Explore the vast range of titles available.

Introduction Globally, prosecutions for non‐disclosure, exposure or transmission of HIV frequently relate to sexual activity, biting, or spitting. This includes instances in which no harm was intended, HIV transmission did not occur, and HIV transmission was extremely unlikely or not possible. This suggests prosecutions are not always guided by the best available scientific and medical evidence. Discussion Twenty scientists from regions across the world developed this Expert Consensus Statement to address the use of HIV science by the criminal justice system. A detailed analysis of the best available scientific and medical research data on HIV transmission, treatment effectiveness and forensic phylogenetic evidence was performed and described so it may be better understood in criminal law contexts. Description of the possibility of HIV transmission was limited to acts most often at issue in criminal cases. The possibility of HIV transmission during a single, specific act was positioned along a continuum of risk, noting that the possibility of HIV transmission varies according to a range of intersecting factors including viral load, condom use, and other risk reduction practices. Current evidence suggests the possibility of HIV transmission during a single episode of sex, biting or spitting ranges from no possibility to low possibility. Further research considered the positive health impact of modern antiretroviral therapies that have improved the life expectancy of most people living with HIV to a point similar to their HIV‐negative counterparts, transforming HIV infection into a chronic, manageable health condition. Lastly, consideration of the use of scientific evidence in court found that phylogenetic analysis alone cannot prove beyond reasonable doubt that one person infected another although it can be used to exonerate a defendant. Conclusions The application of up‐to‐date scientific evidence in criminal cases has the potential to limit unjust prosecutions and convictions. The authors recommend that caution be exercised when considering prosecution, and encourage governments and those working in legal and judicial systems to pay close attention to the significant advances in HIV science that have occurred over the last three decades to ensure current scientific knowledge informs application of the law in cases related to HIV.

Preventing new HIV infections remains a global challenge. Young women continue to bear a disproportionate burden of infection. Oral pre-exposure prophylaxis (PrEP), offers a novel women-initiated prevention technology and PrEP trials completed to date underscore the importance of their inclusion early in trials evaluating new HIV PrEP technologies. Data from completed topical and systemic PrEP trials highlight the role of gender specific physiological and social factors that impact PrEP uptake, adherence and efficacy. Here we review the past and current developments of HIV-1 prevention options for women with special focus on PrEP considering the diverse factors that can impact PrEP efficacy. Furthermore, we highlight the importance of inclusion of female scientists, clinicians, and community advocates in scientific efforts to further improve HIV prevention strategies.

The isolation of HIV-1 was a fundamental step for understanding HIV and the disease it causes. Here, Françoise Barré-Sinoussi, Anna Laura Ross and Jean-François Delfraissy look back on three decades of research that have changed the lives of people infected with HIV and have inspired hope for a cure. This year marks the thirtieth anniversary of the publication of the study that first reported the isolation of HIV-1. In this Timeline article, we provide a historical perspective of some of the major milestones in HIV science, highlighting how translational research has affected treatment and prevention of HIV. Finally, we discuss some of the current research directions and the scientific challenges ahead, in particular in the search for a cure for HIV.

Background Antiretroviral therapy significantly reduces HIV viral burden and prolongs life, but does not cure HIV infection. The major scientific barrier to a cure is thought to be the persistence of the virus in cellular and/or anatomical reservoirs. Discussion Most efforts to date, including pharmaco, immuno or gene therapy, have failed to cure patients, with the notable exception of a stem cell transplant recipient commonly known as the Berlin patient. This case has revived interest in the potential to cure HIV infection and has highlighted the need to resolve critical questions in the basic, pre-clinical and clinical research spheres as they pertain specifically to efforts to eradicate HIV from the body of an infected person (a sterilizing cure) or at least render the need for lifelong antiretroviral therapy obsolete (functional cure). This paper describes ongoing debates in each of these research spheres as they were presented and discussed at a satellite session that took place at the 6 th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Rome in July 2011. Summary The resolution of these debates may have important implications for the search for a cure, the most efficient ways to identify and test promising interventions, and ultimately the availability of such a cure to diverse groups of HIV patients around the world.

WHO needs to endorse PrEP unambiguously as an HIV prevention option for all populations at substantial risk of HIV infection, including women at risk and people who inject drugs, and issue comprehensive implementation guidance, as the US Centers for Disease Control and Prevention have done for the USA.13 Gilead Sciences and governments should work together to accelerate regulatory approval of tenofovir-emtricitabine as PrEP.

So how far have we come towards finding a cure? And how much further will we need to go? The past year has yielded some encouraging advances, together with a very clear reminder that the challenge of finding a cure for HIV was never easy, and is unlikely to get any easier.

To advance T cell–based HIV vaccine development, it is necessary to evaluate the immune correlates of a protective CD8 + T-cell response. We have developed an assay that assesses the capacity ex vivo of HIV-specific CD8 + T cells to suppress HIV-1 infection of autologous CD4 + T cells. This assay directly reflects the ultimate effector function of CD8 + T cells, the elimination of infected cells, and accurately differentiates the effective CD8 + T-cell response in spontaneous HIV controllers from ineffective responses in other patients. In this article, we describe all the steps from cell purification to assessment of viral replication by HIV-p24 ELISA and analysis, along with conditions for cell culturing, and how to choose the viral infectious dose that gives the most reliable results. We also depict the conditions of a rapid assay on the basis of flow cytometry analysis of intracellular HIV-Gag products. These procedures take 14–17 d when the p24 ELISA assay is used, or 6 d with the intracellular Gag assay.

ARV therapy cannot cure HIV mainly because the virus is able to integrate its DNA into the genomes of long-lived immune cells called memory CD4 T cells, preventing the immune system from recognizing and clearing these cells. The French National Agency for Research on AIDS and Viral Hepatitis provided more than euro7 million (US$8.6 million) last year. Since 2006, the state-funded California Institute of Regenerative Medicine has spent more than $40 million on gene-therapy approaches that would, for example, make cells resistant to HIV infection.

HIV controllers (HICs), rare HIV-1 infected individuals able to control viral replication without antiretroviral therapy, are characterized by an efficient polyfunctional and cytolytic HIV-specific CD8+ T cell response. The mechanisms underlying the induction and maintenance of such response in many HICs despite controlled viremia are not clear. Dendritic cells play a crucial role in the generation and reactivation of T cell responses but scarce information is available on those cells in HICs. We found that monocyte derived dendritic cells (MDDCs) from HICs are less permissive to HIV-1 infection than cells from healthy donors. In contrast MDDCs from HICs are particularly efficient at capturing HIV-1 particles when compared to cells from healthy donors or HIV-1 patients with suppressed viral load on antiretroviral treatment. MDDCs from HICs expressed on their surface high levels of syndecan-3, DC-SIGN and MMR, which could cooperate to facilitate HIV-1 capture. The combination of low susceptibility to HIV-1 infection but enhanced capacity to capture particles might allow MDDCs from HICs to preserve their function from the deleterious effect of infection while facilitating induction of HIV-specific CD8+ T cells by cross-presentation in a context of low viremia.

Between the first analysis of patient samples in early 1983 and the determination of the sequence of HIV-1 in 1985, a vast amount of data was accumulated on HIV through the integrated efforts of clinicians, virologists, immunologists, molecular biologists and epidemiologists. These early years of HIV research quickly led to strategies for the diagnosis, monitoring and treatment of HIV/AIDs