Key Principles and Recommended Regimens for First-line Antiretroviral Therapy
Source: Clinical Resources From inPractice HIV

Module

Paul E. Sax, MD, discusses issues to be considered in selecting an initial antiretroviral regimen as well as considerations for special patient settings.

Learning Objectives

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

  • Integrate best practices in the management of first-line antiretroviral therapy

Topics covered include:

  • Introduction
  • Antiretroviral Treatment Guidelines for First-line Therapy in Adult Patients
  • Pretherapy Antiretroviral Resistance Testing
  • Clinical Trials of NNRTI-Based vs PI-Based Therapy
  • Clinical Trials of INSTI-Based vs NNRTI-Based Therapy
  • Clinical Trials of INSTI-Based vs Boosted PI-Based Therapy
  • Choosing Among the Integrase Inhibitors for First-line Therapy
  • Choosing Among the NNRTIs for First-line Therapy
  • Choosing Among the Boosted PIs for First-line Therapy
  • Selection of the NRTI Pair
  • Maraviroc-Based Initial Therapy
  • NRTI-Limiting Approaches in Initial Therapy
  • Recommendations for Special Situations
 

Program Directors

  • Joseph J. Eron, Jr.
    MD
    Daniel R. Kuritzkes
    MD
    Kathleen E. Squires
    MD
    Joel E. Gallant
    MD, MPH

Faculty

  • Paul E. Sax
    MD
  • Release Date:
    January 20, 2017

Information on this Educational Activity

Program Directors

Joseph J. Eron, Jr., MD

Professor of Medicine and Epidemiology
University of North Carolina School of Medicine
Director, AIDS Clinical Trials Unit
University of North Carolina
Chapel Hill, North Carolina

Joseph J. Eron, Jr., MD, has disclosed that he has received funds for research support from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen, and ViiV; consulting fees from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Merck, Roche Molecular Systems, Tibotec/Janssen, and ViiV; and has served on the data and safety monitoring board for TaiMed.

 

Daniel R. Kuritzkes, MD

Chief, Division of Infectious Diseases
Brigham and Women's Hospital
Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Daniel R. Kuritzkes, MD, has disclosed that he has received consulting fees from Bionor, Gilead Sciences, GlaxoSmithKline, InnaVirVax, Janssen, Merck, Oncolys, Teva, ViiV, and ViroStatics; fees for non-CME/CE services from Merck; and funds for research support from Gilead Sciences.

 

Kathleen E. Squires, MD

W. Paul and Ida H. Havens Professor of Infectious Diseases
Director,
Division of Infectious Diseases
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania

Kathleen E. Squires, MD, has disclosed that she has served on advisory boards for scientific purposes for Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, and ViiV; has served on advisory boards for marketing purposes for Gilead Sciences and Janssen; and has received funds for research support from Gilead Sciences.

 

Joel E. Gallant, MD, MPH

Medical Director of Specialty Services
Southwest CARE Center
Santa Fe, New Mexico
Adjunct Professor of Medicine
Division of Infectious Diseases
Johns Hopkins University School of Medicine
Baltimore, Maryland

Joel E. Gallant, MD, MPH, has disclosed that he has received consulting fees from Bristol-Myers Squibb, Gilead Sciences, Merck, Janssen, Theratechnologies, and ViiV/GlaxoSmithKline and funds for research support from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, Sangamo, and ViiV/GlaxoSmithKline.

 

Faculty

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

Paul E. Sax, MD, has disclosed that he has received consulting fees from AbbVie, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline/ViiV, Janssen, and Merck and funds for research support from Bristol-Myers Squibb, Gilead Sciences, and GlaxoSmithKline/ViiV.
 

Staff

Jenny Schulz, PhD


Editorial Director, Virology & Other Therapeutic Areas

Jenny Schulz, PhD, has nothing to disclose with regard to commercial interests.
 

Jennifer M. Blanchette, PhD


Managing Editor

Jennifer M. Blanchette, PhD, has nothing to disclose with regard to commercial interests.
 

Heather Stieglitz, PhD


Editorial Contributor

Heather Stieglitz, PhD, has nothing to disclose with regard to commercial interests.
 

  • How I Approach Patients Who Are Reluctant to Initiate ART

    Daniel R. Kuritzkes MD - 9/8/2015    5 comments / Last Comment: 9/24/2016
    In this patient case example, I review how I counsel patients who are hesitant to begin first-line ART.
  • Adherence Concerns: Are We Limited to Boosted PIs?

    Joseph J. Eron, Jr. MD - 8/24/2015    3 comments / Last Comment: 9/3/2015
    My take on why an integrase inhibitor–based regimen makes sense for an ART-naive patient who struggles with adherence to care and medications.
  • ART in Older Patients: How I Manage Drug–Drug Interactions With Concomitant Medications

    Anton L. Pozniak MD, FRCP - 10/20/2015    16 comments / Last Comment: 5/10/2016
    As our patients age, they experience metabolic changes and more frequently develop conditions such as bone mineral density loss, cardiovascular disease, diabetes, and malignancies, all of which will affect the choice of first-line ART.
  • My Approach to First-line ART for Patients With High Cardiovascular Disease Risk

    William G. Powderly MD - 10/6/2015    4 comments / Last Comment: 11/8/2015
    When treating HIV in patients with risk factors for CVD, selecting the optimal ART regimen is only part of the equation.
  • Why ART Trials Specific to Women Are Important

    Kathleen E. Squires MD - 9/28/2016    2 comments / Last Comment: 10/19/2016
    Although almost one half of new HIV infections worldwide occur in women, to date, clinical trials for FDA-approved ART regimens have largely been conducted in men. Here is my take on why women-specific ART trials are important.