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HIV Management In Depth

New Paradigms of First-Line HIV Therapy: Determining When (and With What) to Start

Eric Daar, M.D.Trevor Hawkins, M.D.
Eric Daar, M.D.Trevor Hawkins, M.D.
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A Podcast Discussion With Eric Daar, M.D., and Trevor Hawkins, M.D.

November 11, 2009

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Outlook for Treatment-Naive Patients

Bonnie Goldman: To conclude: Dr. Daar, is it a good time or a bad time to be selecting therapy for someone with HIV?

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Eric Daar: This is an extraordinary time. When I meet people who are newly diagnosed and starting therapy for the first time, I always tell them that, while it's unfortunate that they have to deal with HIV as a part of their life, the timing couldn't be better. We do have a lot of data. We have a lot of options. I think there's every reason to believe that the overwhelming majority of people we start therapy on for the first time will ultimately end up on a regimen that will be extremely easy for them to take; very, very well tolerated; and will probably suppress their virus and control their disease for many, many years, if not a lifetime.

Trevor Hawkins: I am similarly optimistic with my patients, and supportive of that. I think we have so many efficacious regimens. As I said before, I think tolerability becomes such a driving issue, both short-term tolerability and long-term issues. I think the outlook for people who get infected obviously is so much better than it was in the past. I think we have every reason to believe it will continue to improve.

Bonnie Goldman: Well, we've run out of time. Thank you so much Dr. Hawkins and Dr. Daar for sharing your knowledge and insights.

That's it for the first topic in TheBodyPRO.com's new series HIV Management Today. Stay tuned for other discussions in this series. Thanks again for listening!

This transcript has been lightly edited for clarity.

To view the next installment in HIV Management Today, "Clinical Management of the HIV-Infected Woman," click here.


References

  1. Starting antiretroviral therapy earlier yields better clinical outcomes [press release]. National Institutes of Health; June 8, 2009. Available at: www.nih.gov/news/health/jun2009/niaid-08a.htm. Accessed November 11, 2009.
  2. Kitahata MM, Gange SJ, Abraham AG, et al, for the NA-ACCORD Investigators. Effect of early versus deferred antiretroviral therapy for HIV on survival. N Engl J Med. April 30, 2009;360(18):1815-1826.
  3. Sterne J, and the When to Start Consortium. When should HIV-1-infected persons initiate ART? Collaborative analysis of HIV cohort studies. In: Program and abstracts of the 16th Conference on Retroviruses and Opportunistic Infections; February 8-11, 2009; Montréal, Canada. Abstract 72LB.
  4. Kitahata M, Gange S, Moore R, and the North American AIDS Cohort Collaboration on Research and Design. Initiating rather than deferring HAART at a CD4+ count >500 cells/mm3 is associated with improved survival. In: Program and abstracts of the 16th Conference on Retroviruses and Opportunistic Infections; February 8-11, 2009; Montréal, Canada. Abstract 71.
  5. Lewden C, Chêne G, Morlat P, et al, and the Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS) CO8 APROCO-COPILOTE and CO3 AQUITAINE Study Groups. HIV-infected adults with a CD4 cell count greater than 500 cells/mm3 on long-term combination antiretroviral therapy reach same mortality rates as the general population. J Acquir Immune Defic Syndr. September 1, 2007;46(1):72-77.
  6. Heaton R, Franklin D, Clifford D, et al. HIV-associated neurocognitive impairment remains prevalent in the era of combination ART: the CHARTER study. In: Program and abstracts of the 16th Conference on Retroviruses and Opportunistic Infections; February 8-11, 2009; Montréal, Canada. Abstract 154.
  7. Hader S. A "modern response" to a "modern epidemic": HIV/AIDS in the District of Columbia. In: Program and abstracts of the 16th Conference on Retroviruses and Opportunistic Infections; February 8-11, 2009; Montréal, Canada. Abstract 57.
  8. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents (PDF). Washington, DC: US Dept of Health and Human Services; November 3, 2008.
  9. European AIDS Clinical Society. EACS guidelines: clinical management and treatment of HIV infected adults in Europe (PDF). November 2009.
  10. Cohen MS, Gay C, Kashuba ADM, Blower S, Paxton L. Narrative review: antiretroviral therapy to prevent the sexual transmission of HIV-1. Ann Intern Med. April 17, 2007;146(8):591-601.
  11. Gotuzzo E, Nguyen B-Y, Markowitz M, et al, and the Protocol 004 Part II Study Team. Sustained antiretroviral efficacy of raltegravir as part of combination ART in treatment-naive HIV-1 infected patients: 144-week data. In: Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract MOPEB030.
    View poster: Download PDF
  12. Riddler SA, Haubrich R, DiRienzo AG, et al, for the AIDS Clinical Trials Group Study A5142 Team. Class-sparing regimens for initial treatment of HIV-1 infection. N Engl J Med. May 15, 2008;358(20):2095-2106.
  13. Uy J, Yang R, Wirtz V, Sheppard L, Absalon J. Efficacy and safety of atazanavir/r vs. lopinavir/r in treatment-naive patients with advanced disease: CASTLE study 96-week results. In: Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract MOPEB041.
    View poster: Download PDF
  14. Fourie J, Flamm J, Rodriguez-French A, et al. ARTEMIS: week 96 safety and efficacy of darunavir/r by gender, age and race. In: Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract CDB072.
    View poster: Download PDF
  15. Clotet B, Bellos N, Molina J-M, et al, on behalf of the POWER 1 and 2 study groups. Efficacy and safety of darunavir-ritonavir at week 48 in treatment-experienced patients with HIV-1 infection in POWER 1 and 2: a pooled subgroup analysis of data from two randomised trials. Lancet. April 7, 2007;369(9568):1169-1178.
  16. Madruga JV, Berger D, McMurchie M, et al, on behalf of the TITAN study group. Efficacy and safety of darunavir-ritonavir compared with that of lopinavir-ritonavir at 48 weeks in treatment-experienced, HIV-infected patients in TITAN: a randomised controlled phase III trial. Lancet. July 7, 2007;370(9581):49-58.
  17. Sabin CA, Worm SW, Weber R, et al, and D:A:D Study Group. Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in the D:A:D study: a multi-cohort collaboration. Lancet. April 26, 2008;371(9622):1417-1426.
  18. Stein JH, Currier JS. Risk of myocardial infarction and nucleoside analogues. Lancet. April 26, 2008;371(9622):1391-1392.
  19. Cutrell A, Brothers C, Yeo J, Hernandez J, Lapierre D. Abacavir and the potential risk of myocardial infarction. Lancet. April 26, 2008;371(9622):1413.
  20. Lang S, Mary-Krause M, Cotte L, et al, and the Clinical Epi Group of the French Hosp Database on HIV. Impact of specific NRTI and PI exposure on the risk of myocardial infarction: a case-control study nested within FHDH ANRS CO4. In: Program and abstracts of the 16th Conference on Retroviruses and Opportunistic Infections; February 8-11, 2009; Montréal, Canada. Abstract 43LB.
    View slides: Download PowerPoint
  21. Bedimo R, Westfall A, Drechsler H, Tebas P. Abacavir use and risk of acute myocardial infarction and cerebrovascular disease in the HAART era. In: Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract MOAB202.
    View slides: Download PowerPoint
  22. Smith C, and D:A:D Study Group. Association between modifiable and non-modifiable risk factors and specific causes of death in the HAART era: the data collection on adverse events of anti-HIV drugs study. In: Program and abstracts of the 16th Conference on Retroviruses and Opportunistic Infections; February 8-11, 2009; Montréal, Canada. Abstract 145.
  23. Zolopa AR, Andersen J, Komarow L, et al, for the ACTG A5164 study team. Early antiretroviral therapy reduces AIDS progression/death in individuals with acute opportunistic infections: a multicenter randomized strategy trial. PLoS One. May 18, 2009;4(5):e5575.
  24. Wheeler W, Mahle K, Bodnar U, Kline R, Hall I, McKenna M, and the US Variant, Atypical and Resistant HIV Surveillance (VARHS) Group. Antiretroviral drug-resistance mutations and subtypes in drug-naive persons newly diagnosed with HIV-1 infection, US, March 2003 to October 2006. In: Program and abstracts of the 14th Conference on Retroviruses and Opportunistic Infections; February 25-28, 2007; Los Angeles, Calif. Abstract 648.
    View poster: Download PDF
  25. Ross L, Florance A, Wine B, et al. Factors associated with HIV-1 mutations linked to drug resistance in antiretroviral therapy naive HIV-infected individuals in the United States from 2000-2005 (PREPARE Study). In: Program and abstracts of the 46th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 27-30, 2006; San Francisco, Calif. Abstract H-993.
  26. Hull M, Moore D, Harris M, et al. A lamivudine (3TC)-based backbone in conjunction with a boosted protease inhibitor (PI) is sufficient to achieve virologic suppression in the presence of M184V mutations. In: Program and abstracts of the 49th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 12-15, 2009; San Francisco, Calif. Abstract H-916.
  27. Squires K, Young B, DeJesus E, et al. Similar efficacy and tolerability of atazanavir (ATV) compared to ATV/ritonavir (RTV, r), each in combination with abacavir/lamivudine (ABC/3TC), after initial supression with ABC/3TC + ATV/r in HIV-1 infected patients: 84-week results of the ARIES trial. In: Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract WELBB103.
    View slides: Download PowerPoint

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This article was provided by TheBodyPRO.com. It is a part of the publication HIV Management in Depth.
 

 

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