Beyond Viral Suppression: A Case Study Addressing Internalized HIV Stigma

In this episode, Gregory Huhn, MD, MPHTM, uses a case study to explore the reasons healthcare professionals and people living with HIV may want to further optimize ART in the setting of viral suppression. To determine the best outcome for this case study, Dr Huhn discusses the reasons individuals may not be satisfied with daily oral ART and examines data to suggest that, for some individuals with virologic suppression, switching to long-acting ART may address internalized HIV stigma.Finally, Dr Huhn takes a look at the optimal candidates for switching to a long-acting ART regimen and settings where proviral DNA genotyping may be considered prior to switching.Presenter:Gregory Huhn, MD, MPHTMInterim Chief, Division of Infectious DiseasesSenior Director of HIV ServicesCook County HIV Integrated ProgramsInterim Medical Director, The RMR CORE CenterProfessor, Division of Infectious DiseasesRush University Medical CenterChicago, IllinoisTo access all of our new podcast episodes, subscribe to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.See the full program here.

In this episode, Maria Buti, MD, and her patient discuss opportunities to optimize care for people living with hepatitis B virus (HBV), including: Barriers to HBV screening, including patient- and provider-specific barriers (eg, lack of education, failure to disclose or discuss risk factors, perceived low risk, stigma)Applying CDC recommendations for universal HBV screening in adults Strategies to improve HBV transitions of care (eg, improved education, simplify criteria for screening and monitoring, alternative testing sites)Importance of testing close contacts for HBV after initial diagnosis and promoting HBV vaccination Presenter: Maria Buti, MDProfessor of MedicineSenior ConsultantLiver UnitHospital Universitario Valle HebronBarcelona, SpainContent based on an online CME program supported by an independent educational grant from Gilead Sciences, Inc.Link to full program:https://bit.ly/49TuZ8UGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

In this episode, Joseph J. Eron, Jr., MD, and Monica Gandhi, MD, MPH, discuss the key HIV studies from CROI 2024 that are influencing their clinical practice, including:New data surrounding long-acting ART, including:The CARES study of LA CAB + RPV in a Sub-Saharan African population using a public health approachThe IMPAACT 2017 MOCHA study evaluating switching to LA CAB + RPV in adolescents living with HIVThe ACTG A5359 LATITUDE study of LA CAB + RPV in people with adherence challenges to oral ARTUpdated data from San Francisco’s Ward 86 Clinic using LA CAB + RPV in people without viral suppression at baselineCase series of LA CAB (± RPV) + LEN for select people living with HIV unable to take oral ART and unable to use LA CAB + RPV aloneData on comorbidities and coinfections, including:A REPRIEVE proteomic analysis to elucidate mechanistic pathways of statin effects on plaqueThe ACTG A5371 SLIM LIVER study of semaglutide for MASLD in people living with HIVThe impact of Doxy-PEP guideline implementation on STIs in men who have sex with men and transgender women in San FranciscoPotential novel treatment options on the horizon for people living with HIV, including:Phase II data on LEN + ISL dosed orally once weeklyEarly data on other oral weekly optionsData on bNAbs in combination or with other ART agentsPresenters:Joseph J. Eron, Jr., MDProfessor of Medicine, School of MedicineHerman and Louise Smith Distinguished ProfessorChief, Division of Infectious DiseasesDirector, Clinical Core, UNC Center for AIDS ResearchAdjunct Professor of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaMonica Gandhi, MD, MPHProfessor of MedicineDivision of HIV, Infectious Diseases, and Global MedicineMedical Director, Ward 86 HIV ClinicUniversity of California, San FranciscoSan Francisco, CaliforniaContent based on an online CME program supported by independent educational grants from Gilead Sciences; Merck & Co., Inc.; and ViiV Healthcare.Link to full program: https://bit.ly/4awdWJMGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts or Spotify.

In this episode, Mark S. Sulkowski, MD, FIDSA, FAASLD; Tatyana Kushner, MD, MSCE; Paul Y. Kwo, MD; and patient advocate Jacki Chen, PhD, consider barriers and solutions for more expansive HBV treatment in the United States. Topics include:Patient subgroups to consider for treatment outside guideline criteriaAdverse event and cost-effectiveness considerationsIntegration of patient perspectives in wider treatmentPresenters:Mark S. Sulkowski, MD, FIDSA, FAASLDProfessor of MedicineDirector, Division of Infectious Diseases, Johns Hopkins Bayview Medical CenterJohns Hopkins University School of MedicineBaltimore, MarylandTatyana Kushner, MD, MSCEAssociate ProfessorDivision of Liver DiseasesIcahn School of Medicine at Mount SinaiNew York, New YorkPaul Y. Kwo, MDProfessor of MedicineDirector of HepatologyStanford University School of MedicinePalo Alto, CaliforniaJacki Chen, PhDPatient Advocate Link to full program: https://bit.ly/3TuqFHILink to the slides:https://bit.ly/4a60GM4Get access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

In this episode, Robert Wong, MD, MS, and a patient discuss opportunities to optimize care for people living with hepatitis B virus (HBV), including:Opportunities to improve patient education, including education for expectant mothers with HBVPotential cultural considerations that may result in delayed HBV diagnosis and care Stigma reduction with universal HBV screening and vaccinationStrategies to improve patient education (eg, online resources, advocacy groups, use of layman’s terms and diagrams, repetition)Presenter: Robert Wong, MD, MS Clinical Associate Professor Division of Gastroenterology and HepatologyStanford University School of MedicinePalo Alto, CaliforniaContent based on an online CME program supported by an independent educational grant from Gilead Sciences, Inc.Link to full program: https://bit.ly/49TuZ8UGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

Listen to Roger Bedimo, MD, MS, FACP, discuss considerations for older people living with HIV, including:Polypharmacy and deprescribingThe risk of cardiovascular events with various ART regimensApproaches for managing weight gainPresenter:Roger Bedimo, MD, MS, FACPProfessor of MedicineInterim Director, Office of Global HealthUT Southwestern Medical CenterChief, Infectious Diseases SectionVA North Texas Health Care SystemDallas, TexasGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.To download the slides:  https://bit.ly/49zrnZsTo view the full online program:https://bit.ly/49x0W6D

In this episode, Dr. Bedimo discusses best practices for individualized care in transgender women living with HIV, including:Providing services in a gender-affirmative care modelProactive counseling on drug-drug interactions with gender-affirming hormone therapyStrategies to reduce adverse eventsPresenter:Roger Bedimo, MD, MS, FACPProfessor of MedicineInterim Director, Office of Global HealthUT Southwestern Medical CenterChief, Infectious Diseases SectionVA North Texas Health Care SystemDallas, TexasGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.To download the slides: https://bit.ly/49zrnZsTo view the full online program:https://bit.ly/49x0W6D

In this episode, Renslow Sherer, MD, and Trinh P. Vu, PharmD, BCIDP, discuss how to optimize the use of COVID-19 antivirals and how to navigate drug-drug interactions between COVID-19 treatments and a patient’s home medications. Their discussion includes:Current COVID-19 landscapeCOVID-19 testing and vaccination recommendationsTreatment guidelines and antiviral options for nonhospitalized adults with COVID-19Resources for assessing and managing COVID-19 antiviral-related drug-drug interactionsAnswers to learners’ most pressing questionsPresenters:Renslow Sherer, MDProfessor of MedicineSection of Infectious Diseases and Global HealthUniversity of ChicagoChicago, IllinoisTrinh P. Vu, PharmD, BCIDPClinical Pharmacy Specialist in Infectious DiseasesDepartment of PharmacyEmory University Hospital MidtownAtlanta, GeorgiaSlideset: https://bit.ly/4c6kwbJDownloadable resource:https://bit.ly/49rofP6Full program: https://bit.ly/3P16TR8Get access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts or Spotify.

In this episode, Nancy Reau, MD, discusses new data on hepatitis B virus presented at AASLD 2023, including:Current therapiesStudies 108 and 110: Factors Linked With Lack of Virologic Suppression After 8 Yr of TAF or TDFKaiser Permanente Northern California: HCC or Death With TDF vs ETV for Chronic Hepatitis BEarly vs Late Postpartum Cessation of TDF Initiated for Prevention of Vertical HBV TransmissionInvestigational functional cure strategiesB-Together: Sequential Bepirovirsen and PegIFN Added to NA Therapy for Chronic HBV InfectionMARCH Part B: VIR-3434 ± VIR-2218 ± PegIFN Added to NA Therapy for Chronic HBV InfectionREEF-IT: JNJ-3989 + NA ± JNJ-6379 With PegIFN Add-on Consolidation in Patients With HBeAg-Positive CHBHBV003: VTP-300 + Nivolumab Added to NA Therapy for Chronic HBV InfectionCVP-NASVAC: Nasally Administered Therapeutic Vaccine for Chronic HBV InfectionPresenter:Nancy Reau, MDProfessor of MedicineRichard B. Capps Chair of HepatologyChief, Section of HepatologyAssociate Director, Solid Organ TransplantationRush University Medical Center Chicago, IllinoisLink to full program: https://bit.ly/47XJlU4

In this episode, LaRon E. Nelson, PhD, RN, FNP, FNAP, FNYAM, FAAN, discusses the role that healthcare professionals (HCPs) may be playing in their patients’ pre-exposure prophylaxis (PrEP) persistence and strategies to modify their approach to encourage persistence, from Clinical Care Options (CCO), including:Racial disparities in the PrEP care continuumConsideration that PrEP persistence may be less about relationship to the drug than the environmentExamples of HCP implicit bias regarding PrEP responsibility based on racism and sexual prejudiceImpact of HCP implicit bias on PrEP persistenceImpact of racism on clinical cognitionThe demonstrated effects of stereotype threat and the potential healthcare implicationsWays to improve clinical conversations about PrEPProviding person-centered care to encourage PrEP persistence using the Client‑Centered Care Coordination (C4™) ModelFacultyLaRon E. Nelson, PhD, RN, FNP, FNAP, FNYAM, FAANIndependence Foundation ProfessorSchool of NursingYale UniversityNew Haven, ConnecticutFollow along with the slides: https://bit.ly/497cahKLink to full program:https://bit.ly/3ZlICsLGet access to all of our new podcasts by subscribing to the CCO Infectious Disease podcast on Apple Podcasts, Google Podcasts, or Spotify.