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...
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 information comes from...
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...
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 personal health as well a...
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, or FTC. In these stu...
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 cancer sc...
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, oversee...
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 resulting in...
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:
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 achieve and...
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...
