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Topics in Antiviral Medicine

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https://www.readbyqxmd.com/read/29906790/strategies-for-linkage-to-and-engagement-with-care-focus-on-intervention
#1
Thomas P Giordano
Retention of HIV-infected patients in care is crucial to optimizing individual patient outcomes and reducing transmission of HIV. A number of strategies are available to improve linkage to care; among them, the AntiRetroviral Treatment and Access Services intervention should be considered standard of care at the clinic level. With regard to retention in care, the Retention Through Enhanced Personal Contact intervention has been shown to improve retention rates and the Centers for Disease Control and Prevention Data to Care program has been successful in assisting public health authorities to locate and return to treatment patients presumed to be lost to follow-up...
June 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29906789/new-and-noteworthy-in-tuberculosis-diagnostics-and-treatment
#2
Susan Swindells
People with HIV infection with latent tuberculosis (TB) infection (LTBI) are at a 10-fold greater risk of developing active disease. Interferon gamma release assays and tuberculin skin testing have approximately 65% to 70% specificity for diagnosing LTBI in HIV-infected patients. LTBI can be successfully treated with isoniazid preventive therapy and early antiretroviral therapy (ART). Rapid molecular diagnostics have approximately 88% sensitivity and 98% specificity for identifying active TB. ART should be started early in patients with TB...
June 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29727296/croi-2018-advances-in-antiretroviral-therapy
#3
Hong-Van Tieu, Barbara S Taylor, Joyce Jones, Timothy J Wilkin
The 2018 Conference on Retroviruses and Opportunistic Infections (CROI) showcased exciting data on new investigational agents including MK-8591 and tri-specific antibody targeting 3 highly conserved epitopes on HIV-1 in a single antibody. Clinical trials of initial antiretroviral therapy (ART) and switch studies involving bictegravir/emtricitabine/tenofovir alafenamide were presented. Intensification of initial ART with integrase strand transfer inhibitors did not increase the risk of immune reconstitution inflammatory syndrome...
May 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29727295/croi-2018-highlights-of-viral-hepatitis
#4
Anne F Luetkemeyer, David L Wyles
At the 2018 Conference on Retroviruses and Opportunistic Infections (CROI), there was a major focus on hepatitis C virus (HCV) elimination and improving each component of the hepatitis C care cascade. Several countries and cohorts have demonstrated the remarkable impact that universal HCV testing and unrestricted access to hepatitis C treatment can have on markedly reducing incident HCV infections and HCV infection prevalence, including in people who inject drugs and HIV/HCV-coinfected populations. However, in many settings, substantial barriers to widespread HCV treatment remain, including undiagnosed HCV infection, particularly in populations outside the standard "baby boomer" birth cohort (ie, born 1945-1965); restricted access to hepatitis C treatment in those with known HCV infection; reinfection with HCV; and migration of HCV-infected populations...
May 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29727294/croi-2018-complications-of-hiv-infection-and-antiretroviral-therapy
#5
Judith S Currier, Diane V Havlir
This year marked the 25th Conference on Retroviruses and Opportunistic Infections (CROI), and although there is much progress to celebrate in terms of treatment of HIV infection and expanding ART globally, many challenges remain. Tuberculosis is still the leading cause of death among people with HIV infection globally. This year, the results of investments in research to improve the prevention and treatment of tuberculosis were a highlight of the meeting. Noninfectious causes remain an important source of morbidity...
May 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29727293/croi-2018-advances-in-basic-science-understanding-of-hiv
#6
Mario Stevenson
The conference on Retroviruses and Opportunistic Infections represents the most important venue for the dissemination of research advances in HIV and AIDS. The 25th conference, held in Boston, featured presentations that provided insight into the mechanisms of HIV-1 spread in tissues as well as new information on mechanisms of HIV-1 persistence in individuals on effective antiretroviral treatment. The ability of the conference to convey research findings for a general audience is enhanced, to a large part, by preconference workshops...
May 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29727292/croi-2018-epidemic-trends-and-advances-in-hiv-prevention
#7
Susan P Buchbinder, Albert Y Liu
At the 2018 Conference on Retroviruses and Opportunistic Infections, trends in and risk factors for in HIV infection were highlighted. In the United States, new HIV diagnoses are highest in the South and among African Americans and are increasing in rural areas. Youth remain highly vulnerable to HIV infection globally. The epidemiology of HIV infections among people who inject drugs is changing, with overdose deaths, a major public health concern. Phylogenetics are being used to identify HIV transmission clusters and hotspots, which can inform prevention efforts...
May 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29689541/management-of-long-term-complications-of-hiv-disease-focus-on-cardiovascular-disease
#8
Judith S Currier
HIV-infected individuals on effective antiretroviral therapy experience a number of non-AIDS noncommunicable diseases, such as cardiovascular disease, more frequently than uninfected individuals. Common pathways for such diseases are chronic immune activation and inflammation, including the prolonged inflammation associated with lower nadir CD4+ cell count. Prevention and treatment of non-AIDS conditions include treatment of traditional risk factors, lifestyle interventions, earlier initiation of antiretroviral therapy, and potentially therapies specifically targeting inflammation and immune activation (eg, statins)...
April 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29689540/investigational-antiretroviral-drugs-what-is-coming-down-the-pipeline
#9
Roy M Gulick
Over the past 30 years, antiretroviral drug regimens for treating HIV infection have become more effective, safer, and more convenient. Despite 31 currently approved drugs, the pipeline of investigational HIV drugs remains full. Investigational antiretroviral drugs include the nucleoside analogue reverse transcriptase translocation inhibitor (NRTTI) MK-8591, a long-acting compound that could be dosed once weekly. Investigational nonnucleoside analogue reverse transcriptase inhibitors (NNRTIs) include doravirine, which is active in vitro against NNRTI-resistant HIV and was potent and well-tolerated when used in combination with a dual-nucleoside analogue RTI (nRTI) backbone in treatment-naive individuals...
April 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29689539/maximizing-the-benefits-of-hiv-preexposure-prophylaxis
#10
Susan P Buchbinder
Preexposure prophylaxis (PrEP) with tenofovir/emtricitabine (slash indicates coformulation) is highly effective in preventing new HIV infections. PrEP efficacy is strongly associated with adherence. In clinical trials, PrEP has been more effective in men who have sex with men and HIV-serodiscordant heterosexual couples than in women, likely reflecting pharmacokinetic differences between levels of tenofovir disoproxil fumarate in vaginal and rectal tissues, and poorer adherence in studies in women. Current guidelines recommend daily PrEP for men and women; however, PrEP taken at least 4 days per week for men may be as effective as daily PrEP, and women must take PrEP 6 to 7 days per week to maximize efficacy...
April 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29689538/opioids-and-hiv-infection-from-pain-management-to-addiction-treatment
#11
Chinazo O Cunningham
HIV-infected persons are more likely to have chronic pain, receive opioid analgesic treatment, receive higher doses of opioids, and to have substance use disorders and mental illness compared with the general population, putting them at increased risk for opioid use disorder. Management of opioid use in HIV-infected individuals can be complex, and the limited data on opioid treatment in this population are conflicting with regard to its effect on HIV outcomes. Buprenorphine treatment for opioid use disorder improves HIV outcomes and other outcomes...
April 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29689537/hiv-infection-advances-toward-a-cure
#12
Daniel C Douek
Achieving cure of HIV infection requires eliminating all replication-competent virus from the reservoir of latently infected cells or completely inhibiting infected cells from emerging from latency. Strategies include very early use of antiretroviral therapy; hematopoietic stem cell transplantation; "shock-and-kill" approaches; immune therapy with immune checkpoint inhibitors; gene therapy, including use of CC chemokine receptor 5-modified CD4+ T cells; and broadly neutralizing antibody therapy. Success is likely to require a combination of approaches...
April 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28208122/a-conversation-among-the-ias-usa-board-of-directors-hot-topics-and-emerging-data-in-hiv-research-and-care
#13
Constance A Benson, Judith S Currier, Carlos Del Rio, Joel E Gallant, Roy M Gulick, Jeanne M Marrazzo, Douglas D Richman, Michael S Saag, Robert T Schooley, Paul A Volberding
The IAS-USA volunteer Board of Directors met in October 2016 for its annual meeting. For the second year, the Board conducted a live, hour-long, interactive, roundtable webinar covering current questions and issues in HIV research, prevention, and care. Important highlights from the Board's discussion, which was moderated by Paul A. Volberding, MD, are included below. Members of the IAS-USA volunteer Board of Directors are Constance A. Benson, MD; Judith S. Currier, MD; Carlos del Rio, MD; Joel E. Gallant, MD, MPH; Roy M...
December 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28208121/2017-update-of-the-drug-resistance-mutations-in-hiv-1
#14
Annemarie M Wensing, Vincent Calvez, Huldrych F G√ľnthard, Victoria A Johnson, Roger Paredes, Deenan Pillay, Robert W Shafer, Douglas D Richman
The 2017 edition of the IAS-USA drug resistance mutations list updates the figures last published in November 2015. The mutations listed are those that have been identified by specific criteria for evidence and drugs described. The figures are designed to assist practitioners in identifying key mutations associated with resistance to antiretroviral drugs and, therefore, in making clinical decisions regarding antiretroviral therapy.
December 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28208120/cardiovascular-complications-of-hiv-infection
#15
REVIEW
Marshall J Glesby
HIV-infected individuals are at increased risk for cardiovascular events. Widely used cardiovascular disease (CVD) risk calculators to determine indications for statin treatment are not well validated for use in the HIV-infecte population. Some experts advocate including HIV infection as an independent risk factor for CVD. The effects of antiretroviral therapy on lipid profiles and the potentially increased risk for cardiovascular events must be taken into account when selecting treatment for HIV-infected individuals...
December 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28208119/hiv-prevention-opportunities-and-challenges
#16
REVIEW
Jeanne M Marrazzo
Preexposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF)-based regimens has been shown to be effective in preventing acquisition of HIV infection, with protective efficacy being dependent on adherence to treatment. Data from the PROUD (Preexposure Option for Reducing HIV in the UK) and IPERGAY (Action to Prevent Risk Exposure By and For Gay Men) studies, the later of which employed event-driven PrEP, showed a high rate of protective efficacy of PrEP with TDF and emtricitabine among men who have sex with men...
December 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28820727/sustained-off-treatment-response-after-discontinuation-of-long-term-nucleos-t-ide-analogue-treatment-in-hbeag-seronegative-hepatitis-b-a-case-series
#17
Marion Muche, Ulrike Meyer, Britta Siegmund, Rajan Somasundaram, Hans-Joerg Epple
International guidelines recommend lifelong nucleos(t)ide analogue (NA) treatment in individuals with chronic hepatitis B (CHB) infection who are hepatitis B e antigen (HBeAg) seronegative, because hepatitis B surface antigen (HBsAg) seroconversion is rarely achieved. However, after terminating therapy, sustained responses and HBsAg loss have been observed. Clinical characteristics identifying persons with favorable outcomes after discontinuing NA therapy have not yet been defined. This case series describes outcomes of 6 individuals with HBeAg-seronegative CHB infection without cirrhosis and low plasma levels of HBsAg who discontinued long-term NA treatment...
July 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28820726/barriers-to-treatment-access-for-chronic-hepatitis-c-virus-infection-a-case-series
#18
Alexander J Millman, Boatemaa Ntiri-Reid, Risha Irvin, Maggie H Kaufmann, Andrew Aronsohn, Jeffrey S Duchin, John D Scott, Claudia Vellozzi
Restrictive policies on access to new, curative hepatitis C treatments represent a substantial barrier to treating patients infected with hepatitis C. This case series demonstrates challenges experienced by patients and practitioners in accessing these treatments and highlights several strategies for navigating the treatment preauthorization process.
July 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28820725/understanding-hepatitis-c-virus-drug-resistance-clinical-implications-for-current-and-future-regimens
#19
David L Wyles, Anne F Luetkemeyer
Viral resistance to direct-acting antiviral drugs may impact their effectiveness during treatment of hepatitis C virus (HCV) infection. Most data on HCV drug resistance concern genotypes 1 and 3. The clinical impact of resistance to HCV nonstructural protein 5A (NS5A) inhibitors and a practical approach to indications and methods for resistance testing are discussed.
July 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28820724/neurologic-complications-in-persons-with-hiv-infection-in-the-era-of-antiretroviral-therapy
#20
Dennis Kolson
Neurologic complications in persons with HIV infection are less severe in the era of potent antiretroviral therapy but remain highly prevalent. Prior to the use of antiretroviral therapy, opportunistic infections of the central nervous system (CNS) and CNS malignancy were common. Progressive multifocal leukoencephalopathy (PML), however, remains a diagnostic challenge in HIV-infected individuals, and no effective antiviral treatment for PML is currently available. Primary neurologic complications of acute HIV infection include aseptic meningitis and acute inflammatory demyelinating polyneuropathy...
July 2017: Topics in Antiviral Medicine
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