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Case 1 - Initiating ARV Therapy

Infectious Diseases
Curriculum:
Challenging Cases in HIV Management: The Patient Waiting Room
Credits:
1 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.
 

Richard A. Elion, MD

Richard A. Elion, MD
Associate Clinical Professor of Medicine
George Washington University School of Medicine
Washington, DC

Richard A. Elion, MD, is an Associate Clinical Professor of Medicine at George Washington University School of Medicine and an Adjunct Professor in the Milliken School of Public Health at GW as well. Dr. Elion is a consultant to the Washington DC Dept of Health in prevention and in private practice in Washington DC. He is currently the director of research for the DC Wellness Program, a prevention program for sexually transmitted diseases. Richard graduated from the Temple University School of Medicine and did his residency at Duke University Medical Center. Dr. Elion has also completed the course work for a Masters in Counseling from University of Santa Monica. Dr. Elion has also been an active investigator in hiv prevention and PrEP and was the principal investigator in the PrEP demo project recently published in JAMA.
 
Dr. Elion has had an active clinical practice for over thirty years and had been the Prinicipal Investigator of numerous clinical trials including the newly formed Aids Clinical Trial Group site in Washington DC as well as the PI for the Multi site Aids Cohort Study in conjunction with Johns Hopkins. Dr. Elion was a founding member of the American Academy of HIV Medicine and a past board member of the HIVMA, a division of the IDSA. He is working on various HIV prevention projects with the Department of Health and converting a city wide STD program into a center for prevention studies.

Charles Hicks, MD

Charles Hicks, MD
Professor of Medicine
Director
Owen Clinic
University of California
San Diego, CA

Charles Hicks, MD, is board-certified in internal medicine and infectious disease. He provides primary care, including preventive care and diagnosis and treatment of acute and chronic diseases for adults with HIV and AIDS. Dr. Hicks is director of UC San Diego Health System’s Owen Clinic.
 
Dr. Hicks completed fellowships in infectious disease and medical science at Walter Reed Army Medical Center. He completed his residency and an internship in internal medicine at Letterman Army Medical Center in San Francisco. He received his medical degree from George Washington University and his bachelor’s degree from United States Military Academy in West Point, N.Y.
 
Dr. Hicks is active in infectious disease research with an emphasis on new treatment and medications for individuals with HIV/AIDs. He is widely published in critically reviewed medical journals, including the Journal of Infectious Disease, the American Journal of Medicine, Annals of Internal Medicine, the Journal of American Medical Association, Clinical Infectious Diseases, AIDS and AIDS Research and Human Retroviruses.
 
As a professor of clinical medicine, Dr. Hicks is involved in training and mentoring medical students, residents and fellows at UC San Diego School of Medicine.  Prior to joining UC San Diego Health System, Dr. Hicks served as a professor of medicine at Duke University Medical Center. When not at work, Dr. Hicks enjoys spending time with his family and enjoying a nice glass of wine!
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:
Richard A. Elion, MD
Associate Clinical Professor of Medicine
George Washington University School of Medicine
Washington, DC
 
Disclosures:
Consultant: Gilead, Janssen, ViiV
Speakers Bureau: Bristol-Myers Squibb, Gilead, Janssen, Merck, ViiV
Contracted Research: AbbVie, Bristol-Myers Squibb, Gilead, Janssen, Merck, ViiV
 
Charles Hicks, MD
Professor of Medicine
Director
Owen Clinic
University of California
San Diego, CA
 
Disclosures:
Advisory Board: Bristol-Myers Squibb, Gilead, Merck, Janssen, ViiV
Contributor: UpToDate
 
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 1.0 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 rapid advances in HIV management, health care providers need to remain informed about guideline changes, developments in antiretroviral therapy, and special issues for patients with concurrent infections. This interactive, case-based CME activity will review evidence-based guidelines for initiating antiretroviral therapy in patients who also require treatment/prevention of opportunistic infections. Expert commentaries offered by faculty will discuss ways to optimize treatment strategies that incorporate clinical research and guidelines into practice.

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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