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- Module 3 Overview
Antiretroviral Therapy - 0%Lesson 1
Antiretroviral Medications and Initial TherapyActivities- 0%Lesson 2
Adverse Effects of Antiretroviral MedicationsActivities- 0%Lesson 3
Drug Interactions with Antiretroviral MedicationsAntiretroviral Therapy Overview3rd Edition
Module Core Competency
Apply Evidence-Based Antiretroviral Therapy for Persons with HIV
Target Audience
The Antiretroviral Therapy module is geared toward clinicians who provide antiretroviral therapy to persons with HIV, with an emphasis on initiating antiretroviral therapy and management of virologic failure.Editor
David H. Spach, MDDavid H. Spach, MD
Professor of Medicine
Division of Allergy & Infectious Diseases
University of WashingtonDisclosures: NoneFree CNE/CME
Available in theModule Lessons
1Lesson 1 Antiretroviral Medications and Initial Therapy
- Learning Objectives
- List the major classes of antiretroviral medications
- Explain the mechanism of action with each class of antiretroviral medications
- Summarize evidence supporting antiretroviral treatment of all persons with HIV
- Describe recommended antiretroviral regimens for treatment-naïve individuals and discuss factors to consider when selecting an initial regimen
- Discuss recommended laboratory studies to obtain at baseline and while monitoring response to therapy
- Quick ReferenceAntiretroviral Medications and Initial Therapy Core Concepts
- Background
- HIV Life Cycle and Antiretroviral Drug Targets
- When to Initiate Antiretroviral Therapy
- Antiretroviral Regimens for Initial Therapy
- Choosing a Specific Antiretroviral Regimen
- Monitoring Response to Antiretroviral Therapy
- Poor CD4 Response to Antiretroviral Therapy
- Discontinuation or Treatment Interruption
- Summary Points
2Lesson 2 Adverse Effects of Antiretroviral Medications
- Learning Objectives
- Summarize common adverse effects associated with antiretroviral medications
- Identify serious adverse effects caused by antiretroviral therapy
- List appropriate baseline laboratory studies to perform when starting antiretroviral therapy
- Discuss frequency of types of laboratory tests for monitoring persons taking antiretroviral therapy
- Explain management strategies for antiretroviral-related adverse effects
- Quick ReferenceAdverse Effects of Antiretroviral Medications Core Concepts
3Lesson 3 Drug Interactions with Antiretroviral Medications
- Learning Objectives
- Explain the difference between pharmacokinetics and pharmacodynamics
- Access resources for checking drug interactions that involve antiretroviral medications
- Identify commonly used antiretroviral medications that often cause significant drug interactions
- Discuss how antiretroviral medications can increase or decrease levels of some medications when coadministered
- Describe potential drug interactions between antiretroviral medications and medications commonly used to treat comorbid conditions
- Quick ReferenceDrug Interactions with Antiretroviral Medications Core Concepts
- Overview
- Acid Suppressive Therapy and Supplements
- Antimycobacterials
- Cardiovascular Medications
- Corticosteroids
- Hepatitis C Treatments
- HMG-CoA Reductase Inhibitors (Statins)
- Mental Health Medications
- Opioid Agonist Therapy
- Oral Anticoagulants and Antiplatelet Therapy
- Phosphodiesterase Type 5 (PDE5) Inhibitors
- Miscellaneous Interactions
- Summary Points
4Lesson 4 Switching or Simplifying Antiretroviral Therapy
- Learning Objectives
- Discuss the rationale for switching or simplifying antiretroviral therapy
- Describe common situations to consider for simplifying antiretroviral therapy
- Explain why some antiretroviral medications generally warrant a switch to a newer agent
- List the two-drug regimens that have been FDA-approved for maintenance antiretroviral therapy
- Summarize key findings with studies involving a switch to an integrase strand transfer inhibitor
- Quick ReferenceSwitching or Simplifying Antiretroviral Therapy Core Concepts
- Principles of Switching or Simplifying Antiretroviral Therapy
- Switching to an Integrase Strand Transfer Inhibitor
- Switching to a Non-Nucleoside Reverse Transcriptase Inhibitor
- Within-Class Nucleoside Reverse Transcriptase Inhibitor Switches
- Simplifying Therapy to An Oral Two-Drug Regimen
- Simplifying Therapy to Injectable Cabotegravir and Rilpivirine
- Simplifying Maintenance Therapy to Monotherapy
- Summary Points
5Lesson 5 Evaluation and Management of Virologic Failure
- Learning Objectives
- Describe the management of intermittent and persistently detectable HIV RNA levels in persons receiving antiretroviral therapy
- Discuss the indications for and types of resistance testing for patients with virologic failure
- Utilize an HIV resistance database tool to assist in the optimal selection of regimens in persons with HIV drug resistance
- Summarize concepts of resistance with different antiretroviral drug classes
- Explain key considerations when selecting a salvage antiretroviral regimen in persons with virologic failure
- Quick ReferenceEvaluation and Management of Virologic Failure Core Concepts
- Introduction
- Definition of Terms Related to Virologic Responses
- Causes of Virologic Failure
- Approach to Detectable HIV RNA Levels
- HIV Drug Resistance Assays
- Indications for HIV Drug-Resistance Testing
- Interpretation of Drug-Resistance Assays
- Nucleoside Reverse Transcriptase Inhibitor Resistance
- Non-Nucleoside Reverse Transcriptase Inhibitor Resistance
- Integrase Strand Transfer Inhibitor Resistance
- Protease Inhibitor Resistance
- Entry Inhibitor Resistance
- Capsid Inhibitors
- General Approach to Management of Virologic Failure
- Summary Points
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Funded by
Health Resources and Services Administration (HRSA)
Created at
University of Washington
An AETC Program
Part of
IDEA Platform
CME provided byUniversity of Alabama Birmingham
CNE provided byUniversity of Washington School of Nursing
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