CMEonHIV.com is dedicated to providing online CME presentations (slides with voiceover) on HIV/AIDS for healthcare professionals given by local and international experts to keep you up-to-date on the ongoing developments in the field.
Conference
"Antiretroviral Therapy Issues in HIV-Infected Women" Dr. Sharon Walmsley (biography) English - 2003-03-30 - 34 minutes
Summary : There are little published data on the short and long term effects of antiretroviral therapy in women. Clinical trials have generally enrolled fewer than 20% women and have been underpowered to look at gender specific differences in efficacy and side-effects of drug therapy. In addition, post-marketing surveillance of antiretroviral drugs has been limited and not gender specific. Observational cohorts (e.g. SWISS, ICONA, BC Center for Excellence) have proved invaluable for addressing issues of efficacy and tolerability of antiretroviral agents outside the clinical trial setting. Information derived from these cohorts is frequently used by physicians to inform treatment decisions. Unfortunately, existing cohorts are primarily composed of gay and bisexual men. Consequently it has become necessary to extrapolate findings from men to guide treatment options for women.
There are several potential reasons gender may influence the response to antiretroviral drugs including differences in body mass, hormonal status, and drug metabolism. In fact, there is evidence that women are at increased risk for certain side effects, for example, rash with nevirapine and gastrointestinal side effects with ritonavir. There also may be differences in the manifestations of drug related effects, such as breast enlargement, that particularly impact women's self-esteem. For women taking antiretrovirals, such adverse events may affect their ability to adhere to therapy. Furthermore, simply the perception that women are at greater risk for toxicity could contribute to delays (either by women or their health care providers) in the initiation of therapy, depriving women of meaningful immune reconstitution that could prevent serious outcomes of HIV infection.
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