Three decades of HIV/AIDS research have brought understanding of and insight into all aspects of the immune pathology, anti-viral immunity, and the diverse manifestations of this disease. With unprecedented speed, antiretrovirals became available that target different steps in the HIV replication cycle, which are now effectively used in combination therapy. Combination antiretroviral therapy also reduces the likelihood of onward HIV transmission, and HIV treatment is a crucial component of HIV prevention, in combination with public health approaches, in particular the promotion of regular HIV testing and safe practices. Despite enormous international collaborative efforts and detailed research into neutralizing antibodies and HIV specific cellular immunity, effective immunotherapy or an efficacious vaccine are not yet available. Major aspects of HIV infection are still not well understood, and much remains to be done to ensure affected people and communities benefit from the knowledge that has accumulated and that drives clinical and public health innovation.
In the past decade, our thinking about HIV pathogenesis has significantly changed, and it is now believed that not the loss of CD4+ T cells through HIV cytopathic infection, but the chronic inflammation that HIV induces, may eventually cause immune deficiency and non-AIDS diseases such as cardiovascular disease and inflammation induced artherosclerosis. However, the virus-host interactions that differ pathologically from non-pathological HIV and SIV are still unknown. Chronic immune activation and inflammation are considered major drivers of the disease, but it is unclear which interactions of HIV with the innate immune system via which receptors are critical. It is suggested that inflammation is also the cause of HIV-associated non-AIDS diseases and, given that even in HAART-controlled HIV infections the risk for non-AIDS disease is high, inflammation may be a therapeutic target in HIV infection. HIV-specific immunity does affect viral load and slows down disease progression, but eventually fails in almost all patients.
Better understanding the pathogenesis of HIV in the host and the dissemination of HIV in the population are both essential to effective control of the epidemic. Research on pathogenesis and public health address two sides of the same coin and underpin the effective control of HIV-associated disease and the spread of HIV in the population. As an innovative collaboration and cross-fertilization between
Frontiers in Immunology and
Frontiers in Public Health, the HIV and AIDS specialty section aims to bring together studies on pathogenesis and on public health aspects. Reflecting this broadened scope, HIV and AIDS wants to publish articles that deal with: 1) the pathogenesis of HIV and SIV infection and those that deal with the molecular origins of its immune activation and regulation; 2) genetics of HIV acquisition and disease; 3) HIV immunity and development of prophylactic vaccines; 4) origins and pathology of HIV associated non-AIDS diseases (for instance CVD and neuropathology) in patients on cART and their potential for immunotherapy; 5) HIV eradication therapy; 6) behavioral, social and structural factors that affect HIV risk and prevention; 7) efficacy and effectiveness of public health and combination HIV prevention approaches; 8) successful engagement with HIV treatment and care.