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Topics in Antiviral Medicine

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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
#1
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
#2
Annemarie M Wensing, Vincent Calvez, Huldrych F Günthard, 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
#3
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
#4
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/28394763/abstracts-from-the-2017-conference-on-retroviruses-and-opportunistic-infections-february-13-16-2017-seattle-washington
#5
(no author information available yet)
No abstract text is available yet for this article.
April 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28402930/hiv-treatment-and-prevention-an-overview-of-recommendations-from-the-ias-usa-antiretroviral-guidelines-panel
#6
REVIEW
Paul A Volberding
Updated recommendations from the IAS-USA Antiretroviral Guidelines Panel on antiretroviral therapy for the treatment and prevention of HIV infection in adults were published in the Journal of the American Medical Association in 2016. The updated, evidence-based recommendations address when to initiate antiretroviral therapy, recommended initial antiretroviral regimens, including integrase strand transfer inhibitor (InSTI)-based regimens, recommended regimens for persons in whom an InSTI is not an option, and special treatment considerations...
February 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28402929/kidney-disease-and-hiv-infection
#7
REVIEW
Christina M Wyatt
The risk of acute and chronic kidney disease remains higher in HIV-infected persons than in the general population, and kidney disease in HIV-infected persons is associated with poor outcomes, including increased mortality. HIV-associated nephropathy occurs less frequently in the era of antiretroviral therapy. HIV immune complex kidney disease is being diagnosed more frequently, but the term is currently used to refer to a heterogeneous group of kidney diseases. Comorbid chronic kidney disease poses a growing burden in HIV-infected persons due to an overrepresentation of risk factors such as black race, diabetes, hypertension, and coinfection with hepatitis C virus...
February 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28402928/management-of-advanced-fibrosis-in-the-context-of-hepatitis-c-virus-infection
#8
REVIEW
Elizabeth C Verna
Advanced fibrosis may be present in a substantial proportion of individuals with asymptomatic, chronic hepatitis C virus (HCV) infection, including those who have been newly diagnosed. HCV treatment improves all-cause and liver-related mortality in individuals with advanced fibrosis, and there is some evidence that reversal of decompensated liver disease may occur in those with a sustained virologic response. HCV treatment is also crucial for individuals undergoing liver transplantation, as recurrent HCV infection posttransplantation is associated with accelerated fibrosis progression and increased risk of poor outcomes...
February 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28402927/hepatitis-c-virus-inflammation-and-cellular-aging-turning-back-time
#9
REVIEW
Susanna Naggie
There is evidence that hepatitis C virus (HCV) infection, like HIV infection, may be associated with chronic inflammation, immune activation, and immune senescence, which contribute to increased risks for cardiometabolic or other diseases outside the liver, as well as to ongoing damage in the liver. These effects may persist after a sustained virologic response (SVR) is achieved with HCV therapy. Such findings support initiation of treatment for HCV-infected individuals before damage to the liver is apparent and monitoring of individuals for complications even after an SVR is achieved...
February 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27398771/advance-care-planning-and-hiv-infection-in-the-era-of-antiretroviral-therapy-a-review
#10
REVIEW
Aroonsiri Sangarlangkarn, Jessica S Merlin, Rodney O Tucker, Amy S Kelley
In the era of antiretroviral therapy, HIV infection has become a chronic illness with associated multimorbidity, and practitioners are faced with an emerging population of HIV-infected patients with evolving needs for advance care planning (ACP), defined as communication between individuals and their proxies to plan for future health care decisions. This article provides a review of original research studies on ACP in HIV-infected adults in the era of antiretroviral therapy (1996-present) from PubMed, EMBASE, and PsycINFO...
December 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27398770/management-of-lipid-levels-and-cardiovascular-disease-in-hiv-infected-individuals-just-give-them-a-statin
#11
REVIEW
James H Stein
Current guidelines for managing cholesterol to reduce cardiovascular disease (CVD) risk focus on providing the appropriate intensity of statin therapy to reduce low-density lipoprotein cholesterol (LDL-C) level. There is very little evidence supporting the use of treatments aimed at raising high-density lipoprotein cholesterol level or reducing triglyceride levels. HIV-infected persons have excess risk of CVD compared with the general population. Statins are less effective at reducing LDL-C levels in HIV-infected persons who are also at greater risk for adverse effects from statin treatment...
December 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27398769/antiretroviral-therapy-for-hiv-infection-when-to-initiate-therapy-which-regimen-to-use-and-how-to-monitor-patients-on-therapy
#12
REVIEW
Steven C Johnson
Antiretroviral therapy is recommended for all patients with HIV infection. The benefit of immediate antiretroviral therapy was confirmed by results from the START (Strategic Timing of Antiretroviral Treatment) trial, which showed a 57% reduction in risk for the composite end point of AIDS-related events, serious non-AIDS-related events, or death from any cause with immediate treatment in antiretroviral therapy-naive participants with CD4+ cell counts above 500/µL. Other changes in HIV care include the widespread adoption of integrase strand transfer inhibitor-based regimens...
December 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27398768/treatment-of-acute-hiv-infection-and-the-potential-role-of-acutely-hiv-infected-persons-in-cure-studies
#13
REVIEW
Susan J Little
Diagnosis of acute HIV infection is important for accurate estimation of HIV incidence, identifying persons who are unaware of their HIV infection, and offering immediate treatment and risk-reduction strategies. The higher viral loads associated with acute HIV infection are associated with an increased risk of transmission. Current treatment recommendations are the same for acute and established infections. Studies of acute HIV infection indicate that initiation of antiretroviral therapy during this period may allow greater recovery of CD4+ T-cell count and function and may result in a smaller latent viral reservoir and a skewing of infection away from central memory CD4+ T cells toward shorter-lived transitional memory CD4+ T cells...
December 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27841983/elements-of-the-hiv-care-continuum-improving-engagement-and-retention-in-care
#14
Michael J Mugavero
The HIV care continuum (or treatment cascade) classifies individuals with HIV infection who are diagnosed, linked to care, retained in care, on antiretroviral therapy, and virally suppressed, to assess the effectiveness of health care and treatment from a population-level health perspective. Initially, it was estimated that only approximately 50% of individuals diagnosed with HIV infection are retained in care, and a lower percentage is virally suppressed. In an HIV clinic, retention in care should be addressed from a system perspective but focus on persons on an individual basis, and success in retention of a high proportion of individuals in care is likely to depend on collaboration with surrounding communities, local health departments, and other agencies...
October 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27841982/sexually-transmitted-infections-in-the-context-of-hiv-disease-clinical-implications
#15
Dana W Dunne
Universal screening and frequent retesting are required to reduce the burden of sexually transmitted infections in the HIV-infected population. Dual treatment is available for gonorrhea, expedited partner therapy is effective and legal in most states, sexually transmitted infection rates are high in the context of preexposure prophylaxis, and there is a continuing rise in rates of syphilis, particularly early neurosyphilis. This article summarizes a presentation by Dana W. Dunne, MD, FACP, at the IAS-USA continuing education program, Improving the Management of HIV Disease, held in New York, New York, in March 2016...
October 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27841981/clinically-significant-drug-drug-interactions-between-hepatitis-c-virus-and-hiv-treatments
#16
REVIEW
Jennifer J Kiser
The potential for drug-drug interactions is an important consideration in the treatment of HIV/hepatitis C virus (HCV) coinfection. Regimens for HCV genotype 1 infection are discussed in the context of an individual on stable antiretroviral therapy, to determine which HCV treatments may be initiated without requiring a change in antiretroviral regimen or an increase in monitoring for potential drug-drug interactions. The effects of potential interactions between HCV drugs and other therapeutic classes of drugs are also discussed...
October 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27841980/the-affordable-care-act-in-the-united-states-and-hiv-disease-past-present-and-future
#17
REVIEW
Timothy M Westmoreland
From its beginning, the AIDS epidemic crystallized some of the major flaws of the American health care system. Most private health insurance was associated with employment, and job loss meant insurance loss. Private insurers refused new coverage for people with HIV infection. Medicaid, an important program for uninsured people with low income, was limited to only those in certain categories (eg, pregnant women or children), and although people who had progressed to AIDS were categorized as eligible (ie, "disabled"), those with early stage HIV disease were not...
July 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27841979/understanding-cost-and-value-in-hepatitis-c-therapy
#18
REVIEW
Benjamin P Linas
Access to newer therapies for the treatment of hepatitis C virus (HCV) infection is limited by the costs of these treatments. Newer HCV regimens have been shown to be cost-effective in early stages and late stages of the disease, but payers in the United States may refuse to reimburse for treatment of early disease because of budget constraints. Approaches that can maximize patients' access to appropriate therapy include having dedicated staff to handle prior authorizations and appeals, keeping records of successful approaches to prior authorizations and appeals and sharing these approaches with colleagues, and communicating with patients so that they will not be lost to appropriate health care...
July 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27841978/hiv-transmission-and-injection-drug-use-lessons-from-the-indiana-outbreak
#19
REVIEW
Diane M Janowicz
A recent outbreak of HIV infection centered in the rural town of Austin in Scott County, Indiana, was associated with widespread injection drug use and a socio-economically depressed population. Control of the outbreak required coordinated efforts by state, federal, local, and academic institutions to implement and maintain on-site programs and services that included contact tracing, HIV and hepatitis C virus testing, insurance enrollment, syringe exchange, rehabilitation services, care coordination, preexposure prophylaxis, and HIV treatment...
July 2016: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/27841977/hiv-infection-in-hard-to-reach-populations
#20
REVIEW
Carlos Del Rio
HIV disproportionately impacts populations that have traditionally suffered from health disparities; thus, it is unsurprising that health disparities are a major driver of the ongoing HIV epidemic in the United States. High rates of HIV prevalence and incidence are now seen in the Southern United States and among black men who have sex with men, transgender women, and individuals in low-income settings. In addition, substance use continues to be a major driver of the HIV epidemic and impacts care outcomes. Efforts at reducing HIV transmission must include focus on engagement and retention in care among individuals at risk of being lost to care...
July 2016: Topics in Antiviral Medicine
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