Latest Updates

• Updated DHHS and EACS recommendations for first-line antiretroviral therapy

• First ever boosted PI–based single-tablet ART regimen approved by the FDA includes an indication for use as a switch regimen in patients with virologic suppression on their current regimen and no resistance to darunavir or tenofovir

• FDA approval of new NNRTI doravirine as single agent to be used in combination with other ARVs and as fixed-dose, single-tablet regimen coformulated with lamivudine and tenofovir disoproxil fumarate for treatment-naive adults

• FDA approval of new NNRTI doravirine as single agent to be used in combination with other ARVs and as fixed-dose, single-tablet regimen coformulated with lamivudine and tenofovir disoproxil fumarate for treatment-naive adults

• Primary analysis at 48 weeks of noninferiority trial comparing first-line doravirine plus 2 NRTIs vs ritonavir-boosted darunavir plus 2 NRTIs

• Week 48 analysis of noninferiority trial comparing first-line doravirine/lamivudine/tenofovir disoproxil fumarate vs efavirenz/emtricitabine/tenofovir disoproxil fumarate

• New considerations when choosing between NNRTIs for first-line therapy

• FDA approval of doravirine in combination with other ARVs for treatment-naive adults

• FDA approval of coformulated doravirine/lamivudine/tenofovir DF as a complete ART regimen for treatment-naive adults

• Updated information on research strategies for HIV eradication

• Updated with latest WHO guidelines on the use of ART for treatment and prevention of HIV infection

• Updated 2018 guidelines from EASL include revised treatment recommendations for patients with HIV/HCV coinfection

• 2018 updates to AASLD HBV guidelines include recommendations on use of tenofovir AF for HBV treatment

• Updated 2018 AASLD guidelines on management of NAFLD

• Revised EASL recommendations on management of alcoholic liver disease

• Updated IAS-USA guidelines now include on-demand oral FTC/TDF PrEP as alternative to daily oral PrEP for MSM with infrequent sexual exposures

• Interim results from the Prevenir trial demonstrate daily and on-demand oral FTC/TDF PrEP effectively prevented HIV infection in predominantly MSM cohort in Paris region

• Results from PARTNER1/2 trials in serodiscordant heterosexual and MSM couples show essentially no risk of linked HIV transmission within couples when HIV-positive partner is receiving suppressive ART

• Updated initial ART recommendations from the IAS-USA panel

• FDA approval of ibalizumab for heavily treatment–experienced patients with multidrug-resistant HIV

• FDA approval of coformulated darunavir/cobicistat/emtricitabine/tenofovir AF as a complete ART regimen

• New interim recommendations from DHHS and IAS-USA regarding dolutegravir use in women of childbearing age

• Updated with the latest recommendations on baseline laboratory testing and screening

• New information related to ongoing monitoring and follow-up

• Current recommendations on vaccinations for disease prevention

• Updated IAS-USA recommendations for first-line ART

• New interim recommendations from DHHS and IAS-USA regarding dolutegravir use in women of childbearing age

• FDA approval of first-ever PI-based fixed-dose, single-tablet regimen, darunavir/cobicistat/emtricitabine/tenofovir alafenamide

• FDA approval of ibalizumab-uiyk for use in combination with other ARV agents in heavily treatment–experienced patients with multidrug-resistant HIV

• Once-daily oral PrEP now FDA approved for use in at- risk adolescents along with safer sex practices

• Revised DHHS recommendations on initial ART in children with HIV infection

• Updated DHHS recommendations on initial ART in infants with HIV infection

• Updated monitoring recommendations for pediatric patients with HIV infection

• New DHHS recommendations on the use of dolutegravir in sexually mature adolescent girls

• New interim recommendations from DHHS regarding dolutegravir use in adults and adolescents with HIV who are pregnant or of childbearing potential

• New clinical trial results on cholesterol levels associated with initiating the investigational NNRTI doravirine

• Updated recommendations and clinical trial data on use of statins for dyslipidemia in HIV-infected patients, including updates on drug–drug interactions

• Results on lipid effects associated with switching from suppressive 3-drug regimen to 2-drug regimen including dolutegravir, plus results from Study 1878 demonstrating significant improvements in lipid parameters following switch from a suppressive boosted PI–based regimen to a bictegravir-based regimen

• New recommendations on initiating lipid-friendly regimens in treatment-naive patients to decrease dyslipidemia risk, along with new data from a small randomized study indicating that a Mediterranean-style diet was associated with significantly improved cardiovascular parameters vs a low-fat diet

• Latest guidance from the WHO on managing dyslipidemia among HIV-infected patients in resource-limited settings

• Updated information on eGFR restrictions for metformin use

• WHO guidance on primary care of diabetes in resource-limited settings

• New results on CVD risk and cumulative exposure to darunavir/ritonavir, risk of a recurrent CVD event and abacavir exposure, and data on platelet function as potential mediator of the association between abacavir use and CVD events

• New information on systematic underestimation of CVD risk when using common risk calculators for HIV-infected patients

• Updated to include drug–drug interactions between bictegravir/emtricitabine/tenofovir alafenamide and:
• Antiarrhythmics
• Antiepileptics
• Antimycobacterials
• St John’s wort
• Polyvalent cation-containing antacids and supplements
• Metformin
• New language in prescribing information for darunavir/cobicistat to reiterate interaction with ticagrelor
• Updated dosage thresholds for statins coadministered with PIs

• Updated epidemiologic data on HIV incidence in the United States  
• Updated epidemiologic data on the incidence of sexually transmitted diseases

• New clinical trial data on the effects of an NRTI-sparing 2-drug ART on bone
• New management options
• Long-term data on bone safety outcomes with tenofovir alafenamide
• New observational data on ARVs and fracture risk

• 2 new coformulated regimens, dolutegravir/rilpivirine and bictegravir/emtricitabine/tenofovir alafenamide, approved by the FDA for use as complete ART regimens in patients with virologic suppression on their current regimen and no history of virologic failure or resistance to any of the regimen components

• 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

• 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 approval and DHHS guideline recommendation of bictegravir/emtricitabine/tenofovir AF as first-line therapy

• Updated with new data on investigational long-acting strategies for HIV treatment and prevention

• 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

• Updated DHHS recommendations on initial antiretroviral therapy for adults and adolescents and for children 12 years of age or older who have not reached sexual maturity

• Updated with latest US epidemiological data for:
• Syphilis
• Gonorrhea
• Chlamydia
• Genital herpes
• Trichomoniasis
• Pelvic inflammatory disease

• Updated to reflect the latest guidance from the DHHS on switch strategies for virologically suppressed patients

• FDA approval of the fixed-dose coformulation dolutegravir/rilpivirine for use as a complete switch regimen in patients with virologic suppression on stable ART for ≥ 6 months with no history of treatment failure and no RAVs to either drug

• Revised CDC epidemiologic data including the incidence of new HIV infections, percentages of HIV-infected individuals unaware of their status, and new data from subpopulation analyses
• Updated information on FDA-approved rapid HIV assays

• Expanded FDA indication for raltegravir use in infants younger than 4 weeks of age

• The latest guidance from professional organizations worldwide establish consensus recommendation that ART should be offered to all patients with HIV, regardless of CD4+ cell count

• 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

• 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

• Updated AASLD/IDSA HCV management guidance includes recommendations on use of newly approved HCV regimens in HCV/HIV-coinfected patients

• New data from interim analysis of DAWNING trial evaluating dolutegravir plus 2 NRTIs for patients experiencing virologic failure of a first-line NNRTI-based regimen

• Revised DHHS recommendations on initial ART in children with HIV infection

• 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

• New information on noninvasive approaches in evaluating bone microarchitecture in HIV infection
• Updates on bone safety outcomes with tenofovir alafenamid
• Recent findings on the effects of tenofovir DF–containing HIV pre-exposure prophylaxis on bone health

• 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

• 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

• Revised to reflect the latest guidance on management of HCV/HIV coinfection from the AASLD/IDSA, DHHS, and EASL
• Updated EACS guidelines on treatment for HBV/HIV-coinfected patients, regardless of CD4+ cell count

• 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

• Integration of conclusions from SELECT trial demonstrating noninferiority of lopinavir/ritonavir plus raltegravir vs lopinavir/ritonavir plus 2-3 NRTIs in patients experiencing failure of an NNRTI-based regimen

• 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 

• Updated with current incidence data from the CDC
• New section on pre-exposure prophylaxis in minority populations

• 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

• 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

• Updated with 2016 guidelines from the American Diabetes Association
• Revised with more recent data on prevalence of thyroid disease in patients with HIV infection

• Updated guidance from the DHHS on recommended ART regimens during pregnancy to prevent perinatal HIV transmission

• 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

• FDA approval of new coformulated NRTI pair, emtricitabine/tenofovir alafenamide
• Updated initial ART recommendations from the DHHS
• Revised ART guidelines from the International Antiviral Society-USA panel

• New data from the ARIA trial demonstrate superior efficacy of dolutegravir/abacavir/lamivudine vs atazanavir/ritonavir plus emtricitabine/tenofovir DF as initial therapy in HIV-infected women

• 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

• New information on the role of suppressive acyclovir therapy in reducing risk of genital ulcer disease in patients who are starting antiretroviral therapy with CD4+ cell counts < 250 cells/mm³ 
• Updated recommendations for the management of CMV retinitis, including in the setting of ART initiation

• New guidance for the management of treatment failure in Chagas disease
• Updated treatment recommendations for toxoplasmosis in the absence of preferred pyrimethamine regimens

• Revised recommendations on cervical cancer screening intervals for HIV-positive women
• Updated recommendations now include 9-valent HPV vaccine for prevention of HPV in HIV-positive individuals

• FDA approval of the fixed-dose coformulation elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide for the treatment of HIV infection includes a switch indication for patients with virologic suppression on stable ART for ≥ 6 months with no history of treatment failure and no RAVs to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide components

• Updated recommendations on cervical cancer screening for HIV-infected women

• 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

• 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

• New guidelines from the EACS recommend initiating ART in all HIV-infected patients, regardless of CD4+ cell count
• EACS strongly recommends PrEP for people at substantial risk of HIV infection

• The latest global and US estimates of HIV prevalence among adolescents and young adults
• Updated DHHS recommendations on initial antiretroviral therapy for adults and adolescents

• New World Health Organization and British HIV Association guidelines recommend initiating ART in all HIV-infected patients, regardless of CD4+ cell count

• New World Health Organization guideline recommends offering daily oral PrEP as an additional prevention option in combination with other preventive strategies for individuals at high risk for acquiring HIV infection

• STRIIVING study demonstrated that switch from virologically suppressive regimen to once-daily single-tablet abacavir/dolutegravir/lamivudine noninferior to continuing baseline regimen for maintenance of viral suppression at Week 24

• 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

• 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

• New DHHS guidance on prevention of perinatal HIV transmission
• New data on NNRTI-based therapy in HIV-infected children
• New data on INSTI-based therapy in HIV-infected children
• New data on the efficacy of vaccination for measles, mumps, and rubella in HIV-infected children

• 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

• 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

• 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

• 2015 guidelines on the treatment of sexually transmitted diseases from the CDC include several key updates, including revised recommendations for gonorrhea treatment, trichomoniasis diagnosis, and genital wart therapy

• 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

• 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

• 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

• FDA approval of first fifth-generation diagnostic HIV test to distinguish between HIV-1 antibodies, HIV-2 antibodies, and HIV-1 p24 antigen in human serum or plasma specimens

• 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

• Phase III WAVES trial demonstrates superior virologic efficacy of EVG/COBI/TDF/FTC vs ATV/RTV + TDF/FTC at Week 48 in treatment-naive HIV-infected women

• 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

• The latest data on biomarkers potentially associated with paradoxical TB-IRIS
• Recent findings on the incidence of paradoxical IRIS

• 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

• Updated to incorporate drug–drug interactions with recently approved coformulated tablets atazanavir/cobicistat and darunavir/cobicistat
• New data on drug–drug interactions with use of HCV direct-acting antivirals

• 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

• 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

• 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

• New guidance from the CDC, DHHS, and IDSA on the treatment of candidiasis

• 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

• Updated with new recommendations from the American College of Obstetricians and Gynecologists on prenatal and perinatal HIV screening

• Updated recommendations from the CDC, DHHS, and IDSA on the diagnosis of C difficile

• Updated to reflect new recommendations from the CDC and DHHS on the diagnosis of acute HIV infection using HIV-1/HIV-2 antibody or p24 antigen combination immunoassays

• 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

• New data demonstrating a high rate of unintended pregnancies with levonorgestrel implants plus an efavirenz-based ART regimen

• Newly updated DHHS recommendations for first-line antiretroviral therapy

• New DHHS guidance on the use of antiretroviral agents in pediatric patients

• New guidance from the Osteo Renal Exchange Program panel of HIV specialists on screening and management of bone disease in patients with HIV infection

• FDA approval of atazanavir/cobicistat and cobicistat/darunavir fixed-dose combinations

• FDA approval of atazanavir/cobicistat and cobicistat/darunavir fixed-dose combinations 

• New expanded indication for elvitegravir/cobicistat/emtricitabine/tenofovir DF to include patients who are virologically suppressed

• New FDA approval of a human papillomavirus 9-valent vaccine

• New FDA approval of a human papillomavirus 9-valent vaccine

• High efficacy of emtricitabine/tenofovir as PrEP in MSM demonstrated by 2 randomized trials, PROUD and IPERGAY

• Updated to reflect FDA approval of cobicistat and elvitegravir as single agents 
• Revised guidance from the European AIDS Clinical Society on recommended initial and alternative first-line regimens for patients with HIV infection 

• 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 

• 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

• 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

• 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

• Updated to reflect FDA approval of cobicistat as a single agent for boosting darunavir and atazanavir
• Revised guidance from the European AIDS Clinical Society on first-line HIV regimens

• New guidance on secondary prophylaxis for Chagas disease
• New guidance on when to stop secondary prophylaxis for Leishmaniasis
• New section summarizing key roles for primary care physicians in the management of parasitic infections in HIV-infected patients 

• 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

• 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 

• 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

• 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

• Updated to reflect FDA approval of the coformulated single-tablet regimen abacavir/dolutegravir/lamivudine

• Updated to include FDA approval of dapagliflozin and empagliflozin
• Updated with 2014 guidelines from the American Diabetes Association
• Updated to include new section with key information for primary care physicians 

• 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

• 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

• 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

• Updated with inclusion of the World Health Organization guidelines on the management of cryptococcosis disease in resource-limited settings
• Updated with new information on the pathogenesis of cryptococcal-associated IRIS
• Included new section with key information for primary care providers

• Updated with the 2014 revised management guidelines from the International Antiviral Society-USA panel

• New section added with considerations for primary care physicians

• Updated with the 2014 revised management guidelines from the International Antiviral Society-USA panel

• 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

• New section added with considerations for primary care physicians

• Updated with new data on the case study of the “Mississippi Baby,” the infant treated with early ART

• Updated to include new data on the case study in Mississippi of the infant receiving early ART

• Updated with new data on the case study of the infant from Mississippi who received early ART

• Updated to include new data from the case study in Mississippi of the infant who received early ART

• 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

• 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

• 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

• New data on adherence among adolescents and young adults living with HIV
• New section emphasizing considerations for primary care physicians managing adolescents and young adults living with HIV 

• Pediatric formulation of atazanavir now available

• 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

• Newly revised section on first-line virologic failure provides management principles specific to the type of first-line regimen used (NNRTI, INSTI, or PI based)
• New section summarizing key roles for primary care physicians in the management of first-line antiretroviral therapy failure

• Updated to include new data on the association between HIV infection, ART, and bone diseases 
• New section summarizing key roles for primary care physicians in the management of HIV-infected patients with complications such as lipoatrophy, lipohypertrophy, and bone diseases 

• 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

• First comprehensive PrEP clinical practice guidelines published by the CDC in May 2014

• The latest guidance from the US DHHS panel recommends less frequent CD4+ cell count monitoring during antiretroviral therapy for patients with stable disease

• US FDA labeling change indicates rifabutin no longer contraindicated with rilpivirine, but coadministration requires increased rilpivirine dose

• Revised guidelines on first-line antiretroviral therapy from the US DHHS panel

• 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 

• 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 

• Randomized ACTG A5234 trial demonstrates no virologic efficacy benefit of partner-based modified directly observed therapy among patients in low- and middle-income countries switching from a failing first-line antiretroviral regimen to second-line therapy

• 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

• 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

• 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

• 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

• 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

• Revised epidemiologic data from UNAIDS

• Data from the ACTG A5257 trial comparing atazanavir/ritonavir, darunavir/ritonavir, and raltegravir, each in combination with emtricitabine/tenofovir DF, in treatment-naive patients

• 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

• 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

• Updated with new recommendations from the British HIV Association on the management of HIV-associated malignancies

• 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 

• 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

• 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

• Updates on the use of PrEP for reducing the risk of sexually acquired HIV infection
• Evaluation of sexual risk behavior during the iPrEx study 
  • Subanalysis of high-risk subgroups in the Partners PrEP study of tenofovir or emtricitabine/tenofovir in HIV-negative partners in HIV-serodiscordant heterosexual couples
• Updated findings from discontinued HIV vaccine trials
  • Long-term follow-up data on MRKAd5 gag/pol/nef vaccine use in the discontinued Phambili trial 
  • Interim data and safety monitoring board review findings from HVTN 505 showing a lack of efficacy of second-generation CD8+ T-cell–inducing HIV vaccine
• 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

• Summary bullets added to show key highlights for quick point-of-care reference on management of treatment-experienced HIV-infected patients

• Summary bullets added to show key highlights for quick point-of-care reference on management of non–AIDS-defining cancers

• Summary bullets added to show key highlights for quick point-of-care reference on evaluation and management of individuals exposed to HIV

• Updated to reflect FDA approval of a switch indication for emtricitabine/rilpivirine/tenofovir DF in virologically suppressed patients

• Summary bullets added to show key highlights for quick point-of-care reference on management of hematologic disorders commonly associated with HIV infection

• Summary bullets added to show key highlights for quick point-of-care reference on management of renal complications in the setting of HIV infection and its treatment

• Summary bullets added to show key highlights for quick point of care reference

• Summary bullets added to show key highlights for quick point–of-care reference (Topic: Viral Infections)

• Summary bullets added to show key highlights for quick point of care reference

• Summary bullets added to show key highlights for quick point of care reference (Topic: Lab Assays)

• Updated to include: FDA approval of a switch indication for emtricitabine/rilpivirine/tenofovir in HIV-1-infected patients virologically suppressed on a stable ritonavir-boosted PI regimen

• Summary bullets added to show key highlights for quick point of care reference

Updated to reflect recommendations in the 2013 HIV primary care guidelines and the 2013 OI prevention and treatment guidelines, including:

• Initial evaluation of patients
• Screening for sexually transmitted disease
• Ongoing monitoring and follow-up
• Prophylaxis for opportunistic infections

• Summary bullets added to show key highlights for quick point of care reference

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:
  • 96- and 144-week data from Study 102 comparing elvitegravir/cobicistat and efavirenz
  • 96-week data from Study 103 comparing elvitegravir/cobicistat and atazanavir/ritonavir
• Updated data from the phase III program for dolutegravir
  • 48- and 96-week data from the SPRING-2 trial, comparing dolutegravir and raltegravir
  • 48-week data from the SINGLE trial, comparing dolutegravir and efavirenz
  • 48-week data from the FLAMINGO trial, comparing dolutegravir and darunavir/ritonavir
• Updated recommendations from Dr. Sax on regimens to consider for first-line therapy for specific patients

• Summary bullets added to show key highlights for quick point of care reference (Topic: Lipoatrophy and Bone Disease)

• Summary bullets added to show key highlights for quick point-of-care reference (Topic: HIV Testing and Diagnosis).

• Revised DHHS recommendations on the use of integrase inhibitors in first-line therapy
• Revised recommendations for first-line therapy from the European AIDS Clinical Society

• Summary bullets added to show key highlights for quick point-of-care reference (Topic: HIV-Infected Women)

• Updated with new recommendations in the CDC OI guidelines regarding the management of acute retinal necrosis and treatment for CMV retinitis

• Summary bullets added to show key highlights for quick point of care reference (Topic: Developed World)

• Summary bullets added to show key highlights for quick point of care reference

• Summary bullets added to show key highlights for quick point of care reference

• Summary bullets added to show key highlights for quick point of care reference (Topic: HIV and Minority Communities)

• Summary bullets added to show key highlights for quick point of care reference

• Summary bullets added to show key highlights for quick point of care reference (Topic: Neurologic)

• 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

• 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

• New data on the prevalence of IRIS in resource-limited settings
• Results from randomized studies evaluating the impact of timing of antiretroviral therapy initiation on cryptococcal IRIS
• Updated guidance from the CDC on antiretroviral therapy initiation in patients with cryptococcosis

• 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

• 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

• 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

• 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

• 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

• 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

• Updated to include new WHO consolidated guidelines on the use of antiretroviral therapy for treatment and prevention of HIV infection

• Recent data assessing the use of rituximab to treat idiopathic thrombocytopenic purpura is presented
• New information from the SMART study on the impact of ART interruption on thrombocytopenia

• 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

• The latest estimates of HIV prevalence among adolescents and young adults in the United States
• New data on HIV risk behavior in adolescents
• New recommendations on transition of HIV-positive adolescents into adult services from the Committee on Pediatric AIDS 

• 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

• Revised CDC epidemiologic data including the incidence rate for new infections, percentages of HIV-infected individuals unaware of their status, and new data from subpopulation analyses
• Head-to-head trial data for 6 of the 7 rapid HIV tests currently available in the United States

• 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%

• New subgroup analyses from phase III clinical trials exploring the impact of race and ethnicity on treatment response
• New data on social factors that influence clinical outcomes in minority populations 

• Epidemiologic data on correlates of bone disease in HIV-infected patients 
• New clinical trial data on the effects of antiretroviral therapies on bone 
• New clinical trial data on the effects of newer NRTIs on mitochondria 
• New data on management of lipohypertrophy 

• 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

• 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

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

• Revised epidemiologic data from UNAIDS
• New data on HIV prevention strategies in the developing world

• 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

• Updated to reflect FDA approval and latest trial data on dolutegravir

• Updated with the latest epidemiologic data on HIV incidence from the CDC
• Added new data on the incidence of sexually transmitted diseases
• Updated with new data on the use of antiretroviral therapy for prevention of HIV transmission

• 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

• 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

• Updated with new recommendations from the World Health Organization regarding the timing of antiretroviral therapy

• 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

• 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

• 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)

• 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

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• Updated to include recommendations from the New York City Department of Health and Mental Hygiene regarding meningococcal vaccination

• 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

• 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  

• 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

• New recommendations for immunization with pneumococcal vaccine

• Updated with information suggesting optimal timing of antiretroviral therapy in patients with opportunistic infections
• Includes new information on updated DHHS recommendations on starting antiretroviral therapy in children up to 5 years of age

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• New information on neurologic complications of HIV in older patients
• New data on the prevalence of HIV in older individuals
• Recent guidelines on the timing of initial antiretroviral therapy in older patients
• Updated information on the association between HIV and cardiovascular disease
• New information on the association between antiretroviral therapy and liver-related adverse outcomes in patients with HIV and hepatitis coinfection

• References reviewed and updated to reflect recent publications 

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications   

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications 

• References reviewed and updated to reflect recent guideline updates

• References updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• References reviewed and updated to reflect recent publications

• Updated to include published references developed from conference data

• Updated to include published references developed from conference data

• 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

• 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

• Updated with CDC interim guidance on PrEP for heterosexually active adults at ongoing, very high risk of sexually acquired HIV infection

Updated to include:

• Discussion of the FDA approval of the over-the-counter OraQuick In-Home HIV Test

• 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

• Updated with new gonorrhea epidemiologic data
• Updated with new CDC guidance on gonorrhea treatment (Table)

• 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

• Updated to reflect revised guidance on timing of antiretroviral initiation in 2012 IAS-USA guidelines

• Updated to reflect a new study indicating increased mortality associated with early vs delayed antiretroviral therapy in patients with cryptococcal meningitis

• Updated to describe the outcome of clinical trial of immediate vs delayed ART for patients treated for cryptococcal meningitis with amphotericin B
• Do you know the appropriate time to start antiretroviral therapy when treating an HIV-infected patient with cryptococcal meningitis? Click here.

• 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.

• Includes 2012 revision of BHIVA Guidelines for ART in Adults

• Updated with new recommendations from WHO on starting ART regardless of CD4+ cell count in the infected partner and of a serodiscordant couple to reduce risk of HIV transmission

• 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

• Updated to include the expanded age range for the use of fosamprenavir in children

• Updated to include the recent approval of etravirine in children older than 6 years of age

• Updated to reflect primary endpoint data from phase III trials of elvitegravir/cobicistat in first-line therapy

• 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

• 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

• Updated to include a table of approved antiretrovirals for pediatric use, including recently expanded indications of darunavir, tenofovir, and raltegravir 

• Updated to reflect recommendations regarding starting antiretroviral therapy in patients with malignancies 

• 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

• Updated with CDC guidance on syphilis screening
• Updated with extensive new gonorrhea epidemiological data
• Updated to mention the first reported case of LGV L2b proctitis in a woman
• Updated with data evaluating the use of quadrivalent HPV vaccine in healthy men who have sex with men

• 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

• 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

• 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

Updated to include:

• Updated data from the CDC on the number of new HIV infections in 2009
• New data on the role of early HIV detection and treatment to prevent transmission
• Approval of a second combined antibody/antigen test (“fourth-generation” immunoassay)

• 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

• 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 
• Updated to show new data regarding risk factors for non-Hodgkin’s lymphoma
• Updated with new drug-drug interaction data relevant to the treatment of AIDS-related lymphomas 
• 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 

• 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

• 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

• Updated to reflect new data indicating that CMV retinitis is a risk factor for excess mortality in patients with AIDS 
• Updated to include new data showing that discontinuation of anti-CMV therapy after immune recovery does not increase the risk of poor outcomes 

• Updated to include new data from the SAPiT, CAMELIA, and STRIDE studies regarding the impact of timing of antiretroviral therapy initiation and development of IRIS 

• 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

• 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

• 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 

• Updated to include data showing a link between lopinavir/ritonavir and transient adrenal dysfunction in newborns
• Updated to address the approval of new, more concentrated testosterone formulations
• Updated with new data from the MACS cohort suggesting that sex hormones play a role in the pathogenesis of glucose abnormalities among HIV-infected men and a separate study showing an association between vitamin D deficiency and diabetes in HIV
• Updated with new recommendations from the American Diabetes Association regarding the use of A1c in the diagnosis of diabetes mellitus
• Updated to address updated classification of ‘prediabetes’ vs ‘person at increased risk for diabetes’, as outlined by the American Diabetes Association
• Updated with new data regarding the potential increased risk of bladder cancer with the use of pioglitazone and the subsequent updated safety information required in the product label by the FDA
• Updated to include the May 2011 approval of linagliptin for type 2 diabetes

• Content reviewed and validated

• Expanded information about community-acquired MRSA in HIV-infected patients.
• Expanded information on risk factors for bacteremia with S aureus in HIV-infected patients.
• Expanded information on risk factors for mortality with S pneumoniae community-acquired pneumonia in HIV-infected patients.

• New data on the risk of myocardial infarction in HIV-infected patients 
• New data on vitamin D insufficiency in older HIV-infected patients 
• New data on frailty in HIV-infected 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 

• 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

• Updated to reflect the updated 2011 DHHS pediatric guidelines

• 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

• Updated with new recommendations on CD4+ cell count testing 
• Updated with new recommendations on screening for bone disease 
• Updated with new information on the use of live vaccines
• Updated with information on the 2011 seasonal flu vaccine

• 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

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

• 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

• Data from the STAR study of patients randomized to lopinavir/ritonavir monotherapy or plus tenofovir and lamivudine
• Updated data from the VIKING study demonstrating better virologic responses in patients with the Q148 mutation when dolutegravir was administered twice daily

• Updated with DHHS guideline recommendations that CD4+ cell count may be monitored only every 12 months in stable, virologically suppressed patients and that virologic failure may be defined as confirmed HIV-1 RNA > 200 copies/mL
• Updated to include information on new COBAS TaqMan assay

• Updated with information about the use of mobile text messaging and adherence

• Updated to reflect new data on predictors of IRIS in patients with cryptococcal meningitis

• Updated HIV prevalence estimates from the Centers for Disease Control and Prevention
• Updated sexually transmitted disease estimates from the Centers for Disease Control and Prevention
• New data on antiretroviral therapy for the prevention of HIV transmission in serodiscordant couples

• Updated epidemiologic data from UNAIDS
• New data on HIV prevention trials in the developing world

• Updated HIV prevalence estimates from the Centers for Disease Control and Prevention 
• Updated HIV prevalence estimates from the European Centre for the Epidemiological Monitoring of HIV/AIDS 

• Updated to discuss implications of results of HPTN 052 study showing that early antiretroviral therapy reduced HIV transmission
• Updated to indicate publication of new EACS guidelines

• Updated to reflect the approval of extended-release nevirapine
• Updated to reflect the approval of rilpivirine for treatment-naive patients

• Updated to reflect new FDA warning on the use of lopinavir/ritonavir in premature babies.

• 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
• Updated to reflect new information in the atazanavir prescribing information about dosing in pregnancy and the postpartum period

• Updated to include new definition of virologic failure based on January 2011 US Department of Health and Human Services adult antiretroviral guidelines. 

• New recommendations from the 2011 US Department of Health and Human Services Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents

• 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

• FDA approval of the quadrivalent human papillomavirus vaccine for the prevention of anal cancer and associated precancerous lesions

• FDA approval of a new rapid HIV test delivering results in approximately 60 seconds

• 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
• Updated to include guidelines from the European AIDS Clinical Society

• 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

• Update on WHO guideline recommendations regarding initiation of therapy

• 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

• Updated to reflect the May 2010 DHHS guidelines on use of antiretrovirals during pregnancy
• Updated ACOG guidelines

• Updated to include discussion of rituximab plus concurrent infusional EPOCH chemotherapy for HIV-associated B-cell non-Hodgkin’s lymphoma

• 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

• FDA approval of bivalent human papillomavirus vaccine
• Updated data from studies
• Updated references

• 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

• Updated with new section on behavioral management for patients with personality disorders

• 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.

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

• New data on couples-based intervention strategies for special populations

• Recommendations for antiretroviral therapy initiation in older patients according to the updated IAS-USA guidelines
• New data on the relationship between HIV infection, antiretroviral therapy, and bone loss
• New data on the association between antiretroviral therapy and loss of renal function

• Content reviewed and recertified

• Expanded indication of tenofovir to include treatment of patients aged 12 to younger than 18 years
• Updates from the 2010 pediatric guidelines

• Updated to reflect new pharmacokinetic data.

• Updated with new information about baseline integrase resistance testing
• Updated with new recommendations regarding screening for TB and STDs
• Updated with information about 2010 seasonal flu vaccine and H1N1

• Updated to reflect new WHO guidelines for antiretroviral therapy for adults and adolescents, children, and pregnant women
• Updated to reflect new guidelines for the treatment of HIV-infected patients with cryptococcal meningitis
• Updated to reflect new data on clinical vs laboratory monitoring for antiretroviral therapy
• Updated to reflect data on the impact of H1N1 influenza in resource-limited settings
• Updated to reflect new data on the treatment of tuberculosis in the context of antiretroviral therapy
• Updated to reflect new data on the use of antiretroviral therapy in breast-feeding mothers and its efficacy in preventing mother-to-child HIV transmission

• Updated to reflect new guidelines on testosterone therapy, an FDA statement regarding the use of propylthiouracil, new American Diabetes Association guidelines, an FDA statement regarding cardiovascular safety with rosiglitazone, and the newly available therapies liraglutide and saxagliptin.

• Updated to reflect new guidelines for management of cryptococcal meningitis 

• Updated to reflect new data on rooming immunocompromised patients with those who have Pneumocystis pneumonia
• Updated to reflect new data on discontinuing prophylaxis for Pneumocystis pneumonia
• Updated to include data on clinical implications of mutations to sulfa medications

• Updated with expanded information about community-acquired MRSA in HIV-infected patients.

• Updated surveillance data from the Centers for Disease Control
• New data on benefits of early testing and linkage to care from Washington, DC

• Updated with new information about zoster live vaccine and HIV-infected patients
• Updated with information about trials of treatment of HSV as a preventive measure for transmission of HIV-1 in serodiscordant couples

• Updated to include information on the importance of screening for microalbuminuria in HIV-infected patients
• Updated to include information about antiretrovirals and tubular necrosis

• Updated to include 5-year results from the SOCA research group on CMV retinitis in the HAART era, mortality data in the setting of resistant CMV in patients with AIDS, and discussion of HIV neuroretinal disorder.

• Updated with data on the CAPRISA study evaluating tenofovir 1% gel for the prevention of HIV in women

• Updated epidemiologic data from UNAIDS
• New data on HIV prevention trials in the developing world 
• References reviewed and updated to reflect recent publications

• Updated with data from STARTMRK and ACTG 5202 on contemporary ART regimens and limb fat
• Updated to reflect the approval of tesamorelin for reduction of excess visceral abdominal fat in HIV-infected patients with lipodystrophy
• Updated to include new data on Vitamin D deficiency in HIV-infected patients
• Updated to include new data on factors associated with decreased bone mineral density in HIV-infected persons.

• Updated to reflect the updated 2010 DHHS pediatric guidelines

• New data on switching a boosted PI–based regimen to a raltegravir-based regimen
• New data on sequencing integrase inhibitors

• Updated data from the CDC on the percentage of patients in the United States unaware of their HIV status
• New data from Washington, DC, showing the success of a routine HIV testing program
• Approval of a combined antibody/antigen test (“fourth-generation” immunoassay)

• Updated data from the ARIES trial of switching from atazanavir/ritonavir to unboosted atazanavir
• New data on switching from a boosted PI to raltegravir
• New data on lipid improvements upon switching from abacavir/lamivudine to tenofovir/emtricitabine
• New data on switching NNRTIs in virologically suppressed patients due to toxicity

• Updated with results of the phase III ECHO and THRIVE studies comparing rilpivirine vs efavirenz in treatment-naive patients
• Updated with manufacturer withdrawal of vicriviroc from further development

• Updated to reflect results of the CAMELIA trial comparing HAART initiation at Week 2 vs Week 8 of TB therapy in coinfected patients

• Updated to include an FDA safety warning about saquinavir/ritonavir
• Updated information of the use of vicriviroc in treatment-experienced patients

• Updated to reflect new data from the 2010 CROI meeting on expansion of HIV testing, behaviors in women with concurrent relationships, and progression of AIDS in white vs non-white women
• Additions also reflect newly published data on stigma among young blacks and Hispanics, conspiracy beliefs regarding HIV among blacks, linkages to care, late initiation of treatment among minorities, and the relationships between access to care and outcomes

• Benefit of antiretroviral therapy in reducing HIV transmission within serodiscordant couples
• Relationship of community viral load and rate of new HIV infections
• Effectiveness of HIV testing initiatives to increase early diagnoses and linkage to care
• Negative results of a recent trial of the microbicide PRO 2000

• Updated with published data from the SWITCHMRK trial

• Updated with new data on risks of non-AIDS–defining cancers, bone disease, and renal impairment in the older HIV-infected patient

• Updated with new data on the use of raltegravir in pediatric patients

• Updated to reflect CROI 2010 data on disease progression in women and transmission rates during pregnancy as well as new published data on disparities in treatment initiation in women and the need for screening in older patients.

• Updated to reflect November 30, 2009, updates to WHO guidelines

• Updated to reflect December 2009 DHHS guideline revision and expanded indication for maraviroc.