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The PRN Notebook
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2023 Immunization Resources

For the most up-to-date immunization resources please visit 2023 Immunization Resources
Next Live PRN Meeting via Zoom - Free CME/MOC for Clinicians:
Featured Articles & VideosVisit The PRN Notebook
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management
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Empowering Cisgender Women: Inclusion and Awareness of PrEPEmpowering Cisgender Women: Inclusion and Awareness of PrEP

While much effort is utilized to promote HIV pre-exposure prophylaxis (PrEP) in gay and bisexual MSM as well as trans women, we must not diminish the critical need for PrEP for at-risk cisgender women, especially those of childbearing age. To focus on the specific needs of cisgender women, we are pleased to present Dr. Shobha Swaminathan, Director of HIV Programs at Rutgers New Jersey Medical School. Dr. Swaminathan will speak on PrEP eligibility and benefits in cisgender women, navigating the prescription process and adherence strategies for these women, as well as new PrEP options favorable to cisgender women in the pipeline.
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EACS 2023: Highlights from the European AIDS Conference in WarsawEACS 2023: Highlights from the European AIDS Conference in Warsaw

Every two years the European AIDS Clinical Society (EACS) holds its biannual conference on HIV/AIDS, coinfections, and complications, similar in many respects to the annual Conference on Retroviruses and Opportunistic Infections (CROI) in the United States.This year the EACS conference, known as EACS 2023, will be held in Warsaw, Poland. We are fortunate to have Juergen Rockstroh, the current EACS guidelines chair, report to PRN on the highlights of this important international conference, including an update on the evolving epidemiology in Europe, the challenges around HIV care in migrant populations, new data on ART, as well as updates on HIV comorbidities and aging.
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coinfections
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2023 Update on Immunization Recommendations for Individuals With and At-risk for HIV Disease2023 Update on Immunization Recommendations for Individuals With and At-risk for HIV Disease

Preventive measures, including prophylaxis, have always been a critical part of HIV medicine. Vaccines play a special role as a scalable modality to reduce epidemic diseases worldwide. In our current times we must rebut misinformation about vaccine safety and efficacy to keep our patients fully updated with the immunizations they need to maintain optimal health. When our patients return for routine HIV or PrEP follow-up, we all have an ideal opportunity to evaluate and encourage recommended vaccines. Please join us for this update by Dr. Denise Benkel from the NYC DOH Bureau of Immunization about what we can do now. There is no time to lose!
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coinfections
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Update on Hepatitis B and D in People With or At-Risk for HIV CoinfectionUpdate on Hepatitis B and D in People With or At-Risk for HIV Coinfection

The risks for hepatitis B and D lurk in the background for anyone with or at-risk for HIV. It is particularly important to keep this in mind when patients initiate or change medications for HIV and PrEP. Of course, we have had safe and effective vaccinations to prevent hepatitis B for many years, but for patients who have a history of hepatitis B, and are therefore at risk for hepatitis D, additional monitoring is necessary, and extra caution is advised when changing HIV treatment or prevention strategies, to guard against hepatic flare or rebound.  In this important program, Dr. Debika Bhattacharya. the Chair of the Hepatitis Transformative Science Group (TSG) within the AIDS Clinical Trials Group (ACTG), will address these issues and provide updates in the management of hepatitis B and D.
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progression
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Towards an HIV Cure: Understanding HIV Persistence and Therapeutic ApproachesTowards an HIV Cure: Understanding HIV Persistence and Therapeutic Approaches

HIV cure has been limited to only a few cases over the past couple decades, starting with the Berlin Patient, but what is needed is a safer and scalable cure aimed at far broader populations of people living with HIV. This year, the International AIDS Society focused on HIV cure research from around the world at IAS 2023. We are fortunate to have Dr. Sharon Lewin, the current President of the IAS, who presided over IAS 2023, speak on this critical area of research so that one day we may hopefully be able to transform HIV from a manageable to a curable disease.
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Treatment Challenges of Multi-Drug Resistant HIV-1 Infection Treatment Challenges of Multi-Drug Resistant HIV-1 Infection

On a recent survey, approximately one-third of our audience responded that they have patients with multi-drug resistant (MDR) HIV-1, which was higher than we anticipated. Although we hope the absolute number of patients failing therapy is small, this statistic underscores the reality that a significant number of us need to continue searching for new treatment options/classes/strategies that can serve the needs of our most vulnerable patients. PRN continues to spotlight emerging treatment research, and we are pleased to continue this effort with Dr. Ali Rai, from the National Institute of Allergy and Infectious Diseases (NIAID), who will help us understand the dimensions of the current challenge, utilize the most up-to-date methods for determining HIV resistance, and ways that you can help your patients access research studies for novel treatment modalities.
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Clinical Research Highlights from IAS 2023 Clinical Research Highlights from IAS 2023

Every other year the International AIDS Society holds its scientific meeting, and this year the meeting is in Brisbane, Australia. We are extremely fortunate to have Dr. James McMahon, Lead of the Clinical Science Committee (Track B) at IAS 2023, present the highlights of this important conference to our PRN audience. Dr. McMahon is also the current Vice President and President-Elect for Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. If you’re not planning to travel to Brisbane, PRN is delighted to bring Dr. McMahon’s perspective to you!
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transmission
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What is Chemsex? Epidemiology, Harms & ImpactsWhat is Chemsex? Epidemiology, Harms & Impacts

Chemsex is something we don’t often talk about, but it plays a critical role in the spread of HIV and other STIs. Dr. Gary Whitlock is Service Director at 56 Dean Street, a sexual health clinic in the heart of London’s Soho, specialising in reducing infections and promoting sexual wellbeing amongst the LGBTQI+ community, and an international leader in dealing with this important challenge to clinical care and harm reduction. We hope that this presentation will be of help to you in coping with some of the most difficult barriers that our patients face.
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Update on HIV-1 bNAbs for the Prevention, Therapy, and Cure of HIVUpdate on HIV-1 bNAbs for the Prevention, Therapy, and Cure of HIV

Anti-HIV broadly neutralizing antibodies (bNAbs), alone or in combination, are some of the most exciting agents in the pipeline for the prevention, management, salvage, and potential cure of HIV. Dr. Marina Caskey, one of the most prominent researchers leading the way in this new field of immunotherapy, returns with an update on bNAbs in clinical development, and results from HIV-prevention trials utilizing bNAbs.
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coinfections
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Kaposi Sarcoma and KSHV Transmission in MSM and Other High Risk GroupsKaposi Sarcoma and KSHV Transmission in MSM and Other High Risk Groups

Although we see Kaposi Sarcoma less frequently these days, it is far from gone, as we know from seroprevalence data for the causative virus, KSHV. We have had numerous talks at PRN over the past 30 years on the discovery of KSHV and the evolving therapies for the manifestations of KS. Now it is time to focus again on the silent sexual transmission of this infection and a reminder of the various manifestations of this disease in people living with HIV. In this presentation, Sheena Knights will share her recent research in the ongoing spread of KSHV in at-risk populations and health disparities that may still contribute to mortality among MSM with HIV.
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coinfections
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Update on Mpox and Preventing Future OutbreaksUpdate on Mpox and Preventing Future Outbreaks

The explosion of mpox that caught everybody by surprise and most severely affected our immunodeficient patients has receded, but is not gone. It is important now that mpox be included in our pantheon of sexually transmitted infections and include necessary preventive immunization for our patients at risk moving forward.
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coinfections
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Sexual Transmission of HCV Among MSMSexual Transmission of HCV Among MSM

For men who have sex with men and for transgender women who have sex with men, acute or primary hepatitis C has been shown to be a sexually transmitted infection. Similarly, HCV reinfection has been shown to be sexually transmitted as well. It is of critical importance that we keep this in mind for our patients on PrEP to prevent HIV infection, as well as our patients living with HIV. In this presentation, Daniel S. Fierer explains the risks, the incidence, early diagnosis, and treatment strategies for both HCV primary infection and reinfection.
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Body Fat Changes with Aging in People with HIV: Implications for Healthspan and LifespanBody Fat Changes with Aging in People with HIV: Implications for Healthspan and Lifespan

Aging with HIV disease is often accompanied by bothersome body fat changes that affect our patients’ self-images. But fat depots also have variable effects on health outcomes that we need to understand in order to best serve our aging patient population.
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Update on Inflammation, Aging, and CMV Co-Infection in Treated HIVUpdate on Inflammation, Aging, and CMV Co-Infection in Treated HIV

Immune activation and chronic inflammation persist throughout the course of HIV disease and contribute to the multimorbidities that complicate the management of our patients as they age. CMV coinfection seems to be a particularly troublesome cofactor for many PLWH. Peter Hunt returns with an update on the most recent research pertinent to understanding these complexities as they relate to aging.
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complications
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Getting to the Heart of the Matter: Updates on Cardiovascular Disease in HIVGetting to the Heart of the Matter: Updates on Cardiovascular Disease in HIV

Cardiovascular disease is an ongoing problem in HIV management. We are pleased that Mabel Toribio is able to provide an update for cisgender and transgender men and women with or at risk for CVD.
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Updates From CROI 2023Updates From CROI 2023

Trip Gulick returns to PRN to spotlight key research from the Conference on Retrovirology and Opportunistic Infections (CROI).  Dr Gulick will target the latest advances in HIV treatment, and prevention, as well as other pandemic diseases reported at the recent CROI 2023.  CME and MOC are available.
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complications
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Non-AIDS-Defining Cancers in People Living with HIVNon-AIDS-Defining Cancers in People Living with HIV

Thanks to the benefits of antiretroviral therapy, we rarely see AIDS-defining cancers in people living with HIV. Yet as our patients age, they are at higher risk for other cancers and Dr. Keith Sigel will bring us up to date on screening, diagnosis, and treatment of non-AIDS-defining cancers in PLWH.
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Black Lives (with HIV) Matter: Dismantling Systemic Racism to End the HIV Epidemic Among Black MSMBlack Lives (with HIV) Matter: Dismantling Systemic Racism to End the HIV Epidemic Among Black MSM

It is vital for HIV clinicians to focus on the ongoing inequities in health care that our Black and brown patients continue to face today. Dr. Ofole Mgbako will help us recognize the ongoing nuances of systemic racism in HIV care, appreciate its historical roots, and consider potential strategies to dismantle systemic racism along the HIV care continuum.
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How to Manage a Pandemic: Science, Public Health and CultureHow to Manage a Pandemic: Science, Public Health and Culture

The international spread of infectious diseases challenges our daily medical practices, our hospital capabilities, patient perception of public health priorities and the moving target of scientifically driven responses. Starting with HIV, we had to overcome stigma to fight for a unified and worldwide response which is ongoing. That infrastructure has contributed significantly to our subsequent responses to viral hepatitis, and most recently COVID-19 and monkeypox.
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Highlights from HIV Glasgow 2022: What Was New and Exciting?Highlights from HIV Glasgow 2022: What Was New and Exciting?

HIV Glasgow is an important biennial international meeting on HIV drug therapy and related issues including coinfections, other epidemic diseases and the effects of war in Europe. Don’t miss this timely update by Jürgen Rockstroh which will also include the most recent changes in HIV treatment guidelines in the UK and Europe.
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coinfections
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Prevention Strategies for Immune Compromised IndividualsPrevention Strategies for Immune Compromised Individuals

While precautions against disease transmission have been reduced in public gathering spaces, current recommendations for the general population do not really address the extra precautions and strategies necessary to protect our most vulnerable immune-compromised patients, including those with immune failure from HIV/AIDS and immune suppression from transplants or cancer chemotherapy. Understanding the unique needs of such patients as well as vaccine limitations and safety precautions are critically important to the well-being, quality of life, and survival of the immune-compromised. Don’t miss this important presentation by Angélica Cifuentes Kottkamp that dives into the details.
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coinfections
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Updates from IDWeek 2022 on HIV, Monkeypox and COVID-19Updates from IDWeek 2022 on HIV, Monkeypox and COVID-19

IDSA’s annual conference, IDWeek, is always a rich source of research information that pertains to our patient populations. This year, Raj Gandhi will focus on highlights from IDWeek on HIV, MPXV, and COVID-19. Don’t miss this important and timely update!
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coinfections
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STImulating Sexual Health Updates: Diagnosis & Management of Sexually Transmitted InfectionsSTImulating Sexual Health Updates: Diagnosis & Management of Sexually Transmitted Infections

Our knowledge of, and clinical skills in diagnosis of, sexually transmitted infections are constantly evolving. It is critical that we are up to date on all of the STIs because patients often with more than one at a time. Culturally sensitive sexual histories and physical exams are critical for early diagnosis and treatment for interrupting chains of transmission in the communities that we serve. Don’t miss this STImulating update by Rosalyn Plotzker.
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Diverse Case Presentations of Monkeypox in NYCDiverse Case Presentations of Monkeypox in NYC

Monkeypox crashed into our communities earlier this year spreading like wildfire, especially in sexually active MSM. There were many diverse clinical presentations, so we have brought together a panel of NYC primary care providers to share their experiences in diagnosing this new sexually transmitted infection.

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Predicting Success and Failure on Long-acting Cabotegravir/RilpivirinePredicting Success and Failure on Long-acting Cabotegravir/Rilpivirine

Is long-acting cabotegravir/rilpivirine 100% effective? Not quite. Though relatively rare, there are measurable factors that, when present, are independent predictors of virologic failure in people on treatment with injectable, CAB/RPV LA for HIV disease. Dr. Kuritzkes, a long-time thought leader in HIV treatment success and failure, dives into the details.
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coinfections
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2022 Update on Immunization Recommendations for Individuals With and At-risk for HIV Disease2022 Update on Immunization Recommendations for Individuals With and At-risk for HIV Disease

Immunizations are our best bet for combatting preventable disease in all people, young and old. And in our patients with and at-risk for HIV infection, immunizations have never been more important than in the topsy-turvy world of infectious diseases we are living through! Dr. Jane Zucker returns with critical updates to current vaccine recommendations in adults and adolescents and Dr. Tristan McPherson will add updates on current monkeypox (MPX) prevention strategies.
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Highlights from the 24th International AIDS Conference: Montreal 2022Highlights from the 24th International AIDS Conference: Montreal 2022

This program presented by David Hardy is a review of highlights from AIDS 2022: the live 24th International AIDS Conference in Montreal, Canada, including clinically relevant advances in antiretroviral therapy and PrEP, emerging adverse effects, as well as new agents for HIV treatment and prevention.
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coinfections
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Monkeypox Epidemic Outside of Endemic Regions: Experience from the UK & EuropeMonkeypox Epidemic Outside of Endemic Regions: Experience from the UK & Europe

The last thing we need is another pandemic, but it looks like that is what is happening with Monkeypox (MPX), especially in men who have sex with men (MSM). This epidemic outside of endemic regions of Africa was first noted in England and other parts of Europe. Now that this infection is exploding in the United States, we have invited Sanjay Bhagani from the Royal Free in London to speak on his experiences dealing with MPX from the very beginning.

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Impact of COVID-19 on HIV and HCV Screening and Lessons Learned for 2022Impact of COVID-19 on HIV and HCV Screening and Lessons Learned for 2022

We all know how COVID-19 has upended health care since 2020 but how much has it affected HIV and HCV screening, diagnosis, and treatment? How can we get back on track in 2022? Don’t miss this thought-provoking presentation by Martin Hoenigl.
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progression
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PET Imaging Provides Novel Insights Into HIV/SIV and SARS-CoV-2 Disease ProgressionPET Imaging Provides Novel Insights Into HIV/SIV and SARS-CoV-2 Disease Progression

We have seen the dazzling and thought-provoking images from Tom Hope in the past and in this new presentation we will see further advances from macro- to micro-imaging that reveal progression of SIV and SARS-CoV-2 infection in non-human primate models. His recent research focuses on HIV-related mucosal immunology, HIV transmission and prevention science, as well as infection-related disease progression for COVID-19 and long COVID.
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Weight Gain and Obesity in People with HIVWeight Gain and Obesity in People with HIV

What is the current impact of antiretroviral therapy on weight gain?  And how do weight gain and adipose distribution effect clinical outcomes in people living with HIV?  Todd Brown provide a comprehensive review of the current evidence, as well as optimal approaches to weight gain prevention and treatment in PLWH.
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HIV Remission in a Woman of Mixed Race with AML and HIV: The New York PatientHIV Remission in a Woman of Mixed Race with AML and HIV: The New York Patient

First there was the Berlin patient, then the London patient, and now, we have the New York patient who is a mixed-race cisgender woman cured of HIV.  There are other important differences between this new cure including the use of cord blood in her stem cell transplant.  Don’t miss this important description of her case, as presented by Drs. Marshall Glesby and Deborah Persaud.
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coinfections
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Long COVID in People With and Without HIVLong COVID in People With and Without HIV

What are the post-acute sequelae of SARS-CoV-2 that define long COVID? Is it different in people living with HIV? This presentation by Keri Althoff will help you understand the phenotypes and possible mechanisms of long COVID. Dr. Althoff will also focus on the manifestations of long COVID in people living with HIV.

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complications
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Prostate Cancer in Cisgender Gay and Bisexual Men and Trans WomenProstate Cancer in Cisgender Gay and Bisexual Men and Trans Women

Is the experience of diagnosis and treatment of prostate cancer different in gay and bisexual men than it is in straight men?  Dr. Channa Amarasekera, the director of the first Gay and Bisexual Men’s Urology Program in the country, thinks so. In this important presentation, you will learn about his efforts to improve the urologic care experience, outcomes and quality of life for cisgender men who identify as gay or bisexual.  You will also appreciate how HIV infection influences prostate cancer screening and treatment.
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Preventing Anal Cancer: Results from the ANCHOR StudyPreventing Anal Cancer: Results from the ANCHOR Study

We have known for a long time that the incidence of anal cancer associated with HPV infection is higher amongst people living with HIV. But now, with the results of the ANCHOR study, we know that identification of anal high-grade squamous intraepithelial lesions (HSIL) through high resolution anoscopy (HRA) followed by destruction of these pre-cancerous lesions has been proven to prevent progression to anal cancer. In this presentation, Joel Palefsky returns to PRN to share the exciting results of the ANCHOR study and its implications for a new standard of care in people living with HIV.
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CROI 2022: Updates on HIV Treatment & Prevention and SARS-COV-2CROI 2022: Updates on HIV Treatment & Prevention and SARS-COV-2

Every year the Conference on Retrovirology and Opportunistic Infections (CROI) is packed with important new information in HIV medicine and again this year includes COVID-19 as well. Don’t miss this engaging review by Trip Gulick on CROI 2022 highlights in HIV cure, new drugs, treatment strategies and prevention, as well as the latest on SARS CoV-2 and COVID-19.
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Rapid Initiation of HIV Antiretroviral Treatment (RIA)Rapid Initiation of HIV Antiretroviral Treatment (RIA)

Early diagnosis of HIV disease and linkage to medical care have finally come of age.  But how can we speed the accurate diagnosis and initiation of a safe antiretroviral regimen and stop the chain of further transmission? What barriers have we overcome, and which barrier remain?  Don’t miss this important talk by Tony Urbina on the current state-of-the-art in rapid initiation of antiretroviral treatment (RIA) for HIV infection.
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Healthy Aging with HIV in the Context of COVID-19Healthy Aging with HIV in the Context of COVID-19

When you really think about it, healthy aging is the ultimate goal of HIV management.  In the context of polypharmacy so often seen in older people, and in the midst of the the COVID-19 pandemic, Giovanni Guaraldi will help you understand the principles of HIV geriatric medicine, assess biological age with frailty, appreciate different models of HIV care in older adults, and maintain optimal antiretroviral therapy while deprescribing polypharmacy.
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Organ Transplantation for People Living with HIV/AIDS: Advances and ChallengesOrgan Transplantation for People Living with HIV/AIDS: Advances and Challenges

We all know that some of our patients living with HIV may one day need a heart, liver or kidney transplant—but do all of our HIV positive patients know that they can be organ donors? In her comprehensive and up-to-date presentation, Sapna Mehta reviews the current studies evaluating outcomes of HIV positive organ use for HIV positive recipients.  It’s time to spread the word.
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coinfections
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HIV/HCV CoinfectionHIV/HCV Coinfection

How does HIV coinfection affect the epidemiology, progression and treatment of hepatitis C (HCV)?  In this presentation, Brianna Norton will bring you up-to-date on the natural progression of liver disease in HIV/HCV coinfected individuals and discuss the differences in HCV epidemiology among HIV/HCV coinfected versus HCV monoinfected individuals. Dr. Norton will also discuss drug-drug interactions between HIV antiretrovirals and HCV directly-acting-antivirals.
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Inflammation, Morbidity and Mortality in Treated HIV: Roles of Asymptomatic CMV and Sex DifferencesInflammation, Morbidity and Mortality in Treated HIV: Roles of Asymptomatic CMV and Sex Differences

Chronic inflammation caused by herpesviruses (especially CMV) and by sex differences, leads to end-organ morbidities in HIV disease despite optimal treatment of HIV. In this presentation, Peter Hunt explores the causes and consequences of persistent immune activation in treated HIV infection, including its impact on age-related morbidity and mortality as well as HIV persistence.
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R4P 2021: Updates on the HIV Pre-Exposure Prophylaxis PipelineR4P 2021: Updates on the HIV Pre-Exposure Prophylaxis Pipeline

Every two years, HIV Research for Prevention (R4P) meets internationally and focuses solely on prevention modalities, technologies, and strategies.  In this thought-provoking presentation, Craig Hendrix reviews the highlights of HIV R4P, including long-acting PrEP, on-demand PrEP, and multipurpose prevention technologies
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Controversies in Testosterone Treatment 2020 in Cisgender and Transgender MenControversies in Testosterone Treatment 2020 in Cisgender and Transgender Men

Testosterone is prescribed frequently for hypogonadism in cisgender men living with HIV, aging cisgender men, and for gender-affirming therapy in transgender men.  But do we fully understand the benefits?  And what do we really know about the risks?  This presentation by Todd Brown will bring you up to date on the outcomes from pertinent studies including the Testosterone Trials (TTrials) in older cisgender men and what is presently known about the potential risks in transgender men.
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Atherosclerotic Cardiovascular Disease in HIV: Special Focus on Transgender and Cisgender WomenAtherosclerotic Cardiovascular Disease in HIV: Special Focus on Transgender and Cisgender Women

We all know that our patients living with HIV are at higher risk for atherosclerotic cardiovascular disease. But data on women has been lacking. In this presentation by Mabel Toribio, you will learn to describe mechanisms of heightened atherosclerotic cardiovascular disease among people living with HIV, along with prevention and treatment strategies. Dr. Toribio will be presenting her most current research, which includes under-represented populations – in particular, transgender and cisgender women.
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The Berlin Patient: Eradication of HIV with CCR5 Deficient Hematopoietic Stem CellsThe Berlin Patient: Eradication of HIV with CCR5 Deficient Hematopoietic Stem Cells

This lecture was originally posted in 2012 but due to its ongoing relevance we are highlighting it again on our home page. CME credit is no longer available for this archived presentation. Almost everybody has heard of the "Berlin Patient," but how many of us have had an opportunity to meet and listen to his doctor from Berlin? In this video you will hear Gero Hütter tell about his rationale for performing a bone marrow transplant with CCR5 deficient hematopoietic stem cells, the long term outcomes for his patient, further research to understand if he has been "cured," and attempts to repeat this unique success.

The PRN Notebook

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TRANSMISSION

Transmission, Diagnosis and the HIV Epidemic

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PROGRESSION

Pathogenesis and Progression of HIV Disease.

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MANAGEMENT

Treatment, Resistance and Management of HIV/AIDS

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COMPLICATIONS

Complications and Comorbidities

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COINFECTIONS

Coinfections and Opportunistic Infections

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