3tc

In this episode, Joseph Ahn, MD, MS, MBA; Christina Delacruz Leyson, MD; and Alice Chan, a person who experienced pregnancy as a person living with chronic hepatitis B, discuss solutions for overcoming barriers to HBV care in people of childbearing potential and their infants, including:

• HBV screening and vaccination in pregnancy
• Management of pregnant people who are HBsAg positive
• Infant care
• Breastfeeding

Presenters: 

Joseph Ahn, MD, MS, MBA
Professor of Medicine, Section Chief
Division of Gastroenterology and Hepatology
Oregon Health & Science University
Portland, Oregon

Christina Delacruz Leyson, MD
Associate Professor
Medical Director, Liver Transplant Program
Program Director, Hepatology Fellowship
University of Kentucky
Lexington, Kentucky

Alice Chan, person living with chronic hepatitis B

Link to downloadable slides:
https://bit.ly/3rXLTC7

Link to program: 
https://bit.ly/3L3Kz6l

In this episode, Carolyn Chu, MD, MSc, FAAFP, AAHIVS, discusses using HIV-ASSIST to aid in the selection of an ART regimen for PWH coinfected with HBV and HCV. Listen as she covers:

• How HIV-ASSIST supports ART selection in primary care
• Updates to viral hepatitis recommendations including:  
•              CDC HBV screening and testing recommendations
•              AASLD simplified HCV treatment approach for PWH
• HIV-ASSIST for managing HIV/HBV coinfections, including ensuring that NRTIs that are effective for both HIV and HBV are included in an ART regimen and alerting the user when an additional HBV treatment is needed 
• HIV-ASSIST for managing HIV/HCV coinfections, including showing how the HIV-ASSIST tool incorporates drug‒drug interaction considerations from the University of Liverpool HIV Drug Interaction Checker

Carolyn Chu, MD, MSc, FAAFP, AAHIVS
Chief Clinical Officer
National Clinician Consultation Center
Professor
Clinical Family Community Medicine
University of California, San Francisco
San Francisco, California

Link to full program: bit.ly/3pwaH2Y

In this episode, Christine Katlama, MD, and Babafemi Taiwo, MBBS, discuss optimizing ART for people with HIV who are treatment experienced or failing a current ART regimen, including:

• Recycling agents from the NRTI, NNRTI, INSTI, and PI classes in salvage ART regimens
• Maintaining NRTIs in second-line and salvage ART regimens, including the use of 3TC, TFV, and ABC
• ART regimen simplification
• When to perform genotypic resistance testing, including for PWH who have been off ART
• When to perform DNA genotyping for archived resistance testing
• Considering LA CAB + RPV with prior NNRTI exposure, ART resistance, or past adherence concerns with oral ART
• Using boosted DRV + DTG in salvage regimens
• Switching from boosted PIs to INSTIs in PWH receiving second-line therapy
• Second-line regimens with LA CAB + RPV failure 

Christine Katlama, MD 
Professor 
Sorbonne University APHP Paris 
Head, HIV/Hepatitis Clinical and Research Unit 
Department of Infectious Diseases 
Paris, France 

Babafemi Taiwo, MBBS 
Gene Stollerman Professor of Medicine 
Chief, Division of Infectious Diseases 
Northwestern University Feinberg School of Medicine 
Chicago, Illinois 

Link to full program: https://bit.ly/3Z44Gq3

In this episode, Sonya Krishnan, MD, MHS, discusses using HIV-ASSIST to aid in the selection of an ART regimen for a virologically suppressed PWH who is planning a pregnancy. Listen as she covers:

• How to input patient specific factors into the HIV-ASSIST tool
• Discussion of available education sheets to review the data and recommendations for her current ART regimen in pregnancy
• An explanation of why some regimens are ranked lower because of adherence factors such as increased pill burden or dosing frequency
• Guidelines informing the HIV-ASSIST output, including DHHS and IAS-USA, and the frequency with which updates are incorporated
• How to use the HIV-ASSIST output to guide regimen selection in pregnancy
• Use of the HIV-ASSIST tool in shared decision-making and patient counseling

Sonya Krishnan, MD, MHS
Assistant Professor
Division of Infectious Diseases
Johns Hopkins University
Baltimore, Maryland

Link to full program: 
bit.ly/3pwaH2Y

 In this episode, 2 Australian HIV experts share their thoughts on some of the most important HIV insights gained during the past year in the context of HIV care in Australia.

Specifically, the faculty discuss the continued dominance of second-generation INSTI-based regimens as mainstay HIV therapy in Australia, including in both 2-drug and 3-drug oral regimens; the emergence of 2-drug long-acting injectable therapy as a switch strategy; key aspects of successfully expanded oral PrEP programs in the region; the potential role of long-acting injectable PrEP; and key new advances in HIV cure research.  

Presenters:

Sharon R. Lewin, AO, FRACP, PhD, FAHMS
Director, The Peter Doherty Institute for Infection and Immunity
Professor of Infectious Diseases
University of Melbourne  
Consultant Infectious Diseases Physician
Alfred Hospital and Royal Melbourne Hospital  
Melbourne, Australia

Don Smith, MD
Conjoint Professor
School of Population Medicine
University of New South Wales
Senior Staff Specialist
Albion Centre
South Eastern Sydney Local Health Network
Sydney, Australia

Content based on an online program supported by an independent educational grant from Gilead Sciences, Inc. and ViiV Healthcare.  

Link to full program:
http://bit.ly/3YD8T4E

In this episode, Canadian HIV experts share their thoughts on some of the most important new insights from HIV treatment and prevention research over the past year.

Specifically, the faculty discuss treatment strategies for patients with a history of NRTI resistance based on findings from the 2SD and NADIA trials; the latest data informing the use of 2-drug oral and injectable treatment regimens; prevention approaches for HIV and other sexually transmitted infections based on findings from the DoxyPEP, HPTN 083, and HPTN 084 trials; and other emerging innovations in HIV care.

Presenters:
Jean-Guy Baril, MD
Associate Professor
Family Medicine
Université de Montreal
Montreal, Quebec, Canada

Alexander Wong MD, FRCPC
Associate Professor
Department of Medicine
University of Saskatchewan
Regina, Saskatchewan, Canada

Content based on an online program supported by an independent educational grant from Gilead Sciences, Inc. and ViiV Healthcare.  

Link to full program:
http://bit.ly/3YD8T4E

In this episode, 2 European HIV experts share their thoughts on some of the most important new antiretroviral therapy insights from HIV research over the past year.

Specifically, the faculty discuss findings from real-world and long-term studies of 2-drug oral regimens, the latest on 2-drug long-acting injectable therapy, how 2-drug options fit into rapid start strategies, and other new and emerging innovations in HIV treatment, including the availability of lenacapavir for multidrug-resistant HIV treatment and resumption of islatravir clinical development.

Presenters:

Jürgen K. Rockstroh, MD
Professor of Medicine
University Hospital Bonn
Department of Medicine I
Bonn, Germany

Alexandra Calmy, MD, FMH, PhD
HIV/AIDS Unit Director
Infectious Diseases Division
Geneva University Hospitals
University of Geneva
Geneva, Switzerland

Content based on an online program supported by an independent educational grant from Gilead Sciences, Inc. andViiV Healthcare.

Link to full program:
http://bit.ly/3Hz0jNa

In this episode, Annette Haberl, MD, and William R. Short, MD, MPH, AAHIVS, discuss when to consider an ART switch during pregnancy, including:

• Current DHHS, EACS, WHO, BHIVA, and German/Austrian guidelines for the use of ARVs in pregnancy
• What data and recommendations for the use of ARVs during pregnancy are currently missing from the guidelines
• Available data on newer ARVs in the ARV pregnancy registry
• Pharmacokinetic data for newer ARVs including BIC/FTC/TAF and LA CAB + RPV in pregnancy
• Recommendations for 2-drug ART regimens in pregnancy
• What to do when someone becomes pregnant on a newer ART regimen that is not yet recommended by the guidelines

Annette Haberl, MD
Physician
Head of HIV and Women
HIVCENTER Frankfurt
Department of Infectious Disease
Hospital of the Johann Wolfgang Goethe University
Frankfurt, Germany

William R. Short, MD, MPH, AAHIVS
Associate Professor of Medicine
Division of Infectious Diseases
Department of Medicine
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania

Link to full program:
https://bit.ly/3HPu4Lk

In this episode, Tristan J. Barber, MA, MD, FRCP, and Darcy Wooten, MD, discuss switching ART with virologic suppression, including:

• Switching with prior or unknown resistance
  • Data on switching to BIC/FTC/TAF with a preexisting M184V/I mutation from a pooled analysis of 6 phase III studies
  • The impact of baseline resistance on outcomes following a switch to BIC/FTC/TAF in Black PWH from the BRAAVE 2020 study
  • A post hoc analysis of the SALSA study of DTG/3TC outcomes at Week 48 by baseline resistance
  • Data from the SOLAR 3D study on switching to DTG/3TC from a 3- or 4-drug ART regimen with a history of M184V
  • A retrospective analysis of switching to DTG/3TC with archived M184V/I from the French Dat’AIDS Cohort
• Switching to long-acting ART
  • Guidance on candidates for LA CAB + RPV
  • Data on risk factors for virologic failure with LA CAB + RPV
• Considering an ART switch after weight gain
  • Data on weight gain after ART initiation by ARV class and drug
  • Mean change in weight by sex at Week 96 in the ADVANCE study
  • DHHS guideline recommendations regarding weight gain with ART

Tristan J. Barber, MA, MD, FRCP
Honorary Associate Professor
Institute for Global Health
University College London
Consultant in HIV Medicine
Ian Charleson Day Centre
Royal Free Hospital
London, United Kingdom  

Darcy Wooten, MD
Associate Professor of Medicine
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
San Diego, California

In this episode, Chloe Orkin, MBChB, FRCP, MD​, discusses strategies for successful antiretroviral therapy (ART) initiation. Her overview includes:

• Recommendations for rapid ART
• First-line ART regimens for treatment-naive people with HIV
• IMEA 055 FAST study
• STAT study
• DIAMOND study
• Antiretroviral resistance mutations
• Patient perspectives on the importance of rapid ART initiation

Presenter:

Chloe Orkin, MBChB, FRCP, MD
Professor of HIV
Queen Mary, University of London​
Consultant Physician​
Lead for HIV Research
Barts Health NHS Trust​
The Royal London Hospital​
London, United Kingdom​

Panelists:

Linda-Gail Bekker, MBChB, DTM&H, DCH, FCP(SA), PhD​
Director
Desmond Tutu HIV Centre​
Past President
International AIDS Society​
Faculty of Health Sciences
University of Cape Town
Cape Town, South Africa​

Nagalingeswaran Kumarasamy, MBBS, FRCP, PhD​
Chief and Director
VHS Infectious Diseases Medical Centre​
Director, Chennai Antiviral Research and Treatment (CART) Clinical Research Site​
Voluntary Health Services​
Chennai, India

Babafemi Taiwo, MBBS​
Gene Stollerman Professor of Medicine​
Chief, Division of Infectious Diseases​
Northwestern University
Feinberg School of Medicine​
Chicago, Illinois

Content based on an online CME program supported by an independent educational grant from Gilead Sciences.

Follow along with the slides: 
https://bit.ly/3dSNoum

Link to full program:
https://bit.ly/3AE2AV1

In this episode from the series “Key Decisions in HIV Care,” Daria Podlekareva, MD, PhD, and Mark S. Sulkowski, MD, discuss important considerations for ART use in patients with coinfections, including:

• DHHS testing and treatment recommendations for HBV in patients with HIV
• Data suggesting that tenofovir alone may not suppress HBV in all PWH
• Data from NA-ACCORD showing that incomplete HBV DNA suppression is associated with HCC in patients with HIV/HBV
• Data for the use of entecavir as an add-on therapy if an HIV ART regimen is not HBV active
• Data showing that lamivudine alone is associated with resistance in patients with HIV/HBV
• Discussion of HBV management in the setting of 2-drug regimens for HIV if the patient is coinfected
• Recommendations from the DHHS, EACS, and WHO to start ART as soon as possible in patients with TB/HIV coinfection
• Data from the SAPiT, ACTG A5221 STRIDE, and CAMELIA studies to show the benefits of early ART in patients with TB/HIV
• Recommendations from the EACS guidelines on what ART regimens are recommended with TB/HIV
• Drug-drug interaction considerations between ART and TB treatment
• Discussion of the prevention and management of TB-associated IRIS

Presenters:

Daria Podlekareva, MD, PhD
Centre of Excellence for Health, Immunity and Infection (CHIP)
Rigshospital, University of Copenhagen
Copenhagen, Denmark  

Mark S. Sulkowski, MD
Professor of Medicine
Medical Director, Viral Hepatitis Center
Chief, Infectious Disease
Johns Hopkins Bayview Medical Center
Johns Hopkins University School of Medicine
Baltimore, Maryland

Content based on an online CME program supported by educational grants from Gilead Sciences, Inc.; Janssen Therapeutics, Division of Janssen Products, LP; and ViiV Healthcare.

Follow along with slides:
https://bit.ly/3zHySMO

See the entire program at:
https://bit.ly/2TXTYWx

In this episode, William R. Short, MD, MPH, AAHIVS, explores recommendations and data on switching to 2-drug single-tablet ART regimens.

Listen as he gives his perspectives on:

• Indications for the available 2-drug single-tablet regimens: DTG/RPV and DTG/3TC
• The SWORD-1 and SWORD-2 studies evaluating switching to DTG/RPV in virologically suppressed patients
• Real-world experience with switching to DTG/RPV from the OPERA study
• The TANGO study evaluating switching to DTG/3TC from a stable TAF-based ART regimen
• The SALSA study evaluating switching to DTG/3TC from any stable 3-drug ART regimen

Presenter:
William R. Short, MD, MPH, AAHIVS
Associate Professor of Medicine
Division of Infectious Diseases
Department of Medicine
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania

Follow along with the slides at:
https://bit.ly/3n0Z8wU

See the entire program at:
https://bit.ly/2TXTYWx

In this episode, Darcy Wooten, MD, discusses new HIV data from IDWeek 2021, including:

• A rapid test-and-treat program to start DTG/3TC in patients newly diagnosed with HIV (STAT)
• Efficacy when switching from 3-drug to 4-drug TAF-based regimens to DTG/3TC (TANGO)
• Virologic outcomes with 2-drug vs 3-drug ART regimens (Trio Health HIV Network Study)
• Metabolic complications in treatment-naive patients (Study 1489 and Study 1490)
• Resistance analysis of an investigational agent, lenacapavir (CALIBRATE)
• The Positive Perspectives Survey to evaluate the U=U Educational Campaign in North American patients

Presenter:

Darcy Wooten, MD
Associate Professor of Medicine
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
San Diego, California

Link to full program:
https://bit.ly/3BCHF2E

In this second of 2 episodes, Shobha Swaminathan, MD, and Eric S. Daar, MD, review key data influencing their practice following the IAS 2021 Conference, including data on investigational antiretroviral agents, lenacapavir and islatravir, and alternative dosing of BPaL for MDR-TB.  

This episode includes discussion of:

• An extension of FLAIR, demonstrating virologic efficacy and safety of long-acting CAB plus RPV at Week 124
• A Week 26 safety and efficacy analysis of CAPELLA, a study of lenacapavir in heavily treatment–experienced PWH
• CALIBRATE, a study of the safety and efficacy of lenacapavir in treatment-naive PWH
• A Week 96 safety analysis of Protocol 011, evaluating islatravir plus DOR in treatment-naive patients
• A Week 24 safety and pharmacokinetic analysis of Protocol 016, evaluating oral islatravir once monthly for PrEP
• ZeNix, a phase III trial of pretomanid, bedaquiline, and linezolid (BPaL) in patients with highly resistant TB

Presenters:

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

Shobha Swaminathan, MD
Associate Professor
Division of Infectious Diseases  
Department of Medicine
Rutgers New Jersey Medical School
Newark, New Jersey

Follow along with the slides at:
https://bit.ly/3hvRN5b

Content based on an online CME program supported by an educational grant from ViiV Healthcare.

In this first of 2 episodes, Shobha Swaminathan, MD, and Eric S. Daar, MD, review key data influencing their practice following the IAS 2021 Conference, including results from studies on HIV and COVID-19 outcomes; virologic and metabolic outcomes of DTG/3TC; long-acting CAB plus RPV for ART in treatment-naive PWH.  

This episode includes discussion of:

• A Global Clinical Platform that evaluated outcomes of PWH hospitalized with COVID-19
• A post hoc analysis of TANGO, evaluating the virologic and metabolic outcomes when switching to DTG/3TC vs continued 3- or 4-drug TAF-based regimens
• A Week 48 analysis of SALSA, demonstrating virologic efficacy and favorable safety profile of switching to DTG/3TC vs continuing a 3-drug ART regimen

Presenters:

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

Shobha Swaminathan, MD
Associate Professor
Division of Infectious Diseases  
Department of Medicine
Rutgers New Jersey Medical School
Newark, New Jersey

Follow along with the slides at:
https://bit.ly/3hvRN5b

Content based on an online CME program supported by an educational grant from ViiV Healthcare.

In this episode, Paul E. Sax, MD, discusses emerging drug therapies and treatment options for patients with HIV, including rapid initiation of ART, long-acting ART, and 2-drug ART regimens. The overview will include analyses from:

• The RAPID ART program in San Francisco, where same-day initiation of ART led to faster HIV-1 RNA suppression that was maintained at greater than 92% during a 3-year period
• The DIAMOND study analyzing virologic efficacy and safety at 48 weeks after initiating DRV/COBI/FTC/TAF within 24 hours of HIV infection diagnosis
• A rapid ART start program in young PWH in New Orleans that demonstrated achievement of viral suppression in fewer than 30 days and no discontinuations due to adverse events
• The ATLAS (including ATLAS-2M) and FLAIR studies that demonstrated efficacy and safety of long-acting injectable CAB plus RPV
• SWORD-1 and SWORD-2 that demonstrated switching to a 2-drug regimen of DTG plus RPV in virologically suppressed adults was safe and effective
• GEMINI-1 and GEMINI-2 that demonstrated noninferiority of DTG plus 3TC compared with DTG plus FTC/TDF
• TANGO that demonstrated safety and efficacy of switching to DTG/3TC in virologically suppressed adults receiving a TAF-based regimen

In addition, Dr. Sax reviews current recommendations by the DHHS, WHO, and IAS-USA regarding these emerging therapies and treatment paradigms.  

Presenter:

Paul E. Sax, MD
Clinical Director
HIV Program and Division of Infectious Diseases
Brigham and Women’s Hospital
Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Follow along with the slides at:
https://bit.ly/3zdPwm2 

Content based on an online CME program supported by an educational grant from ViiV Healthcare.

Link to full program:
https://bit.ly/3ux6FF8

In this episode, Jennifer Cocohoba, PharmD, and Jason Schafer, PharmD, MPH, discuss key studies from IAS 2021 that will influence the role of the pharmacist in the treatment and prevention of HIV. Their discussion includes analyses of:

• The 144-week analysis of the TANGO study, showing high rates of virologic suppression of patients switched from a TAF-containing regimen to DTG plus 3TC
• The 144-week analysis of the TANGO study, showing high rates of virologic suppression of patients switched from a TAF-containing regimen to DTG plus 3TC
• An extension of the FLAIR study, evaluating efficacy and safety of long-acting CAB plus RPV in treatment-naive patients
• The CUSTOMIZE study, an implementation effectiveness study that evaluated the feasibility of implementing provision of long-acting CAB plus RPV in the clinic setting
• The HPTN 084 study of PrEP using CAB vs TDF plus FTC in sexually active cisgender women
• The CALIBRATE and CAPELLA studies of long-acting lenacapavir in treatment-naive and treatment-experienced patients, respectively

In addition, Drs. Cocohoba and Schafer discuss key considerations of these medications, including cost and acquisition logistics.

Presenters:

Jennifer Cocohoba, PharmD
Professor
Department of Clinical Pharmacy
University of California, San Francisco
San Francisco, California

Jason Schafer, PharmD
Professor and Vice Chair
Jefferson College of Pharmacy
Thomas Jefferson University
Philadelphia, Pennsylvania

Content based on conference coverage of IAS 2021 with educational rant support from Gilead Sciences, Inc.; Janssen Therapeutics, Division of Janssen Products, LP; Merck Sharp & Dohme Corp.; and ViiV Healthcare.

Link to full program:
https://bit.ly/3z8SBnC