2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Limitations of ART

 Drug toxicity

 Safety in pregnancy

 Drug interactions  Drug resistance  Need for adherence  Cost  Not curative

Slide25of 50FromSC Johnson, MD atNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

Potential Adverse Effects of Commonly Used Agents

Drug Potential Adverse Effects Tenofovir DF Renal toxicity. Osteopenia. Tenofovir AF Weight gain. Abacavir

Hypersensitivity. Possible CV risk.

Dolutegravir

Weight gain. Safety in early pregnancy.

Bictegravir

Weight gain.

• Weight gain will be discussed more during the conference.

Slide26of 50FromSC Johnson, MD atNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

Abacavir Hypersensitivity Hypersensitivity to abacavir is a multi-organ clinical syndrome usually characterized by signs or symptoms in 2 or more of the following groups: • Fever • Rash • Gastrointestinal (including nausea, vomiting, diarrhea, or abdominal pain) • Constitutional (including malaise, fatigue, or achiness) • Respiratory (including shortness of breath, cough, or sore throat)

Slide27of 50FromSC Johnson, MD atNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.