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Printable Handouts
Navigable Slide Index
- Introduction
- Talk outline
- Goals of antiretroviral therapy (ART)
- Outcomes of successful HIV therapy
- Effect of Zidovudine on HIV
- The revolution of “triple therapy”: 1996
- How far we came
- Treatment works
- Impact of ART on life expectancy
- Mortality & ART coverage
- Why is ART (if started) so successful?
- Convenience: dramatic gains since mid-1990’s
- When to start HIV treatment?
- When to START?
- Begin at the START
- Immediate ART prevents AIDS
- Treat early but also immediately after diagnosis
- Models of linkage to care
- What about elite controllers (EC)?
- Start by providing antiretroviral therapy
- HIV: what to start in 2018?
- Targets for HIV treatment
- Antiretroviral therapy 2018: >25 options
- Recommended initial antiretroviral therapy
- What to start
- Currently available ART classes
- Randomized controlled trials: INSTI vs. NNRTI
- Randomized controlled trials: INSTIs vs. PI
- Shift to integrase inhibitor-based therapy
- New integrase inhibitor (Bictegravir)
- ONCEMRK
- Integrase inhibitors
- Continued improvement in ART classes
- Reducing HIV therapy toxicity
- Tenofovir alafenamide (TAF)
- TAF vs. TDF
- TAF/FTC switch study
- TAF or TDF
- New drugs to control HIV drug resistance
- Virologic failure and resistance emergence
- Resistant HIV-1 will always be with us
- Possible new agents for resistant HIV-1
- Rapid ART initiation for new diagnoses
- Antiretroviral therapy in prevention
- Viral load predicts heterosexual transmission
- Probability of HIV transmission per coital act
- HIV transmission by stage of infection
- ART for prevention of HIV transmission
- The impact of ART on HIV transmission
- HIV transmission according to sexual behavior
- Pre-exposure prophylaxis (PrEP)
- Clinical trial evidence for HIV prevention options
- PrEP works if you take It
- Effect of PrEP implementation on HIV incidence
- HIV cure: current approaches
- Definitions count, what do we mean “cure”?
- Current efforts
- National HIV/AIDS strategy: 2020 goals
- Thank you
Topics Covered
- Goals and benefits of antiretroviral therapy
- When to begin antiretroviral treatment
- First line and HIV treatment model
- Avoiding side effects and drug resistance
- New approaches in progress
- Role of antiretroviral drugs in prevention of infection
- Curing HIV infection
- HIV care systems
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Volberding, P. (2018, August 30). HIV therapy: taking advantage of progress [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 26, 2024, from https://doi.org/10.69645/PQOI3006.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Paul Volberding has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Immunology
Transcript
Please wait while the transcript is being prepared...
0:00
HIV therapy. Taking advantage of progress,
and I'm Paul Valberding from the University of California, San Francisco.
0:10
The outline of my presentation is shown on this slide.
I'll talk about the goals and benefits of therapy.
When treatment should start.
What is the recommend first-line treatment?
Can side effects and drug resistance be avoided?
What new approaches are in progress?
The role of antiretroviral drugs in prevention?
What is being done to cure HIV infection?
And then finally, and a very brief summary of various approaches to HIV care systems.
0:36
The goals of HIV therapy are really quite simple.
First, we want to suppress HIV replication to levels
non-detectable by the most sensitive available assays.
We want to continue lifelong treatment with no interruptions.
We want to avoid all drug toxicity both short and long-term,
and we want to treat all infected persons globally as soon as HIV is diagnosed.
1:02
If we do our best,
what are the outcomes of successful HIV therapy?
We will see the CD4 counts stay or rise to healthy levels.
We will prevent opportunistic diseases,
and we will prevent all further HIV transmission by all routes.
1:21
In our early days of therapy showed that we could slow the virus down,
but our earliest treatments did not reverse the disease.
This is a typical slide of
an AZT trial in the early days of the epidemic where you see that compared to placebo,
AZT slowed the time of decline in the CD4 cell count,
but it didn't make the CD4 cell count increase.