Case 3 - HIV Treatment Options in the Setting of Drug Resistance

Infectious Diseases
Curriculum:
Challenging Cases in HIV Management: The Patient Waiting Room
Credits:
0.75 AMA PRA Category 1 Credit(s)™
Launch Date:
March 31, 2016
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Infectious disease specialists, HIV treaters, and other health care professionals involved in the treatment of patients with HIV

Relevant Terms:

HIV, HIV treatment regimens

Paul E. Sax, MD

Paul E. Sax, MD
Clinical Director
Division of Infectious Diseases
Brigham and Women's Hospital Professor of Medicine
Harvard Medical School
Boston, MA

Dr. Paul E. Sax is Clinical Director of the Division of Infectious Diseases and the HIV Program at Brigham and Women's Hospital (BWH), and Professor of Medicine at Harvard Medical School. Dr. Sax received his MD from Harvard Medical School in 1987. He served his residency in Internal Medicine at BWH, while continuing his postdoctoral education with a fellowship in the Infectious Disease Unit of Massachusetts General Hospital. Dr. Sax is board certified in Internal Medicine and Infectious Diseases. He is Editor-in-Chief of Open Forum Infectious Diseases, is on the Peer Review board of the HIV/AIDS Section of UpToDate, and the editorial advisory board of Medscape HIV/AIDS. Dr. Sax is also on the core faculty of the International AIDS Society - USA and the New England AIDS Education and Training Center. In addition to his clinical and teaching work, Dr. Sax's ongoing areas of research include clinical trials of antiretroviral therapies, cost-effectiveness of management strategies for HIV, and toxicity of antiretroviral therapy. He is presently the principal investigator at the BWH AIDS Clinical Trials Unit, and is a member of the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) Research Group.
 

Karam Mounzer, MD

Karam Mounzer, MD
Medical Director of Philadelphia FIGHT
Clinical Associate Professor of Medicine
The Perelman School of Medicine at the University of Pennsylvania
Philadelphia, PA

Dr. Mounzer is the Medical Director of the largest, community-based Philadelphia HIV program, Philadelphia FIGHT-– The Jonathan Lax Treatment Center (www.fight.org). State-of-the-art medical care is provided in a setting that includes case management, HIV education, mental health assessments, nutritional counseling, substance abuse referrals, and behavioral-based adherence support intervention and treatment. Dr. Mounzer identified two major gaps in the care of patients with HIV / hepatitis C (HCV) co-infection, and the complexity of multidrug-resistant HIV treatment. He is involved with many clinical trials focusing on drug development and better understanding of HIV immunopathogenesis with the Wistar Institute. Additionally, he is involved in teaching and mentoring fellows, residents and students. He serves as a Clinical Associate Professor of Medicine and continues to participate in our inpatient care and educational programs in the Infectious Disease Division at Penn Presbyterian Medical Center.


 
1. Utilize evidence-based guidelines as well as clinical knowledge of available and emerging therapies to develop initial HIV treatment regimens based on individual patient characteristics.
2. Review the cost-effectiveness of available HIV therapies.
3. Develop simplified HIV treatment regimens that reflect patient preference and increase adherence.
4. Differentiate available and emerging HIV treatment regimens based on resistance profile.
5. Apply knowledge of effective switch strategies and NRTI-sparing regimens that have demonstrated a low risk of virological failure in patients who would benefit from treatment alteration.

Provider Statement:
This continuing medical education activity is provided by
Educational Partner:
 
 
Support Statement:
This activity is supported by an educational grant from ViiV Healthcare.
 
Activity Chair:
Paul E. Sax, MD
Clinical Director
Division of Infectious Diseases
Brigham and Women's Hospital Professor of Medicine
Harvard Medical School
Boston, MA     
 
Disclosures:
Advisory Board: AbbVie, Bristol-Myers Squibb, GlaxoSmithKline/ViiV, Gilead, Janssen, Merck
Investigator: Bristol-Myers Squibb, GlaxoSmithKline/ViiV, Gilead, Merck
 
Faculty:
Karam Mounzer, MD
Medical Director of Philadelphia FIGHT
Clinical Associate Professor of Medicine
The Perelman School of Medicine at the University of Pennsylvania
Philadelphia, PA
 
Disclosures:
Advisory Board: Gilead, Janssen, Merck, ViiV
Investigator: Gilead, Janssen, Merck, ViiV
Consultant: Gilead, Janssen, Merck, ViiV
Speakers Bureau: CCO, Gilead, Janssen, Simply Speaking
 
External Reviewer:
Rebecca A. Clark, MD
No relevant financial relationships to disclose.
 
National Jewish Health and Vindico Medical Education staff report the following relationship(s):
No relevant financial relationships to disclose.
 
Signed disclosures are on file at National Jewish Health, Office of Professional Education, and Vindico Medical Education, Office of Medical Affairs and Compliance.
 
Disclosures:
In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all planners, teachers, authors, and reviewers involved in the development of CME content are required to disclose to the accredited provider their relevant financial relationships. Relevant financial relationships will be disclosed to the activity audience prior to viewing content.
 
Accreditation:
National Jewish Health is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 
 
Credit Designation:
National Jewish Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
This enduring material is approved for 1 year from the date of original release, March 31, 2016 to March 31, 2017.
 
How to Participate in this Activity and Obtain CME Credit:
To participate in this CME activity, you must reference the objectives, answer the pretest questions, watch, read, and listen to the content, complete the CME posttest, and then fill in the evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 66% of the posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, National Jewish Health will issue an AMA PRA Category 1 Credits™ Certificate.
 
Overview: With the availability of highly effective antiretroviral agents and combinations, treatment-experienced HIV patients with extensive drug resistance now have multiple options for suppressive therapy. However, advances in treatment and management also create new challenges for clinicians who must be knowledgeable about the expanding treatment armamentarium, interpretation of various resistance tests, as well as complex issues of pharmacokinetics and drug interactions. This interactive, case-based activity will address the complexity of optimizing therapeutic regimens for treatment-experienced patients with drug-resistant HIV infection. Expert commentaries offered by faculty will provide insight into the selection of antiretroviral therapy for treatment-experienced patients, individualizing therapy based on antiretroviral history with known or suspected resistance, and interactions with concomitant medications.
 
Target Audience: The intended audience for the activity is infectious disease specialists, HIV treaters, and other health care professionals involved in the treatment of patients with HIV.
 
Learning Objectives:
Upon successful completion of the educational series, participants should be better able to:
  • Utilize evidence-based guidelines as well as clinical knowledge of available and emerging therapies to develop initial HIV treatment regimens based on individual patient characteristics.
  • Review the cost-effectiveness of available HIV therapies.
  • Develop simplified HIV treatment regimens that reflect patient preference and increase adherence.
  • Differentiate available and emerging HIV treatment regimens based on resistance profile.
  • Apply knowledge of effective switch strategies and NRTI-sparing regimens that have demonstrated a low risk of virological failure in patients who would benefit from treatment alteration.
Unlabeled and Investigational Usage:
The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage. All activity participants will be informed if any speakers/authors intend to discuss either non-FDA approved or investigational use of products/devices.
 
Copyright Statement:
Created and published by Vindico Medical Education, 6900 Grove Road, Building 100, Thorofare, NJ 08086-9447. Telephone: 856-994-9400; Fax: 856-384-6680. Printed in the USA. Copyright © 2016 Vindico Medical Education. All rights reserved.
 
No part of this publication may be reproduced without written permission from the publisher. The material presented at or in any of National Jewish Health and Vindico Medical Education continuing education activities does not necessarily reflect the views and opinions of National Jewish Health and Vindico Medical Education. Neither National Jewish Health, nor Vindico Medical Education, nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.
 
CME Questions?
Contact us at:
National Jewish Health: proed@njhealth.org or 303-398-1000.
Vindico Medical Education: cme@vindicocme.com or 856-994-9400, ext. 504.
 
 
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