This narrative review examines the evolving epidemiology of HIV in Pakistan from 1987 to 2026, focusing on temporal trends among key populations, geographic hotspots, emerging pediatric infections, and health-system gaps affecting epidemic control. Evidence indicates a persistent concentrated epidemic, with the highest burden among people who inject drugs and continuing transmission among sex workers, transgender populations, and prisoners. HIV transmission remains geographically heterogeneous, with major urban hotspots in Karachi and cities across Punjab. Recent pediatric outbreaks have introduced an important healthcare-associated dimension, with unsafe medical practices and weaknesses in infection prevention and control emerging as major concerns. Pakistan’s HIV epidemic remains concentrated but is becoming increasingly complex. Persistent transmission among key populations, geographic expansion, pediatric infections, and substantial gaps in diagnosis, treatment, and viral suppression highlight the need for strengthened surveillance, prevention, infection control, and continuity of HIV care.
Despite viral suppression with antiretroviral therapy, people with HIV (PWH) remain at increased risk of neurocognitive impairment, neuroinflammation, and potential viral rebound following therapy interruption. Although the central nervous system (CNS) is a recognised HIV reservoir, it is often not fully considered in cure approaches. HIV DNA and ongoing viral transcription persist in the CNS of ART-suppressed PWH, potentially contributing to neuroinflammation and neurocognitive dysfunction. HIV cure strategies, including latency-reversing/promoting agents, broadly neutralising antibodies and other approaches have varying degrees of CNS penetration, efficacy and potential neurotoxicity. Therefore, interventions aimed at silencing or eradicating HIV reservoirs require monitoring of both reservoir-targeting efficacy and neurological adverse effects. Greater consideration of CNS penetration, efficacy in targeting CNS reservoirs, and neurotoxicity is required in HIV cure studies. Developing CNS-inclusive strategies that minimise adverse neurological effects may be an important step in achieving HIV cure.
This review aims to present the current status of the HIV epidemic in Türkiye, to identify the barriers to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95–95–95 targets, and to propose strategies to overcome these challenges. In Türkiye, HIV-related diagnostic and treatment services are integrated into the general health insurance system, and most contemporary antiretroviral therapy (ART) are available.Treatment initiation and virological suppression rates that approach international targets. However, challenges remain in early diagnosis and prevention, particularly among key populations. Recent epidemiological data also indicate a marked increase in HIV diagnosesamong women and young people while stigma, discrimination, limited access to testing, and low awareness among both the public and healthcare professionals continue to hinder progress. Controlling the HIV epidemic in Türkiye requires strengthening early diagnosis, ensuring equitable access to ART, expanding prevention strategies such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and implementing multisectoral approaches to reduce stigma and discrimination. Coordinated actions among policymakers, healthcare providers, and community stakeholders will be critical for achieving national and global HIV targets. The number of HIV cases in Türkiye is increasing, with a notable rise among women and young people. According to ECDC 2024 data, Türkiye and Poland together reported 70
This review summarizes the epidemiology of Cytomegalovirus infections in children exposed to or infected with HIV and the impact of CMV infection on overall health outcomes in this population. CMV infections and cCMV remain a significant burden in HIV exposed and HIV infected children requiring close long-term follow-up. While CMV disease occurs rarely in HIV-infected individuals in the ART-era, the complex interplay between CMV and HIV could have a major impact on childhood health outcomes in HIV-infected and exposed children. Congenital CMV infection (cCMV) is well recognized as the most common congenital viral infection and the leading cause of sensorineural hearing loss (SNHL). CMV-HIV co-infections have been shown to increase the incidence of cCMV, but effect on long-term outcomes remains largely undetermined at this time.
