HIV Journal Options - Volume 5, Issue 2

Stay up to date with the current HIV/AIDS literature through a CME-certified learning module with Expert Commentaries, Capsule Summaries, and CCO’s downloadable slidesets.

Topics include:

• Pretreatment CD4+ Cell Count and Recovery of T-Cell Subsets
• Incidence of Non-AIDS–Defining Cancers in HIV-Infected Patients
• Atazanavir/Ritonavir Monotherapy in Virologically Suppressed Patients
• CHER: Investigation of Antiretroviral Timing in HIV-Infected Infants
• Once- vs Twice-Daily Lopinavir/Ritonavir in Treatment-Naive Patients
• Initiating HAART in HIV/TB-Coinfected Patients
• Increased Mortality Among HIV-Infected Racial Minorities and Women
• Viability of Less Frequent Follow-ups in Virologically Suppressed Patients
  

Strategies for Success in the Most Complex Cases: A Master Class on the Management of Treatment-Experienced Patients

Now Available!

CME-Certified Video Module:

Strategies for Success in the Most Complex Cases: A Master Class on the Management of Treatment-Experienced Patients
In this video module, Program Director Kimberly Y. Smith, MD, MPH, and faculty members Daniel R. Kuritzkes, MD, and Andrew R. Zolopa, MD, review 2 challenging cases involving highly treatment–experienced multidrug-resistant patients. Challenge yourself to build the most appropriate new regimens for these patients.

Answering the Questions: Clinical Considerations in the Use of Integrase Inhibitors

CCO’s expert faculty members provide answers to frequently asked questions about key clinical considerations when incorporating HIV integrase inhibitors into an antiretroviral regimen.

Now Available!

CME-Certified Module:

Answering the Questions: Clinical Considerations in the Use of Integrase Inhibitors William G. Powderly, MD; Paul E. Sax, MD; and Jonathan M. Schapiro, MD, address pressing questions regarding the use of HIV integrase inhibitors in clinical practice.

Downloadable CCO Slideset:

Answering the Questions: Clinical Considerations in the Use of Integrase Inhibitors In this downloadable slideset, Jonathan M. Schapiro, MD, presents data on the most pressing questions regarding the use of HIV integrase inhibitors in clinical practice.

CCO HIV Stay Tuned

Bimonthly CME-certified audio Podcasts, each supported by a variety of online resources.

Evolving Concepts in Antiretroviral Therapy—Volume 2, Edition 1 Watch and listen as W. David Hardy, MD, discusses the clinical relevance of select studies published the first quarter of 2009; Andrew R. Zolopa, MD, reports on the timing of antiretroviral initiation in patients presenting with an opportunistic infection; Anthony M. Mills, MD, discusses his approach to management and treatment of HIV-infected patients with cardiovascular risk; Scott L. Letendre, MD, challenges the participant to manage the treatment of a patient with neurocognitive decline; and Peter J. Ruane, MD, discusses the recently presented SWITCHMRK data on modifying a virologically suppressive antiretroviral regimen. Then download audio, video, and Capsule Summaries for additional reference. Click here to start.

HIV/AIDS Annual Update 2009

Clinical Care Options' HIV/AIDS Annual Update offers the latest information across a wide range of issues for the optimal clinical management of your patients. Expert faculty members prepared the following CME-certified educational modules that are now available on the CCO Web site:

Now Available!

CME-Certified Modules:

The Virus, the Tissues, and Immune Activation: What Makes HIV Infection Pathogenic?  Daniel C. Douek, MD, MRCP, PhD, reviews deletion of gut-associated lymphoid tissue in early HIV-1 infection and the implications for progression of HIV-associated disease.

New Insights Into Persistent Low-Level Viremia  Robert F. Siliciano, MD, PhD, reviews the contribution of viral dynamics and the inhibitory mechanisms of antiretroviral agents to the persistence of low-level HIV-1 viremia during HAART and proposes a quantitative approach to selecting optimal HIV-1 treatment regimens.

Timing and Choice of First-Line Antiretroviral Therapy  Joel E. Gallant, MD, MPH, reviews optimal strategies for the initial treatment of HIV-1 infection in the context of updated guideline recommendations and recent clinical trials data.

Inflammation and Non-AIDS Events: Are Antiretroviral-Treated Patients Aging Too Quickly and If So, Why?  Steven G. Deeks, MD, describes inflammation and immune activation related to HIV infection and how even though viral replication may be suppressed, HIV appears to mediate other disease states previously thought to be non-AIDS related.

Update on Managing Methamphetamine Abuse in the Setting of HIV Infection  Steven Shoptaw, PhD, offers practical management strategies for treating methamphetamine use in HIV-infected patients.

State-of-the-Art Management of Sexually Transmitted Diseases  Jeanne Marrazzo, MD, MPH, reviews current management strategies of sexually transmitted diseases in HIV-infected patients.

Biomedical Approaches to Prevention  Sharon L. Hillier, PhD, outlines the successes and failures of clinical trials of HIV prevention and describes current clinical trials of microbicides and antiretroviral therapy for pre-exposure prophylaxis.

Experiences as an HIV Provider in Africa  Charles Steinberg, MD, reviews data and personal experience about providing healthcare in the resource-poor nation Uganda in Africa.

European Guidelines for Use of Antiretroviral Therapy: Recent Changes and Emerging Data

CCO’s expert faculty members review the most recent European guidelines on the frontline treatment of patients infected with HIV-1 and summarize new clinical findings that have led to changes in recommended treatment strategies and may impact future approaches to antiretroviral regimen selection.

Now Available!

CME-Certified Module:

European Guidelines for Use of Antiretroviral Therapy: Recent Changes and Emerging Data  José Gatell, MD, and Anton L. Pozniak, MD, FRCP, discuss the latest European guidelines on initial antiretroviral therapy and review new data that help define the efficacy of initial regimens.

Downloadable CCO Slideset:

European Guidelines for Use of Antiretroviral Therapy: Recent Changes and Emerging Data In this downloadable slideset, José Gatell, MD, reviews data that have influenced the latest European guidelines and emerging data that may impact future iterations of the guidelines.

Answering the Questions: HIV Tropism in Clinical Practice

In each of these CME-certified modules, expert faculty members Eric S. Daar, MD; Joseph J. Eron, Jr., MD; and Jonathan M. Schapiro, MD, respond to frequently asked questions about HIV tropism, tropism testing, and the implications for clinical management of patients. An accompanying downloadable slideset provides a visual overview of the most pertinent data on HIV tropism.

Now Available!

CME-Certified Modules:
Answering the Questions: HIV Tropism in Clinical Practice

HIV Tropism and the Use of CCR5 Antagonists in Clinical Practice: Answers to Frequently Asked Questions

Downloadable CCO Slideset:

Answering the Questions: HIV Tropism in Clinical Practice Download these slides for review and use in your own educational presentations.

HIV Journal Options - Volume 5, Issue 1

Stay up to date with the current medical literature through a CME-certified learning module and CCO’s Capsule Summaries of the most relevant published articles with accompanying Expert Commentaries and downloadable slidesets.

Topics Include:

• Raltegravir With Optimized Background Therapy for Resistant HIV-1 Infection
• Maraviroc for Previously Treated Patients With R5 HIV-1 Infection
• Week 48 Efficacy and Safety Results of the CASTLE Study
• Week 48 Efficacy and Safety Results of the ARTEMIS Study
• Use of NRTIs and Risk of Myocardial Infarction
• Long-term Consequences of Delayed Regimen Modification After Virologic Failure
• Antiretroviral Resistance and Clinical Progression
• Low CD4+ Cell Count and Atherosclerosis

The Evolving Management of Drug-Drug Interactions in HIV Infection

This new Treatment Update is designed to allow clinicians to explore clinically relevant drug-drug interactions.

Now Available!

CME-Certified Case Vignettes:

Considering Drug-Drug Interactions When Selecting a First-line Antiretroviral Therapy for a Patient With a Complex Medical History Charles W. Flexner, MD, and Paul Pham, PharmD, BCPS, coauthored this case vignette that describes the management of a patient with a medical history and multiple nonantiretroviral medications that increase the potential for drug-drug interactions.

Does Polypharmacy Increase the Likelihood of Renal Toxicity Among Persons With HIV? In this CME-certified Case Vignette, Lynda Szczech, MD, MSCE, FASN, discusses the management of an HIV–infected patient with diabetic nephropathy and heart failure who is being treated with multiple medications in addition to antiretrovirals.

Drug-Drug Interactions Tool This interactive tool will enable readers to select a specific antiretroviral agent from a listing of all FDA-approved antiretroviral agents and then either display and print a report of the interactions between this drug and other antiretroviral agents and commonly prescribed concomitant medications or select multiple concomitant agents from a listing of those most commonly used by HIV-infected patients and create a report on any interactions between the selected antiretroviral agents and other nonantiretroviral medications.

Evolving Options for First-line PI-Based Antiretroviral Regimens

Through a CME-certified Interactive Virtual Presentation and downloadable slideset, this new Treatment Update delivers the latest information on key factors to consider when choosing among the different PI-based antiretroviral regimens available for the frontline treatment of HIV-1 infection.

Now Available!

CME-Certified Interactive Virtual Presentation:

Downloadable PowerPoint Slideset:

CCO Independent Conference Coverage of the 2009 Conference on Retroviruses and Opportunistic Infections

CCO's coverage of the 2009 Conference on Retroviruses and Opportunistic Infections includes Capsule Summaries of key presentations, as well as Expert Analyses, Expert Recaps, slides, and audio and video Expert Highlights that focus on key issues highlighted at the conference.

• Management of Antiretroviral-Naive Patients
• Resistance and Management of Treatment-Experienced Patients 
  

CME-Certified Expert Analyses:

• Management of Antiretroviral-Naive Patients
  Joel E. Gallant, MD, MPH; W. David Hardy, MD; and Kathleen E. Squires, MD, discuss the most clinically relevant new data on first-line treatment strategies for HIV-infected patients presented at the 2009 Conference on Retroviruses and Opportunistic Infections.
  
  
• Resistance and Management of Treatment-Experienced Patients
  Eric S. Daar, MD; Joseph J. Eron, Jr., MD; and Kimberly Y. Smith, MD, MPH, discuss how the latest data presented at the 2009 Conference on Retroviruses and Opportunistic Infections may affect management of antiretroviral-experienced patients.

CME-Certified Expert Recap:

Downloadable Slideset The slideset that accompanies this Expert Recap is available for use as a self-study resource or in your own noncommercial presentations.

An Eye on the Future: Planning for Long-term Antiretroviral Success

This new Treatment Update reviews critical aspects of first-line regimen selection as well as important antiretroviral management strategies in the context of potentially lifelong antiretroviral therapy.


CME-Certified Video Module:
Planning and Strategizing for Long-term Success With Antiretroviral Therapy
W. David Hardy, MD, leads a case-based roundtable with Renslow Sherer, MD; Edwin DeJesus, MD, FACP, AAHIVS; and Matthew B. Goetz, MD, to determine strategies important for long-term antiretroviral therapy.

CME-Certified Modules:

• Factors Associated With Long-term Success With First-line Regimens
  Renslow Sherer, MD, addresses factors that contribute to the attainment of long-term virologic suppression in patients initiating antiretroviral therapy.
  
  
• Strategies for Further Enhancing Outcomes in Patients With Virologic Suppression
  Edwin DeJesus, MD, FACP, AAHIVS, outlines strategies for treatment simplification in virologically suppressed patients and discusses data that indicate that this is a safe and effective strategy in many patients.
  
  
• Management Challenges in Patients Receiving Long-term Antiretroviral Therapy
  Matthew B. Goetz, MD, reviews management issues in older HIV-infected patients who have undergone long-term therapy with antiretroviral medications and explores the intersection of HIV infection, antiretroviral therapy, and/or the normal aging process.

Downloadable CCO Slideset:

Answering the Questions: Initiating Antiretroviral Therapy

CCO’s expert faculty members provide answers to frequently asked questions regarding the initiation of antiretroviral therapy in this new Treatment Update. Discussions include key considerations on when to initiate therapy, assessing patients prior to treatment, and optimal initial regimen selection. Special populations of patients are addressed.

CME-Certified Modules:
Answering the Questions: Initial Antiretroviral Therapy
John A. Bartlett, MD; Paul E. Sax, MD; and Benjamin Young, MD, PhD, in this roundtable answer the questions most pertinent to the initiation of antiretroviral therapy. Special considerations for unique patients and situations are discussed.

Faculty Responses to Additional Questions on Initiating Antiretroviral Therapy 
John A. Bartlett, MD; Paul E. Sax, MD; and Benjamin E. Young, MD, PhD, answer the most compelling additional questions on initiating antiretroviral therapy in HIV-infected antiretroviral-naive patients.

Downloadable CCO Slideset:

Initial Antiretroviral Regimens: State of the ART 2008

Joel E. Gallant, MD, MPH, discusses new data that have an impact on our concept of the initial antiretroviral regimen and how the initial regimen may evolve in the future.

Assessing Antiretroviral Activity: A Practical Guide to Selecting New Agents for Treatment-Experienced Patients

In this new Treatment Update, CCO’s expert faculty members discuss the latest findings from clinical studies regarding the role of HIV resistance and tropism data in designing new regimens for treatment-experienced patients. Case Vignettes provide practical examples of clinical scenarios that may be encountered in practice.

CME-Certified Case Vignettes:

• Selecting and Modifying First-line Antiretroviral Therapy in a Pregnant Patient With Transmitted Drug Resistance
• Designing a New Regimen for a Highly Treatment–Experienced Patient With R5-Only Virus
• Treatment Options for a Patient With Persistent Viremia on Enfuvirtide-Containing Therapy

CME-Certified Interactive Virtual Presentation:
Assessing Antiretroviral Activity: A Practical Guide to Selecting New Agents for Treatment-Experienced Patients 
Watch, listen, and make treatment decisions as Charles B. Hicks, MD, leads you through this interactive presentation exploring the application of various tools and approaches, including resistance and tropism tests, to assess the activity of antiretroviral agents to individualize treatment for antiretroviral-experienced patients.


Slideset:
Assessing Antiretroviral Activity: A Practical Guide to Selecting New Agents for Treatment-Experienced Patients 
Charles B. Hicks, MD, discusses the latest findings from clinical studies regarding the impact of HIV resistance and tropism on the assessment of the antiretroviral activity of specific agents in designing new regimens for treatment-experienced patients.

• 2009 Conference on Retroviruses and Opportunisitic Infections *
  
  
• 2008 International Congress on Drug Therapy in HIV Infection*
  
  
• 2008 ICAAC/IDSA Annual Meeting*
  
  
• 2008 International AIDS Conference
  
  
  
  
  

*CCO is an independent medical education company that provides state-of-the-art medical information to healthcare professionals through conference coverage and other educational programs.

• Toward Timely Treatment: Risks of and Strategies to Address Delayed Antiretroviral Therapy
  Through 2 CME-certified modules, CCO’s expert faculty members discuss key issues related to the timing of antiretroviral therapy initiation.
  
  
• Integrating New Antiretroviral Agents Into Therapeutic Strategies for Treatment-Experienced Patients
  Watch, listen, and make treatment decisions as Eric S. Daar, MD, leads you through a series of interactive clinical scenarios exploring the use of the newly approved antiretroviral agents in virologically suppressive regimens for treatment-experienced patients.
  
  
• The Role of Integrase Inhibitors in HIV Management
  Through a CME-certified video module and 3 downloadable slidesets, CCO’s expert faculty members explore key strategies for the effective use of integrase inhibitors in the context of the most recent clinical trials data and with consideration of mechanisms and consequences of resistance.
  
  
• CCO HIV Stay Tuned - Volume 1
  Bimonthly CME-certified audio Podcasts, each supported by a variety of online resources.
  
  
• Managing Dyslipidemia in HIV-Infected Patients on Therapy: Switch Antiretrovirals or Add Lipid-Lowering Agents?
  Marshall J. Glesby, MD, PhD, and James H. Stein, MD, review evidence, discuss cases, and answer questions on the strategy of switching antiretroviral therapy vs adding lipid-lowering drugs to manage HIV-infected patients with dyslipidemia.
  
  
• Answering the Questions: Practical Management Strategies to Address Cardiovascular Risk in HIV 
  Sally Hodder, MD, Paul E. Sax, MD, and Pablo Tebas, MD, offer practical responses to readers’ questions about managing cardiovascular risks in HIV-infected patients.
  
  
• Managing Insulin Resistance in HIV-Infected Patients
  Read a comprehensive CME-certified module, Todd T. Brown, MD, PhD, describes the incidence, consequences, and management of insulin resistance in the HIV-infected patient population. Then try an Interactive Case Challenge, where you will have the opportunity to make treatment decisions using patient histories and diagnostic information. Compare your answers with your peers and recommendations from William G. Powderly, MD.
  
  
• New Insights Into the Use of PIs Across the Treatment Spectrum
  Watch CME/CE-certified video of an expert faculty panel discussing how recent advances in the PI class may affect treatment decisions in patients with varying levels of antiretroviral experience.

• Managing HIV-Infected Patients With Initial Regimen Failure
  This up-to-date Management Series provides an overview of the causes and consequences of treatment failure with first-line antiretroviral regimens as well as practical clinical strategies for avoiding and managing initial treatment failure in HIV-infected patients.
  
  
• The Role of Integrase Inhibitors in HIV Management
  Review educational modules, case challenges and a downloadable slideset.
  
  
  

• Managing the Care of an HIV-Infected Patient With an Inaccurate Previous Treatment History
  Along with Peter J. Ruane, MD, choose management strategies for a challenging HIV-infected patient.
  
  
• Choosing an Optimal Second-Line Regimen for a Patient With Intermittent Adherence
  Join Karam Mounzer, MD, in managing the care of an HIV-infected patient with erratic behavior and intermittent adherence.
  
  
• A 30-Year-Old Female With Failure of an Initial PI-Based Regimen
  Join W. David Hardy, MD, in managing the care of an HIV-infected female with virologic failure of a first-line boosted PI-based regimen.
  
  
• Management of a Moderately Treatment-Experienced Male Using Novel Antiretroviral Agents
  Andrew R. Zolopa, MD, discusses key issues in the management of a chronically infected patient with persistent viremia.
  
  

Topics

• Adverse Effects and Comorbidities
• Antiretroviral Management
• Epidemiology and Natural History
• Opportunistic Diseases and Coinfection
• Pharmacology
• Resistance
• Special Populations

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FEATURED VIDEO SEGMENT

New This Month

W. David Hardy, MD discusses the clinical implications of three reports on the management of individuals living with HIV. Click here to start.

MOTIVATE: Prevalence of Phenotypic Resistance to Maraviroc in Treatment-Experienced Patients With CCR5-Tropic Virus at Virologic Failure

In a post hoc analysis of MOTIVATE, one third of patients who retained CCR5-tropic virus at virologic failure, most of whom had a suboptimal background regimen, found to be resistant to maraviroc.

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