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Manage episode 493300651 series 3676342
Content provided by Clinical Guidelines Program, Dr. Eileen Scully, and Dr. Christopher Hoffmann. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Clinical Guidelines Program, Dr. Eileen Scully, and Dr. Christopher Hoffmann or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://staging.podcastplayer.com/legal.
48-yr-old man with HIV for 12 years presented 1 year after his last visit with a history of methamphetamine use, inconsistent engagement in care, and a new diabetes diagnosis. He reported no recent ART and no meth use for about 8 months. On returning to care, his viral load was 250,000 copies/mL, the CD4 count was 230 cells/mm3, creatinine levels were elevated, and genotype testing found a K103N mutation. He was motivated to resume ART. Drs. Scully and Hoffmann open with news about HIV cure and measles vaccination, then delve into the case to evaluate the patient’s new ART options in light of his clinical viremia and comorbidities.
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References Cited
- Andreatta K, D'Antoni ML, Chang S, et al. High efficacy of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in Black adults in the United States, including those with pre-existing HIV resistance and suboptimal adherence. J Med Virol. 2024;96(10):e29899. PMID: 39370775.
- Denyer R, Zemskova J, Benator DA. HIV treatment with dolutegravir and doravirine: rationale for selection and clinical outcomes in a highly treatment experienced population. Int J STD AIDS. 2022;33(12):1073-1077. PMID: 36113042
- Figueroa MI, Sued O, Cecchini D, et al. Dual therapy based on co-formulated darunavir/ritonavir plus lamivudine for initial therapy of HIV infection: The ANDES randomized controlled trial. Int J Antimicrob Agents. 2024;64(4):107301. PMID: 39151647
- Kabra M, Barber TJ, Allavena C, et al. Virologic Response to Dolutegravir Plus Lamivudine in People With Suppressed Human Immunodeficiency Virus Type 1 and Historical M184V/I: A Systematic Literature Review and Meta-analysis. Open Forum Infect Dis. 2023;10(11):ofad526. Published 2023 Oct 27. PMID: 38033982
- Paton NI, Musaazi J, Kityo C, et al. Dolutegravir or Darunavir in Combination with Zidovudine or Tenofovir to Treat HIV. N Engl J Med. 2021 Jul 22;385(4):330-341. PMID: 34289276.
- Rolle CP, Berhe M, Singh T, et al. Dolutegravir/lamivudine as a first-line regimen in a test-and-treat setting for newly diagnosed people living with HIV. AIDS. 2021;35(12):1957-1965. PMID: 34115650
- Rossotti R, D'Amico F, Bana NB, et al. Durability of doravirine with dolutegravir dual regimen compared with other dolutegravir-based dual combinations. HIV Med. 2024;25(6):675-683. PMID: 38263787
- Sax PE, Rockstroh JK, Luetkemeyer AF, et al. Switching to Bictegravir, Emtricitabine, and Tenofovir Alafenamide in Virologically Suppressed Adults With Human Immunodeficiency Virus. Clin Infect Dis. 2021;73(2):e485-e493. PMID: 32668455
Related Guidance and Guidelines
NYSDOH AI Clinical Guidelines Program:
- ChemSex: Questions and Answers
- HIV Resistance Assays
- Resource: ART Drug-Drug Interactions
- Stimulant Use Clinical Guidance
- Substance Use Harm Reduction in Medical Care
- Use of Injectable CAB/RPV LA as Replacement ART in Virally Suppressed Adults
Clinical Info HIV.gov:
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