Episode 32 - Update on the New Antiretroviral Therapy Guidelines - Dr Rajesh Gandhi

Going anti-Viral

In this episode of Going anti-Viral, Dr Michael Saag speaks with Dr Rajesh Gandhi of Harvard Medical School and Massachusetts General Hospital about the new IAS-USA recommendations for HIV treatment and prevention. Dr Gandhi is the Chair of the guidelines panel, which published its recommendations in the Journal of the American Medical Association on December 1, 2024. Dr Gandhi and Dr Saag discuss the process by which the updated guidelines were created and provide an update on what’s new in the current edition. They address other important topics like how to treat patients with opportunistic infections, guidance on when to change therapy, and strategies for preventing HIV acquisition. Finally, Dr Gandhi makes recommendations for those using the guidelines, especially those using them for the first time.

0:00 – Introduction

1:19 – Overview of the guidelines’ creation process

3:52– New recommendations on when to start antiretroviral therapy

6:37 – New guidance on what regimens to start

9:34 – Discussion of other agents like bictegravir and dolutegravir in pregnancy

10:45 – How to treat patients with an opportunistic infection

14:09 – Concern about immune reconstitution inflammatory syndrome (IRIS)

16:33 – Guidance on when to change therapy and providing support

21:18 – How do the guidelines help people stay healthy – management of cancer, cardiovascular risk, and weight gain

24:41 – Discussion on prevention of HIV and sexually transmitted diseases

30:19 – What could not be addressed in the guidelines

33:17 – Final comments and how to use the guidelines

Resources: https://jamanetwork.com/

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Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections.

Going anti-Viral’s host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences.
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