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Roy M. Gulick, MD, MPH
In this program Trip Gulick discusses important events leading up to the International AIDS Society conference - AIDS 2018 - including the 2018 UNAIDS data report on the global AIDS response, the FDA approval of the first PI-based single-tablet regimen for HIV, and the publication in JAMA of the IAS-USA 2018 recommendations for antiretroviral treatment and prevention of HIV infection. With this background, Dr. Gulick proceeds to discuss highlights of the AIDS 2018 meeting in Amsterdam, including new research on HIV treatment initiation, HIV and TB coinfection, and HIV switch studies. Due to the length of this program, we have split this into two parts. Be sure to watch both!
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Roy M. Gulick, MD, MPH
In this continuation of highlights from AIDS 2018 in Amsterdam, Dr. Gulick finishes his review of HIV switch studies, and goes on to discuss drug toxicities, ARVs in pregnancy and pediatrics, drug resistance, PrEP, including important information for PrEP in trans women, and further efforts to discover a cure for HIV infection. Don’t miss either of the two parts of this important and exciting program!
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Karen Palmore Beckerman, MD
Efforts to prevent mother-to-child transmission of HIV are the oldest and most successful examples of HIV prophylaxis, and a model for post-exposure prophylaxis and the expanded efforts we now have, such as Treatment as Prevention. But even though it is rare, we still see mother-to-child transmission of HIV, especially when mothers become acutely infected during pregnancy or while nursing. It is important to understand the deficiencies and oversights in routine standards of care, if we hope to finally reduce perinatal HIV infection to zero.
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Elaine J. Abrams, MD
Growing up is always difficult. Remember? But growing up with perinatal HIV infection, adds new dimensions to the physical and psychosocial challenges that children face as they struggle simply to survive, and hopefully thrive. This important presentation by Elaine Abrams will help you identify interventions that may help you improve the outcomes of young people growing up with HIV and care for them with a deeper understanding when they transition to adult medical care.
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Douglas S. Kwon, MD, PhD
We hear more and more about the microbiome these days, but what impact does the microbiome have in people with or at risk for HIV infection? We know the gut lymphoid system is rapidly and permanently impaired by HIV, and chronic use of antiretroviral drugs for HIV and antibiotic prophylaxis against opportunistic infections can affect the gut, but need we be concerned about the microbiome? This fascinating program will help you understand what is presently known about the interplay of the bacterial microbiome and mucosal immunity, the resulting effects on HIV susceptibility and HIV-associated chronic inflammation, and the latest efforts to leverage the microbiome to prevent HIV transmission and improve health for those living with HIV.
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Benjamin J. Eckhardt, MD
Injection drug use is a growing problem across the country, and a well-known risk for transmission of hepatitis C. But can HCV in our patients who continue to inject drugs be successfully be treated? Does HIV/HCV coinfection decrease the odds for success? Can they be re-infected with HCV once cured? Will treatment of HCV in in these patients help stop the HCV epidemic? Unlike HIV, HCV is now curable, but we will never end the HCV epidemic if we cannot adequately serve our most vulnerable populations. This important program grapples with the barriers, both real and imagined, that stand in our way.
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Francine Cournos, MD
As a medical provider, you can have a powerful impact on the behavioral health of your patients living with HIV, but you need to know how to sort out what is required and what is optional, and utilize practical behavioral strategies to evaluate and manage depression, anxiety and stress. This presentation by Dr. Francine Cournos is packed with clinical pearls that will help you serve your patients mental health needs more effectively, while preserving your own sanity.
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Robert H. Remien, PhD
If we do not address mental health issues at the primary care level, we are very unlikely to be able to bring an end to the HIV epidemic. Mental health problems contribute not only to HIV acquisition, but also to poorer outcomes at every step in the HIV treatment cascade. Since people living with HIV disease have significantly higher rates of mental health disorders than that of the general population, in this program, Dr. Robert Remien focuses on strategies we can use to integrate mental health assessment and treatment into routine HIV care. Only then will we be able to achieve our “90-90-90” and “EtE” goals.
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Jane R. Zucker, MD, MSc
This past year was another bad year for influenza, and a good reminder that vaccines can play an important role in the prevention of many infections, and even cancer, in our patients living with, and at risk for HIV disease, including the meningococcal vaccine, and vaccines for HAV, HBV, and HPV, just to name a few. But when should we offer them? How many can we give at one time. If and when are certain vaccines contraindicated? And how can we help our patients keep track of their vaccines in an online registry? Dr. Jane Zucker answers all of these questions, and more, in this important and stimulating presentation.
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Roy M. Gulick, MD, MPH
Every year, the Conference on Retrovirology and Opportunistic Infections (CROI) sets the bar for scientific research and evidence-based clinical advances in the fields of HIV treatment, prevention, and drug development. As anticipated, 2018 was no exception, and in this exciting presentation, Dr. Roy (Trip) Gulick targets “news that you can use” -- highlights from CROI 2018 most likely to affect treatment and prevention strategies, drug choices, and what’s coming soon in the development pipeline. If you are involved in the day-to-day care of people who are living with, or at risk for HIV infection, don’t miss this engaging update.
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Netanya Sandler Utay, MD
How do we explain where HIV comes from? Or how long it takes from exposure for infection to begin, and how do we detect it? What is the virus doing during the brief acute stages, and during lifelong chronic HIV infection? In this program Netanya Utay answers these questions related to HIV pathogenesis, its impact on the immune system during acute infection and the consequences of chronic immune activation, despite life-saving antiretroviral therapy.
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Demetre C. Daskalakis, MD, MPH
“Queer Health Warrior,” Demetre Daskalakis, who also happens to be our Deputy Commissioner at the New York City Department of Health and Mental Hygiene, is serious about ending the HIV epidemic in New York. And so are we. So how are we doing? And how can we all work together to accomplish this goal by the end of 2020? Don’t miss this engaging update on the strategies and efforts currently underway to prevent HIV transmission and infection, and ways that you can help. After all, HIV is an emergency, so let’s treat it that way!
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Jordan J. Feld, MD, MPH, FRCP(C)
While we are still struggling to find a cure for HIV, we are already over the finish line with HCV. The combination treatments that we currently have for HCV are so effective and well-tolerated, in fact, that further drug development has been discontinued! In this program, Jordan Feld fills you in on the success of available HCV treatment options and urges you to join the effort to diagnose and treat HCV in your practice. HCV can be cured, and now it is time for us to see that our patients who need treatment get it!
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Daniel C. Douek, MD, MRCP, PhD
When your patients ask you what progress is being made in efforts to cure HIV disease, what can you say? Currently, there are many different approaches to eliminating HIV from people living with it, but which ones show promise for a scalable cure in the real world? And is it time to give up on a magic bullet, and instead look to combinations of cure modalities? For up to date answers to all these questions, don’t miss this important program by Danny Douek.
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Carmen D. Zorrilla, MD
We all know that natural disasters disrupt healthcare services, and when they cause catastrophic levels of destruction to infrastructure, as in the case of hurricane Maria in Puerto Rico, the consequences can be overwhelming. But some services, like labor and delivery, simply cannot be interrupted or postponed. This presentation by Carmen Zorrilla underscores the urgency of keeping her high-risk obstetrical unit operational throughout this devastating event, and the consequent struggle to restore broader healthcare services in San Juan and throughout Puerto Rico in the aftermath of a hurricane.
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Joanna L. Starrels, MD, MS
There are many treatment options for chronic pain. But dealing with this common problem in clinical practice can be stressful due to patient expectations and the complex issues surrounding prescription opioid use and opioid use disorder. Hardly a day goes by that we don’t read something new in the papers about drug overdose and the opioid epidemic that is sweeping the country. So don’t miss this practical and helpful program on strategies for successful pain management, how to use tools such as urine testing to identify and treat opioid use disorder, and how to counsel patients on the risks of illicit drugs and the use of naloxone to prevent death from opioid overdose.
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Bernard M. Branson, MD
Just how fast and accurate are the rapid tests you are using at the point-of-care? And what about the laboratory tests you are ordering to confirm infection or sort out false positives from false negatives? The early diagnosis of HIV infection is critical to ending the epidemic, and our patients who seroconvert while on PrEP present a special challenge. Understanding the advantages as well as the limitations of current HIV diagnostic tests informs not only our interpretation of the tests results we receive, but the way we explain these results to our patients. We also have a commitment to diagnosing HCV in our patients with, or at risk for HIV. This presentation by Bernard Branson reviews and compares the current diagnostic tools available, as well as newer assays in the development pipeline.
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Daniel R. Kuritzkes, MD
Resistance to antiretroviral therapy and virologic failure have been a challenge to optimal treatment of HIV throughout this epidemic. With the more potent and adherence-friendly regimens we have today, the treatment failures we used to see so often, are less frequent now, but no less important when they occur. We still need to be alert to the current risks for drug resistance, not just for our patients on chronic therapy for HIV, but also for our patients who seroconvert while failing PrEP. And that is why are pleased to present this important update on HIV drug resistance by one of the foremost experts in the field—Dan Kuritzkes.
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Wafaa El-Sadr, MD, MPH
The extraordinary benefits of antiretroviral therapy -- especially survival, quality of life, and decrease risk for transmission – are just as true globally, as they are here in the USA. This is most important in resource-poor areas of the world hardest hit by the epidemic, where there are many challenges to healthcare delivery that require innovative solutions to maintain and expand HIV diagnosis and treatment. But even with the enormous success of global efforts over the last 15 years, “what got us here” as Wafaa El-Sadr points out, is still not enough to end the global epidemic as we move forward. So what else is needed? Differentiated Service Delivery (DSD) may help, but what is that, you may be asking? Don’t miss this opportunity to learn about this new model for global health initiatives that can increase the precision of public health efforts to end the HIV epidemic worldwide.
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Susan Blank, MD, MPH
In New York City, the number new HIV infections is dropping, thanks to PrEP (pre-exposure prophylaxis) and U=U (undetectable equals untransmittable). But with a simultaneous decrease in condom use, sexually transmitted bacterial infections are rising—especially the big three: syphilis, gonorrhea and Chlamydia. This important presentation, by Dr Susan Blank from the NYC DOHMH, will bring you up to date on the epidemiology and impact of these bacterial STIs in our communities, especially in MSM who are most highly affected, and women of child-bearing age who are most vulnerable to catastrophic outcomes. Dr Blank also targets best practices for treatment of these bacterial STIs, while reducing the risks for treatment failure and development of drug resistance.
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Roy M. Gulick, MD, MPH
We may not have a cure for HIV, but the treatment options keep expanding and improving, and prevention strategies are working better than ever. This program targets the most recent advances in HIV treatment and prevention from the International AIDS Conference in Paris, including updates on what to start, how to switch, second and third line treatment options, and new NUCs, non-NUCs and integrase inhibitors in the drug development pipeline, as well as drugs with new mechanisms-of-action, such as an orally-dosed attachment inhibitor, an entry inhibitor and maturation inhibitor. So if you want to stay up to date and know what is in the horizon, do not miss this important program.
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Stephen E. Goldstone, MD, FACS
Our patients living with HIV are at higher risk for HPV-related anal cancer, but when and how should we be screening them? At what age do we start? Is anal cytology enough, or are there other tests that could improve screening? Are inspection of perianal skin and digital rectal exams really necessary? What do we do with abnormal screening results? Does ablation of precancerous lesions really help, or do they just keep coming back in the same places? For answers to these and many other questions, don’t miss this important program.
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Todd T. Brown, MD, PhD
The prevention and treatment of endocrine and metabolic diseases, such as diabetes, dyslipidemia, osteoporosis, and hypogonadism, will improve the health and quality of life of our patients living with HIV disease, and also attenuate aging-related declines in physical and cognitive function. Laboratory screening for metabolic problems and early treatment with medication and lifestyle modification can significantly decrease the risk of complications from cardiovascular disease and bone fracture in HIV-positive patients, resulting in a healthier aging process.
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Eugenia L. Siegler, MD
Yes we are all getting older, and older. And thanks to combination antiretroviral therapy, our patients living with HIV are getting older too. But what additional risks in aging do they face? And how do the risks of older people who have been on ART for years differ from people who become newly infected with HIV at an older age? This program helps us better understand and assess age-related syndromes, the risks for frailty, and ways to improve the care of our patients living with and growing older with HIV disease.
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Andrew J. Muir, MD
The treatment of HCV, even in the presence of HIV coinfection, just keeps getting better. This program reviews the advances in HCV treatments, but focuses on the newest direct-acting antvirals (DAAs) for the treatment of HCV monoinfection, as well as HCV/HIV coinfection. Dr Muir also calls attention to recent DAA drug safety issues, regarding the activation of HBV, in people with past or current HBV while on DAA therapy for HCV, and how to monitor patients with current or prior HBV during and following DAA treatment of HCV.
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Daniel S. Fierer, MD
For many years, stable heterosexual HCV discordant couples have failed to implicate HCV as a sexually transmissible disease. But more recently we have seen an epidemic of HCV in HIV-infected MSM, suggesting that sexual transmission is possible. In this program, Daniel Fierer discusses outcomes of studies showing the presence of HCV in semen as well as rectal secretions, and further suggests that sexual transmission of HCV in MSM is associated with condomless anal sex and use of non-injectable party-drugs, rather than physical trauma or shared needles.
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Bruce D. Walker, MD
Why is natural immunity to HIV ineffective in the vast majority of out patients? And yet, how is it that a small minority of our treatment-naïve patients can maintain low or undetectable levels of HIV without antiretroviral therapy? What secrets might these HIV-controllers reveal that may contribute to vaccine functional cure in our patients who are susceptible to, and cannot control HIV spontaneously? Don’t miss this exciting and thought-provoking lecture by Bruce Walker, who has led the way in research characterizing HIV elite controllers, what makes them so special, and why this is important in strategies to cure HIV disease.
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