TDF/FTC (Truvada) is the only ARV combination currently approved by the FDA for use as preexposure prophylaxis (PrEP). The multinational Phase 3 DISCOVER Study compared the efficacy and safety of TAF/FTC (Descovy) with TDF/FTC, in HIV-uninfected cisgender MSM and transgender women at high risk of se...
At CROI 2019, investigators presented 48-week results from the Phase 3 international multisite ATLAS and FLAIR studies of long-acting 2-drug injectable therapy. The study regimen consisted of the integrase inhibitor cabotegravir (CAB) plus the NNRTI rilpivirine (RPV), both given every 4 weeks as int...
In April 2019, the U.S. Food and Drug Administration approved a combination pill comprising the integrase inhibitor dolutegravir (DTG), 50 mg, and the NRTI lamivudine (3TC), 300 mg, for use as a complete ARV regimen for initial HIV treatment of patients. The approval specifies that DTG/3TC is intend...
The emergence of chronic disease complications in controlled HIV disease has changed the landscape of HIV clinical care. HIV infection confers an increased cardiovascular disease risk which is thought to be due to a complex interplay of mechanistic factors. While traditional cardiovascular risk fact...
Cross-posted from TargetHIV coverage of the 2018 National Ryan White Conference.
Regional AETCs across the United States are working to bring new clinicians into the HIV workforce through inter-professional education (IPE) programs. IPE trains learners in teams in clinical settings where trainees lea...
Taking effective HIV medications as prescribed offers many benefits for people with HIV—life expectancy normalizes and viral loads drop below detectable levels, preventing the risk of sexual transmission in those who achieve and maintain durable viral suppression. Unfortunately, many individuals fac...
Antiretroviral therapy (ART) has been very successful at preserving immune function and controlling opportunistic infections among individuals infected with HIV. Oral mucosal diseases associated with advanced immunosuppression, including candidiasis and hairy leukoplakia, are significantly less comm...
When a patient presents to your emergency department, urgent care or clinic with a chief complaint of sexual assault within the last 24 hours, the challenge is recognizing that, along with safety and criminal justice concerns, this patient has emergent health needs. One of the most urgent of these i...
The International AIDS Society (IAS)-USA recently released its 2018 HIV treatment and prevention recommendations. The document is particularly notable for its discussion of "When to Start ART."
The IAS-USA recommends "rapid" or immediate start of ART upon diagnosis of HIV, stating that treatment "sho...
Although DTG currently is not a desirable medication for women to take pre-conception (see Dolutegravir in Early Pregnancy: Updates on Possible Risk of Neural Tube Defects), findings from the DolPHIN study suggest that it may be a very useful agent for women who start ART during late pregnancy. The...
Integrase inhibitors have become primary treatment for most people with HIV; however, the impact of newer integrase inhibitors on pregnancy outcomes has not been well described. Researchers for the observational Tsepamo study have been examining birth outcomes in Botswanan women treated with various...
Two pharmacokinetic studies from AIDS 2018 help elucidate the disposition of tenofovir alafenamide (TAF) and cobicistat-boosted darunavir during pregnancy.
The IMPAACT P1026s study examined plasma concentrations of TAF with and without cobicistat in 43 pregnant women. For women taking 25 mg of TAF da...
As we have commented in the past, initial ARV regimens consisting of 2 drugs tend to perform poorly in comparison with currently recommended 3-drug regimens. Yet, given toxicity concerns about some ARVs (particularly about tenofovir DF and abacavir) and cost concerns about 3-drug regimens, the searc...
The U.S. Food and Drug Administration has given approval to a coformulation of darunavir 800 mg/cobicistat 150 mg/emtricitabine 200 mg/tenofovir alafenamide (TAF) 10 mg, to be marketed under the brand name Symtuza. DRV/COBI/FTC/TAF constitutes a complete regimen for patients with susceptible HIV, an...
Health care delivery often involves a one-size-fits-all approach. As clinicians, we treat a patient with a particular diagnosis similar to the last patient we saw with the same diagn...
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 darunavir 800 mg/cobi...
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 treatment failure...
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 entry...
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 World He...
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 inter...
