HIV Pharmacotherapy Review PDF

HIV Pharmacotherapy Review...

HIV Pharmacotherapy Review More clinical pearls at pyrls.com The following is a summary of pharmacotherapy recommendations for adolescents and adults with HIV-1 infection, primarily from the Department of Health and Human Services. Please note: This is a simplified summary of guideline recommended ART in patients with HIV. It is not comprehensive. When choosing a treatment plan for an individual patient, various factors should be considered, including the treatment efficacy, side effect profile, the number of pills required, how often the medication needs to be taken, the likelihood of interactions with other drugs, results from resistance testing, any other existing health conditions (e.g., renal/hepatic impairment), availability of the treatment, and its cost. Baseline Evaluation Treatment Goals Drug Abbreviations BIC: bictegravir HIV RNA level (viral load) Serum lipids ➤ Achieve and sustain maximum suppression of HIV RNA in the plasma Integrase Inhibitors (INSTIs) CAB-LA: long-acting cabotegravir HIV antigen/antibody Complete blood count Ideally below the lower limit of detection (undetectable = untransmittable, or “U=U”) DTG: dolutegravir CD4 cell count Chemistry panel 3TC: lamivudine ➤ Restore and maintain immune system function HLA-B*5701 screening Urinalysis ABC: abacavir Nucleoside/Nucleotide Reverse Ideally CD4 count >500 cells/mm3 FTC: emtricitabine G6PD deficiency screening STI screening Transcriptase Inhibitors (NRTIs) TAF: tenofovir alafenamide Genotypic drug-resistance testing Immunization history ➤ Minimize HIV-related health complications and extend both the length and quality of life TDF: tenofovir disoproxil fumarate Hepatitis A, B and C serologies Pregnancy test Protease Inhibitors (PIs) DRV: darunavir Opportunistic infection screening Cancer screening ➤ Prevent the transmission of HIV to other persons Pharmacokinetic Booster COBI: cobicistat Initial ART for Most Persons with HIV Monitoring Prophylaxis Against For individuals with HIV with no prior history of using CAB-LA as PrEP, This is a simplified summary of routine monitoring parameters following baseline evaluation and initiation of ART. the following ART regimens are recommended: It is not comprehensive. Additional testing is warranted upon ART modification, delay or failure (or when indicated). Opportunistic Infection (OI) BRAND NAME(S) GENERIC ABBREVIATIONS CD4 Count Obtain upon initiation/modification of ART, then: Indication Recommended Prophylaxis* Biktarvy BIC/FTC/TAF Pneumocystis pneumonia (PCP) Less frequent monitoring (e.g., every 6 months) may be considered in