IMPLEMENTING CLINICAL RECOMMENDATIONS: ART STRATEGIES, TOOLS, AND HEALTHY SYSTEMS/SERVICE DELIVERY RECOMMENDATIONS 11-14: ADHERENCE
|
|
- Ronald Mason
- 7 years ago
- Views:
Transcription
1 IMPLEMENTING CLINICAL RECOMMENDATIONS: ART STRATEGIES, TOOLS, AND HEALTHY SYSTEMS/SERVICE DELIVERY RECOMMENDATIONS 11-14: ADHERENCE John G. Bartlett Johns Hopkins University School of Medicine May
2 THE CONTINUUM OF HIV CARE -- US 100% 75% 80% 50% 77% 66% 89% 77% 25% Of all with HIV infection, 850,000 individuals do not have suppressed HIV RNA (72%) MMWR (60), 2011
3 ART STRATEGIES Among regimens of similar efficacy and tolerability, once-daily regimens are recommended for treatment-naive patients beginning ART (II B). Switching treatment-experienced patients receiving complex or poorly tolerated regimens to once-daily regimens is recommended, given regimens with equivalent efficacy (III B). Among regimens of equal efficacy and safety, fixed-dose combinations are recommended to decrease pill burden (III B).
4 ADHERENCE TOOLS FOR PATIENTS Reminder devices and use of communication technologies with an interactive component are recommended (I B). Education and counseling using specific adherence-related tools is recommended (I A).
5 EDUCATION AND COUNSELING INTERVENTIONS Individual one-on-one ART education is recommended (II A). Providing one-on-one adherence support to patients through 1 or more adherence counseling approaches is recommended (II A). Group education and group counseling are recommended; however, the type of group format, content, and implementation cannot be specified on the basis of the currently available evidence (II C). Multidisciplinary education and counseling intervention approaches are recommended (III B). Offering peer support may be considered (III C).
6 THE NON-VALUE OF PILL COUNTS: FEM-PrEP (Van Damme. NEJM 2012) Trial: Randomized, double-blind placebo-controlled trial in 2,120 HIV negative women in South Africa. Results Placebo TDF/FTC n=1,058 n=1,062 Adherence report 95% 95% Pill counts 88% 88% TDF levels >10 ng/ml Failure % No failure %
7 WHAT TO START Guideline Backbone 3 rd Drug DHHS, IAS-USA TDF/FTC EFV, RAL, British ATV/r, DRV/r European TDF/FTC EFV, NVP ABC/3TC ATF/r DRV/r LPV/r, RAL WHO TDF/3TC EFV, NVP AZT/3TC
8 ART REGIMEN: REGIMEN SELECTION Goal: NDV, avoid resistance, ADR Factors in the decision: Baseline resistance test Co-morbidities: Core, Renal, HBC, Pregnancy, Psychological issues Potency: Undefeated regimens Urgency: Pregnancy, HIVAN, AIDS, Primary HIV Resistance to resistance: FOTO (EFV) and PI/r Cost and coverage
9 WHAT TO START: PILL BURDEN Regimen x/d Pills EFV/TDF/FTC* 1 1 ATV/r/2 NRTIs 1 3 DRV/r/2 NRTIs 1 4 RAL/2 NRTIs 2 3 *RPV/TDF/FTC
10 Study : ATRIPLA VS. QUAD IN TREATMENT-NAÏVE (N=700): HIV-1 RNA < 50 copies/ml (Sax P CROI. Abstr. 101) +3.6%, 95% CI 3.6 (-1.6% to +8.8%) CD4+ change: Quad +239 vs. EFV +206 c/mm 3 (p=0.009) Sax P, et al. 19th CROI; Seattle, WA; March 5-8, Abst. 101.
11 COST OF CARE Contemporary costs/yr. (AIDS 2010;24:2705) HAART $12,000 (72%) Meds (other) $ 2,100 In-patient $ 600 Out-patient $ 400 Total (Meds) $ 16,600 Growth: 40,000/yr survival + T&T all: $800 million
12 US PATENT EXPIRATIONS 12 AZT/3TC NVP AZT ddc ddi d4t 3TC ABC EFV DLV AZT/3TC/ABC ABC/3TC TDF GS7340 = 2025 TDF/FTC VVC* RAL (SP) MVC ETR RPV EVG SQV RTV IDV NFV TPV DRV LPV/ RTV caps RTV boosting ATV LPV/RTV tabs CVC=
13 FREQUENCY OF RESISTANCE MUTATIONS WITH VIROLOGIC FAILURE Class Trials Resistance mutations PI/r 7 1/255 (0.4%) NNRTI 3 69/213 (32%) II 2 68/102 (67%) CCR /29 (45%)
14 DHHS GUIDELINES 2012 VL CD4 Pre ART 3-6 mos. 3-6 mos. Start Baseline Baseline 2-8 wks* On ART 3-6 mos mos. *week VL (log 10 c/ml < <50
15 P4P4P: THE STATUS OF PAYING PATIENTS FOR SELF CARE Practice: Widespread and international Incentives: Cash, groceries, lottery tickets, meal tickets. Conditions: Chronic smoking, obesity, BP control, diabetes, HIV HIV trial: HPTN 65 Controlled trial, (unblinded) HIV test $25, Enroll in care $70, NDV $280/yr (1.7% of HIV care cost) Status: Widely practiced, no one wants to talk about it.
16 A TEST OF FINANCIAL INCENTIVES TO IMPROVE WARFARIN ADHERENCE (VOLPP KG. BMC HEALTH SYS RES 2008;8:272)
17 THE POWER OF HOPE (Harris J, De Angelis. JAMA 2012;300:2912) With a deeper understanding of the science of care, physicians will increasingly realize that a meaningful patient-physician relationship leaves each patient better able to adhere to the treatment plan.
18 HEALTHCARE OUTCOMES IN HIV: REDUCING DISPARITIES (MOORE R. CID; IN PRESS) Issue: Major issue in HIV care is retention in care and adherence Method: Moore Clinic data N=6,366 Pt/yrs 27,941 Demographics: B 77%, F 34% Risk: IDU-45%; MSM 30% Insurance: Private 15% Results: Calculated life expectancy at age 28 yrs = 73.4 yrs for all groups race, gender and risk
19 HEALTHCARE OUTCOMES IN HIV: REDUCING DISPARITIES (MOORE R. CID; IN PRESS) Issue: Major issue in HIV care is retention in care and adherence Method: Moore Clinic data N=6,366 Pt/yrs 27,941 Demographics: B 77%, F 34% Risk: IDU-45%; MSM 30% Insurance: Private 15% Results: Calculated life expectancy at age 28 yrs = 73.4 yrs for all groups race, gender and risk
20 VL FOR 3 HIV RISK CATEGORIES OVER TIME (MOORE RD. CID 2012; IN PRESS)
21 ART ADHERENCE IAPAC GUIDANCE: Scientifically validated systematic approaches Regimen selection: Drugs that will work (science) Drugs patients will take (art) Factors to consider: Documentation metric: VL Impact of patent expiration Cost-support services P4P4P Clinic viral load
Clinical rationale for viral load testing
Clinical rationale for viral load testing Francois Venter Wits Reproductive Health & HIV Institute Caveats I m a believer in VLs My talk looks at resource poor environments Why do we need a rationale???
More informationEACS 2013. Dominique Braun Universitätsspital Zürich
EACS 2013 Switch data Rilpivirine: Swing-trial Elvitegravir: Flamingo-trial Simplification Dual-Therapy: LPV/r + 3TC in the Gardel-trial Mono-Therapy: Darunavir/r mono in clinical setting Boceprevir/Telaprevir
More informationSwitch to Dolutegravir plus Rilpivirine dual therapy in cart-experienced Subjects: an Italian cohort
Switch to Dolutegravir plus Rilpivirine dual therapy in cart-experienced Subjects: an Italian cohort Gaetana Sterrantino Azienda Ospedaliero-Universitaria Careggi Infectious diseases, Florence, Italy Background
More informationAntiretroviral therapy for HIV infection in infants and children: Towards universal access
Antiretroviral therapy for HIV infection in infants and children: Towards universal access Executive summary of recommendations Preliminary version for program planning 2010 Executive summary Tremendous
More informationLow level viremia and HIV-1 drug resistance in patients with virological rebound after suppression with a first line antiretroviral regimen
Low level viremia and HIV-1 drug resistance in patients with virological rebound after suppression with a first line antiretroviral regimen Manuela Colafigli Catholic University of S. Heart Rome, Italy
More informationARV treatment Update 2012. Avondseminarie 18 december 2012 Eric Florence ITG, Antwerpen
ARV treatment Update 2012 Avondseminarie 18 december 2012 Eric Florence ITG, Antwerpen Three big conferences in 2012 http://retroconference.org/2012/ http://www.aids2012.org/ http://www.hiv11.com/ Current
More informationCombination Anti-Retroviral Therapy (CART) - Rationale and Recommendation. M Dinaker. Fig.1: Effect of CART on CD4 and viral load
Combination Anti-Retroviral Therapy (CART) - Rationale and Recommendation M Dinaker INTRODUCTION The wide availability of effective, safe and mostly well tolerated combined anti-retroviral therapy (CART)
More informationProtease Inhibitor Resistance at 2nd-line HIV Treatment Failure in Sub-Saharan Africa
Protease Inhibitor Resistance at 2nd-line HIV Treatment Failure in Sub-Saharan Africa T. Sonia Boender; Raph L. Hamers; Pascale Ondoa; Maureen Wellington; Cleophas Chimbetete; Margaret Siwale; Eman E F
More informationConsolidated guidelines on the use of antiretroviral drugs for treating
TB conference, 10-13 June 2014, Durban, South Africa Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection Dr Augustin Ntilivamunda Objectives of 2013 WHO
More informationTheonest Ndyetabura KILIMANJARO CHRISTIAN MEDICAL CENTRE / KILIMANJARO CLINICAL RESERCH
TREATMENT FAILURE AND PATTERNS OF GENOTYPIC DRUG RESISTANCE MUTATIONS AMONG HAART EXPERIENCED HIV-1 PATIENTS AT KCMC Theonest Ndyetabura KILIMANJARO CHRISTIAN MEDICAL CENTRE / KILIMANJARO CLINICAL RESERCH
More informationHIV Drug resistanceimplications
HIV Drug resistanceimplications for therapy Deenan Pillay Africa Centre for Health and Population Studies, UKZN University College London Potential implications of HAART without virological monitoring:
More informationThe Role of the Primary Care Clinician in HIV Care
The Role of the Primary Care Clinician in HIV Care Jeffrey Kwong, DNP, ANP-BC, AAHIVS, ACRN, FAANP Columbia University School of Nursing New York, NY New York Nurse Practitioner Association Annual Meeting
More informationPaediatric HIV treatment update
Paediatric HIV treatment update James Nuttall Red Cross War Memorial Children s Hospital & University of Cape Town ART Resistance & New Treatment Options 6 th FIDSSA Conference, 5-7 November 2015 ART Eligibility
More informationHighlights in HIV Medicine for Internists
Highlights in HIV Medicine for Internists Charurut Somboonwit,MD,FACP Associate Professor Division of Infectious Diseases and International Mdii Medicine Morsani College of Medicine Disclosure Speaker
More informationHIV Guidelines. New Strategies.
HIV Guidelines. New Strategies. Santiago Moreno Hospital Universitario Ramón y Cajal Madrid HIV Guidelines. New Strategies. Outline HIV Guidelines What is new? New strategies Treatment as Prevention HIV
More informationGeneric antiretrovirals in Europe: a blessing or a curse?
Generic antiretrovirals in Europe: a blessing or a curse? Ricardo Jorge Camacho 1 Molecular Biology Laboratory, Centro Hospitalar de Lisboa Ocidental 2 Instituto de Higiene e Medicina Tropical, Universidade
More informationHPTN 073: Black MSM Open-Label PrEP Demonstration Project
HPTN 073: Black MSM Open-Label PrEP Demonstration Project Overview HIV Epidemiology in the U.S. Overview of PrEP Overview of HPTN HPTN 061 HPTN 073 ARV Drug Resistance Conclusions Questions and Answers
More informationSafety and Efficacy of DAA + PR in HCV/HIV co-infected patients. Mark Sulkowski, MD Johns Hopkins University Baltimore Maryland USA
Safety and Efficacy of DAA + PR in HCV/HIV co-infected patients Mark Sulkowski, MD Johns Hopkins University Baltimore Maryland USA Liver disease is the second leading cause of death amongst HIV-positive
More informationUPDATE IN HIV POST-EXPOSURE PROPHYLAXIS. Weerawat Manosuthi
UPDATE IN HIV POST-EXPOSURE PROPHYLAXIS Weerawat Manosuthi Outline Case scenario of postexposure prophylaxis Risks of and how to manage postexposure prophylaxis Current PEP guideline US PHS 2013 New York
More informationLondon Therapeutic Tender Implementation: Guidance for Clinical Use. 4 th June 2014 FINAL
London Therapeutic Tender Implementation: Guidance for Clinical Use 4 th June 2014 FINAL Contents 3. General principles 4. Financial impact of therapeutic tendering for branded ARVs 5. London ARV algorithm:
More informationHIV. Head - Paediatric HIV Treatment Programmes. Right to Care. Dr Leon Levin
HIV Dr Leon Levin Head - Paediatric HIV Treatment Programmes Right to Care Disclaimer This talk represents my personal experience in managing teenagers with HIV over the last 14 years. It does not purport
More informationTreatment 2.0 as a catalyst for Tasp through Drug / Treatment Optimization
Treatment 2.0 as a catalyst for Tasp through Drug / Treatment Optimization STEFANO VELLA MD ISTITUTO SUPERIORE DI SANITÀ ROME - ITALY DDF 6 WAFAA EL SADR, CROI 2012 The problem is in how to efficiently
More informationHepatitis Update. Study 110: SVR at post-treatment week 24 (SVR24) Jürgen Rockstroh, MD. No ART EFV/TDF/FTC ART/r/TDF/FTC Total
Hepatitis Update Jürgen Rockstroh, MD Study 11: SVR at post-treatment week 24 (SVR24) Patients with Undetectable HCV RNA (Percentage) 8 7 6 5 4 3 2 1 71 No ART EFV/TDF/FTC ART/r/TDF/FTC Total 69 8 74 n/n
More informationFARMACI, INNOVAZIONE e INFEZIONE DA HIV / AIDS
FARMACI, INNOVAZIONE e INFEZIONE DA HIV / AIDS Stefano Vella Dipartimento del Farmaco Istituto Superiore di Sanità - Roma Stages of HIV-1 Life Cycle Targeted by Anti-HIV Drugs In: Gulick RM, Topics HIV
More informationMeeting Report 15 th PK Workshop, Washington, 2014 Produced by www.hiv-druginteractions.org
Page 1 of 7 HIV Interaction Studies presented at the 15 th International Workshop on Clinical Pharmacology of HIV and HCV Therapy, Washington, April 2014. This report summarises interaction studies relating
More informationManagement of HIV/HCV Co-infected Patients
Management of HIV/HCV Co-infected Patients David Wyles, MD Associate Professor of Medicine Division of Infectious Diseases University of California, San Diego San Diego, California Disclosures Grants/Research
More informationGuidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents Visit the AIDSinfo website to access the most up-to-date guideline. Register for e-mail notification of guideline
More informationDie Toronto Konferenz. K. Arasteh Auguste-Viktoria-Klinikum
Die Toronto Konferenz K. Arasteh Auguste-Viktoria-Klinikum Subjektive Schwerpunkte Medizinische Prävention Monotherapie CD4 guided treatment interuption (CD4-TI) HIV Prävention (Gita Ramjee) Rationale
More informationChapter 3 South African guidelines and introduction to clinical cases
Chapter 3 South African guidelines and introduction to clinical cases 3.1. South African national antiretroviral guidelines When this book was published in 2012 the current national antiretroviral treatment
More informationComprehensive Case Management Reassessment
Comprehensive Case Management Reassessment Reassessment Date: Date of previous Assessment/Reassessment: Name: Client ID # Address: If Reassessment early or late explain: Current HIV Status: Asymptomatic
More informationResidential Course on Clinical Pharmacology of Antiretrovirals 2005 2015
Residential Course on Clinical Pharmacology of Antiretrovirals 2005 2015 Gianni Di Perri Clinica di Malattie Infettive Università degli Studi di Torino Ospedale Amedeo di Savoia This project took place
More informationMinimum costs to produce treatments for HIV, Hepatitis B/C and cancer. Dr Andrew Hill, Pharmacology and Therapeutics, Liverpool University, UK
Minimum costs to produce treatments for HIV, Hepatitis B/C and cancer Dr Andrew Hill, Pharmacology and Therapeutics, Liverpool University, UK Africa, 1999: mass treatment for HIV/AIDS is not feasible 2
More informationHBV screening and management in HIV-infected children and adolescents
HBV screening and management in HIV-infected children and adolescents Linda Aurpibul M.D. Research Institute for Health Sciences, Chiang Mai University 8% HIV and Hepatitis B Co-infection Among Perinatally
More informationEfficacy of lead-in silibinin and subsequent triple therapy in difficult-to-treat HIV/hepatitis C coinfected patients
Second Silibinin Workshop, Cologne, 23 rd May 2014 Efficacy of lead-in silibinin and subsequent triple therapy in difficult-to-treat HIV/hepatitis C coinfected patients Dominique L Braun, MD Division of
More informationBritish HIV Association (BHIVA) guidelines for the treatment of HIV-infected adults with antiretroviral therapy (2006)
r 2006 British HIV Association HIV Medicine (2006), 7, 487 503 British HIV Association (BHIVA) guidelines for the treatment of HIV-infected adults with antiretroviral therapy (2006) B Gazzard on behalf
More informationTreating HIV in children with tuberculosis
International AIDS Society - Industry Liaison Forum Meeting 5 March 2012 Treating HIV in children with tuberculosis Helen McIlleron, Division of Clinical Pharmacology University of Cape Town Challenges
More informationPaediatric HIV Drug Resistance in African Settings
Paediatric HIV Drug Resistance in African Settings Dr Cissy Kityo Mutuluuza INTEREST Meeting May 5-9, 2014 Lusaka, Zambia Background: ART for children in sub- Saharan Africa 2.3 million children with HIV
More informationNON-OCCUPATIONAL POST EXPOSURE PROPHYLAXIS FOR SEXUAL ASSAULT SURVIVORS. Carl LeBuhn, MD
NON-OCCUPATIONAL POST EXPOSURE PROPHYLAXIS FOR SEXUAL ASSAULT SURVIVORS Carl LeBuhn, MD Post-Exposure Prophylaxis (PEP) The use of therapeutic agents to prevent infection following exposure to a pathogen
More informationHIV/HCV Co-Infection
HIV/HCV Co-Infection 2015 Kentucky Conference on Viral Hepatitis Matt Cave, M.D. Associate Professor Department of Medicine Division of Gastroenterology, Hepatology, & Nutrition Department of Pharmacology
More informationUnderstanding Pharmacokinetic Variability and Managing Drug Interactions
Understanding Pharmacokinetic Variability and Managing Drug Interactions Courtney V. Fletcher, Pharm.D. Dean, College of Pharmacy Professor, Department of Pharmacy Practice and Division of Infectious Diseases
More informationSpecial Considerations
Special Considerations Women and cart to Treatment What is medication adherence? taking medication exactly the way it is prescribed by the doctor taking the right amount of medication at the right time
More informationHIV (Human Immunodeficiency Virus) Screening and Pre-Exposure Prophylaxis Guideline
HIV (Human Immunodeficiency Virus) Screening and Pre-Exposure Prophylaxis Guideline Background... 2 Screening... 2 Recommendations... 2 Ordering and consent... 2 Indications for Periodic HIV Screening...
More informationDOI: 10.1111/hiv.12119 2014 British HIV Association HIV Medicine (2014), 15 (Suppl. 1), 1 85
DOI: 10.1111/hiv.12119 British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2012 (Updated November 2013. All changed text is cast in yellow highlight.)
More informationHIV Update: Epidemiology and Pathophysiology
HIV Update: Epidemiology and Pathophysiology MATEC Michigan AIDS Research and Education Center Wayne State University School of Medicine (313) 962-2000 matecmichigan.org 1 Epidemiology of the Epidemic:
More informationCase Finding for Hepatitis B and Hepatitis C
Case Finding for Hepatitis B and Hepatitis C John W. Ward, M.D. Division of Viral Hepatitis Centers for Disease Control and Prevention Atlanta, Georgia, USA Division of Viral Hepatitis National Center
More information1/26/2015. Epidemiology of the Epidemic: World. Epidemiology of the Epidemic: United States. HIV Update: Epidemiology and Pathophysiology
HIV Update: Epidemiology and Pathophysiology MATEC Michigan AIDS Research and Education Center Wayne State University School of Medicine (313) 962-2000 matecmichigan.org Epidemiology of the Epidemic: World
More informationRoutine HIV Monitoring
Routine HIV Monitoring Guideline of the HIV/AIDS Division at San Francisco General Hospital Statement of Guideline: Patients will be routinely evaluated and monitored for HIV parameters, antiretroviral
More informationNEW INSIGHTS INTO MANAGING HIV-1
Learning Objectives Integrate recent clinical trial data into updated HIV management guidelines to provide the most individualized treatment for HIV-1-infected patients Develop a patient-centered approach
More informationL infettivologia del 3 millennio: AIDS ed altro
L infettivologia del 3 millennio: AIDS ed altro VI Convegno Nazionale 15-16 -17 maggio 2014 Centro Congressi Hotel Ariston Paestum (SA) La deintensificazione terapeutica in HIV: Razionale e vantaggi della
More informationChallenges in Prevention of Mother to Child HIV Transmission
Photo: Lora Iannotti Challenges in Prevention of Mother to Child HIV Transmission Lynne M. Mofenson, M.D. Pediatric, Adolescent and Maternal AIDS Branch Eunice Kennedy Shriver National Institute of Child
More informationTHE SOUTH AFRICAN ANTIRETROVIRAL TREATMENT GUIDELINES 2013
THE SOUTH AFRICAN ANTIRETROVIRAL TREATMENT GUIDELINES 2013 VERSION 14 March 2013 Contents Acronym glossary... 2 1. Goals of the programme... 3 2. Objectives... 3 3. Specific Objectives... 3 4. Adults and
More informationhiv/aids Programme Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants
hiv/aids Programme Programmatic update Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants EXECUTIVE SUMMARY April 2012 EXECUTIVE SUMMARY Recent developments
More informationClinical case HIV HCV coinfection
Clinical case HIV HCV coinfection Dominique Salmon HUPC, Paris Descartes University PHC, January 2016 Disclosures Board of experts for Gilead and BMS Objectives To discuss: Results of DAA combination in
More informationSlide 1 HIV/ HCV Coinfected people: what are the specific concerns they face?
Slide 1 HIV/ HCV Coinfected people: what are the specific concerns they face? Marion Peters MD University of California San Francisco 2011 Slide 2 Special issues Effect of HIV on HCV Effects of HCV on
More informationAntiretroviral Drugs in the Treatment and Prevention of HIV Infection
Antiretroviral Drugs in the Treatment and Prevention of HIV Infection Noga Shalev, MD Uses of Antiretroviral Agents Treatment of chronic HIV infection Prevention of mother-to-child transmission [PMTCT]
More informationPrioritizing Second-Line Antiretroviral Drugs for Adults and Adolescents: a Public Health Approach
Prioritizing Second-Line Antiretroviral Drugs for Adults and Adolescents: a Public Health Approach Report of a WHO Working Group Meeting World Health Organization HIV Department Geneva, Switzerland 21-22
More informationRegulatory Approach in Germany and in the EU to Fixed Dose Combination Medicinal Products Using HIV/AIDS Treatment as an Example
Regulatory Approach in Germany and in the EU to Fixed Dose Combination Medicinal Products Using HIV/AIDS Treatment as an Example Prof. Dr. rer. nat. habil. Harald G. Schweim President Federal Institute
More informationOUTLINE POST EXPOSURE PROPHYLAXIS (PEP) OCCUPATIONAL RISK OF VIRAL TRANSMISSION WITH SHARP INJURY FROM INFECTED SOURCE:
Professional needle stick accidents should be dealt with within 48 hours. An ARC (Aids Reference Centre) or an emergency department must be contacted as soon as possible. OUTLINE POST EXPOSURE PROPHYLAXIS
More informationThe use of alcohol and drugs and HIV treatment compliance in Brazil
The use of alcohol and drugs and HIV treatment compliance in Brazil André Malbergier, MD, PhD Hospital das Clínicas Medical School University of São Paulo Brasil The Casa da AIDS offers specialized integral
More informationHIV/AIDS: Controversies 2008-10
HIV/AIDS: Controversies 2008-10 1. Prevention 2. Treatment Josep M Gatell Hospital Clinic. Barcelona. gatell0@attglobal.net AIDS: year 2008-10 AIDS is a STD and a world wide epidemy (sub-saharan Africa,
More informationNewton Kendig, MD RADM, Assistant Surgeon General, USPHS Assistant Director Health Services Division, FBOP
Newton Kendig, MD RADM, Assistant Surgeon General, USPHS Assistant Director Health Services Division, FBOP I do not have any relevant financial relationships with any commercial interests. At the end of
More informationHIV infection in injecting drug users
HIV Clinical Skills Series 4 th International Training Course Tallinn 2010 HIV infection in injecting drug users Marika Raukas West-Tallinn Central Hospital Estonia InjectionDrug Users Transmission via
More informationAids Fonds funding for programmes to prevent HIV drug resistance
funding for programmes to prevent HIV drug resistance Call for proposals July 2012 Page 1 van 10 grants@aidsfonds.nl Documentnumber 20120719/JKA/RAP Universal Access Lifting barriers to universal access
More information2015-10-26 10:58 FOR UK AND EMEA MEDICAL MEDIA ONLY. (Logo: http://photos.prnewswire.com/prnh/20140324/ny88746logo)
2015-10-26 10:58 Janssen Receives Positive CHMP Opinion Recommending EDURANT(R)Black Triangle Drug (rilpivirine) for the Treatment of Adolescents Aged 12 to
More informationHepatitis B and C Co-infection. Mark Hull MHSc, FRCPC Clinical Assistant Professor Division of AIDS
Hepatitis B and C Co-infection Mark Hull MHSc, FRCPC Clinical Assistant Professor Division of AIDS Objectives Review natural history of hepatitis coinfection Brief overview of treatment indications for
More informationPharmacist Support For Antiretroviral Adherence
Pharmacist Support For Antiretroviral Adherence Jennifer Cocohoba, Pharm.D.,MAS, AAHIVP Associate Clinical Professor University of California San Francisco School of Pharmacy Clinical Pharmacist, UCSF
More informationWhy Community Engagement?
Why Community Engagement? Community engagement as a community-based or driven empowerment model is seen as more effective than topdown approaches Multi-level sociological interventions with empirically
More informationThe Botswana Combination Prevention Project (BCPP)
The Botswana Combination Prevention Project (BCPP) The Next Phase of HIV Prevention in Botswana A collaboration between MoH CDC-Botswana, HSPH-BHP Presenter: M.J. Makhema NAC 4 th September 2012 Mashi
More informationAn Introduction to Medication Adherence
An Introduction to Medication Adherence Medication Adherence Project (MAP) A project of the Cardiovascular Prevention & Control Program and the Fund for Public Health in New York Drugs don t work in patients
More informationJanssen Global Public Health: HIV Medicines Access & Partnerships Program APRIL 2014. Julius Bustamante, Pajaros
Julius Bustamante, Pajaros Artwork from Hospital Audiences, Inc. (HAI), a nonprofit organization that inspires healing, growth and learning through access to the arts for the culturally underserved. Janssen
More informationUp to $402,000. Insight HIV. Drug Class. 1.2 million people in the United States were living with HIV at the end of 2011 (most recent data).
HIV Background, new developments, key strategies Drug Class Insight INTRODUCTION Human Immunodeficiency Virus (HIV) is the virus that can lead to Acquired Immunodeficiency Syndrome, or AIDS. No safe and
More informationDidactic Series. Updated Post-Exposure Prophylaxis (PEP) Guidelines. Daniel Lee, MD UCSD Medical Center, Owen Clinic January 9, 2014
Didactic Series Updated Post-Exposure Prophylaxis (PEP) Guidelines Daniel Lee, MD UCSD Medical Center, Owen Clinic January 9, 2014 ACCREDITATION STATEMENT: University of California, San Diego School of
More informationMINISTRY OF HEALTH GUIDELINES ON USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION RAPID ADVICE
MINISTRY OF HEALTH GUIDELINES ON USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION RAPID ADVICE June 2014 This guideline is under copyright of the National AIDS and STI Control Programme
More informationDesigning Non-Inferiority. on Adherence HPTN 083. Brett Hanscom, PhD HPTN SDMC Seattle, WA 6/14/2016
Designing Non-Inferiority Trials when the Noninferiority Margin Depends on Adherence HPTN 083 Brett Hanscom, PhD HPTN SDMC Seattle, WA 6/14/016 Introduction HPTN 083 Randomized trial of injectable Cabotegravir
More informationAktuell HIV-forskning 2014-05-06
Aktuell HIV-forskning 2014-05-06 Alexey Kashpersky Aktuell HIV-forskning Bot Smittsamhet Nya läkemedel HIV och åldrande Etc HPTN 052 Prevention Conclusion Early ART that suppresses viral replication led
More informationGuidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents Visit the AIDSinfo website to access the most up-to-date guideline. Register for e-mail notification of guideline
More informationRobert G. Knodell, M.D. Maryland Chapter, American College of Physicians Fb February 3, 2012
Treatment of Hepatitis C:Present and Future Robert G. Knodell, M.D. Scientific Meeting Maryland Chapter, American College of Physicians Fb February 3, 2012 Presentation Objectives Appreciate the Public
More informationCDC occupation Codes used to code ( map ) facility locations
CDC occupation Codes used to code ( map ) facility locations CDC (occupation) Code BLS SOC (2000)* CDC (occupation) Code BLS SOC (2000)* ATT-Attendant/orderly 31-1012 CLA-Clerical/administrative CNA-Nurse
More informationPromoting Adherence to HIV Antiretroviral Therapy
Promoting Adherence to HIV Antiretroviral Therapy New York State Department of Health AIDS Institute INTRODUCTION Adherence to treatment is an essential component of HIV care. Currently available antiretroviral
More informationMEDICATION THERAPY ADHERENCE CLINIC : DIABETES
MEDICATION THERAPY ADHERENCE CLINIC : DIABETES PHARMACEUTICAL SERVICES DIVISION MINISTRY OF HEALTH MALAYSIA First Edition, 2010 Pharmaceutical Services Division Ministry of Health, Malaysia ALL RIGHT RESERVED
More informationHIV and Hepatitis Co-infection. Martin Fisher Brighton and Sussex University Hospitals, UK
HIV and Hepatitis Co-infection Martin Fisher Brighton and Sussex University Hospitals, UK Useful References British HIV Association 2010 http://www.bhiva.org/documents/guidelines/hepbc/2010/ hiv_781.pdf
More informationAntiretroviral Therapy for HIV Infection: When to Initiate Therapy, Which Regimen to Use, and How to Monitor Patients on Therapy
Perspective Antiretroviral Therapy for HIV Infection: When to Initiate Therapy, Which Regimen to Use, and How to Monitor Patients on Therapy Antiretroviral therapy is recommended for all patients with
More informationEXPANDED HIV TESTING AND LINKAGE TO CARE (X-TLC) IN HEALTHCARE SETTINGS ON THE SOUTH SIDE OF CHICAGO
EXPANDED HIV TESTING AND LINKAGE TO CARE (X-TLC) IN HEALTHCARE SETTINGS ON THE SOUTH SIDE OF CHICAGO R Eavou, M Taylor, C Bertozzi-Villa, D Amarathithada, R Buffington, D Pitrak and N Benbow HIV Prevention
More informationThe Value of Innovation in HIV/AIDS Therapy
White Paper September 2014 The Value of Innovation in HIV/AIDS Therapy Erin Ellwanger, Harrison Kim, and Thomas Goss, PharmD Boston Healthcare Associates, Inc. Boston; Washington, D.C.; Berlin; Shangai;
More informationIntegrating Medical Care Coordination Services into HIV Clinic Medical Homes
Integrating Medical Care Coordination Services into HIV Clinic Medical Homes Carlos Vega-Matos, M.P.A. HIV Care Services Division Division of HIV and STD Programs Background DHSP funds HIV Clinics to provide
More informationThis lecture offers theoretical and practical information about drug interactions in antiretroviral therapy.
Drug interactions Institute of Tropical Medicine, Antwerpen, October 2007 Learning objectives This lecture offers theoretical and practical information about drug interactions in antiretroviral therapy.
More informationANTIRETROVIRAL PRICE REDUCTIONS
UNTANGLING THE WEB OF ANTIRETROVIRAL PRICE REDUCTIONS 16th Edition July 2013 www.msfaccess.org THE MSF ACCESS CAMPAIGN In 1999, on the heels of MSF being awarded the Nobel Peace Prize and largely in response
More informationManagement of non response or relapse following HCV therapy. Greg Dore Darrell Crawford
Management of non response or relapse following HCV therapy Greg Dore Darrell Crawford Learning objectives To understand importance of characterisation of prior HCV therapy response To explore options
More informationPrevalenza HIV/HCV in Italia
Prevalence of HIV/HCV co-infection by region, 2013 WHO global systematic review of prevalence of HIV/HCV Ab co-infection based on prevalence studies in HIV+ persons stratified by risk group (where available)
More informationClinical Criteria for Hepatitis C (HCV) Therapy
Diagnosis Clinical Criteria for Hepatitis C (HCV) Therapy Must have chronic hepatitis C, genotype and sub-genotype specified to determine the length of therapy; Liver biopsy or other accepted test demonstrating
More informationThe Basics of Drug Resistance:
CONTACT: Lisa Rossi +1-412-641-8940 +1-412- 916-3315 (mobile) rossil@upmc.edu The Basics of Drug Resistance: QUESTIONS AND ANSWERS HIV Drug Resistance and ARV-Based Prevention 1. What is drug resistance?
More informationHealth risk assessment: a standardized framework
Health risk assessment: a standardized framework February 1, 2011 Thomas R. Frieden, MD, MPH Director, Centers for Disease Control and Prevention Leading causes of death in the U.S. The 5 leading causes
More informationSTUDY PROGRESS AND SAFETY MONITORING PLAN TEMPLATE
STUDY PROGRESS AND SAFETY MONITORING PLAN TEMPLATE (Intended primarily for use in monitoring of Phase III/IV trials) Final December 20, 2006 20 DEC 06; Version 2.0 1 of 15 No.: DWD-POL-SR-01.00A2 TABLE
More informationPoster # 42 Resistance in PBMCs Can Predict Virological Rebound after Therapy Switch in cart- Treated Patients with Undetectable HIV-RNA
Poster # 42 Resistance in PBMCs Can Predict Virological Rebound after Therapy Switch in cart- Treated Patients with Undetectable HIV-RNA D Armenia 1, M Zaccarelli 2, V Borghi 3, W Gennari 3, A Giannetti
More informationCirrhosis and HCV. Jonathan Israel M.D.
Cirrhosis and HCV Jonathan Israel M.D. Outline Relationship of fibrosis and cirrhosisprevalence and epidemiology. Sequelae of cirrhosis Diagnosis of cirrhosis Effect of cirrhosis on efficacy of treatment
More informationPresented by: Canadian Working Group on HIV and Rehabilitation
Rehabilitation in the Context of HIV: An Interprofessional Course for Occupational Therapists, Physiotherapists, Speech-Language Pathologists and Audiologists Presented by: Canadian Working Group on HIV
More informationUsing HIV Surveillance Data to Calculate Measures for the Continuum of HIV Care
Using HIV Surveillance Data to Calculate Measures for the Continuum of HIV Care Anna Satcher Johnson, MPH Symposium on Measuring the HIV Care Continuum Center for AIDS Research University of Washington
More informationCytoreductive Therapy for Autologous Cell Therapy in HIV
Cytoreductive Therapy for Autologous Cell Therapy in HIV Ronald Mitsuyasu, MD Professor of Medicine UCLA Center for Clinical AIDS Research and Education (CARE Center) HSC Transfer from CCR5-delta 32 Donor
More informationSTOP HIV TB: Special Populations, The Vancouver Experience
STOP HIV TB: Special Populations, The Vancouver Experience Rolando Barrios, MD Assistant Director BC Centre for Excellence in HIV/AIDS Senior Medical Director Vancouver Community Health Services, Vancouver
More informationJNC-8 Blood Pressure and ACC/AHA Cholesterol Guideline Updates. January 30, 2014
JNC-8 Blood Pressure and ACC/AHA Cholesterol Guideline Updates January 30, 2014 GOALS Review key recommendations from recently published guidelines on blood pressure and cholesterol management Discuss
More information