AIDS Research and Human Retroviruses

Porphyrins, a class of heterocyclic macrocycles, have garnered significant attention for their potential antiviral properties, particularly against human immunodeficiency virus (HIV). This review explores how porphyrins and their derivatives inhibit HIV replication, focusing on their interactions with key viral components, including reverse transcriptase, protease, and integrase. In addition, the review highlights the role of porphyrins in photodynamic therapy (PDT) as a novel approach to targeting HIV-infected cells. Recent studies have demonstrated that metalloporphyrins, in particular, exhibit enhanced antiviral activity due to their unique structural and electronic properties. Despite promising in vitro and preclinical results, challenges such as cytotoxicity, bioavailability, and resistance mechanisms remain unaddressed. This review provides a comprehensive analysis of the current state of research on porphyrins as anti-HIV agents, emphasizing their potential as a therapeutic strategy and identifying key areas for future investigation. The findings underscore the importance of porphyrins in the ongoing search for effective antiviral therapies against HIV.

People aging with HIV (PAWH) experience greater impairment in physical and pulmonary function than individuals aging without HIV. We examined whether baseline physical function was associated with subsequent pulmonary impairments. Associations of frailty and physical function (gait speed [m/s], grip strength [kg]) with pulmonary function (<80% predicted diffusing capacity for carbon monoxide [DL_CO] and forced expiratory volume [FEV₁]) 3 years later were modeled; age, HIV status, and smoking were assessed as effect modifiers. Among 1,024 men (54% PAWH, 10% frail, 51% prefrail), mean (SD) age = 53 (12) years, cumulative smoking = 12 (19) pack-years, gait speed = 1.1 (0.2) m/s, and grip strength = 36.6 (9.2) kg. Frailty, prefrailty, and weak grip strength were associated with higher odds of subsequent impaired DL_CO and FEV₁. Slow gait speed was associated with higher odds of DL_CO impairment but not FEV₁. No statistically significant modifications were found. Interventions to improve physical function may help preserve pulmonary function.

Long-acting injectable cabotegravir–rilpivirine (LA CAB/RPV) is an antiretroviral option for virologically suppressed people with HIV, but real-world discontinuation and failure patterns remain incompletely described. We retrospectively reviewed 201 adults who received LA CAB/RPV at a large academic infectious diseases clinic (January 2022–April 2025). Median time on therapy was 380 days (IQR 206–729). At the end of follow-up, 160 (80%) remained on LA CAB/RPV and 30 (15%) discontinued, most commonly due to insurance barriers (n = 8, 27%); adherence issues and patient preference each accounted for 23% (n = 7). Virologic failure occurred in 4 patients (2%) and was often accompanied by emergent or pre-existing non-nucleoside reverse transcriptase inhibitor and/or integrase strand transfer inhibitor resistance mutations; all patients achieved resuppression after switching back to oral ART. LA CAB/RPV was generally well tolerated, but system-level access and care-continuity barriers were major drivers of discontinuation, underscoring the importance of robust support systems and resistance-informed patient selection.

Mutation and recombination are key mechanisms in the adaptation, spread, and genetic diversity of human immunodeficiency virus (HIV)-1. We identified two novel unique recombinant forms (URFs) from two persons living with HIV-1, both infected through homosexual contact in Hebei, China. Phylogenetic and recombinant analysis based on the near full-length genome (NFLG) sequences revealed that they originated from CRF01_AE and B. NFLG sequencing revealed complex recombinant patterns in both samples, indicating ongoing recombination and co-infection in men who have sex with men (MSM). The emergence of novel URFs underscores the complexity of the HIV-1 epidemic among MSM and highlights its evolving molecular diversity and epidemiological implications.