Isolated anti-HBc positivity, defined as the presence of anti-HBc in the absence of HBsAg and anti-HBs, may reflect prior exposure to HBV, occult HBV infection, or a false-positive result. This study aimed to assess the prevalence of isolated anti-HBc positivity and its associated factors among PLWH in Istanbul, Turkey. This retrospective cross-sectional study included adult People Living With HIV (PLWH) who underwent HBV serological testing between January 2000 and December 2019 at a tertiary hospital in Istanbul. Demographic and clinical characteristics were analyzed. Among 386 PLWH, 8.8% (n = 34) had isolated anti-HBc positivity. Compared with HBV-seronegative PLWH (n = 194), these patients were older (48 [IQR 42-54] vs. 42 [35-50] years; p = 0.007), more likely to have BMI ≥ 25 kg/m² (p = 0.025), and to report smoking (p = 0.041), based on available data. Pre-ART HBV DNA testing was available in 13/34 (38.2%) patients with isolated anti-HBc, and all tested samples were HBV DNA-negative. Isolated anti-HBc prevalence was 8.8% in PLWH; older age, BMI ≥25 kg/m², and smoking were more common in this group. Although no HBV DNA was detected in the tested subset, limited HBV DNA testing precluded estimation of OBI prevalence in this cohort. Recognition of isolated anti-HBc positivity and occult HBV infection is important for ART selection and patient follow-up. Although isolated anti-HBc positivity was identified in 8.8% of this cohort, more systematic and risk-stratified HBV DNA assessment is needed to better define the true burden of occult HBV infection.

Malaria and HIV remain two of the most serious public health threats in sub-Saharan Africa (SSA), where both infections occur at disproportionately high levels. Their co-occurrence within the same populations presents a complex clinical and epidemiological challenge that con-tributes substantially to morbidity and mortality across the region. This review examines current evidence on the epidemiology of malaria and HIV co-infection in SSA, with particular attention to key risk factors and the health outcomes associated with dual infection. It also evaluates chal-lenges in the clinical management of co-infected individuals, including diagnostic limitations, treatment interactions, and health system constraints. Evidence from recent studies indicates that closer coordination of malaria and HIV services may improve patient outcomes while increasing the efficiency of health delivery systems. Continued progress in diagnostic capacity, antimalarial therapies, and antiretroviral treatment, alongside improvements in health infrastructure, will be important for addressing this dual disease burden. International health initiatives and collabora-tive research programs may further strengthen integrated approaches and expand regional capac-ity for surveillance and treatment. Community engagement and targeted health education also play a critical role in encouraging timely care seeking and reducing stigma related to HIV infec-tion. This review identifies persistent gaps in surveillance systems, clinical management, and in-tegrated control strategies for malaria and HIV co-infection in SSA. Addressing these gaps will be important for informing future research priorities and supporting public health policies aimed at reducing the burden of both diseases in the region.

<p>In the published version of this article [1], the author identified the error in the reported funding grant number. This has now been corrected. </p> <p> The original article can be found online at: https://www.eurekaselect.com/article/150528ss </p> <p> Details of the error and a correction are provided here. </p> <p> ORIGINAL: </p> <p> FUNDING </p> <p> This research was financially supported by the National Natural Science Foundation of China (grant number: 321600034), the Guangxi Natural Science Foundation of China (grant number: 2021GXNSFAA075026), and the Baise Science and Tech-nology project of Guangxi, China (grant numbers: 20212346 and 20224146). </p> <p> CORRECTED: </p> <p> FUNDING </p> <p> This research was financially supported by the National Natural Science Foundation of China (grant number: 32160034), the Guangxi Natural Science Foundation of China (grant number: 2021GXNSFAA075026), and the Baise Science and Tech-nology project of Guangxi, China (grant numbers: 20212346 and 20224146). The authors apologize for any inconvenience caused.</p>

Cancers remain a major cause of mortality among individuals with HIV infection. This study aimed to determine the incidence, prevalence, and mortality of AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) in people living with HIV (PLWH). This retrospective, cross-sectional study was conducted in Istanbul. Among patients diagnosed with HIV/AIDS between January 2011 and December 2019, those who developed cancer were analyzed. To assess changes in cancer types over time, the study period was divided into three-year intervals. Cancer was diagnosed in 57 (3.9%) of the 1,438 patients. The mean CD4 count was 272.3/mm³. Patients in the cancer group had significantly higher mean age at HIV diagnosis, higher HIV RNA levels, and lower CD4+ T lymphocyte counts. A notably high rate (72%) of simultaneous diagnosis of cancer and HIV was observed in the ADCs group. Kaposi sarcoma was identified in 23 (71.8%) patients, and non-Hodgkin lymphoma (NHL) in 9 patients. Hodgkin lymphoma and lung cancer were the most common cancers in the NADCs group. People living with HIV are experiencing longer life expectancy due to ART; however, this also increases cancer risk, emphasizing the need for national screening guidelines that consider age, gender, and immune status. A multidisciplinary approach is essential for effective prevention and treatment strategies. Since cancer risk is multifactorial, larger prospective and multicenter studies are needed to strengthen and expand these findings. These findings highlight that AIDS-defining cancers continue to be a significant clinical concern in Turkey. Cancer screening should be integrated both at the time of HIV diagnosis and during routine follow-up of PLWH.

While care for people with HIV has significantly improved, opportunistic infections remain a risk for patients. Antiretrovirals can interact with the drugs used to treat opportunistic infections, and care must be taken to minimize these interactions. We completed a narrative review of medications to treat opportunistic infections in people with HIV and antiretrovirals. Here we review the risks of opportunistic infections, most notably hepatitis B, hepatitis C, tuberculosis, cryptococcal meningitis, and pneumocystis pneumonia, in people with HIV, including known and potential interactions between antiretrovirals and the treatments for opportunistic infections, and the mechanisms of these interactions. We also discuss immune reconstitution inflammatory syndrome, an inflammatory response due to immune rebound, which can occur in people treated with antiretrovirals, particularly in patients who have active opportunistic infections. While the risk of IRIS has decreased for many opportunistic infections, it can still occur, particularly in patients who are infected with Cryptococcus neoformans. Treating opportunistic infections in people with HIV requires considerable care and expertise. While advancements in care have simplified treatment for these patients, there is still a considerable risk of interactions between antiretrovirals and opportunistic infections, as well as the drugs used to treat them. Future strategies, including newer agents, regimen simplification, and comprehensive management strategies, can further decrease the risk of interactions between antiretrovirals and opportunistic infection agents, as well as further decrease the risk of IRIS.

Some HIV patients stay in an immune unresponsive state after antiretroviral therapy (ART), with a notably higher risk of AIDS-related and non-AIDS-related complications. Double-negative T cells (DNT) can compensate for immunity and prevent immune overactivation in HIV patients. Also, immune non-responders (INRs) have fewer DNT cells than immune responders (IRs). HIV infection and ART can change the dynamic function of cell mitochondria, which are crucial in ferroptosis. Ferroptosis is a form of cell death marked by the accumulation of reactive oxygen species (ROS) and iron-dependent lipid peroxidation. Yet, the changes in DNT cell function in INRs and the impact of ferroptosis on immune reconstitution remain unclear. Our study focused on the expression level of DNT cells in HIV immune non-responders. Then, we detected markers of ferroptosis, cell activation, proliferation, killing function, and inflammatory states of DNT cells in INRs. The study involved 88 PLHIVs who had received antiretroviral therapy for over 4 years and tested virus-negative. These patients were classified into two groups: 28 INRs (CD4 < 350/μl) and 60 IRs (CD4 ≥350/μl). Additionally, 25 sex- and age-matched HCs were included. Flow cytometry was used to detect ferroptosis markers (JC-1, Lipid ROS, lipid peroxidation), cell proliferation, and cell activation. Transmission electron microscopy (TEM) was applied to observe mitochondrial morphology. Finally, statistical analysis was performed on the detection results. After long-term antiretroviral therapy, we found that INRs had a lower DNT cell count than IRs. Regarding proliferation and activation, our results showed higher CD38/HLA-DR co-expression and Ki67 expression in INRs' DNT cells than in IRs', indicating over-activation of DNT cells in INRs. In terms of killing function, the perforin and granzyme B levels in INRs' DNT cells were lower than those in IRs', suggesting impaired killing function of DNT cells in INRs. For ferroptosis, the proportion of DNT cells with decreased MMP in INRs was higher than in IRs and HCs. INRs' DNT cells also had higher levels of lipid ROS and lipid peroxidation compared to those in IRs and HCs. TEM revealed that the mitochondria of INRs' DNT cells had typical morphological features. Moreover, INRs' DNT cells had a greater degree of inflammation. Our study centered on the proliferation, activation, ferroptosis, killing function, and inflammatory status of DNT cells in INRs. We found that DNT cells in INRs had more active proliferation and activation, weakened killing function, mitochondrial function with typical ferroptosis features, and increased TNF-αlevels. Correlation analysis indicated that DNT cell overactivation (Ki-67+, CD38+HLA-DR+), MMP reduction ratio, and TNF-αexpression were negatively related to immune reconstitution in PLHIVs. In contrast, the killing function (perforin+) of DNT cells was positively related to it. These findings provide a theoretical basis for targeting the functional remodeling of DNT cells. In the future, therapeutic strategies can be explored, such as regulating the mitochondrial metabolic pathway or enhancing the immunoregulatory activity of DNT cells. These strategies can thus offer innovative solutions to the dilemma of immune reconstitution in HIV-infected individuals.

Despite significant advances in HIV antiretroviral treatment, and proven efficacy of HIV prevention options, an effective and affordable HIV vaccine is still necessary for the elimination of HIV, particularly in Africa. Furthermore, viral and host factors unique to the African continent provide a strong scientific rationale for local vaccine discovery efforts. Several key challenges hamper Africa's vaccine research and production capabilities. These include inadequate funding for African-led research, equipment and infrastructure challenges, lack of preclinical evaluation capacity, limited manufacturing facilities for clinical-grade vaccines, and a shortage of scientists with specialized laboratory, bioinformatics and biostatistics training. A recently established African-led consortium seeks to strengthen African HIV vaccine contributions by providing support, training and funding to address these gaps by strengthening discovery research and conducting early phase clinical trials of existing and novel Africa-derived vaccine candidates while strengthening African manufacturing infrastructure and capacity. Constant and robust community and stakeholder engagement will be key to ensuring the success of the consortiums' efforts in providing sustainable vaccine development, manufacturing and clinical testing in Africa. Given the magnitude of the HIV burden in Africa, with largely undescribed viral and host diversity, it is vital that HIV vaccine discovery evolves to include the underutilized scientific expertise and capacity on the African continent. Recent interruptions in the funding of consortia in Africa threaten this type of progress and can derail progress in vaccine discovery.

Peripheral blood lymphocyte subsets have been shown to influence prognosis in HIV-associated Diffuse Large B-Cell Lymphoma (HIV-DLBCL), a rare and highly aggressive form of non-Hodgkin's lymphoma linked to immunosuppression and abnormal B-cell proliferation. To lay the foundation for individualized therapy based on factors such as CD4+/CD8+ ratio and Treg/NK cell characteristics, this retrospective study was conducted to explore the variations in lymphocyte subset levels. Overall, 51 HIV-DLBCL patients, 50 DLBCL patients, and 42 Healthy Donors (HD) were enrolled in the study. Data were extracted from outpatient records and the Hospital Information Management System. SPSS 27.0 software was used for statistical analysis of the data. Significant differences in lymphocyte subsets were observed between groups. HIVDLBCL patients showed decreased CD4⁺ T cell and regulatory T cell (Treg) counts/percentages compared to DLBCL patients and HD, but increased CD8⁺ T cell counts and percentages, as well as Treg percentages. Age-stratified analysis revealed that older HIV-DLBCL patients had lower CD8⁺ T cell counts, reduced CD3⁺ T cell percentages, and elevated CD56⁺CD16⁺ NK cell proportions compared to their younger counterparts. This study revealed a distinct pattern of immune dysregulation in HIV-DLBCL patients, characterized by CD4⁺ T cell depletion and CD8⁺ T cell expansion, which is consistent with previous studies. Age-related immunosenescence may exacerbate the increased proportion of NK cells and the decline in T-cell function, suggesting a poorer prognosis in elderly patients. However, the lack of association between lymphocyte subsets and chemotherapy efficacy may reflect the broad impact of standard regimens on immune reconstitution. Limitations include the small sample size, absence of functional experiments, and failure to assess the influence of coinfections. Future studies should expand the cohort and integrate multi-omics data to validate these findings. Patients with HIV-DLBCL have distinctive alterations in peripheral blood lymphocyte subsets, such as a decreased absolute count and percentage of CD4+ T cells, in comparison to individuals with DLBCL. These alterations appear age-related and showed no significant association with prior antiretroviral therapy. The therapeutic effect of chemotherapy for HIV-DLBCL, however, might not be impacted by the low absolute count and percentage of CD4+ T-cells in peripheral blood, as well as whether or not they had previously received antiretroviral therapy.

"Immunological non-responders" (INRs) are individuals living with HIV who are undergoing Highly Active Antiretroviral Therapy (HAART) but fail to restore their CD4⁺ T-cells count despite effective viral control. The incomplete immune restoration in INRs is often associated with the low-productive proliferation of memory CD4⁺ T lymphocytes. The ability of CD4⁺ T cells to divide is critically dependent on the glycolytic pathway, which supplies the necessary energy and building blocks for cell division. We hypothesize that impaired glycolytic activity in the memory CD4⁺ T cells of INRs contributes to their ineffective proliferation, ultimately limiting immune restoration. This study involved two groups of HIV-infected HAART-treated subjects: INR and Immunological Responders (IR). A third group consisted of healthy controls, comprising uninfected volunteers. To identify the metabolic factors contributing to immunological non-response to therapy, glucose uptake, and lactate production were measured in the memory CD4⁺ T cells from all three groups. INR had the highest activation level in memory CD4+ T cells and the greatest glucose uptake. However, both groups of HIV-infected patients had significantly reduced lactate production compared to the healthy donors. Short-term phytohemagglutinin stimulation provoked an increase in lactate production in memory CD4+ T lymphocytes. Nevertheless, we found significantly reduced lactate production levels in activated memory CD4+ Т cells of INR an IR. In INRs, there is a discrepancy between the highly activated phenotype of memory CD4⁺ T lymphocytes and their glycolytic activity. This reduced glycolysis may explain the lowproductive proliferation of memory CD4⁺ T lymphocytes in INRs.

Tuberculosis (TB), caused by Mycobacterium tuberculosis, often becomes a comorbidity in individuals infected with Human Immunodeficiency Virus (HIV), the cause of Acquired Immunodeficiency Syndrome (AIDS). HIV-positive individuals have a 30- fold higher risk of contracting TB compared to non-HIV individuals. Assessment of HIV-TB disease progression commonly relies on measuring CD4 cell counts. However, in areas with limited access, the World Health Organization (WHO) recommends using Total Lymphocyte Count (TLC) ≤ 1200 cells/μL as an alternative. Additionally, chest X-rays, a widely accessible radiological method, aid in diagnosing TB in HIV-positive patients, complementing TLC in assessing disease progression in limited facilities. The objective of this study was to analyze the differences in the location and characteristics of TB lesions based on HIV status and TLC levels. A case-control study was conducted at Adam Malik Central Hospital on pulmonary TB patients from December 2021 to December 2022, meeting inclusion criteria. Evaluation of TB lesion locations and characteristics was performed by two researchers, while HIV status and TLC data were extracted from medical records. The study involved 154 subjects, including 77 HIV-positive and 77 non-HIV individuals. The percentage of male participants was 81.8%, with a mean age of 43.4 ± 14.4 years. The significant differences in the characteristics and locations of lesions (cavities, miliary lesions, fibrosis, atelectasis, and upper and lower lung) were revealed in HIV-positive and HIV-negative patients. Similarly, significant differences in the characteristics and locations of lesions (cavities, miliary lesions, fibrosis, atelectasis, and upper and lower lung) were revealed in a patient with TLC ≤ 1200 and TLC > 1200. The study highlights significant differences in the characteristics and locations of tuberculosis lesions about HIV status and total lymphocyte count levels among pulmonary TB patients. HIV-positive individuals exhibited distinct patterns of TB lesions compared to their HIV-negative counterparts, indicating the impact of HIV on TB disease progression. Furthermore, variations in lesion characteristics were also observed based on TLC levels, with notable differences between patients with TLC ≤ 1200 cells/μL and those with TLC > 1200 cells/μL. These findings underscore the importance of considering both HIV status and TLC in the assessment and management of TB in affected individuals. TLC can serve as an alternative to CD4 measurement in situations where access to CD4 testing is limited.