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Viruses
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HIV Elimination as the Goal by 2030
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HIV Elimination as the Goal by 2030

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Viral Immunology, Vaccines, and Antivirals".

Deadline for manuscript submissions: closed (20 July 2023) | Viewed by 13800

Special Issue Editor

Dr. Avelin F. Aghokeng

E-Mail Website
Guest Editor
Institut de Recherche pour le Développement (IRD), Marseille, French
Interests: virology; HIV/AIDS; hepatitis; SARS-CoV-2
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Our society constantly faces important public health crises, potentially affecting millions of people and, often, many lives lost. The HIV/AIDS epidemic is one of these crises, mobilizing the global community over the last forty years. Over that period, huge progress has been made to reduce the burden of the disease by improving the diagnosis as well as the access to more potent antiretroviral drugs and engaging in better monitoring of this life-long treatment. Building on these successes, UNAIDS has launched ambitious initiatives and targets as the 90–90–90 targets, and designed transformative actions to end the global AIDS epidemic by 2030. Although the impressive scale-up of antiretroviral treatments over the past 20 years, especially in the most affected regions of the world (e.g., sub-Saharan Africa), makes such a goal achievable, there are still important challenges, including but not limited to the sustained access to this treatment, the impact of new emerging or reemerging infections, the need of innovative diagnostics and treatment monitoring strategies, specificities of key populations, treatment failures and the danger of drug resistance, aging and new needs for people on treatment, etc.

In this Special Issue, I welcome your recent research and results that present linkages with this ambitious goal of HIV/AIDS elimination by the next decade. I am convinced that this Special Issue will help inform the global community about the ongoing successes and the remaining challenges towards achieving this goal.

Dr. Avelin F. Aghokeng
Guest Editor

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Keywords

  • HIV/AIDS
  • elimination
  • 95/95/95 UNAIDS targets
  • antiretroviral
  • viral load suppression
  • drug resistance
  • aging
  • key populations
  • co-infection

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Published Papers (6 papers)

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Research

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13 pages, 439 KiB  
Article
Factors Associated with Late Diagnosis of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in a University Hospital in Brazil: Challenges to Achieving the 2030 Target
by Ligia Maria Nascimento Arantes, Andrey Oeiras Pedroso, Mayra Gonçalves Menegueti, Elucir Gir, Eliã Pinheiro Botelho, Ana Cristina de Oliveira e Silva and Renata Karina Reis
Viruses 2023, 15(10), 2097; https://doi.org/10.3390/v15102097 - 17 Oct 2023
Cited by 5 | Viewed by 1671
Abstract
Introduction: This study aimed to identify factors associated with late diagnosis and clinically monitor newly diagnosed HIV/AIDS patients. Method: Retrospective study, based on secondary data from a specialized unit at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the [...] Read more.
Introduction: This study aimed to identify factors associated with late diagnosis and clinically monitor newly diagnosed HIV/AIDS patients. Method: Retrospective study, based on secondary data from a specialized unit at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the University of Sao Paulo. Data collection included sociodemographic, behavioral, clinical, and laboratory data of newly diagnosed HIV patients between 2015 and 2019. Data analysis was undertaken using inferential statistical tests. Results: A total of 314 individuals were newly diagnosed with HIV/AIDS, 86.6% (272) had a late diagnosis and 53.8% (169) were diagnosed very late. Using the adjusted odds ratio, we observed that bisexual and MSM patients were less likely to have a late diagnosis compared to straight patients. Individuals who entered through the emergency department and Outpatient Clinic had a lower chance of having a very late diagnosis compared to those diagnosed in the ward/inpatient unit. Having a higher education and university education were protective factors against having a very late diagnosis of HIV infection compared to elementary school education only. In addition, male patients were more likely to have a very late diagnosis compared to female patients. Conclusions: This study evidenced a high prevalence of late and very late diagnoses. Therefore, attention should be directed towards factors related to late and very late presentation. Full article
(This article belongs to the Special Issue HIV Elimination as the Goal by 2030)
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18 pages, 2608 KiB  
Article
Efficacy, Convenience, Safety and Durability of DTG-Based Antiretroviral Therapies: Evidence from a Prospective Study by the Italian MaSTER Cohort
by Paolo Fusco, Paola Nasta, Eugenia Quiros-Roldan, Alice Tondinelli, Cecilia Costa, Chiara Fornabaio, Nicola Mazzini, Mattia Prosperi, Carlo Torti and Giampiero Carosi
Viruses 2023, 15(4), 924; https://doi.org/10.3390/v15040924 - 6 Apr 2023
Cited by 1 | Viewed by 2264
Abstract
Background: Dolutegravir (DTG) is recommended by international guidelines as a main component of an optimal initial regimen of cART (combination antiretroviral treatment) in people living with HIV (PLWH) and in case of switching for failure or optimization strategies. However, studies on the [...] Read more.
Background: Dolutegravir (DTG) is recommended by international guidelines as a main component of an optimal initial regimen of cART (combination antiretroviral treatment) in people living with HIV (PLWH) and in case of switching for failure or optimization strategies. However, studies on the performance of DTG-containing regimens and indications for switching therapies in the long term are sparse. The purpose of this study was to evaluate prospectively the performance of DTG-based regimens, using the metrics of “efficacy”, “safety”, “convenience” and ‘’durability’’, among a nationally representative cohort of PLWH in Italy. Methods: We selected all PLWH in four centers of the MaSTER cohort who initiated a DTG-based regimen either when naïve or following a regimen switch between 11 July 2018 and 2 July 2021. Participants were followed until the outcomes were recorded or until the end of the study on 4 August 2022, whichever occurred first. Interruption was reported even when a participant switched to another DTG-containing regimen. Survival regression models were fitted to evaluate associations between therapy performance and age, sex, nationality, risk of HIV transmission, HIV RNA suppression status, CD4+ T-cell count, year of HIV diagnosis, cART status (naïve or experienced), cART backbone and viral hepatitis coinfection. Results: There were 371 participants in our cohort who initiated a DTG-based cART regimen in the time frame of the study. The population was predominantly male (75.2%), of Italian nationality (83.3%), with a history of cART use (80.9%), and the majority initiated a DTG-based regimen following a switch strategy in 2019 (80.1%). Median age was 53 years (interquartile range (IQR): 45–58). Prior cART regimen was based mostly on a combination of NRTI drugs plus a PI-boosted drug (34.2%), followed by a combination of NRTIs plus an NNRTI (23.5%). Concerning the NRTI backbone, the majority comprised 3TC plus ABC (34.5%), followed by 3TC alone (28.6%). The most reported transmission risk factor was heterosexual intercourse (44.2%). Total interruptions of the first DTG-based regimen were registered in 58 (15.6%) participants. The most frequent reason for interruption was due to cART simplification strategies, which accounted for 52%. Only 1 death was reported during the study period. The median time of total follow-up was 556 days (IQR: 316.5–722.5). Risk factors for poor performance of DTG-containing-regimens were found to be: a backbone regimen containing tenofovir, being cART naïve, having detectable HIV RNA at baseline, FIB-4 score above 3.25 and having a cancer diagnosis. By contrast, protective factors were found to be: higher CD4+ T-cell counts and higher CD4/CD8 ratio at baseline. Conclusion: DTG-based regimens were used mainly as a switching therapy in our cohort of PLWH who had undetectable HIV RNA and a good immune status. In this type of population, the durability of DTG-based regimens was maintained in 84.4% of participants with a modest incidence of interruptions mostly due to cART simplification strategies. The results of this prospective real-life study confirm the apparent low risk of changing DTG-containing regimens due to virological failure. They may also help physicians to identify people with increased risk of interruption for different reasons, suggesting targeted medical interventions. Full article
(This article belongs to the Special Issue HIV Elimination as the Goal by 2030)
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20 pages, 2131 KiB  
Article
Loss to Follow-Up from HIV Pre-Exposure Prophylaxis Care in Men Who Have Sex with Men in West Africa
by August Eubanks, Bakary Coulibaly, Bintou Dembélé Keita, Camille Anoma, Ter Tiero Elias Dah, Ephrem Mensah, Gwenaëlle Maradan, Michel Bourrelly, Marion Mora, Lucas Riegel, Daniela Rojas Castro, Issifou Yaya, Bruno Spire, Christian Laurent, Luis Sagaon-Teyssier and the CohMSM-PrEP Study Group
Viruses 2022, 14(11), 2380; https://doi.org/10.3390/v14112380 - 28 Oct 2022
Cited by 3 | Viewed by 2183
Abstract
Loss to follow-up (LTFU) from HIV pre-exposure prophylaxis (PrEP) care compromises the goal of HIV elimination. We investigated the proportion of LTFU and associated risk factors among men who have sex with men (MSM) enrolled in a PrEP demonstration project in Burkina Faso, [...] Read more.
Loss to follow-up (LTFU) from HIV pre-exposure prophylaxis (PrEP) care compromises the goal of HIV elimination. We investigated the proportion of LTFU and associated risk factors among men who have sex with men (MSM) enrolled in a PrEP demonstration project in Burkina Faso, Côte d’Ivoire, Mali, and Togo. CohMSM-PrEP, a prospective cohort study, was conducted between November 2017 and June 2021 in community-based clinics. MSM aged 18 years or older at substantial risk of HIV infection received a comprehensive prevention package, including PrEP and peer education. LTFU was defined as not returning to the clinic for six months. Associated risk factors were investigated using a time-varying Cox’s model. Of 647 participants followed up for a median time of 15 months, 372 were LTFU (57.5%). LTFU was associated with younger age (adjusted hazard ratio [95% Confidence Interval]; 1.50 [1.17–1.94]), unemployment (1.33 [1.03–1.71]), depression (1.63 [1.12–2.38]), and perceiving no HIV risk with stable male partners (1.61 [1.23–2.10]). Contacting peer educators outside of scheduled visits was protective (0.74 [0.56–0.97]). Our findings show that LTFU from PrEP care in West African MSM is a major challenge to achieving HIV elimination, but that the involvement of peer educators in PrEP delivery helps to limit LTFU by providing users with adequate support. Full article
(This article belongs to the Special Issue HIV Elimination as the Goal by 2030)
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Review

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14 pages, 1547 KiB  
Review
HIV-1 Non-Group M Strains and ART
by Elodie Alessandri-Gradt, Alice Moisan and Jean-Christophe Plantier
Viruses 2023, 15(3), 780; https://doi.org/10.3390/v15030780 - 17 Mar 2023
Cited by 1 | Viewed by 2622
Abstract
To eliminate HIV infection, there are several elements to take into account to limit transmission and break viral replication, such as epidemiological, preventive or therapeutic management. The UNAIDS goals of screening, treatment and efficacy should allow for this elimination if properly followed. For [...] Read more.
To eliminate HIV infection, there are several elements to take into account to limit transmission and break viral replication, such as epidemiological, preventive or therapeutic management. The UNAIDS goals of screening, treatment and efficacy should allow for this elimination if properly followed. For some infections, the difficulty is linked to the strong genetic divergence of the viruses, which can impact the virological and therapeutic management of patients. To completely eliminate HIV by 2030, we must therefore also be able to act on these atypical variants (HIV-1 non-group M) which are distinct from the group M pandemic viruses. While this diversity has had an impact on the efficacy of antiretroviral treatment in the past, recent data show that there is real hope of eliminating these forms, while maintaining vigilance and constant surveillance, so as not to allow more divergent and resistant forms to emerge. The aim of this work is therefore to share an update on the current knowledge on epidemiology, diagnosis and antiretroviral agent efficacy of HIV-1 non-M variants. Full article
(This article belongs to the Special Issue HIV Elimination as the Goal by 2030)
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20 pages, 1614 KiB  
Review
Human T-Cell Leukemia Virus Type 1-Related Diseases May Constitute a Threat to the Elimination of Human Immunodeficiency Virus, by 2030, in Gabon, Central Africa
by Eldridge Fedricksen Oloumbou, Jéordy Dimitri Engone-Ondo, Issakou Mamimandjiami Idam, Pamela Moussavou-Boudzanga, Ivan Mfouo-Tynga and Augustin Mouinga-Ondeme
Viruses 2022, 14(12), 2808; https://doi.org/10.3390/v14122808 - 16 Dec 2022
Cited by 2 | Viewed by 2289
Abstract
The Joint United Nations Program on HIV/AIDS (UNAIDS) has adopted the Sustainable Development Goals (SDGs) to end the HIV/AIDS epidemic by 2030. Several factors related to the non-suppression of HIV, including interruptions of antiretroviral therapy (ART) and opportunistic infections could affect and delay [...] Read more.
The Joint United Nations Program on HIV/AIDS (UNAIDS) has adopted the Sustainable Development Goals (SDGs) to end the HIV/AIDS epidemic by 2030. Several factors related to the non-suppression of HIV, including interruptions of antiretroviral therapy (ART) and opportunistic infections could affect and delay this projected epidemic goal. Human T-Cell leukemia virus type 1 (HTLV-1) appears to be consistently associated with a high risk of opportunistic infections, an early onset of HTLV-1 and its associated pathologies, as well as a fast progression to the AIDS phase in co-infected individuals, when compared to HIV-1 or HTLV-1 mono-infected individuals. In Gabon, the prevalence of these two retroviruses is very high and little is known about HTLV-1 and the associated pathologies, leaving most of them underdiagnosed. Hence, HTLV-1/HIV-1 co-infections could simultaneously imply a non-diagnosis of HIV-1 positive individuals having developed pathologies associated with HTLV-1, but also a high mortality rate among the co-infected individuals. All of these constitute potential obstacles to pursue targeted objectives. A systematic review was conducted to assess the negative impacts of HTLV-1/HIV-1 co-infections and related factors on the elimination of HIV/AIDS by 2030 in Gabon. Full article
(This article belongs to the Special Issue HIV Elimination as the Goal by 2030)
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Other

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5 pages, 238 KiB  
Opinion
Future of Antiretroviral Drugs and Evolution of HIV-1 Drug Resistance
by Charlotte Charpentier, Quentin Le Hingrat, Valentine Marie Ferré, Florence Damond and Diane Descamps
Viruses 2023, 15(2), 540; https://doi.org/10.3390/v15020540 - 15 Feb 2023
Cited by 1 | Viewed by 1841
Abstract
Highly active antiretroviral (ARV) therapy has been used for many years, but the use in low- and middle-income countries of antiretroviral drugs with low genetic barrier to resistance, combined with limited availability of viral load testing, has led to higher rates of acquired [...] Read more.
Highly active antiretroviral (ARV) therapy has been used for many years, but the use in low- and middle-income countries of antiretroviral drugs with low genetic barrier to resistance, combined with limited availability of viral load testing, has led to higher rates of acquired drug resistance, sustaining the rate of transmitted drug resistance. Here, we describe the evolution of ARV drugs with the ongoing development of injectable long-acting forms and the requirements regarding all new ARV drugs (i.e., no transmitted drug resistance, no cross-resistance and high genetic barrier to resistance). Then, we report the evolution of both transmitted and acquired resistance regarding new ARV drugs. The WHO has set very ambitious but motivating goals for HIV testing, treatment and viral suppression, aiming to achieve rates of 95% for all three by 2025. Reaching these goals requires a wide implementation and use of close virological monitoring in LMICs. Full article
(This article belongs to the Special Issue HIV Elimination as the Goal by 2030)
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