Choosing Among Current Antiretroviral Regimens.The Relevance of Drug–Drug Int...hivlifeinfo
In this downloadable slideset, Jürgen K. Rockstroh, MD, reviews how selection of antiretroviral therapy is influenced by drug–drug interactions and differing antiretroviral genetic barriers to resistance.
Format: Microsoft PowerPoint (.ppt)
File size: 1.17 MB
Date posted: 11/4/2016
АРТ в 2016-2017 гг: неизменная потребность в индивидуализации лечения для улу...hivlifeinfo
In this downloadable slideset, Danielle Ciuffetelli, PharmD, and Elly Fatehi, PharmD, BCPS, review important considerations when selecting initial ART and explore how formularies can be better managed to ensure delivery of optimal care for diverse populations of HIV-infected patients. Illustrative cases provide useful examples of key factors involved in treatment selection, including comorbidities, patient preferences and disposition, concomitant medications, and childbearing potential.
Format: Microsoft PowerPoint (.ppt)
File size: 2.46 MB
Date posted: 1/10/2017
In this downloadable slideset, Joel E. Gallant, MD, MPH, reviews the evidence behind the latest antiretroviral guidelines and offers a glimpse at upcoming agents currently under investigation.
Format: Microsoft PowerPoint (.ppt)
File size: 3.00 MB
Date posted: 6/15/2015
Ключевые слайды по индивидуальному выбору АРТ / Key Slides on Individualized ...hivlifeinfo
Слайды с последними данные и рекомендациями по выбору АРТ, как для пациентов, ранее не получавших лечения, так и пациентов с вирусологической супрессией. Оценки разных вариантов лечения, индивидуализация АРТ для женщин детородного возраста и во время беременности, пациентов с опортунистическими инфекциями и новые данные об исследовательских стратегиях АРТ.
Современное лечение ВИЧ.Усилить или не усилить : преимущества и недостатки бу...hivlifeinfo
Современное лечение ВИЧ.Усилить или не усилить : преимущества и недостатки бустированных режимов АРТ / Contemporary Management of HIV.To Boost or Not to Boost-Advantages and Disadvantages of Boosted ART.2017
In this downloadable slideset, Eric S. Daar, MD, and Program Director Joseph J. Eron, Jr., MD, review advantages and disadvantages of boosted ART regimens for managing patients with HIV.
Format: Microsoft PowerPoint (.ppt)
File size: 514 KB
Date posted: 6/16/2017
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусной супрессией и ...hivlifeinfo
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусной супрессией и у пациентов с вирусологической неудачей. /Contemporary Management of HIV. Modifying Antiretroviral Therapy in Virologically Suppressed Patients and Those With Treatment Failure.2016
In this downloadable slideset, W. David Hardy, MD, and Program Director Eric S. Daar, MD review key data and optimal approaches for modifying ART in patients who are virologically suppressed or have experienced treatment failure.
Format: Microsoft PowerPoint (.ppt)
File size: 2.07 MB
What’s New in Coformulated Antiretroviral Regimens.2014Hivlife Info
Andrew R. Zolopa, MD, discusses how new agents are contributing to the development of novel coformulated antiretroviral agents and regimens.
Format: Microsoft PowerPoint (.ppt)
File size: 1.33 MB
Choosing Among Current Antiretroviral Regimens.The Relevance of Drug–Drug Int...hivlifeinfo
In this downloadable slideset, Jürgen K. Rockstroh, MD, reviews how selection of antiretroviral therapy is influenced by drug–drug interactions and differing antiretroviral genetic barriers to resistance.
Format: Microsoft PowerPoint (.ppt)
File size: 1.17 MB
Date posted: 11/4/2016
АРТ в 2016-2017 гг: неизменная потребность в индивидуализации лечения для улу...hivlifeinfo
In this downloadable slideset, Danielle Ciuffetelli, PharmD, and Elly Fatehi, PharmD, BCPS, review important considerations when selecting initial ART and explore how formularies can be better managed to ensure delivery of optimal care for diverse populations of HIV-infected patients. Illustrative cases provide useful examples of key factors involved in treatment selection, including comorbidities, patient preferences and disposition, concomitant medications, and childbearing potential.
Format: Microsoft PowerPoint (.ppt)
File size: 2.46 MB
Date posted: 1/10/2017
In this downloadable slideset, Joel E. Gallant, MD, MPH, reviews the evidence behind the latest antiretroviral guidelines and offers a glimpse at upcoming agents currently under investigation.
Format: Microsoft PowerPoint (.ppt)
File size: 3.00 MB
Date posted: 6/15/2015
Ключевые слайды по индивидуальному выбору АРТ / Key Slides on Individualized ...hivlifeinfo
Слайды с последними данные и рекомендациями по выбору АРТ, как для пациентов, ранее не получавших лечения, так и пациентов с вирусологической супрессией. Оценки разных вариантов лечения, индивидуализация АРТ для женщин детородного возраста и во время беременности, пациентов с опортунистическими инфекциями и новые данные об исследовательских стратегиях АРТ.
Современное лечение ВИЧ.Усилить или не усилить : преимущества и недостатки бу...hivlifeinfo
Современное лечение ВИЧ.Усилить или не усилить : преимущества и недостатки бустированных режимов АРТ / Contemporary Management of HIV.To Boost or Not to Boost-Advantages and Disadvantages of Boosted ART.2017
In this downloadable slideset, Eric S. Daar, MD, and Program Director Joseph J. Eron, Jr., MD, review advantages and disadvantages of boosted ART regimens for managing patients with HIV.
Format: Microsoft PowerPoint (.ppt)
File size: 514 KB
Date posted: 6/16/2017
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусной супрессией и ...hivlifeinfo
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусной супрессией и у пациентов с вирусологической неудачей. /Contemporary Management of HIV. Modifying Antiretroviral Therapy in Virologically Suppressed Patients and Those With Treatment Failure.2016
In this downloadable slideset, W. David Hardy, MD, and Program Director Eric S. Daar, MD review key data and optimal approaches for modifying ART in patients who are virologically suppressed or have experienced treatment failure.
Format: Microsoft PowerPoint (.ppt)
File size: 2.07 MB
What’s New in Coformulated Antiretroviral Regimens.2014Hivlife Info
Andrew R. Zolopa, MD, discusses how new agents are contributing to the development of novel coformulated antiretroviral agents and regimens.
Format: Microsoft PowerPoint (.ppt)
File size: 1.33 MB
HIV Alert :Updating Your Practice Based on New Guideline Recommendations.2016hivlifeinfo
In this downloadable slideset, Eric S. Daar, MD, and Paul E. Sax, MD, review recent updates to expert guideline recommendations for ART—including new initial therapy recommendations, revised guidance on switch strategies for virologically suppressed patients, and other key recommendation updates.
Format: Microsoft PowerPoint (.ppt)
File size: 1.09 MB
Date posted: 9/19/2016
HIV Alert:ART Considerations for Aging Patients.2018hivlifeinfo
In this downloadable slideset, Eric S. Daar, MD, and David A. Wohl, MD, provide expert recommendations for older patients with HIV, both in terms of ART selection and general management.
Format: Microsoft PowerPoint (.ppt)
File size: 545 KB
Date posted: 2/12/2018
Начало АРТ впервые.Наилучшая практика.Best Practices in Antiretroviral Therap...hivlifeinfo
Best Practices in Antiretroviral Therapy: Initiating First-line Therapy
In this downloadable slideset, Charles B. Hicks, MD, discusses data on initiating antiretroviral therapy in HIV-infected patients.
Format: Microsoft PowerPoint (.ppt)
File size: 2.16 MB
Современное лечение ВИЧ : АРТ как профилактика.Contemporary Management of HIV...hivlifeinfo
Contemporary Management of HIV. Antiretroviral Therapy As Prevention.2016
In this downloadable slideset, Kenneth Mayer, MD, and Program Director Eric S. Daar, MD, review key data and optimal approaches for pre- and post-exposure prophylaxis in patients at risk for HIV infection.
Format: Microsoft PowerPoint (.ppt)
File size: 2.13 MB
Confronting the Challenges of HIV Care in an Aging Population.2019hivlifeinfo
Еxpert faculty use case-based examples to examine considerations for aging patients with HIV. Topics include ART modification, bone loss, renal impairment, cardiovascular risk, and cognitive decline.
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусологической супре...hivlifeinfo
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусологической супрессией (2021) / Contemporary Management of HIV: Modifying ART in Virologically Suppressed Patients 2021
Should Integrase Inhibitors Be Your First Choice When Starting HIV Therapy- E...Hivlife Info
In this downloadable slideset, Joseph J. Eron, Jr., MD, and Daniel Kuritzkes, MD, review key data on the evolving use of INSTIs in patients beginning HIV therapy.
Format: Microsoft PowerPoint (.ppt)
File size: 2.29 MB
Топ достижений лечения ВИЧ в 2017 г / Top Advances in ART for 2017hivlifeinfo
Top Advances in ART for 2017
In this downloadable slideset, Joel E. Gallant, MD, MPH, provides a comprehensive update on ART management.
Format: Microsoft PowerPoint (.ppt)
File size: 579 KB
Date posted: 3/29/2017
HIV Alert: Best Practices in ART Following Recent Drug Approvals.2016hivlifeinfo
In this downloadable slideset, Eric S. Daar, MD, and Joel E. Gallant, MD, MPH, review best practices and provide expert opinion in using newly approved ART options for treating patients with HIV.
Format: Microsoft PowerPoint (.ppt)
File size: 816 KB
Date posted: 5/12/2016
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...hivlifeinfo
Вопросы, связанные с АРТ первого ряда, смена арв-стратегии для пациентов с вирусной супрессией, акцентом на возрастающую роль новыхантиретровирусных стратегий.
Сравнение режимов лечения ВИЧ в разрезе различных клинических сценариев.ART...hivlifeinfo
This downloadable slideset summarizes optimal evidence-based antiretroviral therapy management strategies for a series of challenging clinical cases and is based on a satellite symposium presented at HIV Glasgow 2016.
Format: Microsoft PowerPoint (.ppt)
File size: 1.32 MB
Date posted: 11/11/2016
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...hivlifeinfo
Clinical Impact of New Data From CROI 2017
Expert faculty members Joel E. Gallant, MD, MPH, and Charles B. Hicks, MD, summarize key studies from this important annual conference.
Format: Microsoft PowerPoint (.ppt)
File size: 1.25 MB
Date posted: 3/3/2017
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...hivlifeinfo
Набор слайдов c рассмотрением важных вопросов об АРТ первого ряда, арв-препаратами пролонгированного действия и схемами АРТ с двумя препаратами, акцент в публикации на роль новых стратегий.
In this downloadable slideset, expert faculty members Andrew Carr, MBBS, MD, FRACP, FRCPA; Daniel R. Kuritzkes, MD; and Ian M. Sanne, MBBCH, FCP(SA), review key studies presented at the 2016 International AIDS Conference.
Format: Microsoft PowerPoint (.ppt)
File size: 1.28 MB
Date posted: 8/5/2016
Integrating Recent Data When Selecting First-line Antiretroviral Therapy.2015...Hivlife Info
Joseph J. Eron Jr., MD
W. David Hardy, MD
Paul E. Sax, MD
How do leading experts select first-line antiretroviral therapy for their HIV-infected patients?
Review these downloadable slides for key clinical trial data and the latest DHHS recommendations for first-line antiretroviral therapy.
HIV/AIDS Update From Boston 2014.CCO Official Conference Coverage.March 3-6,2014Hivlife Info
Topics covered include:
* First -line raltegravir, atazanavir/ritonavir, or darunavir/ritonavir
* Switching to elvitegravir-based therapy
* 92-week data on first-line dolutegravir
* Risk of HIV transmission with undetectable viral load
* Latest insights from cure research
New hepatitis C virus treatments
Современное лечение и профилактика ВИЧ : передовые стратегии лечения у пациен...hivlifeinfo
Стратегии смены АРТ у пациентов с вирусной супрессией, включая смену АРТ при резистентности, рекомендации по инъекционным препаратам длительного действия , смена АРТ до или во время беременности
HIV Alert :Updating Your Practice Based on New Guideline Recommendations.2016hivlifeinfo
In this downloadable slideset, Eric S. Daar, MD, and Paul E. Sax, MD, review recent updates to expert guideline recommendations for ART—including new initial therapy recommendations, revised guidance on switch strategies for virologically suppressed patients, and other key recommendation updates.
Format: Microsoft PowerPoint (.ppt)
File size: 1.09 MB
Date posted: 9/19/2016
HIV Alert:ART Considerations for Aging Patients.2018hivlifeinfo
In this downloadable slideset, Eric S. Daar, MD, and David A. Wohl, MD, provide expert recommendations for older patients with HIV, both in terms of ART selection and general management.
Format: Microsoft PowerPoint (.ppt)
File size: 545 KB
Date posted: 2/12/2018
Начало АРТ впервые.Наилучшая практика.Best Practices in Antiretroviral Therap...hivlifeinfo
Best Practices in Antiretroviral Therapy: Initiating First-line Therapy
In this downloadable slideset, Charles B. Hicks, MD, discusses data on initiating antiretroviral therapy in HIV-infected patients.
Format: Microsoft PowerPoint (.ppt)
File size: 2.16 MB
Современное лечение ВИЧ : АРТ как профилактика.Contemporary Management of HIV...hivlifeinfo
Contemporary Management of HIV. Antiretroviral Therapy As Prevention.2016
In this downloadable slideset, Kenneth Mayer, MD, and Program Director Eric S. Daar, MD, review key data and optimal approaches for pre- and post-exposure prophylaxis in patients at risk for HIV infection.
Format: Microsoft PowerPoint (.ppt)
File size: 2.13 MB
Confronting the Challenges of HIV Care in an Aging Population.2019hivlifeinfo
Еxpert faculty use case-based examples to examine considerations for aging patients with HIV. Topics include ART modification, bone loss, renal impairment, cardiovascular risk, and cognitive decline.
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусологической супре...hivlifeinfo
Современное лечение ВИЧ: модификация АРТ у пациентов с вирусологической супрессией (2021) / Contemporary Management of HIV: Modifying ART in Virologically Suppressed Patients 2021
Should Integrase Inhibitors Be Your First Choice When Starting HIV Therapy- E...Hivlife Info
In this downloadable slideset, Joseph J. Eron, Jr., MD, and Daniel Kuritzkes, MD, review key data on the evolving use of INSTIs in patients beginning HIV therapy.
Format: Microsoft PowerPoint (.ppt)
File size: 2.29 MB
Топ достижений лечения ВИЧ в 2017 г / Top Advances in ART for 2017hivlifeinfo
Top Advances in ART for 2017
In this downloadable slideset, Joel E. Gallant, MD, MPH, provides a comprehensive update on ART management.
Format: Microsoft PowerPoint (.ppt)
File size: 579 KB
Date posted: 3/29/2017
HIV Alert: Best Practices in ART Following Recent Drug Approvals.2016hivlifeinfo
In this downloadable slideset, Eric S. Daar, MD, and Joel E. Gallant, MD, MPH, review best practices and provide expert opinion in using newly approved ART options for treating patients with HIV.
Format: Microsoft PowerPoint (.ppt)
File size: 816 KB
Date posted: 5/12/2016
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...hivlifeinfo
Вопросы, связанные с АРТ первого ряда, смена арв-стратегии для пациентов с вирусной супрессией, акцентом на возрастающую роль новыхантиретровирусных стратегий.
Сравнение режимов лечения ВИЧ в разрезе различных клинических сценариев.ART...hivlifeinfo
This downloadable slideset summarizes optimal evidence-based antiretroviral therapy management strategies for a series of challenging clinical cases and is based on a satellite symposium presented at HIV Glasgow 2016.
Format: Microsoft PowerPoint (.ppt)
File size: 1.32 MB
Date posted: 11/11/2016
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...hivlifeinfo
Clinical Impact of New Data From CROI 2017
Expert faculty members Joel E. Gallant, MD, MPH, and Charles B. Hicks, MD, summarize key studies from this important annual conference.
Format: Microsoft PowerPoint (.ppt)
File size: 1.25 MB
Date posted: 3/3/2017
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...hivlifeinfo
Набор слайдов c рассмотрением важных вопросов об АРТ первого ряда, арв-препаратами пролонгированного действия и схемами АРТ с двумя препаратами, акцент в публикации на роль новых стратегий.
In this downloadable slideset, expert faculty members Andrew Carr, MBBS, MD, FRACP, FRCPA; Daniel R. Kuritzkes, MD; and Ian M. Sanne, MBBCH, FCP(SA), review key studies presented at the 2016 International AIDS Conference.
Format: Microsoft PowerPoint (.ppt)
File size: 1.28 MB
Date posted: 8/5/2016
Integrating Recent Data When Selecting First-line Antiretroviral Therapy.2015...Hivlife Info
Joseph J. Eron Jr., MD
W. David Hardy, MD
Paul E. Sax, MD
How do leading experts select first-line antiretroviral therapy for their HIV-infected patients?
Review these downloadable slides for key clinical trial data and the latest DHHS recommendations for first-line antiretroviral therapy.
HIV/AIDS Update From Boston 2014.CCO Official Conference Coverage.March 3-6,2014Hivlife Info
Topics covered include:
* First -line raltegravir, atazanavir/ritonavir, or darunavir/ritonavir
* Switching to elvitegravir-based therapy
* 92-week data on first-line dolutegravir
* Risk of HIV transmission with undetectable viral load
* Latest insights from cure research
New hepatitis C virus treatments
Современное лечение и профилактика ВИЧ : передовые стратегии лечения у пациен...hivlifeinfo
Стратегии смены АРТ у пациентов с вирусной супрессией, включая смену АРТ при резистентности, рекомендации по инъекционным препаратам длительного действия , смена АРТ до или во время беременности
Основы ведения АРТ у многократно леченных пациентов 2022 / Foundations of ART...hivlifeinfo
Основы ведения АРТ у многократно леченных пациентов (2022)
Тактики ведения пациентов с большим опытом лечения, включая анализ резистентности, последние рекомендации и данные по новым схемам АРТ
New Data on Resistance to DAAs and Implications for Therapy.2015hivlifeinfo
In this downloadable slideset, Nezam H. Afdhal, MD, FRCPI, provides guidance on testing for and management of resistance in HCV-infected patients treated with DAA therapy.
Format: Microsoft PowerPoint (.ppt)
File size: 1.39 MB
Date posted: 10/30/2015
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...hivlifeinfo
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary Management of HIV. New Data From CROI 2017
In this downloadable slideset, Charles B. Hicks, MD, and Program Director Joseph J. Eron, Jr., MD, review key new HIV data presented at the Seattle 2017 meeting.
Topics include:
-Prevention
-New data on currently available ART
-Switch/simplification strategies for virologically suppressed patients
-Investigational ARV agents
-Treatment complications and comorbidities
Оптимизация лечения ВИЧ в 2018 году / HIV Treatment Optimization: 2018hivlifeinfo
HIV Treatment Optimization: 2018
In this downloadable slideset, Eric S. Daar, MD, provides a comprehensive update on ART management.
Format: Microsoft PowerPoint (.ppt)
File Size: 723 KB
Released: April 26, 2018
Joseph Eron, M.D., of University of North Carolina at Chapel Hill, presents "The State of the Art in HIV Cure Research – Hope or Hype: What Does It Mean for Patients" at AIDS Clinical Rounds
Evolving Switch Strategies for Virologically Suppressed HIV-Infected Patients...Hivlife Info
Доктор David A. Wohl при участии группы экспертов, рассматривает основные исследования о том, когда и как, при каких условиях переводить пациентов со стабильной супрессией ВИЧ на новые методы лечения .
Similar to Managing Treatment-Experienced Patients With Multidrug Resistance-Emerging Options and Strategies for Success.2017 (20)
Дискуссии о здоровом старении с ВИЧ /Key Slides on Healthy Aging With HIV.2022hivlifeinfo
Дискуссии о здоровом старении с ВИЧ
Узнайте о медицинских и немедицинских проблемах, с которыми сталкиваются стареющие пациенты с ВИЧ, включая дополнительные проблемы, с которыми сталкиваются пожилые женщины и пожилые люди, живущие в условиях ограниченных ресурсов.
Key Slides on ART for HIV : Evolving Concepts and Innovative Strategies.2020hivlifeinfo
Expert-authored slides on evolving ART concepts, including simplification to 2-drug therapy, ART safety during pregnancy, weight gain, and long-acting injectable ART.
File Size: 580 KB
Released: October 20, 2020
Clinical Impact of New Data From AIDS 2020hivlifeinfo
current ART in principal populations, including older patients and women who become pregnant; metabolic outcomes during ART; HIV and COVID-19; investigational ART strategies; and HIV prevention.
Слайдсет о новом в лечении ВИЧ.Key Slides on What’s Hot in HIV Treatment.2020 hivlifeinfo
Expert-authored slides on the latest issues relating to HIV care, featuring patient cases and considerations for optimal treatment approaches. Topics include integrating newer ARVs, individualizing ART for women of childbearing potential and during pregnancy, adverse events during ART, and anticipated roles of emerging ART strategies.
Гиперлипопротеидемия(а) как опасное генетически обусловленное нарушение липид...hivlifeinfo
Гиперлипопротеидемия(а) как опасное генетически обусловленное нарушение липидного обмена и фактор риска атеротромбоза и сердечно-сосудистых заболеваний
Липопротеид(а) [Лп(а)] представляет собой сложный надмолекулярный комплекс, принадлежащий к апоВ100 содержащим липопротеидам. Лп(а) состоит из ЛНП-подобной частицы, в которой молекула апобелка В100 ковалентно связана дисульфидной связью с уникальной полиморфной молекулой апобелка(а). Концентрация Лп(а) генетически контролируется, при этом варьирует в очень широком диапазоне. Повышенный уровень Лп(а) является независимым фактором риска атеросклероза коронарных, сонных и периферических артерий, ИБС и стеноза аортального клапана, сопутствующих сердечно-сосудистых осложнений, а также осложнений после операций реваскуляризации миокарда. Несмотря на это, уровень Лп(а) по-прежнему не учитывается в стратификации риска сердечно-сосудистых заболеваний. Отчасти, это может быть связано с тем, что ни современная лекарственная терапия, ни новые поколения биологических гиполипидемических препаратовтерапия практически не влияют на концентрацию Лп(а), за исключением 20-30% снижения Лп(а) никотиновой кислотой и ингибиторами пропротеиновой конвертазы субтилизин-кексин 9 типа (PCSK9).
Лекция освящает современные представления о Лп(а), как факторе риска сердечно-сосудистых заболеваний, возможности и целесообразности его определения, а также посвящена современным возможностям коррекции гиперлипопротеидемии(а).
Физическая активность и физические тренировки как метод профилактики сердечно...hivlifeinfo
Чушкин М.И., Мандрыкин С.Ю., Карпина Н.Л., Попова Л.А. Физическая активность и физические тренировки как метод профилактики сердечно-сосудистых заболеваний. Кардиология. 2018;58(9S):10-18
Большое число данных свидетельствует, что функциональные возможности кардиореспираторной системы являются не менее важным фактором прогноза летальности, чем курение, артериальная гипертензия, ожирение, гиперхолестеринемия, СД. Пациенты с большей физической активностью имеют значительно меньший риск ССЗ, чем пациенты, ведущие неактивный образ жизни. В данном обзоре авторы показали возможности оценки физической активности и основные положения назначения физических тренировок для сохранения и повышения функциональных возможностей кардиореспираторной системы.
Key Slides on Individualizing ART Management Based on Treatment Safety and To...hivlifeinfo
Обзор последних рекомендаций DHHS , индивидуализация лечения в отдельных группах пациентов, минимизация побочных эффектов и межлекарственных взаимодействий
Современное лечение ВИЧ.Обобщённые данные с конференции CROI 2020 / Contempor...hivlifeinfo
Современное лечение ВИЧ.Обобощенные данные с конференции CROI 2020 / Contemporary Management of HIV.Integrating New Data From CROI 2020
Широкий спектр вопросов, включая стратегии АРТ на поздних стадихя заболевания, менеджмент ожирения, метаболические исходы АРТ, данные по АРТ во время беременности и пр
Format: Microsoft PowerPoint (.ppt)
File Size: 554 KB
Released: April 14, 2020
Свобода интернета 2018: делегирование репрессий.Доклад Международной Агорыhivlifeinfo
«Настоящий доклад посвящен обзору вмешательства в свободу интернета в России в 2018 году и основан на данных постоянного мониторинга ситуации, который мы ведем более 10 лет.
Как обычно, доклад состоит из двух основных разделов, первый из которых посвящен описанию результатов мониторинга с приведением наиболее показательных примеров, а второй – авторской оценке состояния свободы интернета. В приложении даны сводные результаты мониторинга в виде таблицы со ссылкой на дату, источник, регион и вид ограничения по каждому известному эпизоду, а также карта нарушений, на которой цветом обозначен уровень относительной свободы интернета в отдельных субъектах Федерации.»
https://guides.files.bbci.co.uk/bbc-russian/AGORA_Freedom-of-the-Internet-2018.pdf
Современное лечение ВИЧ.Объединенные данные с конференции IAS 2019 / Contemp...hivlifeinfo
Review key HIV data from IAS 2019 on the updated NTD risk in women receiving ART at conception, PrEP, first-line and switch options, and early-phase investigational strategies.
Clinical Impact of New Data From IAS 2019hivlifeinfo
July 21-24, 2019; Mexico City, Mexico
Download slide highlights of key studies addressing current issues in HIV care, as reported at this important annual conference.
Предиабет-определение, риски, подходы к диагностике и профилактике сахарного ...hivlifeinfo
Предиабет-определение, риски, подходы к диагностике и профилактике сахарного диабета 2 типа и сердечно-сосудистых осложнений.Консенсус экспертов РКО.2019
"Результаты международного эпидемиологического проекта HAPIEЕ показали, что распространенность преддиабета в Российской Федерации (РФ), определяемого по нарушенной гликемии натощак, может быть еще выше — от 28,1% при отрезной точке по уровню глюкозы плазмы ≥6,1 ммоль/л (критерий Российской ассоциации эндокринологов) до 54.8 % при при отрезной точке по уровню глюкозы плазмы ≥5,6 ммоль/л (критерий ADA), соответственно."
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...hivlifeinfo
Learn unique perspectives across Europe on PrEP, rapid ART initiation, ART in women, and options for switching ART.
Format: Microsoft PowerPoint (.ppt)
File Size: 1.33 MB
Released: July 10, 2019
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Managing Treatment-Experienced Patients With Multidrug Resistance-Emerging Options and Strategies for Success.2017
1. Managing Treatment-Experienced Patients
With Multidrug Resistance: Emerging Options
and Strategies for Success
This program is supported by an educational grant from
Theratechnologies Inc.
2. Please feel free to use, update, and share some or all of these
slides in your noncommercial presentations to colleagues or
patients
When using our slides, please retain the source attribution:
These slides may not be published, posted online, or used in
commercial presentations without permission. Please contact
permissions@clinicaloptions.com for details
Slide credit: clinicaloptions.com
About These Slides
3. Faculty
Eric S. Daar, MD
Chief, Division of HIV Medicine
Harbor-UCLA Medical Center
Professor of Medicine
David Geffen School of Medicine
at UCLA
Los Angeles, California
Daniel R. Kuritzkes, MD
Chief, Division of Infectious
Diseases
Brigham and Women’s Hospital
Professor of Medicine
Harvard Medical School
Boston, Massachusetts
4. Faculty Disclosures
Eric S. Daar, MD, has disclosed that he has received consulting
fees from Bristol-Myers Squibb, Gilead Sciences, Merck, Teva,
and ViiV and funds for research support from Gilead Sciences,
Merck, and ViiV.
Daniel R. Kuritzkes, MD, has disclosed that he has received
consulting fees from CytoDyn, Gilead Sciences, Janssen, Merck,
and ViiV and funds for research support from Gilead Sciences
and Merck.
6. History of MDR HIV
In the pre-HAART era, MDR HIV emerged as a result of sequential, partially
suppressive ARV regimens[1,2]
Combination ART transformed HIV into a manageable condition, but early
suboptimal 3-drug regimens led to continued selection for resistant HIV[2,3]
– Low-potency ARVs with adherence challenges due to toxicity[3]
– Cross-resistance within drug classes[3,4]
Improved efficacy of modern ARVs has led to even less resistant HIV[2]
– Expansion of ARVs and ARV classes allows for virologic suppression in pts with
MDR HIV via informed use of combination regimens[4]
1. Lima VD, et al. Am J Epidemiol. 2010;172:460-468. 2. Richman DD. Clin Infect Dis. 2016;62:1318-1319.
3. Harris M, et al. AIDS Res Treat. 2012;2012:595762. 4. Tang MW, et al. Drugs. 2012;72:e1-e25. Slide credit: clinicaloptions.com
7. Decrease in Prevalence of MDR HIV in the US in
Recent Era of HIV Treatment
Assessment of phenotypic drug resistance patterns in US samples submitted to Monogram
Biosciences for HIV resistance testing from 2003-2012 (N = 62,397)
Slide credit: clinicaloptions.comPaquet AC, et al. Antivir Ther. 2014;19:435-441.
0
10
20
30
40
50
60
ResistantSamples(%)
1-Class Resistance
PI
NRTI
NNRTI
0
10
20
30
40
50
60
2-Class Resistance
PI and NRTI
PI and NNRTI
NRTI and NNRTI
0
10
20
30
40
50
60
3-Class Resistance
8. Prevalence of Transmitted MDR HIV in the US:
Selected Studies
Transmission of HIV resistant to a single class of ARV more common
than HIV resistant to multiple classes[1,3]
– 13.6%, 2.1%, and 0.5% of transmitted HIV resistant to 1, 2, and 3 ARV
classes, respectively[3]
1. Baxter JD, et al. HIV Med. 2015;16:77-87. 2. INSIGHT START Study Group.
N Engl J Med. 2015;373:795-807. 3. Kim D, et al. CROI 2013. Abstract 149. Slide credit: clinicaloptions.com
Prevalence of Transmitted Drug-Resistant HIV
(2009-2013), %[1-3]
Overall
NRTI
NNRTI
PI
12.6-16.2
3.7-6.7
8.1-8.4
2.0-4.5
9. Current Status of INSTI Resistance in the US
Transmitted INSTI resistance remains rare and rates of on-treatment INSTI
resistance continue to be low[1-3]
1. Hernandez AL, et al. CROI 2017. Abstract 478. 2. Davy T, et al. CROI 2017. Abstract 483.
3. Koullias Y, et al. CROI 2017. Abstract 493. Slide credit: clinicaloptions.com
Study Key Findings
CDC National HIV
Surveillance System[1]
Prevalence of INSTI resistance for HIV diagnoses through 2014:
65/14,468 (0.4%)
Pre-ART prevalence of INSTI resistance (ie, transmitted): 2/4631
(0.04%)
UNC CFAR HIV Clinical
Cohort[2]
2015 INSTI resistance prevalence in 685 pts who began ART in
2007 or later: 1%
Modeling study[3]
Assuming 0.1% rate of transmitted INSTI resistance and $250
cost per test: pre-ART INSTI resistance testing correlated with
worse outcomes, higher costs vs no test
10. MDR Still a Significant Concern in HIV
Despite modern ARV combination regimens revolutionizing the treatment of HIV,
MDR HIV remains relevant
Contributions to MDR HIV in today’s pts include
– Nonadherence
– Inadequate past treatment in pre- and early-HAART eras
– Transmission of harbored MDR HIV variants
– Pharmacokinetic factors
Due to cross-resistance within a drug class, fully active ARV options diminish with
each successive viral failure
Pts harboring MDR HIV pose increased risk of drug-resistant virus transmission
Tang MW, et al. Drugs. 2012;72:e1-e25. Imaz A, et al. AIDS Rev. 2011;13:180-193.
Lima VD, et al. Am J Epidemiol. 2010;172:460-468 Slide credit: clinicaloptions.com
12. Causes of Treatment Failure
DHHS Guidelines.
Poor adherence
Insufficient drug level
Viral replication in the
presence of drug
Resistant virus
Social/personal issues
Regimen issues
Toxicities
Suboptimal
potency
Wrong dose
Host genetics
Poor absorption
Rapid clearance
Poor activation
Drug interactions
Virologic failure
Transmitted or Acquired
Slide credit: clinicaloptions.com
13. Results used to inform design of new ART regimens for pts experiencing VF
DHHS: Recommendations for Resistance
Testing
DHHS Guidelines.
Question Recommendation
Who should receive
resistance testing?
Pts with VF and HIV-1 RNA levels > 1000 copies/mL
May be considered for pts with 500-1000 copies/mL
When should testing be
conducted?
While on failing ART regimen or < 4 wks from treatment end
May still be considered after 4 wks
What types of testing
should be conducted?
First-/second-line failure: genotypic testing
Suspected MDR: genotypic plus phenotypic testing
When considering CCR5 antagonist: tropism assay
If prior failure on INSTI-containing regimen, test for INSTI resistance
Other considerations Prior treatment history should be obtained
Slide credit: clinicaloptions.com
15. Randomized, open-label, multicenter phase III trial in sub-Saharan Africa
LPV/RTV + RAL
(n = 433)
LPV/RTV + 2-3 NRTIs*
(n = 426)
HIV-infected pts
> 12 yrs of age
with confirmed VF on
NNRTI + 2 NRTIs
and no prior PIs
(N = 1277)
Wk 96
LPV/RTV 400/100 mg and RAL 400 mg dosed BID.
*New or recycled NRTIs chosen WITHOUT genotype by clinician.
EARNEST: Second-line LPV/RTV ± RAL or 2-3
NRTIs in PI-Naive Pts
Wk 12
LPV/RTV Monotherapy
(n = 418)
LPV/RTV + RAL
(n = 418)
Paton NI, et al. N Engl J Med. 2014;371:234-247. Slide credit: clinicaloptions.com
Stratified by study center,
CD4+ cell count (< 200 vs
≥ 200 cells/mm3)
16. EARNEST: Boosted PI + RAL Comparable to
Boosted PI + NRTIs
SECOND-LINE[3] and ACTG 5273[4,5] showed similar results
LPV/RTV + RAL
(n = 433)
LPV/RTV + 2/3 NRTIs
(n = 426)
LPV/RTV monotherapy
(n = 418)
References in slidenotes. Slide credit: clinicaloptions.com
100
80
60
40
20
0
Pts(%)
HIV-1 RNA < 50 copies/mL,
Wk 96[1]
7473
44
P < .001
HIV-1 RNA < 400 copies/mL
Through Wk 144[2]
0
20
40
60
80
100
LPV/RTV + NRTI
(Number of Active NRTIs)
Pts(%)
88
0 LPV/
RTV +
RAL
77 8185
61
1 2-3 LPV/
RTV
17. DHHS: Management of First-line Failure
DHHS Guidelines.
*If RAL or EVG resistance detected, DTG + boosted PI can be used if DTG susceptible.
Slide credit: clinicaloptions.com
Failing Regimen (+ NRTIs)
Boosted PI: Enforce adherence
Modify for convenience or toxicity
NNRTI: Boosted PI + NRTIs
Boosted PI + INSTI
INSTI: Boosted PI + NRTIs
Boosted PI + active INSTI*
18. Randomized, double-blind, placebo-controlled, multicenter phase III trials
BENCHMRK: Raltegravir + OBR for MDR HIV
Steigbigel RT, et al. N Engl J Med. 2008;359:339-354.
Eron JJ, et al. Lancet Infect Dis. 2013;13:587-596.
HIV-infected pts ≥ 16 yrs of age with
HIV-1 RNA > 1000 copies/mL,
no prior INSTIs,
and multiclass resistance*
(N = 703)
Placebo + OBR†
(n = 237)
Raltegravir 400 mg BID + OBR†
(n = 466)
Wk 156
*Documented phenotypic or genotypic resistance to ≥ 1 drug in each of 3 oral ARV classes (ie, NRTI, NNRTI, and PI).
†Investigator-selected based on ART history, BL resistance, and lab data; DRV and TPV investigational at time of studies but permitted.
Wk 48Wk 16Randomized 2:1; stratified
by enfuvirtide use and PI
resistance (1 vs > 1)
All pts offered
open-label
raltegravir to
Wk 240
Baseline: median yrs of ART, 10; median previous drugs, 12;
> 95% resistant to > 1 PI
Slide credit: clinicaloptions.com
19. BENCHMRK: Efficacy of Raltegravir + OBR
Through Wk 156
Placebo + OBR
Raltegravir + OBR
Eron JJ, et al. Lancet Infect Dis. 2013;13:587-596.
59
45 43
60
24
8 5
20
233/
396
51/
209
2/437/93
26/
61
68/
152
13/
64
76/
126
69
38
156/
226
43/
112
66
29
17/
58
81/
123
0
20
40
60
80
100
0 ≥ 1
PtsWithHIV-1RNA
<50copies/mL(%)
n/N =
Overall
Active PIs in OBR
0 1
Agents in OBR for Which
Phenotypic Sensitivity Demonstrated
2
61
43
16/
37
39/
64
≥ 3
Slide credit: clinicaloptions.com
20. DHHS: Management of ART Failure Second-line
ARV Failure
Goal: fully suppressive ARV regimen
If susceptible to boosted PI, regimen can
be similar to those for first-line failure
If not susceptible to boosted PI, new
regimen should have a minimum of 2
(preferably 3) fully active drugs if possible
– Susceptibility to drug predicted from pt
treatment history, prior and current
resistance and tropism testing, MoA of
novel drug class
Not recommended to add single agent to
failing regimen due to risk of developing
resistance to entire regimen
DHHS Guidelines.
Boosted PI + NRTIs
Boosted PI + active INSTI
2 and preferably
3 fully active drugs
Yes No
PI
Susceptible
Slide credit: clinicaloptions.com
22. DHHS: Treatment of Pts With MDR HIV for Whom
Optimal Virologic Suppression Is Not Possible
Goals: minimize toxicity, preserve immunologic function, delay
clinical progression, minimize further resistance
– Reduction of HIV-1 RNA > 0.5 log10 copies/mL correlated with
clinical benefit
– If resistant, rarely a reason to continue NNRTIs, ENF, EVG, or RAL:
no evidence of clinical benefit; may promote further resistance, limit
future treatment options
Consider enrolling pt in clinical study, expanded access program,
or FDA single-pt access to investigational agent
DHHS Guidelines. Slide credit: clinicaloptions.com
23. Emerging Investigational Agents for Pts With
MDR HIV
1. Lalezari JP, et al. Lancet HIV. 2015;2:e427-437. 2. Granados-Reyes ER, et al. HIV Glasgow 2016.
Abstract O335A. 3. ClinicalTrials.gov. NCT02362503. 4. Lewis S, et al. CROI 2017. Abstract 449LB.
5. Lin H-H, et al. CROI 2017. Abstract 438. 6. Lalezari J, et al. CROI 2017. Abstract 437. Slide credit: clinicaloptions.com
Investigational Agent Phase MoA
Fostemsavir[1-3] III
Prodrug; when metabolized binds gp120
to prevent CD4+ cell attachment, entry
Ibalizumab[4,5] III Humanized anti-CD4 receptor mAb
PRO 140[6]
IIb/III Humanized anti-CCR5 mAb
24. TMB-301: Ibalizumab in Pretreated Pts Infected
With Multidrug-Resistant HIV
Ibalizumab: humanized mAb to CD4 receptor that blocks HIV entry into CD4+ T-cells
– FDA breakthrough and orphan drug designations
Single-arm, open-label phase III trial
– Primary endpoint: ≥ 0.5 log10 HIV-1 RNA decrease at Day 14
Lewis S, et al. CROI 2017. Abstract 449LB. Slide credit: clinicaloptions.com
Pts with HIV-1 RNA
> 1000 copies/mL;
on ART ≥ 6 mos, on stable
ART ≥ 8 wks; resistant to
≥ 1 ARV from 3 classes,
sensitive to ≥ 1 ARV for OBR
(N = 40)
Wk 25
Ibalizumab
2000 mg IV Day 7
(loading dose)
Continue Failing ART
Days 0-14
Ibalizumab
800 mg IV Day 21, Q2W
(maintenance dose)
Switch to OBR
Day 14
Primary Endpoint:
Day 14Control Period:
Day 0-7
25. TMB-301: Pt Characteristics
Lewis S, et al. CROI 2017. Abstract 449LB.
Baseline Characteristic Pts
(N = 40)
Mean age, yrs 51 ± 11
Male, % 85
Mean duration of HIV infection, yrs 21
Mean VL, copies/mL
VL ≥ 100,000 copies/mL, %
100,287
18
Mean CD4+ cell count, cells/mm3 150
Median CD4+ cell count, cells/mm3 73
Previously treated with ≥ 10 ARVs, % 28
Fostemsavir required in OBR, % 43
Slide credit: clinicaloptions.com
Characteristic, % Pts
(N = 40)
Phenotypic/genotypic resistance
NRTI
NNRTI
PI
INSTI
93
93
88
68
Number of exhausted ARV classes
≥ 1
≥ 2
≥ 3
≥ 4
All
88
73
53
35
15
26. TMB-301: Efficacy
Lewis S, et al. CROI 2017. Abstract 449LB.
Virologic Outcome
Ibalizumab
+ OBR
Day 14
≥ 0.5 log10 HIV-1 RNA decrease, % 83*
≥ 1.0 log10 HIV-1 RNA decrease, % 60
Mean HIV-1 RNA decrease, log10 1.1
Wk 24
≥ 1.0 log10 HIV-1 RNA decrease, % 55
≥ 2.0 log10 HIV-1 RNA decrease, % 48
HIV-1 RNA < 50 copies/mL, % 43
HIV-1 RNA < 200 copies/mL, % 50
Mean HIV-1 RNA decrease from BL, log10 1.6
*Primary endpoint; P < .0001 vs 3% at end of control period.
Slide credit: clinicaloptions.com
Outcome,
cells/mm3
Baseline CD4+ Cell Count
(cells/mm3)
< 50
(n = 17)
50-200
(n = 10)
> 200
(n = 13)
Mean baseline
CD4+ cell count
12 109 363
Mean increase in
CD4+ cell count at
Wk 24
Missing equals
failure analysis
9 75 78
Per protocol
analysis
15† 75 81‡
†n = 7. ‡n = 10.
27. TMB-301: Safety
9 pts reported 17 serious AEs[1]
– 1 drug-related serious AE (IRIS) resulted in discontinuation
9 other pts discontinued
– Death (n = 4; liver failure, Kaposi sarcoma; end-stage AIDS, lymphoma)
– Consent withdrawal (n = 3)
– Lost to follow-up (n = 2)
No cases of anti-ibalizumab antibodies
Phase III TMB-311 study ongoing; extension for pts from TMB-301; accepting new
pts[2]
IM dosing may be viable as administration route as compared with IV dosing[3]
1. Lewis S, et al. CROI 2017. Abstract 449LB. 2. ClinicalTrials.gov.
NCT02707861. 3. Lin H, et al. CROI 2017. Abstract 438. Slide credit: clinicaloptions.com
28. AI438011: Fostemsavir + RAL + TDF in
Treatment-Experienced Pts
Fostemsavir: prodrug; proposed MoA: binding HIV-1 gp120 prevents viral attachment and
entry into host CD4+ cells
Randomized, active-controlled phase IIb study, blinded to dose
– Primary endpoint: HIV-1 RNA < 50 c/mL at Wk 24
Granados-Reyes ER, et al. HIV Glasgow 2016. Abstract O335A.
Llamoso C, et al. HIV Glasgow 2016. Abstract O335B. Slide credit: clinicaloptions.com
Fostemsavir 600 mg QD* PO + RAL + TDF
(n = 51)
HIV-infected pts with exposure
to ≥ 1 ARV for ≥ 1 wk;
HIV-1 RNA ≥ 1000 c/mL;
CD4+ ≥ 50 cells/mm3; virus
susceptible to RAL, TDF, ATV, and
fostemsavir IC50 < 100 nM
(N = 254)
Wk 48Wk 24: 1̊ endpoint
ATV/RTV 300/100 mg QD + RAL + TDF
(n = 51)
Fostemsavir 1200 mg QD PO + RAL + TDF
(n = 50)
Fostemsavir 400 mg BID* PO + RAL + TDF
(n = 50)
Fostemsavir 800 mg BID* PO + RAL + TDF
(n = 49)
Wk 96
*Fostemsavir dose changed to 1200 mg QD from Wk 48 to Wk 96.
29. AI438011: Efficacy, Safety of Fostemsavir + RAL
+ TDF
At Wk 96, 90% of pts had HIV-1 RNA < 50 copies/mL in both fostemsavir and
ATV/RTV arms in observed analysis[1]
– No significant differences in virologic efficacy regardless of race, sex, age, BL HIV-1
RNA, BL CD4+ cell count, or IC50 subgroups[1]
– Fostemsavir generally well tolerated, with higher rates of grade 2-4 treatment-emergent
AEs (37% vs 9%) and d/c for AEs (10% vs 3%) for ATV/RTV arm vs fostemsavir arm[2]
Phase III trial of fostemsavir in heavily treatment–experienced pts ongoing[3]
1. Granados-Reyes ER, et al. HIV Glasgow 2016. Abstract O335A. 2. Llamoso C, et al.
HIV Glasgow 2016. Abstract O335B. 3. ClinicalTrials.gov. NCT02362503. Slide credit: clinicaloptions.com
Wk 49
Placebo
Pts with HIV-1 RNA ≥ 400 c/mL
on current regimen; ≤ 2 classes of active
approved ARVs left to compose OBR due to
resistance, intolerance, or contraindications Fostemsavir + OBR
Day 8*
Fostemsavir Fostemsavir + OBR
FostemsavirAs above but with no active approved ARV options remaining
*1° endpoint: mean log10 HIV=-1 RNA change from BL.
30. PRO 140 for Heavily Treatment–Experienced Pts
PRO 140: humanized IgG4 CCR5 mAb
Ongoing phase IIb/III study of PRO 140 plus OBR for heavily treatment–
experienced pts (estimated N = 30)
– Primary endpoint: proportion with > 0.5 log10 HIV-1 RNA change from BL at Day 7
– PRO 140 dose: 350 mg QW SC
ClinicalTrials.gov. NCT02483078.
Wk 25
Placebo +
Current Regimen
Pts with CCR5-tropic virus and
HIV-1 RNA ≥ 400 c/mL on current regimen;
resistance to ≥ 1 ARV in ≥ 3 classes or
≥ 2 classes plus options limited by
intolerance or cross resistance;
must have ≥ 1 fully active drug available
Day 7
PRO 140 +
Current Regimen
PRO 140 + OBR
Slide credit: clinicaloptions.com
31. Options When Limited Information Available for
Tx-Experienced Pt With Suspected Resistance
If have treatment history, but lack results of resistance testing
– Start regimen of 2-3 drugs predicted to be active based on treatment
history
In absence of self-reported history, medical records, and resistance
testing results
– Restart on most recent ARV regimen followed by drug resistance testing
at Wk 2 or 4 to guide selection of next regimen
DHHS Guidelines. Slide credit: clinicaloptions.com
32. Take-home Points
For pts with virologic failure and potential MDR HIV, genotypic and phenotypic
resistance testing results and treatment history should inform the construction of new
ART regimens
– When considering CCR5 antagonist, tropism assay should be performed
For pts with confirmed MDR, the goal of a new regimen is a minimum of 2 (preferably
3) active drugs if possible
– For pts with resistance to currently available agents, consider enrolling pt in clinical study,
expanded access program, or FDA single-pt access to investigational agent
Investigational agents with novel MoAs may provide options for pts with MDR HIV
– Fostemsavir (gp120 binder; prevents CD4+ cell attachment), ibalizumab (anti-CD4
receptor mAb), PRO 140 (anti-CCR5 mAb)
Slide credit: clinicaloptions.com
33. clinicaloptions.com/hiv
Slidesets on best practices in HIV management with expert faculty commentary
Postconference clinical updates available following CROI, the International AIDS
Conference, and IDWeek
Go Online for More CCO
Coverage of HIV!