Bibliographic record
Abstract
Like a pendulum, the therapeutic recommendations to initiate antiretroviral therapy (ART) have changed over the last two decades. Indeed, initiation of ART has swung from an initial “treat hard and early”, to a CD4 T cell count spanning from 200 to 500 and recently to a “as soon as the patient is ready”. Changes on the optimal timing to initiate ART were based on the following 1) Availability of new ART with increased potency, improved tolerance and reduced pill burden; 2) Evidence that controlled viral replication on ART is associated with a dramatic decrease in HIV transmission; 3) New insights on HIV pathogenesis and on the establishment and maintenance of HIV reservoirs. Recent findings on HIV pathogenesis concerning the relationships between CD4 T cell counts, immune activation, non-infectious clinical events and cancers will be presented. Specifically, the influence of CD4 nadir on the quality of long-term immune reconstitution and viral reservoir persistence following ART initiation will be highlighted. We will also focus on the clinical relevance of maintaining certain CD4 T cell subsets like central memory pool for an optimal cytotoxic HIV-specific and vaccination responses. We will also revisit the tissue and cellular localizations of HIV reservoirs according to the time of treatment initiation. Furthermore, ethical considerations on a “patient-centered medicine” for early ART initiation will be discussed. Particularly, the advantages and inconveniences of a life-long treatment on a patient’s quality of life, drug-resistance development, long-term drug toxicity, cost and observance issues will be presented. The very early ART initiation reveals a new frontier 1) Allowing for some patients an ART-free viral control post-drug discontinuation era 2) Selecting optimal patients harboring a reduced HIV reservoir to be invited to participate in clinical trials aiming to HIV eradication. We are entering in a new era where “Treating early to be able to stop early” will be the focus of our future collaborating research efforts to vividly improve the life of HIV-infected people.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.005 |
| Scholarly communication | 0.008 | 0.012 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.006 | 0.017 |
| Insufficient payload (model declined to judge) | 0.054 | 0.022 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".