HIV/AIDS Treatment Flashcards
Regimens for first-line ART: INSTIs and 2 NRTIs
BIC/FTC/TAF
DTG/ABC/3TC
DTG/XTC/TAF or TDF
RAL/XTC/TAF or TDF
Regimen for first-line ART: INSTI and NRTI
DTG/3TC
When can you NOT use DTG/3TC?
HIV-1 RNA >500,000c/ml, HBV coinfection, resistance testing results haven’t come back yet
Single tablet regimens for ART: INSTIs
DTG/3TC
DTG/3TC/ABC
When can you use DTG/3TC/ABC?
If HLA-B*5701 negative
Single-tablet regimens for ART: NNRTIs
EFV/3TC/TDF
RPV/FTC/TAF or TDF
Preferred options in pregnancy
DTG, RAL
Preferred ART regimen for pregnant women
Dual NRTI backbone and an INSTI OR boosted PI
Dual NRTI backbone options for pregnant women
3TC/ABC
FTC/TDF
3TC/TDF
INSTI options for pregnant women
DTG
RAL BID
Boosted PI options for pregnant women
ATV/RTV
DRV/RTV BID
Alternative regimen for pregnant women
NRTI backbone and NNRTI
NRTI backbone options for pregnant women (alternative treatment)
FTC/TAF
3TC/ZDV
NNRTI options for pregnant women
EPV, RPV
Elvitegravir/cobicistat/emtricitabine/tenofovir brand name
Genvoya/Stribild
Genvoya/Stribild must be taken with…
…food
CrCl requirement for Genvoya
CrCl mist be >70ml/min and not fall below 50ml/min
BBW with emtricitabine and tenofovir
Lactic acidosis and severe hepatomegaly
What is the booster in Genvoya?
Cobicistat
Genvoya/Stribild DDI with warfarin
Monitor INR
Genvoya/Stribild DDI with anticonvulsants
Use Keppra instead of other anticonvulsants
Genvoya/Stribild DDI with inhaled corticosteroids
Contraindicated: budesonide, mometasone, fluticasone (all other ones must be monitored carefully or are okay to use)
Genvoya/Stribild CI with anticoagulants
Avoid Eliquis, dabigatran, Xarelto, ticagrelor
CIs with Genvoya/Stribild
Rifampin, St. John’s wort, ergotamines, cisapride, lovastatin, simvastatin, Viagra, triazolam, midazolam
ADEs of integrase inhibitors
GI distress, CNS disturbances, rash, false elevation of SCr, weight gain
Integrase inhibitors interactions
cations, PPIs are CI’ed, antacids must be taken ≥2 hours before or ≥6 hours after administration
ADEs of NNRTIs
Liver toxicity, rash, hyperglycemia, hyperlipidemia
Efavirenz must be dosed when?
At night
Rilpivirine causes what ADE?
Neuropsychiatric effects (feeling drunk, high, etc.)
Entry inhibitor drugs
Enfurvirtide, maraviroc, ibalizumab
When are entry inhibitors used?
In heavily treatment-experienced patients who have failed previous treatment secondary to resistance
When to consider an ART switch
Simplify regimen
Enhance tolerability or decrease toxicity
Prevent or mitigate DDIs
Eliminate food/fluid requirements
Allow for optimal ART use during pregnancy
Decrease costs
