BOOK
Updates in HIV and AIDS: Part I, An Issue of Infectious Disease Clinics, E-Book
(2014)
Additional Information
Book Details
Abstract
This first part of a 2-part issue of Infectious Disease Clinics, edited by Michael S. Saag, MD and Henry Masur, MD, is devoted to HIV/AIDS. This issue will cover global epidemiology; testing, staging, and evaluation; linkage to care, retention in care; antiretroviral therapy: current drugs, when to start, what to start, failure; update on opportunistic infections; HIV co-morbidities; and co-infection Hepatitis B and Hepatitis C.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Updates in HIV andAIDS: Part I | i | ||
Copyright\r | ii | ||
Contributors | iii | ||
Contents | vii | ||
Infectious disease clinics\rOf north america\r | x | ||
Erratum | xi | ||
Dedication | xiii | ||
A Tribute to Dr Robert C. Moellering Jr (1937–2014) | xiii | ||
Preface | xv | ||
HIV/AIDS | xv | ||
Global Epidemiology of HIV | 323 | ||
Key points | 323 | ||
Introduction | 323 | ||
Sub-Saharan Africa | 326 | ||
Asia | 329 | ||
North Africa and the Middle East | 330 | ||
Latin America and the Caribbean | 330 | ||
North America, Western Europe, and Oceania | 331 | ||
Eastern Europe and Central Asia | 332 | ||
Discussion and Program Implications | 333 | ||
References | 334 | ||
HIV Testing, Staging, and Evaluation | 339 | ||
Key points | 339 | ||
Introduction | 339 | ||
Race and Ethnicity | 340 | ||
MSM | 341 | ||
Pregnant Women and Perinatally Acquired HIV | 342 | ||
Youth | 342 | ||
Staging | 342 | ||
Acute HIV Infection | 342 | ||
Chronic HIV Infection | 344 | ||
AIDS | 344 | ||
Testing | 345 | ||
Screening Recommendations | 345 | ||
Diagnostic Tools | 345 | ||
Initial evaluation and care | 347 | ||
Initial Evaluation | 347 | ||
Clinical Testing and Case Management | 347 | ||
Summary | 352 | ||
References | 352 | ||
Engagement in Human Immunodeficiency Virus Care | 355 | ||
Key points | 355 | ||
Introduction | 355 | ||
Improved HIV outcomes with combination ART | 356 | ||
Linkage and Retention in Care | 356 | ||
Early entry into care | 356 | ||
Attendance to clinic visits | 358 | ||
Monitoring and measuring retention in care | 358 | ||
Interventions to improve entry and retention in care | 360 | ||
Adherence to ART | 360 | ||
Monitoring ART adherence | 360 | ||
Improving adherence | 361 | ||
Adherence reminders | 361 | ||
Behavioral interventions | 362 | ||
Additional Interventions | 363 | ||
Case management, supportive services (housing, food, transportation), and pharmacy support | 363 | ||
Nursing-based and community-based counselor care | 363 | ||
Priority Populations | 364 | ||
Pregnancy | 364 | ||
Substance use disorders | 364 | ||
Mental illness | 364 | ||
Incarceration, homelessness, and marginally housed individuals | 365 | ||
Children, adolescents, and young adults | 365 | ||
Future Research | 366 | ||
References | 366 | ||
Antiretroviral Therapy | 371 | ||
Key points | 371 | ||
Introduction | 371 | ||
Goals and principles of antiretroviral therapy | 373 | ||
HIV life cycle and targets of antiretroviral drug therapy | 375 | ||
Rationale for combination antiretroviral therapy | 375 | ||
NRTIs | 376 | ||
Abacavir | 377 | ||
Emtricitabine and Lamivudine | 380 | ||
Tenofovir Disoproxil Fumarate (or Tenofovir) | 380 | ||
Zidovudine | 380 | ||
NNRTIs | 381 | ||
Efavirenz | 381 | ||
Etravirine | 384 | ||
Nevirapine | 384 | ||
Rilpivirine | 385 | ||
PI | 385 | ||
Atazanavir | 386 | ||
Darunavir | 387 | ||
Fosamprenavir | 387 | ||
Lopinavir | 391 | ||
Saquinavir | 391 | ||
Tipranavir | 392 | ||
Integrase inhibitors | 392 | ||
Dolutegravir | 393 | ||
Elvitegravir | 393 | ||
Raltegravir | 396 | ||
CCR5 antagonist | 396 | ||
Fusion inhibitor | 398 | ||
Summary | 398 | ||
References | 398 | ||
Antiretroviral Therapy | 403 | ||
Key points | 403 | ||
Introduction | 403 | ||
HIV treatment guidelines | 404 | ||
Evidence informing the question of when to start ART | 406 | ||
Observational Data | 407 | ||
Clinical Trials | 410 | ||
Studies of Pathogenesis and End-Organ Disease | 410 | ||
Treatment as Prevention | 411 | ||
ART Toxicity | 411 | ||
Antiretroviral Resistance | 412 | ||
Conditions strongly favoring ART initiation | 412 | ||
Pregnancy | 413 | ||
Acute Opportunistic Infections | 413 | ||
Other Comorbid Conditions | 413 | ||
Acute HIV Infection | 414 | ||
Challenges and considerations | 414 | ||
Summary | 414 | ||
References | 415 | ||
Beginning Antiretroviral Therapy for Patients with HIV | 421 | ||
Key points | 421 | ||
Introduction | 421 | ||
Pharmacologic strategies | 422 | ||
Recommended initial regimens: Tenofovir versus ABC | 423 | ||
Tenofovir | 423 | ||
ABC | 424 | ||
Recommended initial ART regimens: Single-tablet, once-daily regimens | 424 | ||
EFV/TDF/FTC | 424 | ||
EVG/COBI/TDF/FTC | 426 | ||
RPV/TDF/FTC | 427 | ||
DTG/ABC/3TC | 427 | ||
Recommended initial ART regimens: Multiple-tablet regimens | 427 | ||
Boosted PI-Based Regimens | 427 | ||
INSTI Options | 430 | ||
NNRTI with ABC Option | 431 | ||
Alternative initial regimens | 432 | ||
NRTI-sparing or NRTI-limiting options | 432 | ||
Summary and future directions | 433 | ||
References | 433 | ||
Antiretroviral Therapy | 439 | ||
Key points | 439 | ||
Introduction | 439 | ||
Art-experienced individuals with suboptimal virologic response | 440 | ||
Causes of Suboptimal Virologic Response | 441 | ||
Suspected Drug Resistance | 441 | ||
Management of Suboptimal Virologic Response | 442 | ||
Clinical scenario: suboptimal virologic response on first-line therapy | 442 | ||
NRTIs plus NNRTI | 442 | ||
NRTIs plus pharmacologically boosted PIs | 443 | ||
NRTIs plus InSTI | 443 | ||
Clinical scenario: suboptimal virologic response after having failed multiple regimens with drug-resistant virus | 444 | ||
Treatment strategies when a fully suppressive regimen is likely to be achievable | 444 | ||
Treatment strategies when a fully suppressive regimen is unlikely to be achievable | 445 | ||
Clinical scenario: drug resistance testing cannot be performed | 445 | ||
Clinical scenario: drug resistance testing shows no significant mutations | 446 | ||
Clinical scenario: individuals with a history of suboptimal virologic response who have been off therapy for months | 446 | ||
ART-experienced individuals with virologic suppression | 446 | ||
Switching NRTIs | 447 | ||
Switching NNRTIs | 447 | ||
Switching a Pharmacologically Boosted PI | 448 | ||
Switching from an InSTI | 449 | ||
Switching ART in Patients Virologically Suppressed with Underlying Multidrug Resistance | 449 | ||
Monitoring After Antiretroviral Switch | 449 | ||
Summary/Discussion | 450 | ||
References | 450 | ||
HIV-Related Metabolic Comorbidities in the Current ART Era | 457 | ||
Key points | 457 | ||
Introduction | 457 | ||
CVD | 459 | ||
Epidemiology | 459 | ||
HIV-Related Factors | 459 | ||
Traditional Risk Factors | 460 | ||
Prevention | 460 | ||
Renal | 460 | ||
Epidemiology | 460 | ||
Prevention | 461 | ||
Bone disease | 462 | ||
Epidemiology | 462 | ||
Risk Factors for Low BMD | 462 | ||
Fracture Risk | 463 | ||
Screening for Low BMD | 463 | ||
Diabetes mellitus | 464 | ||
Epidemiology | 464 | ||
Risk Factors | 464 | ||
Obesity and HIV | 465 | ||
Summary | 466 | ||
References | 466 | ||
Human Immunodeficiency Virus and Coinfection with Hepatitis B and C | 477 | ||
Key points | 477 | ||
Background | 477 | ||
Epidemiology and risk factors | 478 | ||
HBV and HBV/HIV | 478 | ||
HCV and HCV/HIV | 479 | ||
Genotypes | 479 | ||
HBV | 479 | ||
HCV | 479 | ||
IL28B | 480 | ||
Natural history of coinfected states | 480 | ||
HBV in HIV | 480 | ||
HIV with HBV | 481 | ||
HCV in HIV | 481 | ||
HIV with HCV | 482 | ||
Diagnosis and screening: in the HIV-infected population | 483 | ||
Treatment | 484 | ||
HBV: Treatment of Monoinfection Compared with Coinfection: Limitations and Considerations | 484 | ||
Treatment of HBV Only | 484 | ||
Treatment of Both HIV and HBV | 485 | ||
Monitoring Treatment of HBV in the Coinfected Patient | 485 | ||
HCV: treatment of monoinfection compared with coinfection: limitations and considerations | 486 | ||
PEG/RBV | 487 | ||
Protease inhibitor + PEG/RBV (telaprevir, boceprevir, SMV) | 487 | ||
Nucleotide inhibitors (SOF) | 488 | ||
Other agents in development (coformulations) | 488 | ||
Case selection for HCV therapy and ART | 489 | ||
Practice guidelines recommendations | 489 | ||
Monitoring treatment outcome and managing adverse events | 489 | ||
Other issues | 490 | ||
Cost and Access to Care | 490 | ||
Primary and Secondary Prevention | 491 | ||
Summary | 491 | ||
References | 492 | ||
Update on Opportunistic Infections in the Era of Effective Antiretroviral Therapy | 501 | ||
Key points | 501 | ||
Introduction | 501 | ||
TB in HIV-Infected Patients | 502 | ||
Epidemiology | 502 | ||
Latent TB infection | 502 | ||
Treatment of LTBI | 503 | ||
Diagnosis of Active TB | 503 | ||
GeneXpert | 503 | ||
Lipopolysaccharide antigen lipoarabinomannan | 504 | ||
Treatment of TB in HIV-infected patients | 504 | ||
When to start ART in an HIV-infected patient with TB | 504 | ||
TB meningitis | 506 | ||
Antiretroviral medication choice in patients with HIV/TB | 506 | ||
Cryptococcus | 507 | ||
Epidemiology | 507 | ||
Diagnosis | 507 | ||
CrAg LFA | 507 | ||
Treatment of CM: the induction phase | 508 | ||
Consolidation and maintenance therapy | 508 | ||
When to start ART | 508 | ||
Cryptococcal IRIS | 509 | ||
PML | 509 | ||
Treatment of PML | 509 | ||
PML-IRIS | 510 | ||
PCP | 510 | ||
Diagnosis | 510 | ||
When to start ART in a patient with PCP | 510 | ||
Recommendations for PCP prophylaxis | 511 | ||
Vaccine-Preventable OIs | 511 | ||
HPV | 511 | ||
Epidemiology | 511 | ||
HPV vaccine | 511 | ||
Varicella and zoster vaccines | 512 | ||
Epidemiology | 512 | ||
Vaccination in HIV-infected patients | 512 | ||
Acknowledgments | 512 | ||
References | 512 | ||
Index | 519 |