S47(5) HIV Regimens

Question 1

First – Line Therapy For MOST People Living with HIV

Answer 1

Tenofovir alafenamide/ emtricitabine/bictegravir

Abacavir/ lamivudine/dolutegravir

Tenofovir (alafenamide or disoproxil fumarate)/ emtricitabine/dolutegravir

Tenofovir (alafenamide or disoproxil fumarate)/ emtricitabine/raltegravir

Question 2

Tenofovir alafenamide/ emtricitabine/bictegravir

Answer 2

TAF - Weight gain
TAF - Expensive

bictegravir - 2 before 6 after

Question 3

Abacavir/ lamivudine/dolutegravir

Answer 3

abacavir - HLA 5701*B testing
abacavir - hepatic elimination
abacavir - increase cardiovasular risk

dolutegravir - neural tube defects

Question 4

Tenofovir (alafenamide or disoproxil fumarate)/ emtricitabine/dolutegravir

Answer 4

TDF - kidney impairment
TDF - osteoporosis

TAF - Weight gain especially with INSTI

dolutegravir - neural tube defects

Question 5

Tenofovir (alafenamide or disoproxil fumarate)/ emtricitabine/raltegravir

Answer 5

TDF - kidney impairment
TDF - osteoporosis

TAF - Weight gain especially with INSTI

Question 6

High cardiac risk

Answer 6

Avoid abacavir and PI

Question 7

Hyperlipidemia

Answer 7

Avoid PIs and efavirenz
Significant DDI with statins vs PIs and NNRTIs
Tenofovir disoproxil fumarate lowers lipids

Question 8

Kidney disease

Answer 8

Avoid tenofovir disoproxil fumarate

Question 9

Osteoporosis

Answer 9

Avoid tenofovir disoproxil fumarate

Question 10

Psychiatric illnesses

Answer 10

Avoid efavirenz and rilpivirine

Question 11

QTc prolongation

Answer 11

Avoid efavirenz and rilpivirine

Question 12

Weight gain concerns

Answer 12

Consider not using tenofovir alafenamide especially in combination with a INSTI`

Question 13

HIV is an infection with human immunodeficiency virus that can lead to a severe infection classified as auto immunodeficiency syndrome (AIDS)

Answer 13

True

Question 14

NRTIs: know the differences between the tenofovir formulations, abacavir canNOT be administered to someone who is HLA5701*B positive, abacavir should be avoided in patients with a high risk for cardiac events but does not require renal dose adjustment

Answer 14

True

Question 15

INSTIs: minimal side effects apart from weight gain, avoid co-administration with polyvalent cations, concern for neural tube defects

Answer 15

True

Question 16

NNRTIs: efavirenz associated with vivid nightmares so should be taken on an empty stomach at bedtime, efavirenz can exacerbate psychiatric and mental health conditions

Answer 16

True

Question 17

PIs: lipodystrophy, hyperlipidemia, insulin resistance, DDI, must be boosted with a PK enhancer

Answer 17

True

Question 18

PK enhancers: used in combination with PIs, DDI

Answer 18

True

Question 19

New start in treatment naïve for MOST patients: 2 NRTIs + 1 INSTI

Answer 19

True