A Look Back at 2010 HIV/AIDS Research (Part 2) Expert Commentary A Clinical Context Report

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Supported in part by an educational grant from Bristol-Myers Squibb A Look Back at 2010 HIV/AIDS Research (Part 2)

Clinical Context Series Target Audience The goal of this program is to provide HIV/AIDS specialists, virologists, infectious disease specialists, experts in the care of patients with HIV/AIDS, physician assistants and nurse practitioners with up-to-date information and multiple perspectives on the pathogenesis, symptoms, risk factors, and complications of HIV/AIDS as well as current and emerging treatments and best practices in the management of HIV/AIDS.

Activity Learning Objectives

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CME Information Credit Designation Credit Designation Albert Einstein College of Medicine designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credits.™ Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Barry S. Zingman, MD Medical Director AIDS Center Montefiore Medical Center Professor of Clinical Medicine Albert Einstein College of Medicine Bronx, NY Discussant

Disclosure Information Barry S. Zingman, MD, has disclosed that he has no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity.

Disclosure Information and have disclosed that they have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity. Dori F. Zaleznik, MD, Associate Clinical Professor of Medicine, Harvard Medical School, Boston, Michael Smith and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner, have disclosed that they have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity. andhave no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity. The staff of Albert Einstein College of Medicine, MedPage Today, and Projects In Knowledge have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity.

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Raltegravir 770 treatment-naive patients Once-daily raltegravir (800 mg) versus 400 mg bid 83.2% of once-daily patients undetectable versus 88.9% of bid patients Difference exceeded pre-set noninferiority margin Source: Eron J, et al "QDMRK, a phase III study of the safety and efficacy of once daily vs twice daily RAL in combination therapy for treatment-naïve HIV-infected patients" CROI 2011

TLC-Plus (HPTN 065) Two test cities: Washington, DC, and the Bronx, NY Four nonintervention cities: Chicago, Houston, Miami, Philadelphia Intervention includes: Expanded HIV testing with social mobilization, targeted messaging to promote testing, universal testing in emergency departments and hospital inpatient admissions. Linkage-to-Care and Viral Suppression components randomize sites to test a financial incentive compared with standard care. Currently under way; three-year duration. HIV Prevention Trials Network.

iPrEX Phase III randomized clinical trial Tenofovir/emtricitabine (Truvada) versus placebo Healthy volunteers at high risk for HIV Drugs reduced risk of acquiring HIV 44% compared with placebo Among those with at least 90% adherence, risk reduced 73% Grant RM, et al. "Preexposure chemoprophylaxis for HIV prevention in men who have sex with men" N Engl J Med 2010

Raltegravir once a day proved inferior to bid dosing in treatment-naive patients The TLC-Plus trial is testing different ways of expanding HIV testing and treatment The iPrEX trial showed that prophylactic medications can reduce the likelihood of acquiring HIV in a high-risk population Summary At the end of this activity, participants should understand:

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