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Advances in HIV Prevention, Treatment and Cure: a special issue of PLOS Medicine

PLOS

This week, publication of a special issue on Advances in HIV Prevention, Treatment and Cure begins in PLOS Medicine, advised by guest editors Linda-Gail Bekker of the Desmond Tutu HIV Centre, University of Cape Town, South Africa; Steven Deeks of the University of California San Francisco, USA; and Sharon Lewin of the Peter Doherty Institute of Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Australia.

HIV/AIDS remains one of the world's most critical health challenges, with around 36.7 million people living with HIV and an estimated 1.8 million new infections in 2016. Although progress in research, care, advocacy and donor funding has brought antiretroviral therapy to some 19.5 million people, AIDS-related illnesses continue to claim a million lives annually. The special issue will feature research and discussion articles aimed at advancing progress against HIV/AIDS, with ambitious global goals seeking to bring the epidemic under control by 2020.

In a Research Article, Samantha Kaplan of Yale School of Medicine, USA and colleagues report on almost 40,000 participants in an established antiretroviral programme in Khayelitsha township in South Africa, where maintaining long-term care--required for consistent viral suppression--is an important issue. About a quarter of patients were estimated to have disengaged from treatment in a 2-year period, but some 33% of these patients re-engaged in care. In a further research paper, Tonia Poteat, of the Johns Hopkins School of Public Health, Baltimore, USA and colleagues describe behavioural and psychosocial factors associated with HIV infection in two key populations at elevated risk--transgender women and men who have sex with men, across 8 African countries.

In a research paper reporting on Link4Health, a cluster-randomized trial in Swaziland, Margaret McNairy of ICAP, Columbia University, New York, USA and colleagues describe the effect of a combined intervention comprising 5 evidence-based methods aimed at improving HIV linkage to and retention in care, including point-of-care testing, accelerated initiation of antiretroviral therapy and non-cash incentives. With a primary trial outcome of combined linkage to care at 1 month and retention in care at 12 months, McNairy and colleagues report substantial benefits for people with HIV as compared with standard care (adjusted relative risk 1.52, 95% CI 1.19-1.96).

In a Perspective article, Wafaa El-Sadr, also of ICAP in New York, and colleagues discuss the need for differentiated approaches to HIV prevention and care, tailored to the needs of specific groups of people (such as pregnant women or sex workers) and the relevant health care settings.

Turning to the long-term consequences of HIV infection, in another Research Article Mark Boyd of the Kirby Institute, University of New South Wales and the Faculty of Health and Medical Sciences, University of Adelaide, Australia and colleagues report analyses from D:A:D, a large multinational study focusing on comorbidities and the adverse effects of antiretroviral treatment. Boyd and colleagues assess the risks of cardiovascular disease and chronic kidney disease by predicted 5-year risk scores in people with HIV infection. As anticipated they find elevated risks of each disease occurring together with the other--for example, people at high risk of cardiovascular disease had a 5.63 fold increase (95% CI 4.47-7.09) in risk of chronic kidney disease events compared to those at low risk. The authors report that, for people at high risk of cardiovascular and renal disease, the risk of both comorbidities was multiplicative as compared with that of people at low risk, and note that the risks for cardiovascular and chronic kidney disease in people with HIV should be assessed together.

Curing HIV infection remains an elusive goal. In a further research paper, Timothy Henrich of the University of California San Francisco, USA and colleagues describe detailed analyses of two patients who received prophylactic antiretroviral treatment within an estimated 10 to 12 days of HIV infection (at which point infection had not been identified), later followed by full antiretroviral therapy with four individual drugs. Although cure was not achieved in either case, detailed analyses allow the authors to follow the sequence of events and estimate the size of the viral reservoir, to inform future efforts towards curing HIV infection.

The Special Issue will continue with further research and discussion articles appearing over the next several weeks.

Research Article (1)

Funding:

SK was supported by the National Institutes of Health Office of the Director, Fogarty International Center, Office of AIDS Research, National Cancer Center, National Heart, Blood, and Lung Institute, and the NIH Office of Research for Women's Health through the Fogarty Global Health Fellows Program Consortium comprised of the University of North Carolina, Johns Hopkins, Morehouse and Tulane (R25TW009340;http://globalhealth.unc.edu/ujmt-fogarty-global-health-fellowship/). GM was supported by the Wellcome Trust (098316; https://wellcome.ac.uk), the European & Developing Countries Clinical Trials Partnership (EDCTP (SP.2011.41304.074; http://www.edctp.org), the South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation (NRF) of South Africa (Grant No 64787; http://www.nrf.ac.za/division/rcce/instruments/research-chairs), NRF incentive funding (UID: 85858; http://www.nrf.ac.za/division/kfd/instruments/incentive-funding-rated-researchers) and the South African Medical Research Council through its TB and HIV Collaborating Centres Programme with funds received from the National Department of Health (RFA# SAMRC-RFA-CC: TB/HIV/AIDS-01-2014). AB was supported by the National Institutes of Health (R01 HD080465, U01 AI069924; http://nih.gov) and National Research Foundation (NRF) incentive funding (http://www.nrf.ac.za/division/kfd/instruments/incentive-funding-rated-researchers). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

The authors have read the journal's policy and declare the following competing interests: MO does not have any competing interests that would influence this paper, but does work with the team developing the software used to collect the source data whose guidance and mentorship to the national government are for the benefit of all public health facilities using the software, not just those facilities that are contributing to this paper. This is a non-commercial entity. The other authors have declared that no competing interests exist.

Citation:

Kaplan SR, Oosthuizen C, Stinson K, Little F, Euvrard J, Schomaker M, et al. (2017) Contemporary disengagement from antiretroviral therapy in Khayelitsha, South Africa: A cohort study. PLoS Med 14(11): e1002407. https://doi.org/10.1371/journal.pmed.1002407

Author Affiliations:

Yale School of Medicine, New Haven, Connecticut, United States of America Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Medecins Sans Frontières (Southern Africa Medical Unit), Johannesburg, South Africa; Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa; Department of Health, Provincial Government of the Western Cape, Cape Town, South Africa; Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa

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Research Article (2)

Funding:

Work in Togo and Burkina Faso was supported by Project SEARCH, which was funded by the US Agency for International Development under Contract GHH-I-00-07-00032-00 and by the President's Emergency Plan for AIDS Relief (PEPFAR). Work in Côte d'Ivoire was funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria through the Government of Côte d'Ivoire National AIDS Control Program (PNPEC) contract to Enda Santé, an organization based in Senegal, and subcontracted for technical assistance to Johns Hopkins University. Work in Lesotho was funded by the US Agency for International Development (USAID, AID-674-A-00-00001), and implemented by Population Services International/Lesotho (PSI). Work in Swaziland was funded by PEPFAR through the USAID Swaziland (GHH-I-00-07-00032-00). Finally, this publication was made possible with help from the Johns Hopkins University Center for AIDS Research, an NIH funded program (P30AI094189), which is supported by the following NIH Cofunding and Participating Institutes and Centers: National Institute of Allergy and Infectious Diseases (NIAID), National Cancer Institute (NCI), National Institute of Child Health and Human Development (NICHD), National Heart, Lung, and Blood Institute (NHLBI), National Institute on Drug Abuse (NIDA), National Institute of Mental Health (NIMH), National Institute on Aging (NIA), Fogarty International Center (FIC), National Institute of General Medical Sciences (NIGMS), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the Office of AIDS Research (OAR). Efforts for this publication were also supported by National Institutes of Mental Health and Office of AIDS Research of the National Institutes of Health under award number R01MH110358. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

The authors have declared that no competing interests exist.

Citation:

Poteat T, Ackerman B, Diouf D, Ceesay N, Mothopeng T, Odette K-Z, et al. (2017) HIV prevalence and behavioral and psychosocial factors among transgender women and cisgender men who have sex with men in 8 African countries: A cross-sectional analysis. PLoS Med 14(11): e1002422. https://doi.org/10.1371/journal.pmed.1002422

Author Affiliations:

Epidemiology Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America; Biostatistics Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America; Enda Sante, Dakar, Senegal; Joint United Nations Programme on HIV and AIDS Country Office, Mbabane, Swaziland; People's Matrix Association, Maseru, Lesotho; Programme d'Appui au Monde Associatif et Communautaire, Ouagadougou, Burkina Faso; Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso; Institut Africain de Sante Publique, Ouagadougou, Burkina Faso; ONG Arc-en-Ciel, Lome, Togo; Ministère de la Sante et de l'Hygiène Publique, Abidjan, Cote d'Ivoire; Health Research Department, Strategic Information Division, Ministry of Health, Mbabane, Swaziland; Centre for the Development of People, Lilongwe, Malawi; Social, Health, and Empowerment Feminist Collective of Transgender Women of Africa, East London, South Africa; Malawi College of Medicine, Blantyre, Malawi

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Research Article (3)

Funding:

This study was funded by the National Institutes of Health (NIH), NIH Award Number: RO1A1100059, and the Gates Foundation OPP1145477. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

The authors have declared that no competing interests exists.

Citation:

McNairy ML, Lamb MR, Gachuhi AB, Nuwagaba-Biribonwoha H, Burke S, Mazibuko S, et al. (2017) Effectiveness of a combination strategy for linkage and retention in adult HIV care in Swaziland: The Link4Health cluster randomized trial. PLoS Med 14(11): e1002420. https://doi.org/10.1371/journal.pmed.1002420

Author Affiliations:

ICAP at Columbia University, New York, New York, United States of America; Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America; Ministry of Health, Kingdom of Swaziland, Mbabane, Swaziland; Bill and Melinda Gates Foundation, Seattle, Washington, United States of America

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Perspective

Funding:

The authors received no specific funding for this work.

Competing Interests:

The authors have declared that no competing interests exist.

Citation:

El-Sadr WM, Harripersaud K, Rabkin M (2017) Reaching global HIV/AIDS goals: What got us here, won't get us there. PLoS Med 14(11): e1002421. https://doi.org/10.1371/journal.pmed.1002421

Author Affiliations:

ICAP at Columbia University, Mailman School of Public Health, New York, New York, United States

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Research Article (4)

Funding:

Data on Adverse Events (D:A:D) Study:The D:A:D study was supported by the Highly Active Antiretroviral Therapy Oversight Committee (HAARTOC), a collaborative committee with representation from academic institutions, the European Agency for the Evaluation of Medicinal Products, the United States Food and Drug Administration, the patient community, and pharmaceutical companies with licensed anti-HIV drugs in the European Union: AbbVie, Bristol-Myers Squibb, Gilead Sciences Inc., ViiV Healthcare, Merck & Co Inc. and Janssen Pharmaceuticals. Supported also by a grant [grant number DNRF126] from the Danish National Research Foundation (CHIP & PERSIMUNE); by a grant from the Dutch Ministry of Health, Welfare and Sport through the Center for Infectious Disease Control of the National Institute for Public Health and the Environment to Stiching HIV Monitoring (ATHENA); by a grant from the Agence nationale de recherches sur le sida et les hépatites virales [ANRS, Action Coordonnée no.7, Cohortes] to the Aquitaine Cohort; The Australian HIV Observational Database (AHOD) is funded as part of the Asia Pacific HIV Observational Database, a program of The Foundation for AIDS Research, amfAR, and is supported in part by a grant from the U.S. National Institutes of Health's National Institute of Allergy and Infectious Diseases (NIAID) [grant number U01-AI069907] and by unconditional grants from Merck Sharp & Dohme; Gilead Sciences; Bristol-Myers Squibb; Boehringer Ingelheim; Janssen-Cilag; ViiV Healthcare. The Kirby Institute is funded by The Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales; by grants from the Fondo de Investigación Sanitaria [grant number FIS 99/0887] and Fundación para la Investigación y la Prevención del SIDA en Espanã [grant number FIPSE 3171/00], to the Barcelona Antiretroviral Surveillance Study (BASS); by the National Institute of Allergy and Infectious Diseases, National Institutes of Health [grants number 5U01AI042170-10, 5U01AI046362-03], to the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA); by primary funding provided by the European Union's Seventh Framework Programme for research, technological development and demonstration under EuroCoord grant agreement n° 260694 and unrestricted grants by Bristol-Myers Squibb, Janssen R&D, Merck and Co. Inc., Pfizer Inc., GlaxoSmithKline LLC, (the participation of centres from Switzerland is supported by The Swiss National Science Foundation (Grant 108787)) to the EuroSIDA study; by unrestricted educational grants of AbbVie, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Pfizer, Janssen Pharmaceuticals to the Italian Cohort Naive to Antiretrovirals (The ICONA Foundation); and financed within the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (grant #148522) and by the SHCS research foundation. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

I have read the journal's policy and the authors of this manuscript have the following competing interests: MB has received research grants, paid to his institution from Merck Sharp & Dohme and Gilead Sciences. MB has also received honoraria for participation on HIV advisory boards and preparation and delivery of educational materials from Gilead Sciences, Janssen-Cilag, Merck Sharp & Dohme and ViiV Healthcare. AM has received honoraria, travel support, speaker fees and consultancy fees from ViiV, BMS, BI, Gilead, and Wragge LLC; AP received speaker fees for a 2015 conference for Gilead Sciences; ML has received unrestricted research grants, paid to his institution, from Boehringer Ingelhiem, Gilead Sciences, Merck Sharp & Dohme, Bristol-Myers Squibb, Janssen-Cilag, ViiV HealthCare; ML has also received consultancy and presentation fees from Gilead Sciences, and DSMB sitting fees from Sirtex Pty Ltd; PR through his institution has received independent scientific grant support from Gilead Sciences, Janssen Pharmaceuticals Inc, Merck & Co, Bristol-Myers Squibb and ViiV Healthcare; PR has served on a scientific advisory board for Gilead Sciences and ViiV Healthcare, as well as on a data safety monitoring committee for Janssen Pharmaceuticals Inc, and has chaired a scientific symposium by ViiV and received remuneration; CS's institution has received a grant from the D:A:D Oversight Committee for the analysis and co-ordination of the D:A:D Study; CS has also received personal fees from Gilead Sciences, ViiV Healthcare and Janssen-Cilag for the membership of Data Safety and Monitoring Boards, Advisory Boards, Speaker Panels and for the preparation of educational materials.

Citation:

Boyd MA, Mocroft A, Ryom L, Monforte Ad, Sabin C, El-Sadr WM, et al. (2017) Cardiovascular disease (CVD) and chronic kidney disease (CKD) event rates in HIV-positive persons at high predicted CVD and CKD risk: A prospective analysis of the D:A:D observational study. PLoS Med 14(11): e1002424. https://doi.org/10.1371/journal.pmed.1002424

Author Affiliations:

Kirby Institute, University of New South Wales, Sydney, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Department of Infection and Population Health, University College London, London, United Kingdom; Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Dipartimento di Scienze della Salute, Clinica di Malattie Infettive e Tropicali, Azienda Ospedaliera-Polo Universitario San Paolo, Milan, Italy; ICAP at Columbia University, New York, New York, United States of America; Division of Infectious Diseases, Saint-Pierre University Hospital, Universite Libre de Bruxelles, Brussels, Belgium; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Public Health, Nice University Hospital, Nice, France; Centre Hospitalier Universitaire de Bordeaux, Universite´ de Bordeaux, Bordeaux, France; Bordeaux Population Health, INSERM U1219, Universite´ de Bordeaux, Bordeaux, France,; Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherland; HIV Monitoring Foundation, Amsterdam, The Netherlands

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Research Article (5)

Funding:

This research was supported as part of the amfAR Institute for HIV Cure Research (amfAR 109301), the Delaney AIDS Research Enterprise (DARE; AI096109 and A127966), NIH-NIAID R33 (AI116205; TJH), and NIH-NIAID (AI098480; TJH). The SCOPE cohort was also supported by the UCSF/Gladstone Institute of Virology & Immunology CFAR (P30 AI027763) and by NIH ORIP (K01 OD018244, KMP), R01AI120024 (JNB), and 1R01DK108349-01 (SAY). This research was also supported by the Collaboratory for AIDS Research on Eradication (CARE; U19 AI096113 and 1UM1AI126619), the BEAT-HIV Delaney Collaboratory (1UM1Al126620), the UCSD CFAR (AI306214), the Department of Veterans Affairs (1 IK2CX000520-01, SAY), the James B. Pendleton Charitable Trust, intramural funding to the National Cancer Institute, and by Leidos Biomedical Research, Inc. subcontract 12XS547 (JWM). No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

I have read the journal's policy and the authors of this manuscript have the following competing interests: AYL has led trials in which Gilead has donated study drug. SEC was the protocol co-chair and a site principle investigator of the US PrEP demonstration project for which Gilead donated study drug. JWM has share options in C0-Crystal, Inc; is on the scientific advisory board for Gilead Sciences; and has received research funding from Gilead Sciences, Janssen Pharmaceuticals, and Abbott Molecular. SGD declares the research group has received external funding to support our research from ViiV, Gilead, and Merck. He is also a guest editor for the PLOS Medicine special issue on Advances in HIV Prevention, Treatment and Cure. DRK is a consultant, research support and speaker for Gilead; a consultant for Janssen; a consultant, research support and speaker for Merck; a consultant and research support for ViiV.

Citation:

Henrich TJ, Hatano H, Bacon O, Hogan LE, Rutishauser R, Hill A, et al. (2017) HIV-1 persistence following extremely early initiation of antiretroviral therapy (ART) during acute HIV-1 infection: An observational study. PLoS Med 14(11): e1002417. https://doi.org/10.1371/journal.pmed.1002417

Author Affiliations:

Division of Experimental Medicine, University of California, San Francisco, California, United States of America; Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, California, United States of America; San Francisco Department of Public Health, San Francisco, California, United States of America; Program for Evolutionary Dynamics, Harvard University, Cambridge, Massachusetts, United States of America; HIV Dynamics and Replication Program, Center for Cancer Research, National Cancer Institute, Frederick, Maryland, United States of America; The Wistar Institute, Philadelphia, Pennsylvania, United States of America; Center for AIDS Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Universite de Montreal, Montreal, Quebec, Canada; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, United States of America; Harvard Medical School, Boston, Massachusetts, United States of America; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Howard Hughes Medical Institute, Baltimore, Maryland, United States of America; Department of Neurology, University of California, San Francisco, California, United States of America; University of California San Diego, La Jolla, California, United States of America; Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America; San Francisco Veterans Affairs Medical Center, San Francisco, California, United States of America; University of California, San Francisco, San Francisco, California, Unites States of America

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