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Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Plenary 2 - Joe Eron - Where we are and where we are going
Tuesday plenary 2 - A great overview of the current situation and where we are headed
90 90 90 are high targets
Integrases will help achieve these higher proportion of fully suppressed patients for longer before resistance occurs and needing fewer regimen changes over the projected treatment period for some of 80 years.
-persisting treatment gap - those in care and not in therapy > 10 % in most clinic populations
-whole life treatment from diagnosis despite
-adverse events, pregnancy, childhood and adolescence, periods of poor adherence, drug interactions
-Toxicity - but this is decreasing
eg TDF will be replaced by TAF - lessening BMD loss and reducing proximal renal tubule issues
Duel therapies - eg Dolutegravir + 3TC - less exposureto potential toxicities
- Resistance - but the use of potent therapies up front has made resistance rare
- Are there enough agents to last 80 years
New agents/ different classes will overcome resistance to previously used drugs
- Adherence issues - particularly at some stages in their life for some patients - adolescents and drug users for example - Long acting therapies like Cabotegravir and Rilpilvirine will help