UCSF Center for HIV Information

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UCSF CHI Online

Resources: 1

Articles: 27

  • Possible Safety Issue with Dolutegravir during Pregnancy: Reports of Neural Tube Defects

    On May 18, 2018, the U.S. Food and Drug Administration and the World Health Organization announced that cases of neural tube defects have been reported in babies of women with HIV who were on treatment with dolutegravir at the time of conception and during early pregnancy. The...

  • Immediate ART Initiation Improves Time to Viral Suppression

    The availability of ART immediately after the diagnosis of HIV offers many possible benefits, including earlier engagement in care and earlier HIV suppression, which may result in personal and public health benefits. Based on randomized clinical trials done in developing-world settings, the...

  • Darunavir/Cobicistat/FTC/TAF Single-Pill Combination in Treatment-Experienced Patients: EMERALD Study

    The EMERALD Study is a Phase III, open-label, noninferiority study in which 1,141 patients with stable HIV suppression on a regimen comprising a boosted protease inhibitor plus TDF/FTC were randomized (2:1) to either switch to an investigational single-tablet regimen containing...

  • Naltrexone Improves Virologic Suppression

    Release from correctional settings is a high-stakes time for persons with HIV, as it is for those with other health issues. People with substance use disorders often relapse, and those with HIV often stop ART and do not engage in HIV care, increasing the risk of declines in...

  • Rifampin Drug-Drug Interactions with Newer Antiretrovirals (TAF, Bictegravir, Dolutegravir)

    Treatment of tuberculosis (TB) in HIV-infected persons remains challenging, in part because of drug interactions between rifampin and some ARVs that may compromise antiretroviral therapy (ART). Three studies presented at CROI provide clinicians with additional guidance on how to manage certain...

  • Ibalizumab Approved for Persons with Multidrug Resistant HIV

    Ibalizumab (TNX-355), an entry inhibitor, has been approved by the FDA for use in persons with an extensive ARV treatment history and multidrug resistant HIV who are on a failing ARV regimen. Ibalizumab (trade name: Trogarzo) is a monoclonal antibody that binds the CD4 receptor and blocks HIV...

  • Bictegravir Approved for Initial ART, in Combination with TAF/FTC

    Bictegravir (BIC), a new integrase inhibitor, was recently approved by the FDA for use in a single-pill coformulation with TAF/FTC (brand name: Biktarvy) as initial therapy and as a switch regimen for patients who are already on a suppressive ART regimen and who have no history of...

  • Bictegravir/TAF/FTC in Women

    The single-pill combination of bictegravir (BIC) with tenofovir alafenamide (TAF) and emtricitabine (FTC), recently approved by the FDA, has been shown in four Phase III trials to be effective as initial therapy and as a switch regimen in patients with stably suppressed HIV RNA...

  • Undetectable = Untransmittable: Effective HIV Treatment Prevents HIV Transmission

    In September 2017, the U.S. Centers for Disease Control and Prevention (CDC) officially recognized that suppressing HIV through antiretroviral therapy (ART) prevents sexual transmission of HIV. In a "Dear Colleague" letter, CDC officials said, "people who take ART daily as prescribed and...

  • Doravirine in Initial Therapy: DRIVE-AHEAD Study

    Doravirine (DOR) is an investigational NNRTI that currently is being developed in a coformulation with TDF and FTC. A Phase 3 comparison of DOR + 2 NRTIs (87% of study subjects were given TDF/FTC) and DRV/r + 2 NRTIs in initial therapy was presented at CROI earlier this year (DRIVE-FORWARD); the...

  • Bictegravir in Initial Therapy

    Bictegravir (BIC) is an investigational integrase inhibitor that is being studied as part of a coformulation with tenofovir alafenamide (TAF) and emtricitabine (FTC). Two Phase 3 trials comparing a single-tablet regimen of BIC/TAF/FTC (50/25/200 mg) with regimens containing dolutegravir (DTG)...

  • On the Way: The First Protease Inhibitor-Based Single-Tablet Regimen

    The EMERALD Study is a Phase 3 randomized (2:1), open-label, noninferiority study examining the strategy of switching patients with suppressed HIV RNA on a regimen consisting of a boosted protease inhibitor plus tenofovir disoproxil fumarate (TDF)/emtricitabine to an investigational single-...

  • CROI 2017: Failure of Dolutegravir Monotherapy

    Leading up to this year, some researchers and clinicians had optimistically viewed dolutegravir an invincible ARV, a drug so mighty that it was unlikely to fail, and even more unlikely to be victim to emergent resistance mutations. Two presentations at CROI demonstrated the...

  • CROI 2017: Doravirine Noninferior to Darunavir + Ritonavir in Initial Treatment

    Doravirine is an investigational NNRTI that is active in vitro against many common NNRTI resistance mutations (including K103N, Y181C, and E138K). It is given once daily, has no food restrictions, and can be given with acid-blocking medications. In a Phase 2 study of treatment-...

  • CROI 2017: Bictegravir and Dolutegravir, Head-to-Head Comparison

     

    Bictegravir is an investigational integrase inhibitor that is dosed once daily, unboosted. It is active in vitro against many viruses with integrase resistance mutations. A Phase 2 double-blind placebo-controlled study randomized treatment-naive patients (n...

  • CROI 2017: Dolutegravir in 2-Drug Simplification Studies

    In recent years, a number of studies have evaluated 2-drug or even 1-drug ARV regimens, either in initial therapy or in switch regimens for patients with virologic suppression on 3-drug therapy. In general, these have not been as successful in achieving or maintaining virologic suppression as...

  • HIV Meds Update: PrEP Uptake by Sex, Race, and Age

    At the ASM Microbe meeting in June, researchers from Gilead Sciences presented data on use of TDF/FTC (Truvada) PrEP in the United States according to sex and race. They evaluated national pharmacy databases to identify prescriptions of TDF/FTC given for PrEP between January 2012 and September...

  • HIV Meds Update - RAPID: Immediate ART Initiation

    This publication presents the results of San Francisco General Hospital's Ward 86 pilot study of immediate ART initiation. This RAPID program systematically offered ART to patients upon diagnosis of HIV; patients were referred from HIV testing sites in San Francisco. Of the 39 patients who...

  • HIV Meds Update: Treatment as Prevention: Suppressive ART, Condomless Sex, and HIV Transmission Risk - also a Word on HPTN 052

    The PARTNER Study, a multisite European study, evaluated rates of HIV transmissions within serodifferent heterosexual and MSM couples (n = 548 and n = 340, respectively, contributed eligible data). The HIV-positive partners were on ART with HIV RNA levels of <200 copies/mL, and the couples...

  • HIV Meds Update: ART in Acute HIV--Decreasing HIV DNA

    We know that very early treatment in acute HIV infection decreases HIV RNA; this study shows it also greatly decreases proviral DNA (and reservoir size). Researchers investigated 2 small cohorts of patients in Thailand with acute (and very early) HIV infection, 1 untreated and 1 treated with ART...

  • Accessibility: The Bigger Picture

    I have been working on website accessibility for many years in my role as Production Manager at the UCSF Center for HIV Information. Despite that experience, I still encounter problems that confound me. I recently reached out to an accessibility expert for ideas on how to manage a particularly...

  • Use of Dolutegravir in Dialysis

    Dolutegravir has several characteristics that, in theory, suggest it will not be significantly removed by dialysis: It has a large apparent volume of distribution (17.4 L) and is highly protein bound (98.9%). A small study of 5 HIV-infected patients with end-stage renal disease undergoing...

  • PrEP: Bone Density Improves after Stopping TDF/FTC

    Tenofovir disoproxil fumarate (TDF) may cause decreases in bone mineral density (BMD) both in HIV-infected patients treated with TDF-containing ARV regimens and in HIV-uninfected persons who use it for PrEP. A substudy of the large iPrEx trial of TDF/FTC PrEP in MSM and transgender...

  • Efavirenz, Dolutegravir, and Darunavir: Pharmacokinetics during Pregnancy

    Three studies presented at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI) explored the pharmacokinetics of antiretrovirals administered during pregnancy. These studies support the use of standard-dose efavirenz, once-daily dolutegravir, and BID ritonavir-boosted...

  • Switching from TDF/FTC to TAF/FTC

    Researchers at the 2016 Conference on Retroviruses and Opportunistic Infections presented results from a randomized double-blind, double-dummy switch study of TAF/FTC. Over 660 patients with virologic suppression on TDF/FTC-containing 3-drug regimens were either switched to TAF/FTC (200/10 mg...

  • Tissue Levels of TAF: Too Low for PrEP?

    A pharmacokinetic study presented at the Conference on Retroviruses and Opportunistic Infections in Boston in February evaluated concentrations of tenofovir (TFV) and TFV-diphosphate (DP) in genital and rectal tissue and in anogenital fluid samples after administration of oral tenofovir...

  • START-ing TEMPRANO: Early Initiation of Antiretroviral Therapy for HIV

    The prevailing opinion among experts regarding the optimal CD4 T-cell count at which to start patients on antiretroviral therapy (ART) has shifted several times during the evolution of HIV treatment. These shifts reflect attempts to strike a balance between preventing HIV-associated illness and...