Latest Updates
4/9/2018
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AIDS-Defining Cancers
- Updated findings on the role of ART in management of Kaposi’s sarcoma
- New data on investigational approaches to Kaposi’s sarcoma treatment
- New findings related to the management of diffuse large B-cell lymphoma
- The latest information on the treatment of primary central nervous system lymphoma
- Revised guidance on cervical cancer screening and follow up
4/3/2018
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First-line ART
- New advice from the DHHS and International Antiviral Society-USA regarding choices for recommended first-line ART
- Discussion of regimens when INSTI-based regimens are not favored
- Choices for recommended regimens for first-line antiretroviral therapy from the European AIDS Clinical Society
- Choices for alternative regimens for first-line antiretroviral therapy from the European AIDS Clinical Society
- Considerations for choosing NNRTI vs INSTI first-line therapy
- Rationale for choosing boosted PI vs INSTI first-line therapy
- New information on the link between cumulative use of darunavir + ritonavir and risk of myocardial infarction in the D:A:D trial
- New information related to the FDA and approval and DHSS guideline recommendation of bictegravir/emtricitabine/tenofovir AF as first-line therapy
3/21/2018 - Optimizing Adherence to Antiretroviral Therapy
3/1/2018
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ARV Overview
- New guideline changes from the DHHS and European AIDS Clinical Society
- FDA approval of coformulated dolutegravir/rilpivirine for use as a switch regimen in patients with virologic suppression
- New information on abacavir and cardiovascular risk
- Week 144 update on phase III comparisons of tenofovir DF and tenofovir AF
- New information on atazanavir and cardiovascular risk compared with other boosted PIs
- Discussion of the use of darunavir/ritonavir in NRTI-sparing regimens
- FDA approval of coformulated bictegravir/emtricitabine/tenofovir AF as a complete ARV regimen for treatment-naive patients and as a switch regimen for virologically suppressed patients
2/13/2018 - Adolescents
2/8/2018
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Sexually Transmitted Diseases
- Updated with latest US epidemiological data for:
- Syphilis
- Gonorrhea
- Chlamydia
- Genital herpes
- Trichomoniasis
- Pelvic inflammatory disease
2/5/2018 - Suppressed Patients
1/18/2018 - Suppressed Patients
1/9/2018 - Testing and Diagnosis
12/14/2017 - HIV in Children
12/12/2017 - Lab Assays
12/11/2017
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Women With HIV
- Updated guidance from the DHHS, with particular focus on the following areas:
- Recommendations regarding coadministration of combined oral contraceptives and ARV agents
- New information on the combined use of regimens containing cobicistat and injectable contraceptives
- New information on the combined use of regimens containing ritonavir and injectable and implantable contraceptives
- Updated guidance on ART in women with HIV
- New information on the treatment of acute HIV in pregnancy and the use of regimens with elvitegravir/cobicistat and tenofovir AF in pregnancy
- Updated recommended and alternative ARV regimens for use during pregnancy
- Clarified recommendations on the use of intrapartum zidovudine prophylaxis in patients with detectable HIV-1 RNA < 1000 copies/mL
- New information and recommendations regarding the drug–drug interaction between cobicistat and methylergonovine
- Updated recommendations for postpartum management of women with HIV and their babies
11/3/2017
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Drug-Drug Interactions
- Updated to reflect most recent DHHS ART guidelines
- Unique drug–drug interactions of once-daily, high-dose formulation of raltegravir as compared to twice-daily raltegravir regimen
- Updated drug–drug interactions between platelet aggregation inhibitors and ARV agents
- Recommendations for use of novel oral anticoagulants with ARV agents
- Updated drug–drug interactions between antipsychotics and ARV agents
- Updated drug–drug interactions between antidepressants and ARV agents
- Updated drug–drug interactions between antiepileptics and ARV agents
- Drug–drug interactions of the HCV DAAs glecaprevir/pibrentasvir and sofosbuvir/velpatasvir/voxilaprevir with ARV agents
- Updated drug–drug interactions of ARV agents with miscellaneous drugs
10/19/2017 - Hepatic Disease
8/14/2017 - Treatment-Experienced Patients
6/19/2017 - HIV in Children
3/30/2017
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TB and Other Mycobacterial Infections
- Latest global TB epidemiologic data from the 2016 WHO Global Health
Report
- Latest TB epidemiologic data for the United States from the
CDC
- Latest TB epidemiologic data for children
- Latest epidemiologic data for MDR, RR, and XDR TB
- Clarified recommendations for the treatment of latent TB infection in
HIV-infected individuals on antiretroviral therapy
- New technologies for the diagnosis of TB
- TB treatment recommendations reflect most recent ATS/CDC/IDSA
guidelines
- MDR and XDR TB treatment recommendations reflect most recent WHO treatment
guidelines for drug-resistant TB
- New discussion of delamanid and linezolid in section on TB treatment
recommendations
3/27/2017 - Lipoatrophy and Bone Disease
3/16/2017
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Drug-Drug Interactions
- Updated to include discussion of renal transporter inhibition by cobicistat, ritonavir, and rilpivirine
- Updated to incorporate drug–drug interactions with recently approved TAF coformulated antiretrovirals
- Updated to include discussion of potential drug–drug interactions of the antifungal isavuconazole with PIs and NNRTIs
- Revised to include table of guideline recommendations for use of anticoagulants and antiplatelets with antiretroviral agents
- Added contraindication warning for clonazepam from the prescribing information for PIs
- Updated to include drug–drug interactions of the HCV DAAs daclatasvir, elbasvir/grazoprevir, and sofosbuvir/velpatasvir with antiretroviral agents
3/14/2017
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Renal Disease
- Combined cystatin C–estimated GFR creatinine equation is most accurate for HIV-positive patients
- New table showing differential diagnosis of acute interstitial nephritis in HIV-positive patients
- New discussion on improvements in renal safety with tenofovir alafenamide fumarate compared with tenofovir disoproxil fumarate
2/27/2017 - Hepatic Disease
2/14/2017
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Overview of HIV Prevention
- Dapirivine vaginal ring shows significant protection against HIV transmission in 2 phase III trials
- VRC01 vaccine slightly delayed viral rebound in virologically suppressed patients discontinuing ART but did not maintain virologic suppression at 8 weeks
- NEXT-PrEP study comparing maraviroc alone vs maraviroc plus tenofovir DF as PrEP showed acceptable safety profiles and 4 of 5 seroconversions occurred in patients with low or undetectable plasma drug concentrations
- ECLAIR study shows injectable cabotegravir PrEP safe and well tolerated
1/11/2017
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Dyslipidemia
- Studies show lipid parameters favor tenofovir DF over tenofovir AF in the single-tablet combination with cobicistat/elvitegravir/emtricitabine
- Switch to dolutegravir monotherapy shows marked improvement in lipid parameters in small cohort of virologically suppressed patients
- New data suggest prevalence of metabolic syndrome varies widely by criteria used
- Data from the STRIIVING trial showed switching ART regimens to abacavir/dolutegravir/lamivudine resulted in increases in LDL and total cholesterol
- Data from a large cohort shows elevated risk of MI associated with nadir CD4+ cell counts but that risk has declined in recent years
- Small study suggests sitagliptin lowers glucose and markers of inflammation in patients with HIV infection on ART and may be used for patients who cannot tolerate or have inadequate responses to other agents
12/15/2016 - Treatment-Experienced Patients
12/12/2016 - HIV and Minority Communities
12/12/2016
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Non–AIDS-Defining Cancers
- Included data from several recent studies comparing outcomes in anal cancer between patients with and without HIV infection
- Brentuximab vedotin expanded approval for post-HSCT consolidation therapy for patients with classical Hodgkin’s lymphoma
- Nivolumab included as an option for relapse or progression following HSCT and brentuximab vedotin therapy in patients with classical Hodgkin’s lymphoma
11/18/2016
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HIV Exposure
- Updated with current guidance from the CDC, New York State Department of Health AIDS Institute, and WHO on antiretroviral postexposure prophylaxis, which include changes to recommended PEP regimens
- A recent retrospective study evaluating nonoccupational PEP given at an HIV clinic found that nearly one half of people initiated on PEP failed to attend their follow-up outpatient clinic appointment
- New discussion on later-generation antigen/antibody combination testing
- 2 studies show that HIV transmission greatly reduced or nonexistent in patients with virologic suppression
11/14/2016 - Endocrine Disorders
11/14/2016
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Suppressed Patients
- Data from DORiVir study show efficacy of switch to dolutegravir/rilpivirine with improved lipid profile
- New data included for switching from tenofovir DF– to tenofovir AF–containing regimens
- Switch to emtricitabine/rilpivirine/tenofovir AF effective with improvements in renal and bone safety found in 2 studies
- Updated with Week 48 data for the ATLAS-M trial on switch to atazanavir/ritonavir plus lamivudine dual therapy
11/8/2016 - Women With HIV
10/31/2016
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First-line ART
- Revised DHHS, IAS-USA, and EACS recommendations for first-line antiretroviral therapy
- Coformulated emtricitabine/rilpivirine/tenofovir AF demonstrated bioequivalent to emtricitabine/rilpivirine/tenofovir DF
- Week 144 data included for cobicistat- vs ritonavir- boosted atazanavir with emtricitabine/tenofovir DF
- Week 96 analysis included for tenofovir AF vs tenofovir DF with cobicistat/elvitegravir/emtricitabine demonstrating equivalent efficacy and improved bone and renal safety
10/18/2016 - ARV Overview
9/19/2016 - Women With HIV
9/7/2016
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Fungal Infections
- Updated guidance from the CDC on the use of topical and systemic antifungal agents to treat oropharyngeal candidiasis
- Updated oral fluconazole dosing for chronic suppressive therapy of mucosal candidiasis
- New CDC recommendation that all newly diagnosed HIV-infected individuals with CD4+ cell counts ≤ 50-100 cells/mm3 should undergo routine serum cryptococcal antigen testing
- Updated CDC cryptococcosis treatment recommendations
- Updated guidance from the CDC for the treatment of cryptococcosis in patients initiating antiretroviral therapy
7/26/2016 - Viral Infections
4/1/2016
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Optimizing Adherence to Antiretroviral Therapy
- Recertified for Point of Care Credit
3/1/2016 - Parasitic Infections
2/29/2016 - Sexually Transmitted Diseases
2/18/2016 - Suppressed Patients
2/9/2016 - Women With HIV
1/27/2016 - ARV Overview
12/15/2015
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First-line ART
- Revised recommendations for first-line therapy from the European AIDS Clinical Society
- FDA approval of new fixed-dose, single-tablet regimen, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide
- Addition of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide to DHHS-recommended first-line ART regimens
10/29/2015 - Adolescents
10/21/2015 - Overview of HIV Prevention
10/14/2015 - Suppressed Patients
10/12/2015
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Drug-Drug Interactions
- Revised prescribing information for cobicistat/elvitegravir/emtricitabine/tenofovir DF and elvitegravir includes contraindications with several antiepileptic agents
- Revised prescribing information for dolutegravir and abacavir/dolutegravir/lamivudine includes new dosing recommendations for coadministration with carbamazepine
- Revised prescribing information for dolutegravir and abacavir/dolutegravir/lamivudine includes new dosing recommendations for coadministration with metformin
9/30/2015
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Women With HIV
- The latest data and expert recommendations on the use of various contraceptive methods in HIV-positive women
- New data from the WAVES trial demonstrating superior efficacy of cobicistat/elvitegravir/emtricitabine/tenofovir DF vs atazanavir/ritonavir plus emtricitabine/tenofovir DF as initial therapy in HIV-infected women
- Updated guidelines on recommended ART regimens during pregnancy
9/28/2015
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Considerations for Aging HIV-Infected Patients
- The latest epidemiologic data from the CDC HIV Surveillance report
- Recent data suggest age-associated comorbidities occur at similar ages in HIV-infected and non-HIV–infected individuals
- New studies report that rates of undiagnosed HIV infection in older patients are decreasing, although delays in diagnosis are longer for older patients vs younger patients
- Results of the START and TEMPRANO trials provide strong evidence for initiation of ART in all patients regardless of age or CD4+ cell counts
- Additional data from the VA and the NA-ACCORD cohort on the association between abacavir use and cardiovascular disease risk
- Longitudinal analysis demonstrates that proportion of patients meeting criteria for metabolic syndrome decreases after 96 weeks of ART
- HCV coinfection associated with increased risk of osteopenia and osteoporosis in patients with HIV infection
- New data suggest ritonavir-boosted atazanavir or lopinavir but not other PIs, along with tenofovir DF associated with nephrotoxicity
- Tenofovir alafenamide associated with more favorable bone and renal safety profile vs tenofovir DF
9/28/2015 - HIV in Children
9/23/2015
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Overview of HIV Prevention
- Updated results from the PROUD and IPERGAY trials demonstrating high efficacy of tenofovir DF/emtricitabine as PrEP in MSM
- High efficacy of tenofovir DF/emtricitabine as PrEP for HIV-uninfected partners in heterosexual serodiscordant couples in the The Partners Demonstration Project
- Data from randomized HPTN 067/ADAPT trial comparing daily vs time-driven vs event-driven oral PrEP generally support current recommendations for continuous daily oral PrEP
- New findings from 2 trials evaluating real-world uptake, adherence, and overall feasibility of oral PrEP
- Updated results from the FACTS-001 trial demonstrating tenofovir 1% gel not effective as PrEP in women
- Final analysis of HPTN 052 study demonstrates 93% reduction in risk of linked HIV transmission during 10-year period with early ART for seropositive partner in serodiscordant couples
9/22/2015
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Hepatic Disease
- Daclatasvir in combination with sofosbuvir approved by the FDA for the treatment of genotype 3 HCV infection
- Ombitasvir/paritaprevir/ritonavir in combination with ribavirin approved by the FDA for the treatment of genotype 4 HCV infection
- Updated AASLD/IDSA recommendations on the treatment of HCV, including in patients with HIV coinfection
9/16/2015 - Sexually Transmitted Diseases
9/14/2015
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Secondary HIV Prevention
- Updated with revised guidance on secondary HIV prevention produced by the CDC, the HRSA, and the NIH
- Updated epidemiologic data on HIV incidence in the United States
- Updated epidemiologic data on the incidence of sexually transmitted diseases
- Updated recommendations on screening for HIV transmission risk
- Updated recommendations on screening for sexually transmitted diseases
- Updated to include new data and guidance on the use of antiretroviral therapy for HIV prevention
9/11/2015
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Psychiatric Disorders
- The latest recommendations and information on drug–drug interactions between antiviral agents and psychotropic drugs from the DHHS
- New data suggest the presence of asymptomatic neurocognitive disorders is associated with faster progression to HAD
- The MOCA and CAT-Rapid brief screening tools were shown to have the best sensitivities for screening for HAD in a study comparing 5 different tools
- The latest estimates on depression prevalence in patients with HIV infection
- New data suggest switching from efavirenz-containing ART to efavirenz-free ART reduces neuropsychiatric symptoms
- Results of a recent study indicate that text messaging systems may improve medication adherence in patients with bipolar disorder and HIV infection
9/9/2015
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Lab Assays
- New study showing importance of CD4/CD8 in predicting high risk of non-AIDS–related morbidity and mortality
- START trial demonstrates significant reduction in risk of serious AIDS-related and non-AIDS–related events with initiation of ART at CD4+ cell count > 500 cells/mm3 compared with deferred therapy
- New findings demonstrate that patients with persistent low-level viremia (defined as HIV-1 RNA either 50-199 or 200-499 copies/mL) are at greater risk of virologic failure
- Two recent studies comparing reproducibility of HIV-1 RNA assay types showed significant differences between assays when HIV-1 RNA levels were in the range of 50-200 copies/mL
9/8/2015 - Testing and Diagnosis
8/26/2015
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Lipoatrophy and Bone Disease
- The latest guidance from the EACS on the prevention and management of lipoatrophy
- New data from the A5260s study on fat changes with atazanavir/ritonavir, darunavir/ritonavir, or raltegravir in combination with tenofovir DF/emtricitabine
- Data from the single-arm AtLaS study demonstrate decreased trunk fat in virologically suppressed patients who switched from a 3-drug atazanavir/ritonavir-based regimen to atazanavir/ritonavir plus lamivudine
- UPBEAT study finds IDU and longer time since HIV diagnosis associated with lower BMD
- Several phase III trials demonstrate improvements in BMD with tenofovir alafenamide vs tenofovir DF when each combined with cobicistat/elvitegravir/emtricitabine
- Data on BMD outcomes from A5260s and CASTLE metabolic substudies
8/25/2015 - First-line ART
8/19/2015
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Timing of Initiation of First-line Antiretroviral Therapy
- New guidance from the DHHS on when to initiate ART in children
- Data available from the TEMPRANO study on the effect of early ART initiation vs ART initiation based on WHO guidelines with and without isoniazid prophylaxis
- New data on timing of ART initiation in acute HIV infection
- Updated guidance from the DHHS on the initiation of ART in patients with HIV/HCV coinfection
- New guidance from the HIV Medicine Association of the Infectious Diseases Society of America on the initiation of ART in patients with HIVAN
- Study results demonstrate greatly reduced HIV transmission rates in serodiscordant couples receiving PrEP
- The latest data suggest similar survival with early vs deferred ART in patients newly diagnosed with cryptococcal meningitis in high-income countries
- START trial demonstrates significant reduction in risk of serious AIDS-related and non–AIDS-related events with initiation of ART at CD4+ cell count > 500 cells/mm3 compared with deferred therapy
8/18/2015 - Management of IRIS
8/17/2015
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Global HIV Epidemiology
- Updated recommendations on ART initiation in children younger than 12 months of age
- Revised epidemiologic data from UNAIDS
- Updated with current data on the prevalence of HIV/AIDS in IDUs in resource-limited settings from the United Nations Office on Drugs and Crime
- New data on PrEP from the Partner Demonstration Project, IPERGAY, and PROUD trials
8/7/2015 - Drug-Drug Interactions
7/31/2015
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Suppressed Patients
- New section on maintenance switching to dual therapy of boosted PI and NRTI to maintain virologic suppression including 3 randomized clinical trials showing noninferiority to triple-drug regimen maintenance (SALT, ATLAS-M, OLÉ trials)
- Higher rate of virologic rebound through Week 48 in patients switched from a triple-drug regimen to dual boosted atazanavir and raltegravir
- Using a strict definition of virologic failure, Week 48 results of the randomized PROTEA trial showed that switching from virologically suppressive antiretroviral therapy to darunavir/ritonavir monotherapy was inferior to boosted darunavir plus 2 NRTIs for virologic efficacy, but a post hoc analysis elucidated that the loss of efficacy was distinctive to patients with CD4+ cell nadirs < 200 cells/mm3
- Week 96 data from the LATTE study demonstrate similar virologic efficacy with cabotegravir and rilpivirine–based, NRTI-sparing treatment simplification strategy vs continued treatment with efavirenz plus 2 NRTIs
- Week 96 data from the randomized, open-label MODAt study confirmed earlier results that switching virologically suppressed patients from atazanavir/ritonavir plus 2 NRTIs to atazanavir/ritonavir monotherapy was inferior to continuing atazanavir/ritonavir plus 2 NRTIs in an intent-to-treat virologic efficacy analysis that treated cases of regimen reintensification as failures
7/29/2015
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Hepatic Disease
- New guidelines from AASLD/IDSA and EASL include revised treatment recommendations for patients with HIV/HCV coinfection
- An updated description of adverse events that might be expected in HIV/HCV-coinfected patients receiving highly active DAA regimens
- The latest information on important drug–drug interactions that must be considered when treating patients coinfected with HIV and HCV
7/23/2015
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Dyslipidemia
- Results from the ACTG 5257 trial on lipid changes among ritonavir-boosted atazanavir or darunavir, or raltegravir treatment regimens
- Subanalysis of the ATADAR study suggesting improved LDL subfractions with darunavir/ritonavir compared with atazanavir/ritonavir
- New data from the STaR trial showing benefit of emtricitabine/rilpivirine/tenofovir DF vs efavirenz/emtricitabine/tenofovir DF on lipid parameters
- New information on prevalence and risk factors for metabolic syndrome in patients with HIV infection
- Results of SATURN study demonstrating rosuvastatin reduces carotid intima-media thickness in patients with HIV
- New results suggesting atorvastatin may reduce coronary atherosclerosis in patients with HIV infection
- Recent data suggesting adding rosuvastatin is better option than switching PIs as a strategy to lower LDL cholesterol with fewer adverse effects
- Recommendations from the AHA/ACC on diet and exercise to reduce cardiovascular disease
- New information on factors that affect accuracy of hemoglobin A1c testing in patients with HIV
- Update on D:A:D cohort investigating myocardial infarction risk with abacavir use
- New data from the NA-ACCORD trial evaluating association between abacavir use and cardiovascular disease
- New data indicating that CVD risk assessment algorithms created for the general population underestimate actual CVD risk in HIV populations
- CVD risk with combinations of antiretroviral agents evaluated in a VA cohort
7/6/2015 - Fungal Infections
7/6/2015
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ARV Overview
- New data demonstrate improved renal and bone safety with cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide vs cobicistat/elvitegravir/emtricitabine/tenofovir DF
- The latest findings from several studies show no association of efavirenz with neuropsychological impairment or suicidality
- Week 48 data from phase III study demonstrate comparable efficacy and safety of cobicistat vs ritonavir for boosting atazanavir
- New section on pharmacologic boosters
6/24/2015
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Optimizing Adherence to Antiretroviral Therapy
- Disruptive behavior and attention deficit hyperactivity disorder are associated with nonadherence in youth
- Results from ACTG A5257 trial demonstrated raltegravir and darunavir/ritonavir are equally tolerable and both superior to atazanavir/ritonavir tolerability
- Vaginal ring delivery of dapivirine for PrEP currently under investigation as means of improving adherence
- Partner-based training with modified directly observed therapy does not result in improved adherence
- Updated to reflect current guidance from EACS
6/15/2015 - Women With HIV
6/15/2015 - Bacterial Infections
6/15/2015 - Testing and Diagnosis
6/9/2015
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Overview of HIV Prevention
- Updated results from the PROUD and IPERGAY trials demonstrating high efficacy of emtricitabine/tenofovir DF as PrEP in MSM
- High efficacy of emtricitabine/tenofovir DF as PrEP for HIV-uninfected partners in heterosexual serodiscordant couples in the The Partners Demonstration Project
- Updated results from the FACTS-001 trial demonstrating tenofovir 1% gel not effective as PrEP in women
5/21/2015 - Women With HIV
5/5/2015 - HIV in Children
4/13/2015 - Lipoatrophy and Bone Disease
3/30/2015 - Treatment-Experienced Patients
3/19/2015 - ARV Overview
3/12/2015 - Suppressed Patients
2/5/2015 - Sexually Transmitted Diseases
1/14/2015 - Overview of HIV Prevention
11/17/2014 - ARV Overview
11/14/2014
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Sexually Transmitted Diseases
- Revised US epidemiologic data for syphilis
- The latest CDC prevalence data for gonorrhea demonstrate higher rates among HIV-infected vs HIV-uninfected MSM
- 0.7% increase in chlamydia incidence in the United States from 2011 to 2012 represents the smallest annual increase since nationwide chlamydia incidence reporting began
- Latest IDSA primary care guidelines recommend that an anal Pap smear be performed in all HIV-infected MSM and women with a history of anal intercourse or abnormal cervical Pap test results as well as all HIV-infected persons with genital warts
- The latest epidemiologic trends in pelvic inflammatory disease
- New phase II efficacy and safety data on the use of pritelivir for the treatment of genital herpes
- New section summarizing key roles for primary care physicians in the management of STDs in patients with HIV infection
11/14/2014
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TB and Other Mycobacterial Infections
- Updated global TB epidemiologic data from the 2014 WHO Global Health Report
- Updated with current TB epidemiologic data for the United States from the CDC
- A new mathematical model that predicts a higher incidence of pediatric TB cases
than previously estimated
- Revised WHO guidance on adult and pediatric dosing of antimycobacterial agents
- New discussion of the GeneXpert MTB/RIF assay for use in the diagnosis
of pediatric TB
- New data on the efficacy of the “9-month Bangladesh regimen” for the treatment
of MDR-TB
- New data on coadministration of isoniazid with ART to prevent TB in patients
with HIV infection
- New data on timing of ART after TB treatment suggesting no benefit to early ART
initiation
- New section summarizing key roles for primary care physicians in the management
of HIV-infected patients with tuberculosis and Mycobacterium avium
complex infection
11/7/2014
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Non–AIDS-Defining Cancers
- New information on risk factors for non-AIDS defining malignancies
- New guidance from the British HIV Association on the management of several types of cancer in patients with HIV infection, including anal cancer, Hodgkin’s lymphoma, lung cancer, hepatocellular carcinoma, and testicular germ cell cancers
- New incidence data on hepatocellular carcinoma in HIV-infected patients with cirrhosis
- New data showing 3 times higher cancer mortality rates in HIV-infected patients who are cigarette smokers compared with nonsmokers
- New section summarizing key roles for primary care physicians in the management of non–AIDS-defining malignancies in patients with HIV infection
11/6/2014
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Management of IRIS
- Revised prevalence data on IRIS in symptomatic patients
- New epidemiologic data on lymphoma-associated IRIS
- New findings on biomarkers predictive of paradoxical TB-associated IRIS
- The latest results from the COAT trial evaluating early vs delayed ART initiation in patients with cryptococcal meningitis
- Recent case reports demonstrate rare gastrointestinal presentations of CMV-associated IRIS
- Recently identified biomarkers associated with increased risk of hepatic flares in HBV-associated IRIS
- New discussion on temporarily switching to less hepatotoxic INSTIs in patients with HBV- and HCV-associated IRIS
- Updated discussion on therapeutic procedures for the treatment of tuberculosis- and cryptococcus-associated IRIS
- New section summarizing key roles for primary care physicians in the management of HIV-infected patients with IRIS
10/30/2014 - First-line ART
10/29/2014 - Parasitic Infections
10/24/2014
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Renal Disease
- New guidance from the HIV Medicine Association of the IDSA on the evaluation of kidney function and damage in patients with HIV infection
- New guidance from the HIV Medicine Association of the IDSA on the which antiretroviral agents to avoid in patients with low eGFR
- New discussion on the use of cystatin C–estimated GFR in patients with HIV
- New discussion on urinary renal biomarkers available for screening and diagnosis of proximal tubular injury
- New guidelines from the Eighth Joint National Committee on the management of high blood pressure
- New discussion on the genetic basis for the increased risk of HIVAN in black patients
- New section summarizing key roles for primary care physicians in the evaluation and management of kidney function and disease in patients with HIV infection
9/30/2014
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HIV and Minority Communities
- New data on why minorities are underrepresented in clinical trials
- Updated information on obesity and weight gain risk among minority populations
- The latest findings on the differences in virologic failure rates in men vs women taking atazanavir/ritonavir
- New section summarizing key roles for primary care physicians in the management of HIV-infected patients from minority communities
9/26/2014
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Management of Drug Users
- Revised expert guidelines advise against methadone use in patients with or at risk of prolonged QTc intervals
- New safety data on extended-release naltrexone
- New section highlighting management considerations for incarcerated individuals with HIV infection
- New section summarizing key roles for primary care physicians in the management of HIV-infected drug users
9/18/2014
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Specific Symptom Complexes
- Updated HIV testing and diagnosis guidelines from the CDC recommend a new algorithm that allows more accurate diagnosis of acute HIV infection
- New data reveal that asymptomatic neurocognitive impairment is associated with an increased risk for developing HIV-associated neurocognitive disorder
- Updated D:A:D cohort data on causes of death among HIV-infected patients
- New section summarizing key roles for primary care physicians in the management of HIV-infected patients with specific symptom complexes
9/12/2014 - ARV Overview
8/28/2014
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HIV Care, Resource Limited
- Updated with new epidemiologic data from UNAIDS
- Updated with key data on the pneumococcal 23-polyvalent vaccine
- Updated with new data on the use of mobile phones in patient communication
- Updated cryptococcal meningitis data and recommendations
- Updated with discussion of noncommunicable diseases
- Updated with inclusion of latest recommendations for people who inject drugs
8/28/2014 - Endocrine Disorders
8/22/2014
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Bacterial Infections
- Updated with diagnostic recommendations for pyomyositis from the IDSA’s 2014 guidelines on the management of skin and soft tissue infections
- Updated with treatment recommendations on Staphylococcus aureus infections from the IDSA’s 2014 guidelines on the management of skin and soft tissue infections
- Updated with new incidence data on HIV-infected MRSA carriers
- Included new section with key information for primary care physicians
8/22/2014
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Management of Hematologic Disorders
- New section added with considerations for primary care physicians managing patients with hematologic complications of HIV infection
- Updated to reflect new hypotheses on the contribution of HIV-associated immune activation to anemia
- Updated to include recent recommendations from the ASH “Choosing Wisely” campaign regarding the conservative use of RBC transfusion for the treatment of anemia
- Updated with recent recommendations from the American Society for Clinical Oncology for managing neutropenia
- Updated to reflect recent data on the management of HIV-associated immune thrombocytopenic purpura
8/18/2014 - Fungal Infections
8/8/2014 - ARV Overview
7/31/2014 - First-line ART
7/31/2014 - HIV-Associated Ocular Complications
7/30/2014
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Management of Neurologic Diseases
- New data on the relationship between antiretroviral CNS penetration and HIV-associated dementia
- New data on the prognosis of PML in HIV-infected individuals
- Recent findings on the incidence of stroke in HIV-infected individuals
- New data on the association between autonomic neuropathy and comorbidities during HIV infection
- New section with considerations for primary care physicians
7/22/2014 - HIV Pathogenesis
7/16/2014 - HIV in Children
7/16/2014 - Global HIV Epidemiology
7/11/2014
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Testing and Diagnosis
- Revised algorithm for testing and diagnosis of HIV infection
- Revised CDC epidemiologic data including the estimated number of new infections and percentages of HIV-infected individuals unaware of their status
- Updated findings from Washington DC show increased rates of linkage to care coincided with expanded HIV testing
- New modeling data suggest that HIV testing more frequently than current CDC recommendations advise would be cost effective for all risk groups
- Updated table and information on FDA-approved rapid HIV tests
- Approval of a third combined antibody/antigen test (“fourth-generation” immunoassay)
- New section summarizing key roles for primary care physicians in HIV testing and diagnosis
7/9/2014
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ARV Overview
- Updated and reorganized to focus on antiretroviral agents currently recommended by expert guidelines for the treatment of HIV infection; key features of each agent are reviewed, including dosing, adverse events, resistance, and drug–drug interactions
- New section summarizing key roles for primary care physicians in the management of HIV-infected patients receiving antiretroviral therapy
7/3/2014
-
Developed World
- Revised HIV surveillance data from the European Centre for Disease Prevention and Control
- Updated HIV surveillance data from Australia and New Zealand
- The latest epidemiologic data on HIV infection, other STDs, and viral hepatitis in men who have sex with men
- Current CDC data on HIV infection in injection drug users
- Updated information on racial disparities in HIV infection
- Most recent data on rates of late HIV diagnosis in the United States and Europe
- New data demonstrate risk of non–AIDS-related death with early ART comparable to HIV-uninfected population
- Recent findings support increasing contribution of non-AIDS events to morbidity and mortality in HIV-infected populations
7/2/2014 - Adolescents
6/26/2014
-
Secondary HIV Prevention
- Updated epidemiologic data on HIV incidence in the United States
- Updated epidemiologic data on the incidence of sexually transmitted diseases
- New data on the potential association between emotional distress and HIV transmission risk behavior
- Findings from a longitudinal study demonstrate significant decreases in transmission risk behaviors among HIV-infected individuals who received 9 months of computerized intervention counseling
- Results of a randomized trial demonstrate that brief intervention strategies are effective at reducing sexual transmission risk behavior among MSM who are newly diagnosed with HIV
- New data support the feasibility and acceptability of sex-specific secondary prevention interventions designed for women living with HIV
- Results from Project ROADMAP show reduced high-risk sexual behavior among older women who received secondary prevention intervention targeted to older HIV-positive adults
- New section summarizing key roles for primary care physicians in secondary HIV prevention strategies
6/19/2014 - Treatment-Experienced Patients
6/18/2014 - Lipoatrophy and Bone Disease
6/10/2014
-
HIV Exposure
- Recent data demonstrate a significant association between patient consultation with a social worker and improved attendance at the 6-week serology follow-up visit among patients receiving nonoccupational PEP
- New data suggest that nonoccupational PEP is underused as a strategy to prevent HIV infection
- A recent study evaluating emergency department provision of nonoccupational PEP found that nearly one half of people initiated on PEP failed to attend their follow-up outpatient clinic appointment
- Cost of medications was cited by approximately one half of sexual assault nurse examiner and forensic nurse examiner program coordinators as the most important barrier to routinely offering nonoccupational PEP to individuals with high-risk HIV exposures
- New section summarizing key roles for primary care physicians in the management of occupational and nonoccupational HIV exposure
6/4/2014 - Overview of HIV Prevention
5/30/2014 - Primary Care
5/30/2014
-
Hepatic Disease
- New April 2014 guidelines from EASL incorporate sofosbuvir, simeprevir, and daclatasvir into recommended treatment regimens for patients with HIV/HCV coinfection
- European approval of simeprevir for patients infected with genotype 1 or 4 HCV
- Updated discussion of expert guidance on treatment of HIV/HBV coinfection emphasizing DHHS panel recommendation that all HIV/HBV-coinfected patients initiate antiretroviral therapy that includes 2 agents active against HBV regardless of CD4+ cell count or HBV disease status
- The latest information on important drug–drug interactions that must be considered when treating patients coinfected with HIV and HCV
- 2014 assessment report from the US National Lipid Association Statin Liver Safety Task Force concludes that statin therapy is safe in patients with NAFLD and dyslipidemia
- New section summarizing key roles for primary care physicians in the management of hepatic disease in HIV-infected patients
5/22/2014 - Drug-Drug Interactions
5/21/2014
-
Suppressed Patients
- Switching from ritonavir-boosted PI–based regimen to single-tablet emtricitabine/rilpivirine/tenofovir was noninferior to continued boosted PI–based therapy in the SPIRIT trial
- New data continue to support the importance of long-term virologic suppression (at least 6 months) before switching patients to a ritonavir-boosted PI monotherapy regimen
- Preliminary data from small studies suggest that switching virologically suppressed patients to raltegravir plus etravirine may be a feasible strategy
- Week 48 data from the LATTE study demonstrate similar virologic efficacy with GSK1265744 and rilpivirine–based, NRTI-sparing treatment simplification strategy vs continued treatment with efavirenz plus 2 NRTIs
- High rate of continued virologic suppression through Week 48 in patients switched from efavirenz/emtricitabine/tenofovir DF to rilpivirine/emtricitabine/tenofovir DF
- Week 48 data from the randomized, open-label MODAt study demonstrated that switching virologically suppressed patients from atazanavir/ritonavir plus 2 NRTIs to atazanavir/ritonavir monotherapy was inferior to continuing atazanavir/ritonavir plus 2 NRTIs in an intent-to-treat virologic efficacy analysis that treated cases of regimen reintensification as failures
- Results of the randomized Monarch trial showed that patients switched from virologically suppressive NNRTI- or PI-based antiretroviral therapy to darunavir/ritonavir experienced small but statistically significant lumbar and femur bone mineral density increases
- New section summarizing key roles for primary care physicians when their HIV-infected patients require modification of virologically suppressive antiretroviral regimens
5/21/2014 - First-line ART
5/15/2014
-
Timing of Initiation of First-line Antiretroviral Therapy
- New discussion of guideline recommendations for antiretroviral therapy initiation in the setting of acute or early HIV infection
- Clinical implications of apparent HIV cure in the “Mississippi baby”
- Multicenter AIDS Cohort Study finds that lower CD4+ cell count nadir and longer duration of ART each associated with increased prevalence of coronary artery stenosis > 50% among HIV-infected men
- High response rate to simeprevir plus peginterferon/ribavirin not influenced by CD4+ cell count in patients with genotype 1 HCV/HIV coinfection
- Interim results from the PARTNER trial: no cases of phylogenetically linked HIV transmission within serodiscordant MSM or heterosexual couples in which the HIV-infected partner was receiving suppressive ART, despite ongoing condomless sex
- New section summarizing key roles for primary care physicians in decisions related to the timing of antiretroviral therapy initiation
4/30/2014
-
AIDS-Defining Cancers
- New data on stage-based treatment stratification for Kaposi’s sarcoma
- A recent meta-analysis of treatment for AIDS-related lymphomas shows clear benefit from addition of rituximab to chemotherapy as well as the use of concurrent ART
- New section summarizing key roles for primary care physicians in the management of AIDS-defining cancers
4/28/2014
-
HIV in Children
- New data and discussion on extended daily nevirapine prophylaxis for breast-fed, HIV-exposed infants to prevent postpartum HIV transmission
- New section summarizing key roles for primary care physicians in the management and treatment of HIV-infected children and those exposed to HIV during pregnancy
4/24/2014
-
Women With HIV
- Updated guideline recommendations on measles/mumps/rubella vaccination of HIV-infected persons
- Latest recommendations on the use of statins in high cholesterol risk groups
- Expert discussion on the latest data from studies evaluating potential associations between hormonal contraceptive pill and/or DMPA use and risk of HIV acquisition and/or transmission
- The latest guidance on HPV vaccination in HIV-infected girls and women
- Revised discussion of important factors to consider when initiating antiretroviral therapy in women
- New data on potential sex-based differences in response to antiretroviral therapy
- New discussion of the effects of intimate partner violence on HIV infection and treatment in women
- Updated findings on first-trimester antiretroviral therapy use and risk of birth defects
- New section summarizing key roles for primary care physicians in the management of HIV-infected women
4/11/2014
-
Optimizing Adherence to Antiretroviral Therapy
- New data on adherence to single-tablet regimens
- Meta-analyses of trials exploring the impact of dosing and pill burden on adherence
- Data on investigational nanosuspension formulations of antiretroviral agents
- New data on technological interventions to optimize adherence
- Primary Care Essentials, a summary of key information for primary care professionals
4/9/2014
-
Suppressed Patients
- New phase III results from the STRATEGY-PI and the STRATEGY-NNRTI trials of switching virologically suppressed patients to once-daily cobicistat/elvitegravir/emtricitabine/tenofovir DF
4/3/2014 - First-line ART
4/2/2014
-
HIV Pathogenesis
- New data on a novel SIV vaccine
- Updated data on the usage rate of PrEP
- New research on isolation of functional T-regulatory CD4+ cells
- Updated data on the “Mississippi baby”
- New research on early virologic control
- New data on viral evolution rates
- Updated data on HIV eradication
- Updated data on the CLEAR trial
- Updated data on enhancing immune responses
- Revised primary care ISDA guidelines for the management of patients with HIV
3/21/2014
-
Psychiatric Disorders
- Updated with new data on the association of antiretroviral agents and psychiatric adverse effects, including suicidality
- Updated discussion of safety concerns with certain antidepressants
- Updated with new data on the reported association between HIV-1 RNA in the cerebrospinal fluid and risk of new-onset depression
- Updated information on drug interactions between antiretroviral agents and antipsychotic agents
- Added new section on primary care considerations
3/21/2014
-
Lab Assays
- New data on the clinical relevance of low-level viremia during antiretroviral therapy and factors that may be associated with persistent low-level viremia
- The latest data on studies comparing commercially available viral load assays
- New findings on the feasibility and relevance of drug resistance testing in patients experiencing low-level viremia during antiretroviral therapy
- New section summarizing key roles for primary care physicians in using laboratory tests for the evaluation of HIV disease progression, viral replication, and resistance to antiretroviral medications
3/21/2014 - AIDS-Defining Cancers
3/12/2014
-
HIV in Children
- New DHHS guidelines for preventing and treating opportunistic diseases in HIV-infected children
- New guidance from the 2014 DHHS pediatric antiretroviral therapy guidelines, including revised recommendations on virologic diagnostic testing at birth, antiretroviral therapy in early infancy, selection of antiretroviral therapy in infants, and antiretroviral therapy in children beyond infancy
2/26/2014
-
Dyslipidemia
- New data on the lipid effects of dolutegravir
- Revised DHHS guidance on use of abacavir/lamivudine in first-line ART
- New ACC/AHA guidelines on treatment of blood cholesterol
- New data on use of pitavastatin in HIV-infected patients
- Removal of FDA restrictions on rosiglitazone use
- A summary of key issues for primary care professionals
2/26/2014
-
Considerations for Aging HIV-Infected Patients
- New data on the prevalence of HIV in older individuals
- The latest findings on the impact of chronic immune activation among older HIV-infected patients
- New information from studies evaluating potential mechanisms and treatment strategies for HIV-associated neurocognitive decline
- Updated findings on the impact of antiretroviral therapy on health outcomes among older HIV-infected persons
- New information on virologic and immunologic response to antiretroviral therapy among older HIV-infected patients
- Updated information on risk factors for cardiovascular disease among HIV-infected persons
- New information on HIV-associated metabolic disease
- Recent findings on factors associated with cancer outcomes in HIV-infected patients with non-AIDS–defining malignancies
- New data on fracture risk in HIV-infected persons
- The latest study data on potential associations between antiretroviral therapy and kidney disease
- Updated information on pulmonary dysfunction in HIV infection
- New data on factors associated with frailty in patients with HIV infection
- Updated information on drug toxicity challenges in older HIV-infected patients, including data on the association between age and antiretroviral exposure and expert guidance on managing polypharmacy in this population
- New section summarizing key roles for primary care physicians in the management of aging HIV-infected patients
- Summary bullets added to show key highlights for quick point-of-care reference on the management of HIV infection in older patients
2/21/2014
-
Overview of HIV Prevention
- Updates on the use of PrEP for reducing the risk of sexually acquired HIV infection
- Evaluation of sexual risk behavior during the iPrEx study
- Updated findings from discontinued HIV vaccine trials
- New section summarizing key roles for primary care physicians in HIV prevention
- Summary bullets added to show key highlights for quick point-of-care reference on prevention of HIV infection
2/20/2014 - Hepatic Disease
2/18/2014
-
Non–AIDS-Defining Cancers
- Summary bullets added to show key highlights for quick point-of-care reference on management of non–AIDS-defining cancers
2/18/2014
-
Treatment-Experienced Patients
- Summary bullets added to show key highlights for quick point-of-care reference on management of treatment-experienced HIV-infected patients
2/10/2014 - HIV Exposure
1/27/2014 - ARV Overview
1/24/2014 - Renal Disease
1/24/2014 - Management of Hematologic Disorders
1/15/2014 - Hepatic Disease
1/10/2014 - Management of IRIS
1/9/2014 - Viral Infections
1/8/2014 - Dyslipidemia
1/3/2014 - Lab Assays
12/23/2013 - Management of Drug Users
12/23/2013 - Suppressed Patients
12/23/2013 - Hepatic Disease
12/18/2013 - AIDS-Defining Cancers
12/18/2013 - Primary Care
Updated to reflect recommendations in the 2013 HIV primary care guidelines and the 2013 OI prevention and treatment guidelines, including:
12/17/2013 - First-line ART
Updated to include:
- Final 5-year analysis of the phase III STARTMRK trial comparing raltegravir and efavirenz
- Updated data from the phase III program for elvitegravir:
- Updated data from the phase III program for dolutegravir
- Updated recommendations from Dr. Sax on regimens to consider for first-line therapy for specific patients
12/16/2013 - Lipoatrophy and Bone Disease
12/13/2013 - Testing and Diagnosis
12/11/2013 - ARV Overview
12/11/2013
-
Women With HIV
- Summary bullets added to show key highlights for quick point-of-care reference (Topic: HIV-Infected Women)
12/10/2013
-
HIV-Associated Ocular Complications
- Updated with new recommendations in the CDC OI guidelines regarding the management of acute retinal necrosis and treatment for CMV retinitis
12/5/2013 - Developed World
12/5/2013 - Global HIV Epidemiology
12/3/2013 - HIV and Minority Communities
12/3/2013 - Endocrine Disorders
12/2/2013 - HIV Care, Resource Limited
11/27/2013 - Management of Neurologic Diseases
10/29/2013
-
Non–AIDS-Defining Cancers
- Updated data on the rates of non-AIDS–defining cancers in HIV-infected patients
- Updated information on the potential association between exposure to antiretroviral agents and non-AIDS–defining cancers
- Updated to include new data on potential for drug–drug interactions in patients receiving concomitant chemotherapy and antiretroviral therapy
- Updated with additional information on the role of CD4+ cell count in the development of anal cancer in HIV-infected patients
- Updated with new data on the prognostic factors for Hodgkin lymphoma in HIV-infected patients
- Updated to reflect new guidance on lung cancer screening in high risk patients
- Updated to include new data on the potential complications of treatment of head and neck cancer in patients with HIV
10/29/2013
-
Management of Drug Users
- Guidelines on improving entry into and retention in care in substance users with HIV infection
- A systematic review of antiretroviral adherence interventions in HIV-positive drug users
- New data on drug interactions between opioid substitution agents and NNRTIs
- New data on drug interactions between opioid substitution agents and integrase inhibitors, including the recently FDA-approved dolutegravir
- New data and guidance to clinicians on the use of pre-exposure prophylaxis to reduce HIV transmission in injection drug users
10/24/2013
-
Developed World
- The latest HIV surveillance data from the Centers for Disease Control and Prevention and the Public Health Agency of Canada
- Updated surveillance data from the European Centre for Disease Prevention and Control
- Updated HIV surveillance data from Australia and New Zealand
- Updated epidemiologic data on HIV infection in men who have sex with men
- Updated epidemiologic data on HIV infection in injection drug users
- Updated surveillance data on late diagnosis of HIV infection
10/24/2013
-
ARV Overview
- New information on the use of cobicistat as a boosting agent, including its approval in Europe in September 2013
- Clinical trial data on tenofovir alafenamide fumarate
- Data from the ENCORE1 study of reduced-dose efavirenz
- The latest trial data on rilpivirine
- Data from the FLAMINGO study of dolutegravir vs darunavir/ritonavir
10/24/2013 - Management of IRIS
10/23/2013
-
AIDS-Defining Cancers
- Updated to include information on risk factors for IRIS-associated KS exacerbation
- Updated with new insights regarding the use of specific immunohistochemical staining for endothelial markers, particularly D2-40 and HHV-8, to complement basic hematoxylin and eosin staining to diagnose KS
- Updated to include additional data on the use of antiretroviral therapy and concurrent chemotherapy in HIV-infected patients with KS
- Updated to include information on electrochemotherapy to enhance the delivery of anticancer agents in KS
- Updated to reflect new treatment options and recommendation for patients with HIV-associated lymphomas
- Updated with new data on high-dose chemotherapy with autologous peripheral blood stem cell rescue in HIVassociated lymphoma
- Updated to include additional information on the role of rituximab in CD20+ AIDS–related lymphomas
10/22/2013
-
Women With HIV
- New epidemiologic data on HIV infection in women
- New guidance on the utilization of immunizations in women with HIV
- Updated data on risk of cardiovascular disease for women with HIV
- Emerging data on the use of various contraceptive methods for HIV-positive women
- Updated guidelines on screening for cervical and anal neoplasia in women with HIV
- Updated guidelines on antiretroviral therapy for HIV-positive women
- New information on depression in women who are infected with HIV
- Most recent guidelines on antiretroviral therapy during pregnancy
- Updated recommendations on the use of intravenous zidovudine during labor and delivery
10/21/2013
-
Treatment-Experienced Patients
- Integration of conclusions from recent studies, including SECOND-LINE and EARNEST and OPTIONS
- Expanded discussion of the efficacy of dolutegravir in treatment-experienced patients
- Discussion of the potential role of cobicistat-boosting in patients intolerant of ritonavir
- Expanded section on the management of integrase inhibitor–experienced patients
10/16/2013
-
Bacterial Infections
- Updated with new information on the treatment of Bartonella endocarditis
- Update with new information on Bartonella prevalence in South Africa
- Updated with new information on Clostridium difficile infection risk factors in HIV-infected patients
- Updated with new information on the diagnosis of Clostridium difficile infection in HIV-infected patients
- Updated with new information on the use of fidaxomicin vs vancomycin for treatment of recurrent Clostridium difficile infection
- Updated with new information on the treatment of Clostridium difficile infection with fecal microbiota transplantation
- Updated with new information on prevalence of drug-resistant Salmonella infection in Tanzania
- Updated with new information on the empiric treatment of bacterial respiratory infections
- Updated with new information on the use of pneumococcal vaccines for prevention of bacterial pneumonia
- Updated with new information from the 2013 DHHS guidelines on treatment and prevention of opportunistic infections
10/15/2013 - HIV Care, Resource Limited
10/14/2013 - Adolescents
10/14/2013
-
HIV Pathogenesis
- Updated information on use of ART for prevention and current guideline recommendations
- Revised recommendations from the US DHHS Guidelines regarding treatment of early infection
- Analysis of the possible cure of the “Mississippi baby”
- New data on post-ART control of HIV in the VISCONTI study
- New research on HIV eradication
- New clinical trial data on the use of HDAC inhibitors to induce HIV expression in latent reservoirs
- Updated information on the role of rhIL-7 to expand the CD4+ pool and improve immune constitution
10/14/2013 - Management of Hematologic Disorders
10/3/2013
-
Renal Disease
- Discussion of new data regarding the utility of cystatin C as a measure of kidney function
- Addition of a new section to discuss urine biomarkers of kidney function and injury
- Discussion of measuring proteinuria to assess risk stratification for morbidity and mortality, as outlined by the KDIGO guidelines
- Discussion of creatinine elevations associated with the antiretroviral boosting agent cobicistat and the integrase inhibitor dolutegravir
10/1/2013 - Testing and Diagnosis
9/27/2013
-
Viral Infections
- Updated with additional information on the potential for tenofovir with or without emtricitabine to protect against HSV-2 infection
- Updated to reflect changes to the current guidelines for treatment of acyclovir-resistant mucocutaneous herpes simplex virus
- Updated to reflect changes to the current guidelines for treatment of herpes zoster virus infections
- Updated with information that ocular implants are no longer commercially available in the United States
- Updated to include results from the stage II clinical trial (ACTG A5247) of zoster vaccine live for HIV-infected patients
- Updated to reflect changes to the current guidelines for treatment of CMV retinitis and to note that ganciclovir ocular implants are no longer commercially available in the United States
- Updated to reflect changes to the current guidelines for treatment of immediate sight-threatening CMV lesions and CMV-induced colitis or esophagitis
- Updated to include new data on the utility of systemic therapy for the treatment of CMV retinitis
- Updated with new information suggesting that preemptive therapy with ganciclovir, valganciclovir, or foscarnet for HIV-infected individuals who have never received ART lowers incidence of end-organ CMV by 25%
9/25/2013 - Lipoatrophy and Bone Disease
9/25/2013 - HIV and Minority Communities
9/19/2013
-
Endocrine Disorders
- Updated information on the safety of specific corticosteroids with ritonavir or ritonavir-boosted PI coadministration
- Updated to include an observational study on a premature decline in testosterone levels in HIV-infected males receiving antiretroviral therapy
- Updated to reflect new recommendations from the FDA on rosiglitazone from the joint meeting of the Endocrinologic and Metabolic Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee
- Updated to reflect FDA approval of canagliflozin for the treatment of diabetes mellitus, and discussion of the gliflozin class
9/19/2013
-
Optimizing Adherence to Antiretroviral Therapy
- Updated to include evidence from the SMART trial about drugs and regimen types and their association with adherence
- Updated with information on a randomized trial of Managed Problem Solving and associations with adherence and virologic suppression
- Updated with newer guidelines on entry to care and antiretroviral adherence
9/16/2013 - Specific Symptom Complexes
Updated with the following:
- New epidemiologic data on HIV dementia and information about common comorbidities
- Data from the Veterans Aging Cohort Study on the increased rates of myocardial infarction, end-stage renal disease, and HIV-associated cancers in HIV-infected individuals
- Data on AIDS- and non-AIDS–related deaths in HIV-infected individuals involved in the D:A:D study
- New epidemiologic data on the increasing population of HIV-infected individuals who are over 50 years of age
- Most current recommendations from the CDC on screening for anal cancer in HIV-infected individuals
- Information of the occurrence of noninfectious diarrhea during antiretroviral therapy, and the FDA approval of [drug: crofelemer] for noninfectious diarrhea
- Reports of hepatitis E virus infection in HIV-infected individuals
- The impact of some antiretroviral medications on liver enzymes
9/12/2013
-
Parasitic Infections
- Updated to include data on biomarker-based approaches to Pneumocystis jirovecii pneumonia diagnosis
- Updated to include information on the clinical impact of mutations in the Pneumocystis jirovecii dihydropteroate synthase gene
- Updated to include information on the potential efficacy of caspofungin-based salvage therapy for Pneumocystis jirovecii pneumonia
- Updated with additional information on the treatment of tropical parasitic opportunistic infections in HIV-infected patients
- Updated with data from a literature review on secondary prophylaxis for Trypanosoma cruzi in patients coinfected with HIV
- Updated with information from recent reports of chronic isosporiasis cases that persist despite standard antimicrobial treatment, secondary prophylaxis, and favorable immunologic and virologic response to antiretroviral therapy
- Updated with new recommendations from the Centers for Disease Control and Prevention on the prevention and treatment of opportunistic infections
9/12/2013 - Global HIV Epidemiology
8/29/2013 - Secondary HIV Prevention
8/29/2013
-
HIV in Children
- A recent case report of an HIV-infected newborn who achieved an apparent “functional cure” after early ART intervention
- The 2013 consolidated treatment guidelines from the World Health Organization
- New data on antiretroviral options for HIV-infected infants
- New data on therapy selection in older HIV-infected children
8/28/2013
-
Sexually Transmitted Diseases
- Updated with the latest US epidemiology data from the CDC 2011 Sexually Transmitted Disease Surveillance Network on:
- Syphilis
- Gonorrhea
- Chlamydia
- Human papilloma virus
- Trichomoniasis
- Pelvic inflammatory disease
- Updated with new data on trichomoniasis diagnosis
7/30/2013
-
Fungal Infections
- Updated information from the most recent CDC/NIH/IDSA guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents
- Updated to reflect recent data on the optimal treatment of cryptococcosis
- Updated to reflect new information on the timing of antiretroviral therapy initiation in patients with cryptococcal meningitis
7/26/2013
-
Psychiatric Disorders
- Updated with new data on the prevalence of delirium diagnoses among HIV patients admitted to the ICU
- Updated discussion of dementia and its evolving terminology, overall prevalence, and clinical presentation
- Updated with national cohort data from several countries indicating that depression is a universal diagnosis among HIV-infected individuals
- Updated with new information about drug–drug interactions between psychiatric medications and antiretrovirals
7/24/2013
-
HIV Care, Resource Limited
- Updated with new UNAIDS epidemiologic data regarding resource-limited settings
- Updated with new information on HIV healthcare delivery in developing countries
- Updated with new discussion of initial assessment of HIV-infected patients in developing countries
- Updated with new information on the use of sulfamethoxazole/trimethoprim in HIV-infected pregnant women
- Updated with new information on use of pneumococcal vaccines and human papillomavirus vaccine
- Updated with new data on the availability of antiretroviral therapy in developing countries
- Updated with new recommendations on initiation of antiretroviral therapy in developing countries
- Updated with new information on pre-exposure prophylaxis in developing countries
- Updated with new information on antiretroviral regimens available in developing countries
- Updated with new data on resistance management
- Updated with new recommendations regarding adherence in developing countries
- Updated with new discussion of the management of adverse events
- Updated with new information on the incidence of HIV drug resistance globally
- Updated with new information on the management of HIV patients with cryptococcal meningitis
- Updated with new recommendations on screening for TB
- Updated with new information on the management of TB disease in HIV-infected patients
- Updated with new information on the management of Kaposi’s sarcoma in HIV-infected patients
- Updated with new information on the treatment of cervical cancers in HIV-infected women
- Updated with new recommendations on screening for cervical cancer
- Updated with new information on screening for and treatment of herpes simplex virus 2
- Updated with new information on palliative care in developing countries
- Updated with new data on pre-exposure prophylaxis trials
- Updated with new information on the use of antiretroviral therapy for prevention of mother to child transmission (PMTCT)
7/23/2013
-
Management of Neurologic Diseases
- Updated with additional data on the risk of Alzheimer’s disease in patients with HIV
- Updated to include results from several additional studies regarding the relationship between antiretroviral central nervous system penetration and neuropsychological outcomes
- Updated with new information on the inclusion of PIs in antiretroviral therapy to reduce mortality in patients diagnosed with progressive multifocal leukoencephalopathy
- Updated with new data on the treatment of cryptococcal meningitis and management of cryptococcal meningitis–associated immune reconstitution inflammatory syndrome
- Updated with new data on the treatment of central nervous system tuberculosis and management of tuberculosis-associated immune reconstitution inflammatory syndrome
- Updated with new data on the use of high-dose capsaicin topical patch to treat distal symmetric polyneuropathy
7/2/2013
-
HIV-Associated Ocular Complications
- Updated to discuss recent studies comparing the use of fluconazole and flucytosine as induction therapy to treat cryptococcal meningitis (which may have neuro-ophthalmologic complications)
- Updated to include a new study comparing treatment approaches for cytomegalovirus retinitis, including systemic therapy and intravitreal injections
- Updated to include a study comparing famciclovir with acyclovir treatment in patients with ophthalmic zoster of trigeminal nerve
- Updated to discuss the potential for visual improvement in cases of ocular syphilis among HIV-infected individuals after intravenous antibiotic treatment
7/2/2013 - Primary Care
6/19/2013
-
Hepatic Disease
- Updated to include revised DHHS guidelines for the management of patients who require anti-HBV therapy but not antiHIV therapy
- Updated to include revised DHHS guidelines on deferral of HCV therapy in patients with minimal HCV disease
- Updated to include new data on the risk for liver disease progression in HIV/HCV-coinfected patients
- Updated to include new data on the use of etravirine and rilpivirine in HIV/HCV-coinfected patients who are also receiving boceprevir or telaprevir
- Updated to include revised package insert indication for use of boceprevir in prior null responders to HCV therapy
6/7/2013
-
Suppressed Patients
- New data on predictors of sustained virologic suppression in patients switching to darunavir/ritonavir monotherapy
- Data on outcomes associated with switching from emtricitabine/tenofovir with boosted atazanavir to abacavir/lamivudine with unboosted atazanavir in the ASSURE study
- Switching to single-tablet regimen of emtricitabine/rilpivirine/tenofovir DF from boosted PI regimen (SPIRIT trial)
- Efficacy, safety, and tolerability of 12-hour and 24-hour dosing of raltegravir in treatment-experienced patients on atazanavir-based regimens at baseline
- Data from the KRETA trial suggesting that limb fat recovery was similar with abacavir/lamivudine plus lopinavir/ritonavir vs lopinavir/ritonavir monotherapy
5/22/2013
-
Lab Assays
- Updated with DHHS, IAS, and EACS guideline recommendations on when to start antiretroviral therapy in asymptomatic adults
- Updated to include new DHHS guidelines on when to perform drug resistance testing
- Updated to reflect recent DHHS guideline recommendations on the use of genotypic viral tropism tests
3/25/2013
-
Management of Hematologic Disorders
- References reviewed and updated to reflect recent publications
3/20/2013 - HIV and Minority Communities
3/18/2013
-
Considerations for Aging HIV-Infected Patients
3/18/2013
-
Dyslipidemia
- Information on the effects of raltegravir and elvitegravir on lipid levels
- Updated information regarding interactions between ritonavir-boosted PIs and HMG-CoA reductase inhibitors
- New information on the effect of different ART modifications on dyslipidemia
- Updated IAS-USA recommendations on the use of abacavir in an initial antiretroviral regimen
3/15/2013 - Treatment-Experienced Patients
3/13/2013 - Non–AIDS-Defining Cancers
3/12/2013 - Specific Symptom Complexes
3/1/2013 - HIV Pathogenesis
2/27/2013 - Lipoatrophy and Bone Disease
2/21/2013 - Optimizing Adherence to Antiretroviral Therapy
2/13/2013
-
Global HIV Epidemiology
- Updated to include published references developed from conference data
2/13/2013
-
Developed World
- Updated to include published references developed from conference data
1/28/2013
-
Overview of HIV Prevention
- Updates on the use of PrEP for reducing the risk of sexually acquired HIV infection
- FDA approval of emtricitabine/tenofovir to reduce the risk of sexually acquired HIV infection in adults at high risk
- Updated information on the effectiveness of PrEP from the FEM-PrEP study
- Completion of the VOICE study and the presentation of the results showing that adherence with daily product use was low and no product was shown to be effective for the prevention of HIV in women
- Updates on the use of antiretroviral therapy to reduce the risk of sexual transmission of HIV to uninfected partners
- Retrospective, observational data from China on the real-world effectiveness of antiretroviral therapy for reducing the risk of HIV transmission among heterosexual serodiscordant couples
- New DHHS recommendation to offer antiretroviral therapy to patients at risk of transmitting HIV to sexual partners
- Updated information on the effectiveness of male condoms for preventing the risk of sexual transmission of HIV
- New data on the long-term effectiveness of male circumcision for preventing sexual transmission of HIV
- New findings on the use of behavioral interventions to reduce rates of sexually transmitted diseases
- Guidance for the prevention of HIV transmission to uninfected partners in women attempting conception
- FDA approval of emtricitabine/tenofovir to reduce the risk of sexually acquired HIV infection in adults at high risk
- Updated information on the effectiveness of PrEP from the FEM-PrEP study
- Completion of the VOICE study and the presentation of the results showing that adherence with daily product use was low and no product was shown to be effective for the prevention of HIV in women
- Retrospective, observational data from China on the real-world effectiveness of antiretroviral therapy for reducing the risk of HIV transmission among heterosexual serodiscordant couples
- New DHHS recommendation to offer antiretroviral therapy to patients at risk of transmitting HIV to sexual partners
12/4/2012
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First-line ART
- New EACS guidelines for first-line therapy
- Information on clinical trials of the new integrase inhibitor-based regimen for first-line therapy: cobicistat/elvitegravir/emtricitabine/tenofovir DF
- And the use of this coformulated regimen in first-line therapy
- Data from the STAR trial of the coformulated regimens emtricitabine/rilpivirine/tenofovir DF vs efavirenz/emtricitabine/tenofovir DF
- Updated treatment recommendations for first-line therapy
10/26/2012 - Overview of HIV Prevention
10/22/2012 - Testing and Diagnosis
Updated to include:
9/27/2012 - Sexually Transmitted Diseases
9/27/2012
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Women With HIV
- Includes guidance from the March 2012 DHHS guidelines on antiretroviral therapy in adults and adolescents
- Updated to include the following new guidance from the July 2012 DHHS perinatal guidelines:
- Management of serodiscordant couples
- Recommendations for coadministration of antiretroviral therapy and combined oral contraceptives
- Updated categories and recommendations for use of antiretrovirals in pregnancy
9/26/2012
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ARV Overview
- Updated throughout to reflect 2012 revision of the IAS-USA Panel guidelines
- Updated to reflect the expanded indication for tenofovir/emtricitabine for use as PrEP
- Updated throughout to reflect new recommendations of the DHHS Perinatal Guidelines committee
- Updated to include new information on resistance to rilpivirine
- Updated to include new data from studies of dolutegravir in first-line therapy
- Updated to reflect approval of the coformulated single-tablet regimen cobicistat/elvitegravir/emtricitabine/tenofovir
9/26/2012
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First-line ART
- Updated to reflect new data from phase III trials of elvitegravir/cobicistat in first-line therapy
- Updated to reflect FDA approval of fixed-dose emtricitabine/tenofovir/elvitegravir/cobicistat as a first-line antiretroviral regimen
- Updated to reflect changes in both the DHHS guidelines and IAS-USA guidelines on first-line therapy
7/17/2012 - Management of IRIS
7/6/2012 - HIV Care, Resource Limited
7/6/2012
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Fungal Infections
- Updated to describe outcome of clinical trial of immediate vs delayed ART for patients treated for cryptococcal meningitis with amphotericin.
- A recent trial of immediate vs delayed antiretroviral therapy in patients receiving treatment for cryptococcal meningitis was stopped due to increased mortality with in one of the study arms. Do you know the correct timing of antiretroviral therapy in your patients? Click here.
5/23/2012
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Hepatic Disease
- Updated to include new DHHS guidance on the management of HCV in HIV-infected individuals
- Updated to include new EASL guidance on the management of HBV in HIV-infected individuals
5/22/2012 - HIV Care, Resource Limited
5/10/2012
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Timing of Initiation of First-line Antiretroviral Therapy
- Updated to reflect DHHS guidelines update recommending antiretroviral therapy for all HIV-infected patients, including those with CD4+ cell counts > 500 cells/mm3, and in those at risk of transmitting HIV to an uninfected partner
- Updated to include new recommendations from the World Health Organization that HIV-positive partners in serodiscordant couples should start antiretroviral therapy regardless of CD4+ cell count
5/2/2012 - HIV in Children
4/11/2012 - HIV in Children
4/11/2012 - ARV Overview
2/28/2012
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Hepatic Disease
- Updated to include new drug-drug interaction data on ritonavir-boosted HIV protease inhibitors when coadministered with boceprevir
- Updated to reflect latest guidance on management of HIV/viral hepatitis coinfection from the European AIDS Clinical Society
2/7/2012
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Women With HIV
- Updated to include new data on the potential association between oral or injectable hormonal contraception use and HIV acquisition risk.
- Updated to include updated recommendations from DHHS perinatal guidelines on the use of lopinavir/ritonavir or atazanavir/ritonavir during pregnancy
- Updated to include data on sex differences in response to antiretroviral therapy
2/1/2012
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Bacterial Infections
- Updated with new practice guidelines on the management of Clostridium difficile
- Updated with new information on the diagnosis and treatment of Clostridium difficile
- Updated with new information on the role of Panton-Valentine leukocidin in the pathogenesis of USA300 infections of Staphylococcus aureus
- Updated with new information on the treatment of nonrespiratory manifestations of Staphylococcus aureus infection
- Updated with new information on the prevention of Staphylococcus aureus infection
1/31/2012 - HIV in Children
11/9/2011
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Lipoatrophy and Bone Disease
- Updated with data from the Veterans’ Clinical Case Registry on the risk of osteoporotic fractures with cumulative use of tenofovir and boosted PIs
- Updated with algorithm on identification and management of bone disease
- Updated with clinical recommendations from the European AIDS Clinical Society on management of hyperlactemia, lipoatrophy, and lipohypertrophy
11/7/2011 - Sexually Transmitted Diseases
11/4/2011
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Women With HIV
- Updated with new recommendations regarding the coadministration of antiretrovirals and oral contraceptives
- Updated with results from REALMRK evaluating efficacy of raltegravir in women and blacks
- Updated with the latest recommendations regarding use of antiretrovirals during pregnancy
- Updated to reflect the latest recommendations on postpartum management in HIV-infected women
11/4/2011
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Hepatic Disease
- Updated to include additional efficacy data on tenofovir disoproxil fumarate for HBV
- Updated to include further data and guidance on the use of HCV protease inhibitors in the setting of HIV coinfection
- Updated to include new data on reduced HBV vaccine efficacy in the setting of HIV
- Updated to include new data regarding HCV transmission and reinfection
- Updated to include data on guidelines regarding the use of IL28B testing as a pretreatment
11/3/2011
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Non–AIDS-Defining Cancers
- Updated with new epidemiologic data
- Updated to include new analysis from the Dutch ATHENA cohort regarding risk factors for non-AIDS-defining cancers
- Updated with new studies of anoscopy screening
- Updated with new information on the HPV vaccine
- Updated to include new data on prognosis of anal cancers
- Updated to reflect the FDA approval of brentuximab vedotin
- Updated with new lung cancer epidemiologic data
- Updated to include discussion of lung cancer screening
- Updated to reflect the FDA approval of ipilimumab and vemurafenib for metastatic melanoma
- Updated to include discussion of esophageal and stomach cancers
11/3/2011 - Testing and Diagnosis
Updated to include:
11/3/2011
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HIV Care, Resource Limited
- Updated with new statistics on the worldwide HIV/AIDS epidemic
- Updated with emerging information on the use of antiretroviral therapy as prevention and the contribution of these data on deciding when to start
- Updated with new information on screening for cryptococcal infection
- Updated with information on the Xpert MTB/RIF assay for screening for TB
- Updated with information from TB trials on when to start therapy and risk of IRIS
- Updated with new information on the treatment of Kaposi’s sarcoma
- Updated with new information on use of antiretroviral agents for pre-exposure prophylaxis
11/1/2011
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AIDS-Defining Cancers
- Updated with epidemiologic data for Kaposi’s sarcoma
- Updated with data on the relationship between IRIS, HAART timing, and Kaposi’s sarcoma
- Updated with studies investigating the use of intralesional vincristine for Kaposi’s sarcoma
- Updated with results from a study comparing pegylated doxorubicin liposomal and paclitaxel in patients with Kaposi’s sarcoma
- Updated with data evaluating gemcitabine as salvage therapy in Kaposi’s sarcoma
- Updated with a discussion of studies investigating lenalidomide in Kaposi’s sarcoma
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- Updated with new insight regarding how to best use chemotherapy and conventional whole brain radiotherapy for PCNSL in the HAART era
- Updated to show new epidemiologic and screening data for cervical cancer
11/1/2011
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ARV Overview
- Updated to include information on the FDA meta-analysis of risk of MI in patients participating in randomized clinical trials containing abacavir
- Updated to include information on randomized clinical trials on the use of tenofovir and emtricitabine/tenofovir as pre-exposure prophylaxis in HIV-negative persons at high risk of acquisition of HIV infection
- Updated to include new data on the risk of osteoporosis and chronic kidney disease in clinical cohort patients who have received regimens containing tenofovir and PIs
- Updated to include new information on the relative rate of development of M184V or M184I in patients taking lamivudine vs emtricitabine
- Updated with revised information on the tipranavir resistance scoring system
- Updated to include data from the QDMRK trial that demonstrated inferiority of once-daily vs twice-daily dosing of raltegravir
- Updated to include clinical trial data showing noninferiority of elvitegravir to raltegravir in treatment-experienced patients
- Updated to include new DHHS guideline information on the use of NNRTIs in treatment-naive patients
- Updated to include information on dolutegravir, a new integrase inhibitor entering phase III trials
- Updated with approved indications from European Medicines Agency documents
- Updated to include new guideline recommendations for use of antiretroviral therapy in pregnant women
- Updated throughout to reflect 2011 DHHS and EACS guideline revisions
11/1/2011
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Adolescents
- Updated HIV prevalence estimates from the Centers for Disease Control and Prevention
- Updates from the 2011 Department of Health and Human Services Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents
- New data demonstrating efficacy of antiretroviral therapy in reducing HIV transmission to an uninfected partner
- Barriers to adherence to antiretroviral therapy in HIV-infected adolescent patients
- Updated surveillance data on youth risk behavior
11/1/2011
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HIV and Minority Communities
- Updated to include the most recent epidemiologic data
- Updated to reflect most recent rates of sexually transmitted infections among minority populations
- Updated to include data indicating increased rates of virologic failure among minorities
- Updated to include data on outcomes in blacks from the ACTG 5202 trial
- Updated to include new data showing that black race is associated with missed appointments among HIV-infected patients
- Updated to include new data from WIHS showing that HAART nonuse among minority women was highest for those who drink heavily and had recent exposure to physical violence
- Updated to include new analysis regarding lack of engagement and retention in care (which disproportionately affects minorities) and potential strategies to improve engagement
10/28/2011 - HIV-Associated Ocular Complications
10/25/2011 - Management of IRIS
10/25/2011
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Psychiatric Disorders
- Updated with new information on CNS penetration of antiretrovirals and dementia
- Updated with information on clinical management of depression
- Updated with new agents for major depression and mania associated with bipolar disorder
- Updated with new information about drug-drug interactions between psychiatric medications and antiretrovirals
10/20/2011
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Management of Neurologic Diseases
- Updated to include data from the CHARTER study evaluating the presentation of neurologic complications in persons with HIV infection in the HAART era
- Updated with new data showing an increase in the proportion of stroke hospitalizations occurring in patients with HIV infection in the United States between 1997 and 2007
- Updated to show results from several studies regarding the relationship with antiretroviral CNS penetration and neuropsychological outcomes
- Updated with new data evaluating the relationship between immunosuppression and HIV-related neurologic disorders
- Updated to include new survival data for patients with progressive multifocal leukoencephalopathy who receive optimized HAART
- Updated with new data from the ACTG evaluating risk factors for neuropathy in treated HIV patients
- Updated with new information regarding self-report of symptoms and subsequent diagnosis of sensory neuropathy
10/20/2011
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Viral Infections
- Updated with new information on HIV/HSV-2–coinfected patients and transmission in serodiscordant couples
- Updated with new data on impact of HSV-2 treatment on HIV-1 RNA
- Updated with new information on the role of tenofovir gel as a protective agent against HSV-2 infection
- Updated with new section on the impact of HSV-2 suppression on HIV disease progression
10/13/2011 - Endocrine Disorders
10/11/2011 - Bacterial Infections
10/11/2011
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Specific Symptom Complexes
- Content reviewed and validated
10/7/2011 - Considerations for Aging HIV-Infected Patients
10/4/2011
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Suppressed Patients
- New data on the importance of adherence when switching to PI-based monotherapy
- Long-term follow-up data from the ARIES trial of switching from boosted to unboosted atazanavir
- A meta-analysis of 10 randomized, controlled trials comparing the effectiveness of PI monotherapy vs combination therapy
- Long-term follow-up data from the MONET clinical trial of switching to darunavir/ritonavir monotherapy
9/29/2011
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Management of Drug Users
- Availability of a new soluble form of buprenorphine
- The importance of integrating buprenorphine treatment into HIV clinical care settings as a way to increase retention in HIV care and to increase likelihood of initiating antiretroviral therapy and improved HIV treatment outcomes
- US FDA approval of extended-release naltrexone, administered as a monthly intramuscular injection, for the treatment of opioid dependence
- New protease inhibitor pharmacokinetic data
- The approval of rilpivirine and the drug-drug interaction seen with methadone
9/22/2011
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Management of Hematologic Disorders
- A new understanding regarding the mechanism of ‘anemia of chronic disease’ in HIV-infected patients
- The impact of HAART interruption on anemia development
- The incidence of TTP in the setting of HIV during the HAART era
- That expert assistance is recommended when treating patients with DIC and the appropriate use of transfusion in this setting
9/20/2011 - Primary Care
9/19/2011
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First-line ART
- Updated with information on the use of rilpivirine, a new NNRTI approved for use in first-line therapy
- Updated with information on the effect of tenofovir and PIs on risk of chronic kidney disease
- Updated with data on the effect of tenofovir and boosted PIs on risk for osteoporotic fracture
- Updated with information on an FDA meta-analysis of abacavir and risk of myocardial infarction
- Updated with the results of the QDMRK trial of once-daily raltegravir
- Updated with new information on NRTI-sparing regimens
- Updated with new recommendations of the DHHS on the use of NNRTIs in initial therapy
- Updated to reflect new EACS guidelines recommendations for first-line therapy
9/19/2011 - HIV Pathogenesis
9/19/2011
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Renal Disease
- Updated to include further data on the association between microalbuminuria and proteinuria with all-cause and AIDS-related mortality
- Updated to include data on the use of use of serum creatinine vs cystatin C to measure estimated glomerular filtration rates in HIV-uninfected and HIV-infected men
- Updated to include new data on potential genetic candidates for increased risk of HIVAN and FSGS among blacks
- Updated to include new data on the potential for changes in the homeostasis of calcium and phosphorus, potentially manifesting as earlier elevations in parathyroid hormone in patients receiving tenofovir
- Updated to include new data on the contribution of other medications on tenofovir-associated proximal convoluted tubular dysfunction
9/15/2011
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Dyslipidemia
- New data on lipid levels in patients in the ECHO and THRIVE studies of patients receiving either rilpivirine or efavirenz
- Additional risk factors and mechanisms of abnormal glucose metabolism
- Data from a recent study showing improvements in lipids when switching from abacavir/lamivudine to emtricitabine/tenofovir
- Further insight into the association between abacavir use and the risk of myocardial infarction
- New data on screening and prevention of cardiovascular disease in HIV-infected patients and of cardiovascular disease in HIV-infected patients
9/15/2011 - Overview of HIV Prevention
Updated with results from several HIV prevention trials, including:
- iPrEx study of emtricitabine/tenofovir in HIV-negative men or transgender women who have sex with men
- TDF2 study of emtricitabine/tenofovir in HIV-negative heterosexually active adults
- Partners PrEP study of tenofovir or emtricitabine/tenofovir in HIV-negative partners in HIV-serodiscordant heterosexual couples
- FEM-PrEP study of emtricitabine/tenofovir in high-risk HIV-negative heterosexual African women
- HPTN 052 study of immediate or delayed antiretroviral therapy in HIV-infected partners of serodiscordant couples
9/13/2011
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Parasitic Infections
- Updated with results of a meta-analysis that documented increased HIV-1 RNA in malaria-coinfected patients before treatment for malaria and decreased HIV-1 RNA after treatment for malaria
- Updated to include information on the in vitro synergy of indinavir and chloroquinolone in malaria-infected cell lines and clones
- Updated to include results of a meta-analysis on predictors of relapse of visceral leishmaniasis
- Update to include information on restoration of T-cell responses to Toxoplasma gondii in patients treated with antiretroviral therapy
9/9/2011 - Fungal Infections
9/9/2011 - Lab Assays
9/9/2011 - Treatment-Experienced Patients
8/30/2011 - Secondary HIV Prevention
8/26/2011 - Global HIV Epidemiology
8/16/2011 - Developed World
6/28/2011
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Hepatic Disease
- Updated to reflect FDA approval of boceprevir and telaprevir for the treatment of hepatitis C monoinfection.
6/6/2011 - ARV Overview
4/27/2011 - HIV in Children
3/4/2011 - First-line ART
3/4/2011
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ARV Overview
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Updated to reflect DHHS guideline revision that includes maraviroc plus zidovudine/lamivudine among alternative regimens and has reclassified saquinavir/ritonavir regimens among regimens to be used with caution
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Updated to reflect new information in the atazanavir prescribing information about dosing in pregnancy and the postpartum period
2/4/2011 - Treatment-Experienced Patients
2/4/2011 - Suppressed Patients
1/12/2011
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Sexually Transmitted Diseases
- 2010 Centers for Disease Control and Prevention sexually transmitted disease guidelines, including:
- Updated regimens for the treatment of HPV, gonorrhea, and lymphogranuloma
- Alternative treatment for bacterial vaginosis
- Updated regimens for the treatment of HPV, gonorrhea, and lymphogranuloma
- Alternative treatment for bacterial vaginosis
12/27/2010
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Testing and Diagnosis
Updated to include:
- FDA approval of a new rapid HIV test delivering results in approximately 60 seconds
12/7/2010
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Timing of Initiation of First-line Antiretroviral Therapy
- Update on WHO guideline recommendations regarding initiation of therapy
12/7/2010
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First-line ART
- Updated to reflect recommended/preferred regimen elements
- Updated to include new data on NRTI-sparing regimens
- Updated to include 96-week results of MERIT trial
- Updated to reflect EACS guidelines recommendations for first-line therapy
12/7/2010
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ARV Overview
- Updated to reflect the 2010 IAS-USA antiretroviral guidelines
- Updated to reflect the discontinuation of development of vicriviroc, bevirimat, apricitabine
- Updated to include preliminary information on phenotypic tropism testing of HIV proviral DNA from peripheral blood mononuclear cells
12/7/2010
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Optimizing Adherence to Antiretroviral Therapy
- Updated to include information about previous virologic failure and ability to maintain virologic suppression
- Updated to include new information about patient and clinic factors that may interfere with antiretroviral adherence
- Updated to include new information about simplified regimens and reduced risk of hospitalization
12/7/2010
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Lab Assays
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Updated to reflect current HIV treatment guideline recommendations for initiation of antiretroviral therapy
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Updated to include information on a phenotypic viral tropism test that can be used to assess tropism in patients with undetectable HIV-1 RNA
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Updated to include guidance from European experts on the use of tropism assays
- Updated to include guidelines from the European AIDS Clinical Society
Updated to reflect current HIV treatment guideline recommendations for initiation of antiretroviral therapy
Updated to include information on a phenotypic viral tropism test that can be used to assess tropism in patients with undetectable HIV-1 RNA
Updated to include guidance from European experts on the use of tropism assays
12/2/2010
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Women With HIV
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Updated to reflect the May 2010 DHHS guidelines on use of antiretrovirals during pregnancy
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Updated ACOG guidelines
Updated to reflect the May 2010 DHHS guidelines on use of antiretrovirals during pregnancy
Updated ACOG guidelines
12/1/2010
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AIDS-Defining Cancers
- Updated to include discussion of rituximab plus concurrent infusional EPOCH chemotherapy for HIV-associated B-cell non-Hodgkin’s lymphoma
11/30/2010
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Sexually Transmitted Diseases
- FDA approval of bivalent human papillomavirus vaccine
- Updated data from studies
- Updated references
11/30/2010
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HIV and Minority Communities
- Updated prevalence data on HIV infection among men who have sex with men
- Updated seroprevalence data on herpes simplex virus type 2 in subpopulations
- New data on the link between poverty and HIV infection
- New data on the impact of patient distrust on adherence rates in minority populations
11/24/2010
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Management of Neurologic Diseases
Updated to include:
- commentary on the interactions between aging and neurocognitive function
- updated data on CNS penetration of antiretrovirals
- insights from the CHARTER study on risk factor for distal symmetrical polyneuropathy
11/23/2010
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Management of IRIS
- Updated to include data showing higher levels of d-dimer and C-reactive protein among patients who develop IRIS during antiretroviral therapy; new prevalence data on IRIS in patients initiating antiretroviral therapy; studies evaluating timing of antiretroviral therapy in the setting of TB; a publication of ACTG A5164 data evaluating Cryptococcus as a presenting OI; and prevalence data for paradoxical IRIS in patients initiating antiretroviral therapy with Kaposi’s sarcoma.
11/23/2010
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Psychiatric Disorders
- Updated with new section on behavioral management for patients with personality disorders
11/23/2010
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Hepatic Disease
- Potential for HBV flare in HIV/HBV-coinfected patients discontinuing HIV treatment
- Value of IL28B in predicting response to hepatitis C treatment in HIV/HCV-coinfected patients
- Efficacy of retreating HCV nonresponders
- New data on the efficacy of vitamin E or pioglitazone in nondiabetic adults with NASH
11/22/2010 - Non–AIDS-Defining Cancers
Updated with discussion of the following:
- Association of anal infection with oncogenic HPV types and subsequent development of anal cancer
- Importance of smoking as a risk factor for anal carcinoma
- Treatment options for anal dysplasia and anal cancer in HIV-infected individuals
- Clinical course of lung cancer in HIV-positive patients
- Screening for oropharyngeal cancer or precancerous lesions among patients with HIV infection