HIV Infection — Screening, Diagnosis, and Treatment

Saag, Michael S.

doi:10.1056/nejmcp1915826

Cited by 38 publications

(22 citation statements)

References 40 publications

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“…There are two forms of HIV, HIV-1 and HIV-2, the former being the most common type in the United States, Europe, and Central Africa, and the latter present mostly in West Africa and India [ 7 ].…”

Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

“…However, the blood CD4+ T-cell count is probably the most reliable short-term indicator of disease progression. Therefore, the CD4+ cell count (rather than viral load) is the primary clinical measurement used to determine when to start antiretroviral therapy (ART) [ 7 ].…”

Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

“…The typical person with AIDS presents with long-lasting fever (>1 month), fatigue, weight loss, diarrhea, and generalized lymph node enlargement. After a period, which varies, a wide range of serious opportunistic infections, secondary neoplasms, or clinical neurologic disease may develop [ 7 , 8 ]. Without treatment, most patients with HIV infection progress to AIDS after a chronic phase lasting from 7 to 10 years.…”

Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

“…Apart from the clinical presentation and an accurate medical history, several tests are available to accurately diagnose or confirm an HIV infection (summarized in Figure 1 ). The choice of the most appropriate test for a given clinical presentation depends on an understanding of the natural history of HIV infection (i.e., which marker is present at a given point after infection, as shown in Figure 1 ), the volume of the specimen, and the test-performance specifications [ 7 ]. Another, perhaps an underappreciated consideration, would be the testing capabilities of the infrastructure of the local health care environment.…”

Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

“…The basis for the first two components includes decreasing the gaps in early diagnoses, maintaining linkages to care, rapid initiation of treatment in patients with HIV infection, and maintenance of viral suppression by sustaining successful retention in patient compliance with the designated treatment regimen. It is worth noting that a more comprehensive review on the epidemiologic, clinical, diagnostic, and treatment related aspects of HIV/AIDS has recently been published [ 7 ].…”

Section: Introduction and Historical And Epidemiologic Backgroundmentioning

confidence: 99%

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COVID-19 Vaccines for HIV-Infected Patients

Plummer

Pavia

2021

Viruses

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Nearly 40 years have passed since the initial cases of infection with the human mmunodeficiency virus (HIV) were identified as a new disease entity and the cause of acquired immunodeficiency disease (AIDS). This virus, unlike any other, is capable of causing severe suppression of our adaptive immune defense mechanisms by directly infecting and destroying helper T cells leading to increased susceptibility to a wide variety of microbial pathogens, especially those considered to be intracellular or opportunistic. After T cells are infected, HIV reproduces itself via a somewhat unique mechanism involving various metabolic steps, which includes the use of a reverse transcriptase enzyme that enables the viral RNA to produce copies of its complementary DNA. Subsequent physiologic steps lead to the production of new virus progeny and the eventual death of the invaded T cell. Fortunately, both serologic and molecular tests (such as PCR) can be used to confirm the diagnosis of an HIV infection. In the wake of the current COVID-19 pandemic, it appears that people living with HIV/AIDS are equally or slightly more susceptible to the etiologic agent, SARS-CoV-2, than the general population having intact immune systems, but they may have more serious outcomes. Limited clinical trials have also shown that the currently available COVID-19 vaccines are both safe and effective in affording protection to HIV/AIDS patients. In this review, we further explore the unique dynamic of HIV/AIDS in the context of the worldwide COVID-19 pandemic and the implementation of vaccines as a protective measure against COVID-19, as well as what immune parameters and safeguards should be monitored in this immunocompromised group following vaccination.

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Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

Section: Human Immunodeficiency Virus (Hiv) Pathogenesismentioning

confidence: 99%

Section: Introduction and Historical And Epidemiologic Backgroundmentioning

confidence: 99%

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