Contemporary Management of HIV 2021: Heavily Treatment–Experienced Patients—Audio Recap, Part 3

09/07/21 • 16 min

In this series of 3 episodes, Geeta Gupta, MD, discusses strategies for optimizing ART in heavily treatment–experienced patients with HIV, including management of virologic failure and switching ART in virologically suppressed patients with underlying resistance. The 3 episodes will include analyses from:

BENCHMRK, which demonstrated that the number of active drugs predicts outcomes in treatment-experienced patients
TMB-301, a study that added the monoclonal antibody ibalizumab in pretreated patients with multidrug-resistant HIV and demonstrated significant decreases in HIV-1 RNA
BRIGHTE, which showed that the addition of fostemsavir in heavily treatment–experienced patients with HIV led to a significant decrease in HIV-1 RNA
VIKING-3, a study that demonstrated the addition of DTG dosed BID in INI-resistant patients was effective in decreasing HIV-1 RNA
SWITCHMRK, a study that showed underlying resistance matters when deciding to switch regimens in a treatment-experienced, virologically suppressed patient, especially when switching to a regimen with a low barrier to resistance
DAWNING, a study that demonstrated that DTG, when added to 2 NRTIs, was superior to RTV-boosted LPV in patients with virologic failure on an NNRTI plus 2 NRTIs
BRAAVE, which evaluated safety and efficacy of switching to BIC/FTC/TAF in Black patients virologically suppressed on 2 NRTIs plus a third agent

In addition, Dr. Gupta reviews current DHHS ART guideline recommendations related to managing virologic failure, including drug resistance testing and drug selection, as well as switching recommendations in patients with viral suppression and underlying drug resistance.

Presenter:

Geeta Gupta, MD
Professor
Director, AIDS Education and Training Center
University of California, Irvine
Orange, California

Follow along with the slides at:
https://bit.ly/3zxKBfL

Content based on an online CME program supported by an educational grant from ViiV Healthcare.

Link to full program:
https://bit.ly/3ux6FF8

BENCHMRK, which demonstrated that the number of active drugs predicts outcomes in treatment-experienced patients
TMB-301, a study that added the monoclonal antibody ibalizumab in pretreated patients with multidrug-resistant HIV and demonstrated significant decreases in HIV-1 RNA
BRIGHTE, which showed that the addition of fostemsavir in heavily treatment–experienced patients with HIV led to a significant decrease in HIV-1 RNA
VIKING-3, a study that demonstrated the addition of DTG dosed BID in INI-resistant patients was effective in decreasing HIV-1 RNA
SWITCHMRK, a study that showed underlying resistance matters when deciding to switch regimens in a treatment-experienced, virologically suppressed patient, especially when switching to a regimen with a low barrier to resistance
DAWNING, a study that demonstrated that DTG, when added to 2 NRTIs, was superior to RTV-boosted LPV in patients with virologic failure on an NNRTI plus 2 NRTIs
BRAAVE, which evaluated safety and efficacy of switching to BIC/FTC/TAF in Black patients virologically suppressed on 2 NRTIs plus a third agent

Presenter:

Geeta Gupta, MD
Professor
Director, AIDS Education and Training Center
University of California, Irvine
Orange, California

Follow along with the slides at:
https://bit.ly/3zxKBfL

Content based on an online CME program supported by an educational grant from ViiV Healthcare.

Link to full program:
https://bit.ly/3ux6FF8

Previous Episode

Tackling Racial Disparities in HBV Care

In this episode, Mindie H. Nguyen, MD, MAS, AGAF, FAASLD, and Lewis R. Roberts, MB ChB, PhD, examine the HBV burden and care disparities in specific populations, including Asian Americans and foreign-born immigrants, and strategies to address barriers to care.

Presenters:

Mindie H. Nguyen, MD, MAS, AGAF, FAASLD
Professor of Medicine
Department of Gastroenterology and Hepatology
Stanford University Medical Center
Palo Alto, California

Lewis R. Roberts, MB ChB, PhD
Professor of Medicine and Consultant
Division of Gastroenterology and Hepatology
Mayo Clinic
Rochester, Minnesota

Content based on a CME program supported by educational grants provided by AbbVie; Gilead Sciences, Inc.; and Janssen Therapeutics, Division of Janssen Products, LP

To follow along, download the slides at:
https://bit.ly/3gWStjZ

Link to full program:
https://bit.ly/3kKIb9a

Next Episode

Contemporary Management of HIV 2021: New Data From IAS 2021—Audio Recap, Part 1

In this first of 2 episodes, Shobha Swaminathan, MD, and Eric S. Daar, MD, review key data influencing their practice following the IAS 2021 Conference, including results from studies on HIV and COVID-19 outcomes; virologic and metabolic outcomes of DTG/3TC; long-acting CAB plus RPV for ART in treatment-naive PWH.

This episode includes discussion of:

A Global Clinical Platform that evaluated outcomes of PWH hospitalized with COVID-19
A post hoc analysis of TANGO, evaluating the virologic and metabolic outcomes when switching to DTG/3TC vs continued 3- or 4-drug TAF-based regimens
A Week 48 analysis of SALSA, demonstrating virologic efficacy and favorable safety profile of switching to DTG/3TC vs continuing a 3-drug ART regimen

Presenters:

Eric S. Daar, MD
Chief, Division of HIV Medicine
Harbor-UCLA Medical Center
Professor of Medicine
David Geffen School of Medicine at UCLA
Los Angeles, California

Shobha Swaminathan, MD
Associate Professor
Division of Infectious Diseases
Department of Medicine
Rutgers New Jersey Medical School
Newark, New Jersey

Follow along with the slides at:
https://bit.ly/3hvRN5b

Content based on an online CME program supported by an educational grant from ViiV Healthcare.