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Article ; Online: Prevention, treatment and cure of HIV infection.

Landovitz, Raphael J / Scott, Hyman / Deeks, Steven G

2023 Volume 21, Issue 10, Page(s) 657–670

Abstract: The development of antiretroviral therapy for the prevention and treatment of HIV infection has been marked by a series of remarkable successes. However, the efforts to develop a vaccine have largely failed, and efforts to discover a cure are only now ... ...

Abstract	The development of antiretroviral therapy for the prevention and treatment of HIV infection has been marked by a series of remarkable successes. However, the efforts to develop a vaccine have largely failed, and efforts to discover a cure are only now beginning to gain traction. In this Review, we describe recent progress on all fronts - pre-exposure prophylaxis, vaccines, treatment and cure - and we discuss the unmet needs, both current and in the coming years. We describe the emerging arsenal of drugs, biologics and strategies that will hopefully address these needs. Although HIV research has largely been siloed in the past, this is changing, as the emerging research agenda is marked by multiple cross-discipline synergies and collaborations. As the limitations of antiretroviral drugs as a means to truly end the epidemic are becoming more apparent, there is a great need for continued efforts to develop an effective preventative vaccine and a scalable cure, both of which remain formidable challenges.
MeSH term(s)	Humans ; HIV Infections/drug therapy ; HIV Infections/prevention & control
Language	English
Publishing date	2023-06-21
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2139054-X
ISSN	1740-1534 ; 1740-1526
ISSN (online)	1740-1534
ISSN	1740-1526
DOI	10.1038/s41579-023-00914-1
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Article ; Online: Challenges and Opportunities for Preexposure Prophylaxis.

Cambou, Mary Catherine / Landovitz, Raphael J

Topics in antiviral medicine

2021 Volume 29, Issue 4, Page(s) 399–406

Abstract: Despite major advances in the HIV prevention toolbox in the past decade, there remain substantial social, economic, and structural barriers to access to preexposure prophylaxis (PrEP) that prevent a universal, population-level reduction in HIV incidence. ...

Abstract	Despite major advances in the HIV prevention toolbox in the past decade, there remain substantial social, economic, and structural barriers to access to preexposure prophylaxis (PrEP) that prevent a universal, population-level reduction in HIV incidence. Daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) has been the flagship PrEP regimen, and data support a pericoital/on-demand "2-1-1" dosing schedule for men who have sex with men. Daily oral PrEP with tenofovir alafenamide combined with emtricitabine (TAF/FTC) was approved by the US Food and Drug Administration (FDA) in 2019 for all routes of exposure other than vaginal exposures. The effectiveness of daily oral TDF/FTC has not been consistent in cisgender women outside of serodifferent couples, likely owing to differences in vaginal tissue penetration of PrEP agents resulting in less "forgiveness" of nonadherence. These observations have highlighted the need for additional choices of HIV prevention strategies. Injectable long-acting cabotegravir was recently shown to be superior to daily oral TDF/FTC across risk populations. PrEP studies of islatravir are underway for a monthly oral formulation and a drug-eluting subdermal implant. Lenacapavir, with a novel mechanism of action, is under investigation as a subcutaneous injection at 6-month intervals.
MeSH term(s)	Anti-HIV Agents/therapeutic use ; Emtricitabine/therapeutic use ; Female ; HIV Infections/drug therapy ; HIV Infections/prevention & control ; Homosexuality, Male ; Humans ; Male ; Pre-Exposure Prophylaxis ; Sexual and Gender Minorities
Chemical Substances	Anti-HIV Agents ; Emtricitabine (G70B4ETF4S)
Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2656632-1
ISSN	2161-5853 ; 2161-5853
ISSN (online)	2161-5853
ISSN	2161-5853
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Article ; Online: Assessing the Role of Long-Acting Cabotegravir Preexposure Prophylaxis of Human Immunodeficiency Virus: Opportunities and Aspirations.

Cohen, Myron S / Landovitz, Raphael J

The Journal of infectious diseases

2020 Volume 223, Issue 1, Page(s) 1–3

MeSH term(s)	HIV ; HIV Infections/prevention & control ; Humans ; Models, Theoretical ; Pre-Exposure Prophylaxis ; Pyridones
Chemical Substances	Pyridones ; cabotegravir (HMH0132Z1Q)
Language	English
Publishing date	2020-09-03
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Comment
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiaa555
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Article ; Online: Donate now to prevent sexually transmitted infections later: incentivising testing of sexually transmitted infections.

Beymer, Matthew R / Landovitz, Raphael J

The Lancet. Infectious diseases

2020 Volume 20, Issue 8, Page(s) 885–886

MeSH term(s)	China ; Chlamydia ; Gonorrhea ; Homosexuality, Male ; Humans ; Male ; Sexual and Gender Minorities ; Sexually Transmitted Diseases
Language	English
Publishing date	2020-04-28
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(20)30365-0
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Article ; Online: Promises and challenges: cabotegravir for preexposure prophylaxis.

Spinelli, Matthew A / Grinsztejn, Beatriz / Landovitz, Raphael J

Current opinion in HIV and AIDS

2022 Volume 17, Issue 4, Page(s) 186–191

Abstract: Purpose of review: Tenofovir-based oral PrEP has been effective in reducing population-level HIV incidence in multiple settings, although disparities remain. Injectable cabotegravir-based PrEP is an alternative that may be attractive to individuals with ...

Abstract	Purpose of review: Tenofovir-based oral PrEP has been effective in reducing population-level HIV incidence in multiple settings, although disparities remain. Injectable cabotegravir-based PrEP is an alternative that may be attractive to individuals with adherence challenges or who do not desire to take a daily medication. We review promises and challenges of cabotegravir-based PrEP. Recent findings: Cabotegravir has demonstrated higher effectiveness than oral PrEP in two randomized trials, with a hazard ratio of 0.31 for HIV incidence among MSM and transgender women across multiple settings [95% confidence interval (CI) 0.18-0.62] and 0.11 for cisgender women in sub-Saharan Africa (95% CI 0.040.32). Cabotegravir was also highly effective among populations with disproportionate HIV incidence. Although cabotegravir breakthrough was rare, diagnosis was delayed with use of antigen/antibody-based HIV tests, and resistance occurred with breakthrough infections. Implementation will need to overcome several challenges, including HIV RNA laboratory monitoring not being widely available, requirement for additional staff time and clinic space, and need to provide oral medication during interruptions in dosing. Summary: Cabotegravir-based PrEP is a highly effective additional PrEP option that will expand HIV prevention options. For successful roll-out, strategies for streamlined and accessible delivery of cabotegravir in real-world settings will need to be developed.
MeSH term(s)	Diketopiperazines/therapeutic use ; Female ; HIV Infections/drug therapy ; HIV Integrase Inhibitors/therapeutic use ; Homosexuality, Male ; Humans ; Male ; Pre-Exposure Prophylaxis ; Pyridones/therapeutic use ; Sexual and Gender Minorities
Chemical Substances	Diketopiperazines ; HIV Integrase Inhibitors ; Pyridones ; cabotegravir (HMH0132Z1Q)
Language	English
Publishing date	2022-03-04
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	2502511-9
ISSN	1746-6318 ; 1746-630X
ISSN (online)	1746-6318
ISSN	1746-630X
DOI	10.1097/COH.0000000000000733
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Article ; Online: Novel Antiretroviral Agents.

Cambou, Mary C / Landovitz, Raphael J

Current HIV/AIDS reports

2020 Volume 17, Issue 2, Page(s) 118–124

Abstract: Purpose of review: Combination antiretroviral therapy (cART) has had dramatic effects on morbidity and mortality for persons living with HIV (PLWH). Despite significant progress in treatment efficacy, tolerability, and reducing pill burden, new agents ... ...

Abstract	Purpose of review: Combination antiretroviral therapy (cART) has had dramatic effects on morbidity and mortality for persons living with HIV (PLWH). Despite significant progress in treatment efficacy, tolerability, and reducing pill burden, new agents are needed to address issues of resistance, drug-drug interactions, end organ disease, and adherence. This review covers novel ART agents recently approved or in development. Recent findings: Capsid inhibitors (CAI) demonstrate high potency and potential for extended-duration dosing in pre-clinical trials. While previous maturation inhibitors (MI) were hampered by issues of drug resistance, a recent phase IIa trial for a second-generation MI demonstrated promising antiviral activity. A phase I trial to evaluate a transdermal implant of islatravir, a nucleoside reverse transcriptase translocation inhibitor (NRTTI), maintained concentrations above the target pharmacokinetic threshold at 12 weeks. The attachment inhibitor fostemsavir is available in the USA for compassionate use in multi-drug-resistant (MDR) HIV. New antiretroviral agents show promise for both extended-duration dosing and MDR HIV.
MeSH term(s)	Anti-HIV Agents/pharmacology ; Capsid/drug effects ; Capsid Proteins/antagonists & inhibitors ; Deoxyadenosines/pharmacology ; Drug Discovery/methods ; Drug Therapy, Combination/methods ; HIV Fusion Inhibitors/pharmacology ; HIV Infections/drug therapy ; Humans ; Organophosphates/pharmacology ; Piperazines/pharmacology ; Reverse Transcriptase Inhibitors/pharmacology
Chemical Substances	Anti-HIV Agents ; Capsid Proteins ; Deoxyadenosines ; HIV Fusion Inhibitors ; Organophosphates ; Piperazines ; Reverse Transcriptase Inhibitors ; fostemsavir (97IQ273H4L) ; islatravir (QPQ082R25D)
Language	English
Publishing date	2020-01-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2151206-1
ISSN	1548-3576 ; 1548-3568
ISSN (online)	1548-3576
ISSN	1548-3568
DOI	10.1007/s11904-020-00486-2
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Article ; Online: Optimizing Delivery of Preexposure Prophylaxis--The Next Frontier.

Landovitz, Raphael J

JAMA internal medicine

2016 Volume 176, Issue 1, Page(s) 85–86

MeSH term(s)	African Americans ; Anti-HIV Agents/therapeutic use ; Bisexuality ; Community Health Services/methods ; Female ; HIV Infections/prevention & control ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Male ; Medication Adherence/statistics & numerical data ; Pre-Exposure Prophylaxis/methods ; Sexual Behavior/statistics & numerical data ; Tenofovir/therapeutic use ; Transgender Persons ; Unsafe Sex/statistics & numerical data
Chemical Substances	Anti-HIV Agents ; Tenofovir (99YXE507IL)
Language	English
Publishing date	2016-01
Publishing country	United States
Document type	Comment ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2699338-7
ISSN	2168-6114 ; 2168-6106
ISSN (online)	2168-6114
ISSN	2168-6106
DOI	10.1001/jamainternmed.2015.6530
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Article ; Online: Breakthrough HIV-1 infection in setting of cabotegravir for HIV pre-exposure prophylaxis.

Hazra, Aniruddha / Landovitz, Raphael J / Marzinke, Mark A / Quinby, Connor / Creticos, Catherine

AIDS (London, England)

2023 Volume 37, Issue 11, Page(s) 1711–1714

Abstract: Objective: We describe the first case of HIV-1 infection in the setting of long-acting injectable cabotegravir (CAB-LA) for HIV pre-exposure prophylaxis to occur in the real world.: Design: Case report.: Methods: Electronic medical records were ... ...

Abstract	Objective: We describe the first case of HIV-1 infection in the setting of long-acting injectable cabotegravir (CAB-LA) for HIV pre-exposure prophylaxis to occur in the real world. Design: Case report. Methods: Electronic medical records were reviewed to assess patient history and CAB-LA administration details. Plasma fourth-generation HIV-1/2 Ag/Ab combination immunoassay and HIV-1 RNA quantitative PCR were performed at each injection visit. Results: We report a 28-year-old sex-diverse person assigned male at birth who acquired HIV-1 infection 91 days after transitioning from tenofovir alafenamideemtricitabine to CAB-LA despite on-time dosing and appropriate laboratory monitoring. Conclusion: This patient's history suggests HIV infection despite on-time and appropriate CAB-LA injections. To our knowledge, this is the first case of CAB-LA pre-exposure prophylaxis failure outside the setting of a clinical trial and highlights diagnostic and management challenges that may occur with such breakthrough infections.
MeSH term(s)	Infant, Newborn ; Humans ; Male ; Adult ; HIV Infections/prevention & control ; HIV Infections/drug therapy ; Anti-HIV Agents/therapeutic use ; HIV-1 ; Pre-Exposure Prophylaxis ; Pyridones/therapeutic use
Chemical Substances	Anti-HIV Agents ; cabotegravir (HMH0132Z1Q) ; Pyridones
Language	English
Publishing date	2023-07-03
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000003644
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Article ; Online: Collective Call to Action for HIV/AIDS Community-Based Collaborative Science in the Era of COVID-19.

Shoptaw, Steven / Goodman-Meza, David / Landovitz, Raphael J

AIDS and behavior

2020 Volume 24, Issue 7, Page(s) 2013–2016

Keywords	covid19
Language	English
Publishing date	2020-04-16
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural
ZDB-ID	1339885-4
ISSN	1573-3254 ; 1090-7165
ISSN (online)	1573-3254
ISSN	1090-7165
DOI	10.1007/s10461-020-02860-y
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Article ; Online: Preexposure Prophylaxis For HIV Prevention: What We Know and What We Still Need to Know for Implementation.

Landovitz, Raphael J

Topics in antiviral medicine

2015 Volume 23, Issue 2, Page(s) 85–90

Abstract: ... This article summarizes a presentation made by Raphael J. Landovitz, MD, MSc, at the 2015 Conference ...

Abstract	Preexposure prophylaxis (PrEP) with tenofovir and emtricitabine has been shown to be effective and cost-effective in preventing acquisition of HIV infection. However, PrEP has not yet been widely adopted in the clinical practice setting. Data thus far, although imperfect, do not indicate an increase in risk behaviors in the setting of PrEP, although potential risk compensation outside of the clinical trial setting should be further examined. Substantial work remains to implement and support PrEP use, including identification of optimal settings for providing and managing PrEP, identification of methods to ensure optimal adherence to treatment, and employment of strategies to deliver PrEP to populations at greatest risk. This article summarizes a presentation made by Raphael J. Landovitz, MD, MSc, at the 2015 Conference on Retroviruses and Opportunistic Infections held from February 23 to February 26 in Seattle, Washington.
MeSH term(s)	Anti-Retroviral Agents/therapeutic use ; Disease Transmission, Infectious/prevention & control ; Emtricitabine/therapeutic use ; HIV Infections/prevention & control ; Humans ; Medication Adherence ; Pre-Exposure Prophylaxis/methods ; Risk-Taking ; Tenofovir/therapeutic use
Chemical Substances	Anti-Retroviral Agents ; Tenofovir (99YXE507IL) ; Emtricitabine (G70B4ETF4S)
Language	English
Publishing date	2015-07-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2656632-1
ISSN	2161-5853 ; 2161-5861
ISSN (online)	2161-5853
ISSN	2161-5861
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