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 living 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 living 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 living 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
It's easier than ever to stay on target. The Health Resources and Services Administration's (HRSA) Ryan White HIV/AIDS Program (RWHAP) technical assistance (TA) and training website has undergone a major update to make it easier for users to access tools and materials for the RWHAP. The website, formerly called TARGET Center, is now named TargetHIV. Beyond the name change, there have been multiple revisions and updates, including a new look, easier navigation, and decluttering of the content.
PARTNER1, whose results were reported last year,(1) was one of the studies that supported current efforts to promote the growing scientific consensus supporting "Treatment as Prevention" (TasP) or Undetectable = Untransmittable (U=U).
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 search for a potent and tolerable 2-drug regimen has continued. At the recent International AIDS Conference in late July, data were presented