dhhs

In this episode, Maunank Shah, MD, PhD, discusses using HIV-ASSIST to optimize treatment for both HIV and hyperlipidemia. Listen as he covers:

• Hyperlipidemia and cardiovascular disease risk among people living with HIV
• Recommendations for lipid screening for people living with HIV
• Using HIV-ASSIST to support ART treatment decisions for people living with HIV with comorbidities
• How HIV-ASSIST prioritizes certain ART agents in the setting of hyperlipidemia, including:
  • Deciding between bictegravir, doravirine, dolutegravir, raltegravir, and rilpivirine vs boosted protease inhibitors, including darunavir
  • Deciding between tenofovir disoproxil fumarate and tenofovir alafenamide or abacavir
• How HIV-ASSIST incorporates drug‒drug interaction data from the University of Liverpool HIV Drug Interactions Checker and the DHHS guidelines when considering the use of statin therapy with ART
• How HIV-ASSIST further incorporates drug resistance data from the Stanford HIV Drug Resistance Database

Maunank Shah, MD, PhD 
Associate Professor 
Infectious Diseases 
Johns Hopkins University 
Baltimore, Maryland 

Link to full program: bit.ly/3pwaH2Y

In this episode, Marta Boffito, MD, PhD, FRCP, and Michelle Cespedes, MD, MS, discuss initial ART options, including:

• Recommended first-line ART options for most PWH according to DHHS, IAS-USA, EACS, BHIVA, and WHO guidelines 
• Data for weight gain after ART initiation with different ARV classes and drugs
• Weight gain disparities by race and gender after ART initiation
• Data from the RESPOND study including risk factors for weight gain and CV event risk with INSTI vs non-INSTI–based ART 
• The impact of INSTIs on CV events in the Swiss HIV Cohort study 
• Recommendations for ART and contraception for PWH of childbearing potential 
• Drug–drug interactions between first-line ART and contraceptive options 
• Guideline-recommended first-line ART options in pregnancy with a discussion of how these regimens differ from those recommended for most PWH 

Marta Boffito, MD, PhD, FRCP 
Consultant Physician 
Clinical Director, HIV, Sexual and Gender Health, Dermatology 
Chelsea and Westminster Hospital NHS Foundation Trust 
Imperial College London 
London, United Kingdom 

Michelle Cespedes, MD, MS 
Professor of Medicine 
Division of Infectious Disease 
Department of Medicine 
Icahn School of Medicine at 
Mount Sinai 
New York, New York 

Link to full program: bit.ly/3HPu4Lk

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, Daniel R. Kuritzkes, MD, discusses considerations for patients experiencing weight gain on antiretroviral therapy, including:

• Commonly implicated antiretroviral therapy regimens and patient populations

• Guideline recommendations for management of weight gain

Presenter:

Daniel R. Kuritzkes, MD
Harriet Ryan Albee Professor of Medicine
Harvard Medical School
Chief, Division of Infectious Diseases
Brigham and Women’s Hospital
Boston, Massachusetts

To download the slides: 
bit.ly/3odUA9C

To view the full online program: 
bit.ly/3ZjSFhg

In this episode, Isolde Butler, MD, and Brenda E. Crabtree Ramírez, MD, discuss rapid ART initiation for people newly diagnosed with HIV, including:

• The HIV care continuum in the United States and Latin America
• Barriers to HIV diagnosis, including stigma, discriminatory laws and policies, social determinants of health, and lack of access to healthcare
• Factors that predict delayed care linkage and inconsistent HIV care and treatment
• Improved clinical outcomes that have been shown with rapid ART initiation, first in low- and middle-income countries and now worldwide
• Recommendations for rapid ART—and regimen choices—from the DHHS, IAS-USA, CENSIDA, EACS, and WHO
• Recommendations for transitioning from PrEP to ART when someone seroconverts while receiving either oral PrEP or LA CAB for PrEP
• Barriers to rapid ART initiation in their individual care settings
• The future of LA injectable ART for initial treatment and rapid initiation

Isolde Butler, MD
Chief Medical Officer
CrescentCare
New Orleans, Louisiana

Brenda E. Crabtree Ramírez, MD
Assistant Professor, HIV Program
Department of Infectious Diseases
Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán
Mexico City, Mexico

Link to full program: bit.ly/3HPu4Lk

In this episode, Daniel R. Kuritzkes, MD, discusses considerations for rapid initiation of antiretroviral therapy in patients who are newly diagnosed with HIV, including:

• Recommended regimens
• Management of patients previously receiving PrEP
• Timing of laboratory testing

Presenter:

Daniel R. Kuritzkes, MD
Harriet Ryan Albee Professor of Medicine
Harvard Medical School
Chief, Division of Infectious Diseases
Brigham and Women’s Hospital
Boston, Massachusetts

To download the slides: 
https://bit.ly/3odUA9C

To view the full online program: 
https://bit.ly/3ZjSFhg

In this episode, Marta Boffito, MD, PhD, FRCP, and Jens D. Lundgren, MD, DMSc, address key considerations when evaluating antiretroviral therapy safety and tolerability in aging patients and those with possible cardiometabolic toxicities, including:

• Monitoring for cardiometabolic syndromes (eg, lipid panels, coronary artery calcification scores)
• Approaching antiretroviral-related weight gain in clinical practice
• Interpreting results from RESPOND on cardiovascular risk with integrase strand transfer inhibitors
• Collaborating with other specialties (eg, cardiologists, dietitians) to provide a multidisciplinary approach for managing comorbidities, including prevention and management

Faculty: 

Marta Boffito, MD, PhD, FRCP
Consultant Physician/Professor
HIV/Research
Chelsea and Westminster Hospital
Imperial College London
London, United Kingdom

Jens D. Lundgren, MD, DMSc
Professor
Rigshospital, University of Copenhagen 
Director
Centre of Excellence for Health, Immunity and Infection (CHIP)
Rigshospital, University of Copenhagen
Copenhagen, Denmark

Link to full program:
http://bit.ly/3PM3nYe

Link to downloadable slides: 
http://bit.ly/3WgYycz

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, Roger Bedimo, MD, MS, FACP, discusses key considerations for switching ART in virologically suppressed patients who are pregnant or trying to conceive. His discussion includes:

• DHHS Perinatal Guideline recommendations
• French Perinatal Cohort study on the implications of viral suppression when changing ART in the first trimester of pregnancy
• IMPAACT 2010 Update on the safety and efficacy of DTG vs EFV and TDF vs TAF in pregnancy
• DolPHIN-2 study of virological suppression with DTG- vs EFV-based ART started in late pregnancy

Presenter:

Roger Bedimo, MD, MS, FACP
Professor of Medicine
Division of Infectious Diseases
University of Texas Southwestern Medical Center
Section Chief
Division of Infectious Diseases
Department of Internal Medicine
VA North Texas Health Care System
Dallas, Texas

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

Link to full program: 
https://bit.ly/3UYTF8Q

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

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,” Cristina Mussini, MD, and William R. Short, MD, MPH, AAHIVS, discuss important considerations for ART with opportunistic infections, including: 

• When to start ART with pneumocystis pneumonia including discussion of the ACTG 5164 study of immediate vs delayed ART with opportunistic infections
• EACS, DHHS, and IAS-USA guideline recommendations for starting ART in the setting of most opportunistic infections
• Considerations for the administration of ART to patients who are unable to swallow or critically ill and intubated
• Treatment of Kaposi sarcoma and considerations for starting ART to avoid drug–drug interactions with Kaposi sarcoma treatment
• Considerations for starting ART with cytomegalovirus and the risk for IRIS from cytomegalovirus
• Discussion of treatment of cytomegalovirus and overlapping toxicities between its treatment and ART
• When to start ART with cryptococcal meningitis and the data to support delayed treatment initiation with this particular opportunistic infection
• EACS, DHHS, and IAS-USA guideline recommendations for starting ART in the setting of cryptococcal meningitis specifically
• Treatment of cryptococcal meningitis and managing drug–drug interactions between ART and antifungal therapy

Presenters:
Cristina Mussini, MD
Head of Department of Infectious Diseases and Tropical Medicine
Full Professor of Infectious Diseases
Infectious Diseases Clinics 
University Hospital
University of Modena and Reggio Emilia
Reggio Emilia, Italy 

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 

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 the slides at:
https://bit.ly/3uktrm1

Link to full program:
https://bit.ly/3q2DlGd

Hear insights from 3 faculty experts as they present emerging data and guidelines and engage in discussion on patient-centered ART selection for people with HIV.

Topics include assessing treatment options; individualizing ART for women of childbearing potential and during pregnancy, patients with OIs, and during the COVID-19 pandemic; and new data on investigational ART strategies. 

Learn how to:

• Apply the results of recent clinical studies and evolving treatment guidelines on the timing and choice of first-line ART and switch strategies and managing treatment-experienced patients with HIV
• Integrate individual patient factors such as drug–drug interactions, comorbidities, pregnancy status, adherence, and dosing preferences when selecting optimal ART
• Appropriately counsel patients regarding the anticipated clinical role of new and investigational ART regimens in individualized care

Presenters:
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

Jean-Michel Molina, MD, PhD
Head of the Department of
Infectious Diseases
Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris
Professor of Infectious Diseases
University of Paris
Paris, France

Cristina Mussini, MD
Head of Department of Infectious Diseases and Tropical Medicine
Full Professor of Infectious Diseases
Infectious Diseases Clinics 
University Hospital
University of Modena and Reggio Emilia
Reggio Emilia, Italy

Follow along with the slides at: 
https://bit.ly/329c8ZP

See the entire program at:
https://bit.ly/3FkRofM

In this episode of Nursing Australia, hosted by Nurse Robbie, we hear:

-        The latest Nursing Australia News (02:08)

A nurse practitioner earns the right to prescribe HIV medicines, nurses speak up for primary health care reform, infection control checks still lacking in aged care and remembering nurses killed by COVID-19. 

-        COVID vaccine: Immunising the nation (06:41)

When a COVID vaccine arrives in Australia, primary health care nurses will play a key role in immunising the Australian population. Learn about what nurses need to do to prepare for the mass-vaccination and the logistics of getting the vaccines into your clinic or facility. 

-        Vaccines: Recommended vs funded (12:29)

Nurses know the NIP funded vaccines inside-out, but how often do you speak to your patients about the recommended vaccines, but not funded ones? We discuss how to raise this sometimes-tricky conversation and share the reasoning behind recommended vs funded vaccines. 

For health care professionals, there is an in-depth discussion available centered around the meningococcal vaccines. Find that here: https://apna.asn.au/hub/bexsero-gsk 

-        Jane’s story: Helping the homeless (21:23)

Driving into the gym carpark in Launceston one morning, Nurse Practitioner Jane Laidlaw was surprised to see a person rough sleeping in a car. She felt compelled to do something to help and the result is a thriving nurse-led clinic that has helped hundreds of homeless people. 

-        Financial wellness for nurses (32:03)

When we think of wellness, physical and mental health often come to mind. But financial wellness is just as important. In this segment, tailored for nurses, hear some tips and tricks to maximise your potential tax refund. 

Hosted by: Matthew St Ledger & Mitch Wall
Produced by: Leith Alexander & Matthew St Ledger

In the first episode of Nursing Australia, hosted by Nurse Robbie, we hear:

- The latest Nursing Australia News (02:56)

Calls to grow the workforce of skilled nurses in aged care to stop the COVID spread, fresh data on the effect of coronavirus on the nursing workforce and eye protection for all Victorian GP nurses becomes mandatory. 

- Aimee’s story: Catching COVID in the clusters (07:00)

Aged care, disability, and mental health nurse Aimee Sibson was let go from her job at the beginning of the COVID-19 pandemic and put her hand up to work on the Victorian COVID Response Taskforce. She was sent into Melbourne’s housing commission towers under the Government-imposed hard lockdown and caught COVID in the line of duty. 

Aimee wrote a letter to Victorian Premier Daniel Andrews about her experience, you can read it here: https://apna.asn.au/files/Aimee%20Sibson%20-%20Letter%20to%20Daniel%20Andrews.pdf 

- Kids' vaccination drop: The effect of COVID-19 on early childhood vaccinations (14:28)

During COVID-19, nurses have observed that some patients are reluctant to attend clinics to receive scheduled immunisations. We explore the risks associated with children missing their early childhood vaccinations. For health care professionals find our more information about routine childhood immunisations here: www.apna.asn.au/hub/rotavirus-vaccine 

- Panel discussion: The future of primary health care nursing in a post-COVID world (18:07)

Once the pandemic has passed and we all return to a more normal life, what will be the lasting effect on primary health care nursing as a profession? Hear from APNA Founder and Nurse Ambassador, Sam Moses and APNA Program Manager, Nursing in Primary Health Care, Lisa Collison.

- Nurse wellness with Sarah Cosgrave (30:15)

In these crazy times, we all need to take some time-out for ourselves, especially nurses. Join nurse Sarah Cosgrave for a guided meditation that will leave you feeling relaxed, reconnected and re-energised. 

Sarah is a Nourished Nurturer and founder of the global community, ‘The Nurtured Nurse Project’. Trained as a Critical Care Nurse, Sarah knows firsthand that nurses are facing a global epidemic of nurse burnout. It is Sarah’s mission to empower nurses with the tools and techniques to support their wellness so that they can continue sustainably supporting the journey of wellness in others. As a wellness consultant Sarah supports nurses guiding them to feel relaxed, reconnected and re-energised within their mind, body and soul.

Hosted by: Matthew St Ledger & Mitch Wall
Produced by: Leith Alexander & Matthew St Ledger