HIV 2015/16
A readable book on HIV infection with which physicians can work specifically and practically.
HIV 2015/16
A readable book on HIV infection with which physicians can work specifically and practically.
Which antiretroviral therapy to start with? When and how to switch? What strategies are available for patients with multi-resistant viruses? How to treat for renal failure or pregnancy, AIDS, hepatitis co-infection or HIV-2? Where are the advances and pitfalls on the way to cure? And how can HIV infections be prevented? Those who want to answer these questions must stay on the ball. HIV 2015/2016 helps – with clear instructions for practical action.
The HIV book is a textbook that is freely available on the Internet. The concept was developed in 1991 by Bernd Sebastian Kamps. The idea was to create a book on HIV infection that gives practical help to physicians, but also to members of other professions who deal with HIV patients, remains independent in content and form, avoids cumbersome, pseudo-scientific slang in favor of readability, and is freely available and retrievable via the Internet (decisive changes can be called up free of charge on this website at any time). Since the first edition in 1991, the book has been published annually and has been downloaded by thousands of physicians worldwide. The complete edition HIV 2015/2016 (774 pages) is freely available.
For the free download click here:
HIV2015/16-full version as pdf
TABLE OF CONTENTS
1. Introduction
The HIV epidemic
Transmission routes
The natural course of HIV infection
Disease progression
Epidemiology
Summary
2. HIV Testing
3. Pathogenesis of HIV-1 Infection
4. Preventive HIV-1 Vaccine
Induction of neutralizing antibodies
Induction of HIV-1-specific T cells
Recombinant viral vectors
5. Acute HIV-1 Infection
Introduction
Definition and classification
Signs and symptoms
Diagnosis
Immunological and virological events during AHI
Treatment
6. ART 2015/2016
6.1. Perspective
6.2. Overview of antiretroviral agents
6.3. ART 2017/2018: The horizon and beyond
6.4. Goals and principles of therapy
6.5. When to Start ART
6.6. What to start with
6.7. When to switch
6.8. How to switch ART
6.9. Salvage therapy
6.10. When to stop ART – A review of treatment interruption
6.11. Monitoring
6.12. Prevention of HIV infection
6.13. Global access to HIV treatment
7. Management of Side Effects
Gastrointestinal side effects
Hepatotoxicity
Renal problems
Neurological side effects
Allergic and skin reactions
Osseous side effects
Hematological changes
Lipodystrophy syndrome
8. HIV Resistance and Viral Tropism Testing
Assays for resistance testing
Interpretation of genotypic resistance profiles
Summary
Resistance tables
9. Opportunistic Infections (OIs)
Pneumocystis pneumonia (PCP)
Cerebral toxoplasmosis
CMV retinitis
Candidiasis
Tuberculosis (TB)
Atypical mycobacteriosis
Herpes simplex
Herpes zoster
Progressive multifocal leukoencephalopathy (PML)
Bacterial pneumonia1
Cryptosporidiosis
Cryptococcosis
Salmonella septicemia
Immune reconstitution inflammatory syndrome (IRIS)
Wasting syndrome
Rare OIs
10. Kaposi’s Sarcoma
Pathogenesis
Signs, symptoms and diagnosis
Diagnosis
Treatment
11. Malignant Lymphomas
Systemic non-Hodgkin lymphomas (NHL)
Primary CNS lymphoma
Hodgkin lymphoma (HL)
Multicentric Castleman’s disease (MCD)
12. Non-AIDS-defining Malignancies
Anal carcinoma
Testicular tumors
Lung cancer
13. HIV and HBV/HCV Coinfektions
HIV and HCV coinfection
HIV and HBV coinfection
14. Human Pegivirus HPgV Infection
15. HIV and Sexually Transmitted Diseases
Epidemiology
Syphilis (Lues)
Gonorrhea (the clap)
Chlamydia infection, lymphogranuloma venereum
Genital ulcers (ulcus molle, soft chancre, chancroid)
Condylomata acuminata (fig warts)
Shigellosis
16. Vaccinations and HIV
Practical approach to vaccinations
Details of selected vaccines in HIV+ patients
17. Traveling with HIV
Malaria prophylaxis
Special risks
18. HIV-2 Infection
19. HIV und Gynecology
Prophylaxis
Infections
HPV-associated diseases
20. HIV and Pregnancy
HIV therapy in pregnancy
Antiretroviral agents in pregnancy
Antiretroviral transmission prophylaxis
Therapy of neonates
21. HIV and Wanting to be a Parent
22. Antiretroviral Therapy in Children
Drug interactions
Monitoring efficacy and watching out for failure
Change of therapy
Supportive therapy and prophylaxis
Conclusion
23. HIV and Renal Function
Nephroprotection
Clinical manifestation/diagnosis of nephropathy
Routine tests for renal impairment
HIV-associated nephropathy (HIV-AN)
Other cases of post-infectious glomerulonephritis
Principles of therapy of glomerulonephritis
Practical treatment of hypertension in HIV
Nephrotoxicity
Renal side effects of antiretroviral therapy
Renal insufficiency and ART
Dosage of antiretrovirals in cases of renal insufficiency
OIs and renal insufficiency
24. HIV and Cardiac Diseases
Coronary artery disease (CAD)
Congestive heart failure
Pericardial effusion
Cardiac arrhythmias
Valvular heart disease/endocarditis
HIV-associated pulmonary arterial hypertension
Further cardiac manifestations
25. HIV and Respiratory Diseases
Talking with the patient
Pulmonary complications and comorbidities
Diagnostic strategy for pulmonary infiltrates
26. HIV-related Thrombocytopenia
27. HIV-associated Skin and Mucocutaneous Diseases
Introduction
28. HIV-1-associated Neurocognitive Disorder (HAND) and Myelopathy
HIV-1-associated neurocognitive disorder (HAND)
HIV-associated myelopathy
29. Neuromuscular Diseases
Polyneuropathy and polyradiculopathy
Clinical features
Diagnosis
Treatment
Myopathy
Clinical features
Diagnosis
Treatment
30. The new HIV+ Patient
The initial interview
Laboratory tests
Examinations
31. Post-Exposure Prophylaxis (PEP)
Transmission routes and risks
Effectiveness and limitations of PEP
When is PEP indicated?
Potential risks of PEP
Initial interventions
Initiation of PEP
Management of PEP
32. Drug-Drug Interactions
Part 1: ART + ART
Part 2: ART + concomitant medications
Gastrointestinal agents
Antiarrhythmic drugs
Antidepressants
Antidiabetics (oral)
Antihistamines
Antihypertensive therapy
Anticonvulsants
Anthelmintic agents
Antimycotic agents
Calcium channel antagonists (CCB)
Immunosuppressants/Chemotherapeutic agents
Contraception
Antimalarials/Antiprotozoals
Phosphodiesterase type 5 inhibitors
Statins/Lipid lowering drugs
Anti-addictive drugs
Antiviral drugs
Others
33. Drug Profiles
3TC (lamivudine)
Abacavir
Acyclovir
Amphotericin B
Atazanavir
Atovaquone
Atripla®
Azithromycin
AZT (zidovudine)
Boceprevir
Cidofovir
Clarithromycin
Clindamycin
Cobicistat
Combivir®
Complera® (Europe: Eviplera®)
Co-trimoxazole (trimethoprim-sulfamethoxazole)
d4T (stavudine)
Daclatasvir
Dapsone
Darunavir
Dasabuvir
Daunorubicin (liposomal)
ddI (didanosine)
Delavirdine
Dolutegravir
Doxorubicin (liposomal)
Efavirenz
Elvitegravir
Emtricitabine
Ethambutol
Etravirine
Fluconazole
Fosamprenavir
Foscarnet
Ganciclovir
Harvoni®
Indinavir
Interferon -2a/2b
Isoniazid
Itraconazole
Kivexa® (US: Epzicom)
Lopinavir/r
Maraviroc
Nelfinavir
Nevirapine
Pentamidine
Pyrimethamine
Raltegravir
Ribavirin
Rifabutin
Rifampin
Rilpivirine
Ritonavir
Saquinavir
Simeprevir
Sofosbuvir
Stribild®
Sulfadiazine®
T-20 (enfuvirtide)
Telaprevir
Tenofovir
Tipranavir
Triumeq®
Trizivir®
Truvada®
Valganciclovir
Viekirax®
This project has been supported with unrestricted grants from:
Which antiretroviral therapy to start with? When and how to switch? What strategies are available for patients with multi-resistant viruses? How to treat for renal failure or pregnancy, AIDS, hepatitis co-infection or HIV-2? Where are the advances and pitfalls on the way to cure? And how can HIV infections be prevented? Those who want to answer these questions must stay on the ball. HIV 2015/2016 helps – with clear instructions for practical action.
The HIV book is a textbook that is freely available on the Internet. The concept was developed in 1991 by Bernd Sebastian Kamps. The idea was to create a book on HIV infection that gives practical help to physicians, but also to members of other professions who deal with HIV patients, remains independent in content and form, avoids cumbersome, pseudo-scientific slang in favor of readability, and is freely available and retrievable via the Internet (decisive changes can be called up free of charge on this website at any time). Since the first edition in 1991, the book has been published annually and has been downloaded by thousands of physicians worldwide. The complete edition HIV 2015/2016 (774 pages) is freely available.
For the free download click here:
HIV2015/16-full version as pdf
TABLE OF CONTENTS
1. Introduction
The HIV epidemic
Transmission routes
The natural course of HIV infection
Disease progression
Epidemiology
Summary
2. HIV Testing
3. Pathogenesis of HIV-1 Infection
4. Preventive HIV-1 Vaccine
Induction of neutralizing antibodies
Induction of HIV-1-specific T cells
Recombinant viral vectors
5. Acute HIV-1 Infection
Introduction
Definition and classification
Signs and symptoms
Diagnosis
Immunological and virological events during AHI
Treatment
6. ART 2015/2016
6.1. Perspective
6.2. Overview of antiretroviral agents
6.3. ART 2017/2018: The horizon and beyond
6.4. Goals and principles of therapy
6.5. When to Start ART
6.6. What to start with
6.7. When to switch
6.8. How to switch ART
6.9. Salvage therapy
6.10. When to stop ART – A review of treatment interruption
6.11. Monitoring
6.12. Prevention of HIV infection
6.13. Global access to HIV treatment
7. Management of Side Effects
Gastrointestinal side effects
Hepatotoxicity
Renal problems
Neurological side effects
Allergic and skin reactions
Osseous side effects
Hematological changes
Lipodystrophy syndrome
8. HIV Resistance and Viral Tropism Testing
Assays for resistance testing
Interpretation of genotypic resistance profiles
Summary
Resistance tables
9. Opportunistic Infections (OIs)
Pneumocystis pneumonia (PCP)
Cerebral toxoplasmosis
CMV retinitis
Candidiasis
Tuberculosis (TB)
Atypical mycobacteriosis
Herpes simplex
Herpes zoster
Progressive multifocal leukoencephalopathy (PML)
Bacterial pneumonia1
Cryptosporidiosis
Cryptococcosis
Salmonella septicemia
Immune reconstitution inflammatory syndrome (IRIS)
Wasting syndrome
Rare OIs
10. Kaposi’s Sarcoma
Pathogenesis
Signs, symptoms and diagnosis
Diagnosis
Treatment
11. Malignant Lymphomas
Systemic non-Hodgkin lymphomas (NHL)
Primary CNS lymphoma
Hodgkin lymphoma (HL)
Multicentric Castleman’s disease (MCD)
12. Non-AIDS-defining Malignancies
Anal carcinoma
Testicular tumors
Lung cancer
13. HIV and HBV/HCV Coinfektions
HIV and HCV coinfection
HIV and HBV coinfection
14. Human Pegivirus HPgV Infection
15. HIV and Sexually Transmitted Diseases
Epidemiology
Syphilis (Lues)
Gonorrhea (the clap)
Chlamydia infection, lymphogranuloma venereum
Genital ulcers (ulcus molle, soft chancre, chancroid)
Condylomata acuminata (fig warts)
Shigellosis
16. Vaccinations and HIV
Practical approach to vaccinations
Details of selected vaccines in HIV+ patients
17. Traveling with HIV
Malaria prophylaxis
Special risks
18. HIV-2 Infection
19. HIV und Gynecology
Prophylaxis
Infections
HPV-associated diseases
20. HIV and Pregnancy
HIV therapy in pregnancy
Antiretroviral agents in pregnancy
Antiretroviral transmission prophylaxis
Therapy of neonates
21. HIV and Wanting to be a Parent
22. Antiretroviral Therapy in Children
Drug interactions
Monitoring efficacy and watching out for failure
Change of therapy
Supportive therapy and prophylaxis
Conclusion
23. HIV and Renal Function
Nephroprotection
Clinical manifestation/diagnosis of nephropathy
Routine tests for renal impairment
HIV-associated nephropathy (HIV-AN)
Other cases of post-infectious glomerulonephritis
Principles of therapy of glomerulonephritis
Practical treatment of hypertension in HIV
Nephrotoxicity
Renal side effects of antiretroviral therapy
Renal insufficiency and ART
Dosage of antiretrovirals in cases of renal insufficiency
OIs and renal insufficiency
24. HIV and Cardiac Diseases
Coronary artery disease (CAD)
Congestive heart failure
Pericardial effusion
Cardiac arrhythmias
Valvular heart disease/endocarditis
HIV-associated pulmonary arterial hypertension
Further cardiac manifestations
25. HIV and Respiratory Diseases
Talking with the patient
Pulmonary complications and comorbidities
Diagnostic strategy for pulmonary infiltrates
26. HIV-related Thrombocytopenia
27. HIV-associated Skin and Mucocutaneous Diseases
Introduction
28. HIV-1-associated Neurocognitive Disorder (HAND) and Myelopathy
HIV-1-associated neurocognitive disorder (HAND)
HIV-associated myelopathy
29. Neuromuscular Diseases
Polyneuropathy and polyradiculopathy
Clinical features
Diagnosis
Treatment
Myopathy
Clinical features
Diagnosis
Treatment
30. The new HIV+ Patient
The initial interview
Laboratory tests
Examinations
31. Post-Exposure Prophylaxis (PEP)
Transmission routes and risks
Effectiveness and limitations of PEP
When is PEP indicated?
Potential risks of PEP
Initial interventions
Initiation of PEP
Management of PEP
32. Drug-Drug Interactions
Part 1: ART + ART
Part 2: ART + concomitant medications
Gastrointestinal agents
Antiarrhythmic drugs
Antidepressants
Antidiabetics (oral)
Antihistamines
Antihypertensive therapy
Anticonvulsants
Anthelmintic agents
Antimycotic agents
Calcium channel antagonists (CCB)
Immunosuppressants/Chemotherapeutic agents
Contraception
Antimalarials/Antiprotozoals
Phosphodiesterase type 5 inhibitors
Statins/Lipid lowering drugs
Anti-addictive drugs
Antiviral drugs
Others
33. Drug Profiles
3TC (lamivudine)
Abacavir
Acyclovir
Amphotericin B
Atazanavir
Atovaquone
Atripla®
Azithromycin
AZT (zidovudine)
Boceprevir
Cidofovir
Clarithromycin
Clindamycin
Cobicistat
Combivir®
Complera® (Europe: Eviplera®)
Co-trimoxazole (trimethoprim-sulfamethoxazole)
d4T (stavudine)
Daclatasvir
Dapsone
Darunavir
Dasabuvir
Daunorubicin (liposomal)
ddI (didanosine)
Delavirdine
Dolutegravir
Doxorubicin (liposomal)
Efavirenz
Elvitegravir
Emtricitabine
Ethambutol
Etravirine
Fluconazole
Fosamprenavir
Foscarnet
Ganciclovir
Harvoni®
Indinavir
Interferon -2a/2b
Isoniazid
Itraconazole
Kivexa® (US: Epzicom)
Lopinavir/r
Maraviroc
Nelfinavir
Nevirapine
Pentamidine
Pyrimethamine
Raltegravir
Ribavirin
Rifabutin
Rifampin
Rilpivirine
Ritonavir
Saquinavir
Simeprevir
Sofosbuvir
Stribild®
Sulfadiazine®
T-20 (enfuvirtide)
Telaprevir
Tenofovir
Tipranavir
Triumeq®
Trizivir®
Truvada®
Valganciclovir
Viekirax®
This project has been supported with unrestricted grants from:
LATEST NEWS
27.11.2020
EPIDEMIOLOGICAL BULLETIN
Just in time for World AIDS Day 1.12., the Robert Koch Institute has published the current key epidemiological data on HIV and AIDS in Germany.
The total number of new HIV infections has risen slightly in 2019 compared to 2018 (2,500) and is estimated at 2,600. The number of estimated new HIV infections among men who have sex with men (MSM) remained relatively constant. The total number of people with an HIV infection in Germany rose to 90,700. A clear effect of the pre-exposure prophylaxis (PrEP) is therefore not yet visible; on the other hand, the PrEP has only been a health insurance benefit since September 1, 2019. The share of so-called late presenters also remains high. With regard to the UNAIDS target 90-90-90 (90% of all people diagnosed with HIV, 90% of whom receive antiretroviral therapy, 90% of whom have a viral load below the detection limit), Germany is at 88-96-96 according to RKI estimates. Thus, there is still room for improvement, especially in terms of diagnoses.
29.08.2020
HIV AND COVID-19
In the meantime, it has been found that HIV protease inhibitors probably have no effect on SARS-CoV-2.
In the British RECOVERY study, the Lopinavir/r arm was discontinued for lack of efficacy. For Tenofovir, several studies are still ongoing. In the meantime, however, there are some new data on co-infection with HIV/SARS-CoV-2, and we will publish a summary shortly. Until then, please refer to the website COVIDreference.com, where you will find a longer chapter on HIV and COVID-19 (as of end of June) under Content – Comorbidities, which will probably be updated and available in German at the end of September.
LATEST NEWS
27.11.2020
EPIDEMIOLOGICAL BULLETIN
Just in time for World AIDS Day 1.12., the Robert Koch Institute has published the current key epidemiological data on HIV and AIDS in Germany.
The total number of new HIV infections has risen slightly in 2019 compared to 2018 (2,500) and is estimated at 2,600. The number of estimated new HIV infections among men who have sex with men (MSM) remained relatively constant. The total number of people with an HIV infection in Germany rose to 90,700. A clear effect of the pre-exposure prophylaxis (PrEP) is therefore not yet visible; on the other hand, the PrEP has only been a health insurance benefit since September 1, 2019. The share of so-called late presenters also remains high. With regard to the UNAIDS target 90-90-90 (90% of all people diagnosed with HIV, 90% of whom receive antiretroviral therapy, 90% of whom have a viral load below the detection limit), Germany is at 88-96-96 according to RKI estimates. Thus, there is still room for improvement, especially in terms of diagnoses.
29.08.2020
HIV AND COVID-19
In the meantime, it has been found that HIV protease inhibitors probably have no effect on SARS-CoV-2.
In the British RECOVERY study, the Lopinavir/r arm was discontinued for lack of efficacy. For Tenofovir, several studies are still ongoing. In the meantime, however, there are some new data on co-infection with HIV/SARS-CoV-2, and we will publish a summary shortly. Until then, please refer to the website COVIDreference.com, where you will find a longer chapter on HIV and COVID-19 (as of end of June) under Content – Comorbidities, which will probably be updated and available in German at the end of September.
THE EDITORS
Christian Hoffmann, MD, PhD
Hoffmann started his work on HIV/AIDS in 1995 as a research fellow at the Outpatient Clinic of Infectious Diseases, University of Eppendorf, Hamburg. He also worked at the University of Kiel, the Curatorium for Immunodeficiency, Munich and at the ifi institute, Hospital St. Georg, Hamburg. He has been the Editor of HIV Medicine since 2003 and the Scientific Secretary of the Munich AIDS Days since 2002. He has been elected chair of the KAAD (German Clinical AIDS Working Group) 2007-2010 and participated in numerous clinical trials on HIV and AIDS. CH published more than 100 refereed papers, abstracts, and book chapters. His research interests encompass HIV-related malignancies, opportunistic infections and new ARVs. He currently works at the Infektionsmedizinisches Centrum Hamburg which is among the largest HIV centres in Germany.
Jürgen Rockstroh, MD, PhD
Rockstroh is a Professor of Medicine at the University of Bonn and has been Head of an HIV outpatient clinic since 1995. He is an investigator from various HIV studies and has considerable experience with various ARVs and clinical trials for treatment of HIV and hepatitis co-infection. Jürgen Rockstroh’s department treats the world’s largest cohort of HIV-infected haemophiliacs. His research interests encompass antiretroviral therapy, the course of HIV disease in haemophiliacs, HIV/HCV co-infection, and cytokines and apoptosis before and after antiretroviral therapy. JKR is a prolific speaker at international conferences and has published more than 100 articles and book chapters. From 2007-2011, he was the president of the German AIDS Society (DAIG). He is also a member of the Executive Committee of the European AIDS Clinical Society and the Co-Chairman of the 12th European AIDS Conference held in Cologne 2009.
CONTACT | ORDER A BOOK
We are always thankful for hints, criticism, corrections and ideas.
The HIV book 2015/16 can be ordered directly from Medizin Fokus Verlag as a hardcopy by mail and prepayment (no cash on delivery). The books are usually shipped within 1-3 working days. Please fill out the contact form completely with your address and e-mail address.
ATTENTION:
When paying to the account, please make sure to include your name and delivery address!
Medizin Fokus Verlag
Hamburger Sparkasse
IBAN DE59 2005 0550 1241 1414 21
SWIFT HASPDEHHXXX
Price
€ 45 / each book
€ 40 / book – quantity discount ≥ 5 books
€ 35 / book – quantity discount ≥ 10 books
Shipping charges:
Germany: included
European Union: € 5 per book
International (Non-EU): € 10 per book
CONTACT | ORDER A BOOK
We are always thankful for hints, criticism, corrections and ideas.
The HIV book 2015/16 can be ordered directly from Medizin Fokus Verlag as a hardcopy by mail and prepayment (no cash on delivery). The books are usually shipped within 1-3 working days. Please fill out the contact form completely with your address and e-mail address.
ATTENTION:
When paying to the account, please make sure to include your name and delivery address!
Medizin Fokus Verlag
Hamburger Sparkasse
IBAN DE59 2005 0550 1241 1414 21
SWIFT HASPDEHHXXX
Price
€ 45 / each book
€ 40 / book – quantity discount ≥ 5 books
€ 35 / book – quantity discount ≥ 10 books
Shipping charges:
Germany: included
European Union: € 5 per book
International (Non-EU): € 10 per book