Today and Tomorrow: Managing Resistance in Heavily ART-Experienced People with HIV

Faculty

David Alain Wohl, MD
Professor of Medicine, Institute of Global Health and Infectious Diseases
Site Leader, Global Infectious Diseases Clinical Trials Unit, Chapel Hill Site, The University of North Carolina (UNC) at Chapel Hill School of Medicine
David Alain Wohl, MD

In response to the HIV pandemic, Dr. Wohl has focused his career on optimizing the treatment of HIV infection, including identifying the most effective therapeutic approaches and minimizing the adverse effects of therapy. Cognizant that HIV disproportionately affects the most vulnerable, he has worked to improve HIV care and prevention for often marginalized individuals such as the incarcerated, men who have sex with men, and those living in poverty.

Dr. Wohl is active within the U.S. AIDS Clinical Trials Group (ACTG) and HIV Prevention Trials Network (HPTN), and served two terms as a member of the U.S. Department of Health and Human Services (DHHS) Panel on Antiretroviral Guidelines and was recently invited to serve on the DHHS Panel on Opportunistic Infection Guidelines.

As part of the response to the 2013-2016 Ebola outbreak in West Africa, Dr. Wohl led UNC clinical research efforts to test interventions for Ebola Virus Disease in Liberia and now is a principal investigator of a clinical cohort that longitudinally follows Ebola survivors, as well as a study to determine the natural history of Lassa fever.

In addition to his research and administrative activities, Dr. Wohl maintains a large HIV continuity clinic at UNC.

Sorana Segal-Maurer, MD
Director, The Dr. James J. Rahal Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens
Professor of Clinical Medicine, Weill Cornell Medical College, Cornell University
New York, NY
Sorana Segal-Maurer, MD

Sorana Segal-Maurer, MD is Director of Infectious Diseases at NewYork-Presbyterian Queens in Flushing, NY and Professor of Clinical Medicine at Weill Cornell Medicine in New York, NY. She has published extensively, as author of peer-reviewed articles on HIV treatment adherence, diagnosis, and treatment of metabolic and morphologic changes in HIV infected patients, and is an author of the section, “Nutritional Metabolism and Support in the Setting of HIV Infection“, in the Adult Nutrition Support Core Curriculum textbook. She is actively involved in HIV research, serving as principal investigator or co-investigator in phase II, III, IV clinical trials as well as investigator-initiated trials. Currently, she is the lead author on the 2022 NEJM publication of the CAPELLA trial where the use of lenacapavir was evaluated in a cohort of heavily treated persons living with HIV. She has been in clinical practice for nearly 30 years.

Dr. Segal-Maurer is board-certified in infectious diseases and is a Diplomate of the American Board of Medical Examiners. She received her medical degree from Icahn School of Medicine in New York, NY and completed an internship, residency, and infectious diseases fellowship at Albert Einstein College of Medicine/Montefiore Medical Center in Bronx, NY.

Statement of Need

The use of antiretroviral (ARV) medication therapies has led to successful treatment for many patients with HIV. However, antiretroviral therapy (ART) resistance and medication adherence problems can reduce the chances of treatment success.1,2 Health care professionals (HCPs) need up-to-date education on the causes of ART resistance and non-adherence for patients who are treatment-experienced, as well as the treatment alternatives available including new ARV therapies with varying mechanisms of delivery (e.g., oral vs. injections). With this education, HCPs will be better prepared to treat patients with HIV who are treatment-experienced, reducing or mitigating the problems of ART treatment resistance and medication non-adherence.

In this CMEOCast podcast, expert faculty will present the latest information on the causes of ART resistance and medication non-adherence in patients with HIV and discuss the latest medication therapies that may prevent or counter treatment resistance and non-adherence, especially in patients who are treatment-experienced.


  • World Health Organization (WHO). WHO fact sheet: HIV drug resistance. WHO Website. https://www.who.int/news-room/fact-sheets/detail/hiv-drug-resistance. Published November 18, 2020. Accessed June 2, 2021.
  • Benson C, Wang X, Dunn, KJ, et al. Antiretroviral adherence, drug resistance, and the impact of social determinants of health in HIV-1 patients in the US. AIDS Behav. 2020;24(12):3562-3573.

 

Learning Objectives

At the end of this CME/CE activity, participants should be able to:

  • Identify the etiology of ARV treatment resistance to improve HCPs’ competence in assessing and managing HIV in individuals who are heavily treatment experienced.
  • Apply efficacy and safety data for current and new ARV treatments that minimize risk of treatment resistance in treatment-experienced patients with HIV.
  • Evaluate efficacy and safety data for new and emerging long-acting oral and injectable ART regimens for heavily treatment-experienced people with HIV, including individuals with ARV resistance.

Financial Support

Supported by an educational grant from Gilead Sciences, Inc. This educational activity is supported by an independent educational grant from ViiV Healthcare.

ViiV Healthcare was not involved in the development of content or selection of faculty for this educational activity.

Target Audience

Physician associates (PAs), nurse practitioners (NPs), nurses, pharmacists, primary care physicians, and physicians specializing in infectious disease

Credit Information

Jointly Accredited Provider

In support of improving patient care, CME Outfitters, LLC, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Interprofessional (IPCE) 0.75

This activity was planned by and for the healthcare team, and learners will receive 0.75 Interprofessional Continuing Education (IPCE) Credit for learning and change.

Physicians (ACCME) 0.75

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Nurses (ANCC) 0.75

This activity is designated for 0.75 contact hour. Nurse practitioners can apply for AMA PRA Category 1 Credit(s)™ through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit(s)™ from Jointly Accredited Organizations. Nurse practitioners can also apply for credit through their state boards.

Note for California Nurses

This continuing nursing education activity was approved by the California Board of Registered Nursing. CME Outfitters, LLC’s provider number is CEP15510.

Pharmacists (ACPE) 0.75

This application-based activity is approved for 0.75 contact hour (0.075 CEUs) of continuing pharmacy credit.
UAN: JA0007185-0000-22-111-H01-P

PAs (AAPA) 0.75

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ABIM MOC 0.75

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 medical knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

MIPS Improvement Activity

Completion of this accredited CME activity meets the expectations of an Accredited Safety or Quality Improvement Program (IA_PSPA_28) for the Merit-based Incentive Payment Program (MIPS). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Royal College MOC

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Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and mitigated any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process.


Dr. Wohl reports the following financial relationships: Advisory Board: Gilead Sciences, Inc.; Janssen Pharmaceuticals, Inc.; Theratechnologies Inc.; and ViiV Healthcare; Consultant: Gilead Sciences, Inc.; and Janssen Pharmaceuticals, Inc. Grants and Research Support: Eli Lilly and Company; Gilead Sciences, Inc.; Merck & Co., Inc.; and ViiV Healthcare


Dr. Segal-Mauer reports the following financial relationships: Consultant: Gilead Sciences, Inc. and Janssen Pharmaceuticals, Inc. Speakers Bureau: Gilead Sciences, Inc. and Janssen Pharmaceuticals, Inc.


The following peer reviewer and CME Outfitters staff have no financial relationships to disclose:

  • Michael Franks, APRN, AGACNP-BC, FNP-BC (peer reviewer)
  • Mary Gleason (planning committee)
  • Kellie Busby, PharmD (planning committee)
  • Susan H. Yarbrough, CHCP (planning committee)
  • Sandra Caballero, PharmD (planning committee)
  • Sharon Tordoff (planning committee)

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credits

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PD-094-120922-90

 

Today and Tomorrow: Managing Resistance in Heavily ART-Experienced People with HIV
Event Date: 12/09/2022