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Demetre C. Daskalakis, MD, MPH

Update on Recent Cases of Invasive Meningococcal Disease Among MSM

Special 5-Minute Public Health Announcement: After a lull in reported cases, there has been a recent cluster of Invasive Menigococcal Disease, even in some men who had already received the recommended preventive vaccines. Demetre Daskalakis, in his newly appointed role at the New York City Department of Health and Mental Hygiene, discusses the details of these disturbing new cases in this special brief public health announcement to the PRN audience.

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Kari Yacisin, MD, MSc

Fast Facts about Ebola-- What NYC Providers Need to Know

Special 5-Minute Public Health Announcement: With the frequency of international travel to NYC and the potential for travelers returning from areas of Africa affected by Ebola, this brief presentation on the Ebola epidemic was added to PRN’s August 2014 meeting as a public health service for primary-care providers. It is important for all clinicians in NYC to be familiar with relevant travel history, the signs and symptoms of Ebola, and the triage of suspected cases.

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David M. Margolis, MD

Towards an HIV Cure: Real Progress And Real Problems

The advances in the management of chronic HIV disease have been extraordinary, but only one person—the Berlin patient—has ever achieved a “functional cure.” HIV cure research is a complicated yet exciting field, with recent setbacks, such as the failure of cure in the Mississippi baby. Purging latent reservoirs is necessary if the chronically infected are to ever be completely free of HIV infection. David Margolis, a leader in the field of cure research updates what is presently known as well as current research that may someday make eradication of HIV more easily achievable.

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Fabienne Laraque, MD, MPH

A Public Health Approach to Hepatitis C in NYC

As clinicians caring for people living with HIV, we are already aware of the increased risk of sexual transmission of hepatitis C in HIV-positive MSM, but we may also care for people born between 1945-65, for people with a recent or past history of intravenous drug use, tattoos, piercings, or who had a medical procedure with anesthesia from a multidose vial. With new rapid tests for HCV that are easily performed at the point-of-care, and all-oral interferon-free treatments for hepatitis C that are more effective and better tolerated, the role of the primary care provider in diagnosing HCV has never been more important. In this presentation, Fabienne Laraque discusses the epidemiology of HCV in New York City, and resources that will help all primary-care clinicians improve diagnosis and linkage to care.

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Jürgen Rockstroh, MD, PhD

Management of HIV/HCV Coinfection in 2014: Cure for All?

In HIV-HCV coinfection, liver-related death remains the number one cause of death, led by decompensated cirrhosis, but also including liver cancer and post-transplant complications. But HCV is curable. The indications for HCV treatment in HCV/HIV co-infected patients are no different than in patients with HCV mono-infection, and the same treatment regimens can be used in HIV-coinfected patients as in patients without HIV infection, since the virological results have been shown to be identical. The role of primary care, especially providers with HIV treatment experience, is critical in identifying candidates for HCV treatment earlier, and securing treatment with newer directly acting agents that more effectively reverse the outcomes of this life-threatening coinfection.

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Joel M. Palefsky, MD, CM, FRCP(C)

Anal Cancer Prevention: Moving Forward, New Hope

Human papillomavirus is, by far, the most common sexually transmitted disease, but in HIV medicine there is a higher risk for HPV-related complications. Why? In addition to high risk of oral and anogenital HPV infection through shared sexual behavioral risk, HIV reduces the immune response to HPV, and direct interactions between HIV and epithelial cells potentiate new HPV infection. So, both primary and secondary prevention efforts, as well as early diagnosis and treatment are critical to the long-term health of our patients with and at-risk for HIV and HPV coinfection. Learn more about the epidemiology, preventive vaccines, physical exam, laboratory assessment, and treatment of HPV-associated complications in this video of Joel Palefsky’s presentation to PRN.

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Daniel Douek, MD, PhD

The Good, the Bad and the Ugly of Inflammation in HIV Infection

Inflammation plays an important role at every stage for HIV infection, from the acute stages of primary infection until death. But even though antiretroviral therapy has radically slowed progression of this disease to near-normal life expectancy, we see immune activation and inflammation in various manifestations, contributing to HIV disease progression, and increasing the risks of morbid non-AIDS events and mortality. Join us for this comprehensive and thought-provoking review of the many changing faces of inflammation in HIV disease.

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Thomas Cherneskie, MD, MPH

Bacterial STIs in NYC: Epidemiological Trends, Diagnostic Considerations and Management Issues in People With or At Risk for HIV Disease

If you have a patient with a sore throat or rectal complaints are you requesting a thorough sexual history and appropriate STD testing? The threat of sexually transmitted bacterial diseases—not just the usual suspects, but also drug-resistant gonorrhea, lymphogranuloma venereum and mycoplasma genitalium -- is increasing even as HIV prevention shows promise of improvement. At this strategic point in time, it is prudent to review the most current recommendations for bacterial STI diagnosis and treatment in the era of oral sex, HIV-serosorting, HIV pre-exposure prophylaxis and condomless sex.

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Martin H. Markowitz, MD

Long-Acting Next-Generation PrEP Agents to Prevent Infection with HIV

Pre-exposure prophylaxis is currently our best possible means of slowing or perhaps stopping the HIV epidemic, but the success of currently available PrEP is strongly dependent on the adherence of each individual to a one-pill-a-day regimen. Longer-acting drugs in the research pipeline, with intermittent dosing up to 3 months apart, may help stabilize preventive levels of prophylactic antiretroviral agents more consistently over time, and may play an important role in the future of PrEP.

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Demetre Daskalakis, MD, MPH

HIV Pre-Exposure Prophylaxis in the Real World

Get ready. If your HIV-negative patients have not already asked you about pre-exposure prophylaxis for the prevention of HIV infection, this presentation will help you answer their questions when they do. And if they already have started asking you for PrEP, this will help you fine-tune your responses, recommendations and management. The rate of new infections with HIV have remained constant over the last decade despite ongoing reminders for consistent condom use, and the use of antiretroviral drugs for PrEP is a new strategy that may greatly enhance ongoing efforts to reduce HIV transmission in vulnerable populations at highest risk for infection.

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Samuel T. Merrick, MD

Virologic and Immunologic Monitoring in HIV-positive Adults: Updated New York State Guidelines

The standard of care for laboratory monitoring of HIV disease has changed, placing the emphasis on measurement of virologic control at variable intervals based on adherence. Routine quarterly measurement of CD4 cells has been replaced with more rational and cost effective strategies. For all the details of the updated guidelines on monitoring virologic and immunologic trends in HIV management, from the AIDS Institute of the New York State Department of Health, please see this video of Sam Merrick’s recent presentation at PRN.

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Roy M. Gulick, MD, MPH

Advances in the Treatment and Prevention of HIV Infection: CROI 2014, Focus on ART

Hot on the heels of CROI 2014, this up-to-date review of HIV treatment and prevention strategies, antiretroviral initiation, options for treatment failure, and new agents in development, is not to be missed. Even if you attended this live meeting, we hope you will find this presentation by Trip Gulick helpful in your day-to-day decision-making.

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Rajesh T. Gandhi, MD

Diagnosis and Treatment of Acute HIV: A Stitch in Time?

Over the years at PRN, we have revisited the pros and cons of early treatment of HIV, even during the acute stage of primary HIV infection. And now, with safer long-term treatment alternatives, the tide is turning toward early treatment as a potential means of preserving immune function, decreasing mutant strains in reservoirs, decreasing risk of further transmission, and improving the chance for a future cure. In this presentation, Raj Gandhi provides an overview of the signs and symptoms of acute HIV, how to diagnose it and initiate treatment, evidence-based research demonstrating the benefits of early treatment, and the potential for functional cure.

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Blayne Cutler, MD, PhD

The HIV Epidemic in NYC and the Nation: What the Numbers Tell Us

Are we ending the HIV/AIDS epidemic in New York? Rapid HIV tests are readily available and easy to use, oral consent for rapid HIV testing is allowed, pre-test counseling is no longer required, and New York State mandates that all primary care providers offer HIV testing to all patients 13-64 years of age and assure linkage to care for positives. So how are we doing? Join us to hear Blayne Cutler discuss the current trends in New York and the nation, advances in testing, management and prevention, and the critical role primary care plays in ending this epidemic.

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Provider Resources

CME

Members Only

PRN is pleased to offer this new CME opportunity designed for physicians, nurse practitioners and physician assistants caring for patients with or at risk for HIV disease and its many complications. Based on content from The PRN Notebook, credit for each course will be available for a limited period of time noted on each activity.

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Full PRN membership is now open to clinicians nationwide.

  • Monthly Meeting Announcements and Pre-registration
  • CME for Meeting Attendees
  • Special Events

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