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  • 1.  recently updated CDC PrEP guidelines, point of clarification

    Posted 12 days ago

    I'm curious what providers are doing about the somewhat confusing new PrEP guidelines update from last month.  

    For patients who have taken ART in the past 90 days as PEP or PrEP, we now would run both an HIV screen AND a viral load every 3 months?  I think I see what they're trying to catch here but the lab and cost burden are taking me by surprise.  I found it odd this significant change wasn't called out in the "What's New" intro.  

    PrEP Guideline 2021 Update (cdc.gov)  pages 15, 30 and 31 are what I'm referring to.

    Any other takes or insights? 

    Thanks in advance,
    Josh Rohr PA-C



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    Joshua Rohr
    Seattle WA
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  • 2.  RE: recently updated CDC PrEP guidelines, point of clarification

    Posted 11 days ago

    I will not be checking HIV PCR for q3mo follow up for those on oral PrEP unless clinically indicated. Note you will need to check PCRs with Cabotegravir use/before each injection. We discussed this with our ID faculty at UCLA, some of whom contributed to the guidelines and are leading PrEP experts, and they agreed. 


    Best,
    Josh 

    Josh Khalili MD, AAHIVS 




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    Joshua Khalili
    Los Angeles CA
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  • 3.  RE: recently updated CDC PrEP guidelines, point of clarification

    Posted 11 days ago
    This is different that the guideline that is put out by NYS AIDS Institute and I'm not doing VL every 3 months.  I sent a question to them and asked it be forwarded to the guideline committee.  I'll let you know what I hear.

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    Mary Angerame
    Rochester NY
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  • 4.  RE: recently updated CDC PrEP guidelines, point of clarification

    Posted 6 days ago
    Good afternoon, 

    I had to review the guidelines again myself. I will say that the summary table on page 15 is confusing. But in reading the rest of the guidelines and recommendation, I understand the recommendation to check an HIV PCR ( as suggested by the algorithm diagram) is in instances where there is a reported or potential exposure to HIV and there is concern for acute HIV infection. As the two figures 4a and 4b are under the header of ACUTE HIV INFECTION. So I understand it to say that IF you have a person on PrEP currently and there is a history suggestive of ACUTE HIV INFECTION, then you should proceed with an Ag/Ab test AND a PCR. 
    I await clarification from the Guideline Committe.  I am sure Dawn Smith, would welcome the commentary 


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    Quintin Robinson
    Absolute Care Medical Center & Pharmacy
    Atlanta GA
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  • 5.  RE: recently updated CDC PrEP guidelines, point of clarification

    Posted 5 days ago

    I submitted the question to Dr. Gonzalez who is the Chair for the NYS AIDS Institute PrEP guidelines.  His response:

     

     

    Mary Angerame, MS, APN-BC, AAHIVS

    Anthony L. Jordan Health Center

    82 Holland St.

    Rochester NY 14605

    585-520-9264

     

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