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insulin resistance
  Français - August 16, 2011
CMEonHIV.com is dedicated to providing online CME presentations (slides with voiceover) on HIV/AIDS for healthcare professionals given by local and international experts to keep you up-to-date on the ongoing developments in the field.
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New and interesting topics in HIV medicine are always emerging and we present those here.



Panel Discussion - Panel Discussion
Economics in HIV - More than counting beans? - Dr. Jonathan Anderson
Vaccines and immunotherapy for HIV - Prof. Stephen Kent
Clinical Pharmacology in the HIV Clinic - Dr. Elizabeth Phillips
Strengths and pitfalls of using observational studies to... - Dr. Marina Klein
Double Trouble - HIV and HSV - Dr. Robert Finlayson
HIV infection and injecting drug use: a global perspective - Dr. Alex Wodak
HIV and Syphilis - Dr. Darren Russell
Introduction: Initiating and Managing Treatment with... - Prof. Mark Wainberg
Initiating HAART with Abacavir - Dr. Richard Lalonde
Clinical Diagnosis - Dr. Anita Rachlis
Managing Abacavir Hypersensitivity - Dr. Elizabeth Phillips
Patient Counseling - Linda Robinson and Dr. John MacLeod
Course Evaluation -
HPV-16, 18, 31, 45 Viral Loads in Anal Intraepithelial... - Dr. Alexandra de Pokomandy
Intermediate Antiretroviral (ARV) Adherence Thresholds and... - Jesse Raffa
From Lab to Clinic: Potential Applications of... - Dr. Anita Rachlis
Subtype C Isolates Rapidly Select for K65R Resistance with... - Dr. Bluma Brenner
Clinical Applications of Pharmacogenetics in HIV - Dr. Simon Mallal
Clinical Applications of Pharmacogenetics/Pharmacogenomics... - Dr. Mona Loutfy
Matters of the Heart: Insulin resistance and HIV - Dr. Greg Bondy
Chairman's Introduction - Dr. Jens Lundgren
Is it Superior to be Non-inferior? - HIV Statistics made... - Naomi Givens
CMEonHIV.com Pharmacists' Section - Linda Robinson
Plenary Session: Clinical Sciences - Dr. Daniel R. Kuritzkes
DXA-Derived Body Composition Parameters: Association with... - Dr. Julian Falutz
Edmonton dot for HAART II : Inner city patient retention,... - Wendi Monahan
Impact of depression on all cause mortality among men and... - Dr. Robert Hogg
Simplified protease inhibitor trial : Antiviral effect of... - Dr. Marianne Harris
The effect of a psychotherapeutic intervention support on... - Nimâ Machouf
HIV-Infected intravenous drug users (ivdus) on Nevirapine... - Jesse Raffa
Metabolic Toxicities from Antiretroviral Drugs According to... - Rosa Morales
Outcome of Initial HAART Regimen in HIV-HCV Co-Infecttion - CL Cooper
Distinct Patterns of Drug Susceptibility and Fitness for... - Dr. Bluma Brenner
Genotypic Resistance Assay for Entire GP41 Sequence with... - Dr. Mona Loutfy
Nucleotide and Amino Acid Polymorphisms at Drug Resistance... - Dr. Dan Turner
Hepatitis C (HCV) Co-Infection reduces success of... - Dr. Marina Klein
Study Case : Case Presentations by Attendees to the Faculty - Dr. Peter Phillips
Short course directly observed therapy (DOT) with... - Harout Tossonian

 Conference 
"Panel Discussion"
Panel Discussion (biography)
English - 2009-04-24 - 7 minutes
(7 slides)

   


 Conference 
"Economics in HIV - More than counting beans?"
Dr. Jonathan Anderson (biography)
English - 2009-02-12 - 40 minutes
(50 slides)

Summary :
Economics can seem like counting beans, says Dr. Anderson, but it doesn’t represent what economics is really about.

In economic evaluation, the costs and outcomes are compared for two different courses of action. The incremental cost-effectiveness ratio represents Cost A minus Cost B divided by Outcomes A minus Outcomes B. This ratio is used to decide between one intervention and another. Dr. Anderson shows some examples of how such decisions are made in Australia, referring to antenatal testing for HIV, pre-exposure prophylaxis, post-exposure prophylaxis, circumcision, and sex worker STI checks.

The Prescription Benefits Advisory Committee (PBAC) advises the government on the effectiveness and cost-effectiveness of new ARVs. For example, darunavir was recently reported to cost $15, 000 to $45, 000 per quality adjusted life year gained, and raltegravir from $45,000 to $75,000.

Health economics gets used for funding of medications and procedures, and review of funding. Dr. Anderson talks about how health economics can be abused in decision making; and the Assessing Cost-Effectiveness Approach (ACE) which is being used to prioritise interventions based on economics plus a range of factors.

Copyright © 2009 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The role of economics in the health field
- The meanings of common economics terms
- Economics studies in HIV
- How economics gets used and abused
- Future research

   


 Conference 
"Vaccines and immunotherapy for HIV"
Prof. Stephen Kent (biography)
English - 2008-10-10 - 45 minutes
(51 slides)

Summary :
It is estimated that around 33 million people, globally, live with HIV (UNAIDS, 2007). Considerable research is currently being focused on developing a vaccine against this virus, as many specialists believe that it is vital to halting the HIV pandemic. Prof. Kent explains why a dead protein vaccine is considered inadequate and a live attenuated vaccine is considered unsafe, which leaves current efforts directed towards the development of a genetically engineered ‘live’ vector vaccine. In order to be effective, this vaccine should induce T cell responses against HIV and, ideally, broad neutralizing antibodies to HIV.

A recent trial, the STEP trial, was conducted to evaluate a vaccine composed of an adenovirus vector expressing parts of HIV. Prof. Kent explains the results released in 2007 and the repercussions they have had on research in this field. The trial was halted, as the vaccine not only was found to be ineffective, both for preventing infection and for attenuating viral loads in those infected, but appeared to result in a higher rate of HIV infections in patients having been previously exposed to adenoviruses.

Lastly, Prof. Kent discusses therapeutic vaccines, the idea of which is based on the hypothesis that sensitizing an infected patient’s immune system to HIV will reduce viral loads by countering the virus’ ability to avoid presentation to the host’s immunity cells. The OPAL study (1) was conducted in infected macaques using an SIV vaccine aiming to evoke CD4 and CD8 T cell responses to either the gag protein alone, or to several peptides at once. Prof. Kent examines its results pertaining to the decrease in viral load, the safety, and the immunogenicity associated with the vaccine, and explains future plans in this specific area of research.


Copyright © 2009 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, the participant will be able to discuss:

-Epidemiological data on HIV prevalence
-HIV-1 preventive vaccine development strategies and the results they have yielded so far
-Development of a therapeutic vaccine, and the OPAL study

Bibliographic references :
(1) Chea et al Induction of T-Cell Immunity to Antiretroviral Drug-Resistant Human Immunodeficiency Virus Type 1 J Virol. 2005 June; 79(12): 7728–7737

   


 Conference 
"Clinical Pharmacology in the HIV Clinic"
Dr. Elizabeth Phillips (biography)
English - 2008-07-21 - 75 minutes
(51 slides)

Summary :
As more options open up in the field of HIV drugs, it has become possible to look for medication that fits patients on an individual level, minimizing adverse effects. In the past decade, many pharmacogenetic associations in HIV have been suggested. Only a few of the studies have been reproduced, and these are detailed by Dr. Phillips in this conference.

The presence of the HLA-B*5701 allele is a predictive factor for abacavir hypersensitivity in most cases. There has been some discussion as to whether it should be screened for in all patients before prescription of HIV medication, as opposed to members of populations known to have a higher prevalence of carriage being screened only. A strong argument in the favor of doing so is that with current globalization trends, racial phenotypic statistics are becoming increasingly unreliable.

Another association that has been made is between the CYP2B6 G516T polymorphism and efavirenz pharmacokinetics. The metabolism of the drug being affected, an adjustment in dose may be required depending on the genotype of the patient. Another issue to be considered is the interaction efavirenz may have with rifampin, an agent used to treat tuberculosis. Additional studies must be conducted before the importance of this interaction can be confirmed.

The combination of HIV treatment with oral contraceptives has also been investigated, leading to the conclusion that it is advisable to use additional methods of contraception with all boosted protease inhibitors, efavirenz, and nevirapine.

With tenovir, the main concern is renal disease. Several risk factors have been identified, such as anemia and hypertension, and a recent study recommends monitoring the glomerular filtration rate.

The efficacy of different drugs must also be considered. An important aspect is compartmentalization and how much of the drug enters the central nervous system, which determines how effective a drug will be in preventing HIV dementia and progressive multifocal leukoencephalopathy. From a more general perspective, several questions have been raised and are under investigation, such as which is the best combination of agents and how early treatment for HIV should begin.

Finally, Dr. Phillips talks about the risk of cardiovascular disease in HIV and the risk of myocardial infarction with use of abacavir, ddI, and thymidine, with mention of a study identifying biomarkers that are affected by HIV treatment.

Copyright © 2008 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation the participant will be able to discuss current data on:
-Interactions between HIV drugs and host
-Pharmacogenetic associations in HIV
-HIV drugs and cardiovascular risk

Bibliographic references :
Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. January 29, 2008; 1-128.

Mallal S, Phillips E, Carosi G, Molina JM, Workman C, Tomazic J, Jägel-Guedes E, Rugina S, Kozyrev O, Cid JF, Hay P, Nolan D, Hughes S, Hughes A, Ryan S, Fitch N, Thorborn D, Benbow A; PREDICT-1 Study Team.HLA-B*5701 Screening for Hypersensitivity to Abacavir N Engl J Med. 2008 Feb 7;358(6):568-79

Haas DW, Ribaudo HJ, Kim RB, Tierney C, Wilkinson GR, Gulick RM, Clifford DB, Hulgan T, Marzolini C, Acosta EP.Pharmacogenetics of efavirenz and central nervous system side effects: an Adult AIDS Clinical Trials Group study AIDS. 2004 Dec 3;18(18):2391-400.

Scott Letendre, MD; Jennifer Marquie-Beck, BS; Edmund Capparelli, PharmD; Brookie Best, PharmD; David Clifford, MD; Ann C. Collier, MD; Benjamin B. Gelman, MD, PhD; Justin C. McArthur, MPH, MBBS; J. Allen McCutchan, MD; Susan Morgello, MD; David Simpson, MD; Igor Grant, MD; Ronald J. Ellis, MD, PhD; for the CHARTER GroupValidation of the CNS Penetration-Effectiveness Rank for Quantifying Antiretroviral Penetration Into the Central Nervous System Arch Neurol. 2008 Jan;65(1):65-70

Strategies for Management of Antiretroviral Therapy (SMART) Study Group, El-Sadr WM, Lundgren JD, Neaton JD, Gordin F, Abrams D, Arduino RC, Babiker A, Burman W, Clumeck N, Cohen CJ, Cohn D, Cooper D, Darbyshire J, Emery S, Fätkenheuer G, Gazzard B, Grund B, Hoy J, Klingman K, Losso M, Markowitz N, Neuhaus J, Phillips A, Rappoport C.CD4+ count-guided interruption of antiretroviral treatment N Engl J Med. 2006 Nov 30;355(22):2283-96

   


 Conference 
"Strengths and pitfalls of using observational studies to determine therapeutic benefits/harm"
Dr. Marina Klein (biography)
English - 2008-04-25 - 25 minutes
(23 slides)

Summary :
The reason that randomized control trials are the gold standard in study design for assessing efficacy is that they present the advantages of eliminating conscious bias in physician selection and patient self-selection, and of balancing unknown confoundings and biases that affect the outcome. However, Dr. Klein points out the disadvantages of randomized clinical trials. Having to follow such large numbers of patients over a significant period of time is an obstacle, not only to the ease of conduct of the study, but to the feasibility of the trial and the generalization of the results.

An interesting alternative that permits the study of rare events and toxicities is the use of observational studies with large cohorts and cohort collaborations, such as the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). This allows the accumulation of very large numbers of patients without incurring significant additional costs.

Dr. Klein discusses the problems associated with this method of investigation, and the strategies that can be used to managed them.

One of the major issues is called confounding, which is the result of naturally occurring associations between different risk factors. This confuses the relationship we are interested in with the effect of something else. When this concept is applied to the prescription of different medications amongst patients with the same medical condition, it is referred to as confounding by indication. Similarly, drug channeling is the preferential prescription of drug therapies with similar indications to patients according to their baseline prognoses.

Another problem that must be monitored is the determination of causality. A drug does not necessarily cause the outcome to which it is associated by observation. Thus, Dr. Klein outlines a set of criteria against which to measure the causal association.

Copyright © 2008 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation the participant will be able to discuss:

-The strengths and limitations of clinical trials vs observational studies

   


 Conference 
"Double Trouble - HIV and HSV"
Dr. Robert Finlayson (biography)
English - 2007-08-20 - 28 minutes
(30 slides)

Summary :
In HIV-positive individuals co-infection with Herpes Simplex Virus (HSV) is common.

HSV-2 infection has been associated with an increased risk of HIV seroconversion (1), and the natural history of genital herpes in HIV co-infected individuals is different than in non-HIV infected persons (2).

The Rakai study showed that genital ulcer disease increased the risk of HIV transmission in 174 monogamous HIV-discordant couples (3). Another study from Pune, India found that recent HSV-2 infection was associated with higher risk of acquiring HIV (4). HSV infection also activates HIV replication and may facilitate the transmission of HIV-1 (5). HIV is a risk factor for HSV reactivation (6).

What is the interaction between HSV-1 and HIV-1 in AIDS pathogenesis? A cell line chronically infected by HIV-1 and HSV-1 has been created that produces HIV-1 particles pseudotyped by the HSV-1 envelope – a recombinant virion that could infect a large spectrum of CD4 cells. This could spread HIV-1 infection to different organs, and lead to a high HIV-1 viral load in the absence of circulating CD4 cells in the terminal phases of AIDS.

Dr. Finlayson discusses the strength of the evidence in support of HSV facilitating the acquisition of HIV and transmission of HIV, and how this affects clinical practice.

Copyright © 2008 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- HSV-2 infection and the risk of HIV acquisition
- HSV-2 infection and the risk of HIV transmission
- Clinical implications

Bibliographic references :
1. Keet IP, Lee FK, van Griensven GJ, Lange JM, Nahmias A, Coutinho RA.
Herpes simplex virus type 2 and other genital ulcerative infections as a risk factor for HIV-1 acquisition. Genitourin Med. 1990 Oct;66(5):330-3.

2. Augenbraun M, Feldman J, Chirgwin K, Zenilman J, Clarke L, DeHovitz J, Landesman S, Minkoff H.Increased Genital Shedding of Herpes Simplex Virus Type 2 in HIV-Seropositive Women Ann Intern Med. 1995 Dec 1;123(11):845-7.

3. Gray RH, Wawer MJ, Brookmeyer R, Sewankambo NK, Serwadda D, Wabwire-Mangen F,
Lutalo T, Li X, vanCott T, Quinn TC; Rakai Project Team.
Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda Lancet. 2001 Apr 14;357(9263):1149-53.

4. Steven J. Reynolds et al. Recent Herpes Simplex Virus Type 2 Infection and the Risk of Human Immunodeficiency Virus Type 1 Acquisition in India The Journal of Infectious Diseases 2003;187:1513–1521.

5. CHEN, CHENG Y et al. Human Immunodeficiency Virus Infection and Genital Ulcer Disease in South Africa: The Herpetic Connection.
Sexually Transmitted Diseases. 27(1):21-29, January 2000.

6. Erlich KS, Mills J, Chatis P, Mertz GJ, Busch DF, Follansbee SE, Grant RM, Crumpacker CS. Acyclovir-resistant herpes simplex virus infections in patients with the acquired immunodeficiency syndrome. N Engl J Med. 1989 Feb 2;320(5):293-6.

   


 Conference 
"HIV infection and injecting drug use: a global perspective"
Dr. Alex Wodak (biography)
English - 2007-08-20 - 48 minutes
(28 slides)

Summary :
HIV infection among injecting drug users (HIV/IDUs) has become a recognised problem in an increasing number of countries. Some HIV/IDU epidemics evolve slowly and some rapidly, and the rate is unpredictable.

HIV prevention among IDUs involves education, needle syringe programs, drug treatment, and community development. This strategy is often referred to as "harm reduction", which implies that reducing harm from drugs is a higher priority than reducing consumption. This is a widespread public health approach, though still not accepted in the USA and Sweden.

Harm reduction is safe, effective and cost-effective. Dr. Wodak discusses some issues with implementation, and makes some concluding comments.

Copyright © 2008 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Epidemiology of HIV in injection drug users
- History of the global illicit drug problem
- Strategies to control the spread of HIV in IDUs
- Harm reduction implementation: issues

   


 Conference 
"HIV and Syphilis"
Dr. Darren Russell (biography)
English - 2007-05-26 - 41 minutes
(30 slides)

Summary :
In this presentation Dr. Russell discusses the manifestations of syphilis in HIV-infected individuals, some epidemiological data and treatment concerns.

According to data from the National Centre in HIV Epidemiology and Clinical Research, the diagnosis rate of syphilis per hundred thousand is much higher in the Northern Territory than elsewhere in Australia, and this is largely due to the high rates in Indigenous populations. Since 2001 however syphilis rates in the Northern Territory have been dropping. Data from New South Wales show a sharp increase in infectious syphilis notifications in homosexually active men since 2001-2002.

A study published in 2004 concluded that syphilis facilitates the transmission of HIV, and regular syphilis screening of HIV-infected individuals is warranted (1). Dr. Russell shows the clinical manifestations of syphilis in HIV-infected individuals, and discusses HIV and neurosyphilis (2) and the diagnosis of neurosyphilis.

With regards to treatment of non-tertiary syphilis in HIV, Dr. Russell talks about the use of intramuscular benzathine penicillin G versus procaine penicillin, then what should be the serological follow-up after treatment, and finally, screening.

Copyright © 2007 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation the participant will be able to discuss:

HIV and syphilis:
- Epidemiology
- Transmission dynamics
- Clinical interactions
- Treatment
- Screening

Bibliographic references :
1. Buchacz, Kate; Patel, Pragna; Taylor, Melanie; Kerndt, Peter R; Byers, Robert H; Holmberg, Scott D; Klausner, Jeffrey DSyphilis increases HIV viral load and decreases CD4 cell counts in HIV-infected patients with new syphilis infections AIDS. 18(15):2075-2079, October 21, 2004.

2. Libois A, De Wit S, Poll B, Garcia F, Florence E, Del Rio A, Sanchez P, Negredo E, Vandenbruaene M, Gatell JM, Clumeck N.
HIV and Syphilis: When to Perform a Lumbar Puncture Sexually Transmitted Diseases. 34(3):141-144, March 2007.

   


 Conference 
"Introduction: Initiating and Managing Treatment with Abacavir - A Self-Learning Program"
Prof. Mark Wainberg (biography)
English - 2007-03-15 - 5 minutes
(11 slides)

Learning objectives :
After completing this program, the participant will be able to:
- Describe strategies for initiating HAART
- Discuss benefits of abacavir therapy, either initial or secondary
- Recognize hypersensitivity reactions to abacavir
- Explain the value of histocompatibility testing as a strategy to reduce the risk of hypersensitivity reactions

   


 Conference 
"Initiating HAART with Abacavir"
Dr. Richard Lalonde (biography)
English - 2007-03-15 - 25 minutes
(33 slides)

Learning objectives :
After completing this module, the participant will be able to:
- Describe strategies for initiating HAART
- Discuss benefits of abacavir therapy, either initial or secondary
- Recognize hypersensitivity reactions to abacavir
- Explain the value of histocompatibility testing as a strategy to reduce the risk of hypersensitivity reactions

   


 Conference 
"Clinical Diagnosis"
Dr. Anita Rachlis (biography)
English - 2007-03-15 - 25 minutes
(31 slides)

Learning objectives :
After completing this module, the participant will be able to:
- Critically evaluate the clinical diagnosis of a true hypersensitivity reaction to abacavir
- Provide a differential diagnosis of a hypersensitivity reaction in association with confounding factors and symptoms

   


 Conference 
"Managing Abacavir Hypersensitivity"
Dr. Elizabeth Phillips (biography)
English - 2007-03-15 - 25 minutes
(27 slides)

Learning objectives :
After completing this module, the participant will be able to:
- Comprehend the standards of care for potential abacavir hypersensitivity reactions among HIV patients
- Comprehend real-life management of potential abacavir hypersensitivity reactions among HIV patients

   


 Conference 
"Patient Counseling"
Linda Robinson and Dr. John MacLeod (biography)
English - 2007-03-15 - 25 minutes
(33 slides)

Learning objectives :
After completing this module, the participant will be able to:
- Understand the issues surrounding initiating abacavir therapy for treatment-naïve and treatment-experienced patients
- Employ effective counseling strategies for patients initiating abacavir therapy, including those with hypersensitivity reactions

   


 Conference 
"Course Evaluation"
(biography)
English - 2007-03-15 - 5 minutes

   


 Conference 
"HPV-16, 18, 31, 45 Viral Loads in Anal Intraepithelial Lesions in HIV-seropositive Men"
Dr. Alexandra de Pokomandy (biography)
English - 2006-05-27 - 20 minutes
(21 slides)

Summary :
The Human Immunodeficiency and PapillomaVirus Research Group (HIPVIRG) is an ongoing prospective study following HIV infected men in the Montreal area. The objective is to examine the evolution of HPV induced anal intraepithelial neoplasia (AIN). This study gathered data on lifestyle, viral loads, CD4+ counts, anal cytology, HPV testing and anal biopsies. A cross-sectional study from this cohort was conducted by De Pokomandy and colleagues to explore the association of HPV 16, 18, 31, and 45 viral loads and the grade of AIN. This association was computed using multivariate logistic regression. Outcome was defined as high grade (AIN = 2 or 3) versus low grade (AIN = normal or 1) as identified by anal biopsies and the exposure to viral loads for the four HPV subtypes were measured by real-time PCR. Covariates of age, CD4+ count and smoking were adjusted for. Dr. De Pokomandy presents her findings on the level of HPV viral load as AIN lesion grade increases. Moreover, she discusses other potential risk factors for low grade versus high grade AIN.

Copyright © 2006 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- An overview of HIV and HPV (human papillomavirus) infection and anal intraepithelial neoplasia (AIN);
- The HIPVIRG cohort study;
- The association of HPV viral loads and the grade of AIN in HIV seropositive men.

   


 Conference 
"Intermediate Antiretroviral (ARV) Adherence Thresholds and the Development of Drug Resistance"
Jesse Raffa (biography)
English - 2006-05-26 - 19 minutes
(16 slides)

Summary :
Adherence to antiretroviral treatment can substantially contribute to the rate of emergence of HIV drug resistance mutations. It’s been widely accepted that emergence of drug resistance is directly proportional to the patients level of adherence to treatment. Otherwise stated, it’s generally believed that an adherence nearing 100 percent precludes the risk of developing resistance mutations. A study by Raffa and colleagues sought to disprove this notion.

In this talk, the speaker presents data examining HIV plasma viral load, genotypic resistance histories, treatment, and adherence (measured via a surrogate methadone adherence). Patients were stratified by adherence levels below 80 percent, between 80 and 90 percent, and above 90 percent. The rate of accumulation of drug resistance was measured using multiple poisson regression model. The results of this study reveal an interesting adherence threshold important in the emergence of drug resistance.

Copyright © 2006 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- Conventional belief in treatment adherence and the emergence of drug resistance;
- A study investigating specific adherence levels and the risk of drug resistance;
- Empirical models to predict drug resistance as a function of adherence.

Bibliographic references :
David L. Paterson, MB, BS, FRACP; Susan Swindells, MD; Jeffrey Mohr, MSW; Michelle Brester, RN; Emanuel N. Vergis, MD; Cheryl Squier, RN; Marilyn M. Wagener, MPH; and Nina Singh, MD Adherence to Protease Inhibitor Therapy and Outcomes in Patients with HIV Infection Ann Intern Med 2000, 133:21-30

   


 Conference 
"From Lab to Clinic: Potential Applications of Pharmacogenetics in HIV Clinical Practice"
Dr. Anita Rachlis (biography)
English - 2006-05-26 - 22 minutes
(14 slides)

Summary :
In this presentation, Dr. Rachlis provides a brief overview of the current clinical trials and impediments of antiretroviral therapy.

Since the introduction of highly active antiretroviral therapy (HAART), progression to AIDS and death rates have significantly declined. It is generally accepted that HAART has contributed profoundly to our progress towards treating the disease. Despite these efforts numerous caveats remain. Toxicity, drug resistance, and clinical benefits of timing of therapy continue to challenge us and shape our choice of initial antiretroviral treatments. Other important considerations when selecting a drug regimen include flexibility, versatility, and adherence.

Various clinical trials have, and continue to assess, the efficacy of fixed dose regimens. These include: zidovudine/lamivudine, abacavir/lamivudine, tenofovir/emtricitabine, and zidovudine/lamivudine/abacavir. Of particular focus in this presentation are clinical studies investigating abacavir and tenofovir in fixed dose regimens.

In conclusion, Dr. Rachlis reviews the benefits and pitfalls of these fixed dose regimens. Overall, this presentation provides a thorough overview of current clinical trials and considerations for initiating HAART.

Copyright © 2006 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- Efficacy of NRTI backbones;
- Toxicity of NRTI backbones.

Bibliographic references :
Joel E. Gallant, M.D., M.P.H., Edwin DeJesus, M.D., José R. Arribas, M.D., Anton L. Pozniak, M.D., Brian Gazzard, M.D., Rafael E. Campo, M.D., Biao Lu, Ph.D., Damian McColl, Ph.D., Steven Chuck, M.D., Jeffrey Enejosa, M.D., John J. Toole, M.D., Ph.D., Andrew K. Cheng, M.D., Ph.D., for the Study 934 Group
Tenofovir DF, Emtricitabine, and Efavirenz vs. Zidovudine, Lamivudine, and Efavirenz for HIV
N Engl J Med. 2006; 354:251-60

   


 Conference 
"Subtype C Isolates Rapidly Select for K65R Resistance with Tenofovir in Cell Culture"
Dr. Bluma Brenner (biography)
English - 2006-05-26 - 25 minutes
(15 slides)

Summary :
In under a quarter of a century, the AIDS epidemic has surpassed malaria and tuberculosis worldwide and is considered the leading cause of death in developing countries. Though highly active antiretroviral therapy (HAART) is successful in stabilizing this epidemic, the beneficiaries of HAART treatment are primarily in the western world. Africa, East Asia, and Eastern Europe bear the brunt of poverty and other factors conducive to the epidemic. In addition to these health disparities there are also increasing variations of HIV strains. Prior to 1984, HIV subtype B predominated most endemic areas, with the exception of Ethiopia where subtype C was more prevalent. Since 1984, non-B subtypes expanded at an alarming rate necessitating further research to understand treatment responses of these subtypes. In an in vitro model, Brenner and colleagues examine the genotype and phenotype of resistant strains. In this study, clinical virus isolates of various subtypes were exposed to tenofovir to assess the rate of selection for the K65R mutation. Isolates with differential response rates were further examined for phenotypic similarities.

Copyright © 2006 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- Epidemiology of HIV subtypes;
- Response to tenofovir in various HIV subtypes;
- Phenotypic profile among subtype variants.

   


 Conference 
"Clinical Applications of Pharmacogenetics in HIV"
Dr. Simon Mallal (biography)
English - 2006-05-26 - 35 minutes
(25 slides)

Summary :
Given on behalf of Dr. Elizabeth Phillips, Dr. Mallal presents pharmacogenetics and pharmacogenomics in clinical practice. Polymorphisms in both hosts and pathogens constitute a large challenge in therapy. Pathogenic adaptability, as seen in HIV, will shape the response to particular drug interventions. Similarly, the host genetic makeup will also affect the response to treatment. Drugs therefore help us elucidate these polymorphic backgrounds.

Pharmacogenetics refers to a clinical entity (phenotype) that is further characterized by genetics (genotype). Conversely, pharmacogenomics attempts to identify the genotype in order to predict the risk of developing a particular phenotype.

Pharmacogenetic and pharmacogenomic approaches in choosing an optimal antiretroviral regimen are exemplified in abacavir hypersensitivity reactions. Clinical diagnosis of abacavir hypersensitivity has been shown to yield false positives (CNA3005, CNA30024). This over diagnosis subsequently leads to prompt discontinuation of abacavir which incurs significant healthcare costs. A study by Dr. Phillips and colleagues (2005) demonstrated that disrupting treatment too early resulted in increased consultations with emergency physicians and/or specialists with higher costs for services. Furthermore, it took longer for these patients to achieve undetectable viral loads.

Studies show that abacavir hypersensitivity can be more accurately diagnosed with the patch test. Dr. Mallal reiterates the differences between pharmacogenetics and pharmacogenomics by pointing out that patch testing should be employed in abacavir sensitized individuals, therefore serving as a diagnostic test and not a predictive test.

Copyright © 2006 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation participants will be able to discuss:
- Pharmacogenetics versus pharmacogenomics;
- Pharmacogenetics and potential applications in HIV therapeutics;
- Benefits of patch testing in diagnosing abacavir hypersensitivity.

Bibliographic references :
Annalise M Martin, David Nolan, Silvana Gaudieri, Elizabeth Phillips, Simon Mallal. Pharmacogenetics of antiretroviral therapy: Genetic variation of response and toxicity Pharmacogenomics. Sept 2004, 5(6), 643-655.

David W. Haas, Heather J. Ribaudo, Richard B. Kim, Camlin Tierney, Grant R. Wilkinson, Roy M. Gulick, David B. Clifford, Todd Hulgan, Catia Marzolini, Edward P. Acosta. Pharmacogenetics of efavirenz and central nervous system side effects: An adult AIDS Clinical Trials Group study AIDS. December 3, 2004, 18(18), 2391-2400.

Ribaudo HJ, Haas DW, Tierney C, Kim RB, Wilkinson GR, Gulick RM, Clifford DB, Marzolini C, Fletcher CV, Tashima KT, Kuritzkes DR, Acosta EP; Adult AIDS Clinical Trials Group Study. Pharmacogenetics of plasma efavirenz exposure after treatment discontinuation: An adult AIDS clinical trials group study Clinical Infectious Diseases. Feb. 1, 2006, 42(3), 401-7.

Elizabeth Phillips, John Sullivan, Sandra Knowles, Neil Shear. Utility of patch testing in patients with hypersensitivity syndromes associated with abacavir AIDS. 8 Nov. 2002, 16(16), 2223-5.

Phillips, Elizabeth J.; Wong, Gavin A.; Kaul, Rupert; Shahabi, Kamnoosh; Nolan, David A.; Knowles, Sandra R.; Martin, Annalise M.; Mallal, Simon A.; Shear, Neil H. Clinical and immunogenetic correlates of abacavir hypersensitivity AIDS. 10 June 2005, 19(19), 979-981.

Annalise M. Martin, David Nolan, Silvana Gaudieri, Coral Ann Almeida, Richard Nolan, Ian James, Filipa Carvalho, Elizabeth Phillips, Frank T. Christiansen, Anthony W. Purcell, James McCluskey, and Simon Mallal. Predisposition to abacavir hypersensitivity conferred by HLA-B*5701 and a haplotypic Hsp70-Hom variant Proceedings of the National Academy of Sciences of the United States of America. 15 March 2004, 101(12), 4180-4185.

Simon Mallal. Host genetics unplugged: Removing the camouflage of viral adaptation. Current Opinion in HIV and AIDS. May 2006, 1(3), 218-219.

Elizabeth Phillips. The pharmacogenetics of antiretroviral therapy. Current Opinion in HIV and AIDS. May 2006, 1(3), 249-256.

   


 Conference 
"Clinical Applications of Pharmacogenetics/Pharmacogenomics in HIV"
Dr. Mona Loutfy (biography)
English - 2006-01-20 - 42 minutes
(34 slides)

Summary :
On behalf of Dr. Elizabeth Phillips, Dr. Mona Loutfy presents the clinical applications of pharmacogentics which is defined as the hereditary response to drugs. There are 3 different types of patients in a clinical setting; those that respond to the particular medication with little to no toxicity, those that respond with strong toxic effects and those that never respond. As genetic predisposition plays a strong role in this response, further research of pharmacogenetics is essential. This could prove useful in precluding unnecessary therapy or detrimental outcomes. Moreover, pharmacogenetics can help us gain insight on disease mechanisms and other therapeutic targets. In summary, the approach of genetically screening patients attempts to individualize treatment options. However, disadvantages do exist when applying pharmacogenetics in clinical practice. Dr. Loutfy takes a closer look at these and distinguishes between pharmacogenetics and pharmacogenomics.

Altered genetics and the effect on drug response are exemplified in cases such as Gilbert’s syndrome and hyperbilirubinemia which are rather benign conditions associated with atazanavir. A more pressing condition linked with a genetic predisposition is known as the abacavir hypersensitivity reaction (HSR). 2 key studies have associated the susceptibility to HSR with the specific HLA type; the HLA-B5701. The patch test for abacavir hypsensitivity has shown promise in diagnosing and preventing HSR. A study by Phillips et al., showed HLA-B5701 patients tested positive in the patch test. Nevertheless, Dr. Loutfy cautions that there are cases where HLA-B5701 individuals were abacavir tolerant. A study by Rauch et al., examined the clinical effectiveness of prospective genetic screening of HLA-B5701 and found that the rate of abacavir HSR significantly reduced. It is important to recognize that there is often a misdiagnosis of abacavir HSR due to its vague phenotype. HSR can manifest as fever, flu-like symptoms, rash, abdominal pain, diarrhea, etc. Most of these symptoms might not be a result of the abacavir but rather other drugs.

The clinical impact and costs of over diagnosing abacavir HSR is significant since it is required to stop all treatments under these circumstances. This ultimately leads to a longer time to viral load suppression and therefore patients are more likely to seek medical attention. In conclusion, Dr. Loutfy addresses the possibility of generalizing this genetic screening for a specific clinic population.

Copyright © 2006 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- pharmacogenetics and pharmacogenomics;
- the advantages and disadvantages in applying pharmacogenetics to clinical practice;
- the difficulties in characterizing abacavir hypersensitivity;
- the abacavir patch test;
- the evidence and experience of genetic screening for abacavir hypersensitivity.

Bibliographic references :
Julia Kirchheiner, Uwe Fuhr & Jürgen Brockmöller Pharmacogenetics-based therapeutic recommendations – Ready for clinical practice? Nature Reviews Drug Discovery 2005, 4(8), 639-647.

Margalida Rotger et al. Gilbert syndrome and the development of antiretroviral therapy-associated hyperbilirubinemia.The Journal of Infectious Diseases. Oct. 2005, 192(8), 1381-6.

David W Haas, L Smeaton, R Shafer, G Robbins, G Morse, L Labbe, G Wilkinson, D Clifford, M Dube, R D'Aquila, V DeGruttola, R Pollard, A George, J Donahue, and R Kim. Pharmacogenetics of Long-term Response to Efavirenz- and Nelfinavir-containing Regimens: NWCS213, an Analysis of ACTG 384 12th CROI, Boston 2005, #81.

Heather J. Ribaudo, David W. Haas, Camlin Tierney, Richard B. Kim, Grant R. Wilkinson, Roy M. Gulick, David B. Clifford, Catia Marzolini, Courtney V. Fletcher, Karen T. Tashima, Daniel R. Kuritzkes, and Edward P. Acosta. Pharmacogenetics of Plasma Efavirenz Exposure after Treatment Discontinuation: An Adult AIDS Clinical Trials Group Study. Clinical Infectious Diseases. 2006, 42, 401-7.

Mallal S., Nolan D., Witt C., Masel G., Martin A., Moore C., Sayer D., Castley A., Mamotte C., Maxwell D., James I., Christiansen F.
Association between presence of HLA-B*5701, HLA-DR7, and HLA-DQ3 and hypersensitivity to HIV-1 reverse-transcriptase inhibitor abacavir The Lancet, 2 March 2002. 359. 727-732.

Hetherington S, Hughes AR, Mosteller M, Shortino D, Baker KL, Spreen W, Lai E, Davies K, Handley A, Dow DJ, Fling ME, Stocum M, Bowman C, Thurmond LM, Roses AD.Genetic variations in HLA-B region and hypersensitivity reactions to abacavir. The Lancet, 20 March 2002. 359. 1121-1122.

Annalise M. Martin, David Nolan, Silvana Gaudieri, Coral Ann Almeida, Richard Nolan, Ian James, Filipa Carvalho, Elizabeth Phillips, Frank T. Christiansen, Anthony W. Purcell, James McCluskey, and Simon Mallal. Predisposition to abacavir hypersensitivity conferred by HLA-B*5701 and a haplotypic Hsp70-Hom variant. PNAS, 15 March 2004. 101(12), 4180-4185.

Phillips, Elizabeth J. ; Wong, Gavin A; Kaul, Rupert C; Shahabi, Kamnoosh C; Nolan, David A; Knowles, Sandra R; Martin, Annalise M; Mallal, Simon A; Shear, Neil H. Clinical and immunogenetic correlates of abacavir hypersensitivity. AIDS, 10 June 2005. 19(9), 979-981.

Nolan D, Gaudieri S, Mallal S. Pharmacogenetics: a practical role in predicting antiretroviral drug toxicity? Journal of HIV Therapy, May 2003. 8(2), 36-41.

Rauch, A. Prospective genetic screening decreases the incidence of abacavir hypersensitivity reactions in the Western Australian HIV Cohort EACS, Dublin, 2005.

J Hernandez, A Cutrell, T Bonny, S Castillo, C Brothers, J Hee, W Powell and T Scott. 5th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. July 2003, Paris, France.

Phillips E.J., Yip B., Hogg R.S., Montaner J.S.G.
Determinants of and healthcare utilization associated with early discontinuation of abacavir: a case for genetic screening. EACS, Dublin, 2005.

Martin AM, Nolan D, Mallal S. HLA-B*5701 typing by sequence-specific amplification: validation and comparison with sequence-based typing. Tissue Antigens, June 2005. 65(6), 571.

   


 Conference 
"Matters of the Heart: Insulin resistance and HIV"
Dr. Greg Bondy (biography)
English - 2006-01-20 - 51 minutes
(68 slides)

Summary :
Both insulin resistance and antiretroviral therapy independently contribute to the development of cardiovascular disease. Dr. Bondy reviews the guidelines for treating HIV positive patients newly diagnosed with type 2 diabetes (T2D) while taking into consideration these cardiovascular risk factors.

While diabetes education, and diet and exercise remains the recommended approach to anyone newly diagnosed with T2D, in patients with symptomatic glycemic control problems immediate attention may be required. In addition, it has been shown that diet and exercise often fails in maintaining glycemic control. Dr. Bondy recommends using glyburide with increasing doses of metformin until optimal therapeutic conditions are attained. Long term use would involve gradually removing the glyburide and replacing it by a thiazolidinedione.

Dr. Bondy provides an overview of the advantages and disadvantages of several oral anti-diabetic agents. These include sulfonylureas, biguanides, alpha-glucosidase inhibitors, carbamoylmethyl benzoic acids, and thiazolidinediones.

The Canadian diabetes guidelines (CDA) recommend the use of metformin, a biguanide, as the first line drug due to its cardio protective effects. In support of these cardio protective effects is the UKPDS study, however, Dr. Bondy cautions us that it is important to recognize the small samples sizes used in this study. All aside, due to the possible cardio protective effects and weight loss effects, metformin may be a useful first line approach for HIV patients with T2D.

PPAR receptors are another target for oral anti-diabetic agents. As nuclear transcription factors, they alter gene expression ultimately affecting lipid, protein and carbohydrate metabolism as well as cell differentiation. Thiazolidinediones (TZDs), a PPAR agonist, work on liver, adipose, and muscle, to improve glucose and lipid levels. Moreover, studies have linked TZDs with a reduction in inflammation which is a known driver of atherosclerosis. Dr. Bondy presents studies supporting TZDs in reducing atherosclerosis and improving endothelial function. He further presents the PROactive study which was designed to determine the effects of TZDs on several cardiovascular endpoints.

In HIV patients, the D:A:D study have shown that the risk heart disease increases with the duration of exposure to antiretroviral therapy. Dr. Bondy reviews the cardiovascular disease risks in HIV patients and the clinical implications of TZDs. Finally, he addresses the side effects of TZDs and its possible contribution to congestive heart failure and liver disease.

Copyright © 2006 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- Guidelines for treating type 2 diabetes in HIV patients;
- Insulin resistance and vascular disease;
- Thiazolidinediones and vascular protection.

Bibliographic references :
Opara JU, Levine JH. The deadly quartet--the insulin resistance syndrome. Southern Medical Journal, 1997. (90). 1162- 1168.

Leif Groop, Camilla Schalin, Anja Franssila-Kallunki, Elisabeth Widén, Agneta Ekstrand and Johan Eriksson. Characteristics of non-insulin-dependent diabetic patients with secondary failure to oral antidiabetic therapy. American Journal of Medicine, August 1989. 87(2). 183-190.

UKPDS Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. The Lancet, 1998. 854-865.

Barnett AH. Insulin-sensitizing agents--thiazolidinediones (glitazones). Current Medical Research and Opinion, 2002. 18(suppl), S31-S39.

Marie-Bernard Debril, Jean-Paul Renaud, Lluis Fajas, Johan Auwerx. The pleiotropic functions of peroxisome proliferator-activated receptor ? Journal of Molecular Medicine, March 2001. 79(1), 30-47.

H. Yki-Järvinen. Thiazolidinediones. New England Journal of Medicine, Sept. 2004. 351(11), 1106-1118.

E Bonora, G Targher, M Alberiche, RC Bonadonna, F Saggiani, MB Zenere, T Monauni and M Muggeo. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care, 2000. 23(1), 57-63.

SM Haffner, RA Valdez, HP Hazuda, BD Mitchell, PA Morales, and MP Stern. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes, 1992. 41(6), 715-722.

Plutzky J, Viberti G, Haffner S. Atherosclerosis in type 2 diabetes mellitus and insulin resistance: mechanistic links and therapeutic targets. Journal of Diabetes and its Complications, Nov-Dec 2002. 16(6), 401-415.

Priya Mohanty, Ahmad Aljada, Husam Ghanim, Deborah Hofmeyer, Devjit Tripathy, Tufail Syed, Waddah Al-Haddad, Sandeep Dhindsa and Paresh Dandona. Evidence for a Potent Antiinflammatory Effect of Rosiglitazone. Journal of Clinical Endocrinology and Metabolism, 2004. 89(6), 2728-2735.

Andrea Natali, Stephanie Baldeweg, Elena Toschi, Brunella Capaldo, Daniele Barbaro, Amalia Gastaldelli, John S. Yudkin, and Ele Ferrannini. Vascular Effects of Improving Metabolic Control With Metformin or Rosiglitazone in Type 2 Diabetes. Diabetes Care, 2004. 27, 1349-1357.

Jagdip S. Sidhu, Zoltan Kaposzta, Hugh S. Markus, and Juan Carlos Kaski . Effect of Rosiglitazone on Common Carotid Intima-Media Thickness Progression in Coronary Artery Disease Patients Without Diabetes Mellitus. Arteriosclerosis, Thrombosis, and Vascular Biology, 2004. 24(5), 930-934.

The DREAM Trial Investigators. Rationale, design and recruitment characteristics of a large, simple international trial of diabetes prevention: the DREAM trial. Diabetologia, 2004. 47(9), 1519-1527.

Nina Friis-Møller; Rainer Weber; Peter Reiss; Rodolphe Thiébaut; Ole Kirk; Antonella d'Arminio Monforte; Christian Pradier; Linda Morfeldt; Silvia Mateu; Matthew Law; Wafaa El-Sadr; Stephan De Wit; Caroline A Sabin; Andrew N Phillips; Jens D Lundgren; for the DAD study group. Cardiovascular disease risk factors in HIV patients - association with antiretroviral therapy. Results from the DAD study.
AIDS, May 23, 2003. 17(8), 1179-1193.

   


 Conference 
"Chairman's Introduction"
Dr. Jens Lundgren (biography)
English - 2005-11-19 - 9 minutes
(4 slides)

   


 Conference 
"Is it Superior to be Non-inferior? - HIV Statistics made Simple"
Naomi Givens (biography)
English - 2005-02-18 - 41 minutes
(53 slides)

Summary :
Time to brush up on your statistics! Naomi Givens, a statistician with GlaxoSmithKline, reviews the different study designs commonly used in HIV trials. Why is one design chosen over another? What is the difference between the frequently analyzed HIV treatment endpoints and how are they calculated? And just how are the P-value and the confidence interval different?

All of these questions and more are answered in this concise review that is sure to increase your stats savvy.

Also, be sure not to miss an explanation of the Context Study results.

Copyright © 2004 MULTIWEBCAST "State-of-the-Art Webcast Services"

Learning objectives :
After viewing this presentation, participants will be able to discuss:
• The difference between a superiority design and a non-inferiority design
• The reasons why one would choose one design over the other
• How to interpret confidence intervals in both superiority and non-inferiority studies
• The relationship of the P-value to the confidence interval
• How end-points in HIV studies are calculated and what they tell us
• The results of the CONTEXT study

   


 Conference 
"CMEonHIV.com Pharmacists' Section"
Linda Robinson (biography)
English - 2005-01-07 - 11 minutes
(12 slides)

Summary :
Linda Robinson, pharmacist and editorial board member of CMEonHIV.com, welcomes you to the new Pharmacists' Section provided by CMEonHIV.com. In this short presentation, she describes the features of this new section and invites you to submit your ideas to the editorial board on how we can better tailor this section to meet your needs.

   


 Conference 
"Plenary Session: Clinical Sciences"
Dr. Daniel R. Kuritzkes (biography)
English - 2004-05-15 - 52 minutes
(51 slides)

   


 Conference 
"DXA-Derived Body Composition Parameters: Association with Insulin Resistance in HIV infected males on HAART"
Dr. Julian Falutz (biography)
English - 2004-05-15 - 19 minutes
(20 slides)

   


 Conference 
"Edmonton dot for HAART II : Inner city patient retention, lifestyle stabilization and reduced HIV transmission risk by using a "people first" approach"
Wendi Monahan (biography)
English - 2004-05-15 - 19 minutes
(24 slides)

   


 Conference 
"Impact of depression on all cause mortality among men and women initiating HAART"
Dr. Robert Hogg (biography)
English - 2004-05-15 - 14 minutes
(15 slides)

   


 Conference 
"Simplified protease inhibitor trial : Antiviral effect of once daily Saquinavir SGC + Ritonavir (SQV/R) vs twice daily Indinavir + Ritonavir (IDV/R)"
Dr. Marianne Harris (biography)
English - 2004-05-15 - 17 minutes
(17 slides)

   


 Conference 
"The effect of a psychotherapeutic intervention support on patients treated by Efavirenz"
Nimâ Machouf (biography)
English - 2004-05-15 - 15 minutes
(19 slides)

   


 Conference 
"HIV-Infected intravenous drug users (ivdus) on Nevirapine or Kaletra based HAART require different methadone dosing strategies when changing regimens"
Jesse Raffa (biography)
English - 2004-05-15 - 18 minutes
(23 slides)

   


 Conference 
"Metabolic Toxicities from Antiretroviral Drugs According to Gender in HIV Infected Patients"
Rosa Morales (biography)
English - 2004-05-15 - 14 minutes
(16 slides)

   


 Conference 
"Outcome of Initial HAART Regimen in HIV-HCV Co-Infecttion"
CL Cooper (biography)
English - 2004-05-14 - 17 minutes
(25 slides)

   


 Conference 
"Distinct Patterns of Drug Susceptibility and Fitness for Viral Isolates Harboring Thymidine and Nucleoside Analogue Mutations (TAMS and NAMS)"
Dr. Bluma Brenner (biography)
English - 2004-05-14 - 23 minutes
(16 slides)

   


 Conference 
"Genotypic Resistance Assay for Entire GP41 Sequence with GP41 Polymorphisms in T-20 Naïve Patients & New GP41 Mutations in Patiens failing T-20"
Dr. Mona Loutfy (biography)
English - 2004-05-14 - 18 minutes
(26 slides)

   


 Conference 
"Nucleotide and Amino Acid Polymorphisms at Drug Resistance sites in non-B Subtype HIV-1 Variants"
Dr. Dan Turner (biography)
English - 2004-05-14 - 13 minutes
(16 slides)

   


 Conference 
"Hepatitis C (HCV) Co-Infection reduces success of NNRTI-based initial HAART regimens"
Dr. Marina Klein (biography)
English - 2004-05-13 - 17 minutes
(16 slides)

   


 Conference 
"Study Case : Case Presentations by Attendees to the Faculty"
Dr. Peter Phillips (biography)
English - 2002-04-15 - 22 minutes
(18 slides)

Summary :
Medical Director, AIDS Program and Head, St. Paul's Hospital
Moderator: Julio Montaner
Panel Participants: Jose Gatell, Stefano Vella, Giuseppe Pantaleo,
Keith Gallicano, Richard Harrigan, Mark Wainberg, Joep Lange
This Study Case was presented in Whistler (British Columbia) on
April 15th, 2002, Chateau Whistler

   


 Conference 
"Short course directly observed therapy (DOT) with Azithromycin for bacterial infections in HIV-infected intravenous drug users (IVDUS)"
Harout Tossonian (biography)
English - 0000-00-00 - 19 minutes
(22 slides)

   


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