Secondary Infections in HIV/AIDS: Pathogenic Insights and Treatment Innovations

Secondary infections remain a major—and too often preventable—driver of morbidity and mortality in people living with HIV/AIDS, particularly under advanced immunosuppression where immune dysregulation reshapes susceptibility to bacterial and fungal pathogens. Beyond causing acute illness, opportunistic infections can become chronic, relapse despite therapy, and complicate care through drug–drug interactions, toxicity, and antimicrobial resistance, while inflammatory complications (including immune reconstitution inflammatory syndrome, IRIS) can blur the line between treatment response and clinical deterioration.To advance knowledge on secondary infections, this Research Topic focuses on the pathogenesis, clinical spectrum, and management of high-impact secondary infections in HIV/AIDS. Contributions are encouraged that integrate genomics/transcriptomics, microbiology, and immunopathogenesis to define virulence determinants, resistance and tolerance mechanisms, and within-host adaptation under immune suppression. The collection will also highlight therapeutic strategies, alongside adjunctive clinical frameworks—ART timing, IRIS recognition/management, prophylaxis and screening strategies, and microbiome-informed prevention approaches—to support risk stratification and reduce preventable infectious complications.To gain insights into secondary infections in the setting of HIV/AIDS, we welcome submissions that explore the following areas and beyond.• Immune dysregulation in advanced HIV/AIDS and how it reshapes susceptibility to bacterial vs. fungal opportunistic pathogens• Microbial and host determinants of chronicity and persistence, including biofilm formation, immune evasion, and tissue niche adaptation• Genomic and transcriptomic signatures of virulence associated with severe disease phenotypes and dissemination in immunosuppressed hosts• Emergence and spread of antimicrobial/antifungal resistance (and tolerance)• Drug–drug interactions between anti-infectives and antiretroviral therapy, with implications for exposure and efficacy• Infection mechanisms of opportunistic pathogens in vulnerable patients• Diagnostic approaches that improve early detection, staging, and monitoring (e.g., molecular assays, antigen tests, multi-omics biomarkers) to guide management• Prevention strategies spanning prophylaxis, screening, and microbiome-informed interventions, including implementation considerations in diverse settings Topic editors: Michael S. Price, Nádia Sitoe Source: https://www.frontiersin.org/research-topics/85426/secondary-infections-in-hivaids-pathogenic-insights-and-treatment-innovations