HIV/AIDS Treatment

Question 1

Regimens for first-line ART: INSTIs and 2 NRTIs

Answer 1

BIC/FTC/TAF
DTG/ABC/3TC
DTG/XTC/TAF or TDF
RAL/XTC/TAF or TDF

Question 2

Regimen for first-line ART: INSTI and NRTI

Answer 2

DTG/3TC

Question 3

When can you NOT use DTG/3TC?

Answer 3

HIV-1 RNA >500,000c/ml, HBV coinfection, resistance testing results haven’t come back yet

Question 4

Single tablet regimens for ART: INSTIs

Answer 4

DTG/3TC

DTG/3TC/ABC

Question 5

When can you use DTG/3TC/ABC?

Answer 5

If HLA-B*5701 negative

Question 6

Single-tablet regimens for ART: NNRTIs

Answer 6

EFV/3TC/TDF

RPV/FTC/TAF or TDF

Question 7

Preferred options in pregnancy

Answer 7

DTG, RAL

Question 8

Preferred ART regimen for pregnant women

Answer 8

Dual NRTI backbone and an INSTI OR boosted PI

Question 9

Dual NRTI backbone options for pregnant women

Answer 9

3TC/ABC
FTC/TDF
3TC/TDF

Question 10

INSTI options for pregnant women

Answer 10

DTG

RAL BID

Question 11

Boosted PI options for pregnant women

Answer 11

ATV/RTV

DRV/RTV BID

Question 12

Alternative regimen for pregnant women

Answer 12

NRTI backbone and NNRTI

Question 13

NRTI backbone options for pregnant women (alternative treatment)

Answer 13

FTC/TAF

3TC/ZDV

Question 14

NNRTI options for pregnant women

Answer 14

EPV, RPV

Question 15

Elvitegravir/cobicistat/emtricitabine/tenofovir brand name

Answer 15

Genvoya/Stribild

Question 16

Genvoya/Stribild must be taken with…

Answer 16

…food

Question 17

CrCl requirement for Genvoya

Answer 17

CrCl mist be >70ml/min and not fall below 50ml/min

Question 18

BBW with emtricitabine and tenofovir

Answer 18

Lactic acidosis and severe hepatomegaly

Question 19

What is the booster in Genvoya?

Answer 19

Cobicistat

Question 20

Genvoya/Stribild DDI with warfarin

Answer 20

Monitor INR

Question 21

Genvoya/Stribild DDI with anticonvulsants

Answer 21

Use Keppra instead of other anticonvulsants

Question 22

Genvoya/Stribild DDI with inhaled corticosteroids

Answer 22

Contraindicated: budesonide, mometasone, fluticasone (all other ones must be monitored carefully or are okay to use)

Question 23

Genvoya/Stribild CI with anticoagulants

Answer 23

Avoid Eliquis, dabigatran, Xarelto, ticagrelor

Question 24

CIs with Genvoya/Stribild

Answer 24

Rifampin, St. John’s wort, ergotamines, cisapride, lovastatin, simvastatin, Viagra, triazolam, midazolam

Question 25

ADEs of integrase inhibitors

Answer 25

GI distress, CNS disturbances, rash, false elevation of SCr, weight gain

Question 26

Integrase inhibitors interactions

Answer 26

cations, PPIs are CI’ed, antacids must be taken ≥2 hours before or ≥6 hours after administration

Question 27

ADEs of NNRTIs

Answer 27

Liver toxicity, rash, hyperglycemia, hyperlipidemia

Question 28

Efavirenz must be dosed when?

Answer 28

At night

Question 29

Rilpivirine causes what ADE?

Answer 29

Neuropsychiatric effects (feeling drunk, high, etc.)

Question 30

Entry inhibitor drugs

Answer 30

Enfurvirtide, maraviroc, ibalizumab

Question 31

When are entry inhibitors used?

Answer 31

In heavily treatment-experienced patients who have failed previous treatment secondary to resistance

Question 32

When to consider an ART switch

Answer 32

Simplify regimen
Enhance tolerability or decrease toxicity
Prevent or mitigate DDIs
Eliminate food/fluid requirements
Allow for optimal ART use during pregnancy
Decrease costs