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 boosted PIs, 200/25 mg without boosters) or continued on TDF/FTC; the background third agents were not changed. At 48 weeks, 94.3% of TAF/FTC recipients and 93% of TDF/FTC recipients maintained HIV RNA suppression; the difference was not significant.
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 tenofovir alafenamide (TAF). This is of interest because administration of TAF (25 mg orally) results in 90% lower plasma concentrations of the TFV and TFV-DP than TDF, and 7-fold higher levels of TFV in mononuclear cells.
I would like to start this new year introducing myself to the AIDS Education and Training Center (AETC) community. I had the pleasure of joining the AETC National Coordinating Resource Center (NCRC) as a Health Educator in December 2015. I look forward to using my skill set as a Certified Health Educator Specialist and seasoned patient navigator/linkage to care coordinator (LTCC) to provide a perspective based on direct interaction and delivery of care to clients from another standpoint in the healthcare team.
Our understanding of quality in healthcare—how we talk about it and how we measure it—has evolved over time. However, the goal has remained the same: improving the health of people living with HIV. This means constantly challenging ourselves to do better. In essence, do quality improvement (QI) better.
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 death and minimizing medication-related toxicity. Two large randomized controlled clinical trials, the START study and the TEMPRANO study, now demonstrate that earlier treatment with ART is most beneficial to boost immune recovery and prevent clinical events.
National Quality Center (NQC) has completed its evaluation of the in+care Campaign -- the largest HIV quality improvement initiative carried out at the national level. We are pleased to announce that the Campaign demonstrated significant improvements in national retention and viral load suppression (VLS) performance.
Annual meetings of the Centers for Disease Control and Prevention (CDC)-sponsored Elimination of Mother-to-Child Transmission of HIV (EMCT) Stakeholders Group and the Expert Panel on Reproductive Health and Preconception Care for People with HIV, held at the Washington, D.C. headquarters of the American College of Obstetrics and Gynecology (ACOG) the week of May 25th, 2015, provided an exciting and energizing opportunity to discuss challenging clinical and policy issues.
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 double the prevalence of the general population.
A critical shortage of practitioners who treat HIV/AIDS patients in the United States is on the horizon. According the American Academy of HIV Medicine 32% of today’s HIV clinicians will stop providing care over the next 10 years. Nearly one-third of today’s workforce will retire leaving a shortage unless new practitioners can be encouraged to replace them. The current HIV workforce is largely composed of medical providers who entered the field more than 20 years ago. Today, the HIV care system faces a crisis in care capacity as clinicians retire without replacements.
Technology is great…when it works. This comes to mind when technology is supposed to enhance an experience but a malfunction causes that experience to cease. We know that technology should have the capacity to transform our lives, including our lives as HIV care providers. But in order for it to do so, it has to work. It has to be usable (i.e. easy, reliable, and fast). While iPad Minis have been on the market for several years now, a review of the literature yielded no current studies to examine their usability or effectiveness in clinical use.