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 face significant challenges to adhering to a daily regimen of antiretroviral therapy (ART).
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 common among patients on ART.
The AETC Program was well represented at the 2018 National Ryan White Conference on HIV Care & Treatment. The AETC National Coordinating Resource Center exhibited an array of AETC Program developed resources and promotional items.
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."
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 is that the patient may have been exposed to HIV. Non-occupational post-exposure prophylaxis (nPEP) needs to be initiated as soon as possible after known or potential HIV exposure, but throughout the country, there are barriers to this treatment.
The U.S. Food and Drug Administration has approved the NNRTI doravirine for use in initial HIV therapy. FDA approval was based on 48-week results of 2 Phase III studies in treatment-naive persons that showed doravirine + 2 NRTIs resulted in similar rates of viral suppression at 48 weeks as either efavirenz + 2 NRTIs or darunavir/ritonavir + 2 NRTIs. Recommended dosing is 100 mg once daily, with or without food.
Southern states today account for an estimated 44 percent of all people with an HIV diagnosis in the U.S., despite having only about one-third (37%) of the overall U.S. population. Diagnosis rates for people in the South are higher than for Americans overall. Eight of the 10 states with the highest rates of new HIV diagnoses are in the South, as are the 10 metropolitan statistical areas (MSAs) with the highest rates. The South faces internal disparities based on geography.
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 ARV regimens during pregnancy since 2014, and have acquired information on 88,755 births, nearly 22,000 of them to women with HIV.
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 DolPHIN study team randomized 60 pregnant women who were initiating ART in their 3rd trimester to one of t