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      Friday, March 24, 2023
      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
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      CPD

      HIV: Complex Case Study Library Extension

      • Authors: Santiago Moreno, MD, PhD
      • CPD Released: 4/13/2022
      • Valid for credit through: 4/13/2023
      Start Activity

      • Credits Available

        Non-US Physicians - maximum of 1.00 CPD

        You Are Eligible For

        • Letter of Completion

      Target Audience and Goal Statement

      This educational activity is intended for an international audience of non-US HIV specialists, primary care physicians, and hematology/oncology specialists.

      The goal of this activity is for clinicians to be able to manage patients with difficult-to-treat HIV.

      Upon completion of this activity, participants will:

      • Have greater competence related to
        • Using best practices in the management of complex cases

      Disclosures

      WebMD Global requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

      All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships with ineligible companies.

      Faculty

      • Santiago Moreno, MD, PhD

        Head
        Department of Infectious Diseases
        Hospital Ramón y Cajal
        Madrid, Spain

        Disclosures

        Consultant or advisor for: Gilead; GlaxoSmithKline; Janssen; Merck; Pfizer; SOBI; ViiV Healthcare
        Speaker or member of speakers bureau for: Gilead; GlaxoSmithKline; Janssen; Merck; Pfizer; SOBI; ViiV Healthcare
        Research funding from: Gilead; ViiV Healthcare
        Contracted researcher for: Gilead; GlaxoSmithKline; Janssen; Merck; Pfizer; SOBI; ViiV Healthcare

      Editors

      • Shanthi Voorn, PhD

        Medical Education Director, WebMD Global, LLC

        Disclosures

        Disclosure: Shanthi Voorn, PhD, has no relevant financial relationships.

      • Jenny Engelmoer, PhD

        Medical Writer, Sula Communications, The Netherlands

        Disclosures

        Disclosure: Jenny Engelmoer, PhD, has no relevant financial relationships.

      Compliance Reviewer

      • Susan L. Smith, MN, PhD

        Associate Director, Accreditation and Compliance

        Disclosures

        Disclosure: Susan L. Smith, MN, PhD, has no relevant financial relationships.

      Peer Reviewer

      This activity has been peer reviewed and the reviewer has no relevant financial relationships.

      Accreditation Statements

        For Physicians

      • The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.0 continuing professional development credits (CPD).

        Contact WebMD Global

      For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

      Instructions for Participation and Credit

      There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

      This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

      Follow these steps to claim a credit certificate for completing this activity:

      1. Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
      2. Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

      We encourage you to complete an Activity Evaluation to provide feedback for future programming.

      You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

      *The credit that you receive is based on your user profile.

      < CLINICAL ADVANCES IN Beyond HIV: The Modern Landscape and Thriving With HIV
      From Medscape Education
      CPD

      HIV: Complex Case Study Library Extension

      Authors: Santiago Moreno, MD, PhDFaculty and Disclosures

      CPD Released: 4/13/2022

      Valid for credit through: 4/13/2023

      processing....

      References

      1. Department of Health and Human Serives Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. 2017. Accessed November 11, 2021. https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv/adherence-continuum-care
      2. Vela Diagnostics. Sentosa SQ HIV-1 Genotyping Reagents [package insert]. 2019. Accessed November 12, 2021. https://www.fda.gov/media/132293/download
      3. Stanford University. HIV Drug Resistance Database. Published November 22, 2021. Accessed March 15, 2022. https://hivdb.stanford.edu/
      4. Stanford University. NRTI Resistance Notes. Published May 31, 2016. Accessed March 15, 2021. https://hivdb.stanford.edu/dr-summary/resistance-notes/NRTI/
      5. Shafer RW, et al. HIV-1 drug resistance mutations: an updated framework for the second decade of HAART. AIDS Rev. 2008;10:67-84.
      6. Stanford University. HIV drug resistance database. Published February 4, 2019. Accessed November 12, 2021. https://hivdb.stanford.edu/dr-summary/resistance-notes/NNRTI/
      7. Thompson JA, et al. Evolution of protease inhibitor resistance in human immunodeficiency virus type 1 infected patients failing protease inhibitor monotherapy as second-line therapy in low-income countries: an observational analysis within the EARNEST randomized trial. Clin Infect Dis. 2019;68:1184-1192.
      8. Wilen CB, et al. HIV: cell binding and entry. Cold Spring Harb Perspect Med. 2012;2:a006866.
      9. Hardy WD, et al. Two-year safety and virologic efficacy of maraviroc in treatment-experienced patients with CCR5-tropic HIV-1 infection: 96-week combined analysis of MOTIVATE 1 and 2. J Acquir Immune Defic Syndr. 2010;55:558-564.
      10. Maraviroc [prescribing information]. Approved 2007. Revised October 2021.
      11. Fostemsavir [prescribing information]. Approved 2020. Revised October 2020.
      12. Lataillade M, et al. Safety and efficacy of the HIV-1 attachment inhibitor prodrug fostemsavir in heavily treatment-experienced individuals: week 96 results of the phase 3 BRIGHTE study. Lancet HIV. 2020;7:e740-e751.
      13. Moore JP, et al. A monoclonal antibody to CD4 domain 2 blocks soluble CD4-induced conformational changes in the envelope glycoproteins of human immunodeficiency virus type 1 (HIV-1) and HIV-1 infection of CD4+ cells. J Virol. 1992;66:4784-4793.
      14. Emu B, et al. Phase 3 study of ibalizumab for multidrug-resistant HIV-1. New Engl J Med. 2018;379:645-654.
      15. Kozal M, et al. Fostemsavir in adults with multidrug-resistant HIV-1 infection. New Engl J Med. 2020;382:1232-1243.
      16. Gardner EM, et al. Antiretroviral medication adherence and class-specific resistance in a large prospective clinical trial. AIDS. 2010;24:395-403.
      17. Ibalizumab-uiyk [prescribing information]. Approved 2018. Revised April 2021.
      18. Saag MS, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2020 recommendations of the International Antiviral Society-USA Panel. JAMA. 2020;324:1651-1669.
      19. Eron JJ, et al. A week-48 randomized phase-3 trial of darunavir/cobicistat/emtricitabine/tenofovir alafenamide in treatment-naive HIV-1 patients. AIDS. 2018;32:1431-1442.
      20. DeJesus E, et al. Superior efficacy and improved renal and bone safety after switching from a tenofovir disoproxil fumarate- to a tenofovir alafenamide-based regimen through 96 weeks of treatment. AIDS Res Hum Retroviruses. 2018;34:337-342.
      21. University of Liverpool. HIV Drug Interactions. Interaction Checker. Last review March 30, 2022. Accessed March 30, 2022. https://www.hiv-druginteractions.org/
      22. Darunavir, cobicistat, emtricitabine, and tenofovir alafenamide [prescribing information]. Approved 2018. Revised July 2021.
      23. Busse KH, et al. Influence of antiretroviral drugs on the pharmacokinetics of prednisolone in HIV-infected individuals. J Acquir Immune Defic Syndr. 2008;48:561-566.
      24. World Health Organization (WHO). Policy Brief: Update of Recommendations on First- and Second-Line Antiretroviral Regimens. HIV Treatment. 2019. Accessed March 15, 2022. https://www.who.int/publications/i/item/WHO-CDS-HIV-19.15
      25. Punekar YS, et al. Effectiveness and safety of dolutegravir two-drug regimens in virologically suppressed people living with HIV: a systematic literature review and meta-analysis of real-world evidence. HIV Med. 2021;22:423-433.
      26. Cahn P, et al. Dolutegravir plus lamivudine versus dolutegravir plus tenofovir disoproxil fumarate and emtricitabine in antiretroviral-naive adults with HIV-1 infection (GEMINI-1 and GEMINI-2): week 48 results from two multicentre, double-blind, randomised, non-inferiority, phase 3 trials. Lancet. 2019;393:143-155.
      27. Van Wyk J, et al. Efficacy and safety of switching to dolutegravir/lamivudine fixed-dose 2-drug regimen vs continuing a tenofovir alafenamide-based 3- or 4-drug regimen for maintenance of virologic suppression in adults living with human immunodeficiency virus type 1: phase 3, randomized, noninferiority TANGO study. Clin Infect Dis. 2020;71:1920-1929.
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