Clinical Case Vlogs: Practical Insights on Managing HIV in Our Aging Patients

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In this series of video logs, expert faculty discuss their experiences caring for aging patients with HIV. Each short Vlog focuses on a specific case that highlights challenges rendered by a select comorbidity in an older patient living with HIV. Watch the faculty review relevant patient information and walk through considerations that inform best management practices of the patient’s HIV infection and comorbid conditions.
Jonathan Appelbaum, MD, FACP, AAHIVS
Jennifer Cocohoba Headshot
Jennifer Cocohoba, PharmD
Joseph J. Eron, Jr., MD
Monica Gandhi, MD, MPH
Rajesh T. Gandhi, MD
Howard Grossman, MD
Karine Lacombe, MD, PhD
Josep M. Llibre, MD, PhD
Jens D. Lundgren, MD, DMSc
Cristina Mussini, MD
Bisola Ojikutu, MD, MPH
Chloe Orkin Photo
Chloe Orkin, MBChB, FRCP, MD
Melanie Reese
Jürgen K. Rockstroh, MD
Paul E. Sax, MD
Julie A. Womack, PhD, CNM, FNP-BC

Clinical Case Vlogs

Hear expert insight and guideline-based recommendations for assessing ART modification options in aging PWH during virtual visits.

Chloe Orkin Photo Chloe Orkin, MBChB, FRCP, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: October 8, 2021 Expired: October 7, 2022

Hear expert insight and guideline-based recommendations for assessing the causes of weight gain in PWH and learn how to work with patients to develop a plan for managing weight.

Karine Lacombe, MD, PhD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: May 27, 2021 Expired: May 26, 2022

In this short vlog, Dr. Bisola Ojikutu discusses how racial disparities and social determinants of health affect an aging patient with HIV, including a discussion of strategies to address stigma and to strengthen efforts to link and retain older individuals in care.

Bisola Ojikutu, MD, MPH Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: April 29, 2021 Expired: April 28, 2022

In this short vlog, Monica Gandhi, MD, MPH, and her guest and patient, Lisa, discuss HIV and bone health as well as newly updated HIVMA primary care guidance for aging people with HIV.

Monica Gandhi, MD, MPH Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: March 4, 2021 Expired: March 3, 2022

In this short Vlog, Howard Grossman, MD, discusses how he prioritizes vaccination in his older patients with HIV, reviewing the guidelines on recommended vaccines and dosing schedule considerations.

Howard Grossman, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: March 12, 2021 Expired: March 11, 2022

In this short vlog, Monica Gandhi, MD, MPH, discusses the special considerations in caring for older persons with HIV and the Golden Compass Program in San Francisco, California.

Monica Gandhi, MD, MPH Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: January 28, 2021 Expired: January 27, 2022

In this short Vlog, Rajesh T. Gandhi, MD, discusses how he counsels his older patients with HIV on COVID-19 vaccination and reviews the efficacy and safety data on recently authorized COVID-19 vaccines in older persons and persons with HIV.

Rajesh T. Gandhi, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: January 21, 2021 Expired: January 20, 2022

In this short Vlog, Rajesh T. Gandhi, MD, discusses the data on COVID-19 risk in older persons with HIV, the potential implications for vaccine prioritization, and how he counsels an older patient with HIV on COVID-19 vaccine recommendations.

Rajesh T. Gandhi, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: January 20, 2021 Expired: January 19, 2022

In this short Vlog, Professor Josep Llibre discusses considerations for selecting among recommended ART for an older patient newly diagnosed with HIV; he covers ART efficacy, polypharmacy considerations, and weight gain in older patients.

Josep M. Llibre, MD, PhD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: December 21, 2020 Expired: December 20, 2021

In this short Vlog, Professor Cristina Mussini discusses treating a menopausal woman with HIV who has suffered a minor fracture, including considerations for osteoporosis screening and possible ART switching to improve bone health.

Cristina Mussini, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: December 3, 2020 Expired: No longer available for credit

In this short Vlog, Jürgen Rockstroh, MD, discusses treating an older man with HIV who is suspected of recent reinfection with HCV.

Jürgen K. Rockstroh, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: November 10, 2020 Expired: No longer available for credit

In this short Vlog, Dr. Howard Grossman discusses his approach to caring for an aging transgender woman with virologically suppressed HIV who wishes to initiate gender-affirming hormone therapy.

Howard Grossman, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: October 22, 2020 Expired: No longer available for credit

In this short Vlog, Jürgen Rockstroh, MD, discusses treating an older man recently diagnosed with HIV/HBV coinfection, including considerations for switching therapy and recommendations on HCC screening.

Jürgen K. Rockstroh, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: October 20, 2020 Expired: No longer available for credit

In this short Vlog, Dr. Jonathan Appelbaum discusses his approach to managing ART and reducing polypharmacy in an older woman with HIV who presents with frailty and multiple other comorbidities.

Jonathan Appelbaum, MD, FACP, AAHIVS Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: September 24, 2020 Expired: No longer available for credit

In this short Vlog, Professor Jens. D. Lundgren discusses approaches to reduce the risk of cardiovascular disease in an older woman with HIV, including ART modification, smoking cessation, and hypertension management.

Jens D. Lundgren, MD, DMSc Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: September 14, 2020 Expired: No longer available for credit

In this short vlog, Joseph J. Eron, Jr., MD, discusses care of an older man with symptoms suggestive of COPD. He walks through the details of this patient case and considerations for referral to a pulmonologist and ART management.

Joseph J. Eron, Jr., MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: August 28, 2020 Expired: No longer available for credit

In this short Vlog, Dr. Paul Sax discusses care of a patient with HIV and fatty liver disease. He walks through the details of the patient case and highlights key points for regimen selection, including weight gain and metabolic considerations with ART initiation.

Paul E. Sax, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: August 12, 2020 Expired: No longer available for credit

In this short vlog, Joseph J. Eron, Jr., MD, discusses care of an older man with PTSD-like symptoms related to the recent COVID-19 situation. He walks through the details of this patient case and considerations for mental healthcare in persons living with HIV in general and during the current stressful situation.

Joseph J. Eron, Jr., MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: July 28, 2020 Expired: No longer available for credit

In this short Vlog, Professor Chloe Orkin discusses care of a migrant woman from Zimbabwe living in the UK. She walks through the details of the patient case and highlights key points for optimal care of aging patients with comorbidities living in difficult social circumstances.

Chloe Orkin Photo Chloe Orkin, MBChB, FRCP, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: July 23, 2020 Expired: No longer available for credit

In this short Vlog, Dr. Paul Sax discusses care of a patient with HIV who developed COVID-19 pneumonia. Dr. Sax walks through the details of the patient case and highlights key points for optimal care of patients with HIV during the evolving COVID-19 pandemic, including risk factors and treatment options.

Paul E. Sax, MD Physicians: maximum of 0.25 AMA PRA Category 1 Credits Registered Nurses: 0.25 Nursing contact hours Pharmacists: 0.25 contact hours (0.025 CEUs) Released: July 1, 2020 Expired: No longer available for credit

Downloadable Slidesets

Review this case of an aging patient with HIV who is virally suppressed and recently referred to a new provider during the pandemic: includes expert perspectives and DHHS guidelines on when to consider switching ART

Chloe Orkin Photo Chloe Orkin, MBChB, FRCP, MD Released: October 8, 2021

Review this patient case of an aging woman with virologically suppressed HIV who is experiencing weight gain; includes key data on weight gain with ART and guidelines on management.

Karine Lacombe, MD, PhD Released: May 27, 2021

Review this patient case of an older Black man with HIV who is experiencing stigma and lacks social support; includes key data on racial and social determinants of health in older persons with HIV in the United States.

Bisola Ojikutu, MD, MPH Released: April 29, 2021

Review this patient case of an older woman with HIV who is diagnosed with osteoporosis. Monica Gandhi, MD, MPH, discusses the special bone health considerations of older persons with HIV, as well as newly updated HIVMA primary care guidance.

Monica Gandhi, MD, MPH Released: March 4, 2021

Review this patient case of an older man with HIV, including data on vaccine coverage and guidelines on recommended vaccines and dosing schedules.

Howard Grossman, MD Released: March 12, 2021

Review this patient case of an older man with HIV who is facing multiple issues related to aging. Monica Gandhi, MD, MPH, discusses the special considerations in caring for older persons with HIV, and introduces the Golden Compass program in San Francisco, California.

Monica Gandhi, MD, MPH Released: January 28, 2021

Review this patient case of an older man with HIV who is interested in COVID-19 vaccination, including key data on the efficacy and safety of currently authorized COVID-19 vaccines in older persons and persons with HIV.

Rajesh T. Gandhi, MD Released: January 21, 2021

Review this patient case of an older man with HIV who is interested in COVID-19 vaccination, including key data on COVID-19 risk in older persons and persons with HIV that may inform vaccine prioritization.

Rajesh T. Gandhi, MD Released: January 20, 2021

Review this patient case of an older man recently diagnosed with HIV infection, including key data and guidelines that inform optimal ART selection.

Josep M. Llibre, MD, PhD Released: December 21, 2020

Review this patient case of a menopausal woman with HIV who suffered a minor fracture, including guidelines for bone health screening and fracture prevention.

Cristina Mussini, MD Released: December 3, 2020

Review this patient case of an older man with HIV and newly diagnosed HCV reinfection, including relevant data on rates of HCV reinfection and management guidelines for HCV in MSM.

Jürgen K. Rockstroh, MD Released: November 10, 2020

Review this patient case of an aging transgender woman with virologically suppressed HIV who wishes to start gender-affirming hormone therapy, including key information on potential drug-drug interactions.

Howard Grossman, MD Released: October 22, 2020

Review this patient case of an older man recently diagnosed with HIV/HBV coinfection with detectable HBV DNA 1 year after initiating treatment.

Jürgen K. Rockstroh, MD Released: October 20, 2020

Review this patient case of an older woman with HIV on multiple comedications who presents with frailty and other comorbidities; slides include relevant data and guidelines on reducing polypharmacy and drug-drug interactions.

Jonathan Appelbaum, MD, FACP, AAHIVS Released: September 24, 2020

Review this patient case of an older woman with HIV at high risk of cardiovascular disease, including relevant data and recommendations on reducing her risk.

Jens D. Lundgren, MD, DMSc Released: September 14, 2020

Review this patient case of an older man with HIV and suspected COPD, including relevant data and recommendations that inform optimal ART management.

Joseph J. Eron, Jr., MD Released: August 28, 2020

Review this patient case and the relevant data and guideline recommendations that inform optimal ART selection for patients with HIV and fatty liver disease

Paul E. Sax, MD Released: August 12, 2020

Review this patient case of an older man with HIV and PTSD-like symptoms related to the COVID-19 situation, including relevant data and recommendations that inform optimal management.

Joseph J. Eron, Jr., MD Released: July 28, 2020

Review this patient case and evaluate the relevant data and recommendations that inform optimal management of a migrant woman with multiple comorbidities living with difficult social circumstances. 

Chloe Orkin Photo Chloe Orkin, MBChB, FRCP, MD Released: July 23, 2020

Review this patient case and the relevant data and guideline recommendations that inform optimal management of patients with HIV and COVID-19.

Paul E. Sax, MD Released: July 1, 2020

ClinicalThought

The life expectancy of women with HIV is shorter than that of men. Here’s my take on contributing factors to this difference that clinicians should be aware of.

Julie A. Womack, PhD, CNM, FNP-BC Released: August 6, 2020

Estimates suggest that polypharmacy will cause 4.6 million hospitalizations over the next 10 years. How can you keep your patients safe?

Jennifer Cocohoba Headshot Jennifer Cocohoba, PharmD Released: October 12, 2020

As a woman thriving with HIV for 21 years, here’s my take on what providers caring for aging patients with HIV should know.

Melanie Reese Released: January 4, 2021

Expert faculty answer healthcare professionals’ questions on HIV testing and prevention in older individuals.

Howard Grossman, MD Cristina Mussini, MD Released: May 6, 2021

Podcasts

In Part 1of this 4-part series, listen to Joseph J. Eron, Jr., MD, Chloe Orkin, MBChB, FRCP, MD, and Paul E. Sax, MD, answer clinicians’ questions on caring for patients aging with HIV.

Joseph J. Eron, Jr., MD Chloe Orkin Photo Chloe Orkin, MBChB, FRCP, MD Paul E. Sax, MD Released: September 17, 2020

In Part 2 of this 4-part series, listen to Jonathan Appelbaum MD, FACP, AAHIVS; Howard Grossman, MD; and Jürgen K. Rockstroh, MD, answer clinicians’ questions on caring for patients aging with HIV.

Jonathan Appelbaum, MD, FACP, AAHIVS Howard Grossman, MD Jürgen K. Rockstroh, MD Released: November 19, 2020

In Part 3 of this 4-part series, listen to Monica Gandhi, MD, MPH; Rajesh T. Gandhi, MD; and Josep M. Llibre, MD, PhD, answer clinicians’ questions on caring for patients aging with HIV.

Monica Gandhi, MD, MPH Rajesh T. Gandhi, MD Josep M. Llibre, MD, PhD Released: February 10, 2021

In Part 4 of this 4-part series, listen to Howard Grossman, MD, and Cristina Mussini, MD, answer healthcare professionals’ questions on caring for patients aging with HIV.

Howard Grossman, MD Cristina Mussini, MD Released: May 3, 2021
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