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HIV Infection: An Update on Antiretroviral Therapy

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Overview

   Twenty five years after the first case of AIDS was reported, the HIV epidemic remains at global proportions. The number of new HIV infections in the U.S. appears to have stabilized at about 55, 000 cases per year. Although this is a big increase over previous estimates, it results from improved reporting rather than an actual increase in new cases. A “cure” for HIV or an effective vaccine is unlikely to be introduced in the next few decades. Vaccine trials have been stopped due to higher rates of HIV infection among those vaccinated.

   There are currently 23 approved anti-HIV agents among 6 classes. The newer drugs may improve adherence because of improved tolerability. New agents also allow most patients who have failed several drug regimens to achieve viral suppression similar to that of patients who are on their first anti-HIV drug regimen.

   This issue reviews the 6 classes of anti-HIV drugs and the current recommendations for first-line treatment of HIV infection. Recently discovered life-threatening adverse effects of individual agents and long-term HAART are discussed. Easy-to-use tables provide detailed information on appropriate doses, administration strategies, side effects, and key drug interactions to help you effectively participate in drug therapy management. In the Rx Patient Connection, you’ll find the answers to commonly asked questions about HIV medications, including why “drug holidays” are no longer considered a good idea.

Publication Date: Nov-1-08
Expiration Date: Nov-1-11
CE Credit: 2.5 (0.25 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Betty J. Dong, Professor of Clinical Pharmacy, University of California, San Francisco and HIV Pharmacist Specialist for the National HIV Clinicians’ Consultation Center, the Family HIV Clinic at San Francisco General Hospital, the Correctional Medicine Consultation Center, and the International Training and Education Centers for HIV (ITECH).

Disclosure Statement

Disclosure of any financial or personal relationship between the author(s) and any commercial interest producing, marketing, reselling, or distributing a product that appears in this issue is a requirement of publication in The Rx Consultant.Dr. Dong reports she is an investigator on a study funded by Merck.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Identify the preferred antiretroviral regimens for treatment of antiretroviral naïve persons.
    2. Discuss the mechanism, adverse effects, drug interactions, and role in therapy of the newest FDA approved ARVs.
    3. Counsel patients about the proper dosage, administration, side effects, and drug interactions associated with the newest ARVs.
    4. Identify the major complications associated with HAAR and stopping HAART.

Exam & Credit Statement procedures

Upon successful completion of this program and the post test (70%), 2.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Lecturer
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
And
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD


Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

CE for this article is no longer valid.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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CE for this article is no longer valid.