CME/CE Information

Target Audience

This activity is designed to enhance knowledge and clinical competence of physicians, pharmacists, and nurses in the care of HIV-infected patients.

Activity Purpose

The purpose of this series of three activities is to enhance the knowledge and competence of members of the target audience in the treatment of antiretroviral experienced patients with resistant HIV.

Each 30–60-minute activity is intended to provide an expert review of the most current research related to the management of treatment-experienced patients with HIV, emphasizing the clinical implications of the research findings.

Overall Activity Educational Objectives

On completion of all three activities, participants should be able to:

• Describe the most current treatment strategies for management of antiretroviral-experienced patients and their relevance to improved patient care
• Define the relevance of current research to the clinical management of treatment experienced HIV-infected patients with resistance
• Apply recent findings to clinical care, including strategies for sequencing antiretrovirals to preserve treatment options

Statement of Need

As the HIV epidemic enters its third decade, the changing nature of this infection demands greater attention to special populations. Regimen failure from resistance remains a barrier to long-term virologic suppression in HIV-infected patients and is associated with a significantly increased risk of mortality. Complete suppression of plasma HIV is the goal of antiretroviral treatment, even in multiclass-experienced patients. For patients with incomplete virologic suppression due to resistance, current guidelines recommend adding at least one active drug to the regimen and optimizing the nucleoside reverse transcriptase inhibitor (NRTI) background. The availability of recently approved agents active against resistant HIV, such as the nonpeptidic protease inhibitors (PIs) tipranavir and darunavir, the CCR5 receptor antagonist maraviroc, and the fusion inhibitor enfuvirtide, have greatly expanded options for addition of active drugs. Additionally, investigational antiretrovirals with activity against resistant HIV with resistance are likely to be available in the near future. Clinicians need timely education to incorporate changing practices in management of treatment-experienced patients and to understand the place of newly licensed and investigational agents active against resistant HIV.

This educational activity is intended to help clinicians need to stay abreast of current treatment strategies for management of antiretroviral-experienced patients. Enhanced knowledge and clinical competency related to the optimal use of antiretroviral therapy in patients with resistance can lead to improved management and survival in patients with resistant HIV.

Sponsored by the Discovery Institute of Medical Education

Funding Statement

This activity is funded through an educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.

Inquiries

All inquiries should be directed to:
Discovery Institute of Medical Education
35 West Wacker Drive, Suite 1200
Chicago, IL 60601-1636
DIMEinfo@DIMedEd.org
©2007 DIME

October Session

October 30, 2007, HIV eJournal Club Session
Release Date: October 30, 2007
Expiration Date: October 30, 2008

Accreditation Statement

DIME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

DIME designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

Discovery Institute of Medical Education (DIME) is an approved provider of continuing nursing education by the Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

Participants in this activity will be eligible to receive up to 1.0 contact hours of continuing nursing education credit.

Continuing Pharmacy Education Statement

DIME is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. The live program has been assigned the ACPE Universal Program Number 246-000-07-007-L02-P, the archived program has been assigned the ACPE Universal Program Number 246-000-07-008-H02-P, and both have been approved for 1.0 contact hours (0.1 CEUs) of continuing education credit.

Instructions to Receive Credit

In order to receive credit participants are required to participate in the entire teleconference and complete the test and evaluation form found on the website. A minimum score of 70% on the test is required to receive credit. Statements of credit will be made available for electronic download immediately. There is no fee for participating in the activity or for the generation of the statement of credit. Initial release date: October 30, 2007

Article Title

Efficacy and Safety of TMC125 (Etravirine) in Treatment-Experienced HIV-1-Infected Patients in DUET-2: 24-Week Results From a Randomized, Double-Blind, Placebo-Controlled Trial

Learning Objectives

On completion of this activity, participants should be able to:

• Outline the objectives and the design of the DUET-2 clinical study
• Describe the main efficacy and safety findings of the DUET-2 study, including findings in important patient subgroups
• Identify the clinical implications of the DUET-2 results for the management of treatment-experienced patients infected with HIV-1 who are resistant to current NNRTIs as well as to other antiretroviral classes

Faculty

Disclosures

DIME requires that all persons who were in a position to control or influence the content of this CME activity disclose all relevant financial relationships with any commercial interest. This information is used to: (1) determine whether a conflict exists, (2) resolve the conflict by initiating a content validation process, and (3) advise learners of this information.

Disclosure of Unlabeled Use

November Session

November 27, 2007, HIV eJournal Club Session
Release Date: November 27, 2007
Expiration Date: November 27, 2008

Accreditation Statement

DIME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

DIME designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

Discovery Institute of Medical Education (DIME) is an approved provider of continuing nursing education by the Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

Participants in this activity will be eligible to receive up to 1.0 contact hours of continuing nursing education credit.

Continuing Pharmacy Education Statement

DIME is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. The live program has been assigned the ACPE Universal Program Number 246-000-07-009-L02-P, the archived program has been assigned the ACPE Universal Program Number 246-000-07-010-H02-P, and both have been approved for 1.0 contact hours (0.1 CEUs) of continuing education credit.

Instructions to Receive Credit

In order to receive credit participants are required to participate in the entire teleconference and complete the test and evaluation form found on the website. A minimum score of 70% on the test is required to receive credit. Statements of credit will be made available for electronic download immediately. There is no fee for participating in the activity or for the generation of the statement of credit. Initial release date: November 27, 2007

Article Title

Phase 2 Study of the Safety and Efficacy of Vicriviroc, a CCR5 Inhibitor, in HIV-1 Infected, Treatment-Experienced Patients: AIDS Clinical Trials Group 5211

Learning Objectives

On Completion of this activity, participants should be able to:

• Summarize the mechanistic basis for the clinical development of CCR5 chemokine coreceptor inhibitors as antiretroviral agents for HIV-1 infection
• Outline the objectives and the design of the AIDS Clinical Trial Group 5211 Phase 2 study of the CCR5 inhibitor, vicriviroc, in HIV-1–infected, treatment-experienced patients with virologic failure
• Describe the virologic responses, immunologic responses, and coreceptor changes associated with vicriviroc treatment in this study
• Identify current safety concerns regarding the CCR5 inhibitor class in general, and assess the safety findings of this study in light of those concerns
• Discuss the suitability of further clinical development of vicriviroc and its potential place in therapy

Faculty

Disclosures

DIME requires that all persons who were in a position to control or influence the content of this CME activity disclose all relevant financial relationships with any commercial interest. This information is used to: (1) determine whether a conflict exists, (2) resolve the conflict by initiating a content validation process, and (3) advise learners of this information.

Disclosure of Unlabeled Use

December Session

December 19, 2007, HIV eJournal Club Session
Release Date: December 19, 2007
Expiration Date: December 19, 2008

Accreditation Statement

DIME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

DIME designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

Discovery Institute of Medical Education (DIME) is an approved provider of continuing nursing education by the Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

Participants in this activity will be eligible to receive up to 1.0 contact hours of continuing nursing education credit.

Continuing Pharmacy Education Statement

DIME is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. The live program has been assigned the ACPE Universal Program Number 246-000-07-011-L02-P, the archived program has been assigned the ACPE Universal Program Number 246-000-07-012-H02-P, and both have been approved for 1.0 contact hours (0.1 CEUs) of continuing education credit.

Instructions to Receive Credit

In order to receive credit participants are required to participate in the entire teleconference and complete the test and evaluation form found on the website. A minimum score of 70% on the test is required to receive credit. Statements of credit will be made available for electronic download immediately. There is no fee for participating in the activity or for the generation of the statement of credit. Initial release date: December 19, 2007.

Article Title

Guidelines for the Use of Antiretroviral Agents in HIV-1–Infected Adults and Adolescents

Learning Objectives

On completion of this activity, participants should be able to:

• Describe changes to the US Department of Health and Human ServicesGuidelines for the Use of Antiretroviral Agents in HIV-1–infected Adults and Adolescents
• Discuss the evidence basis for new treatment recommendations and changes in the strength of evidence supporting existing recommendations
• Identify new recommendations for laboratory assessments including drug resistance, tropism, and HLA-B*5701
• Define recommendations for treatment initiation in relation to CD4+ cell count
• Explain how to assess and manage virologic and immunologic failure in the course of treatment and when changing antiretroviral regimens
• Discuss new classes of antiretroviral drugs available and data supporting their use in the management of treatment-experienced patients

Faculty

Disclosures

DIME requires that all persons who were in a position to control or influence the content of this CME activity disclose all relevant financial relationships with any commercial interest. This information is used to: (1) determine whether a conflict exists, (2) resolve the conflict by initiating a content validation process, and (3) advise learners of this information.

Disclosure of Unlabeled Use