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Roy M. Gulick, MD, MPH

Advances in the Treatment and Prevention of HIV Infection: CROI 2016, Focus on ART

Don’t miss this engaging review of the recent Conference on Retroviral and Opportunistic Infections (CROI 2016) spotlighting the latest research in HIV treatment and prevention strategies. Topics include prophylaxis, initiation of antiretroviral therapy in newly-diagnosed patients, switch-therapy to decrease toxicities, and choosing new therapeutic combinations for treatment-experienced patients with suboptimal responses. Also, new drugs in the development pipeline that may soon expand therapeutic options for our patients suffering from treatment failure are discussed, as well as research in longer-acting drugs for PrEP and other prevention modalities.

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Richard A. Koup, MD

HIV Vaccines: Moving from Trials and Errors to Rational Design

In the age of PrEP, do we really need an HIV vaccine anymore? Yes. In this presentation, Rick Koup, reminds us of the ongoing need for safe and effective HIV vaccines to stop this world-wide epidemic, the past failures in HIV vaccine trials that have been so disappointing, and the new era of more rational vaccine design that is presently emerging. If your patients ever ask about HIV vaccines, and we are sure they will, this program will help you respond positively.

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Oluwaseun O. Falade-Nwulia, MD, MPH

The Impact of Antiretroviral Drugs on HBV Infection

HIV and HBV testing, prevention, and treatment go hand-in-hand, because our patients at highest risk for one, are also at high risk for the other. And HIV exacerbates the dangers of HBV coinfection. Drugs used for HIV treatment and HIV PrEP will also treat chronic hepatitis B, but cannot guarantee against acute HBV infection. But we have long had a vaccine to protect against HBV infection that we can offer to all people at risk for, or infected with HIV. This important presentation reviews the epidemiology, laboratory testing, treatment and prevention of hepatitis B that may otherwise be overlooked or misunderstood.

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Joel Palefsky, MD, FRCP(C)

Prevention of Anal Cancer in HIV-positive Men and Women: Testing the Paradigm

The risk for HPV-related anal cancer is much higher in our HIV-coinfected patients, despite the many advances in HIV antiretroviral therapy. If given, the HPV vaccines will help prevent anal cancer in our younger patients, but our older patients need help too. Anal cytology and treatment of high-grade squamous intraepithelial lesions (HSIL) may help, and the ANCHOR study, which is now enrolling, is designed to test this hypothesis. Don’t miss this important presentation by Joel Palefsky on ways that you can help your patients prevent this grave complication.

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Oni Blackstock, MD, MHS

PrEP is for Women, Too!

The roll-out of pre-exposure prophylaxis to men who have sex with men is gaining momentum. But PrEP is for women at risk too, and barriers to care, including gender inequality, poverty, racism, gender-based violence, and transphobia must be overcome. Adherence and pharmacokinetics of the genital tract also play an important role in successful prophylaxis for women. This lecture targets the complexities and barriers to successful PrEP for women, as well as the exciting variety of research products in the PrEP pipeline that should provide women with more options for HIV prevention in the future.

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Dost Sarpel, MD

Advances in the Treatment of HCV and HCV/HIV Coinfection

The advances in the successful treatment of chronic HCV just keep coming, and the annual meeting of the AASLD – “the liver meeting” – spotlights these scientific and clinical advances best. In this program, Dost Sarpel reviews the current HCV treatment state-of-the-art, with important notes from the recent liver meeting in San Francisco.

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Sara Gianella Weibel, MD

The Sordid Affair between CMV and HIV

Remember cytomegalovirus? The AIDS-defining sight- and life-threatening complications of CMV coinfection from the pre-HAART era are rarely seen today. But CMV is still with us, sexually transmitted, chronic, incurable, and contributing to inflammation and non-AIDS morbidity in people aging with well-managed HIV.

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Christopher T. Coad, MD, and Donald P. Kotler, MD

AIDS-defining CMV Retinitis & Colitis

Older clinicians in our audience remember the horror of diagnosing and managing AIDS-defining CMV colitis and retinitis in the pre-HAART era, which have now become rare, thanks to the prevention of severe immune deficiency through early initiation of combination antiretroviral therapy for HIV. But severe complications of cytomegalovirus coinfection still happen in people with undiagnosed and/or untreated HIV/AIDS and we must forever be prepared to suspect, swiftly diagnose, and treat both HIV and the many manifestations of CMV in the setting of immune deficiency.

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Preeti Pathela, DrPH, MPH

Epidemiological Synergy: The High Risk of HIV Infection among Men with Sexually Transmitted Bacterial Infections

The New York City Department of Health and Mental Hygiene has data clearly demonstrating increased risk for HIV seroconversion during the months following the diagnosis of a bacterial STI, especially among men who have sex with men (MSM). So if you diagnose an HIV-negative patient with gonorrhea, Chlamydia or syphilis, do not let them out of sight until you have discussed HIV pre-exposure prophylaxis (PrEP). This is especially important in MSM with or at risk for anorectal STIs, and, if we are to end the HIV epidemic, the lag-time to initiation of HIV PrEP may be critical.

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Rajesh T. Gandhi, MD

Antiretroviral Treatment Guidelines: Where We Are Now and What's On the Horizon

It is encouraging that both national and international HIV treatment guidelines support early initiation of antiretroviral drugs, regardless of CD4 count, for the best long-term outcomes, and to decrease transmission. And the guidelines continue to evolve to support efficacy, tolerability and simplicity, while acknowledging scenarios where alternative regimens may be needed. Of course there are comorbidities, drug resistance, and immune failure to consider when choosing or changing regimens. And newer, safer drugs are still coming! Don’t miss this important review on the state-of-the-art and future of antiretroviral therapy for HIV.

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Sharon Mannheimer, MD

Update on Alternative Dosing Strategies for HIV Pre-Exposure Prophylaxis (PrEP)

Preventing HIV transmission to uninfected individuals through the use of pre-exposure prophylactic medication works well when at-risk individuals take it as prescribed, and we are all hoping that PrEP will help stop this epidemic. But PrEP only works as well as adherence allows, and daily dosing is problematic for some people. This presentation details the common barriers to PrEP adherence, limiting side effects of currently recommended PrEP, and important research toward easier or more forgiving regimens, including IPERGAY and ADAPT studies of intermittent PrEP.

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Missak Haigentz, Jr., MD

Addressing the Rise of Non-AIDS Defining Cancers: Implications for Cancer Screening & Treatment

Since the beginning of the HAART era, and as our patients age with HIV disease, we are seeing more non-AIDS defining cancers (NDACs). In fact, HIV infection is associated with an increased risk for some NDACs. But there are some things we can do right now to prevent some of these cancers, including smoking cessation, hepatitis B vaccination, age-appropriate HPV vaccination, and treatment of hepatitis C. Join us for this important presentation on current challenges in the prevention, screening and treatment of NDACs in HIV-positives, with a special focus on lung cancer, prevention, and research.

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Ponni V. Perumalswami, MD

HCV Diagnosis and Linkage to Care

Chronic hepatitis C is curable and the treatment is simpler and more effective than ever. But it is estimated that only half of the people with chronic HCV infection have been diagnosed and the other la are unaware that they have it and can transmit it to other people, and that without treatment it can lead to liver failure, liver transplant, or liver cancer. To change this disastrous situation before people reach end-stage, we have a mandate in New York State to assure primary care providers are asking, testing, and referring candidates for HCV treatment. But shouldn’t we be doing this anyway, even without a mandate? Screening is easy, and referral to care is getting easier too. Don’t miss this important lecture on ways that you can help, and new approaches to assure patient access to ongoing care and treatment.

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Bernard M. Branson, MD

Advances in Testing for HIV and HCV

The laboratory testing for HIV and HCV have never been easier or faster. But do you really know what tests your lab is doing? And how to interpret the test results? And what to order next? The newer diagnostic algorithms are straightforward but in the real world, a deeper understanding of what commercially available tests really show is vital to identifying negatives, staging positives, and advising appropriate care and prevention. This presentation will help you understand the advances in routine laboratory testing for HIV and HCV and how to interpret them to improve of both patient and public health.

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Christopher D. Pilcher, MD

Shooting the Rapids of the HIV Cascade: Outcomes of Initiating ART at Diagnosis

Isn’t it time to start treating HIV disease like the urgent medical and public health problem it is, rather than losing people step after step after step after step in a drawn-out cascade to treatment? In other words, why not start empiric treatment immediately on the same day as point-of-care diagnosis? In this presentation you will hear about the innovative work being done in San Francisco to hasten access to antiretroviral treatment in an effort to decrease loss-to-follow-up, speed treatment to undetectability and reduce transmission.

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Aracelis D. Fernandez, MD, FAAP

Youth and HIV: How Can We Bend the Curve & End the Epidemic

However bad the HIV epidemic may be in the US, it is worse in adolescents and young adults: 26% of new cases are among youth, ages 13-24. It is estimated that 14% of Americans don’t know they are infected, but among youth, it is estimated that 51% are unaware. And African-American youth are disproportionately affected. Don’t miss this important program on the diagnosis, treatment and prevention of HIV and other sexually transmitted diseases in young people who need our help to live longer, healthier and more productive lives.

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Peter W. Hunt, MD

HIV and Aging

From the horrors of AIDS we know so well from the not-so-distant past, aging while on treatment for HIV disease seems like a blessing. But are there surprises awaiting us in this journey? And are there ways that we can prevent complications and improve life expectancy in our patients as they continue to age? For a better understanding of the risks our patients face, and research that is underway to improve the aging process in HIV disease, don’t miss this important lecture by Peter Hunt.

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Anne K. Monroe, MD, MSPH

Diagnosing and Managing Diabetes in HIV-infected Patients

With an estimated prevalence of up to 14% in HIV-infected patients, diabetes is a leading cause of cardiovascular disease, blindness, end-stage renal disease, amputations, and hospitalizations for our patients. Regular screening for diabetes is important, and extra diagnostic caution must be taken in people living with HIV. When diagnosed, changes in lifestyle are critical, and medical management requires individualization. This clinically oriented lecture focuses on therapeutic options including recently approved drugs from new classes of drugs for glycemic control, as well as treatment strategies for optimal management of diabetes and prevention of diabetic morbidities in HIV medicine.

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Dan R. Drozd, MD

Update on Cardiovascular Disease Risk, Management and Prevention in HIV

HIV disease is likely associated with a 50% increased risk for cardiovascular disease, but independent HIV-related risk factors suggest that early and continuous antiretroviral therapy may reduce atherosclerotic cardiovascular disease risk in HIV, especially type 1 myocardial infarctions caused by atherosclerotic plaque rupture. In addition to the direct relation of HIV disease to atherosclerotic disease, questions about reported associations of certain antiretroviral drugs with myocardial infarctions, and the potential use of statins to decreased inflammation and promote plaque regression are discussed in this important program.

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Michael H. Augenbraun, MD, and Sujan Patel, MD

Syphilis Diagnostics, Still Clear as Mud; Syphilis Therapeutics, Not So Much.


Maximizing Syphilis Treatment: Is That History of Penicillin Allergy Real?

As PrEP against HIV gains momentum there is a possibility we will see other STDs consequent to an increase in condomless sex, including syphilis. But how can we best treat syphilis when there is a history of penicillin allergy? In this practical but important program two speakers will tackle the various aspects of syphilis diagnosis, staging, optimizing treatment in penicillin allergic patients, as well as the indications for skin testing for antibiotic hypersensitivity.

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Ian M. McGowan, MD, PhD, FRCP

Update On Vaginal And Rectal Microbicides for HIV Prevention

Although oral PrEP can be highly successful in preventing HIV infection, more options for chemoprophylaxis are needed to meet the diverse needs of varying populations. The development of vaginal and rectal microbicides has been a bumpy road, and so far none have been licensed, but progress is being made. In this program, Ian McGowan, a leading researcher in the field, discusses the science and the studies that will hopefully lead to a variety of licensed microbicides for the prevention of vaginal and rectal transmission.

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Susan J. Little, MD

HIV Sexual Networks, Transmission Dynamics, and Drug Resistance

The early diagnosis and treatment of HIV during the acute or primary stage of infection has lasting benefits for each individual that starts and adheres to antiretroviral therapy, but there are also public health advantages for the community. Tracing the phylogenetics of HIV transmission networks provides insight to contagiousness, length of infection and severity, and transmission of drug resistant variants of HIV. In this exciting lecture, Susan Little, who runs the primary HIV infection program at UCSD demonstrates how early diagnosis and treatment of HIV interrupts network transmission, which may be the most powerful key to ending the HIV epidemic that we currently have.

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A. E. Radix, MD, MPH, FACP

HIV Prevention and Care in Transgender People

Transgender women are at extraordinarily high risk for HIV infection for a number of reasons. We will never be able to end the HIV epidemic if we cannot better serve the needs of transgender individuals in ways that are both culturally sensitive and inclusive. In this thought-provoking lecture, Dr. Radix targets the many challenges our transgender patients face and how we can improve the management and prevention of HIV in this most vulnerable population.

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François Clavel, MD

What Is It with HIV-2?

Now that we are all routinely testing for HIV-2 as part of the new HIV testing algorithm, it will be helpful to know more about how HIV-2 differs from HIV-1 both in pathogenesis and treatment. And who could teach us better than the researcher who first discovered HIV-2, Fancois Clavel, in this fascinating and important lecture.

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Todd T. Brown, MD, PhD

Update on Hypogonadism in Aging HIV-infected Men

Is testosterone replacement for hypogonadism overprescribed in the United States? Is it safe? The diagnosis of hypogonadism is not uncommon in aging HIV-infected men. So understanding the optimal screening recommendations as well as the potential risks and benefits of testosterone therapy, particularly in older men, is extremely important to their well-being. Join us for this important update by Todd Brown.

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David J. Back, PhD

Drug-drug Interactions in HIV and HCV in an Aging Population

Awareness of drug-drug interactions between agents used to treat HIV, coinfections such as hepatitis C, and co-morbidities such cardiovascular, renal, respiratory and metabolic disease, has never been more important. And the risk of adverse interactions of polypharmacy will increase as our patients age and their problem lists get longer. This comprehensive view from David Back, known world-wide for his extensive work in drug interactions at the University of Liverpool, is a must for anybody caring for people living with HIV.

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Christina M. Wyatt, MD

Update on the Kidney in HIV Treatment and Prevention

Who, among your HIV-positive patients, may be at higher risk for kidney disease? And what about your HIV-negative patients who have started or are thinking about PrEP? This program will help you recognize the limitations of current screening tests for kidney disease in your patients with and at risk for HIV disease, and understand the diagnosis and management of antiretroviral-associated nephrotoxicity.

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Robert J. Kaner, MD

Effects of HIV on the Lung

Pulmonary complications of HIV are not what they used to be, but they are no less important. The rapidly progressive opportunistic lung infections that were seen so often in the pre-HAART era, are rare now that earlier treatment of HIV is standard. But non-AIDS-defining bacterial pneumonias, malignancy and pulmonary hypertension continue to be serious problems, and accelerated emphysema is a growing concern due to the high prevalence of smoking in HIV-positives. In this program Rob Kaner discusses all of these issues and will help you improve early diagnosis of emphysema and COPD, critical to improved management and quality of life, and when possible, referral to appropriate research studies.

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Stephen E. Goldstone, MD, FACS

Anything Butt: Common Anorectal Disorders in HIV Medicine

In this lecture Dr Golstone discusses common complaints, workup, diagnosis, treatment and prevention of common anorectal problems in HIV medicine. If your patients ever complain about rectal pain or bleeding, do not forget to do cultures, a digital anorectal exam and if needed, anoscopy, or you may miss something important, something infectious, and something you can treat effectively in your office. To learn more about the skills you will need, as well as practical tips for preventing anorectal problems, please see this important and useful video presentation.

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David M. Margolis, MD

Towards an HIV Cure: Real Progress And Real Problems

The advances in the management of chronic HIV disease have been extraordinary, but only one person—the Berlin patient—has ever achieved a “functional cure.” HIV cure research is a complicated yet exciting field, with recent setbacks, such as the failure of cure in the Mississippi baby. Purging latent reservoirs is necessary if the chronically infected are to ever be completely free of HIV infection. David Margolis, a leader in the field of cure research updates what is presently known as well as current research that may someday make eradication of HIV more easily achievable.

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Jürgen Rockstroh, MD, PhD

Management of HIV/HCV Coinfection in 2014: Cure for All?

In HIV-HCV coinfection, liver-related death remains the number one cause of death, led by decompensated cirrhosis, but also including liver cancer and post-transplant complications. But HCV is curable. The indications for HCV treatment in HCV/HIV co-infected patients are no different than in patients with HCV mono-infection, and the same treatment regimens can be used in HIV-coinfected patients as in patients without HIV infection, since the virological results have been shown to be identical. The role of primary care, especially providers with HIV treatment experience, is critical in identifying candidates for HCV treatment earlier, and securing treatment with newer directly acting agents that more effectively reverse the outcomes of this life-threatening coinfection.

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Joel M. Palefsky, MD, CM, FRCP(C)

Anal Cancer Prevention: Moving Forward, New Hope

Human papillomavirus is, by far, the most common sexually transmitted disease, but in HIV medicine there is a higher risk for HPV-related complications. Why? In addition to high risk of oral and anogenital HPV infection through shared sexual behavioral risk, HIV reduces the immune response to HPV, and direct interactions between HIV and epithelial cells potentiate new HPV infection. So, both primary and secondary prevention efforts, as well as early diagnosis and treatment are critical to the long-term health of our patients with and at-risk for HIV and HPV coinfection. Learn more about the epidemiology, preventive vaccines, physical exam, laboratory assessment, and treatment of HPV-associated complications in this video of Joel Palefsky’s presentation to PRN.

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Daniel Douek, MD, PhD

The Good, the Bad and the Ugly of Inflammation in HIV Infection

Inflammation plays an important role at every stage for HIV infection, from the acute stages of primary infection until death. But even though antiretroviral therapy has radically slowed progression of this disease to near-normal life expectancy, we see immune activation and inflammation in various manifestations, contributing to HIV disease progression, and increasing the risks of morbid non-AIDS events and mortality. Join us for this comprehensive and thought-provoking review of the many changing faces of inflammation in HIV disease.

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Thomas Cherneskie, MD, MPH

Bacterial STIs in NYC: Epidemiological Trends, Diagnostic Considerations and Management Issues in People With or At Risk for HIV Disease

If you have a patient with a sore throat or rectal complaints are you requesting a thorough sexual history and appropriate STD testing? The threat of sexually transmitted bacterial diseases—not just the usual suspects, but also drug-resistant gonorrhea, lymphogranuloma venereum and mycoplasma genitalium -- is increasing even as HIV prevention shows promise of improvement. At this strategic point in time, it is prudent to review the most current recommendations for bacterial STI diagnosis and treatment in the era of oral sex, HIV-serosorting, HIV pre-exposure prophylaxis and condomless sex.

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Demetre Daskalakis, MD, MPH

HIV Pre-Exposure Prophylaxis in the Real World

Get ready. If your HIV-negative patients have not already asked you about pre-exposure prophylaxis for the prevention of HIV infection, this presentation will help you answer their questions when they do. And if they already have started asking you for PrEP, this will help you fine-tune your responses, recommendations and management. The rate of new infections with HIV have remained constant over the last decade despite ongoing reminders for consistent condom use, and the use of antiretroviral drugs for PrEP is a new strategy that may greatly enhance ongoing efforts to reduce HIV transmission in vulnerable populations at highest risk for infection.

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Rajesh T. Gandhi, MD

Diagnosis and Treatment of Acute HIV: A Stitch in Time?

Over the years at PRN, we have revisited the pros and cons of early treatment of HIV, even during the acute stage of primary HIV infection. And now, with safer long-term treatment alternatives, the tide is turning toward early treatment as a potential means of preserving immune function, decreasing mutant strains in reservoirs, decreasing risk of further transmission, and improving the chance for a future cure. In this presentation, Raj Gandhi provides an overview of the signs and symptoms of acute HIV, how to diagnose it and initiate treatment, evidence-based research demonstrating the benefits of early treatment, and the potential for functional cure.

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Provider Resources


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PRN is pleased to offer this new CME opportunity designed for physicians, nurse practitioners and physician assistants caring for patients with or at risk for HIV disease and its many complications. Based on content from The PRN Notebook, credit for each course will be available for a limited period of time noted on each activity.

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Full PRN membership is now open to clinicians nationwide.

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