, there was no significant difference in ALP, SMD = 0.53 (–0.92 to 1.98, p = 0.4726, I2 = 98%) between PLWH who were ART-naïve and HIV-negative individuals. Conclusions: The results show that HIV infection and ART administration are associated with elevated liver function test enzymes, suggesting that each may contribute to liver dysfunction among PLWH. These results highlight the dual risk posed by HIV infection and ART exposure. Full article
(This article belongs to the Special Issue HIV and Viral Hepatitis: Prevention, Treatment and Coinfection)
Show Figures

Figure 1

13 pages, 1637 KB  
Article
Enhanced HIV-1 Neutralizing Antibody Breadth in HTLV-2 Co-Infected Individuals: Influence of Antiretroviral Regimen and B Cell Subset Distribution
by Eloisa Yuste, María J. Ruiz-De-León, José L. Casado, Ana Moreno, María J. Vivancos, María J. Pérez-Elías, Fernando Dronda, Carmen Quereda, Víctor Sánchez-Merino and Alejandro Vallejo
Vaccines 2025, 13(6), 639; https://doi.org/10.3390/vaccines13060639 - 13 Jun 2025
Viewed by 670
Abstract
Background/Objectives: This study aimed to explore how HTLV-2 infection affects the production of broadly neutralizing antibodies (bNAbs) in persons with HIV-1 (PWH) and to assess the impact of boosted protease inhibitors (PIs). Methods: We evaluated broadly neutralizing antibody (bNAb) activity in 65 PWH, [...] Read more.
Background/Objectives: This study aimed to explore how HTLV-2 infection affects the production of broadly neutralizing antibodies (bNAbs) in persons with HIV-1 (PWH) and to assess the impact of boosted protease inhibitors (PIs). Methods: We evaluated broadly neutralizing antibody (bNAb) activity in 65 PWH, which included 27 who were also co-infected with HTLV-2. All participants were former injection drug users with HCV antibodies and were receiving suppressive antiretroviral therapy (ART). Neutralizing activity was assessed against six recombinant HIV-1 viruses that represent five different subtypes. B cell subsets were also analyzed. Results: HTLV-2 co-infection and the lack of ritonavir-boosted protease inhibitors (r-PIs) were both independently associated with higher neutralization scores (p = 0.017 and p = 0.005, respectively). Among those not on r-PIs, individuals co-infected with HTLV-2 showed significantly higher neutralization scores (p = 0.027) and a broader neutralization breadth (83.4% vs. 48.5%, p = 0.015) compared to those infected only with HIV-1. Additionally, HTLV-2 co-infected individuals had more resting memory B cells (p = 0.001) and fewer activated memory B cells (p = 0.017) than the HIV-1 mono-infected individuals. In our multivariate analysis, only HTLV-2 co-infection remained independently associated with neutralization scores (p = 0.027). Elite neutralizers (with a breadth score of ≥10) had more naive B cells and fewer resting memory B cells compared to those with weaker neutralization in both groups. Conclusions: Co-infection with HTLV-2 enhances bNAb production in PWH on suppressive ART and, in particular, in the absence of r-PI regimens. The prominent neutralizing activity corresponded with B cell subset distributions. The results suggest the complexity regarding the interaction between viral co-infections, antiretroviral regimens, and humoral immune compartments and may inform further H1V-1 pathogenesis inquiries or the appropriate design of a vaccine. Full article
(This article belongs to the Section HIV Vaccines)
Show Figures

Figure 1

12 pages, 873 KB  
Article
HIV-1 Genetic Diversity and Transmitted Drug Resistance Mutations in ART-Naïve Individuals in South Korea from 2021 to 2024
by Gayeong Kim, Eun Ji Kim, Min-Seong Kim, Seolhui Kim, Heui Man Kim, Myung-Guk Han and Jin-Sook Wang
Viruses 2025, 17(6), 832; https://doi.org/10.3390/v17060832 - 9 Jun 2025
Viewed by 1071
Abstract
In this study, we investigated the proportion of transmitted drug resistance (TDR) mutations and human immunodeficiency virus (HIV)-1 subtypes among 487 antiretroviral therapy (ART)-naïve individuals in South Korea from 2021 to 2024 to inform more effective treatment strategies. Consistent with previous reports, subtype [...] Read more.
In this study, we investigated the proportion of transmitted drug resistance (TDR) mutations and human immunodeficiency virus (HIV)-1 subtypes among 487 antiretroviral therapy (ART)-naïve individuals in South Korea from 2021 to 2024 to inform more effective treatment strategies. Consistent with previous reports, subtype B was most prevalent among HIV-1 subtypes at 50.7%; however, its proportion decreased annually (p = 0.047). Various subtypes of circulating recombinant forms (CRFs) were analyzed in this study, resulting in high genetic diversity. The subtype distributions of Korean and non-Korean patients differed, with subtype B (53.7%) and CRF01_AE (34.4%) being dominant in the former and latter, respectively. TDR across antiretroviral drug classes was approximately 3.5% in South Korea. Non-nucleoside reverse transcriptase inhibitors elicited the greatest drug resistance, which increased from 2021 to 2023, with a slight decrease in 2024. The integrase strand transfer inhibitor drugs, elvitegravir and raltegravir, most frequently exhibited high resistance scores. We provide a comprehensive overview of the HIV-1 genetic distribution and TDR patterns in South Korea from 2021 to 2024. Within the broader context of HIV-1 epidemiology in Asia and the Pacific, the findings contribute to a comprehensive understanding of the global distribution of HIV-1 resistance and genotypes, enabling the development of effective interventions. Full article
(This article belongs to the Section Viral Immunology, Vaccines, and Antivirals)
Show Figures

Figure 1

8 pages, 869 KB  
Brief Report
Probability of Starting Two-Drug Regimen (2DR) vs. Three-Drug Regimen (3DR) in ART-Naïve and ART-Experienced Person with HIV (PWH) Across the First Wave of COVID-19 Pandemic
by Alessandra Vergori, Nicola Gianotti, Alessandro Tavelli, Camilla Tincati, Andrea Giacomelli, Elena Matteini, Giuseppe Lapadula, Lucia Taramasso, Loredana Sarmati, Antonella D’Arminio Monforte, Andrea Antinori, Alessandro Cozzi-Lepri and on behalf of the ICONA Foundation Study
Viruses 2024, 16(12), 1822; https://doi.org/10.3390/v16121822 - 23 Nov 2024
Viewed by 1492
Abstract
Background: This study examined the impact of the COVID-19 lockdown on antiretroviral therapy (ART) prescriptions among persons living with HIV (PWH) in Italy. Methods: Data from the ICONA cohort included ART-naïve individuals who started ART between January 2019 and December 2022, [...] Read more.
Background: This study examined the impact of the COVID-19 lockdown on antiretroviral therapy (ART) prescriptions among persons living with HIV (PWH) in Italy. Methods: Data from the ICONA cohort included ART-naïve individuals who started ART between January 2019 and December 2022, and ART-experienced individuals who started new ART with HIV RNA ≤50 cps/mL from January 2016 to December 2022. The analysis focused on the proportion of PWH starting or switching to dual (2DR) versus triple (3DR) ART regimens. Comparisons were made using Chi-square and Kruskal-Wallis tests, with logistic regression (LR) to assess associations, adjusting for sex and age. Results: Among 2481 ART-naïve PWH, 17% were female, with a median age of 40. Using 2020 as the comparator (the lockdown year), the odds ratio (OR) from fitting a LR showed a reduced probability of prescribing 2DR both before and after 2020. The proportion of PWH starting 2DR was 9% in 2019, 18% in 2020, 13% in 2021, and 10% in 2022. Among 12,335 ART-experienced PWH, 20% were female, with a median age of 47. The proportion switching to 2DR rose from 24% in 2016 to 38% in 2020, 62% in 2021, and 65% in 2022, showing a >3-fold higher probability to be switched to 2DR instead of 3DR in recent years (2021-2022). Conclusions: For ART-naive PWH, 2DR initiation did not decrease during the 2020 lockdown but changed in the following years, possibly indicating shifts in clinical practice or resuming HIV services. For ART-experienced PWH, 2DR prescriptions increased significantly over time, especially for INSTI-based regimens. Full article
(This article belongs to the Collection Efficacy and Safety of Antiviral Therapy)
Show Figures

Figure 1

19 pages, 1334 KB  
Systematic Review
HIV-1 Antiretroviral Drug Resistance in Mozambique: A Systematic Review and Meta-Analysis
by Paloma Gonçalves, Paulo Mascarenhas, Rute Marcelino, Nédio Mabunda, Arne Kroidl, W. Chris Buck, Ilesh Jani, Claudia Palladino and Nuno Taveira
Viruses 2024, 16(12), 1808; https://doi.org/10.3390/v16121808 - 21 Nov 2024
Cited by 1 | Viewed by 2068
Abstract
This systematic review assessed the prevalence of transmitted and acquired HIV drug resistance (HIVDR) and the associated risk factors in Mozambique. A search of the PubMed, Cochrane, B-On, and Scopus databases up to December 2023 was conducted and included 11 studies with 1118 [...] Read more.
This systematic review assessed the prevalence of transmitted and acquired HIV drug resistance (HIVDR) and the associated risk factors in Mozambique. A search of the PubMed, Cochrane, B-On, and Scopus databases up to December 2023 was conducted and included 11 studies with 1118 HIV-1 pol sequences. Drug resistance mutations (DRMs) to NNRTIs were found in 13% of the drug-naive individuals and 31% of those on ART, while NRTI resistance occurred in 5% and 10%, respectively. Dual-class resistance (NNRTI + NRTI) was detected in 2% of the drug-naive and 8% of ART-experienced individuals. DRMs to protease inhibitors (PIs) were found in 2% of the drug-naive and 5% of ART-experienced individuals. The rate of DRMs was significantly higher in Beira than in Maputo, as well as in pediatric patients than in adults and pregnant women. Subtype C predominated (94%) and was associated with lower viral loads and DRM rates as compared to the other subtypes. The high prevalence of DRMs, particularly to NNRTIs and NRTIs, highlights the need for ongoing surveillance and targeted interventions. These findings are critical for optimizing ART regimens and informing public health strategies in Mozambique, with particular attention to regions such as Beira and vulnerable populations such as pediatric patients. Full article
(This article belongs to the Section Viral Immunology, Vaccines, and Antivirals)
Show Figures

Figure 1

13 pages, 356 KB  
Article
Prevalence and Risk Factors of HIV Drug Resistance in Zimbabwe: Evidence from Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) 2020 Survey
by Munyaradzi Mapingure, Solomon Mukwenha, Innocent Chingombe, Rutendo Birri Makota, Elliot Mbunge, Enos Moyo, Garikayi Chemhaka, John Batani, Brian Moyo and Godfrey Musuka
Trop. Med. Infect. Dis. 2024, 9(11), 257; https://doi.org/10.3390/tropicalmed9110257 - 28 Oct 2024
Cited by 1 | Viewed by 2566
Abstract
(1) Background: HIV drug resistance (HIVDR) poses a significant challenge to the effectiveness of antiretroviral therapy and the overall management of HIVand AIDS. Understanding the predictors of HIVDR is critical for developing strategies to mitigate its impact. The objectives of this study were [...] Read more.
(1) Background: HIV drug resistance (HIVDR) poses a significant challenge to the effectiveness of antiretroviral therapy and the overall management of HIVand AIDS. Understanding the predictors of HIVDR is critical for developing strategies to mitigate its impact. The objectives of this study were to identify the predictors of HIVDR among Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA 2020) study participants, a national population-based survey. (2) Methods: Data from people living with HIV who participated in the ZIMPHIA 2020 were used to determine the predictors of HIVDR. (3) Results: The prevalence of HIVDR was 44.9%. Acquired HIVDR was present in 76.1% of people with a virological failure and transmitted resistance is 22.6% in naïve individuals. Factors associated with HIVDR in adjusted analysis were the number of lifetime sexual partners (aOR = 1.03, 95% CI: 1.01–1.06, p = 0.017), each additional year since the first HIV positive result (aOR = 1.17, 95% CI: 1.09–1.25, p < 0.01), each additional year on ART (aOR = 1.14, 95% CI: 1.06–1.23, p = 0.001), initiating ART before 2014 (aOR = 3.08, 95% CI: 1.72–5.49, p = 0.020), ever had switched antiretrovirals (aOR = 2.47, 95% CI: 1.15–5.29, p = 0.020) or had ever had a viral load test (aOR = 2.54, 95% CI: 1.54–4.17, p < 0.001) and a CD4 count < 350 (aOR = 2.04, 95% CI: 1.48–2.83, p < 0.01), while age ≥ 50 (aOR = 0.56, 95% CI: 0.32–0.98, 32 p = 0.04), condom use at last encounter (OR: 0.49, 95%CI: 0.33–0.73, p < 0.001), and not being on ART (aOR = 0.09, 95% CI: 0.06–0.13, p < 0.01) were associated with reduced odds of HIVDR. Conclusions: HIVDR was high among the participants. There is a need to address HIVDR and enhance the mechanisms already in place. This study introduces more information that would help in developing targeted interventions to prevent HIVDR and improve patient outcomes. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions)
Show Figures

Figure 1

11 pages, 1784 KB  
Article
From Gut to Blood: Redistribution of Zonulin in People Living with HIV
by Max Augustin, Carola Horn, Meryem Seda Ercanoglu, Vincent Bondet, Ute Sandaradura de Silva, Isabelle Suarez, Seung-Hun Chon, Dirk Nierhoff, Alexander Zoufaly, Christoph Wenisch, Elena Knops, Eva Heger, Florian Klein, Darragh Duffy, Michaela Müller-Trutwin and Clara Lehmann
Biomedicines 2024, 12(10), 2316; https://doi.org/10.3390/biomedicines12102316 - 11 Oct 2024
Cited by 2 | Viewed by 1564
Abstract
Background: Gastrointestinal mucosal damage due to human immunodeficiency virus (HIV) infection leads to microbial translocation and immune activation, contributing to the development of non-infectious comorbidities (NICM) in people living with HIV (PLWH). Additionally, persistent proviral HIV-1 in the gut-associated lymphatic tissue (GALT) can [...] Read more.
Background: Gastrointestinal mucosal damage due to human immunodeficiency virus (HIV) infection leads to microbial translocation and immune activation, contributing to the development of non-infectious comorbidities (NICM) in people living with HIV (PLWH). Additionally, persistent proviral HIV-1 in the gut-associated lymphatic tissue (GALT) can trigger immunological changes in the epithelial environment, impacting the mucosal barrier. However, the role of zonulin, a modulator of epithelial tight junctions in GALT during HIV infection, remains poorly understood. Methods: We measured zonulin in serum and intestinal tissue sections from five treatment-naive (HIV+NAIVE) and 10 cART-treated (HIV+cART) HIV+ individuals, along with 11 controls (CTRL). We compared zonulin levels with clinical characteristics, inflammatory markers (IFN-α, CXCR3, and PD-1), and the viral reservoir in peripheral blood (PB) and terminal ileum (TI). Results: Upon HIV infection, TI was found to harbor more HIV DNA than PB. Circulating zonulin levels were highest in HIV+NAIVE compared to HIV+cART or CTRL. Surprisingly, in the gut tissue sections, zonulin levels were higher in CTRL than in HIV+ individuals. Elevated circulating zonulin levels were found to be correlated with CD4+T-cell depletion in PB and TI, and with intestinal IFN-α. Conclusions: The findings of this study indicate a shift in zonulin levels from the gut to the bloodstream in response to HIV infection. Furthermore, elevated systemic zonulin levels are associated with the depletion of intestinal CD4+ T cells and increased gut inflammation, suggesting a potential link between systemic zonulin and intestinal damage. Gaining insight into the regulation of gut tight junctions during HIV infection could offer valuable understanding for preventing NICM in PLWH. Full article
Show Figures

Figure 1

15 pages, 1185 KB  
Article
Patterns of Transmitted Drug Resistance Mutations and HIV-1 Subtype Dynamics in ART-Naïve Individuals in Veneto, Italy, from 2017 to 2024
by Nicholas Geremia, Monica Basso, Andrea De Vito, Renzo Scaggiante, Mario Giobbia, Giuliana Battagin, Federico Dal Bello, Maria Teresa Giordani, Stefano Nardi, Marina Malena, Annamaria Cattelan and Saverio Giuseppe Parisi
Viruses 2024, 16(9), 1393; https://doi.org/10.3390/v16091393 - 30 Aug 2024
Cited by 3 | Viewed by 1743
Abstract
This study investigates the prevalence and patterns of transmitted drug resistance mutations (TDRMs) and HIV-1 subtypes among antiretroviral therapy (ART) naïve individuals in Veneto, Italy, from 2017 to 2024. This research aims to understand the dynamic landscape of TDRMs and HIV-1 genetic diversity [...] Read more.
This study investigates the prevalence and patterns of transmitted drug resistance mutations (TDRMs) and HIV-1 subtypes among antiretroviral therapy (ART) naïve individuals in Veneto, Italy, from 2017 to 2024. This research aims to understand the dynamic landscape of TDRMs and HIV-1 genetic diversity to inform treatment strategies effectively. We included all adult ART-naïve people with HIV (PWH) from seven infectious disease units in Veneto, Italy. We collected the genotypic resistance testing conducted to predict drug susceptibility and subtype distribution using the Stanford HIVdb algorithm. We included 762 PWH, showing a slight but statistically significant decline in the B subtype among Italian PWH (p = 0.045) and an increase in non-B subtypes among foreigners, though it was not statistically significant (p = 0.333). The most frequent mutations were in Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs), especially in non-B subtypes, with a notable rise from 10.7% in 2017–2019 to 15.5% in 2020–2024. Notably, TDRMs were consistently detected, highlighting an ongoing challenge despite the stable prevalence observed over the years. In addition, the data revealed a concerning rise in mutations against newer drug classes, such as integrase inhibitors. Conclusively, the study underscores the necessity of continuous surveillance of HIV subtypes and resistance patterns to adapt ART regimens optimally. Despite the stable levels of drug resistance, the emergence of resistance against newer drugs necessitates ongoing vigilance and possible adjustment in treatment protocols to enhance clinical outcomes and manage HIV drug resistance effectively. Full article
(This article belongs to the Special Issue Viral Resistance)
Show Figures

Figure 1

24 pages, 375 KB  
Review
Treatment Management Challenges in Naïve and Experienced HIV-1-Infected Individuals Carrying the M184V Mutation
by Iordanis Mimtsoudis, Olga Tsachouridou, Karolina Akinosoglou and Symeon Metallidis
Viruses 2024, 16(9), 1392; https://doi.org/10.3390/v16091392 - 30 Aug 2024
Cited by 2 | Viewed by 2200
Abstract
M184V is a single-base mutation in the YMDD domain of reverse transcriptase (RT). The M184V resistance-associated mutation (RAM) is related to virological unresponsiveness to lamivudine (3TC) and emtricitabine (FTC) and induces high-level resistance to these two antiretroviral agents. M184V is rapidly selected in [...] Read more.
M184V is a single-base mutation in the YMDD domain of reverse transcriptase (RT). The M184V resistance-associated mutation (RAM) is related to virological unresponsiveness to lamivudine (3TC) and emtricitabine (FTC) and induces high-level resistance to these two antiretroviral agents. M184V is rapidly selected in the setting of non-suppressive antiretroviral therapy (ART) and accumulates in the HIV reservoir. There were continuous efforts to evaluate the impact of the M184V mutation on the treatment outcomes in people living with HIV (PLWH). Since 3TC remains an extensively used part of recommended antiretroviral combinations, M184V is commonly detected in patients with virological failure (VF). ART guidelines do not recommend the use of drugs impacted by RAMs as they have been confirmed to comprise a risk factor for VF. However, there is evidence that 3TC/FTC can remain active even in the presence of M184V. Given the potential benefits of 3TC in ART combinations, the investigation of M184V remains of high interest to clinicians and researchers, especially in certain regions with limited resources, and especially for its unusual effects. This is a review of the literature on the challenges in treating both naïve and experienced individuals carrying the M184V mutation, including virological failure, virological suppression, and resistance to ART. Full article
10 pages, 765 KB  
Article
Full-Spectrum Surveillance of Pre-Treatment HIV Drug Resistance in Southeastern China
by Jiafeng Zhang, Baochang Sun, Zihang Sheng, Xiaobei Ding, Qin Fan, Gang Huang, Zhihong Guo, Ping Zhong, Lingjie Liao, Hui Xing, Yan Xia, Chengliang Chai and Jianmin Jiang
Pharmaceuticals 2024, 17(7), 900; https://doi.org/10.3390/ph17070900 - 6 Jul 2024
Cited by 2 | Viewed by 1642
Abstract
HIV drug resistance compromises the ability of anti-retroviral therapy (ART) to suppress viral replication, resulting in treatment failure. This study investigates the prevalence of pre-treatment drug resistance (PDR) in newly diagnosed individuals in a prosperous city (Wenzhou) in Southeastern China. A cross-sectional investigation [...] Read more.
HIV drug resistance compromises the ability of anti-retroviral therapy (ART) to suppress viral replication, resulting in treatment failure. This study investigates the prevalence of pre-treatment drug resistance (PDR) in newly diagnosed individuals in a prosperous city (Wenzhou) in Southeastern China. A cross-sectional investigation was carried out among 473 newly diagnosed ART-naive HIV-1-infected individuals between January and December 2022. The protease–reverse transcriptase (PR-RT) region and integrase (IN) region of HIV-1 were amplified by two separately nested PCRs, followed by sequencing. Drug resistance mutations (DRMs) and drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs) and integrase strand transfer inhibitors (INSTIs) were analyzed. The PDR prevalence was 6.5% [95% CI: 4.4–9.1] for any anti-retroviral drug, 0.9% [95% CI: 0.3–2.3] for NRTIs, 4.1% [95% CI: 2.5–6.5] for NNRTIs, 1.8% [95% CI: 0.8–3.6] for PIs and 0.5% [95% CI: 0.1–1.8] for INSTIs. According to the subtyping results of the PR-RT region, 11 different subtypes and 31 unique recombinant forms (URFs) were found. CRF07_BC was the dominant subtype (53.7%, 233/434), followed by CRF01_AE (25.3%, 110/434). V179D (1.6%) and K103N (1.4%) were the most predominant types of NNRTI DRMs. Q58E (1.2%) and M184V (0.7%) were the most frequent PI DRMs and NRTI DRMs, respectively. The INSTI-related DRMs Y143S (causes high-level resistance to RAL) and G163K (causes low-level resistance to EVG and RAL) were found in one patient each. Given the relatively high PDR prevalence of NNRTI (4.1%), non-NNRTI-based ART may be preferred in the future. It is recommended to include genotypic resistance testing before starting ART in regions where feasible. Full article
(This article belongs to the Section Pharmacology)
Show Figures

Figure 1

23 pages, 4962 KB  
Article
Ensemble Learning with Pre-Trained Transformers for Crash Severity Classification: A Deep NLP Approach
by Shadi Jaradat, Richi Nayak, Alexander Paz and Mohammed Elhenawy
Algorithms 2024, 17(7), 284; https://doi.org/10.3390/a17070284 - 30 Jun 2024
Cited by 10 | Viewed by 2838
Abstract
Transfer learning has gained significant traction in natural language processing due to the emergence of state-of-the-art pre-trained language models (PLMs). Unlike traditional word embedding methods such as TF-IDF and Word2Vec, PLMs are context-dependent and outperform conventional techniques when fine-tuned for specific tasks. This [...] Read more.
Transfer learning has gained significant traction in natural language processing due to the emergence of state-of-the-art pre-trained language models (PLMs). Unlike traditional word embedding methods such as TF-IDF and Word2Vec, PLMs are context-dependent and outperform conventional techniques when fine-tuned for specific tasks. This paper proposes an innovative hard voting classifier to enhance crash severity classification by combining machine learning and deep learning models with various word embedding techniques, including BERT, RoBERTa, Word2Vec, and TF-IDF. Our study involves two comprehensive experiments using motorists’ crash data from the Missouri State Highway Patrol. The first experiment evaluates the performance of three machine learning models—XGBoost (XGB), random forest (RF), and naive Bayes (NB)—paired with TF-IDF, Word2Vec, and BERT feature extraction techniques. Additionally, BERT and RoBERTa are fine-tuned with a Bidirectional Long Short-Term Memory (Bi-LSTM) classification model. All models are initially evaluated on the original dataset. The second experiment repeats the evaluation using an augmented dataset to address the severe data imbalance. The results from the original dataset show strong performance for all models in the “Fatal” and “Personal Injury” classes but a poor classification of the minority “Property Damage” class. In the augmented dataset, while the models continued to excel with the majority classes, only XGB/TFIDF and BERT-LSTM showed improved performance for the minority class. The ensemble model outperformed individual models in both datasets, achieving an F1 score of 99% for “Fatal” and “Personal Injury” and 62% for “Property Damage” on the augmented dataset. These findings suggest that ensemble models, combined with data augmentation, are highly effective for crash severity classification and potentially other textual classification tasks. Full article
(This article belongs to the Special Issue AI Algorithms for Positive Change in Digital Futures)
Show Figures

Figure 1

18 pages, 2568 KB  
Article
Human Immunodeficiency Virus Type-1 Genetic Diversity and Drugs Resistance Mutations among People Living with HIV in Karachi, Pakistan
by Abdur Rashid, Li Kang, Feng Yi, Qingfei Chu, Sharaf Ali Shah, Syed Faisal Mahmood, Yimam Getaneh, Min Wei, Song Chang, Syed Hani Abidi and Yiming Shao
Viruses 2024, 16(6), 962; https://doi.org/10.3390/v16060962 - 14 Jun 2024
Cited by 2 | Viewed by 2203
Abstract
The human immunodeficiency virus type-1 epidemic in Pakistan has significantly increased over the last two decades. In Karachi, Pakistan, there is a lack of updated information on the complexity of HIV-1 genetic diversity and the burden of drug resistance mutations (DRMs) that can [...] Read more.
The human immunodeficiency virus type-1 epidemic in Pakistan has significantly increased over the last two decades. In Karachi, Pakistan, there is a lack of updated information on the complexity of HIV-1 genetic diversity and the burden of drug resistance mutations (DRMs) that can contribute to ART failure and poor treatment outcomes. This study aimed to determine HIV-1 genetic diversity and identify drug-resistance mutations among people living with HIV in Karachi. A total of 364 HIV-positive individuals, with a median age of 36 years, were enrolled in the study. The HIV-1 partial pol gene was successfully sequenced from 268 individuals. The sequences were used to generate phylogenetic trees to determine clade diversity and also to assess the burden of DRMs. Based on the partial pol sequences, 13 distinct HIV-1 subtypes and recombinant forms were identified. Subtype A1 was the most common clade (40%), followed by CRF02_AG (33.2%). Acquired DRMs were found in 30.6% of the ART-experienced patients, of whom 70.7%, 20.7%, and 8.5% were associated with resistance to NNRTIs, NRTIs, and PIs, respectively. Transmitted DRMs were found in 5.6% of the ART-naïve patients, of whom 93% were associated with resistance against NNRTIs and 7% to PIs. The high prevalence of DRMs in ART-experienced patients poses significant challenges to the long-term benefits and sustainability of the ART program. This study emphasizes the importance of continuous HIV molecular epidemiology and drug resistance surveillance to support evidence-based HIV prevention, precise ART, and targeted AIDS care. Full article
(This article belongs to the Special Issue The Challenge of HIV Diversity)
Show Figures

Figure 1

21 pages, 945 KB  
Article
An Integrated Machine Learning Approach for Congestive Heart Failure Prediction
by M. Sheetal Singh, Khelchandra Thongam, Prakash Choudhary and P. K. Bhagat
Diagnostics 2024, 14(7), 736; https://doi.org/10.3390/diagnostics14070736 - 29 Mar 2024
Cited by 16 | Viewed by 3780
Abstract
Congestive heart failure (CHF) is one of the primary sources of mortality and morbidity among the global population. Over 26 million individuals globally are affected by heart disease, and its prevalence is rising by 2% yearly. With advances in healthcare technologies, if we [...] Read more.
Congestive heart failure (CHF) is one of the primary sources of mortality and morbidity among the global population. Over 26 million individuals globally are affected by heart disease, and its prevalence is rising by 2% yearly. With advances in healthcare technologies, if we predict CHF in the early stages, one of the leading global mortality factors can be reduced. Therefore, the main objective of this study is to use machine learning applications to enhance the diagnosis of CHF and to reduce the cost of diagnosis by employing minimum features to forecast the possibility of a CHF occurring. We employ a deep neural network (DNN) classifier for CHF classification and compare the performance of DNN with various machine learning classifiers. In this research, we use a very challenging dataset, called the Cardiovascular Health Study (CHS) dataset, and a unique pre-processing technique by integrating C4.5 and K-nearest neighbor (KNN). While the C4.5 technique is used to find significant features and remove the outlier data from the dataset, the KNN algorithm is employed for missing data imputation. For classification, we compare six state-of-the-art machine learning (ML) algorithms (KNN, logistic regression (LR), naive Bayes (NB), random forest (RF), support vector machine (SVM), and decision tree (DT)) with DNN. To evaluate the performance, we use seven statistical measurements (i.e., accuracy, specificity, sensitivity, F1-score, precision, Matthew’s correlation coefficient, and false positive rate). Overall, our results reflect our proposed integrated approach, which outperformed other machine learning algorithms in terms of CHF prediction, reducing patient expenses by reducing the number of medical tests. The proposed model obtained 97.03% F1-score, 95.30% accuracy, 96.49% sensitivity, and 97.58% precision. Full article
Show Figures

Figure 1

Back to TopTop