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6.
Viruses ; 13(10)2021 10 19.
Article in English | MEDLINE | ID: covidwho-1481014

ABSTRACT

The H1N1 pandemic of 2009-2010, MERS epidemic of 2012, Ebola epidemics of 2013-2016 and 2018-2020, Zika epidemic of 2015-2016, and COVID-19 pandemic of 2019-2021, are recent examples in the long history of epidemics that demonstrate the enormous global impact of viral infection. The rapid development of safe and effective vaccines and therapeutics has proven vital to reducing morbidity and mortality from newly emerging viruses. Structural biology methods can be used to determine how antibodies elicited during infection or vaccination target viral proteins and identify viral epitopes that correlate with potent neutralization. Here we review how structural and molecular biology approaches have contributed to our understanding of antibody recognition of pathogenic viruses, specifically HIV-1, SARS-CoV-2, and Zika. Determining structural correlates of neutralization of viruses has guided the design of vaccines, monoclonal antibodies, and small molecule inhibitors in response to the global threat of viral epidemics.


Subject(s)
Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , HIV-1/immunology , SARS-CoV-2/immunology , Zika Virus/immunology , Acquired Immunodeficiency Syndrome/immunology , Acquired Immunodeficiency Syndrome/prevention & control , Antibodies, Monoclonal/immunology , Antibodies, Monoclonal/therapeutic use , COVID-19/immunology , COVID-19/prevention & control , Crystallography, X-Ray , Humans , Viral Vaccines/immunology , Zika Virus Infection/immunology , Zika Virus Infection/prevention & control
7.
PLoS Med ; 18(10): e1003831, 2021 10.
Article in English | MEDLINE | ID: covidwho-1477511

ABSTRACT

BACKGROUND: UNAIDS has established new program targets for 2025 to achieve the goal of eliminating AIDS as a public health threat by 2030. This study reports on efforts to use mathematical models to estimate the impact of achieving those targets. METHODS AND FINDINGS: We simulated the impact of achieving the targets at country level using the Goals model, a mathematical simulation model of HIV epidemic dynamics that includes the impact of prevention and treatment interventions. For 77 high-burden countries, we fit the model to surveillance and survey data for 1970 to 2020 and then projected the impact of achieving the targets for the period 2019 to 2030. Results from these 77 countries were extrapolated to produce estimates for 96 others. Goals model results were checked by comparing against projections done with the Optima HIV model and the AIDS Epidemic Model (AEM) for selected countries. We included estimates of the impact of societal enablers (access to justice and law reform, stigma and discrimination elimination, and gender equality) and the impact of Coronavirus Disease 2019 (COVID-19). Results show that achieving the 2025 targets would reduce new annual infections by 83% (71% to 86% across regions) and AIDS-related deaths by 78% (67% to 81% across regions) by 2025 compared to 2010. Lack of progress on societal enablers could endanger these achievements and result in as many as 2.6 million (44%) cumulative additional new HIV infections and 440,000 (54%) more AIDS-related deaths between 2020 and 2030 compared to full achievement of all targets. COVID-19-related disruptions could increase new HIV infections and AIDS-related deaths by 10% in the next 2 years, but targets could still be achieved by 2025. Study limitations include the reliance on self-reports for most data on behaviors, the use of intervention effect sizes from published studies that may overstate intervention impacts outside of controlled study settings, and the use of proxy countries to estimate the impact in countries with fewer than 4,000 annual HIV infections. CONCLUSIONS: The new targets for 2025 build on the progress made since 2010 and represent ambitious short-term goals. Achieving these targets would bring us close to the goals of reducing new HIV infections and AIDS-related deaths by 90% between 2010 and 2030. By 2025, global new infections and AIDS deaths would drop to 4.4 and 3.9 per 100,000 population, and the number of people living with HIV (PLHIV) would be declining. There would be 32 million people on treatment, and they would need continuing support for their lifetime. Incidence for the total global population would be below 0.15% everywhere. The number of PLHIV would start declining by 2023.


Subject(s)
Disease Eradication , Global Health , Goals , HIV Infections/prevention & control , Models, Biological , Models, Theoretical , Public Health , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/therapy , Adolescent , Adult , COVID-19 , Cause of Death , Epidemics , Female , HIV Infections/epidemiology , HIV Infections/therapy , Humans , Incidence , Male , SARS-CoV-2 , Social Determinants of Health , United Nations , Young Adult
9.
Curr HIV Res ; 19(2): 103-105, 2021.
Article in English | MEDLINE | ID: covidwho-1435695

ABSTRACT

In 2014, The Joint United Nations Program on HIV and AIDS (UNAIDS) has set an ambitious target code-named 90-90-90, which aims to ensure that 90% of all people living with HIV will know their state, 90% of all people diagnosed will receive sustained antiretroviral therapy, and 90% of all people receiving ART will have viral suppression by 2020. Since 2014, many tests and treatment programs have been developed to achieve the above goals worldwide. In 2019, it was reported that many developed countries can reach the target with the right strategies, as well as regions that are still far from the targets. It has been reported that the fourth 90 should be one of the targets related to HIV infection in recent years. This view, beyond virological suppression, was towards developing programs that would enable people living with HIV to live not only longer but also healthy. The socio-cultural and economic obstacles to reach the targets may vary according to geographical regions, but it is clear that COVID-19 disease, which has taken the whole world under the influence since 2019, is a major obstacle to the 90-90-90 targets worldwide. Difficulties in the diagnosis and access to ART and treatment nonadherence which may be encountered more frequently due to many factors may threaten both the health of people living with HIV and public health. The COVID-19 pandemic has disrupted many programs developed in the fight against the HIV epidemic. Considering COVID-19 disease and future epidemics that may create a chaotic environment, analyzing the difficulties experienced in the pandemic retrospectively, and determining new strategies that will bring appropriate solutions to the problems will play an important role in the proper management of future issues.


Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/prevention & control , Anti-Retroviral Agents/therapeutic use , COVID-19/drug therapy , HIV Infections/drug therapy , HIV Infections/prevention & control , Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/epidemiology , HIV Infections/epidemiology , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , United Nations
12.
Afr J AIDS Res ; 20(2): 117-124, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1311356

ABSTRACT

By the end of the first year of the COVID-19 pandemic, in February 2021, the numbers of cases and deaths in southern Africa were low in absolute and relative numbers. The BBC ran a story (which was later retracted) headlined "Coronavirus in Africa: Could poverty explain mystery of low death rate?". A heading in the New York Post said: "Scientists can't explain puzzling lack of coronavirus outbreaks in Africa". Journalist Karen Attiah concluded: "It's almost as if they are disappointed that Africans aren't dying en masse and countries are not collapsing". We wondered if the knowledge that southern African countries have acquired in their struggle against AIDS has contributed to a more effective approach against COVID-19. The viral origins of the diseases through zoonotic events are similar; neither has a cure, yet. In both diseases, behaviour change is an important prevention tool, and there are specific groups that are more vulnerable to infection. Equally, there are important differences: most people with COVID-19 will recover relatively quickly, while people living with HIV will need lifelong treatment. COVID-19 is extremely infectious, while HIV is less easily transmitted.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/transmission , Africa, Southern/epidemiology , COVID-19/prevention & control , COVID-19/transmission , HIV Infections/epidemiology , HIV Infections/prevention & control , HIV Infections/transmission , Humans , SARS-CoV-2
13.
Mem. Inst. Oswaldo Cruz ; 116: e210071, 2021.
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1288716

ABSTRACT

In the space of four decades, Brazil has faced two serious pandemics: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and Coronavirus disease 2019 (COVID-19). The country's response to HIV/AIDS was coordinated by several stakeholders and recognised the importance of scientific evidence in guiding decision-making, and a network offering monitoring and antiretroviral treatment was provided through coordinated efforts by the country's universal health system. Conversely, the lack of a centrally coordinated strategy and misalignment between government ministries regarding the COVID-19 pandemic response, together with the denial of scientific evidence, promotion of ineffective treatments and insufficient vaccination efforts, have all led to the uncontrolled spread of infection, the near-total collapse of the health system and excess deaths.


Subject(s)
Humans , HIV Infections , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/epidemiology , COVID-19 , Brazil/epidemiology , Pandemics/prevention & control , SARS-CoV-2
16.
Ciênc. Saúde Colet ; 26(5): 1853-1862, maio 2021. tab, graf
Article in English, Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1256108

ABSTRACT

Resumo Este ensaio reflete sobre práticas sexuais e prevenção nos contextos das pandemias de AIDS e da COVID-19. Analisa dados coletados entre julho e outubro de 2020, por meio de observação participante, no âmbito de uma pesquisa etnográfica sobre vulnerabilidade e prevenção ao HIV entre homens que fazem sexo com homens da Região Metropolitana do Recife. Os resultados apontam para a relevância da aparência corporal e da vinculação afetiva entre os parceiros no engendramento de emoções que medeiam a lida com risco de infecção em ambas as pandemias. Sinaliza para a necessidade de incorporar essas dimensões comunicacionais em materiais informativos, de modo a torná-los mais eficazes.


Abstract This essay reflects on sexual practices and prevention in the contexts of the AIDS and COVID-19 pandemics. It analyses data collected between July and October 2020 through participant observation, as part of an ethnographic research project on HIV vulnerability and prevention among men who have sex with men in the Metropolitan Region of Recife, state of Pernambuco (PE), Brazil. The results point to the relevance of physical appearance and the affective bond between partners in engendering emotions that mediate coping with the risk of infection during both pandemics. It indicates the need to incorporate those communicational dimensions into informational materials to make them more effective.


Subject(s)
Humans , Male , HIV Infections/prevention & control , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/epidemiology , Sexual and Gender Minorities , COVID-19 , Sexual Behavior , Brazil/epidemiology , Sexual Partners , Homosexuality, Male , Sexuality , Pandemics/prevention & control , SARS-CoV-2
18.
Emerg Infect Dis ; 27(6): 1553-1560, 2021 06.
Article in English | MEDLINE | ID: covidwho-1236653

ABSTRACT

June 2021 marks the 40th anniversary of the first description of AIDS. On the 30th anniversary, we defined priorities as improving use of existing interventions, clarifying optimal use of HIV testing and antiretroviral therapy for prevention and treatment, continuing research, and ensuring sustainability of the response. Despite scientific and programmatic progress, the end of AIDS is not in sight. Other major epidemics over the past decade have included Ebola, arbovirus infections, and coronavirus disease (COVID-19). A benchmark against which to compare other global interventions is the HIV/AIDS response in terms of funding, coordination, and solidarity. Lessons from Ebola and HIV/AIDS are pertinent to the COVID-19 response. The fifth decade of AIDS will have to position HIV/AIDS in the context of enhanced preparedness and capacity to respond to other potential pandemics and transnational health threats.


Subject(s)
Acquired Immunodeficiency Syndrome , COVID-19 , HIV Infections , Hemorrhagic Fever, Ebola , Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , HIV Infections/epidemiology , Hemorrhagic Fever, Ebola/epidemiology , Humans , Pandemics , SARS-CoV-2
19.
Cult Health Sex ; 23(11): 1532-1544, 2021 11.
Article in English | MEDLINE | ID: covidwho-1216545

ABSTRACT

Using crip theory, specifically Barounis' formulation of antiprophylactic citizenship, Piepzna-Samarasinha's conceptualisation of care work, and Shotwell's calls against purity, this paper analyses the making of the film HIV in the Rust Belt during the COVID-19 crisis. HIV in the Rust Belt (directed by Holly Hey) documents some of the experiences of local HIV survivors. During the course of filming, however, a story emerged about the importance of an AIDS facility, David's House Compassion, which had served as a hospice and a resource centre between 1988 to 2003. When COVID-19 arrived in the USA, we were mid-way through filming. Doing this work during the COVID-19 pandemic opened up a host of questions about the porousness of bodies as well as the slippage of time and stigma between the two pandemics. As we continued filming, we were made more aware that the story of David's House Compassion could be just as much as story of COVID-19, representative of antiprophylactic citizenship, an idea of belonging that comes from an openness and vulnerability that only sickness can offer.


Subject(s)
Acquired Immunodeficiency Syndrome , COVID-19 , Hospices , Political Activism , Acquired Immunodeficiency Syndrome/prevention & control , Humans , Pandemics
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