Simian immunodeficiency viruses (SIV) infecting chimpanzees (SIVcpz) and sooty mangabeys (SIVsm) are, respectively, the biological precursors of human immunodeficiency viruses (HIV) Types 1 and 2. Former French colonies in West Africa are the regions where retroviruses first jumped from primates to humans. Ivory Coast is nowadays a country of over 29 million people, being 2% (580,000) persons living with HIV (PLWH). However, one-quarter remains undiagnosed. Heterosexual transmission is by far the most frequent mechanism of HIV acquisition and women exhibit higher rates of infection than men. Despite preventive measures, HIV infection in children throughout breastfeeding remains significant. The proportion of PLWH carrying HIV-1 is rising whereas conversely HIV-2 carriers are steadily declining. A nationwide survey conducted on earlier 2024 showed that a total of 188,880 PLWH were on follow-up. HIV-1 infection was found in 163,947, HIV-2 in 5,114, and coinfection in 3,182. HIV type was not reported for 7,500. Antiretroviral therapy with tenofovir, lamivudine, and dolutegravir is by far the most frequently prescribed regimen in Ivory Coast (n = 168,543). Viral suppression is recognized in 94.3% of treated PLWH, despite one-third acknowledging unwanted treatment interruptions after failure of stock supplies. Given shared transmission routes with HIV, coinfection with other human retroviruses such as Human T-lymphotropic virus type-1 (HTLV-1) and/or hepatitis viruses B, C, and delta are frequent in Ivory Coast. Coinfections remain largely undiagnosed and poorly managed. In summary, the HIV pandemic caused by both HIV-1 and HIV-2 is a major public health challenge in Ivory Coast, where strategies for expanding diagnosis, sustain antiretroviral treatment, and manage coinfections warrant further efforts.

On May 23-24, 2024, the 1 Spanish Conference on Genomic Medicine convened in Madrid, Spain. An international and multidisciplinary group of experts gathered to discuss the current state and prospects of genomic medicine in the Spanish-speaking world. There were 278 attendees from Latin America, US, UK, Germany, and Spain, and the topics covered included rare diseases, genome medicine in national health systems (NHSs), artificial intelligence, and commercial development ventures. One particular area of attention was our still sketchy understanding of genome variants. This is evidenced by the fact that many diagnoses in rare diseases continue to yield odysseys that take years, with up to 50% of cases that may go undiagnosed. Since a lot of the genome remains to poorly understood, as new technologies such as long read sequencing become more ubiquitous and cheaper, it is expected that current gaps in genome references will improve. However, disparities within the NHSs suggest that advancements do not necessarily rely on resources but the appropriate regulation and pathways for education of professionals being properly implemented. This is where Genomics England can be a clinical genomic implementation example for routine health care. Ethical challenges, including privacy, informed consent, equity, representation, and genetic discrimination, also require the need for robust legal frameworks and culturally sensitive practices. The future of genomics in Spanish-speaking countries depends on addressing all of these issues. By navigating these challenges responsibly, Spanish-speaking countries can harness the power of genomics to improve health outcomes and advance scientific knowledge, ensuring that the benefits of personalized medicine are realized in an inclusive and equitable manner.

The acquisition of private medical practices by large health-care corporations is transforming clinical practice in many Western countries. The growing influence of health administration on medical practice is increasingly perceived as a danger by the public and health professionals. Health-care administrators should not replace doctors or invade their competencies. Back to principles, the patient-doctor relationship must be funded in trust. Representing society, governments must try to ensure health care to all citizens, serving one of the fundamental human rights. Using the principle of subsidiarity, administrators should fill gaps in the provision of health care to all patients by doctors.

The creation of the universe out of nothing (ex nihilo) is attributable to the eternal God. Would a direct divine intervention be needed for other singular events, such as the origin of life? Taking apart the human being, created to image and resemblance of God, we argue that current scientific knowledge allows us to rationally admit a continuity between the origins of the universe and the emergence of life on Earth. Although the irruption of living beings from inert matter is a leap or discontinuity in creation, a direct intervention of God would not be indispensable. The initial impulse of creation, with matter and energy in a space-time imbalance, could have triggered reactions between the different elements and a self-organization of metabolites, in accordance with natural physical-chemistry laws. This paradoxical increase of complexity ended with a transition from chemistry to biology. It happened when independence, metabolism, heritability, and life cycle took place in a protocellular unit. In this way, the emergence of life on earth could be part of an evolutionary dynamic of the timeless God's creative act.

The human T-cell leukemia virus type 1 (HTLV-1) was first described in 1980. It is spread in highly endemic regions in the world, such as the Southwestern part of Japan, sub-Saharan Africa and South America, Caribbean, Middle East, and Australo-Melanesia regions. HTLV-1 causes adult T cell leukemia and is associated with many inflammatory conditions, most notably HTLV-1-associated myelopathy/tropic spastic paraparesis. HTLV-2, first isolated in 1982, was recognized as a common infection in intravenous drug users, but a clear association with disease remains elusive. The first estimate of HTLV-1-positive individuals worldwide, in 1993, was around 10-20 millions. Due to the lack of global population-based prevalence studies, this is considered an underestimate at the moment. Furthermore, HTLV-1 prevalence in Europe is impacted by changing migration flows. Particularly, no data on HTLV-1 prevalence in the general population in Italy are available. Here, we report a systematic literature review of studies conducted in Italy on HTLV-1/2 from 1980 to 2023. Based on the criteria we adopted a total of 426 publications were found (64 reviews, 99 epidemiological, and 263 translational studies). The contents of some representative publications are summarized and discussed. Moreover, an approximate estimation of about 26,000 HTLV-1 positive foreigners living in Italy was obtained from updated data of foreigners from each single country officially registered as resident in Italy and from data on HTLV-1 prevalence among the general population in the corresponding countries.

HIV emerged silently taking time to spread and become visible only through geographically isolated clusters of life-threatening immunodeficiency, known as AIDS since the early 80s. The clusters of infection expanded, overlapping to evolve into a pandemic that is ongoing and almost as silent. Phylogenetic analysis places the emergence of HIV-1 group M, the subtype responsible for the pandemic, in the human population more than 100 years ago. Once established, the rate and direction of spread of HIV-1 from local, to national, to contemporary pandemic proportions have varied over time and place. The literature presents many theories on the emergence and drivers of the spread of the virus over the past century. Here, historical evidence and phylogenetic models are reviewed to seek clarity on the emergence, geographic spread and key world events that mark the progression of the HIV-1 pandemic. This narrative review places particular focus on: war (both its direct and indirect affects), trade and economic expansion, changes in sexual behaviors, and public health policy. Investigating the impact of major world events and policy on the emergence and spread of HIV-1 may aid better understanding of what influences the viruses transmission dynamic. By identifying multilateral targets that influence transmission, up-scaled efforts to effectively control, if not remove, HIV-1 from the human population become a possibility. Suggestions for revisions in HIV-1 global public health policy are discussed. Refocused efforts to tackle HIV-1 transmission and replace the need to manage the pathology of this terrible disease are both ethically and economically just.

Compared to either HIV or hepatitis B virus (HBV) monoinfected individuals, HIV/HBV-coinfected individuals have a decreased probability of spontaneous HBV clearance and a greater risk of developing chronic liver damage and a faster progression to cirrhosis and hepatocellular carcinoma. This manuscript attempts to provide a comprehensive review of the landscape of current HIV/HBV coinfection research with a focus on the intricate interactions between these two viruses. Our review will help understand the disease dynamics of HIV/HBV coinfection and has important implications for designing public health strategies.

This study was performed to reveal the risk factors associated with mortality in people living with HIV (PLHIV) who were diagnosed with COVID-19. Studies reporting deaths among PLHIV and infected with SARS-CoV-2 were investigated. After protocol setup and registration, the extracted sources were categorized and assessed for quality. This study examined ten articles with a total of 46,136 patients. Patients aged ≥ 60 years (hazard ratio [HR] = 2.22; 95% CI: 1.617, 3.050; p < 0.001), male (HR = 1.668; 95% CI: 1.179, 2.361; p = 0.004), and people with diabetes (risk ratio [RR] = 3.34; 95% CI: 1.45, 7.68; p = 0.005) were at higher risk of death. Adherence to antiretroviral therapy (ART) reduced mortality risk (RR = 0.90; 95% CI: 0.83, 0.98; p = 0.02). Patients in the survival groups showed a statistically significant lower mean of C-reactive protein (mean difference = 114.08; 95% -74.05, 154.10; p < 0.001). Deceased patients showed higher mean levels of interleukin-6 (IL-6). Chronic respiratory disorders, hypertension, oxygen requirement, admission to an intensive care unit, D-dimer levels, and HIV viral load < 50 copies RNA/mL before admission did not show statistically significant differences between the deceased and survival groups. ART therapy reduced mortality risk (RR = 0.90; 95% 0.83, 0.98; p = 0.02). Identifying PLHIV at higher mortality risk could improve the outcomes of COVID-19 by stratifying these patients to the most effective treatment in a timely fashion.

Africa hosts the highest burden of esophageal cancer (49%) and HIV (60%) worldwide. It is imperative to investigate the synergistic impact of these two diseases on African populations. This study conducted an exhaustive computerized search of databases, including Medline/PubMed, Embase, Web of Science, Scopus, Cochrane library, and African Journals Online, to identify eligible studies up to October 2023. HIV infection was the exposure, esophageal cancer risk was the outcome, and healthy subjects with no cancer history served as comparators. Study quality was assessed using the Newcastle-Ottawa scale, and potential publication bias was evaluated through funnel plots and the Egger test. Meta-analyses were conducted using Stata 17.0 software and involved a thorough examination of 98,397 studies. Out of these, eight studies originating from Eastern and Southern Africa, recognized as esophageal cancer hotspots on the continent, met the eligibility criteria. The analysis revealed a non-significant association between HIV infection and esophageal cancer risk (odds ratio = 1.34 [95% confidence interval, 0.85-2.12]; with 0.26 as p-value of overall effects). The Egger test yielded a p-value of 0.2413, suggesting the absence of publication bias. In summary, this systematic review and meta-analysis indicate that there is no established causal link between HIV infection and esophageal cancer risk. However, further research is essential to delve into the potential mechanisms underlying this relationship.

Sweden is a country with a low prevalence of human lymphotropic T-cell virus (HTLV) infection, estimated at < 0.005%, but the infection rate is notably higher in specific risk groups such as HTLV-2 among intravenous drug users (IVDU) and people originating from HTLV-1 highly endemic areas. Thus, in the most recent study from 2012, the prevalence of HTLV-2 among IVDU in Stockholm was 3.2%. However, much of the epidemiological data on HTLV in Sweden stems from studies conducted primarily between the 1990s and 2007, and the impact of migration to Sweden during the past 15 years has not been evaluated. Despite Sweden's status as a country with generally low prevalence of HTLV, it is prudent to anticipate and prepare for several potential challenges associated with HTLV infection in the future. Proactive measures to enhance awareness, alongside strategies to curtail transmission and mitigate complications, are crucial for addressing this relatively rare, but significant health issue. In this work, we review the current epidemiological knowledge about HTLV in Sweden and discuss future Swedish perspectives.

The aim of this study was systematically review the acquired syphilis before and during follow-up of pre-exposure prophylaxis (PrEP) for HIV. We analyzed articles that studied PrEP users with the outcome of acquired syphilis. The eligibility criteria were studies retrieved from the United States National Library of Medicine (Pubmed), Latin American and Caribbean Health Sciences Literature (Lilacs), Embase and Scopus databases, published between 2012 and 2023, in English, Spanish or Portuguese. We performed the descriptive synthesis and quality analysis of selected studies using the Newcastle Ottawa scale or Cochrane scale. We also used random-effects models to generate pooled rate estimates for syphilis before PrEP and during follow-up. A total of 4412 studies were found and 35 were selected, all in English, and almost all with high or satisfactory quality. The review found a PrEP syphilis rate of 6.0%. A summary of three studies estimated a 2.34-fold increased risk of syphilis acquisition during PrEP, with an incidence rate of 8.89 cases/100 person-years. These findings warrant caution due to study heterogeneity. Compared to HIV-positive individuals, PrEP users exhibit potentially higher syphilis rates, particularly among those aged 33-38 years, and factors such as age ≥ 35 years, MSM status, prior sexually-transmitted infections, and longer PrEP duration (every 6 months) are associated. Future research should further investigate these PrEP-related factors contributing to heightened syphilis risk.

More than two decades after introducing antiretroviral therapy (ART), several challenges still prevail in keeping well people living with HIV, even with "Test and Treat" and/or "Rapid Start of ART" initiatives, as well as the scale-up of ART worldwide to promote access and adherence to treatment. This review examined articles on ART adherence in Africa between 2016 and 2023, published in English and indexed in PubMed. A total of 16 articles out of 2415 were eligible and included for analyses. Overall, good ART adherence rates in sub-Saharan African (SSA) regions ranged from 43% to 84%. Rates in the center of the SSA region ranged from 58% to 80%, in the north from 50% to 83%, in the south from 77% to 84%, in the west from 43% to 60%, and in the east from 69% to 73%. Most African countries use self-reporting to assess treatment adherence, which is frequently unreliable. The main factors with negative influence on ART adherence were comorbidities, lack of motivation, socioeconomic difficulties, or side effects. Conclusion: Adherence to ART is a good indicator for controlling the spread of HIV in a given region. It is important to overcome the barriers that make it difficult to comply with ART and reinforce the factors that facilitate access to medication.

We describe and analyze resistance-associated mutations (RM) and virological failures (VF) on antiretroviral therapy using the latest approved integrase inhibitors (INIs) dolutegravir (DTG), bictegravir (BIC), and cabotegravir (CAB), together with their companion drugs in fixed-dose formulations: BIC/emtricitabine/tenofovir; CAB/rilpivirine; DTG/abacavir/lamivudine; DTG/emtricitabine/tenofovir; and DTG/lamivudine. Systematic literature searches were conducted in PubMed and other electronic databases for clinical studies published between January 2010 and May 2023, according to preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA), which analyzed VFs and RMs of INIs. Fifty clinical studies were included in the synthesis. VF in antiretroviral treatment (ART)-naïve patients occurred in 0.7-4.0%, 0.6-1.4%, and 0.6-9.0% of patients treated with DTG, BIC, and CAB, respectively. VF was reported in patients with previous ART in 0-8.1%, 0-2.0%, and 0.4-2.3% of those treated with DTG, BIC, and CAB, respectively. RMs were detected in ART-naïve patients in only one study with DTG (0.3%), none of the studies with BIC, and three of the studies with CAB (0.1-5.4%). In ART-experienced patients, RMs were detected in 0-1.9% of DTG-treated patients. No cases of RM were detected in the 11 BIC studies reviewed. In the case of CAB, RMs were detected in eight studies, ranging from 0.3% to 1.9% of patients. In conclusion, RM rates in the studies reviewed were generally low using the latest INIs. This review identified BIC as the INI with the lowest number of observed VF and lack of RM.

Smoking among persons living with HIV infection (PLWH) is estimated to be 2-3 times greater than that in the general population. Data suggest that cigarette smoking is more common among PLWH because of several factors, including lower socioeconomic status, previous, or concurrent illicit drug and alcohol use, younger age, lower education level, and concomitant depressive symptoms. Cigarette smoking among PLWH has been associated with a higher risk of certain cancers and infections as well as lowered response to antiretroviral therapy. Randomized controlled trials on behavioral interventions for tobacco use among smokers with HIV were searched in the PubMed, Cochrane Library, EMBASE, and Web of Science databases. The retrieval period was from the inception of databases to November 2023. Network meta-analysis (NMA) was performed using the Stata 18.0 software with 19 studies (3190 subjects), of which 15 reported 7-day point prevalence abstinence and seven of which reported continuous abstinence. The NMA results showed that compared with general advice plus self-help brochure, text messaging (relative risk [RR] = 4.60, 95% confidence interval [CI], 1.12-18.81) and cell phone counseling (RR = 3.29, 95% CI, 1.71-6.32) were the most effective for 7-day point prevalence abstinence among smokers with HIV infection. Moreover, the meta-analysis showed that compared with smoking counseling and self-help brochures, continuous abstinence was statistically significantly enhanced after behavioral interventions (RR = 2.52, 95% CI, 1.51-4.20). The study revealed very low-to-high-quality evidence that text messaging, telephone counseling, and smoking cessation websites were effective for smokers with HIV infection.

HIV epidemics still exist as a major global public health burden, especially in middle- and low-income countries. Given the lack of approved vaccines, antiretroviral therapy (ART) remains the primary approach to reduce the mortality and morbidity linked to this disease. Effective treatment for HIV-1 requires the simultaneous administration of multiple drugs. However, the virus can show resistance to antiretroviral drugs, resulting in treatment failure. Therefore, this study focused on assessing the prevalence of mutations within the Indian HIV-positive population. After assessing the data, we intended to identify the most effective highly active ART (HAART) regimens for individuals with drug-resistant variants. Furthermore, our analysis revealed a spectrum of HIV mutations, with varying effects on protein stability. The significance of this analysis lies in its potential to optimize HAART selection for HIV-positive individuals by accounting for both prevalence and stability-altering mutations. By considering mutation effects on protein stability, we can modify treatment regimens, increasing the likelihood of therapy success and diminishing the risk of resistance. Moreover, this study contributes to the broader field of drug repurposing, offering insights into the rational design of antiretroviral therapies.