BACKGROUND:Depressive disorders are highly prevalent among people living with HIV (PLWH), severely impairing quality of life and antiretroviral therapy (ART) adherence. While ART advances call for reassessing depressive disorders among PLWH prevalence, most studies rely on self-report tools rather than standardized clinical diagnoses. Linked to HIV stigma, low CD4+ T-cell counts, and ART-related side effects, depressive disorders among PLWH requires targeted prevention and intervention strategies. METHODS:An extensive search was conducted across PubMed, Web of Science, and Embase databases up to 30 June 2025 to identify relevant studies. After selecting the appropriate studies that depressive disorders were confirmed through ICD/DSM criteria, a random-effects meta-analysis was performed to estimate the incidence of depressive disorders among PLWH using the event rate. Additionally, we conducted subgroup meta-analyses to explore any discrepancies among different groups. The Joanna Briggs Institute's Quality Assessment Checklist was utilized to evaluate the quality of the included studies. We employed I2 and Q-tests to assess both the magnitude and statistical significance of heterogeneity. RESULTS:The final analysis includes 15 studies with sample sizes ranging from 60 to 124,766. The estimated prevalence of depressive disorders among PLWH was 23.2% (95% CI 14.9-34.2). Significant factors associated with depressive disorders among PLWH were race, alcohol abuse, higher baseline and current CD4+ T-cell count, and longer HIV diagnosis duration (time from HIV diagnosis to depressive disorders diagnosis) (P ≤ 0.001). CONCLUSIONS:Depressive disorders are significantly more prevalent among PLWH than in the general population, with potential associations with race, CD4+ T-cell counts, HIV infection duration, and alcohol misuse.

OBJECTIVES:To report a cluster of two epidemiologically linked construction workers with fulminant necrotizing pneumonia associated with co-infection by Panton-Valentine leukocidin (PVL)-positive methicillin-susceptible Staphylococcus aureus (MSSA) and influenza B virus. METHODS:Clinical characteristics, imaging findings, and microbiological results were retrospectively reviewed. Metagenomic next-generation sequencing (mNGS) was performed on sputum and bronchoalveolar lavage fluid after conventional diagnostic tests failed to identify the causative pathogens. RESULTS:Following shared occupational exposure, both patients developed severe pneumonia. One patient experienced rapid progression and died. For the second patient, mNGS successfully identified co-infection with PVL-positive sequence type 22 MSSA and influenza B virus, prompting a timely shift to targeted antimicrobial therapy that led to survival after prolonged intensive care. CONCLUSION:This report demonstrates the extreme virulence of PVL-positive MSSA-influenza co-infection, highlights the diagnostic value of mNGS in severe treatment-refractory pneumonia, and emphasizes the need for effective respiratory protection in high-risk occupational environments.

Background Despite the widespread implementation of vaccination programs, pertussis continues to spread and remains a major health threat to infants. The present study aimed to identify risk factors of severe pertussis in children to inform clinical decision-making and the development of prevention strategies. Methods This retrospective cohort study included data from paediatric patients diagnosed with pertussis at Beijing You’an Hospital, Capital Medical University (Beijing, China), between January 2006 and December 2023. Multivariable logistic regression was performed to identify independent predictors of severe pertussis, and receiver operating characteristic (ROC) analysis was used to assess discriminative performance. Results Data from 219 children with pertussis were divided in 2 groups according to predefined clinical criteria: severe (n = 21) and non-severe (n = 198). Compared with non-severe cases, severe cases experienced longer hospital stays (median 12 versus [vs.] 8 days) and higher rates of fever, cyanosis, sputum production, and respiratory distress. Marked inflammatory differences were observed, as follows: higher neutrophil counts (median 6.83 vs. 3.65 ×10⁹/L); elevated C-reactive protein (median 3.50 vs. 1.00mg/L); procalcitonin (median 0.12 vs. 0.04ng/mL); increased neutrophil-to-lymphocyte ratio (NLR; median 0.61 vs. 0.29); and a lower lymphocyte percentage (median 56.9% vs. 69.5%) (all p < 0.05). Multivariable analysis identified elevated NLR as an independent predictor of severe pertussis (adjusted odds ratio [OR] 1.884; 95% confidence interval [CI] 1.157–3.066; P = 0.011). ROC curve analysis yielded an area under the curve (AUC) of 0.745 (95% CI 0.640–0.850), with an optimal NLR cut-off of 0.475, yielding a sensitivity of 66.7% and a specificity of 75.5%. Conclusion Elevated NLR was an independent predictor of severe pertussis in children. Future multicentre prospective studies with standardised follow-up periods are warranted to validate these findings.

Mycoplasma pneumoniae pneumonia (MPP) is a highly prevalent form of community-acquired pneumonia (CAP) that can be complicated by severe extrapulmonary manifestations, leading to poor prognosis. The immunopathogenesis of MPP remains incompletely elucidated. This review synthesizes recent advancements, identifying host immune dysfunction and microbial immune evasion as the pivotal dual drivers of MPP immunopathogenesis. We detail how dysregulation of both innate and adaptive immunity—including impaired macrophage function, neutrophil-driven hyperinflammation, paradoxical natural killer (NK) cell activity, and imbalances in T-cell subsets—leads to ineffective pathogen clearance and promotes tissue damage. Concurrently, Mycoplasma pneumoniae perpetuates infection through strategies such as antigenic variation, the expression of an immunoglobulin-binding protein of Mycoplasma (IbpM), and intracellular invasion. Furthermore, we explore the role of autoimmune mechanisms, including molecular mimicry, in mediating extrapulmonary complications. Finally, we highlight the importance of translating these mechanistic insights into targeted immunotherapies and rational vaccine design, which are essential for overcoming current therapeutic limitations and improving clinical outcomes for patients with MPP.

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe complication arising from the co-infection of viral and fungal pathogens in the lungs, with its incidence notably increasing. Although significant progress has been made in elucidating the pathogenesis of CAPA in recent years, the precise pathophysiological mechanisms underlying this condition remain only partially understood. Current evidence indicates that CAPA primarily results from dysregulation of innate antifungal immune responses. Key contributing factors include epithelial barrier dysfunction, impaired phagocytic activity against fungi, aberrant expression of antimicrobial peptides, immunologic tolerance, and lung dysbiosis, all of which collectively weaken host defense mechanisms. Concurrently, excessive pro-inflammatory responses-driven by cytokine storms and oxidative stress associated with antiviral immunity-further exacerbate lung injury in COVID-19 patients, creating a detrimental feedback loop that impairs immune function and heightens susceptibility to CAPA. In this review, we summarize and discuss recent advances in understanding the role of dysregulated innate immunity in the pathogenesis of CAPA. These insights may inform clinical management strategies and improve outcomes for patients suffering CAPA.

Depressive disorders (DD) are more prevalent among people with HIV (PWH) compared to the general population. Research in the general population has confirmed the association between depression and gray matter atrophy as well as reduced cortical thickness. However, there is a lack of neuroimaging studies investigating brain structural changes in PWH with comorbid DD (PWH-DD). This cross-sectional study included 69 HIV-positive men who have sex with men, categorized into PWH-DD (n = 29) and PWH control (n = 40) groups based on the diagnosis of DD. Participants underwent clinical, neuropsychiatric, and MRI evaluations. Voxel-based and surface-based morphometry techniques were applied to analyze gray matter volume (GMV) and cortical anatomical characteristics in structural MRI data. The imaging findings were ultimately correlated with the results of clinical assessments. Compared to participants in the PWH control group, those in the PWH-DD group showed higher scores in evaluation of depression, anxiety, sleep disturbances, childhood trauma, and mental health symptoms, indicating a greater burden of psychological and emotional distress. Comparisons of brain structure showed that participants in the PWH-DD group exhibited lower GMV in the left middle frontal gyrus, shallower sulcal depth in the left supramarginal and bilateral superior parietal regions, and lower fractal dimension in multiple frontal and temporal lobe areas compared to those in the PWH control group. Among all participants, correlation analysis demonstrated that GMV of the left middle frontal gyrus was significantly negatively correlated with Self-Rating Depression Scale scores. This study emphasizes that HIV-positive men who have sex with men with comorbid DD exhibit poorer mental health status and more severe brain structural alterations. However, further longitudinal studies are needed to explore the exact causal relationship between DD and brain structural injury in PWH.

Chronic pulmonary abscess usually results from bacterial or mycobacterium infection, but rarely from aspergillosis. Chronic pulmonary aspergillosis is usually found in a person with structural lung disease or immunocompromise. Here, we report a case of chronic lung abscess of aspergillosis without immunocompromise, structural lung diseases or even clinical symptoms. A 43-year-old female was found a mass shadow with central liquid anechoic area in the apical posterior segment of the left upper lung lobe by chest computerized tomography for 1 month, but had no any systematic or respiratory complaints. The percutaneous abscess puncture was performed and 30 milliliters of yellow purulent fluid were aspirated from the liquid anechoic area. Then Aspergillus terreus was detected by both fluid culture and metagenomics next-generation sequencing. Interestingly, this patient had no history of tuberculosis or chronic pulmonary diseases. Other immunocompromised conditions were also denied through history inquest and laboratory tests. Ultimately, the catheterization and drainage of the lung abscess and 6 months of antifungal therapy with standard dose of voriconazole brought the woman a favorable outcome. Aspergillus lung abscess can occasionally occur in a person without pre-existent lung cavity and immune suppression, which is prone to misdiagnosis because of the rarity and the symptom-free.

An increasing number of treatment guidelines recommend rapid initiation of antiretroviral therapy (ART) after the diagnosis of human immunodeficiency virus (HIV) infection. However, data on the association between rapid ART initiation and alterations in brain structure and function remain limited in people with HIV (PWH). A cross-sectional analysis was conducted on HIV-positive men who have sex with men (MSM) undergoing ART. Fifty-four participants who started ART within 30 days of confirmed HIV diagnosis (rapid ART group) and 20 participants who started ART more than 6 months of confirmed HIV diagnosis (non-rapid ART group) completed clinical assessments and multimodal magnetic resonance imaging scans to obtain both anatomical and resting-state functional images. Compared to PWH in the non-rapid ART group, those in the rapid ART group exhibited a greater total gray matter volume (P = 0.001) and functional changes, including a lower amplitude of low-frequency fluctuations in the left angular gyrus (P < 0.001). Moreover, the results of the main effects and interactions indicated that rapid ART initiation had main effects on major imaging outcomes. The validation analysis results in participants who started ART within 7 days of confirmed HIV diagnosis generally corroborated and complemented the aforementioned findings. Our study demonstrated brain gray matter volume atrophy and functional alterations in PWH of the non-rapid ART group compared to those in the rapid ART group, suggesting that rapid ART initiation may be associated with better brain structure and function changes in HIV-positive MSM.

BackgroundDepressive disorders are highly prevalent among people with HIV (PWH) and are related to aberrant inflammation and immune responses. However, there is currently a lack of investigation into the neurological, inflammatory, endocrine, and immune aspects of HIV-associated depressive disorders (HADD).MethodsThe study involved 33 HIV-positive men who have sex with men with depressive disorders (HADD group) and 47 without neuropsychiatric disorders (HIV control group). Participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans and assessments of peripheral blood. Peripheral blood cytokines, plasma concentrations of hormone and neurotrophic factors, and immune cell levels were determined using liquid chip, enzyme-linked immunosorbent assay, and flow cytometry, respectively. The correlation of imaging alterations with clinical variables and peripheral blood indicators was assessed.ResultsCompared to the HIV control group, the HADD group exhibited a higher fractional amplitude of low-frequency fluctuations in the left superior parietal gyrus, lower regional homogeneity in the left precentral gyrus, and reduced voxel-wise functional connectivity for the seed region in the right precentral gyrus with clusters in the right cuneus, etc. Furthermore, the HADD group had higher levels of interferon-gamma, a higher frequency of non-classical monocytes, and higher expression levels of perforin and CD38 on specific cells. These imaging results were significantly correlated with peripheral blood indicators and clinical variables.ConclusionThis rs-fMRI study provides considerable evidence for abnormal intrinsic brain activity in people with HADD. Furthermore, our data also indicate the detrimental effects of depression-related inflammation on PWH. Therefore, it is imperative to increase attention to HADD and implement effective preventive interventions accordingly.

BackgroundIn the realm of public health, late human immunodeficiency virus (HIV) diagnosis remains prevalent and is associated with neuropsychiatric adverse events. However, there is limited documentation regarding the impact of late HIV diagnosis (LD) on brain integrity, neurotrophic factors, endocrine function, and immunity in HIV-positive men who have sex with men (MSM).MethodsParticipants (38 LD and 34 non-LD of MSM) underwent comprehensive infectious disease and psychiatric assessments, multimodal magnetic resonance imaging (MRI) scans, neurotrophic factors, endocrine, and immunological evaluations. Immune cell levels, along with peripheral plasma concentrations of neurotrophic factors and hormones, were measured using enzyme-linked immunosorbent assays and flow cytometry, respectively. T1-weighted images along with resting-state functional MRI were applied to assess brain function and structure while also examining correlations between imaging alterations and clinical as well as peripheral blood variables. The data for this study originated from a subset of the cohort in HIV-associated neuropsychiatric disorders research.ResultsCompared to participants in the non-LD group, those in the LD group showed a lower total gray matter volume (GMV), with reduced GMV primarily observed in the left supramarginal gyrus. Participants in the LD group exhibited differences in brain function with certain regions and decreased functional connectivity between these altered regions and connected structures. A two-way factorial analysis of variance examining the main effects and interactions between groups and neuropsychiatric disorders revealed significant main effects of LD on specific brain regions. Furthermore, we found that individuals in the LD group had higher levels of cortisol, a lower frequency of central memory T cells, and elevated expression levels of perforin in double-negative T cells. These imaging findings were significantly correlated with endocrine, immune, and clinical variables.ConclusionThis study suggests that LD may contribute to brain injury, endocrine disruption, and immune dysregulation in HIV-positive MSM. Consequently, there is an urgent need to develop public health strategies targeting late diagnosis, with a focus on strengthening screening and early detection for high-risk populations, as well as monitoring brain injury, endocrine, and immune functions in individuals with LD, and formulating precise, individualized intervention strategies to reduce the long-term impact of LD on the health of HIV-positive MSM.

Purpose:Initiating antiretroviral therapy promptly (rapid ART) is linked to better immune recovery in people with HIV (PWH), although its specific effects on immune dysregulation remain partially understood. We have discovered a "pathological proliferation" phenomenon, marked by T cell over-proliferation and exhaustion in PWH, potentially hindering full immune recovery. The objective of this research is to examine how rapid ART affects T-cell pathological proliferation, immune recovery, and systemic inflammation in PWH. Patients and Methods:In this cross-sectional study (conducted at Beijing Youan Hospital, Capital Medical University, China, from April 1 to September 18, 2022), we recruited 39 PWH, including 23 in the rapid ART group (within 30 days) and 16 in the non-rapid ART group (after 180 days). Fasting venous blood samples were collected in the morning. Immune phenotypes of T cells were analyzed using mass cytometry and Luminex. Results:The rapid ART group demonstrated a significant decline in Ki67⁺ CD4⁺ and CD8⁺ T cells. Within this group, a higher percentage of naive T (TN) cells was observed in CD4⁺ T cells, along with a remarkable reduction in Ki67 expression. Additionally, CD8⁺ T cells in the rapid ART group exhibited an increased presence of TN cells while showing a decreased proportion of PD-1/HLA-DR/CD38 high-expressing cells. In addition, the rapid ART group exhibited significantly lower IL-18 levels. TN cells (CD31+ HLA-DR- CD38- CD57- PD-1-) and central memory T (TCM) cells (HLA-DR+ CD38- PD-1- CD57-) that were not suppressed by rapid ART showed significant correlations with baseline CD4 counts, HIV loads, and recent CD4/CD8 ratio. Conclusion:These findings suggest rapid ART may curb pathological T cell proliferation and improved immune recovery in PWH. Despite these benefits, persistent immune activation in some individuals highlights the need for targeted immune monitoring and potential adjunctive interventions to optimize long-term immune health in PWH.

Objective: The lung microbiota of patients with pulmonary diseases is disrupted and impacts the immunity. The microbiological and immune landscape of the lungs in patients with pneumocystis pneumonia (PCP) remains poorly understood. Methods: Multi-omics analysis and machine learning were performed on bronchoalveolar lavage fluid to explore interaction between the lung microbiota and host immunity in PCP. Then we constructed a diagnostic model using differential genes with LASSO regression and validated by qPCR. The immune infiltration analysis was performed to explore the landscape of lung immunity in patients with PCP. Results: Patients with PCP showed a low alpha diversity of lung microbiota, accompanied by the elevated abundance of Firmicutes, and the differential expressed genes (DEGs) analysis displayed a downregulation of MAPK signaling. The MAPK10, TGFB1, and EFNA3 indicated a potential to predict PCP (AUC 1 / 4 0.86). The lung immune landscape in PCP showed the lower levels of na & iuml;ve CD4 & thorn; T cells and activated dendritic cells. The correlation analysis of the MAPK signaling pathway-related DEGs and the differential microorganisms at the level of phylum showed that the Firmicutes was negatively correlated with these DEGs. Conclusion: We profiled the characteristics of lung microbiota and immune landscape in PCP, which may contribute to elucidating the mechanism of PCP. (c) 2024 Institut Pasteur. Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

BackgroundPeople living with HIV (PLWH) fail to achieve normalization of CD4+ T cell counts and function, especially in immunological non-responders (INRs). The frequencies of Ki67+CD4+ T cells were inversely associated with CD4+ T cell counts in HIV infected patients. Early ART did not normalize CD4+ T cell proliferation. However, the features of the abnormal proliferation CD4+ T cell in INRs are far from known.MethodPLWH were divided into INRs (n= 16) and immunological responders (IRs, n= 53) groups. Mass cytometry was applied to peripheral blood T cells to profile the immune cells and liquid chip technique was used to measure plasma levels of cytokines and chemokines. Correlation analyses were conducted to evaluate associations between the degree of CD4+ T cell proliferation and immune function.ResultsThe percentage of Ki67+ CD4+ T cells were significant higher in INRs, and we defined these cells with significant higher level of Ki67, as over-proliferating cells. No significant difference of markers’ expression (HLA-DR, CD38, CD57, PD-1, PD-L1, CD107a, perforin) was found between INRs and IRs. Compared with naïve CD4+ T cells in INRs, Ki67+ CD4+ T cells exhibited lower levels of CD57 and CD38. Whereas Ki67+ T cells exhibited higher levels of CD38 and CD57 and activation compared with differentiated mature central memory CD4+ T cells and effector memory CD4+ T cells. Ki67+ cells did not show higher levels of senescence and activation compared to certain Ki67- CD4+ central memory T cells in IRs. Furthermore, Ki67+ CD4+ Tcm cells exhibited positive correlations with pro-inflammatory cytokines.ConclusionWe proposed and validated the hypothesis of “pathological proliferation” in INRs: excessive proliferation of CD4+ T cells in INRs may be accompanied by aberrant activation, senescence and loss of immune function. Eventually, such over-proliferating but poor-quality cells in INRs result in incomplete recovery of both CD4+ T cell counts and function. An intervention that enhancing the proliferative capacity or functional ability or both of CD4+ T cell in INRs might therefore be beneficial.

Objective:Interstitial lung diseases (ILDs) comprise a heterogeneous group of disorders characterized by inflammation and fibrosis of the pulmonary interstitium, posing significant challenges in identifying their underlying causes. Pneumocystis pneumonia (PCP) is the leading cause of ILD in people living with HIV (PLWH). In individuals with connective tissue diseases, ILD is a frequent complication with significant morbidity and mortality. Methods:A case is presented that details the intricate diagnostic process of rapidly progressive interstitial lung disease (RP-ILD). Results:The patient initially presented with clinical features consistent with ILD, including progressive respiratory symptoms and radiological findings typical of pulmonary inflammation. Coupled with a positive HIV screening result, these findings led to an initial misdiagnosis of PCP, a common opportunistic infection in PLWH. However, despite standard anti-PCP treatment, the patient's condition did not improve, prompting further diagnostic evaluations. Subsequent investigations revealed the presence of serum anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody, a biomarker strongly associated with rapidly progressive ILD in clinically amyopathic dermatomyositis (CADM). Conclusion:This case report offers a novel perspective on the diagnostic process of ILD, particularly emphasizing the importance of distinguishing false-positive antibodies caused by autoimmune diseases in the context of positive HIV screening tests, thereby improving the accuracy of RP-ILD diagnosis and mitigating the mortality burden associated with this condition.

Tuberculous meningitis (TBM) emerges as a grave complication of tuberculosis in people living with HIV (PLWH). The diagnosis and treatment of TBM pose significant challenges, leading to elevated mortality rates. To comprehensively grasp the epidemiological landscape of TBM in PLWH, a systematic review and meta-analysis were meticulously undertaken. We performed a comprehensive search in PubMed, Embase, and Web of Science from database inception to September 19th, 2023, with no limitations on the publication type. The search terms were HIV/AIDS terms (AIDS OR HIV OR PLWH) and TBM-related terms (tuberculous meningitis OR TBM). Studies included in this meta-analysis evaluated the incidence of TBM among PLWH, or we were able to calculate the incidence of TBM among PLWH from the research. The analysis revealed that the prevalence of TBM among PLWH was 13.6

BackgroundPeople living with HIV (PLWH), especially immunological non-responders (INRs), may experience adverse neurologic events. However, the extent of neurological impairment in INRs remains uncertain. This study evaluates brain structure and function, immune dysregulation, and peripheral immunomarkers in INRs and immunological responders (IRs) among PLWH, classified according to immunological response criteria, within a clinical research setting.MethodsThis study utilized multi-modal MRI to assess brain structure and function in INRs (n = 25) and IRs (n = 53). Mass cytometry and Luminex/ELISA assays were employed to analyze peripheral blood monocytes, T cell subpopulations, cytokines, chemokines, neurotrophic factors, and endocrine factors.ResultsNeuroimaging findings revealed notable changes in brain structure and function in INRs, including increased fractional amplitude of low-frequency fluctuations and regional homogeneity in the left middle temporal gyrus, as well as decreased grey matter volume in the left middle temporal gyrus, left lingual gyrus, and right rolandic operculum. Furthermore, INRs exhibited significant alterations in functional connectivity in the temporal and occipital gyrus. Mass cytometry analysis demonstrated significant immune dysregulation in INRs, characterised by increased levels of senescent and activated T cells, and heightened monocyte activation. Additionally, noteworthy associations were found between neurological abnormalities and peripheral levels of immunomarkers, inflammatory cytokines, chemokines, neurotrophic factors, and endocrine factors in INRs.ConclusionThese findings underscore the associations between immune dysfunction and changes in brain structure and function, emphasizing the importance of further investigations in this field.

BackgroundAn estimated 301 million people worldwide suffer from anxiety disorders. People living with HIV/AIDS (PLWHA) are particularly prone to anxiety disorders that could interfere with the important developmental process in an individual’s development and ultimately result in a wide range of negative mental, physical, and psychosocial consequences, as well as poor quality of life in those population groups. Early intervention for anxiety disorders can reverse some of the physical damage caused by anxiety. However, based on systematic reviews and meta-analyses, the specific prevalence of anxiety disorders in PLWHA remains unknown.MethodWe conducted a literature search on PubMed, Embase, and Web of Science up to 22 October 2022. A random-effects meta-analysis was used to pool prevalence rates from the included studies. Sensitivity and subgroup analyses were performed to identify the possible sources of heterogeneity and to compare the prevalence estimates across groups. The Joanna Briggs Institute’s Quality Assessment Checklist was used to assess the quality of the included studies. Cochran’s Q and I2 tests were used to assess the between-study heterogeneity.ResultsTen studies with a total of 238,570 cases were included for the final analysis. Results showed that 15.5% of HIV/AIDS patients had anxiety disorders. The prevalence was higher in females (20.8%) than males (20.7%). The mean age of PLWHA with anxiety disorders was 46.58 ± 11.15 years in these included studies. The subgroup analyses showed significant higher prevalence in non-heterosexual (32.1%).ConclusionWe attempted to quantify literature that could allow for stronger inferences to be made regarding the significantly higher prevalence of anxiety disorders in PLWHA, a finding that suggests the imperativeness of intervention strategies to alleviate suffering and reduce the probable negative ramifications.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442219, identifier CRD42023442219.

Although the widespread use of antiretroviral therapy (ART) has prolonged the life span of people living with HIV (PLWH), the incidence of HIV-associated neurocognitive disorders (HAND) in PLWH is also gradually increasing, seriously affecting the quality of life for PLWH. However, the pathogenesis of HAND has not been elucidated, which leaves HAND without effective treatment. HIV protein transactivator of transcription (Tat), as an important regulatory protein, is crucial in the pathogenesis of HAND, and its mechanism of HAND has received widespread attention. The blood–brain barrier (BBB) and its cellular component brain microvascular endothelial cells (BMVECs) play a necessary role in protecting the central nervous system (CNS), and their damage associated with Tat is a potential therapeutic target of HAND. In this review, we will study the Tat-mediated damage mechanism of the BBB and present multiple lines of evidence related to BMVEC damage caused by Tat.

Tuberculosis (TB) is one of the most common opportunistic infections and is a leading cause of mortality in patients with HIV and AIDS. HIV infection causes serious defects in the host immune system and increases the risk of active TB. TB infection promotes HIV replication and aggravates host damage in patients with HIV/AIDS. Alveolar macrophages (AMs) are essential immune cells during TB and HIV infections. AMs undergo a shift in mitochondrial metabolism during TB or HIV infection, that is, metabolic reprogramming, allowing them to act in the form of classical activated macrophages (M1) and alternative activated macrophages (M2) at different stages of infection. We reviewed the alterations in the mitochondrial energy metabolism of AMs in patients with HIV, TB, and HIV/TB to provide ideas for further research on the role of metabolic reprogramming by AMs in the pathogeneses of HIV, TB, and HIV/TB coinfection.

Background With the measles vaccine coverage rate gradually increasing, adult patients’ epidemiological and clinical characteristics have changed. Aims To analyze the clinical characteristics of adult measles patients in Beijing Youan Hospital. Methods We retrospectively reviewed the electronic medical records of 818 patients diagnosed with measles at Beijing Youan Hospital between June 2010 and October 2021. We divided all hospitalized patients into two demographics groups, using 14 years of age as the cut-off. Results Of the adult inpatients, 110 (74.83%) were aged 20–40. There was an overall peak incidence in 2014, and yearly peaks came in April. Fever, cough, erythema, and Koplik’s spots were present in 79.59%, 82.1%, 99.3%, and 59.8% of the adult group, respectively, compared to 75.26%, 92.0%, 99.9%, and 39.0% of the pediatric group. Decreased lymphocytes and hepatic impairment were common in adults. The adult group’s median level of C-reactive protein was higher than that of the pediatric group (p < 0.05). The positive rate of measles antibody (IgM) detection was 64.6% in the adults and 78.8% in the pediatric group (p < 0.05). Of the adults, 46.9%, 8.8%, and 66% had pneumonia, gastroenteritis, and antibiotic use, compared to 89.6%, 2.7%, and 83.2% of the pediatric patients. The duration of symptoms before admission and the average length of hospital stay was approximately six days in both groups. Conclusions Koplik’s spots are more likely to be detected by clinicians in adult patients admitted to the hospital. Active surveillance is helpful for adults who are negative for IgM on admission. Although the proportion of adult measles patients with liver injury is high, the disease is generally mild. Measles significantly impacts peripheral blood lymphocytes in adults, but adults are at lower risk of concurrent pneumonia than the pediatric group. Clinicians need to pay attention to the appropriate use of antibiotics. Expanding the coverage of the measles vaccination in high-risk areas is beneficial for preventing measles in adults.