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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 care:

• Are you in severe pain? Severe...

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 number...

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 CD4 or viral load. Antibiotic use in...

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 diagnose...

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 by 18...

I remember driving to Chicago on my first day as a Midwest AETC Practice Transformation (PT) Coach. I was filled with both excitement and apprehension to participate in a intensive training titled Building Blocks of High Performing Primary Care. While the concepts of PT were familiar to me after ov...

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 participa...

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 ver...

HIV-positive men and women can now live longer than ever before. A 2013 study found that a newly diagnosed 20 year old on effective antiretroviral therapy (ART) can expect to live into their 70s. A lifespan only slightly lower than in people without HIV.^[1] While this is great news, physicians are l...

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 convention...

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 darunavir du...

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 with b...

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

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 deat...

When incorporating best practices and guidelines for HIV care, clinicians must take into account their clients’ mental health and substance use needs. Approximately 30- 50% of people living with HIV/AIDS have current or past severe to moderate depression. At its highest estimate, that’s more than do...

Co-Author: Susa Coffey, MD; Medical Editor, AETC National Resource Center

An open-label study is evaluating the renal safety of elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild, or the "quad" pill) and cobicistat. For those patients with mild-to-moderate renal impairment (estimated glomerula...

Principal Investigator, New York/New Jersey AETC

About 30% of people receiving care and treatment for HIV infection have major depression. But is it best to conceptualize major depression as a mental illness or a medical illness? If you wake up in a bad mood but your body feels fine, you are very un...

Coauthor: Susa Coffey, MD; Medical Editor, AETC National Resource Center

Treatment of dyslipidemia is often complicated by drug interactions between statins and antiretrovirals. Pitavastatin is one of the newer statins approved and is one of the few that is not metabolized primarily by the CYP450 3A4...