Page 1. Outline. Outline. Building specialized knowledge: HIV. Biological interactions. Social aspects of the epidemic. Programmatic actions
|
|
|
- Elizabeth Walsh
- 5 years ago
- Views:
Transcription
1 Harvard-Brazil Collaborative Public Health Field Course January 2014 Lecture # 8 Building specialized knowledge: HIV Aluisio Segurado Department of Infectious Diseases School of Medicine, University of São Paulo Outline Biological interactions Social aspects of the epidemic Programmatic actions Current challenges Outline Biological interactions Social aspects of the epidemic Programmatic actions Current challenges Page 1
2 Retroviruses MIP-1 MIP-1 M-tropic HIV isolate (R5) T-tropic HIV isolate (X4) RANTES CCR2 CD4 CCR5 CD4 CXCR4 SDF1 Macrophage CD4+ T cell Cytotropism Page 2
3 HIV transmission SEXUAL BLOOD-BORNE VERTICAL - intrauterum - birth - breast feeding HIV genital shedding - associated factors - higher HIV plasma viral load acute infection more advanced clinical status cervicitis/ urethritis HIV genital acquisition Hu J, 2000; Deeks S, 2011; Moir S, 2011 Page 3
4 Immune response in HIV acute infection viral setpoint HIV infection - Natural history Moir S, 2011 Early signs and symptoms of HIV disease -Prolonged fever -Weight loss - Chronic diarrhea Page 4
5 Pneumocystis pneumonia Tuberculosis Cytomegalovirus retinitis Page 5
6 HIV and cancer Outline Biological interactions Social aspects of the epidemic Programmatic actions Current challenges CUMULATIVE GLOBAL ESTIMATE (Dec 2012) People living with HIV New HIV infections (2011) AIDS deaths (2011) Cumulative AIDS deaths 35.3 million 2.3 million 1.6 million 43.9 million UNAIDS, 2013 Page 6
7 ADULTS AND CHILDREN LIVING WITH HIV (Dec estimate) 1,300, ,000 1,500, ,000 1,300, , ,000 3,900,000 25,000,000 51,000 UNAIDS, 2013 HIV/AIDS IN BRAZIL (Nov estimate) 718,000 people living with HIV 686,478 AIDS cases Dept. STD/AIDS/VH, Min. Health, 2013 < 1% general > 5% > 1 populational subgoup HIV/AIDS IN BRAZIL (Nov estimate) concentrated epidemic HIV prevalence = 0.4% (15 49) 0.31% 0.52% Dept. STD/AIDS/VH, Min. Health, 2013 UNAIDS, 2013 Page 7
8 HIV PREVALENCE AMONG MSM - BRAZIL Malta et al. BMC Public Health 2010, 10:317 HIV PREVALENCE AMONG COMMERCIAL SEX WORKERS - BRAZIL. Malta et al. BMC Public Health 2010, 10:317 HIV PREVALENCE AMONG IDU - BRAZIL. Malta et al. BMC Public Health 2010, 10:317 Page 8
9 Outline Biological interactions Social aspects of the epidemic Programmatic actions Current challenges Programatic actions Primary prevention safer sex harm reduction interventions prevention of mother-to-child transmission Brazilian National ART Program universal access to medication distributed free of charge - SUS launched in 1991 zidovudine (AZT) progressively incorporated new ARVs combined therapy (HAART) local production of generic ARVs 2008 compulsory license - efavirenz 2013 test and treat strategy Page 9
10 Antiretroviral therapy Reverse transcriptase inhibitors nucleoside/nucleotide analogues: AZT, 3TC, ddi, abacavir, tenofovir non-nucleoside analogues: nevirapine, efavirenz, etravirine Protease inhibitors - saquinavir, ritonavir, lopinavir, fosamprenavir, atazanavir, darunavir Fusion inhibitors - enfuvirtide, maraviroc Integrase inhibitors: raltegravir Virological and immunological outcomes of successful ART supression of blood viral replication undetectable viremia immune restoration reduction/supression of viral replication in tissues - CNS, genital tract, others remarkable reduction in HIV genital shedding Brazilian response to HIV/AIDS - main peculiar features - historical momentum legal foundations Brazilian Constitution 1988 health a right of citizens and a duty of the State SUS basic principles Berkman, 2005 Page 10
11 Brazilian response to HIV/AIDS - main peculiar features - historical momentum legal foundations combined interventions in prevention and care HIV testing and counseling Promoting condom use Page 11
12 Care responses Health service and laboratory networks Reference hospitals Day hospitals Outpatient clinics ART distribution units Labs CD4 cell counts, HIV viral loads, HIV genotyping Brazilian response to HIV/AIDS - main peculiar features - historical momentum legal issues prevention and care interventions governmental commitment Brazilian response to HIV/AIDS - main peculiar features - historical momentum legal issues prevention and care interventions governmental commitment strong civil society involvement (NGOs and private sector) Berkman, 2005; Nunn, 2012 Page 12
13 Brazilian response to HIV/AIDS - main peculiar features - historical momentum legal issues prevention and care interventions government/civil society commitment human rights perspective Page 13
14 Brazilian HIV epidemic - trends territorial spread Brazilian HIV epidemic - trends territorial spread changes in the proportional distribution of different exposure categories Page 14
15 Distribution of AIDS cases in men aged 13 and over, according to exposure categories and year of diagnosis. Brazil, * Dept. STD/AIDS/VH, Min. Health, 2011 Brazilian HIV epidemic - trends territorial spread changes in the proportional distribution of different exposure categories male-female ratios AIDS male-female ratios, Brazil Male-female ratios in AIDS cases according to year of diagnosis, Brazil, Male-female ratios in AIDS cases in individuals aged 13-19, according to year of diagnosis, Brazil, ,0 15,1 Razão de sexo (M:F) 14,0 12,0 10,0 8,0 6,0 4,0 2,0 0, ,5 6 5,4 4,7 3,9 3,5 3,2 2,7 2,4 2,1 1,9 1,8 1,7 1,6 1,5 1,5 1,5 1,5 1,5 1,5 1, Ano de diagnóstico Razão de sexo (M:F) 7,0 6,1 6,4 6,0 5,0 4,6 4,3 4 4,0 3,1 3,0 2,4 2,2 1,9 2,0 1,5 1,2 1 0,8 0,7 0,6 0,6 0,7 0,7 0,6 0,6 0,6 0,7 0,8 1,0 0, Ano de diagnóstico Dept. STD/AIDS/VH, Min. Health, 2010 Page 15
16 AIDS male-female ratios, Brazil Dept. STD/AIDS/VH, Min. Health, 2013 Clinical outcomes Reduced morbidity incidence of opportunistic infections Dept. STD/AIDS/VH, Min. Health, 2005 Clinical outcomes Reduced morbidity progression to AIDS hospital admissions day hospital use Page 16
17 Clinical outcomes Reduced mortality (AIDS-related deaths) RJ Grinsztejn B, 2013 MDGs and HIV/AIDS UNAIDS, 2013 Global HIV epidemic - trends UNAIDS, 2013 Page 17
18 Global HIV epidemic - trends UNAIDS, 2013 Global HIV epidemic - trends UNAIDS strategy Page 18
19 Outline Biological interactions Social aspects of the epidemic Programmatic actions Current challenges Current challenges - 1 regional discrepancies local epidemics late diagnosis uptake and retention in care Global new HIV infections Page 19
20 AIDS incidence in Brazil (Dec estimate) Dept. STD/AIDS/VH, Min. Health, 2013 AIDS incidence in Brazil Dept. STD/AIDS/VH, Min. Health, 2013 AIDS incidence in Brazil (aged 15-24) Dept. STD/AIDS/VH, Min. Health, 2013 Page 20
21 AIDS mortality in Brazil Dept. STD/AIDS/VH, Min. Health, 2013 Global AIDS-related deaths Late entry into HIV care Grangeiro A, 2011 Page 21
22 HIV/AIDS care cascade - Brazil Dept. STD/AIDS/VH, Min. Health, 2013 HIV/AIDS care cascade sub-saharan Africa UNAIDS, 2013 Current challenges - 2 ART sustainability highly vulnerable populations adherence to ART Page 22
23 Number of people on ART Dept. STD/AIDS/VH, Min. Health, 2013 Number of people on ART Current challenges - 3 coinfections HCV, HPV comorbidities mental health HIV drug resistance chronic AIDS lypodistrophy, cardiovascular risk Page 23
24 Outcomes of chronic ART Deeks S, 2011 Current challenges - 4 Stigma and discrimination need to address more vulnerable populations targeted prevention and care initiatives need to face structural dimensions of vulnerabiliy to HIV acquisition and disease development recent retrenchment in human rights-based response in Brazil Malta C, 2013; Reis RK, 2013 HIV stigma and discrimination UNAIDS, 2013 Page 24
25 Important strategies scaling up HIV testing scaling up early ART test and treat use of combined HIV prevention technologies behavioral, structural and biomedical approaches integrating HIV care and other health care programs STD detection and treatment Microbicides Cervical barriers vaginal diaphragms HIV testing and counseling PREVENTION OF HIV SEXUAL TRANSMISSION Male voluntary circumcision Immunization HIV vaccine HSV-2 therapy ART prophylaxis PEP PrEP TaP HIV integration Tuberculosis care Sexual and reproductive health care Primary care Antenatal and child care Non-communicable diseases Page 25
26 Page 26
Current challenges in HIV care from a Brazilian cohort perspective
Current challenges in HIV care from a Brazilian cohort perspective Aluisio Segurado Department of Infectious Diseases School of Medicine, University of São Paulo Outline Current features of the Brazilian
ART 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:
HIV 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
POST-EXPOSURE PROPHYLAXIS, PRE-EXPOSURE PROPHYLAXIS, & TREATMENT OF HIV
POST-EXPOSURE PROPHYLAXIS, PRE-EXPOSURE PROPHYLAXIS, & TREATMENT OF HIV DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none
HIV 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
TB Intensive Tyler, Texas December 2-4, Tuberculosis and HIV Co-Infection. Lisa Y. Armitige, MD, PhD. December 4, 2008.
TB Intensive Tyler, Texas December 2-4, 2008 Tuberculosis and HIV Co-Infection Lisa Y. Armitige, MD, Ph.D. December 4, 2008 Tuberculosis and HIV Co Infection Lisa Y. Armitige, MD, PhD Assistant Professor
TB/HIV Co-Infection. Tuberculosis and HIV
TB Intensive Tyler, Texas June 2-4, 2010 TB/HIV Co-Infection Lisa Y Armitige, MD, PhD June 3, 2010 Tuberculosis and HIV Co-Infection Lisa Y Armitige, MD, PhD Medical Consultant Heartland National TB Center
I. 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
PAEDIATRIC 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
Program to control HIV/AIDS
90-90-90 Program to control HIV/AIDS Hamid Sharifi Associate Professor in Epidemiology [sharifihami@gmail.com] 1 Targets for ending the AIDS epidemic 2 New HIV infections in low- and middle-income countries,
Multiple choice questions: ANSWERS
Multiple choice questions: ANSWERS Chapter 1. Diagnosis and promotion of serostatus awareness in sub-saharan Africa 1. Antiretroviral therapy reduces HIV transmission from a HIV- positive person to a susceptible
TORONTO GENERAL HOSPITAL HIV AMBULATORY CARE ROTATION
TGH - ambulatory rotation page 1 of 5 TORONTO GENERAL HOSPITAL HIV AMBULATORY CARE ROTATION SITE: Immunodeficiency Clinic, Toronto General Hospital, University Health Network Location: 13 th floor, Norman
GLOBAL AIDS MONITORING REPORT
KINGDOM OF SAUDI ARABIA MINISTRY OF HEALTH GLOBAL AIDS MONITORING REPORT COUNTRY PROGRESS REPORT 2017 KINGDOM OF SAUDI ARABIA Submission date: March 29, 2018 1 Overview The Global AIDS Monitoring 2017
ART 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
Continuing 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
PHCP 403 by L. K. Sarki
PHCP 403 by L. K. Sarki objectives To gain insight into the epidemiology of HIV To gain basic understanding of the etiology of HIV disease To know the clinical manifestations of the disease To gain a basic
World Health Organization. A Sustainable Health Sector
World Health Organization A Sustainable Health Sector Response to HIV Global Health Sector Strategy for HIV/AIDS 2011-2015 (DRAFT OUTLINE FOR CONSULTATION) Version 2.1 15 July 2010 15 July 2010 1 GLOBAL
Nothing to disclose.
Lisa G. Winston, MD University of California, San Francisco San Francisco General Hospital HIV UPDATE FOR THE PRIMARY CARE PROVIDER Nothing to disclose. 1 Outline Epidemiology Screening / testing for HIV
Principles of Antiretroviral Therapy
Principles of Antiretroviral Therapy Ten Principles of Antiretroviral Therapy Skills Building Workshop: Clinical Management of HIV Infection and Antiretroviral Therapy, 11 th ICAAP, November 21st, 2011,
Linkages between Sexual and Reproductive Health and HIV
Linkages between Sexual and Reproductive Health and HIV Manjula Lusti-Narasimhan Department of Reproductive Health and Research World Health Organization The HIV pandemic 25 years 1981 2006 Rationale for
Overview 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
Overview 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
An HIV Update Jan Clark, PharmD Specialty Practice Pharmacist
An HIV Update - 2019 Jan Clark, PharmD Specialty Practice Pharmacist 2 The goal of this program is to provide a review and update of HIV care and to provide a forum for discussing the current local and
Selected 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
0% 0% 0% Parasite. 2. RNA-virus. RNA-virus
HIV/AIDS and Treatment Manado, Indonesia 16 november HIV [e] EDUCATION HIV is a 1. DNA-virus 2. RNA-virus 3. Parasite 0% 0% 0% DNA-virus RNA-virus Parasite HIV HIV is a RNA-virus. HIV is an RNA virus which
Improving accessibility to antiretroviral drugs: A south-south collaboration
Improving accessibility to antiretroviral drugs: A south-south collaboration Jaideep A Gogtay MD Cipla Ltd Mumbai jgogtay@cipla.com Adults and children estimated to be living with HIV at the end of 2000
Selected 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
DNA Genotyping in HIV Infection
Frontier AIDS Education and Training Center DNA Genotyping in HIV Infection Steven C. Johnson M.D. Director, University of Colorado HIV/AIDS Clinical Program; Professor of Medicine, Division of Infectious
Contraception for Women and Couples with HIV. Knowledge Test
Contraception for Women and Couples with HIV Knowledge Test Instructions: For each question below, check/tick all responses that apply. 1. Which statements accurately describe the impact of HIV/AIDS in
HIV medications HIV medication and schedule plan
Living with HIV (human immunodeficiency virus) It may be scary to find out that you re HIV-positive or have AIDS. Coping with this news may be difficult. Although HIV is a serious infection, people with
Malaysian Consensus Guidelines on Antiretroviral Therapy Cheng Joo Thye Hospital Raja Permaisuri Bainun Ipoh
Malaysian Consensus Guidelines on Antiretroviral Therapy 2017 Cheng Joo Thye Hospital Raja Permaisuri Bainun Ipoh Acknowledgement Table of contents Evolution of when to initiate therapy ART improves survival
HIV in the Brain MANAGING COMORBIDITIES IN PATIENTS WITH HIV
HIV in the Brain MANAGING COMORBIDITIES IN PATIENTS WITH HIV Shibani S. Mukerji MD, PhD Massachusetts General Hospital, Division of Immunologic, Inflammatory and Infectious Neurological Diseases Dana-Farber
Central Nervous System Penetration of ARVs: Does it Matter?
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Central Nervous System Penetration of ARVs: Does it Matter? Christina M. Marra, MD Neurology and Medicine (Infectious Diseases) University of Washington 15
This graph displays the natural history of the HIV disease. During acute infection there is high levels of HIV RNA in plasma, and CD4 s counts
1 2 This graph displays the natural history of the HIV disease. During acute infection there is high levels of HIV RNA in plasma, and CD4 s counts decreased. This period of acute infection or serocnversion
HIV 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
HIV PREVENTION, DIAGNOSIS, TREATMENT AND CARE FOR KEY POPULATIONS
POLICY BRIEF HIV PREVENTION, DIAGNOSIS, TREATMENT AND CARE FOR KEY POPULATIONS CONSOLIDATED GUIDELINES JULY 2014 Policy brief: Consolidated guidelines on HIV prevention, diagnosis, treatment and care for
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
Antiretroviral 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,
British HIV Association Guidelines for the Management of Hepatitis Viruses in Adults Infected with HIV 2013 Appendix 2
British HIV Association Guidelines for the Management of Hepatitis Viruses in Adults Infected with HIV 2013 Appendix 2 Systematic literature search 2.1 Questions and PICO criteria Data bases: Medline,
Elimination of mother to child transmission of HIV: is the end really in sight? Lisa L. Abuogi, MD University of Colorado, Denver Dec 3, 2014
Elimination of mother to child transmission of HIV: is the end really in sight? Lisa L. Abuogi, MD University of Colorado, Denver Dec 3, 2014 Outline Background History of prevention of mother to child
NON-OCCUPATIONAL POST EXPOSURE PROPHYLAXIS IN HIV PREVENTION. Jason E. Vercher, PA-C, AAHIVM
NON-OCCUPATIONAL POST EXPOSURE PROPHYLAXIS IN HIV PREVENTION Jason E. Vercher, PA-C, AAHIVM Disclosures No disclosures to report Learning Objectives q Identify Individuals who would benefit from non-occupational
treatment during pregnancy and breastfeeding
treatment during pregnancy and breastfeeding Topics covered Introduction. Preventing parent-to-child transmission. AZT as a single therapy. Treatment begun late in pregnancy. Nevirapine for mothers and
Overview 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
HIV 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
THE HIV LIFE CYCLE. Understanding How Antiretroviral Medications Work
THE HIV LIFE CYCLE Understanding How Antiretroviral Medications Work DEFINITIONS Host: The animal or cell that another organism lives in. In HIV human CD4 T-cells are the host for HIV. Nucleus: The core
Simplifying 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
ART for prevention the task ahead
ART for prevention the task ahead Dr Teguest Guerma WHO/HQS WHO's role and vision Status of the epidemic Overview Progress and challenges in treatment and prevention scale up ART for prevention Questions
Pediatric HIV Infection and the Medical Management of Pregnant Women infected with HIV. Ernesto Parra, M.D., M.P.H.
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
Management of patients with antiretroviral treatment failure: guidelines comparison
The editorial staff Management of patients with antiretroviral treatment failure: guidelines comparison A change of therapy should be considered for patients if they experience sustained rebound in viral
Government of Canada Federal AIDS Initiative Milestones
HIV in Canada: Trends and Issues for Advancing Prevention, Care, Treatment and Support Through Knowledge Exchange Michael R Smith, Senior Policy Advisor, Programs and Coordination Division, Centre for
HIV and AIDS Estimates
and AIDS Estimates Adults and children living with Adults aged 15 and over living with Women aged 15 and over living with Men aged 15 and over living with 200 000 [180 000-210 000] 190 000 [170 000-200
Susan 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
Sexual and Reproductive Health and HIV. Dr. Rita Kabra Training course in Sexual and Reproductive Health Research Geneva 2012
Sexual and Reproductive Health and HIV Dr. Rita Kabra Training course in Sexual and Reproductive Health Research Geneva 2012 Global estimates of HIV-(2009) People living with HIV 33.3 million [31.4 35.3
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents Visit the AIDSinfo website to access the most up-to-date guideline. Register for e-mail notification of guideline
Update 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:
The 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
HIV/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
Colloque scientifique : L économie de la prévention Analysis of Cost-Effectiveness of HIV Prevention
Colloque scientifique : L économie de la prévention Analysis of Cost-Effectiveness of HIV Prevention Julia Walsh MD, MSc Professor School of Public Health University of California Berkeley Objectives Cost-effectiveness
ART FOR HIV PREVENTION: PANACEA OR PANDORA S BOX? KENNETH H. MAYER, M.D.
ART FOR HIV PREVENTION: PANACEA OR PANDORA S BOX? KENNETH H. MAYER, M.D. HIV TRANSMISSION SIGNIFICANT, LOW PROBABILITY EVENT (
HIV Management Update 2015
9/30/15 HIV Management Update 2015 Larry Pineda, PharmD, PhC, BCPS Visiting Assistant Professor Pharmacy Practice and Administrative Science ljpineda@salud.unm.edu Pharmacist Learning Objectives Describe
Class Review: HIV Antiretroviral Agents
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
Tunisian recommendations on ART : process and results
Second Arab Congress of Clinical Microbiology and Infectious Diseases May 24-26, 2012. Tunisian recommendations on ART : process and results M. BEN MAMOU UNAIDS Email: BenmamouM@unaids.org M. CHAKROUN
Dr Valérie Martinez-Pourcher
Educa&ng Nurses About An&retrovirals and HIV Preven&on - State of the Science, Uptake Challenges, and Barriers Dr Valérie Martinez-Pourcher Pitié-Salpêtrière Hospital Paris We need to control HIV replication
HIV and AIDS. Shan Nanji
HIV and AIDS Shan Nanji HIV 2 Description: Enveloped Positive Sense HIV 3 Structural Genes: Cleavage of gp160 leads to formation of ENV: Gp120: attachment to host CD4 T Cell Gp41: GAG (p24) Capsid protein
On the Horizon for Consideration: Biomedical Advances in HIV Prevention
On the Horizon for Consideration: Biomedical Advances in HIV Prevention Francisco Ruiz, MS Senior Manager, National Alliance of State and Territorial AIDS Directors New Jersey Governor's Advisory Council
Translating Science to end HIV in Latin America and the Caribbean
Translating Science to end HIV in Latin America and the Caribbean Mexico City, Mexico, 17 th - 18 th and 21 st April www.iasociety.org IAS 2017 post-conference workshop, 17 April 2018 Challenges for PrEP
The Future of HIV: Advances in Drugs and Research. Shauna Gunaratne December 17, 2018
The Future of HIV: Advances in Drugs and Research Shauna Gunaratne December 17, 2018 Overview Epidemiology Science of HIV How HIV treatment and management have changed over the years New medicines and
HIV 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
versus CD4. PoC - Messaging - Specificity and - Ethics sensitivity of HIV - Feedback from diagnostic tests demonstration projects
PRE-CONFERENCE WORKSHOPS WEDNESDAY, 24 OCTOBER 2018 10h00 14h00 Pre-Conference Workshop Pre-Conference Workshop Pre-Conference Workshop Pre-Conference Workshop ITREMA trial feedback PrEP for the private
The elimination equation: understanding the path to an AIDS-free generation
The elimination equation: understanding the path to an AIDS-free generation James McIntyre Anova Health Institute & School of Public Health & Family Medicine, University of Cape Town Elimination of perinatal
HIV Treatment Guidelines
HIV Treatment Guidelines Together, we can change the course of the HIV epidemic one woman at a time. #onewomanatatime #thewellproject What Are Treatment Guidelines? Issued by variety of global and country-based
PHARMACOKINETICS OF ANTIRETROVIRAL AND ANTI-HCV AGENTS
8. PHARMACOKINETICS OF ANTIRETROVIRAL AND ANTI-HCV AGENTS David Burger José Moltó Table 8.1a: INFLUENCE OF FOOD ON ABSORPTION (AREA UNDER THE CURVE) OF ANTIRETROVIRAL AGENTS NUCLEOSIDE ANALOGUES NtRTI
Since the start t of the HIV/ 1980 s: 77.3 million people have be. In million people were liv
The HIV/AIDS Epidemic and Sustainable Development tgoals Etienne Karita, MD MSc MSPH Kigali, 8 Nov 018 IV/AIDS Burden Since the start t of the HIV/ V/AIDS epidemic i in the early 1980 s: 77.3 million people
Biomedical Prevention in HIV
Biomedical Prevention in HIV CHART - CCAS-CDC 3 RD Joint Meeting Montego Bay, Jamaica August 21-26,2011 Presented by Tina Hylton-Kong, ERTU-CHART Some Slides from Impact of ART on HIV Transmission Wafaa
Criteria 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
BUDGET AND RESOURCE ALLOCATION MATRIX
Strategic Direction/Function ILO Strengthened capacity of young people, youth-led organizations, key service providers and partners to develop, implement, monitor and evaluate HIV prevention programmes
/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
HIV EPIDEMIC UPDATE: FACTS & FIGURES 2012
HIV EPIDEMIC UPDATE: FACTS & FIGURES 2012 Number of Cases Note: In this surveillance report, HIV cases include persons reported with HIV infection (non-aids), advanced HIV (non-aids) and AIDS within a
HIV A 2017 Update Bill Rooney MD SCOR Global Life
NHOLUA November 14, 2017 HIV A 2017 Update Bill Rooney MD SCOR Global Life Agenda 1 2 3 4 5 The Immune System HIV the illness Prevalence Diagnosis Natural Course Treatment A look at 100 HIV patients Changing
Prevention of mother-to-child transmission of HIV. Lars Thore Fadnes Centre for International Health
Prevention of mother-to-child transmission of HIV Lars Thore Fadnes Centre for International Health HIV HIV identified in 1983 AIDS syndrome described in 1981 Kaposi s sarcoma, Pneumocystis jiroveci pnemumonia
Susan 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
5. Over the last ten years, the proportion of HIV-infected persons who are women has: a. Increased b. Decreased c. Remained about the same 1
Epidemiology 227 April 24, 2009 MID-TERM EXAMINATION Select the best answer for the multiple choice questions. There are 60 questions and 9 pages on the examination. Each question will count one point.
HIV PREVENTION, DIAGNOSIS, TREATMENT AND CARE FOR KEY POPULATIONS
POLICY BRIEF HIV PREVENTION, DIAGNOSIS, TREATMENT AND CARE FOR KEY POPULATIONS CONSOLIDATED GUIDELINES 2016 UPDATE Policy brief: Consolidated guidelines on HIV prevention, diagnosis, treatment and care
HIV Prevention. Recent Advances and Implications for the Caribbean
HIV Prevention Recent Advances and Implications for the Caribbean Chris Behrens, MD CCAS/CHART Conference Barbados, August 2010 Cases 200 180 160 140 120 100 80 60 40 20 0 Year HIV Cases AIDS Cases HIV
TOWARDS ELIMINATION OF MOTHER TO CHILD TRANSMISSION OF HIV
TOWARDS ELIMINATION OF MOTHER TO CHILD TRANSMISSION OF HIV Gladwel Muthoni KPA Conference 24 th April, 2018 OUTLINE Burden of HIV in PMTCT Mechanism and timing of Mother to Child Transmission (MTCT) Four
HIV TREATMENT AS PREVENTION THE KEY TO AN AIDS-FREE GENERATION
HIV TREATMENT AS PREVENTION THE KEY TO AN AIDS-FREE GENERATION Adeeba Kamarulzaman Professor of Medicine University of Malaya Executive Council Member International AIDS Society Since the beginning of
Treat All : From Policy to Action - What will it take?
Strategy Finance Integration Cascade of services People centred Political Will Treat All : From Policy to Action - What will it take? Thursday, 9 June, 13.00 14.30 Conference Room 11, United Nations Questions
When 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
Outline. Aim with PMTCT. How are children transmitted. Prevention of mother-to-child transmission of HIV. How does HIV transmit to children?
Prevention of mother-to-child transmission of HIV Outline AimofPMTCT How HIV is transmitted to children Epidemiology of HIV in children How to reduce HIV transmission to children Guidelines Lars T. Fadnes
Can we treat our way out of the HIV epidemic?
Can we treat our way out of the HIV epidemic? Richard E. Chaisson, MD Center for AIDS Research Center for TB Research Johns Hopkins University Schoolboy s (and politician s) tricks for evading the question
Toward global prevention of sexually transmitted infections: the need for STI vaccines
Training Course in Sexual and Reproductive Health Research 2017 Module: Sexually transmitted infections, HIV/AIDS Toward global prevention of sexually transmitted infections: the need for STI vaccines
Optimizing 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)
UNAIDS 2018 THE YOUTH BULGE AND HIV
UNAIDS 218 THE YOUTH BULGE AND HIV UNAIDS Explainer THE YOUTH BULGE AND HIV In many sub-saharan African countries, declines in child mortality combined with a slow decline in fertility have resulted in
Sex Work in Sub-Saharan Africa : Opportunities and Challenges
Sex Work in Sub-Saharan Africa : Opportunities and Challenges Dr Traore Isidore May 26, 2016 Definition of Sex Worker Female, male and transgender adults (18 years of age and above) who receive money or
Towards universal access
Key messages Towards universal access Scaling up priority HIV/AIDS interventions in the health sector September 2009 Progress report Towards universal access provides a comprehensive global update on progress
HIV and AIDS An update
HIV and AIDS An update Barnet branch 24 th February 2009 Neal Marshall Specialist pharmacist HIV services Royal Free Hampstead NHS Trust Objectives To gain an insight into the epidemiology of HIV To gain
KEY ELEMENTS FOR SUCCESSFUL INTERVENTION (1)
KEY ELEMENTS FOR SUCCESSFUL INTERVENTION (1) Mobilization of political will and commitment Good surveillance Learn and adapt from past experiences Unified national planning Rapid implementation KEY ELEMENTS
Nobel /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,
Update on the Medicines Patent Pool
Update on the Medicines Patent Pool Sandeep Juneja November 06, 2012 How the Pool works* The Pool is an innovative licensing mechanism for HIV medicines Licensors Patents Feedback Market Impact Product
Nuclear Receptors Mediated Induction of P-glycoprotein by Antiretroviral Drugs in Human Brain Microvessel Endothelial Cells
Under The Microscope: The Impact of ARTs Nuclear Receptors Mediated Induction of P-glycoprotein by Antiretroviral Drugs in Human Brain Microvessel Endothelial Cells Gary N.Y. Chan, Ph. D. Candidate Supervisor: