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The PRN Notebook
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Featured Articles & VideosVisit The PRN Notebook
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management
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From Abstract to Concrete: Co-infections, Comorbidities and Complications from CROI 2024From Abstract to Concrete: Co-infections, Comorbidities and Complications from CROI 2024

This year we are pleased to announce that PRN will expand its coverage of CROI 2024, with Marshall Glesby focusing on other important highlights, including co-infections, comorbidities and complications.
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ART Highlights from CROI 2024ART Highlights from CROI 2024

Every year, the Conference on Retrovirology and Opportunistic Infections (CROI) leads the way in the science and clinical trials of HIV treatment and prevention. Once again, PRN is proud to have Trip Gulick spotlight the most important developments in ART from CROI 2024.
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complications
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Advances in Anal Cancer Prevention in People with HIVAdvances in Anal Cancer Prevention in People with HIV

PRN has long supported efforts to prevent the devastating outcomes of anal cancer in people living with HIV (PLWH). Much progress has been made through the success of the ANCHOR Study which was ended ahead of schedule due to the indisputably favorable outcomes for people receiving treatment for pre-cancerous anal lesions. This confirmation of proactive efforts to destroy high-grade squamous intraepithelial lesions in and around the anus using high-resolution anoscopy emphasizes the role that we in HIV primary care must routinely incorporate into our care for all PLWH. In this program, Dr. Joel Palefsky, the principal investigator of the ANCHOR Study, will update us on the most recent guidelines for anal cancer prevention.
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coinfections
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Looking Beyond Bugs to Consider Drugs: Drug User Health and HIV/HCV Prevention and TreatmentLooking Beyond Bugs to Consider Drugs: Drug User Health and HIV/HCV Prevention and Treatment

The principles of harm reduction in HIV medicine have been most highly driven through their empathic incorporation in strategies to minimize the harms caused by injection drug use, as exemplified by the effect of needle exchange on the reduction of HIV and HCV transmission and the evolution to HCV treatment as prevention. In this program, Dr. Brianna Norton will help prepare us to prevent, diagnose, and treat HCV coinfection and re-infection in people living with HIV as a continuous effort in harm reduction.
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progression
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HIV Elite Controllers and What We’ve Learned from ThemHIV Elite Controllers and What We’ve Learned from Them

Soon after HIV was discovered, clinicians and researchers became fascinated by a small group of people with HIV who did not progress even though they were not taking antiretroviral therapy (ART). Initially termed long-term non-progressors, some of these individuals maintain undetectable HIV RNA without taking ART and are called HIV elite controllers. In this talk, Dr. Gandhi will talk about how best to diagnose elite controllers in the era of early ART initiation and summarize the factors associated with HIV control. He will talk about the price of this control – namely immune activation and inflammation – in some elite controllers and why ART may be warranted.
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progression
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HIV Post-Treatment Control: Insights On Remission from a Unique European CohortHIV Post-Treatment Control: Insights On Remission from a Unique European Cohort

Antiretroviral treatment cannot eliminate HIV reservoir cells that cause viral rebound if treatment is interrupted, requiring lifelong treatment. However, some people who were diagnosed and initiated ART in the earliest stages of primary HIV infection have demonstrated the ability to stably control viremia after treatment interruption, achieving a status of durable HIV remission. Dr. Sáez-Cirión from the Institut Pasteur in Paris, France, has been studying a cohort of these rare post-treatment controllers for years in the VISCONTI Study, finding that early treatment may favor the maturation of the memory response against the virus, allowing a more efficient secondary response after treatment interruption. A better understanding of the mechanisms of post-treatment control may lead to the development of new immunotherapies to achieve HIV remission.
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Empowering Cisgender Women: Inclusion and Awareness of PrEPEmpowering Cisgender Women: Inclusion and Awareness of PrEP

While much effort is utilized to promote HIV pre-exposure prophylaxis (PrEP) in gay and bisexual MSM as well as trans women, we must not diminish the critical need for PrEP for at-risk cisgender women, especially those of childbearing age. To focus on the specific needs of cisgender women, we are pleased to present Dr. Shobha Swaminathan, Director of HIV Programs at Rutgers New Jersey Medical School. Dr. Swaminathan will speak on PrEP eligibility and benefits in cisgender women, navigating the prescription process and adherence strategies for these women, as well as new PrEP options favorable to cisgender women in the pipeline.
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EACS 2023: Highlights from the European AIDS Conference in WarsawEACS 2023: Highlights from the European AIDS Conference in Warsaw

Every two years the European AIDS Clinical Society (EACS) holds its biannual conference on HIV/AIDS, coinfections, and complications, similar in many respects to the annual Conference on Retroviruses and Opportunistic Infections (CROI) in the United States.This year the EACS conference, known as EACS 2023, will be held in Warsaw, Poland. We are fortunate to have Juergen Rockstroh, the current EACS guidelines chair, report to PRN on the highlights of this important international conference, including an update on the evolving epidemiology in Europe, the challenges around HIV care in migrant populations, new data on ART, as well as updates on HIV comorbidities and aging.
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coinfections
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2023 Update on Immunization Recommendations for Individuals With and At-risk for HIV Disease2023 Update on Immunization Recommendations for Individuals With and At-risk for HIV Disease

Preventive measures, including prophylaxis, have always been a critical part of HIV medicine. Vaccines play a special role as a scalable modality to reduce epidemic diseases worldwide. In our current times we must rebut misinformation about vaccine safety and efficacy to keep our patients fully updated with the immunizations they need to maintain optimal health. When our patients return for routine HIV or PrEP follow-up, we all have an ideal opportunity to evaluate and encourage recommended vaccines. Please join us for this update by Dr. Denise Benkel from the NYC DOH Bureau of Immunization about what we can do now. There is no time to lose!
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coinfections
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Update on Hepatitis B and D in People With or At-Risk for HIV CoinfectionUpdate on Hepatitis B and D in People With or At-Risk for HIV Coinfection

The risks for hepatitis B and D lurk in the background for anyone with or at-risk for HIV. It is particularly important to keep this in mind when patients initiate or change medications for HIV and PrEP. Of course, we have had safe and effective vaccinations to prevent hepatitis B for many years, but for patients who have a history of hepatitis B, and are therefore at risk for hepatitis D, additional monitoring is necessary, and extra caution is advised when changing HIV treatment or prevention strategies, to guard against hepatic flare or rebound.  In this important program, Dr. Debika Bhattacharya. the Chair of the Hepatitis Transformative Science Group (TSG) within the AIDS Clinical Trials Group (ACTG), will address these issues and provide updates in the management of hepatitis B and D.
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progression
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Towards an HIV Cure: Understanding HIV Persistence and Therapeutic ApproachesTowards an HIV Cure: Understanding HIV Persistence and Therapeutic Approaches

HIV cure has been limited to only a few cases over the past couple decades, starting with the Berlin Patient, but what is needed is a safer and scalable cure aimed at far broader populations of people living with HIV. This year, the International AIDS Society focused on HIV cure research from around the world at IAS 2023. We are fortunate to have Dr. Sharon Lewin, the current President of the IAS, who presided over IAS 2023, speak on this critical area of research so that one day we may hopefully be able to transform HIV from a manageable to a curable disease.
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Treatment Challenges of Multi-Drug Resistant HIV-1 Infection Treatment Challenges of Multi-Drug Resistant HIV-1 Infection

On a recent survey, approximately one-third of our audience responded that they have patients with multi-drug resistant (MDR) HIV-1, which was higher than we anticipated. Although we hope the absolute number of patients failing therapy is small, this statistic underscores the reality that a significant number of us need to continue searching for new treatment options/classes/strategies that can serve the needs of our most vulnerable patients. PRN continues to spotlight emerging treatment research, and we are pleased to continue this effort with Dr. Ali Rai, from the National Institute of Allergy and Infectious Diseases (NIAID), who will help us understand the dimensions of the current challenge, utilize the most up-to-date methods for determining HIV resistance, and ways that you can help your patients access research studies for novel treatment modalities.
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Clinical Research Highlights from IAS 2023 Clinical Research Highlights from IAS 2023

Every other year the International AIDS Society holds its scientific meeting, and this year the meeting is in Brisbane, Australia. We are extremely fortunate to have Dr. James McMahon, Lead of the Clinical Science Committee (Track B) at IAS 2023, present the highlights of this important conference to our PRN audience. Dr. McMahon is also the current Vice President and President-Elect for Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. If you’re not planning to travel to Brisbane, PRN is delighted to bring Dr. McMahon’s perspective to you!
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transmission
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What is Chemsex? Epidemiology, Harms & ImpactsWhat is Chemsex? Epidemiology, Harms & Impacts

Chemsex is something we don’t often talk about, but it plays a critical role in the spread of HIV and other STIs. Dr. Gary Whitlock is Service Director at 56 Dean Street, a sexual health clinic in the heart of London’s Soho, specialising in reducing infections and promoting sexual wellbeing amongst the LGBTQI+ community, and an international leader in dealing with this important challenge to clinical care and harm reduction. We hope that this presentation will be of help to you in coping with some of the most difficult barriers that our patients face.
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Update on HIV-1 bNAbs for the Prevention, Therapy, and Cure of HIVUpdate on HIV-1 bNAbs for the Prevention, Therapy, and Cure of HIV

Anti-HIV broadly neutralizing antibodies (bNAbs), alone or in combination, are some of the most exciting agents in the pipeline for the prevention, management, salvage, and potential cure of HIV. Dr. Marina Caskey, one of the most prominent researchers leading the way in this new field of immunotherapy, returns with an update on bNAbs in clinical development, and results from HIV-prevention trials utilizing bNAbs.
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coinfections
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Kaposi Sarcoma and KSHV Transmission in MSM and Other High Risk GroupsKaposi Sarcoma and KSHV Transmission in MSM and Other High Risk Groups

Although we see Kaposi Sarcoma less frequently these days, it is far from gone, as we know from seroprevalence data for the causative virus, KSHV. We have had numerous talks at PRN over the past 30 years on the discovery of KSHV and the evolving therapies for the manifestations of KS. Now it is time to focus again on the silent sexual transmission of this infection and a reminder of the various manifestations of this disease in people living with HIV. In this presentation, Sheena Knights will share her recent research in the ongoing spread of KSHV in at-risk populations and health disparities that may still contribute to mortality among MSM with HIV.
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coinfections
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Update on Mpox and Preventing Future OutbreaksUpdate on Mpox and Preventing Future Outbreaks

The explosion of mpox that caught everybody by surprise and most severely affected our immunodeficient patients has receded, but is not gone. It is important now that mpox be included in our pantheon of sexually transmitted infections and include necessary preventive immunization for our patients at risk moving forward.
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coinfections
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Sexual Transmission of HCV Among MSMSexual Transmission of HCV Among MSM

For men who have sex with men and for transgender women who have sex with men, acute or primary hepatitis C has been shown to be a sexually transmitted infection. Similarly, HCV reinfection has been shown to be sexually transmitted as well. It is of critical importance that we keep this in mind for our patients on PrEP to prevent HIV infection, as well as our patients living with HIV. In this presentation, Daniel S. Fierer explains the risks, the incidence, early diagnosis, and treatment strategies for both HCV primary infection and reinfection.
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Body Fat Changes with Aging in People with HIV: Implications for Healthspan and LifespanBody Fat Changes with Aging in People with HIV: Implications for Healthspan and Lifespan

Aging with HIV disease is often accompanied by bothersome body fat changes that affect our patients’ self-images. But fat depots also have variable effects on health outcomes that we need to understand in order to best serve our aging patient population.
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Update on Inflammation, Aging, and CMV Co-Infection in Treated HIVUpdate on Inflammation, Aging, and CMV Co-Infection in Treated HIV

Immune activation and chronic inflammation persist throughout the course of HIV disease and contribute to the multimorbidities that complicate the management of our patients as they age. CMV coinfection seems to be a particularly troublesome cofactor for many PLWH. Peter Hunt returns with an update on the most recent research pertinent to understanding these complexities as they relate to aging.
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complications
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Getting to the Heart of the Matter: Updates on Cardiovascular Disease in HIVGetting to the Heart of the Matter: Updates on Cardiovascular Disease in HIV

Cardiovascular disease is an ongoing problem in HIV management. We are pleased that Mabel Toribio is able to provide an update for cisgender and transgender men and women with or at risk for CVD.
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Updates From CROI 2023Updates From CROI 2023

Trip Gulick returns to PRN to spotlight key research from the Conference on Retrovirology and Opportunistic Infections (CROI).  Dr Gulick will target the latest advances in HIV treatment, and prevention, as well as other pandemic diseases reported at the recent CROI 2023.  CME and MOC are available.
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complications
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Non-AIDS-Defining Cancers in People Living with HIVNon-AIDS-Defining Cancers in People Living with HIV

Thanks to the benefits of antiretroviral therapy, we rarely see AIDS-defining cancers in people living with HIV. Yet as our patients age, they are at higher risk for other cancers and Dr. Keith Sigel will bring us up to date on screening, diagnosis, and treatment of non-AIDS-defining cancers in PLWH.
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Black Lives (with HIV) Matter: Dismantling Systemic Racism to End the HIV Epidemic Among Black MSMBlack Lives (with HIV) Matter: Dismantling Systemic Racism to End the HIV Epidemic Among Black MSM

It is vital for HIV clinicians to focus on the ongoing inequities in health care that our Black and brown patients continue to face today. Dr. Ofole Mgbako will help us recognize the ongoing nuances of systemic racism in HIV care, appreciate its historical roots, and consider potential strategies to dismantle systemic racism along the HIV care continuum.

The PRN Notebook

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TRANSMISSION

Transmission, Diagnosis and the HIV Epidemic

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PROGRESSION

Pathogenesis and Progression of HIV Disease.

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MANAGEMENT

Treatment, Resistance and Management of HIV/AIDS

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COMPLICATIONS

Complications and Comorbidities

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COINFECTIONS

Coinfections and Opportunistic Infections

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