Pediatric HIV Infection and the Medical Management of Pregnant Women infected with HIV. Ernesto Parra, M.D., M.P.H.
|
|
- Shannon Clarke
- 6 years ago
- Views:
Transcription
1 Pediatric HIV Infection and the Medical Management of Pregnant Women infected with HIV Ernesto Parra, M.D., M.P.H. Adjunct Associate Professor UTHSCSA Department of Pediatrics and Family and Community Medicine
2 Learning Objectives Identify the various risk factors associated with HIV perinatal infection List the prophylactic interventions used to prevent transmission of HIV to newborns Understand the diagnostic screening procedure for determining infection among infants born to mothers with HIV Appreciate the therapeutic challenges in treating infants, children, and adolescents infected with HIV
3 Presentation Outline Scope of Problem Pregnancy and Transmission of HIV Treatment of Newborn Exposed to HIV Dx of HIV in Perinatally Exposed Infant Pediatric Treatment Guidelines Immunization Guidelines Adolescents: Special Consideration
4 Children (<15 years) estimated to be living with HIV 2013 North America and Western and Central Europe 2800 Eastern Europe & Central Asia Caribbean Latin America Middle East & North Africa Sub-Saharan Africa 2.9 million Asia and the Pacific Million UNAIDS
5 Estimated number of children (<15 years) newly infected with HIV 2013 North America and Western and Central Europe <500 Eastern Europe & Central Asia <1000 Caribbean <1000 Latin America 1800 Middle East & North Africa 2300 Sub-Saharan Africa Asia and the Pacific Total: UNAIDS
6 Modes of HIV Infection Among Children Intrauterine Birthing (Vaginal or C-Section) Breast Feeding Contaminated Medical Equipment or Therapies Injecting Drug Use Sexual
7 Modes of HIV Infection Among Children Intrauterine Birthing (Vaginal or C-Section) Perinatal Breast Feeding Contaminated Medical Equipment or Therapies Injecting Drug Use Sexual
8 Modes of HIV Infection Among Children Intrauterine Birthing (Vaginal or C-Section) Perinatal Breast Feeding Contaminated Medical Equipment or Therapies Injecting Drug Use Sexual
9 Estimated Numbers of Perinatally Acquired AIDS Cases by Year of Diagnosis, United States and Dependent Areas 1, No. of cases Year of diagnosis
10
11
12 Screening and Care of 93 Patients Seen at FFACTS by Age (Yrs) in Past 2 years Age NB Number
13 Screening and Care of 93 Patients Seen at FFACTS by Age (Yrs) in Past 2 years Age NB Number
14 Screening and Care of 93 Patients Seen at FFACTS by Age (Yrs) in Past 2 years Age NB Number Perinatally exposed infant screened for HIV every 1.4 wks
15 Screening and Care of 93 Patients Seen at FFACTS by Age (Yrs) in Past 2 years Age NB Number Perinatally exposed infant screened for HIV every 1.4 wks 3% of infants screened are positive for HIV
16 Diagnoses of HIV Infection among Adults and Adolescents, by Sex, United States and 6 Dependent Areas Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
17
18
19
20
21 77%
22 Adults and Adolescents Living with Diagnosed HIV Infection Ever Classified as Stage 3 (AIDS), by Sex, United States and 6 Dependent Areas Note. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
23 Rates of Diagnoses of HIV Infection among Adult and Adolescent Females, 2013 United States and 6 Dependent Areas N = 9,479 Total rate = 6.9 Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
24 Increasing Number of Women of Childbearing Age with HIV Infection in U.S. Near-constant number of women newly infected every year Most of newly infected women are of childbearing age Increasing survival of women infected with HIV Overall, increasing number of infected women of childbearing age in U.S.
25 Presentation Outline Scope of Problem Pregnancy and Transmission of HIV Treatment of Newborn Exposed to HIV Dx of HIV in Perinatally Exposed Infant Pediatric Treatment Guidelines Immunization Guidelines Adolescents: Special Consideration
26 Prevention of MTCT In Pregnancy When do you start cart? What cart do you use? What about a C-Section?
27 Worldwide Timing of MTCT of HIV if No Intervention Pregnancy Labor & Delivery Breast Feeding 10-25% 35-40% 35-40% JAMA 2001; 289;
28 Risk Factors for MTCT of HIV High Maternal Viral Load (HIV-RNA) Low Maternal CD4 Cell Count Primary HIV infection in Pregnancy Duration of Rupture of Membranes Mode of Delivery Genital Tract Infections Low Birth Weight Substance Abuse Cigarette Smoking
29 Risk of HIV Perinatal Transmission in U.S. 25% mother-to-child transmission in untreated mother
30 United States Timing of MTCT of HIV if No Intervention 25% Newborns Infected with HIV Pregnancy Labor & Delivery X Breast Feeding
31 Timing of Perinatal Transmission During Pregnancy 1% Risk 33% Risk 66% Risk 1 st Trimester 2 nd Trimester 3 rd Trimester Conception Delivery
32 Of infants born HIV-positive and go untreated: 30% advance to AIDS and die < 5 years 70% advance to AIDS and die in < 10 years
33 Clinical Course of Untreated Infants Born with HIV Infection Birth 2-5 Years 8-10 Years In Utero 34% Labor & Delivery 66%
34 Clinical Course of Untreated Infants Born with HIV Infection In Utero 34% Birth 2-5 Years 8-10 Years VL CD4 Labor & Delivery 66% VL<20 or VL CD4
35 Clinical Course of Untreated Infants Born with HIV Infection In Utero 34% Birth 2-5 Years 8-10 Years VL CD4 Thrush FTT PCP Diarrhea Regressive Milestone AIDS Death Labor & Delivery 66% VL<20 or VL CD4 Clinically Healthy
36 Clinical Course of Untreated Infants Born with HIV Infection In Utero 34% Birth 2-5 Years 8-10 Years VL CD4 Thrush FTT PCP Diarrhea Regressive Milestone AIDS Death Labor & Delivery 66% VL<20 or VL CD4 Clinically Healthy Adenopathy Mulluscum Parotititis Pneumonia Poor Growth AIDS Death
37 Viral Load Primary Independent Predictor of Perinatal Transmission Viral Load c/ml Transmission Risk >100, % 50, , % 10,001-50, % 1,000-10, % <1,000 <1% Garcia PM, et. al, NEJM Mofenson LM, et. al, NEJM
38 Viral Load Primary Independent Predictor of Perinatal Transmission Viral Load c/ml Transmission Risk >100, % 50, , % 10,001-50, % 1,000-10, % <1,000 <1% Garcia PM, et. al, NEJM Mofenson LM, et. al, NEJM
39 When to Start HIV Therapy Among Pregnant Women who are HIV-Positive If Antiretroviral-Naïve: Start cart ASAP + Genotype If Currently on Antiretroviral Therapy Continue cart (even Efavirenz) + Genotype If Previously Received Antiretroviral Therapy Restart cart + Genotype DHHS Guidelines, 2015
40 When to Start HIV Therapy Among Pregnant Women who are HIV-Positive If Antiretroviral-Naïve: Start cart ASAP + Genotype If Currently on Antiretroviral Therapy Continue cart (even Efavirenz) + Genotype If Previously Received Antiretroviral Therapy Restart cart + Genotype Goal: HIV-RNA=undetectable DHHS Guidelines, 2015
41 Prevention of MTCT In Pregnancy When do you start cart? What cart do you use? What about a C-Section?
42 Preferred cart Regimens for ARV-Naïve HIV-infected Pregnant Women NRTI PI NNRTI ISTI ABC/3TC ATV/r EFV after RAL TDF/FTC or 3TC DRV/r 8 weeks ZDV/3TC gestation DHHS Guidelines, 2015
43 Preferred cart Regimens for ARV-Naïve HIV-infected Pregnant Women NRTI PI NNRTI ISTI ABC/3TC ATV/r EFV after RAL TDF/FTC or 3TC DRV/r 8 weeks ZDV/3TC gestation Preferred Combo=Dual NRTI + PI or NNRTI or ISTI DHHS Guidelines, 2015
44 Preferred cart Regimens for ARV-Naïve HIV-infected Pregnant Women NRTI PI NNRTI ISTI ABC/3TC ATV/r EFV after RAL TDF/FTC or 3TC DRV/r 8 weeks ZDV/3TC gestation Preferred Combo=Dual NRTI + PI or NNRTI or ISTI Prefer > 1 NRTI w/ good transplacental penetration DHHS Guidelines, 2015
45 Preferred cart Regimens for ARV-Naïve HIV-infected Pregnant Women NRTI PI NNRTI ISTI ABC/3TC ATV/r EFV after RAL TDF/FTC or 3TC DRV/r 8 weeks ZDV/3TC gestation Preferred Combo=Dual NRTI + PI or NNRTI or ISTI Prefer > 1 NRTI w/ good transplacental penetration Intensification Therapy: DTG?
46 Prevention of MTCT In Pregnancy When do you start cart? What cart do you use? What about a C-Section?
47 Risk of Perinatal HIV Transmission by Method of Delivery and Viral Load PACTG 367 Cohort, 72 US Sites, single or multi-agent, 2875 births Vaginal Cesarean Viral Load Delivery Section No RNA 22.4% 8.3% 10, % 4.1% 1,000-9, % 2.8% <1, % 0.8% Shapiro, CROI, 2004
48 Risk of Perinatal HIV Transmission by Method of Delivery and Viral Load PACTG 367 Cohort, 72 US Sites, single or multi-agent, 2875 births Vaginal Cesarean Viral Load Delivery Section No RNA 22.4% 8.3% 10, % 4.1% 1,000-9, % 2.8% <1, % 0.8% Shapiro, CROI, 2004
49 Presentation Outline Scope of Problem Pregnancy and Transmission of HIV Treatment of Newborn Exposed to HIV Dx of HIV in Perinatally Exposed Infant Pediatric Treatment Guidelines Immunization Guidelines Adolescents: Special Consideration
50 Perinatal ACTG Protocol 076: Timing Intervention Antipartum: >1 st Trimester ZDV PO: 100 mg x 5/day + Intrapartum: Delivery ZDV IV: 1 mg/kg/hr + Postparum: Newborn ZDV PO: 2 mg/kg x 6/day x 6 wks
51 Perinatal ACTG Protocol 076: Timing Intervention Antipartum: >1 st Trimester ZDV PO: 100 mg x 5/day + Intrapartum: Delivery ZDV IV: 1 mg/kg/hr + Postparum: Newborn ZDV PO: 2 mg/kg x 6/day x 6 wks
52 Perinatal ACTG Protocol 076: Timing Intervention Antipartum: >1 st Trimester ZDV PO: 100 mg x 5/day + Intrapartum: Delivery ZDV IV: 1 mg/kg/hr + Postparum: Newborn ZDV PO: 2 mg/kg x 6/day x 6 wks MTCT Rate: 25%
53 Perinatal ACTG Protocol 076: Timing Intervention Antipartum: >1 st Trimester ZDV PO: 100 mg x 5/day + Intrapartum: Delivery ZDV IV: 1 mg/kg/hr + Postparum: Newborn ZDV PO: 2 mg/kg x 6/day x 6 wks MTCT Rate: 25% 8.3%
54 Perinatal ACTG Protocol 076: Timing Intervention Antipartum: >1 st Trimester ZDV PO: 100 mg x 5/day + Intrapartum: Delivery ZDV IV: 1 mg/kg/hr + Postparum: Newborn ZDV PO: 2 mg/kg x 6/day x 6 wks MTCT Rate: 25% 8.3% (68% ) Cooper EM, NEJM 1994
55 Trends in Perinatal Transmission w/antiretroviral Use The Women & Infant Study: Year Intervention MTCT < 1993 No Treatment 20.0% 1994 ZDV only 10.4% 1995 ZDV + NRTI 3.8% > 1996 ZDV + NRTI + PI 1.2% NRTI = Nucleoside Reverse Transcriptase Inhibitor Class, e.g., AZT, DDI, 3TC PI = Protease Inhibitor Class Cooper ER, JAIDS 2002
56 Treatment of Newborns Whose Mother Receive No Antiretroviral Therapy During Pregnancy Intervention MTCT ZDV 6 wk 4.8% ZDV 6 wk + NVP 3 dose 2.2% ZDV 6 wk + NVP 3 dose + 3TC 2 wk 2.4% Nielsen-Saines K, NEJM 2012
57 Treatment of Newborns Whose Mother Receive No Antiretroviral Therapy During Pregnancy Intervention MTCT ZDV 6 wk 4.8% ZDV 6 wk + NVP 3 dose 2.2% (p=0.03) ZDV 6 wk + NVP 3 dose + 3TC 2 wk 2.4% Nielsen-Saines K, NEJM 2012
58 Treatment of Newborns Whose Mother Receive No Antiretroviral Therapy During Pregnancy Intervention MTCT ZDV 6 wk 4.8% ZDV 6 wk + NVP 3 dose 2.2% (p=0.03) ZDV 6 wk + NVP 3 dose + 3TC 2 wk 2.4% Neutropenia (p=0.001) Nielsen-Saines K, NEJM 2012
59 Treatment of Newborn Exposed to HIV Mother HIV-positive Newborn HIV Tx During Pregnancy - ZDV 4 mg/kg/dose/q12 po Start Day 1 x 6 weeks No Tx During Pregnancy - ZDV 4 mg/kg/dose/q12 po Start Day 1 x 6 weeks + - Nevirapine on Days 1, 3, & 6 12 mg daily po if >2 kg wt 8 mg daily po if < 2 kg wt
60 Peripartum Strategies to Prevent MTCT of HIV Pregnancy MOC use of antiretrovirals Labor & Delivery IV ZDV C-Section if MOC VL > 1,000 copies/ml Infant 4 wks ZDV if Mom VL <1,000 6 wks ZDV + NVP x 3, if MOC VL >1,000 or unknown No breast feeding
61 Presentation Outline Scope of Problem Pregnancy and Transmission of HIV Treatment of Newborn Exposed to HIV Dx of HIV in Perinatally Exposed Infant Pediatric Treatment Guidelines Immunization Guidelines Adolescents: Special Consideration
62 Timeline for Diagnosing HIV in Exposed Infant Birth 2 Weeks 2 months 6 months HIV-RNA CBC HIV-RNA CBC HIV-RNA CBC* HIV-RNA DHHS Guidelines 2015
63 Timeline for Diagnosing HIV in Exposed Infant Birth 2 Weeks 2 months 6 months HIV-RNA CBC HIV-RNA CBC HIV-RNA CBC HIV-RNA HIV Negative: 2 or more HIV-RNA<20 One after 1 st month & one after 4 th month, or 2 after 6 months DHHS Guidelines 2015
64 Timeline for Diagnosing HIV in Exposed Infant Birth 2 Weeks 2 months 6 months HIV-RNA CBC HIV-RNA CBC HIV-RNA CBC HIV-RNA HIV Negative: 2 or more HIV-RNA<20 One after 1 st month & one after 4 th month, or 2 after 6 months HIV Positive: 2 or more HIV-RNA >20 On separate sample lab draws DHHS Guidelines 2015
65 Timeline for Diagnosing HIV in Exposed Infant Birth 2 Weeks 2 months 6 months 18 months HIV-RNA CBC HIV-RNA CBC HIV-RNA CBC HIV-RNA HIV Ab- Assay HIV Negative: 2 or more HIV-RNA<20 One after 1 st month & one after 4 th month, or 2 after 6 months HIV Positive: 2 or more HIV-RNA >20 On separate sample lab draws DHHS Guidelines 2015
66 Presentation Outline Scope of Problem Pregnancy and Transmission of HIV Treatment of Newborn Exposed to HIV Dx of HIV in Perinatally Exposed Infant Pediatric Treatment Guidelines Immunization Guidelines Adolescents: Special Consideration
67 Current Antiretroviral Medications NRTI Zidovudine ZDV Lamivudine 3TC Tenofovir TDF Abacavir ABC Emtricitabine FTC Didanosine DDI Stavudine D4T 2 NRTI Combo Pills ZDV/3TC TDF/FTC ABC/3TC ZDV/3TC/ABC NNRTI Efavirenz EFV Etravirine ETR Nevirapine NVP Rilpivirine RPV Delavirdine DLV Protease Inhibitor (PI) Loprinavir LPV Atazanavir ATV Darunavir DRV Fosamprenavir FPV Ritonavir RTV Nelfinavir NFV Tipranavir TPV Saquinavir SQV Amprenavir APV Indinavir IDV Integrase Inhibitor Raltegravir RAL Elvitegravir EVG Dolutegravir DTG CCR5 Antagonist Maraviroc MVC Fusion Inhibitor Enfuvirtide ENF 3 Drug Combo Pills TDF/FTC/EFV TDF/FTC/RPV TDF/FTC/COBI/EVG ABC/3TC/DTG 2 Drug PI Combo Pills LPV/r ATV/COBI DRV/COBI
68 Current Antiretroviral Medications for Age < 6 Years NRTI Zidovudine ZDV Lamivudine 3TC Tenofovir TDF Abacavir ABC Emtricitabine FTC Didanosine DDI Stavudine D4T Protease Inhibitor Loprinavir LPV Atazanavir ATV Darunavir DRV Fosamprenavir FPV Rtionavir RTV Nelfinavir NFV Tipranavir TPV NNRTI Efavirenz EFV Etravirine ETR Nevirapine NVP Fusion Inhibitor Enfuvirtide ENF
69 Age at Which Antriretroviral Agents Can Be Used Birth ZDV 3TC FTC NVP D4T 2 Wks LPV/r DDI 1 Mo FPV/r RTV 3 Mo ABC ATV/r 2 Yr TDF NFV TPV/r RAL 3 Yr EFV DRV/r 6 Yr ETR ENF 12 Yr DTG EVG 18 Yr RPV IDV/r SQV DLV MVC DHHS Guidelines 2015
70 Age and Practical Feasibility At Which Antriretroviral Agents Can Be Used Birth ZDV 3TC FTC NVP D4T 2 Wks LPV/r DDI 1 Mo FPV/r 3 Mo ABC ATV/r 2 Yr TDF NFV 3 Yr EFV 6 Yr ETR 12 Yr DTG EVG DHHS Guidelines 2015
71 Preferred Regimens > Newborn ZDV ZDV DHHS Guidelines 2015
72 Preferred Regimens > Newborn ZDV/3TC ZDV/FTC DHHS Guidelines 2015
73 Preferred Regimens > Newborn ZDV/3TC ZDV/FTC LPV/r DHHS Guidelines 2015
74 Preferred Regimens > Newborn ZDV/3TC ZDV/FTC LPV/r (ABC/3TC)(ABC/FTC) DHHS Guidelines 2015
75 Preferred Regimens > Newborn >3 Years Old ZDV/3TC ZDV/FTC ABC/3TC ABC/FTC LPV/r (ABC/3TC)(ABC/FTC) AZT/3TC AZT/FTC DHHS Guidelines 2015
76 Preferred Regimens > Newborn >3 Years Old ZDV/3TC ZDV/FTC ABC/3TC ABC/FTC LPV/r (ABC/3TC)(ABC/FTC) AZT/3TC EFV AZT/FTC DHHS Guidelines 2015
77 Preferred Regimens > Newborn >3 Years Old >6 Years Old ZDV/3TC ZDV/FTC ABC/3TC ABC/FTC ABC/3TC ABV/FTC LPV/r EFV (ABC/3TC)(ABC/FTC) AZT/3TC AZT/FTC AZT/3TC AZT/FTC DHHS Guidelines 2015
78 Preferred Regimens > Newborn >3 Years Old >6 Years Old ZDV/3TC ZDV/FTC ABC/3TC ABC/FTC ABC/3TC ABV/FTC LPV/r (ABC/3TC)(ABC/FTC) AZT/3TC EFV AZT/FTC AZT/3TC ATV/r AZT/FTC DHHS Guidelines 2015
79 Preferred Regimens > Newborn >3 Years Old >6 Years Old ZDV/3TC ZDV/FTC ABC/3TC ABC/FTC ABC/3TC ABV/FTC LPV/r (ABC/3TC)(ABC/FTC) AZT/3TC EFV AZT/FTC AZT/3TC ATV/r AZT/FTC > 10 Years Old TDF/3TC TDF/FTC LPV/r EFV ATV/r DHHS Guidelines 2015
80 Problems with Agents of Preferred Regimen Palatability (spit up) Tolerability (vomit) Side effects (e.g., diarrhea, sedation w/lpvr) Dosing frequency Limited formulations available Dosing calculations based on TBSA vs. Weight Contraindicated due to young age
81 Therapy Goals (< 3 months) Viral load = Undetectable CD4 cell count Clinical improvement
82 Frequency of Clinic Follow-up Visits Every 3-4 months, if on cart Every 6 months, if VL<20 & CD4, >2 years DHHS Guidelines 2015
83 Presentation Outline Scope of Problem Pregnancy and Transmission of HIV Treatment of Newborn Exposed to HIV Dx of HIV in Perinatally Exposed Infant Pediatric Treatment Guidelines Immunization Guidelines Adolescents: Special Consideration
84 Recommendation for Routine Pediatric Immunizations of Children Infected with HIV At any CD4%; Routine inactivated immunizations are recommended, but more effective when CD4% >15% (CD4 >200) If CD4% <15%; live attenuated vaccines, e.g., MMR and varicella not recommended If CD4% >15%; MMR and varicella can be given Current Opinion in HIV and AIDS, 2007
85 Presentation Outline Scope of Problem Pregnancy and Transmission of HIV Treatment of Newborn Exposed to HIV Dx of HIV in Perinatally Exposed Infant Pediatric Treatment Guidelines Immunization Guidelines Adolescents: Special Consideration
86
87 HIV Among Youth (Age 13-24) U.S. Incidence of HIV 25.7% of people newly infected (1-in-4 are youth) 75% are men having sex with men (MSM) 57% African American, 20% Latino, 20% White U.S. Prevalence of HIV 6.7% of all people living with HIV 59.5% are unaware of their infection MMWR 61(47) 2012
88 Rates of Diagnoses of HIV Infection Among Adolescents Aged Years, 2013 United States and 6 Dependent Areas N = 1,931 Total Rate = 6.5 Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
89 Prevalence of diagnosed HIV Infection Among Adolescents Aged 13 19, Yearend 2012 United States and Dependent Areas N = 7,300 Total Rate = 24.3 Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
90 Risk Factors for HIV Among Adolescents Concerns regarding sexual identity Sexually transmitted infections Substance abuse Sexual abuse Survival sex Lack of housing or homelessness Concerns for safety
91 Barriers to HIV Testing and Care for Adolescents Concrete Thinking Present Orientation Denial Disorganized lifestyle Autonomy and Trust issues Secrecy and Confidentiality Concerns Isolation lack of parental support Funding Transportation Housing
92 Modes of HIV Infection Among Children Intrauterine Birthing (Vaginal or C-Section) Perinatal Breast Feeding Contaminated Medical Equipment or Therapies Injecting Drug Use Sexual
93 Review of Learning Objectives Identify the various risk factors associated with HIV perinatal infection List the prophylactic interventions used to prevent transmission of HIV to newborns Understand the diagnostic screening procedure for determining infection among infants born to mothers with HIV Appreciate the therapeutic challenges in treating infants, children, and adolescents infected with HIV
94 Known HIV Unknown
The use of antiretroviral agents during pregnancy in Canada and compliance with North-American guidelines
The use of antiretroviral agents during pregnancy in Canada and compliance with North-American guidelines I. Boucoiran, T. Lee, K. Tulloch, L. Sauve, L. Samson, J. Brophy, M. Boucher and D. Money For and
More informationPharmacological considerations on the use of ARVs in pregnancy
Pharmacological considerations on the use of ARVs in pregnancy 11 th Residential Course on Clinical Pharmacology of Antiretrovirals Torino, 20-22 January 2016 Prof. David Burger, PharmD, PhD david.burger@radboudumc.nl
More informationART and Prevention: What do we know?
ART and Prevention: What do we know? Biomedical Issues Trip Gulick, MD, MPH Chief, Division of Infectious Diseases Professor of Medicine Weill Cornell Medical College New York City ART for Prevention:
More informationComprehensive Guideline Summary
Comprehensive Guideline Summary Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents AETC NRC Slide Set Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and
More informationHIV in in Women Women
HIV in Women Susan L. Koletar, MD The Ohio State University How Many of These Women Have HIV? Answer: I don t really know Google Search: Photos of Groups of Women Pub Med Search: HIV and Women 22,732
More informationSusan L. Koletar, MD
HIV/AIDS Susan L. Koletar, MD Division Director, Infectious Diseases Professor of Internal Medicine Department of Internal Medicine The Ohio State University Wexner Medical Center HIV through the Decades
More informationI. HIV Epidemiology. HIV Infection A Primer. Objectives. Disclosures 7/18/2014
Objectives HIV Infection A Primer Discuss the worldwide and domestic epidemiology of HIV infection Review HIV Biology Review HIV Transmission and Prevention Review HIV diagnosis Describe the approaches
More informationSelected Issues in HIV Clinical Trials
Selected Issues in HIV Clinical Trials Judith S. Currier, M.D., MSc Professor of Medicine Division of Infectious Diseases University of California, Los Angeles Issues Evolving Global and Domestic Epidemic
More informationHIV/AIDS Prenatal Care for HIV+ Mothers. 1. Algorithm for Prenatal Screening & Care (Antepartum)
1. Algorithm for Prenatal Screening & Care (Antepartum) 2. Algorithm for Prenatal HIV Screening and Care (Mother refuses screening) 3. Algorithm for Intrapartum Care 4. Prenatal Care for HIV+ Mothers a.
More informationSusan L. Koletar, MD
HIV/AIDS Susan L. Koletar, MD Division Director, Infectious Diseases Professor of Internal Medicine Department of Internal Medicine The Ohio State University Wexner Medical Center HIV through the Decades
More informationCriteria for Oral PrEP
Oral PrEP New Drugs Roy M. Gulick, MD, MPH Chief, Division of Infectious Diseases Professor of Medicine Weill Medical College of Cornell University New York City Safe Criteria for Oral PrEP Penetrates
More informationContinuing Education for Pharmacy Technicians
Continuing Education for Pharmacy Technicians HIV/AIDS TREATMENT Michael Denaburg, Pharm.D. Birmingham, AL Objectives: 1. Identify drugs and drug classes currently used in the management of HIV infected
More informationSelected Issues in HIV Clinical Trials
Selected Issues in HIV Clinical Trials Judith S. Currier, M.D., MSc Professor of Medicine Division of Infectious Diseases University of California, Los Angeles Issues Evolving Global and Domestic Epidemic
More informationUpdate on Antiretroviral Treatment for HIV Infection 2008
Update on Antiretroviral Treatment for HIV Infection 2008 Janet Gilmour MD FRCP(C) Clinical Associate Professor of Medicine University of Calgary November 2008 Disclosure and Acknowledgements Disclosure:
More informationPediatric HIV Update NORTHWEST AIDS EDUCATION AND TRAINING CENTER
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Pediatric HIV Update Christian B. Ramers, MD, MPH Assistant Medical Director, Family Health Centers of San Diego HIV/HCV Distance Education Specialist - NWAETC,
More informationHIV Treatment: New and Veteran Drugs Classes
HIV Treatment: New and Veteran Drugs Classes Jonathan M Schapiro, MD National Hemophilia Center Stanford University School of Medicine Rome, March 2013 Overview Many excellent antiretroviral agents are
More informationHIV/AIDS HIV/AIDS: Outline. Morbidity and Mortality Weekly Report (MMWR)
HIV/AIDS: Outline HIV/AIDS 2013 Roy M. Gulick, MD, MPH Professor of Medicine Chief, Division of Infectious Diseases Weill Medical College of Cornell University New York City January 31, 2013 Epidemiology
More informationThe ART of Managing Drug-Drug Interactions in Patients with HIV
The ART of Managing Drug-Drug Interactions in Patients with HIV Bradley L. Smith, Pharm.D. smith.bradley1@mayo.edu Pharmacy Grand Rounds December 19, 2017 2017 MFMER slide-1 Presentation Objectives Describe
More informationPreventing Mother to Child HIV Transmission: Are We There Yet?!'
Preventing Mother to Child HIV Transmission: Are We There Yet?!' 2017 Michigan Clincal Nursing Conference for HIV and STD Care May 18, 2017 Frankenmuth MI 1 Theodore B. Jones, MD Maternal Fetal Medicine
More informationMEDICAL COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 03/07/18 SECTION: DRUGS LAST REVIEW DATE: 02/19/19 LAST CRITERIA REVISION DATE: ARCHIVE DATE:
FUZEON (enfuvirtide) Non-Discrimination Statement and Multi-Language Interpreter Services information are located at the end of this document. Coverage for services, procedures, medical devices and drugs
More informationHIV - Therapy Principles
HIV - Therapy Principles Manuel Battegay and Christine Katlama Basel, Switzerland and Paris, France Disclosure MB has received honoraria for advisory board participation from Gilead, MSD, Pfizer, ViiV
More informationHIV Treatment: State of the Art 2013
HIV Treatment: State of the Art 2013 Daniel R. Kuritzkes, MD Chief, Division of Infectious Diseases Brigham and Women s Hospital Professor of Medicine Harvard Medical School Success of current ART Substantial
More informationHIV Pharmacology 101ish - 202ish: New HIV Clinicians Workshop
HIV Pharmacology 101ish - 202ish: New HIV Clinicians Workshop Parya Saberi, PharmD, MAS The Medical Management of HIV/AIDS December 2012 Objectives What are commonly used ARVs and where do they work in
More informationACTHIV 2018: A State-of-the-Science Conference for Frontline Health Professionals
Initial Therapy for Antiretroviral Naïve HIV Infected Patients Michelle Cespedes, MD, MS Associate Professor of Medicine Division of Infectious Disease Icahn School of Medicine at Mount Sinai Disclosures
More informationWhen to Start ART. Reduction in HIV transmission. ? Reduction in HIV-associated inflammation and associated complications» i.e. CV disease, neuro, etc
When to Start ART Exact CD4 count at which to initiate therapy not known, but evidence points to starting at higher counts Current recommendation: ART for all patients with CD4 count of
More informationOverview of HIV WRAIR- GEIS 'Operational Clinical Infectious Disease' Course
Overview of HIV WRAIR- GEIS 'Operational Clinical Infectious Disease' Course UNCLASSIFIED Acknowledgments - Dr. Christina Polyak - Dr. Julie Ake Disclaimer The views expressed in this presentation are
More informationCOMPREHENSIVE ANTIRETROVIRAL TABLE: ADULT DOSING, DOSAGE FORM MODIFICATIONS, ADVERSE REACTIONS and INTERACTION POTENTIAL
Generic Name COMPREHENSIVE ANTIRETROVIRAL TABLE: NUCLOESIDE/TIDE REVERSE TRANSCRIPTASE INHIBITORS (N(t)RTIs) Abacavir ABC (Ziagen) Didanosine ddi (Videx EC) Emtricitabine FTC (Emtriva) Lamivudine 3TC (Epivir)
More informationSimplifying HIV Treatment Now and in the Future
Simplifying HIV Treatment Now and in the Future David M. Hachey, Pharm.D., AAHIVP Professor Idaho State University Department of Family Medicine Nothing Disclosure 1 Objectives List current first line
More informationSelecting an Initial Antiretroviral Therapy (ART) Regimen
Selecting an Initial Antiretroviral Therapy (ART) Regimen An HIV Diagnosis is a Call to Action In support of the NYSDOH AIDS Institute s January 2018 call to action for patients newly diagnosed with HIV,
More informationHIV Overview. Mary Marovich, MD, DTMH Division of Retrovirology Walter Reed Army Ins?tute of Research US Military HIV Research Program
HIV Overview Mary Marovich, MD, DTMH Division of Retrovirology Walter Reed Army Ins?tute of Research US Military HIV Research Program www.hivresearch.org 1 Outline HIV Virology, Transmission, and Pathogenesis
More informationHistoric Perspective on HIV and TB Research in Pregnant Women
Historic Perspective on HIV and TB Research in Pregnant Women Lynne M. Mofenson, M.D. Senior HIV Technical Advisor Elizabeth Glaser Pediatric AIDS Foundation High Burden of TB/HIV in Women - 2016 TB HIV
More information/AIDS HIV/ HIV Overview. Nelson L. Michael, MD, PhD Division of Retrovirology Walter Reed Army Institute of Research US Military HIV Research Program
/AIDS HIV/ HIV Overview Nelson L. Michael, MD, PhD Division of Retrovirology Walter Reed Army Institute of Research US Military HIV Research Program www.hivresearch.org 1 WRAIR Tropical Medicine Course
More informationHIV for the Non-ID Pharmacist
Disclosures HIV for the Non-ID Pharmacist I have nothing to disclose at this time Carmen Faulkner-Fennell, PharmD, BCPS (AQ-ID) Clinical Pharmacy Specialist--Infectious Diseases Greenville Hospital System
More informationHIV Treatment Update. Awewura Kwara, MD, MPH&TM Associate Professor of Medicine and Infectious Diseases Brown University
HIV Treatment Update Awewura Kwara, MD, MPH&TM Associate Professor of Medicine and Infectious Diseases Brown University Outline Rationale for highly active antiretroviral therapy (HAART) When to start
More information2016 Perinatal Treatment Guidelines Update
Mountain West AIDS Education and Training Center 2016 Perinatal Treatment Guidelines Update Shireesha Dhanireddy, MD Associate Professor of Medicine, University of Washington 2 November 2016 This presentation
More informationSwitching ARV Regimens: Managing Toxicity and Improving Tolerability; Switches & Class-Sparing Approaches
Switching ARV Regimens: Managing Toxicity and Improving Tolerability; Switches & Class-Sparing Approaches Harry W. Lampiris, MD Chief, Infectious Disease Section, San Francisco VA Medical Center Professor
More informationNorthwest AIDS Education and Training Center Educating health care professionals to provide quality HIV care
Northwest AIDS Education and Training Center Educating health care professionals to provide quality HIV care www.nwaetc.org The Northwest AIDS Education and Training Center (NW AETC), located at the University
More informationCOMPREHENSIVE ANTIRETROVIRAL TABLE: ADULT DOSING**, DOSAGE FORM MODIFICATIONS, ADVERSE REACTIONS and INTERACTION POTENTIAL
COMPREHENSIVE ANTIRETROVIRAL TABLE: NUCLOESIDE/TIDE REVERSE TRANSCRIPTASE INHIBITORS (N(t)RTIs) Abacavir ABC (Ziagen) Didanosine ddi (Videx EC) Emtricitabine FTC (Emtriva) Lamivudine 3TC (Epivir) Stavudine
More information0.14 ( 0.053%) UNAIDS 10% (94) ( ) (73-94/6 ) 8,920
0.14 UNAIDS 0.053% 2 250 60 10% 94 73 20 73-94/6 8,920 12 43 Public Health Service Task Force Recommendations 5-10% for Use of Antiretroviral Drugs in 10-20% Pregnant HIV-1-Infected Women for Maternal
More informationThe Global HIV Epidemic. Jerome Larkin, MD
The Global HIV Epidemic Jerome Larkin, MD Outline Global Epidemiology Natural History of HIV Antiretroviral Therapy Malaria Tuberculosis Prevention of Mother to Child Transmission Post-Exposure Prophylaxis
More informationHIV Diagnosis and Management 2015 Update. Faria Farhat, MD MedStar Washington Hospital Center
HIV Diagnosis and Management 2015 Update Faria Farhat, MD MedStar Washington Hospital Center Objectives Describe the epidemiology and pathogenesis of HIV infection Highlight HIV diagnosis algorithm and
More informationSomnuek Sungkanuparph, M.D.
HIV Drug Resistance Somnuek Sungkanuparph, M.D. Associate Professor Division of Infectious Diseases Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Adjunct Professor
More informationOverview of HIV. LTC Paige Waterman
Overview of HIV LTC Paige Waterman Outline Background and Epidemiology HIV Virology, Transmission, and Pathogenesis Acute HIV infection HIV Diagnostics Management of Health Care Personnel Exposed to HIV
More informationPediatric Antiretroviral Resistance Challenges
Pediatric Antiretroviral Resistance Challenges Thanyawee Puthanakit, MD The HIVNAT, Thai Red Cross AIDS research Center The Research Institute for Health Science, Chiang Mai University Outline The burden
More informationThe New Agents: Management of Experienced Patients and Resistance. Joel E. Gallant, MD, MPH Johns Hopkins University School of Medicine
The New Agents: Management of Experienced Patients and Resistance Joel E. Gallant, MD, MPH Johns Hopkins University School of Medicine T.D. 45 year old man with HIV infection diagnosed in 2000 On multiple
More informationSELECTING THE BEST ART FOR EACH PATIENT
SELECTING THE BEST ART FOR EACH PATIENT Corklin R Steinhart, MD, PhD Head, Global Medical Directors ViiV Healthcare CNVX/HIVP/0025/16 5th Asian Conference on Hepatitis & AIDS 第五届亚洲肝炎与艾滋病学术会议 28-29 May
More informationStarting and Switching ART: 2016
Starting and Switching ART: 2016 Luke Jerram Rajesh T. Gandhi, M.D. Massachusetts General Hospital Harvard Medical School Disclosures: grant support from EBSCO, Gilead, Merck, Viiv Thanks to Henry Sunpath,
More informationEmerging Issues in HIV and Pregnancy. Lynne M. Mofenson, MD. HIV Senior Technical Advisor Elizabeth Glaser Pediatric AIDS Foundation
Emerging Issues in HIV and Pregnancy Lynne M. Mofenson, MD HIV Senior Technical Advisor Elizabeth Glaser Pediatric AIDS Foundation Perinatal Transmission in the ART Era What s New? Antepartum ARV drug
More informationAntiretroviral Therapy
Antiretroviral Therapy Scott M. Hammer, M.D. 1986 1990 ZDV monorx 1990 1995 Alternative NRTI monorx Combination NRTI Rx Introduction of NNRTI s Antiretroviral resistance Pathogenetic concepts Evolution
More informationVisit Reason: Positive Pregnancy Test. HIV Treatment in the Childbearing Woman
Visit Reason: Positive Pregnancy Test. HIV Treatment in the Childbearing Woman Thi-Thi Nguyen, PharmD, BCPS, AAHIVP Mountain Plains AIDS Education and Training Center Conference August 13th, 2015 1 Objectives
More informationWhat s New. In The 2016 Perinatal HIV Treatment Guidelines? Provided by CDC s Elimination of Perinatal HIV Transmission Stakeholders Group
What s New In The 2016 Perinatal HIV Treatment Guidelines? Provided by CDC s Elimination of Perinatal HIV Transmission Stakeholders Group Guidelines for our Online Meeting Room You will be listening to
More informationA Fatal Imbalance. Tropical diseases: 18 new drugs (incl. 8 for malaria) 1.3% 21 new drugs for neglected diseases. Tuberculosis: 3 new drugs
ADDRESSING GAPS IN INNOVATION FOR NEGLECTED PATIENTS: DNDI ANDPEDIATRIC HIV/AIDS Rachel Cohen, Regional Executive Director, DNDi North America Proposals for a Global Innovation System that Responds to
More informationDisclosures. Update on HIV Drug Therapy: A Case based Discussion. Case # 1: Dr. Grant has received grant support from BMS, Gilead, Janssen, and Viiv
Disclosures Update on HIV Drug Therapy: A Case based Discussion Dr. Grant has received grant support from BMS, Gilead, Janssen, and Viiv Philip Grant Assistant Professor Division of Infectious Diseases
More informationSasisopin Kiertiburanakul, MD, MHS
What s Newin Antiretroviral Therapy? Sasisopin Kiertiburanakul, MD, MHS Division of Infectious Diseases Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Rotating RCPT,
More informationOptimizing 2 nd and 3 rd Line Antiretroviral Therapy in Children and Adolescents
Optimizing 2 nd and 3 rd Line Antiretroviral Therapy in Children and Adolescents Victor Musiime, MBChB, MMED, PhD Senior Lecturer, Makerere University Investigator, Joint Clinical Research Centre (JCRC)
More informationHuman Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) in the Long Term Care Setting Part 2: HIV Medications
Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) in the Long Term Care Setting Part 2: HIV Medications Carrie Allen PharmD, CGP, BCPS, BCPP, CCHP Overview - Part 2: HIV
More informationEpidemiology Testing Clinical Features Management
Jason Cronin, MD Epidemiology Testing Clinical Features Management In 1981, 1 the first cases of AIDS were identified among gay men in the US. However, scientists later found evidence that the disease
More informationGaps between Policy and Practice in Managing HIV disease in Asia Pacific
Gaps between Policy and Practice in Managing HIV disease in Asia Pacific Dr. N. Kumarasamy Chief Medical Officer YRGCARE Medical Centre Voluntary Health Services Chief-Chennai Antiviral Research and Treatment
More informationDidactic Series. Switching Regimens in the Setting of Virologic Suppression
Didactic Series Switching Regimens in the Setting of Virologic Suppression Craig Ballard, PharmD, AAHIVP UC San Diego Health Owen Clinic June 14 th, 2018 1 Learning Objectives 1) Describe DHHS guidelines
More informationWHAT S NEW IN THE 2015 PERINATAL HIV GUIDELINES?
WHAT S NEW IN THE 2015 PERINATAL HIV GUIDELINES? Today s Webinar will be starting soon For the audio portion of this meeting: Dial 1-855-702-5382 Enter participant code 596-825-4701# Guidelines for online
More informationAntiretroviral Therapy During Pregnancy and Delivery: 2015 Update
Frontier AIDS Education and Training Center Antiretroviral Therapy During Pregnancy and Delivery: 2015 Update Brian R. Wood, MD Assistant Professor of Medicine, University of Washington Medical Director,
More informationSingle Pill Combinations Versus Generics: Prescribing Practices in a New Healthcare Era
Activity Code FM285 Single Pill Combinations Versus Generics: Prescribing Practices in a New Healthcare Era Monica Gandhi MD, MPH Clinic Director, Ward 86 HIV Clinic, SFGH/UCSF Learning Objectives Upon
More informationWhat's new in the WHO ART guidelines How did markets react?
WHO 2013 ARV Guidelines What's new in the WHO ART guidelines How did markets react? Dr. J. Perriëns Coordinator, HIV Technology and Commodities HIV department, WHO, Geneva When to start in adults Starting
More informationARVs on an Empty Stomach: Food Interaction Studies in a resource Limited Setting
ARVs on an Empty Stomach: Food Interaction Studies in a resource Limited Setting Dr. Andrew D Kambugu, FRCP (UK) Infectious Diseases Institute, Makerere University Outline of Discussion Key Definitions
More informationHIV Update Objectives. Epidemiology. Epidemiology, Transmission and Natural History. Transmission Risk by Exposure. Transmission 9/29/2014
Objectives HIV Update 2014 Jay Sizemore, MD, MPH Medical Director Chattanooga CARES Assistant Professor UTCOM Chattanooga 2October 2014 Review HIV epidemiology and screening/testing guidelines Discuss
More informationPAEDIATRIC HIV INFECTION. Dr Ashendri Pillay Paediatric Infectious Diseases Specialist
PAEDIATRIC HIV INFECTION Dr Ashendri Pillay Paediatric Infectious Diseases Specialist Paediatric HIV Infection Epidemiology Immuno-pathogenesis Antiretroviral therapy Transmission Diagnostics Clinical
More informationNobel /03/28. HIV virus and infected CD4+ T cells
Mechanism of HIV drug resistance. Rodrigo Brindeiro / Amilcar Tanuri Laboratório de Virologia Molecular UFRJ 2 -Asso ciate Research Scientist, Internatio nal Center fo r Aids Care and Treatment Programs-ICAP,
More informationCCC ARV Dosing Recommendations for HIV-exposed infants Updated
USERS NOTE: Please note this document does not provide guidance on overall decisionmaking regarding what medication(s) to use for HIV-exposed infants. This document is meant to facilitate ARV dosing for
More informationAddressing Pediatric Needs of the Most Neglected: next steps
Addressing Pediatric Needs of the Most Neglected: next steps An updated overview of DNDi Pediatric Focus Nathalie Strub Wourgaft (Medical Director) Janice Lee (HIV Pediatric Clinical Manager) A Fatal Imbalance
More informationHIV/AIDS Prenatal Care for HIV+ Mothers. 1. Algorithm for Prenatal Screening & Care (Antepartum)
7/10/18 njm 1. Algorithm for Prenatal Screening & Care (Antepartum) 2. Algorithm for Prenatal HIV Screening and Care (Mother refuses screening) 3. Algorithm for Intrapartum Care 4. Prenatal Care for HIV+
More informationDidactic Series. Update: 2012 HIV Treatment Guidelines. Daniel Lee, MD August 30, 2012
Didactic Series Update: 2012 HIV Treatment Guidelines Daniel Lee, MD August 30, 2012 ACCREDITATION STATEMENT: University of California, San Diego School of Medicine is accredited by the Accreditation Council
More informationAntiretroviral Dosing in Renal Impairment
Protease Inhibitors (PIs) Atazanavir Reyataz hard capsules 300 mg once daily taken with ritonavir 100 mg once daily No dosage adjustment is needed for atazanavir in renal impairment Atazanavir use in haemodialysis
More informationHIV Update. Divya Ahuja, MD Associate Professor of Medicine University of South Carolina School of Medicine
HIV Update Divya Ahuja, MD Associate Professor of Medicine University of South Carolina School of Medicine Rates of Diagnoses of HIV Infection among Adults and Adolescents, 2012 United States and 6 Dependent
More informationOverview of HIV. Christina Polyak, MD, MPH. Research Physician. U.S. Military HIV Research Program, Walter Reed Army Institute of Research
Overview of HIV Christina Polyak, MD, MPH Research Physician U.S. Military HIV Research Program, Walter Reed Army Institute of Research The views expressed are those of the authors and should not be construed
More informationPerinatal HIV Exposure: Antiretroviral Management. Danielle McDonald, PharmD PGY-2 Pediatric Pharmacotherapy Resident
Perinatal HIV Exposure: Antiretroviral Management Danielle McDonald, PharmD PGY-2 Pediatric Pharmacotherapy Resident A presentation for HealthTrust Members June 1, 2018 Learning Objectives for Pharmacists
More informationApproach to a Patient Newly Diagnosed with HIV, Including ART Basics Rajesh T. Gandhi, M.D.
Approach to a Patient Newly Diagnosed with HIV, Including ART Basics Rajesh T. Gandhi, M.D. Disclosures: grant support from Gilead, Roche, EBSCO Objectives Apply current guidelines to initial evaluation
More informationANTIRETROVIRAL TREATMENTS (Part 1of
CCR5 CO-RECEPTOR ANTAGONISTS maraviroc (MVC) Selzentry 25mg, 75mg, FUSION INHIBITORS 20mg/mL ANTIRETROVIRAL TREATMENTS (Part 1of 5) oral soln enfuvirtide (ENF, T-20) Fuzeon 90mg/mL pwd for SC inj after
More informationVitamin D Deficiency in HIV: A Shadow on Long-Term Management?
AIDS Rev. 2014;16:59-74 (Supplementary Data) Vitamin D Deficiency in HIV: A Shadow on Long-Term Management? Chloe Orkin, et al.: Vitamin D deficiency in HIV (Supplementary Data) Chloe Orkin 1, David A.
More informationCUMULATIVE PERINATAL HIV EXPOSURE, AUSTRALIA. Date
CUMULATIVE PERINATAL HIV EXPOSURE, AUSTRALIA 350 300 250 Number 200 150 100 50 0 1/01/1997 1/01/1998 1/01/1999 1/01/2000 31/12/2000 31/12/2001 31/12/2002 Date July 2004 Reported number of perinatally exposed
More informationApproach for the Newly Diagnosed HIV Positive Patient
Approach for the Newly Diagnosed HIV Positive Patient Jason E. Farley, PhD, MPH, ANP-BC, FAAN, AACRN Associate Professor & NP, Johns Hopkins University School of Nursing & Medicine Director, AETC Adult-Gerontology
More informationfor Women Living with HIV Infection
Preconception Counseling for Women Living with HIV Infection Introduction Routine incorporation of preconception care and counseling in primary care settings is needed in order to: 1. Prevent unintended
More informationJosep Mallolas Hospital Clínic Barcelona
Nuevos paradigmas en la infección VIH Josep Mallolas Hospital Clínic Barcelona 1. Do you believe, I have to start ARV therapy? Incidence and Mortality of AIDS in Spain HIV and NON-AIDS complications HIV
More informationHIV Testing. HIV Symposium Patient Jane. Outline: 4/13/2010. What are your primary concerns for this patient?
Patient Jane HIV Symposium 2010 Jess Fogler Waldura, MD Mina Matin, MD National HIV AIDS Clinicians Consultation Center San Francisco General Hospital University of California, San Francisco Referral from
More informationAdvances in HIV Treatment: When to Start Treatment Which Antivirals to Use
Advances in HIV Treatment: When to Start Treatment Which Antivirals to Use Calvin Cohen MD Harvard Vanguard Medical Associates CRI New England Vice Chair, Science Steering Cmte, INSIGHT Boston MA Learning
More informationART for HIV Prevention:
ART for HIV Prevention: KENNETH H. MAYER, M.D. Brown University/The Fenway Institute August 22, 2009 APPROACHES TO PREVENT HIV TRANSMISSION DECREASE SOURCE OF INFECTION Barrier Protection Treat STI Antiretroviral
More informationDisclosures. Goals. US DHHS Guidelines: 1 st Line Therapy. Antiretroviral Therapy Initiation:
Disclosures Antiretroviral Therapy Initiation: From Guidelines to Practice: ART 101 Medical Management of AIDS & Hepatitis December 8, 2017 Research grant support from Gilead Sciences for ongoing work
More informationUPDATE ON PEDIATRIC HIV. Roseann Marone MPH, BSN RN Assistant Professor of Pediatrics 9/5/12
UPDATE ON PEDIATRIC HIV Roseann Marone MPH, BSN RN Assistant Professor of Pediatrics 9/5/12 DID YOU KNOW? HIV/AIDS was identified in 1981 31 years this June USA has over 1 million individuals living with
More informationAntiretroviral Drugs
Antiretroviral Drugs Dr Paddy Mallon UCD HIV Molecular Research Group Associate Dean for Research and Innovation UCD School of Medicine and Medical Science paddy.mallon@ucd.ie UCD School of Medicine &
More informationHIV basics. Katya Calvo Medical Director of Antimicrobial Stewardship
HIV basics Katya Calvo Medical Director of Antimicrobial Stewardship Learning Objectives 1. Review of HIV epidemiology worldwide and locally 2. Review of recommendations on whom to screen 3. Work up of
More informationManagement of Treatment-Experienced Patients: New Agents and Rescue Strategies. Joel E. Gallant, MD, MPH Johns Hopkins University School of Medicine
Management of Treatment-Experienced Patients: New Agents and Rescue Strategies Joel E. Gallant, MD, MPH Johns Hopkins University School of Medicine When to Modify Therapy! Studies to date show better responses
More informationHIV and contraception the latest recommendations
1 8-11 June 2015, Chiang-Mai HIV and contraception the latest recommendations Mary Lyn Gaffield, Sharon Phillips, Rachel Baggaley, Petrus Steyn, and Marleen Temmerman 2 Medical eligibility criteria for
More informationHIV Update: What the Hospital-Based Provider Should Know
HIV Update: What the Hospital-Based Provider Should Know Steven C. Johnson M.D. Division of Infectious Diseases, University of Colorado School of Medicine October 6, 2011 45 year old female Case Study
More informationHIV Drugs and the HIV Lifecycle
HIV Drugs and the HIV Lifecycle Together, we can change the course of the HIV epidemic one woman at a time. #onewomanatatime #thewellproject All HIV drugs work by interrupting different steps in HIV's
More informationUsing new ARVs in pregnancy
Using new ARVs in pregnancy Linda-Gail Bekker With thanks to CN Mnyani SA HIV Clinician s Society Meeting 3 June 2017 We have effective drugs. There is no reason why any mother should die of AIDS. There
More informationToo small, too soon: antiretroviral prophylaxis and treatment in preterm and low birth weight infants
Too small, too soon: antiretroviral prophylaxis and treatment in preterm and low birth weight infants Mark Mirochnick, MD Boston University School of Medicine, Boston, MA, USA Full Term Full Term 34 wks
More informationJULUCA (dolutegravir sodium-rilpivirine hydrochloride) oral tablet
JULUCA (dolutegravir sodium-rilpivirine hydrochloride) oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific
More informationDistribution and Effectiveness of Antiretrovirals in the Central Nervous System
Distribution and Effectiveness of Antiretrovirals in the Central Nervous System Scott Letendre, MD Associate Professor of Medicine HIV Neurobehavioral Research Center and Antiviral Research Center University
More informationOverview of HIV WRAIR- GEIS 'Operational Clinical Infectious Disease' Course
Overview of HIV WRAIR- GEIS 'Operational Clinical Infectious Disease' Course The opinions or assertions contained herein are the private views of the author, and are not to be construed as official, or
More informationFriday afternoon Programme
Friday afternoon Programme Pharmacology and TDM Dr Marta Boffito Consultant Physician, C&W Resistance to new anti-retrovirals Dr Steve Taylor Consultant Physician, Birmingham HIVPA Annual Conference 2008
More informationWhen to start, when to switch ART and monitoring of ARV side effects
When to start, when to switch ART and monitoring of ARV side effects Thanomsak Anekthananon, MD Faculty of Medicine Siriraj Hospital September 4, 2009 Recommended Websites Free e-book: HIV Medicine 2007
More information