Antiretrovirals Archives - Infectious Disease Advisor

HIV-1 Salvage Therapy Can Omit NRTIs and Remain Efficacious and Safe

By

Zahra Masoud

May 7, 2020

People with HIV-1 infection who have virologic failure can safely omit nucleoside reverse transcriptase inhibitors (NRTIs) in new regimens that include > 2 active drugs.

HIV/AIDS

Children With HIV Receiving ART May Have Deficits in Bone Architecture and Strength

By

Zahra Masoud

April 28, 2020

Children living with HIV demonstrate deficits in bone architecture and reductions in bone strength, compared with children without HIV.

HIV/AIDS

Health Benefit of Newer HIV PrEP Do Not Outweigh Cost Effectiveness of Older Formulation

By

Sweta Gupta

April 17, 2020

Although tenofovir alafenamide coformulated with emtricitabine has a marginally more benign side effect profile compared with tenofovir disoproxil fumarate coformulated with emtricitabine the additional cost of the newer HIV PrEP is not justifiable.

HIV/AIDS

Expansion of PrEP Coverage Decreases HIV Diagnosis Rates

By

Zahra Masoud

April 9, 2020

Expanding daily oral antiretroviral pre-exposure prophylaxis to persons at high risk for HIV may accelerate the reductions in new HIV diagnoses in the United States.

CROI 2020

PrEP Care Continuum Among Certain Patient Populations in the United States

By

Bradley van Paridon

April 6, 2020

There is an increased need for PrEP uptake among transgender women, men who have sex with men, and transgender women of color in the United States.

CROI 2020

CMV-Specific Immune Response in Advanced HIV Infections

By

Bradley van Paridon

April 2, 2020

Cytomegalovirus (CMV) viremia is suppressed after the start of antiretroviral treatment (ART) without specific anti-CMV treatment.

CROI 2020

Two-Drug Regimens Comparable With Three-Drug Regimens for HIV

By

Dibash Das, PhD

April 2, 2020

Two-drug regimens are shown to be comparable with 3-drug regimens as viable clinical treatment options for HIV.

$In patients with HIV, the disease process and ART may contribute to bone loss, resulting in osteopenia or osteoporosis and increased fracture risk.3,10 Proinflammatory cytokines and viral load contribute directly to reduced bone mineral density through their effects on osteoclast and osteoblast activity, inhibiting new bone formation and accelerating bone loss.3 Other risk factors for bone loss or fracture in the HIV population include low body mass index, smoking, substance abuse, glucocorticoid therapy, hypogonadism, coinfection with hepatitis B virus or hepatitis C virus, and vitamin D deficiency (affects ~90% of patients).3,11 Bone loss caused by ART emerges within 1 to 2 years after starting therapy.3,11 Tenofovir-based regimens are associated with higher rates of bone loss.3,11 Guidelines suggest avoiding tenofovir disoproxil fumarate or PI-boosting regimens in patients at high risk.3 Bisphosphonates (eg, alendronate or zoledronate) are recommended for those with HIV who have osteoporosis.3$

CROI 2020

The Renal-Bone Axis and ART in Adolescents and Elderly With HIV

By

Zahra Masoud

April 1, 2020

Particular antiretroviral therapy (ART) regimens may decrease bone mass density (BMD) in both adolescents and older people living with HIV (PWHIV).

CROI 2020

Discontinuation of Dolutegravir Due to Neurologic Side Effects Linked to Pre-Existing Mental Illness

By

Zahra Masoud

April 1, 2020

Dolutegravir (DTG) discontinuation due to neuropsychologic side effects (NPS) may be associated with pre-existing psychiatric conditions of depression and anxiety.

After diagnosis in the HIV care continuum is LTC. The CDC and Institute of Medicine (IOM) define LTC as “a period of 3 months or less between documentation of diagnosis and initiation of medical treatment with an HIV care provider/prescriber.”1 The 3-month benchmark was established because data show PLWH who start ART in the first 3 months after diagnosis achieve viral suppression faster than PLWH who delay treatment.1 Despite the critical importance of early ART, only 59% to 80% of PLWH in the United States start HIV care within 3 months of diagnosis.1 Although other high-income countries report higher LTC rates than the United States, their data show that having access to care does not guarantee patients will receive care. Various strategies have been proposed to promote LTC specifically in populations less likely to be linked to care, including drug users and low-income PLWH. Facilitating LTC may require an interdisciplinary team spread among multiple facilities.

CROI 2020

Long-Acting Cabotegravir + Rilpivirine Noninferior to Standard Treatment for HIV

By

Zahra Masoud

March 31, 2020

A long-acting therapy may be noninferior to the current daily oral antiretroviral therapy (ART) in maintaining viral suppression in the treatment of HIV-1 infection.