IDSA News - November 2014  (Plain Text Version)

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In this issue:
Patient Care and Science
•  Now Available: Updated Guideline for Kidney Disease in HIV Patients
•  FDA Approves First Combination Pill for HCV
•  EIN Update: Tracking the Enterovirus D68 Outbreak
Clinical Practice Management
•  HIV Provider Resources: Outpatient Billing and Coding; ACOs and HIV Care
Policy and Advocacy
•  IDSA Testifies Before Congress on Antimicrobial Resistance
•  IDSA Urges Boost in Funding for Public Health Agencies in FY 2016 Budget
•  Society Calls for More Funding of ID Comparative Effectiveness Research
Global ID
•  On the Frontlines of the HIV/TB Response in Africa: Impacts and Gaps
•  Live from Cape Town and Barcelona: Biomedical HIV Prevention and the Fight Against TB
You and Your Colleagues
•  Members on the Move
•  New Members
Education and Resources
•  HIV Minority Clinical Fellowship Program: December 12 Application Deadline
Top Stories
•  From the President
•  The State of the Society: Reports from IDWeek 2014 Business Meeting
•  IDWeek 2014: Post Meeting Resources
•  Congratulations to the 2014 Society Award Winners!


Now Available: Updated Guideline for Kidney Disease in HIV Patients

An updated HIVMA and IDSA guideline for the treatment of chronic kidney disease in patients infected with HIV is available online. Published in the Nov. 1 issue of Clinical Infectious Diseases, the new document updates guidance last issued in 2005.

Antiretroviral therapy (ART) is beneficial for the 5 to 10 percent of HIV-infected patients with reduced kidney function, with the exception of tenofovir—the most widely prescribed ART—which can lead to moderate kidney damage in some patients, according to the updated guideline.

“Research shows HIV patients who have clinically decreased kidney function are less likely to be prescribed ART, probably because physicians and other health care providers are concerned that many of these medications are cleared by the kidneys and don’t want to cause further harm,” said Gregory Lucas, MD, associate professor at Johns Hopkins School of Medicine and co-chair of the guideline panel. “But the outlook for HIV patients with kidney disease is much better now that we have numerous effective treatments for HIV, many of which are not cleared by the kidneys.”

The guideline also recommends kidney transplantation as a viable option in HIV-infected patients whose kidneys are failing. Despite previous concerns that these patients would not fare well on the immunosuppressive therapy necessary to prevent the body from rejecting the organ, initial research suggests they are as likely to survive and maintain a functioning organ as transplant recipients without HIV infection.

Those caring for HIV patients should monitor both kidney function, by estimating glomerular filtration rate (GFR), and kidney damage, with urinalysis or urine protein, the guideline recommends. As many as one in 10 people with HIV have decreased kidney function, and up to twice as many may have other evidence of kidney damage.

Mobile device and pocket-card versions of the updated guideline are available for use at the point of care. These and other clinical tools can be accessed through the practice guidelines section of the IDSA website.