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Updates in HIV and AIDS: Part II, An Issue of Infectious Disease Clinics, E-Book

Updates in HIV and AIDS: Part II, An Issue of Infectious Disease Clinics, E-Book

Michael S. Saag

(2014)

Additional Information

Abstract

This second 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 address the prevention of HIV/AIDS with topics such as: Mother to Child Transmission; Treatment as Prevention; Barrier and Microbicides; Prevention of HIV/AIDS: Pre-exposure Prophylaxis; Post-Exposure Prophylaxis; HIV Vaccine, and a final article addressing the cure of HIV/AIDS.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Updates in HIV andAIDS: Part II i
Copyright ii
Contributors iii
Contents v
Infectious Disease Clinics Of North America viii
Preface ix
Prevention of Perinatal Transmission of Human Immunodeficiency Virus 529
Key points 529
Preconception care 529
Prevention of Undesired Pregnancies 530
Use of Contraception 530
Hormonal Contraception in Human Immunodeficiency Virus 530
Women Who Wish to Conceive or Are at Risk of Conception 531
Antenatal care 535
Evaluation of Human Immunodeficiency Virus Infection in Pregnancy 535
When to Start Antiretroviral Medications 536
Antiretroviral Medications to Initiate in Women Who Are Antiretroviral Naïve 537
Antiretroviral Medications to Start in Women Who Are Antiretroviral Experienced 540
Monitoring the Woman and the Fetus After Initiation of Antiretroviral Therapy 541
Intrapartum care 541
Women of Unknown Human Immunodeficiency Virus Status Who Present in Labor 542
Special Intrapartum Considerations 543
Postpartum care 543
Infant Antiretroviral Prophylaxis 544
References 545
Rationale and Evidence for Human Immunodeficiency Virus Treatment as Prevention at the Individual and Population Levels 549
Key points 549
Introduction 549
Theoretic basis: viral load and human immunodeficiency virus transmission observational studies 550
Untreated Individuals 550
Treated Individuals 550
Plasma Versus Genital Fluid Human Immunodeficiency Virus Concentration and Transmission 551
Clinical trials 551
Individual decision making 552
Population-level prevention: modeling of treatment as prevention 552
Population-based prevention ecological studies 553
Balancing the individual with the population 554
Treatment as prevention and the human immunodeficiency virus prevention landscape 556
Challenges 557
Summary 558
References 558
Pre-exposure Prophylaxis for Human Immunodeficiency Virus 563
Key points 563
Introduction 563
The past: development of pre-exposure prophylaxis as an HIV prevention intervention 564
Prior Evidence of Use of Antiretrovirals for Prevention 564
Animal Trials 564
Randomized Clinical Trials Among Humans 565
Implementation of Pre-exposure Prophylaxis 567
Lessons Learned from the Past 568
Safety 568
Resistance 568
Adherence 568
Behavioral disinhibition 568
The present: assessment of new regimens, delivery mechanisms, and feasibility 569
New Pre-exposure Prophylaxis Regimens 569
Novel Formulations 569
Open-Label Investigations 571
The future: pre-exposure prophylaxis implementation 571
Optimization of Pre-exposure Prophylaxis Regimens 571
Delivery of Pre-exposure Prophylaxis 572
Engagement of High-Risk Populations 573
Guidelines, Goals and Monitoring, and Evaluation 574
Summary 574
References 574
Barrier Methods for Human Immunodeficiency Virus Prevention 585
Key points 585
Introduction 585
Male condom 586
Types of Male Condoms 586
Indications 586
Effectiveness 587
Benefits 587
Limitations 588
Female condom 588
Types of Female Condoms 589
Indications 589
Effectiveness 590
Benefits 592
Limitations 592
Future Directions 592
Microbicides 592
Mechanisms of Action 593
Safety and Effectiveness 593
Surfactants 593
Buffers 594
Blockers 594
Human immunodeficiency virus fusion inhibitors 594
Human immunodeficiency virus replication inhibitors 595
Rectal Microbicides 595
References 596
Prevention of Human Immunodeficiency Virus and AIDS 601
Key points 601
Rationale for postexposure prophylaxis for exposures to human immunodeficiency virus 602
Biologic Plausibility of Postexposure Prophylaxis 602
Animal Models of Postexposure Prophylaxis 602
Epidemiologic and Clinical Data Relevant to Occupational Postexposure Prophylaxis 603
Assessment of the need for occupational and nonoccupational postexposure prophylaxis 603
Baseline Human Immunodeficiency Virus Testing of Occupationally and Nonoccupationally Exposed Individuals 604
Testing of the Source Patient 604
Exposure Type and Risk of Human Immunodeficiency Virus Transmission 604
Details of implementation of postexposure prophylaxis 606
Choosing a Regimen for Postexposure Prophylaxis 606
Timing and Duration of Postexposure Prophylaxis 608
Adverse Effects of Postexposure Prophylaxis 608
Follow-up Assessments for Human Immunodeficiency Virus Postexposure Prophylaxis 609
References 610
Human Immunodeficiency Virus Vaccines 615
Key points 615
Introduction 615
Improvements to vaccine-elicited immune responses 619
Antibodies 619
T Cells 620
Summary 622
Acknowledgments 622
References 622
Finding a Cure for Human Immunodeficiency Virus-1 Infection 633
Key points 633
Introduction 633
The Basic Biology of Retroviral Persistence 633
Human immunodeficiency virus-1 latency 635
Defining a cure 635
Immune control and functional cure of human immunodeficiency virus-1 infection 637
Targeting the latent reservoir 639
Alternative strategies 641
Clinical aspects of human immunodeficiency virus-1 eradication strategies 641
Summary 644
References 644
Index 651