Enhancing care for people living with HIV: current and future monitoring approaches

Abstract

Introduction : Antiretroviral therapy (ART) is the most significant advance in the medical management of HIV-1 infection. Given the fact that HIV cannot be eradicated from the body, ART has to be indefinitely maintained. New approaches need to be defined for monitoring HIV-infected individuals (PLWHIV), including clinical, virologic, immunological parameters and also ways to collect individual points of view and quality of life. Areas covered : We discuss which tests may be used to improve the management of PLWHIV and respond to a comprehensive health demand. Expert opinion : Viral load and CD4 counts are well-validated outcome measures and we still need them, but they do not completely depict the health status of PLWHIV. We need to better understand and to apply to clinical practice what happens in sanctuaries, what is the role of HIV DNA, what is the meaning of low-level viremia. Most of these questions do not yet have a definitive response. Further, we need to understand how to modify these variables in order to improve outcomes. Similar points may be raised for immunological measures and for tests exploring the tolerability of drugs. The goal must be the evolution from a viro/immunologic-based to a comprehensive quality-ofhealth-based evaluation of PLWHIV.

Investigating coping and stigma in people living with HIV through narrative medicine in the Italian multicentre non-interventional study DIAMANTE

“…DIAMANTE is the first observational study integrating narratives as PROs and clinical data in Italy: thus, it is line with those studies suggesting that implementing PROs in clinical practice should represent a key-aspect of LWH strategic management and patient-centred medicine 25 .…”

“…Among PLWH, coping strategies are crucial to overall health and adaptive coping was negatively correlated with enacted and anticipated stigma 24 . As recently suggested 25 , Patient-Reported Outcomes (PROs) should be considered as crucial in PLWH monitoring and become a standard part of mandatory outcome measures in both clinical daily practice and trials. Moreover, as for HIV-related stigma and HRQoL, PLWH can provide unique key-elements to identify their own unmet needs and vulnerabilities 26 .…”

Quantum enhancement in the limit of detection measurement of a phase-based plasmonic biosensor including loss

“…The ongoing quest for an effective vaccine and cure, coupled with efforts to reduce stigma and improve access to prevention and treatment services, remains at the forefront of the global health agenda in addressing the HIV-1 pandemic. [7][8][9] Optical biosensors, particularly those based on surface plasmon resonance (SPR), have emerged as powerful tools in the detection and study of HIV-1. 10,11 These biosensors offer several advantages in the field of virology and immunology, particularly in terms of sensitivity, specificity, and real-time analysis.…”

O baixo peso em pessoas vivendo com HIV/Aids e a percepção dos profissionais de saúde que as assistem

“…O envelhecimento da população vivendo com HIV, o aumento de diagnóstico entre idosos e o uso prolongado de ARV têm sido associados ao desenvolvimento de comorbidades não relacionadas ao HIV. Doenças cardiovasculares, ganho de peso, distúrbios neurocognitivos e doenças ósseas também têm sido observados frequentemente em PVHIV (Maggiolo et al, 2021).…”