Shooting the Rapids of the HIV Cascade: Outcomes of Initiating ART at Diagnosis

Christopher D. Pilcher, MD
Associate Professor of Medicine, UCSF/SFGH HIV/AIDS Division
University of California, San Francisco, CA



CME VIDEOTop of page

About the Presenter: Top of page

Chris Pilcher is an HIV clinician and translational scientist at UCSF where he is Associate Professor of Medicine on the faculty at San Francisco General Hospital. Dr. Pilcher has particular expertise in operating programs for the identification, management and clinical study of individuals with acute and recent HIV infection. In his work in HIV diagnostics he conducted the key studies that led to wide implementation of pooled RNA testing in public health testing programs, and continues to investigate new HIV tests and testing strategies. Additional translational research projects have focused on the events of acute and early HIV infection and impact of early antiretroviral therapy on immunopathogenesis. He currently leads the UCSF Options study of acute HIV in San Francisco, and heads the international CEPHIA network of clinical cohorts; most recently he leads evaluation of the San Francisco RAPID program for rapid initiation of antiretroviral therapy.

Learning Objectives: Top of page

At the completion of this educational session, learners will:
  • Appreciate the reasons why immediate, empiric initiation of antiretroviral therapy has not been adopted as a strategy for managing newly diagnosed HIV infections; and to revisit this reasoning in light of changes in the HIV care and treatment environment (newer regimens, universal ART guidelines, treatment as prevention, PrEP).
  • Be aware of clinical situations in which more rapid antiretroviral therapy may translate to individual clinical benefits for patients who are newly diagnosed with HIV infection; and clinical situations where it may be detrimental.
  • Understand the results of a San Francisco program implementing same day immediate ART at the time of a new positive HIV diagnosis.
  • Appreciate the challenges to broader/national implementation of same day immediate ART and discuss potential solutions.

CME Information: Top of page


This CME activity was approved for AMA PRA Category 1 Credit™ on June 9, 2015 and will terminate June, 2018.

The target audience is all physicians, NPs and PAs involved or interested in HIV education.

This online video and post-activity evaluation are one hour in length.
  • After you complete the video portion of this educational activity there will be a post-activity evaluation and quiz.
  • You must achieve at least 70% correct to receive your CME certificate.
  • If successful, you will be provided instructions to print your CME certificate at the completion of this activity.
  • Accreditation Statement: Top of page


    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Medical Society of the State of New York (MSSNY) and the Physicians’ Research Network (PRN). MSSNY is accredited by the ACCME to provide continuing medical education for physicians.

    The Medical Society of the State of New York designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with extent of their participation in the activity.

    Disclosure Statement: Top of page


    Policies and standards of MSSNY require that speakers and planners for CME activities disclose any relevant financial relationships they may have with commercial interests whose products, devices or services may be discussed in the content of a CME activity.
  • Dr. James Braun (Planner/Course Director) had no relevant financial relationships to disclose.
  • Dr. Pilcher (Presenter) had no relevant financial relationships to disclose. Dr. Pilcher submitted his slides in advance for adequate peer review, and will support his presentation and clinical recommendations with the best available evidence from the medical literature.
  • Financial Support: Top of page

    This PRN CME activity is funded in part by unrestricted educational grants from: Bristol-Myers Squibb, Gilead Sciences, Merck & Co, and ViiV Healthcare.

    How to Obtain CME Credit: Top of page

    To obtain CME credit for this and other PRN programs, please visit the PRN Courses page at the Clinical Education Initiative (CEI) web site. PRN and the Medical Society of the State of New York (MSSNY) jointly sponsor PRN enduring materials for CME, and provide them at no cost to the AIDS Institute of the New York State Department of Health (NYSDOH) for broadcast through the CEI. We thank the NYSDOH for making our CME programs available to a wider audience, and hope you will also browse the many other educational opportunities offered by the CEI.

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