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virus closeup, contagious pathogen. Monkey pox virus closeup, contagious pathogen, infectious zoonotic disease
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Mpox: Current Clinical Considerations on Antiviral Treatment

Jessica Huston, Eric F Egelund

A double-stranded DNA virus of the Orthopoxvirus family, mpox (formerly monkeypox), continues to infect people daily, following the 2022 global outbreak.1 Two clades (clade 1 and clade 2) have been identified, with the 2022 outbreak caused by a subclade of clade 2, referred to as clade 2b.2 Comparatively, clade 1 leads to a more severe disease state and greater […]

touchREVIEWS in Infectious Diseases. 2025;4(1):Online ahead of journal publication

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touchCASES
CE/CME accredited

Towards personalized care for people living with HIV: Supporting open dialogue and informed treatment choices

Topics Covered:
HIV Sexually Transmitted Infections Viral Infections
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Tutorial

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Poll

How do you approach concerns about weight gain for people living with HIV?

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Recommend tracking diet and daily activity
   
Provide information on restricted calorie diets
   
Consider use of medications for weight loss
   
Reassure them that weight gain is normal with ageing
   

Poll

How likely are you to recommend switching antiretroviral therapy for a person living with HIV who is concerned about weight gain?

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Very likely
   
Likely
   
Unlikely
   

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Poll

How common is pill fatigue in your clinic?

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Very common
   
Common
   
Uncommon
   

Poll

What are you most likely to recommend for people living with HIV who are experiencing pill fatigue that is affecting adherence?

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Switch to a long-acting injectable regimen
   
Behavioural strategies to help manage pill fatigue
   
Evaluate further ART simplification, such as from 3 to 2-drug regimen
   

Tutorial

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Tutorial

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Poll

Which of the following messages about ART is most likely to help convince a newly diagnosed individual with HIV to begin therapy?

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Starting ART will reduce the risk of transmitting HIV to others
   
Starting ART will reduce anxiety and stigma of an HIV diagnosis
   
Within about 2 months of starting ART, HIV can be undetectable
   
ART will help ensure a near-normal life span
   

Poll

When would you initiate antiretroviral therapy in a person with newly diagnosed, advanced HIV infection?

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Immediately – at the clinic
   
When the individual is ready – within the next 6 months
   
At the next visit – within 3 months
   
After treating any STIs or opportunistic infections
   
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Case Scenarios

Case 1: Weight gain on long-term ART

David has been living with HIV for many years. While his current regimen has successfully maintained a suppressed viral load, he has recently become concerned about weight gain.
Experts discuss key questions and next steps for David
Duration: 10:52

Case 2: Pill fatigue during ART

Anna has been living with HIV for 4 years and has a suppressed viral load on her current regimen. She is here today to talk about pill fatigue.
Experts discuss key questions and next steps for Anna
Duration: 11:12

Case 3: Starting ART post-HIV diagnosis

Lucas has just received a diagnosis of advanced HIV. He is here to discuss his new diagnosis and next steps.
Experts discuss key questions and next steps for Lucas
Duration: 12:24

Useful Tips

Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German and Spanish.
Associated slides for this activity are available under the Downloads tab.
A practice aid for this activity is available under the Downloads tab.

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touchCASES

Towards personalized care for people living with HIV: Supporting open dialogue and informed treatment choices

0.75 CE/CME credit

Question 1 of 5

Which of the following is the most appropriate next step in the management of a newly-diagnosed, asymptomatic individual with HIV infection?

ART, antiretroviral therapy.

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Guidelines recommend initiating ART immediately (or as soon as possible) after diagnosis.1,2 Starting ART is recommended regardless of CD4 count and genotypic testing should not delay ART initiation.1,2

Abbreviation

ART, antiretroviral therapy.

References

  1. HHS. 2024. Available at: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf (accessed 13 May 2025).
  2. EACS. 2024. Available at: https://eacs.sanfordguide.com/eacs-part1/art/eacs-switch-strategies (accessed 13 May 2025).
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touchCASES

Towards personalized care for people living with HIV: Supporting open dialogue and informed treatment choices

0.75 CE/CME credit

Question 2 of 5

You are managing a 70-year-old male living with HIV. He currently has a suppressed viral load on DTG/ABC/3TC. At a recent examination, he was found to be hypertensive and dyslipidaemic; he is also an occasional smoker. He has no history of resistance and is HBV-immune. You have previously discussed long-acting ART, but he has indicated a dislike of needles. In relation to his ART regimen, and assuming availability and local approval of all options, how would you proceed?

3TC, lamivudine; ABC, abacavir; ART, antiretroviral therapy; CAB, cabotegravir; CV, cardiovascular; DTG, dolutegravir; HBV, hepatitis B virus; PI, protease inhibitor; RPV, rilpivirine.

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Coronary heart disease has been reported as a severe side effect of ABC.1 EACS guidelines recommend that in individuals with a 10-year CVD risk ≥10%, ART modification should be considered, including potential replacement of ABC with TDF or an NRTI-sparing regimen.1 HHS guidelines recommend considering avoidance of ABC in people with multiple CV risk factors or known CV disease.2 There is some evidence that cumulative exposure to PIs may increase the risk of myocardial infarction.3

Abbreviations

ABC, abacavir; ART, antiretroviral therapy; CV, cardiovascular; CVD, cardiovascular disease; EACS, European AIDS Clinical Society; HHS, Human and Health Services; NRTI, nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; TDF, tenofovir disoproxil fumarate.

References

  1. EACS. 2024. Available at: https://eacs.sanfordguide.com/eacs-part1/art/eacs-switch-strategies (accessed 13 May 2025).
  2. HHS. 2024. Available at: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf (accessed 13 May 2025).
  3. DAD study group, et al. N Engl J Med. 2007;356:1723–35.
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touchCASES

Towards personalized care for people living with HIV: Supporting open dialogue and informed treatment choices

0.75 CE/CME credit

Question 3 of 5

Which statement best differentiates pill burden from pill fatigue in relation to ART for HIV?

ART, antiretroviral therapy.

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Pill burden can be defined as the number of tablets, capsules or other dosage forms that a person takes on a regular basis.1 Reducing pill burden has been shown to improve adherence.2 Pill or treatment fatigue represents psychological fatigue occurring as a consequence of long-term medication use and can lead to reduced adherence.3,4

References

  1. Clinicalinfo.HIV.gov. Available at: https://clinicalinfo.hiv.gov/en/glossary/pill-burden#:~:text=HIV%2FAIDS%20Glossary&text=The%20number%20of%20tablets%2C%20capsules,to%20an%20HIV%20treatment%20regimen (accessed 13 May 2025).
  2. Airoldi M, et al. Patient Prefer Adherence. 2010:4:115–25.
  3. Claborn KR, et al. Psychol Health Med. 2015;20:255–65.
  4. IAPAC. 2024. Available at www.iapac.org/fact-sheet/adherence (accessed 13 May 2025).
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Towards personalized care for people living with HIV: Supporting open dialogue and informed treatment choices

0.75 CE/CME credit

Question 4 of 5

You are managing a 45-year-old male living with HIV. He has a suppressed viral load, no history of resistance or HBV infection and is currently taking a single-tablet three-drug ART regimen. At his most recent clinic visit, he indicated that he has a new job that involves significant international travel, and he has already forgotten to take his medication a few times. Assuming availability and local approval, how would you address his issues with adherence?

ART, antiretroviral therapy; HBV, hepatitis B virus.

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Suboptimal adherence can compromise treatment response, and it is important to maximize conditions that promote adherence.1 Changing to a long-acting injectable regimen for convenience or to improve adherence is indicated in treatment guidelines.1,2 Evidence suggests long-acting injectable CAB/RPV has superior efficacy compared with daily oral ART in people living with HIV who have challenges with adherence.3 As this individual is a frequent traveller, a long-acting regimen may be a more practical solution.4

Abbreviations

ART, antiretroviral therapy; CAB, cabotegravir; RPV, rilpivirine.

References

  1. HHS. 2024. Available at: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf (accessed 13 May 2025).
  2. EACS. 2024. Available at: https://eacs.sanfordguide.com/eacs-part1/art/eacs-switch-strategies (accessed 13 May 2025).
  3. Rana AI, et al. Presented at: Presented at CROI 2024, Denver, CO, USA. 3–6 March 2025. Abstr 212.
  4. Aidsmap. 2024. Available at: www.aidsmap.com/about-hiv/what-do-we-know-about-injectable-hiv-medication (accessed 13 May 2025).
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Towards personalized care for people living with HIV: Supporting open dialogue and informed treatment choices

0.75 CE/CME credit

Question 5 of 5

Which of the following most closely reflects best practice for shared decision-making in HIV care?

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Shared decision-making respects an individual’s autonomy in responding to recommendations from a healthcare professional about their HIV care. Through this process, a clinician engages the individual in an open and respectful dialogue to understand their knowledge, experience, healthcare goals and other aspects. With this information and the clinician’s clinical expertise, they collaborate to identify, evaluate and choose from among possible therapy options to develop a treatment plan.

Reference

New York state department of health AIDS institute. 2023. Available at: www.hivguidelines.org/sdm/ (accessed 13 May 2025).

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Case Scenarios

Case 1: Weight gain on long-term ART

David has been living with HIV for many years. While his current regimen has successfully maintained a suppressed viral load, he has recently become concerned about weight gain.
Experts discuss key questions and next steps for David
Duration: 10:52

Case 2: Pill fatigue during ART

Anna has been living with HIV for 4 years and has a suppressed viral load on her current regimen. She is here today to talk about pill fatigue.
Experts discuss key questions and next steps for Anna
Duration: 11:12

Case 3: Starting ART post-HIV diagnosis

Lucas has just received a diagnosis of advanced HIV. He is here to discuss his new diagnosis and next steps.
Experts discuss key questions and next steps for Lucas
Duration: 12:24

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Learning Objectives & Overview

Faculty

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Faculty & Disclosures
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Learning Objectives

After watching this activity, participants should be better able to:

  • Discuss strategies to optimize ART regimens for people living with HIV while maintaining viral suppression
  • Identify key factors associated with individual preferences for antiretroviral therapy, including long-acting or simplified regimens
  • Outline collaborative, person-centred strategies to improve shared decision-making in HIV

Overview

In this activity, Prof. José Arribas, a leading HIV expert, and Ms Harriet Langanke, a journalist and HIV activist, explore three cases of people living with HIV. The discussion encompasses treatment choice at different stages of the HIV journey, with a focus on personalized care and supporting open dialogue.

This activity is jointly provided by USF Health and touchIME.

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Target Audience

This activity has been designed to meet the educational needs of HIV specialists, infectious disease specialists, genito-urinary medicine specialists, sexual health and specialist nurse practitioners, gynaecologists and virologists involved in the care of people with HIV.

USF Accreditation

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Prof. José Arribas discloses: Advisory board/panel fees and consultancy fees from Janssen Pharmaceuticals, MSD and ViiV Healthcare. Grants/research support from MSD.

Ms Harriet Langanke has no interests/relationships or affiliations to disclose in relation to this activity.

Content reviewer

Alicia A Canalejo, APRN has no financial interests/relationships or affiliations in relation to this activity.

touchIME Medical Contributors

Annette Wiggins has no financial interests/relationships or affiliations in relation to this activity.

Kathy Day has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu 

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 24 June 2025. Date credits expire: 24 June 2026.

If you have any questions regarding credit, please contact cpdsupport@usf.edu

EBAC® Accreditation

touchIME is an EBAC® accredited provider since 2023.

This programme is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for 45 minutes of effective education time.

The Accreditation Council for Continuing Medical Education (ACCME®), and the Royal College of Physicians and Surgeons of Canada hold an agreement on mutual recognition on substantive equivalency of accreditation systems with EBAC®.

Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals and the American Medical Association (AMA), physicians may convert EBAC® CE credits to AMA PRA Category 1 CreditsTM. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other health care professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 CreditTM.

Faculty Disclosure Statement / Conflict of Interest Policy

In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event have been mitigated and declared to the audience prior to the CME activities.

Faculty

Prof. José Arribas discloses: Advisory board/panel fees and consultancy fees from Janssen Pharmaceuticals, MSD and ViiV Healthcare. Grants/research support from MSD.

Ms Harriet Langanke has no interests/relationships or affiliations to disclose in relation to this activity.

touchIME Medical Contributors

Annette Wiggins has no financial interests/relationships or affiliations in relation to this activity.

Kathy Day has no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

Date of original release: 24 June 2025. Date credits expire: 24 June 2027.

Time to Complete: 30 minutes

If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org

Faculty & Disclosures2

Prof. José Arribas

University Hospital La Paz, Madrid, Spain
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Prof. José Arribas

University Hospital La Paz, Madrid, Spain

Biography

Prof. José Arribas is head of the Internal Medicine Department at La Paz University Hospital and professor of medicine at the Autonoma University Medical School in Madrid, Spain. He also serves as the research director of HIV and infectious diseases at La Paz University Hospital.

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His research focuses on antiretroviral therapy, the development of new antiretrovirals and emerging infectious diseases. He has authored more than 400 scientific publications, including numerous clinical trials on antiretroviral therapy.

Prof. Arribas is the former President of GeSIDA (the Spanish Group for AIDS Research) and previously chaired the antiretroviral treatment panel of the European AIDS Clinical Society (EACS).

Prof. José Arribas discloses: Advisory board/panel fees and consultancy fees from Janssen Pharmaceuticals, MSD and ViiV Healthcare. Grants/research support from MSD.

Ms Harriet Langanke

GSSG, Cologne, Germany
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Ms Harriet Langanke

GSSG, Cologne, Germany

Biography

Ms Harriet Langanke is a sexologist and journalist specialized in sexual health.

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For over 30 years, she has worked both professionally and as a volunteer in the field of HIV. She is the founder of the German non-profit Foundation Sexuality and Health (GSSG), which supports projects such as DHIVA, a professional magazine focused on women, sexuality and health, and the SHE Project—an initiative empowering women living with HIV. Harriet serves as an advisor to the board of the German STI Society and is an expert in HIV prevention.

Ms Harriet Langanke has no interests/relationships or affiliations to disclose in relation to this activity.

Downloads2

View and download resources from this activity to support your learning and share with colleagues

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File Size: 0.45 MB
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Case Scenarios

Case 1: Weight gain on long-term ART

David has been living with HIV for many years. While his current regimen has successfully maintained a suppressed viral load, he has recently become concerned about weight gain.
Experts discuss key questions and next steps for David
Duration: 10:52

Case 2: Pill fatigue during ART

Anna has been living with HIV for 4 years and has a suppressed viral load on her current regimen. She is here today to talk about pill fatigue.
Experts discuss key questions and next steps for Anna
Duration: 11:12

Case 3: Starting ART post-HIV diagnosis

Lucas has just received a diagnosis of advanced HIV. He is here to discuss his new diagnosis and next steps.
Experts discuss key questions and next steps for Lucas
Duration: 12:24

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This activity is for healthcare professionals outside of the UK.

This activity is funded by an independent medical education grant from ViiV Healthcare.

This activity is jointly provided by USF Health and touchIME.

touchIME is an EBAC® accredited provider.

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This activity is funded by:

This activity is funded by an independent medical education grant from ViiV Healthcare.

This activity is jointly provided by USF Health and touchIME.
touchIME is an EBAC® accredited provider.

The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

USF

USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

EBAC® 

Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

touchIME is an EBAC® accredited provider since 2023.

This content is intended for healthcare professionals.

AMA PRA Category 1 Credits ™ expire: 24 June 2026
EBAC Credits expire: 24 June 2027

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