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CCO Management Series

Managing HIV-Infected Patients With Initial Regimen Failure

Understanding and Preventing Virologic Failure of Initial Antiretroviral Therapy

Module 1 of 2

Program Director: Joseph J. Eron, Jr., MD

Faculty:

Anthony M. Mills, MD
  • Anthony M. Mills, MD

CREDIT INFORMATION

Release Date: October 24, 2008

Expiration Date: October 23, 2009


Physicians: maximum of 1.25 AMA PRA Category 1 Credits

Registered Nurses: 1.4 Nursing contact hours

Status: The activity is not currently available for credit.

Begin the Module

In this CME-certified module, Anthony M. Mills, MD, describes the diverse causes of failure in treatment-naive patients, suggests which patients run the highest risk of failure, and proposes practical guidelines for avoiding failure in clinical practice.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Describe the causes of first-line treatment failure
  • Identify patients at the highest risk of first-line treatment failure
  • Discuss practical strategies for avoiding first-line treatment failure

Abstract

Consequences of Failure: Outcomes and Options After Failure of the Initial Antiretroviral Regimen

Module 2 of 2

Program Director: Joseph J. Eron, Jr., MD

Faculty:

Charles B. Hicks, MDSusanna Naggie, MD
  • Charles B. Hicks, MD
  • Susanna Naggie, MD

CREDIT INFORMATION

Release Date: October 20, 2008

Expiration Date: October 19, 2009


Physicians: maximum of 1.25 AMA PRA Category 1 Credits

Registered Nurses: 1.4 Nursing contact hours

Status: The activity is not currently available for credit.

Begin the Module

Charles B. Hicks, MD, and Susanna Naggie, MD, discuss factors associated with initial treatment failure and summarize important considerations for tailoring optimal second-line regimens based on evidence from recent clinical trials.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Identify common causes of first-line antiretroviral regimen failure
  • Describe the role of drug resistance assessment in tailoring optimal second-line regimens
  • Discuss data guiding the choice of second-line regimens for patients failing either NNRTI- or PI-based initial therapy
  • Recount data from clinical trials investigating agents from new antiretroviral classes in treatment-experienced patients

Interactive Case Challenges

Managing the Care of an HIV-Infected Patient With an Inaccurate Previous Treatment History

Program Director: Joseph J. Eron, Jr., MD

Faculty:

Peter J. Ruane, MD
  • Peter J. Ruane, MD

CREDIT INFORMATION

Release Date: November 18, 2008

Expiration Date: November 17, 2009


Physicians: maximum of 0.75 AMA PRA Category 1 Credits

Registered Nurses: 0.8 Nursing contact hours

Status: The activity is not currently available for credit.

Begin the Case Challenge

Along with Peter J. Ruane, MD, choose management strategies for a patient with an inaccurate treatment history who has failed an initial NNRTI-based regimen.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Articulate the importance of accurate medical and treatment histories as considerations in choosing an antiretroviral regimen
  • Identify patients experiencing antiretroviral treatment failure
  • Discuss practical strategies for choosing a new antiretroviral regimen after first-line treatment failure

Choosing an Optimal Second-Line Regimen for a Patient With Intermittent Adherence

Program Director: Joseph J. Eron, Jr., MD

Faculty:

Karam Mounzer, MD
  • Karam Mounzer, MD

CREDIT INFORMATION

Release Date: December 17, 2008

Expiration Date: December 16, 2009


Physicians: maximum of 1.0 AMA PRA Category 1 Credit

Registered Nurses: 1.0 Nursing contact hour

Status: The activity is not currently available for credit.

Begin the Case Challenge

Join Karam Mounzer, MD, in managing the care of an HIV-infected patient with erratic behavior and intermittent adherence.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Recount factors associated with increased risk of virologic failure in patients receiving first-line antiretroviral therapy
  • Describe the resistance consequences of initial regimen failure
  • Debate the evidence-based selection of new antiretroviral regimens for patients failing first-line therapy

A 30-Year-Old Female With Failure of an Initial PI-Based Regimen

Program Director: Joseph J. Eron, Jr., MD

Faculty:

W. David Hardy, MD
  • W. David Hardy, MD

CREDIT INFORMATION

Release Date: January 22, 2009

Expiration Date: January 21, 2010


Physicians: maximum of 0.75 AMA PRA Category 1 Credits

Registered Nurses: 0.7 Nursing contact hours

Status: The activity is not currently available for credit.

Begin the Case Challenge

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.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Identify virologic failure in patients receiving first-line antiretroviral therapy
  • Describe the resistance consequences of failing a first-line boosted PI-based regimen
  • Discuss the evidence-based selection of new antiretroviral regimens for patients failing first-line boosted PI-based therapy

CCO Slideset

Managing HIV-Infected Patients with Initial Regimen Failure

Download the Slideset


This downloadable slideset includes a didactic review of clinically relevant data important for preventing first-line antiretroviral failure and choosing subsequent regimens for patients with first-line virologic failure.


Format: Microsoft PowerPoint (.ppt) | File size: 2.47 MB | Date posted: 11/25/2008


Initial Regimen Failure Pocket Guide

Resistance Consequences of First-Line Antiretroviral Regimen Failure
This downloadable Pocket Guide, developed by Joseph J. Eron, Jr., MD, provides a convenient reference outlining typical patterns and incidence of resistance after failure of DHHS and IAS-USA recommended first-line regimens in clinical studies.
Download Pocket Guide

Disclaimer: The materials published on the Clinical Care Options Sites reflect the views of the reviewers or authors of the CCO material, not those of Clinical Care Options, LLC, the CME provider, or the companies providing educational grants. The materials may discuss uses and dosages for therapeutic products that have not been approved by the United States Food and Drug Administration. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or using any therapies described in these materials.

Jointly sponsored by Postgraduate Institute for Medicine and Clinical Care Options, LLC.

Contact Info

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Educational grants support only the CME-certified components of this program.