RESUMO
As a result of decades of research-driven breakthroughs in basic and clinical science and recent advances in the broad-scale implementation of interventions for the prevention and treatment of infection with HIV, a turning point has been reached in the global HIV-AIDS pandemic. To end the pandemic and achieve the goal of an AIDS-free generation, researchers and clinicians must follow the dual pathway of optimizing the implementation of existing prevention and treatment interventions and discovering with basic and clinical research new and effective tools in both of these arenas.
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , HIV/imunologia , Pandemias , Vacinas contra a AIDS/imunologia , Síndrome da Imunodeficiência Adquirida/imunologia , Síndrome da Imunodeficiência Adquirida/virologia , Fármacos Anti-HIV/uso terapêutico , Anticorpos Neutralizantes/imunologia , Antígenos Virais/imunologia , Terapia Antirretroviral de Alta Atividade , Humanos , Estados Unidos/epidemiologiaRESUMO
The global experience with COVID-19 holds important lessons for preparing for, and responding to, future emergences of pathogens with pandemic potential.
Assuntos
Defesa Civil , Saúde Global , Pandemias , Humanos , COVID-19 , Pandemias/prevenção & controle , Defesa Civil/educação , Defesa Civil/tendências , Saúde Global/educação , Saúde Global/tendências , ConhecimentoRESUMO
Unprecedented basic and clinical biomedical research advances over the past 4 decades have led to the development of "toolkits" of highly effective interventions for preventing and treating human immunodeficiency virus (HIV). Despite many successes in decreasing the incidence and mortality of HIV, major challenges remain in the goal of ending the HIV pandemic in the United States and globally. Overcoming these challenges will require optimization of the implementation of existing interventions for HIV prevention and treatment together with the continued development of new and innovative approaches that can be readily utilized by individuals with HIV and those at risk of infection.
Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Síndrome da Imunodeficiência Adquirida , Gerenciamento Clínico , HIV , Infecções por HIV/tratamento farmacológico , Implementação de Plano de Saúde , Humanos , Incidência , Pandemias , Vigilância em Saúde PúblicaAssuntos
Doenças Transmissíveis Emergentes/epidemiologia , Vírus da Encefalite Equina do Leste , Encefalomielite Equina/epidemiologia , Animais , Infecções por Arbovirus/diagnóstico , Aves/virologia , Doenças Transmissíveis Emergentes/transmissão , Culicidae/virologia , Diagnóstico Diferencial , Reservatórios de Doenças , Encefalomielite Equina/diagnóstico , Encefalomielite Equina/transmissão , Humanos , Mosquitos Vetores , Estados Unidos/epidemiologiaRESUMO
Many commentators believe that all clinical-trial participants must receive a level of care equivalent to the world's best. Using HIV/AIDS research as an example, we show how this 'Uniform Care Requirement' can undermine biomedical research aimed at improving global health, and then we point towards a more rational and balanced approach to ethical assessment.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Ensaios Clínicos como Assunto , Ética Médica , Terapia Antirretroviral de Alta Atividade , Países em Desenvolvimento , HumanosAssuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Máscaras , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Aerossóis , Betacoronavirus , COVID-19 , Aglomeração , Higiene das Mãos , Humanos , SARS-CoV-2 , Isolamento Social , VentilaçãoRESUMO
While the human immunodeficiency virus (HIV)/AIDS pandemic continues, the incidence of HIV infections has fallen because of the deployment of antiretroviral drugs and multiple prevention modalities. To achieve a durable end to the pandemic, a vaccine remains essential. Recent advances in vaccinology offer new promise for an effective HIV vaccine.
Assuntos
Infecções por HIV/prevenção & controle , Pandemias , Vacinação , Vacinas contra a AIDS , Infecções por HIV/epidemiologia , HumanosRESUMO
It is impossible to know with certainty the first time that an influenza virus infected humans or when the first influenza pandemic occurred. However, many historians agree that the year 1510 a.d.-500 years ago-marks the first recognition of pandemic influenza. On this significant anniversary it is timely to ask: what were the circumstances surrounding the emergence of the 1510 pandemic, and what have we learned about this important disease over the subsequent five centuries? We conclude that in recent decades significant progress has been made in diagnosis, prevention, control, and treatment of influenza. It seems likely that, in the foreseeable future, we may be able to greatly reduce the burden of influenza pandemics with improved vaccines and other scientific and public health approaches.
Assuntos
Influenza Humana/epidemiologia , Influenza Humana/história , Pandemias/história , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Influenza Humana/diagnóstico , Influenza Humana/prevenção & controleRESUMO
Infectious diseases have for centuries ranked with wars and famine as major challenges to human progress and survival. They remain among the leading causes of death and disability worldwide. Against a constant background of established infections, epidemics of new and old infectious diseases periodically emerge, greatly magnifying the global burden of infections. Studies of these emerging infections reveal the evolutionary properties of pathogenic microorganisms and the dynamic relationships between microorganisms, their hosts and the environment.
Assuntos
Bioterrorismo/tendências , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/transmissão , Animais , Bioterrorismo/prevenção & controle , Doenças Transmissíveis Emergentes/microbiologia , Doenças Transmissíveis Emergentes/virologia , Resistência a Medicamentos , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Infecções por HIV/virologia , HumanosRESUMO
Since 2014, acute flaccid myelitis (AFM), a long-recognized condition associated with polioviruses, nonpolio enteroviruses, and various other viral and nonviral causes, has been reemerging globally in epidemic form. This unanticipated reemergence is ironic, given that polioviruses, once the major causes of AFM, are now at the very threshold of global eradication and cannot therefore explain any aspect of AFM reemergence. Instead, the new AFM epidemic has been temporally associated with reemergences of nonpolio enteroviruses such as EV-D68, until recently thought to be an obscure virus of extremely low endemicity. This perspective reviews the enigmatic epidemiologic, virologic, and diagnostic aspects of epidemic AFM reemergence; examines current options for clinical management; discusses future research needs; and suggests that the AFM epidemic offers important clues to mechanisms of viral disease emergence.
Assuntos
Viroses do Sistema Nervoso Central/epidemiologia , Doenças Transmissíveis Emergentes/epidemiologia , Gerenciamento Clínico , Mielite/epidemiologia , Doenças Neuromusculares/epidemiologia , Viroses do Sistema Nervoso Central/diagnóstico , Viroses do Sistema Nervoso Central/etiologia , Viroses do Sistema Nervoso Central/terapia , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/etiologia , Doenças Transmissíveis Emergentes/terapia , Saúde Global , Humanos , Mielite/diagnóstico , Mielite/etiologia , Mielite/terapia , Doenças Neuromusculares/diagnóstico , Doenças Neuromusculares/etiologia , Doenças Neuromusculares/terapiaRESUMO
Emerging and re-emerging infectious diseases, and their determinants, have recently attracted substantial scientific and popular attention. HIV/AIDS, severe acute respiratory syndrome, H5N1 avian influenza, and many other emerging diseases have either proved fatal or caused international alarm. Common and interactive co-determinants of disease emergence, including population growth, travel, and environmental disruption, have been increasingly documented and studied. Are emerging infections a new phenomenon related to modern life, or do more basic determinants, transcending time, place, and human progress, govern disease generation? By examining a number of historically notable epidemics, we suggest that emerging diseases, similar in their novelty, impact, and elicitation of control responses, have occurred throughout recorded history. Fundamental determinants, typically acting in concert, seem to underlie their emergence, and infections such as these are likely to continue to remain challenges to human survival.
Assuntos
Doenças Transmissíveis Emergentes/história , Surtos de Doenças/história , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/história , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Surtos de Doenças/prevenção & controle , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História Antiga , História Medieval , Humanos , Viroses/epidemiologia , Viroses/históriaAssuntos
Fármacos Anti-HIV/efeitos adversos , Infecções por HIV/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Nevirapina/efeitos adversos , Adulto , Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/uso terapêutico , Ensaios Clínicos como Assunto , Feminino , Publicações Governamentais como Assunto , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Humanos , Recém-Nascido , National Institutes of Health (U.S.) , Nevirapina/administração & dosagem , Nevirapina/uso terapêutico , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Saúde Pública , Estados UnidosAssuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Vacinas contra a AIDS , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/transmissão , Adulto , Pesquisa Biomédica/tendências , Feminino , Saúde Global , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Acessibilidade aos Serviços de Saúde , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Masculino , Pandemias , GravidezAssuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Antirretrovirais/uso terapêutico , Surtos de Doenças/prevenção & controle , Infecções por HIV/prevenção & controle , Vacinas contra a AIDS , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Saúde Global , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Cooperação InternacionalRESUMO
The development of a cure is among the foremost contemporary priorities in the field of HIV research. The science that underpins a potential HIV cure should be generalisable to the many millions of persons globally who enter antiretroviral treatment programs with advanced immunosuppression and/or an opportunistic infection. We provide five key suggestions for incorporation into the HIV cure research agenda to maximise the generalisability and applicability of an HIV cure once developed.
RESUMO
Emerging viral diseases pose ongoing health threats, particularly in an era of globalization; however, new biomedical research technologies such as genome sequencing and structure-based vaccine and drug design have improved our ability to respond to viral threats.
Assuntos
Viroses/prevenção & controle , Humanos , Viroses/epidemiologia , Viroses/terapiaRESUMO
The extraordinary scientific advances made in the past three decades to understand, treat, and prevent HIV infection have contributed to the hope that a world free of AIDS is achievable. The growing armamentarium of scientifically proven interventions-including the use of antiretroviral medications to treat and prevent HIV infection, voluntary medical male circumcision, education and counseling about HIV risk and behavior change, condom use, drug and alcohol treatment, and needle exchange programs for injection drug users-offers an unprecedented opportunity to make major gains in the fight against HIV/AIDS. Combining and implementing these interventions as effectively as possible has the potential to dramatically change the trajectory of the HIV/AIDS pandemic. Substantive challenges remain, especially obtaining sufficient funding for HIV-related interventions and developing the operational capacity to deliver them cost-effectively to all in need. If these challenges can be met, the world will have a clear path toward an "AIDS-free generation" in which new HIV infections, as well as illness and death due to AIDS, are increasingly rare.