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Bictegravir/TAF/FTC in Women
The single-pill combination of bictegravir (BIC) with tenofovir alafenamide (TAF) and emtricitabine (FTC) has been shown in four Phase III trials to be effective as initial therapy.Also as a switch regimen in patients with stably suppressed HIV RNA and no resistance to BIC, TAF,...
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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...
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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...
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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...
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Short Bites: Human Papillomavirus (HPV) Update
HPV oral and oropharyngeal cancers are more difficult to detect than tobacco-related cancers because the symptoms are not always obvious to an individual, and health professionals may lack the education and background to diagnose HPV-related lesions. Although there are many adjunctive oral...
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Transitioning Your HIV Practice to a New Doctor
The AIDS epidemic raged around me like a wildfire in the late '80s and early '90s while I trained in medicine in San Francisco. During that storm, I began working with people with HIV. In 1995, ready to start a primary medical practice, I landed at a community clinic in Berkeley, California,...
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Forever Grateful: My Experience as a Rutgers HIV Care Specialization Student
While enrolled in graduate school at the Rutgers University School of Nursing, I continued to work as registered nurse on a labor and delivery unit at an increasingly busy community hospital in central New Jersey. Though my unit boasts delivery rates exceeding 2,000 births per year, most of our...
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Non-Occupational Post-Exposure Prophylaxis (nPEP) in Rural Areas – Does It Exist?
Nurses are on the front-lines of increasing access to health care. As a nurse, my first priority is always the patient. A recent case demonstrates the importance of the role of nursing in providing needed services for patients. In this case, a young person was a victim of sexual assault...
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Short Bites: What Is a Dental Emergency?
What is a dental emergency?I often get this question from non-dental personnel including case managers, physician assistants, nurses, and nurse practitioners. The following is a short list of questions you can ask patients to guide dental referrals for emergency...
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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...
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Short Bites: Effects of Antiretroviral Therapy (ART) on Oral Lesions
A recent study that was conducted among 1200 HIV patient of whom 600 each belonged to with ART and without ART and the occurrence of oral candidiasis and oral hairy leukoplakia. This study shows that oral candidiasis and leukoplakia was less among patients on ART as well as a decrease in the...
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Short Bites: Do I Pre-medicate Patients Based on a High Viral Load and Low CD4 Count?
The question I most commonly get asked by oral health providers is...
Do I pre-medicate patients based on a high viral load and low CD4 count?
There is no supporting data to support the need for routine antibiotic coverage pre or post dental treatment based on the...
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Short Bites: Xerostomia in Patients with HIV
It is estimated that 1.1 million people in the United States are infected with HIV. Of those, 1 in 7 do not know they are infected.[1] The number of new HIV diagnoses fell 19% from 2005 to 2014.[1] Because HIV testing rates have remained stable or increased in recent years, this decrease in...
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Short Bites: Periodontal Health in the Era of Antiretroviral Therapy
The U.S. Department of Health and Human Services currently recommends that every person with HIV begin antiretroviral therapy (ART) as soon as possible after diagnosis. Increased availability of testing and treatment along with the above guidelines have reduced the number of new HIV infections...
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Short Bites: One in Nine American Men are Infected with Oral HPV
According to a new study published in the Journal Annals of Internal Medicine, one in nine American men is infected with the oral form of the human papillomavirus (HPV). Nationwide, rates of oral HPV infection are 11.5% of men vs. 3.2% women. HPV 16, the most common type of high-risk HPV and...
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Giving New Life to New Jersey Syringe Access Programs
I had the honor to help develop the first legal syringe access program (SAP) in Atlantic City, NJ, almost 10 years ago. In 2006, the New Jersey legislature passed the Blood-Borne Disease Harm Reduction Act. This allowed for the establishment of up to six pilot SAPs in NJ. However, approval from...
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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...
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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-...
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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)...
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Recap: 17th Ryan White HIV/AIDS Program Clinical Care Conference
Highlights from Laura W. Cheever, MD, ScM, HRSA HIV/AIDS Bureau Associate Administrator and Conference Co-Chair
The field of HIV/AIDS care and treatment continues to evolve rapidly. Groundbreaking developments in HIV research are regularly presented at international meetings and...
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