{"id":82074,"date":"2024-09-20T14:34:01","date_gmt":"2024-09-20T14:34:01","guid":{"rendered":"https:\/\/www.msdconnect.be\/nl\/hiv-lecture-tour\/"},"modified":"2025-07-17T14:16:00","modified_gmt":"2025-07-17T14:16:00","slug":"hiv-lecture-tour","status":"publish","type":"page","link":"https:\/\/www.msdconnect.be\/nl\/hiv-lecture-tour\/","title":{"rendered":"HIV Lecture Tour"},"content":{"rendered":"\n<div class=\"\nwp-block-mconnect-theme-bannerhas-left-alignment\"\n>\n\t<img loading=\"lazy\" decoding=\"async\" width=\"1400\" height=\"695\" src=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?w=1400\" class=\"wp-block-mconnect-theme-banner__image\" alt=\"\" style=\"object-position: 50% 50%;\" srcset=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg 2612w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=300,149 300w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=768,381 768w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=1024,508 1024w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=1536,762 1536w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=2048,1016 2048w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=320,159 320w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=120,60 120w, https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/hiv-lecture-tour-banner.jpg?resize=1400,695 1400w\" sizes=\"auto, (max-width: 1400px) 100vw, 1400px\" \/>\t<div class=\"wp-block-mconnect-theme-banner__content-container-wrap\">\n\t\t<div class=\"\n\t\twp-block-mconnect-theme-banner__content-container\n\t\thas-white-color\t\thas-teal-500-background-color\t\"\n\t\t style=\"background-color: \"\n\t>\n\t\t\t<h2 class=\"wp-block-mconnect-theme-banner__heading\">Highlights of the conference held by Prof.\u00a0Marta Boffito on optimizing care for aging HIV patients<\/h2>\n\t\t\t<p class=\"wp-block-mconnect-theme-banner__summary\"><\/p>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<section class=\"mhh-mcn-v1-section mhh-mcn-v1-section--031b29ff94cbbf71862b4ec9eba8a18c mhh-mcn-section mhh-mcn-v1-section--align-full\">\n    <div class=\"mhh-mcn-container\">\n    \n\n<h3 class=\"wp-block-heading has-black-color has-text-color  mhh-mcn-v1-heading mhh-mcn-v1-heading--828c578d5468672bbb6f38ee5f1f2d56\" id=\"symposium-takeaways\">Main highlights:<\/h3>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--3315e81c34a60f4b140042ad1abe3504 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--04c3698e2eab8f3ba19d8304d2720d9b mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-3 mhh-mcn-column--l-3\">\n    \n\n<p dir=\"ltr\" lang=\"en-US\" class=\"has-black-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--bdd2ce1ed7a75f7734401a14acc792a6\">The length of diagnosis, and not age, is the main predictor for PLWH to suffer from multiple comorbidities<sup>1<\/sup><\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--51a8b5c3d1d7e31f1647dcad7dee934d mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-3 mhh-mcn-column--l-3\">\n    \n\n<p dir=\"ltr\" lang=\"en-US\" class=\"has-black-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--83e60a926c01ebd2217ad4106a56e1e6\">De-prescription of cART and non cARTs is increasingly more important, coupled to exploring newer drugs like dolutegravir and doravirine that are characterized by less drug-drug interactions<sup>2-4<\/sup><\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--a917a2f8bcaff78b07a81485f8c0bbdc mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-3 mhh-mcn-column--l-3\">\n    \n\n<p dir=\"ltr\" lang=\"en-US\" class=\"has-black-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--4728c83ec9d4dd2a9c0924c2fe04aa56\">The MDT of Chelsea and Westminster Hospital links to wider care teams and specialties, including the GP.<sup>5<\/sup><\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--7ab5d2a8de8326a58c4bc559dc535b80 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-3 mhh-mcn-column--l-3\">\n    \n\n<p dir=\"ltr\" lang=\"en-US\" class=\"has-black-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--94f055f4b9755c495e716912aa009818\">The MDT of Chelsea and Westminster Hospital conducts fragility and geriatric assessment and follows a 7-point clinical pathway for PLWH over 50 y.o, providing them with personalized care<sup>5<\/sup><\/p>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n<\/section>\n\n\n\n<section class=\"mhh-mcn-v1-section mhh-mcn-v1-section--31be5c0dde42b9f5d08f0c56a518cc84 mhh-mcn-section mhh-mcn-v1-section--align-full\">\n    <div class=\"mhh-mcn-container\">\n    \n\n<h3 class=\"wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--c4599cf54a555133451d07866eb3a8dd\" id=\"video-summary\">(re)watch the summary of Dr Boffito\u2019s conference<\/h3>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--57ef9853b5b6e5216fce07de1a13aba7 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--9d868bac18358936d21b523ac257cec5 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-3 mhh-mcn-column--l-3\">\n    <\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--c9c4f9ef9e3878f6fad7ec20e233ad06 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-6 mhh-mcn-column--l-6\">\n    \n\n<div  class=\"inpsyde-brightcove__player\" style=\"position: relative\">\n\n    \n    <video-js class=\"video-js vjs-fluid\" data-embed=\"default\" data-player=\"wpDhMYhEmz\" data-account=\"4090876667001\" data-video-id=\"6362159675112\" data-application-id=\"TU9POgRJ\" aria-label=\"Video\" controls poster-url=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/a09152ab-53f6-4687-8030-06bd5c0c48c9\/c6007df0-d7e5-479a-aa22-b87cbb673c08\/1280x720\/match\/image.jpg\"><\/video-js>\n\n        <img\n        class=\"inpsyde-brightcove__poster\"\n        src=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/a09152ab-53f6-4687-8030-06bd5c0c48c9\/c6007df0-d7e5-479a-aa22-b87cbb673c08\/1280x720\/match\/image.jpg\"\n        alt=\"\"\n        fetchpriority=\"high\"\n        decoding=\"async\"\n        aria-hidden=\"true\"\n    \/>\n    \n    \n    <script src=\"https:\/\/players.brightcove.net\/4090876667001\/wpDhMYhEmz_default\/index.min.js\"><\/script>\n<\/div>\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--9d868bac18358936d21b523ac257cec5 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-3 mhh-mcn-column--l-3\">\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n<\/section>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 dir=\"ltr\" lang=\"en-US\" class=\"wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--e8e3fe6ff255490d1075271d5faa990c\">Dive into the different themes addressed by Dr Boffito<\/h2>\n\n\n\n<h4 dir=\"ltr\" lang=\"en-US\" class=\"wp-block-heading has-teal-500-color has-text-color  mhh-mcn-v1-heading mhh-mcn-v1-heading--bf74fcfd0c62100cc94ebdd8677956ee\"><strong>Aging HIV population and the impact of their comorbidities<\/strong><\/h4>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--d8530ea4ac7bb42e2218ddaa308a2fc0 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--cedf71a781de1e353556de3c956dbc15 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-4 mhh-mcn-column--l-4\">\n    \n\n<p class=\"has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--2d8f52f9988ffa45fd5718d6543fe952\">What are the impact of co-morbidities on aging HIV patients?<sup>3<\/sup><\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--17eb63b259f8d8083cd03de78cbb2315 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<div  class=\"inpsyde-brightcove__player\" style=\"position: relative\">\n\n    \n    <video-js class=\"video-js vjs-fluid\" data-embed=\"default\" data-player=\"wpDhMYhEmz\" data-account=\"4090876667001\" data-video-id=\"6362162306112\" data-application-id=\"TU9POgRJ\" aria-label=\"Video\" controls poster-url=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/579eebd2-912b-4ec1-bacd-b104d02fa72b\/6aaa4e12-bde8-4fe9-ace5-7763ad51094c\/1280x720\/match\/image.jpg\"><\/video-js>\n\n        <img\n        class=\"inpsyde-brightcove__poster\"\n        src=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/579eebd2-912b-4ec1-bacd-b104d02fa72b\/6aaa4e12-bde8-4fe9-ace5-7763ad51094c\/1280x720\/match\/image.jpg\"\n        alt=\"\"\n        fetchpriority=\"high\"\n        decoding=\"async\"\n        aria-hidden=\"true\"\n    \/>\n    \n    \n    <script src=\"https:\/\/players.brightcove.net\/4090876667001\/wpDhMYhEmz_default\/index.min.js\"><\/script>\n<\/div>\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<h4 dir=\"ltr\" lang=\"en-US\" class=\"wp-block-heading has-teal-500-color has-text-color  mhh-mcn-v1-heading mhh-mcn-v1-heading--9dbdf3eb759975cdaf6f9c8aab8cc5a0\"><strong>Clinical pathway in people living with HIV; part 1<\/strong><\/h4>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--4cecdf467651f550561f723f8bda69af mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--2713a3e879ae03aff28dd780ff0ef656 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-4 mhh-mcn-column--l-4\">\n    \n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--90b2e9fbff80ac69d7b6adb1dc4b86b5\">Dr. Boffito and her team implemented a clinical pathway checklist of 7 items to conduct on PLWH over 50\u2019s<sup>5<\/sup><br>Part 1 covers: drug history and interactions, renal function, endocrine function and cancer screening<\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--4ae2e1308ca2763a28840dd5ccdacca8 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<div  class=\"inpsyde-brightcove__player\" style=\"position: relative\">\n\n    \n    <video-js class=\"video-js vjs-fluid\" data-embed=\"default\" data-player=\"wpDhMYhEmz\" data-account=\"4090876667001\" data-video-id=\"6362161616112\" data-application-id=\"TU9POgRJ\" aria-label=\"Video\" controls poster-url=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/a2f8e485-d815-41d2-8739-50a1660e7b65\/aec142b1-e762-4692-9018-6ed3be592f0d\/1280x720\/match\/image.jpg\"><\/video-js>\n\n        <img\n        class=\"inpsyde-brightcove__poster\"\n        src=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/a2f8e485-d815-41d2-8739-50a1660e7b65\/aec142b1-e762-4692-9018-6ed3be592f0d\/1280x720\/match\/image.jpg\"\n        alt=\"\"\n        fetchpriority=\"high\"\n        decoding=\"async\"\n        aria-hidden=\"true\"\n    \/>\n    \n    \n    <script src=\"https:\/\/players.brightcove.net\/4090876667001\/wpDhMYhEmz_default\/index.min.js\"><\/script>\n<\/div>\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<h4 dir=\"ltr\" lang=\"en-US\" class=\"wp-block-heading has-teal-500-color has-text-color  mhh-mcn-v1-heading mhh-mcn-v1-heading--7c0f42584263b678b10c06c4ddf320f3\"><strong>Clinical pathway in people living with HIV; part 2<\/strong><\/h4>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--73ad8304ad65b478bfce9c1f2103dfa3 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--16c8d3ad486236b035d0aefefa315291 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-4 mhh-mcn-column--l-4\">\n    \n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--8fd646edab0b072c09ab7ccb581b4dad\">Dr. Boffito and her team implemented a clinical pathway checklist of 7 items to conduct on PLWH over 50\u2019s<sup>5<\/sup><br>Part 2 covers: cardiovascular risk assessment, bone mineral density and cognitive function<\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--90c0e3cd03b8acfabda823ab25af8662 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<div  class=\"inpsyde-brightcove__player\" style=\"position: relative\">\n\n    \n    <video-js class=\"video-js vjs-fluid\" data-embed=\"default\" data-player=\"wpDhMYhEmz\" data-account=\"4090876667001\" data-video-id=\"6362160140112\" data-application-id=\"TU9POgRJ\" aria-label=\"Video\" controls poster-url=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/3de8082b-70de-4c79-ba38-fd2c648ac9b8\/015f8510-700e-4ce7-81d1-71d6bc1f6e89\/1280x720\/match\/image.jpg\"><\/video-js>\n\n        <img\n        class=\"inpsyde-brightcove__poster\"\n        src=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/3de8082b-70de-4c79-ba38-fd2c648ac9b8\/015f8510-700e-4ce7-81d1-71d6bc1f6e89\/1280x720\/match\/image.jpg\"\n        alt=\"\"\n        fetchpriority=\"high\"\n        decoding=\"async\"\n        aria-hidden=\"true\"\n    \/>\n    \n    \n    <script src=\"https:\/\/players.brightcove.net\/4090876667001\/wpDhMYhEmz_default\/index.min.js\"><\/script>\n<\/div>\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<h4 dir=\"ltr\" lang=\"en-US\" class=\"wp-block-heading has-teal-500-color has-text-color  mhh-mcn-v1-heading mhh-mcn-v1-heading--4d5dc4b1b4d1036ba0f7e454674ff5b2\"><strong>Frailty pathway for people living with HIV<\/strong><\/h4>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--222bf849abb3e725db205cd57f716ff4 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--62574d3d0be60be882a9ac67e38ccabc mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-4 mhh-mcn-column--l-4\">\n    \n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--7d4e8b261b01bbc3fc47b11e53718ac1\">A multidisciplinary team (MDT) consultation using the principles of comprehensive geriatric assessment has been setup in a geriatric\/HIV clinic at the Chelsea and Westminster hospital, where frailty is assessed using Rockwood Clinical Frailty Scale<sup>5<\/sup><\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--f40cb6c9ad53f650750a6be459c0915a mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<div  class=\"inpsyde-brightcove__player\" style=\"position: relative\">\n\n    \n    <video-js class=\"video-js vjs-fluid\" data-embed=\"default\" data-player=\"wpDhMYhEmz\" data-account=\"4090876667001\" data-video-id=\"6362161720112\" data-application-id=\"TU9POgRJ\" aria-label=\"Video\" controls poster-url=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/32d9545b-3db7-40b4-ba28-67f07362659b\/155d273b-f385-4c63-bab9-08d86f8b1dbc\/1280x720\/match\/image.jpg\"><\/video-js>\n\n        <img\n        class=\"inpsyde-brightcove__poster\"\n        src=\"https:\/\/cf-images.us-east-1.prod.boltdns.net\/v1\/static\/4090876667001\/32d9545b-3db7-40b4-ba28-67f07362659b\/155d273b-f385-4c63-bab9-08d86f8b1dbc\/1280x720\/match\/image.jpg\"\n        alt=\"\"\n        fetchpriority=\"high\"\n        decoding=\"async\"\n        aria-hidden=\"true\"\n    \/>\n    \n    \n    <script src=\"https:\/\/players.brightcove.net\/4090876667001\/wpDhMYhEmz_default\/index.min.js\"><\/script>\n<\/div>\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<section class=\"mhh-mcn-v1-section mhh-mcn-v1-section--25bf8692f27dd0ff3c6d5f5883a7cc4d mhh-mcn-section mhh-mcn-v1-section--align-full\">\n    <div class=\"mhh-mcn-container\">\n    \n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--46b61fb44bd5b22b3de87ea36f5bb969 mhh-mcn-v1-columns mhh-mcn-columns--gutter-l\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--93d63f35ca20ca0e84d7e92cf871c054 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-4 mhh-mcn-column--l-4\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--8f329c01da8efbf25dd5ee3e7613f315\">\n                    <img loading=\"lazy\" decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-82109\"\n        src=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/prof-marta-boffito.jpg?quality=80&#038;lossy=1\"\n        width=\"844\"\n        height=\"670\"\n                alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--9ff302ad933e00f63bc98c9c93b31de3 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<h2 dir=\"ltr\" lang=\"en-US\" class=\"wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--00c5e606710ffc62b0d02447b70ad656\">Meet the expert<\/h2>\n\n\n\n<h4 dir=\"ltr\" lang=\"en-US\" class=\"wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--202af5310163724a37aea265b1d6bf2f\">Prof&nbsp;Marta Boffito MD, PhD, FRCP, MBA<\/h4>\n\n\n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--5327e04c72c5741234b21d09575063e4\" dir=\"ltr\" lang=\"en-US\">Consultant&nbsp;Physician; Clinical Director HIV, Sexual and Gender Health, Dermatology<br>Chelsea&nbsp;and Westminster&nbsp;Hospital<\/p>\n\n\n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--2e3e5b0471537791f964fec3f7b1c381\" dir=\"ltr\" lang=\"en-US\">Originally interested in psychiatry, Boffito became interested in infectious diseases while in medical school in Italy. <br>\u201cI became passionate about HIV because although at that time there was no effective antiretroviral treatment, the empathy around the disease and the motivation to find treatment were astonishing\u201d, states Boffito. Her passion for HIV was further strengthened when she pursued infectious diseases training in Italy and at the San Francisco General Hospital, CA, USA. Driven by a desire to improve ARV treatment, Boffito decided to pursue a PhD in clinical pharmacology at the University of Liverpool, Liverpool, UK. After completing her PhD, Boffito began working as a research fellow at the Chelsea and Westminster Hospital, London, UK, where she is currently the clinical director of HIV, sexual and gender health, and dermatology services.6<\/p>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n<\/section>\n\n\n\n<section class=\"mhh-mcn-v1-section mhh-mcn-v1-section--8848885a21bac55ec7e89418bdcf85f5 mhh-mcn-section mhh-mcn-v1-section--align-full\">\n    <div class=\"mhh-mcn-container\">\n    \n\n<h3 class=\"wp-block-heading has-black-color has-text-color  mhh-mcn-v1-heading mhh-mcn-v1-heading--faaa4f0469925e98e4f16a59c3f30088\" id=\"symposium-takeaways\">Written summary<\/h3>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--ad5da5cacdb6133df74a4147671ee11f mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--c737d124731b9412dbaae55151c53312 mhh-mcn-column mhh-mcn-column--6 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--350fb08af2d1395fbd3caf51728d3474\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-82111\"\n        src=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/Summary01.jpg?quality=80&#038;lossy=1\"\n        width=\"400\"\n        height=\"564\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--98043245237dc5dec1ee27e9bd80f46b mhh-mcn-column mhh-mcn-column--6 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--3e68c521d6a0a9ddaf93dca8238673e0\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-82112\"\n        src=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/Summary02.jpg?quality=80&#038;lossy=1\"\n        width=\"400\"\n        height=\"564\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--bc041ea8e3245ff795eaa173de25f077 mhh-mcn-column mhh-mcn-column--6 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--4d723e6797ba1e8cf8eb918d4a1559b5\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-82113\"\n        src=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/Summary03.jpg?quality=80&#038;lossy=1\"\n        width=\"400\"\n        height=\"564\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1e2a76454be444a01b8543404f4310cf mhh-mcn-column mhh-mcn-column--6 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--0489534be25e78157531ef918737bf33\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-82114\"\n        src=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/Summary04.jpg?quality=80&#038;lossy=1\"\n        width=\"400\"\n        height=\"564\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--4e83fb11882e82a1bb9f9ff250570039 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-4 mhh-mcn-column--l-4\">\n    \n\n<p dir=\"ltr\" lang=\"en-US\" class=\"has-black-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--726557b5b268724d1a17fb1638b438ae\"><strong><a href=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/uploads\/sites\/34\/2024\/10\/Lecture-Tour-Boffito-article-ecrit-reprenant-les-elements-importants-de-la-presentation.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Download our written summary<br><\/a><\/strong>that also includes the Frailty pathway and frailty scale used by Dr Boffito and her multidisciplinary team<\/p>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n<\/section>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n<div class=\"mhh-mcn-v1-accordion mhh-mcn-v1-accordion--3082627483966eb8ddb0f63625bd3608 mhh-mcn-v1-accordion--default\" data-configuration=\"{&quot;variation&quot;:&quot;default&quot;,&quot;speed&quot;:0,&quot;hasFirstItemExpanded&quot;:false}\"        >\n    \n\n<section\n    id=\"accordion-6a317a1a2ee89\"\n    class=\"mhh-mcn-v1-accordion-molecule mhh-mcn-v1-accordion-molecule--fb3d7f1a566e1579564036e66512fec6 mhh-mcn-v1-accordion-molecule--closed\"\n            >\n    <h4\n        id=\"accordion-6a317a1a2ee89-header\"\n        class=\"mhh-mcn-v1-accordion-molecule-header\"\n    >\n        <button\n            class=\"mhh-mcn-v1-accordion-molecule-header__heading\"\n            aria-expanded=\"false\"\n            aria-controls=\"accordion-6a317a1a2ee89-content\"\n        >\n                        <span class=\"mhh-mcn-v1-accordion-molecule-header__title\">\n                Abbreviations            <\/span>\n            <span class=\"mhh-mcn-v1-accordion-molecule-header__icon-dropdown\" aria-hidden=\"true\">\n                \n<svg width=\"1em\" height=\"1em\" class=\"mh-icon mh-icon--kind-generic mh-icon--name-dropdown-arrow mh-icon--dropdown-arrow\" role=\"img\" aria-hidden=\"true\">\n    \n    \n    <use xlink:href=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/themes\/cex-wpvip-mhh-mconnect-theme-new-3.0\/modules\/icons\/resources\/icons\/svg\/generic\/dropdown-arrow.svg#dropdown-arrow\"><\/use>\n<\/svg>\n            <\/span>\n        <\/button>\n    <\/h4>\n    <div\n        id=\"accordion-6a317a1a2ee89-content\"\n        class=\"mhh-mcn-v1-accordion-molecule-content\"\n        role=\"region\"\n        aria-labelledby=\"accordion-6a317a1a2ee89-header\"\n    >\n        <div class=\"mhh-mcn-v1-accordion-molecule-content__body\">\n            \n\n<p dir=\"ltr\" lang=\"fr-BE\" class=\"has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--efe41a0178ae05d39da9cf45485e06cf\"><strong>ART:<\/strong> antiretroviral therapy; <strong>ARV:<\/strong> antiretroviral; <strong>cART:<\/strong> combination ART; <strong>FRCP:<\/strong> fellow of the royal college of physicians; <strong>GP:<\/strong> general practitioner; <strong>HIV:<\/strong> human immunodeficiency virus; <strong>MBA:<\/strong> master in business administration; <strong>MD:<\/strong> medical doctor; <strong>MDT:<\/strong> multidisciplinary team; <strong>PhD:<\/strong> Doctor of Philosophy; <strong>PLWH:<\/strong> people living with HIV.<\/p>\n\n        <\/div>\n    <\/div>\n<\/section>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-accordion mhh-mcn-v1-accordion--e0442c7fd5fe61dbb28c1b5fe9649314 mhh-mcn-v1-accordion--default\" data-configuration=\"{&quot;variation&quot;:&quot;default&quot;,&quot;speed&quot;:0,&quot;hasFirstItemExpanded&quot;:false}\"        >\n    \n\n<section\n    id=\"accordion-6a317a1a2f5ea\"\n    class=\"mhh-mcn-v1-accordion-molecule mhh-mcn-v1-accordion-molecule--a452a537e3d1078aec8fb442733a33d1 mhh-mcn-v1-accordion-molecule--closed\"\n            >\n    <h4\n        id=\"accordion-6a317a1a2f5ea-header\"\n        class=\"mhh-mcn-v1-accordion-molecule-header\"\n    >\n        <button\n            class=\"mhh-mcn-v1-accordion-molecule-header__heading\"\n            aria-expanded=\"false\"\n            aria-controls=\"accordion-6a317a1a2f5ea-content\"\n        >\n                        <span class=\"mhh-mcn-v1-accordion-molecule-header__title\">\n                References            <\/span>\n            <span class=\"mhh-mcn-v1-accordion-molecule-header__icon-dropdown\" aria-hidden=\"true\">\n                \n<svg width=\"1em\" height=\"1em\" class=\"mh-icon mh-icon--kind-generic mh-icon--name-dropdown-arrow mh-icon--dropdown-arrow\" role=\"img\" aria-hidden=\"true\">\n    \n    \n    <use xlink:href=\"https:\/\/www.msdconnect.be\/nl\/wp-content\/themes\/cex-wpvip-mhh-mconnect-theme-new-3.0\/modules\/icons\/resources\/icons\/svg\/generic\/dropdown-arrow.svg#dropdown-arrow\"><\/use>\n<\/svg>\n            <\/span>\n        <\/button>\n    <\/h4>\n    <div\n        id=\"accordion-6a317a1a2f5ea-content\"\n        class=\"mhh-mcn-v1-accordion-molecule-content\"\n        role=\"region\"\n        aria-labelledby=\"accordion-6a317a1a2f5ea-header\"\n    >\n        <div class=\"mhh-mcn-v1-accordion-molecule-content__body\">\n            \n\n<ol class=\"mhh-mcn-v2-clist mhh-mcn-v2-clist--49fbcd481fa4197aa22991ecdc0aa9c6 mhh-mcn-list mhh-mcn-v2-clist--ordered mhh-mcn-v2-clist--ordered-decimal\" dir=\"ltr\" lang=\"nl-BE\" start=\"1\">\n    \n<li class=\"mhh-mcn-list-item mhh-mcn-v2-list-item\">\n    <em>Dr Marta Boffito, expert opinion shared during the presentation held in the CHU of Liege<\/em>    <\/li>\n\n\n<li class=\"mhh-mcn-list-item mhh-mcn-v2-list-item\">\n    <em>Smit M, et al. Future challenges for clinical care of an ageing population infected with HIV: a modelling study. Lancet Infect Dis. 2015 Jul;15(7):810-8<\/em>    <\/li>\n\n\n<li class=\"mhh-mcn-list-item mhh-mcn-v2-list-item\">\n    <em>Schouten J, et al. Cross-sectional comparison of the prevalence of age-associated comorbidities and their risk factors between HIV-infected and uninfected individuals: the AGEhIV cohort study. Clin Infect Dis. 2014 Dec 15;59(12):1787-97<\/em>    <\/li>\n\n\n<li class=\"mhh-mcn-list-item mhh-mcn-v2-list-item\">\n    <em>Deeks SG, et al. HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity. BMJ. 2009 Jan 26;338:a3172<\/em>    <\/li>\n\n\n<li class=\"mhh-mcn-list-item mhh-mcn-v2-list-item\">\n    <em>Guaraldi et al. Presentation done at the 18th IWCADRH 2016 . Available on: https:\/\/www.natap.org\/2016\/AdverseReactComor\/AdverseReactComor_15.htm. Last accessed June 2024<\/em>    <\/li>\n\n\n<li class=\"mhh-mcn-list-item mhh-mcn-v2-list-item\">\n    <em>Kazi F, et al. Marta Boffito-The happy warrior. Lancet Infect Dis. 2023 Aug;23(8):896.<\/em>    <\/li>\n\n<\/ol>\n\n        <\/div>\n    <\/div>\n<\/section>\n\n<\/div>\n\n\n\n<p dir=\"ltr\" lang=\"en-US\" class=\"has-gray-700-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--5b7a71790ba80b3d4ea248ed7ebaefd5\"><em>Please consult the full prescribing information before prescribing or delivering the product.<\/em><\/p>\n\n\n\n<div class=\"wp-block-mconnect-theme-tabs tabs \">\n\t<div class=\"tabs__tab-group\">\n\t\t\n\n<div class=\"wp-block-mconnect-theme-tab-item tabs__tab-item sub__entry__content \" id=\"delstrigo-pifeltro-smpc-en\" data-tab-label=\"&lt;strong&gt;DELSTRIGO\u00ae SmPC - 10\/2025&lt;\/strong&gt;\" data-tracking-id=\"tabs__tab-item\">\n\t\n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--c7fa659e5592989d18f6dd985a56ec53\"><strong>1. NAME OF THE MEDICINAL PRODUCT <\/strong>Delstrigo 100&nbsp;mg\/300&nbsp;mg\/245&nbsp;mg film-coated tablets. <strong>2. QUALITATIVE AND QUANTITATIVE COMPOSITION <\/strong>Each film-coated tablet contains 100&nbsp;mg of doravirine, 300&nbsp;mg of lamivudine (3TC), and 245 mg of tenofir disoproxil as tenofovir disoproxil fumarate (TDF). Excipient with known effect: Each film-coated tablet contains 8.6&nbsp;mg lactose (as monohydrate). For the full list of excipients, see section&nbsp;6.1. <strong>3. PHARMACEUTICAL FORM <\/strong>Film-coated tablet (tablet). Yellow, oval-shaped, tablet of dimensions 21.59&nbsp;mm x 11.30&nbsp;mm, debossed with the corporate logo and 776 on one side and plain on the other side. <strong>4. CLINICAL PARTICULARS 4.1 Therapeutic indications <\/strong>Delstrigo is indicated for the treatment of adults infected with human immunodeficiency virus type 1 (HIV\u20111) without past or present evidence of resistance to the non-nucleoside reverse transcriptase inhibitors (NNRTI) class, lamivudine, or tenofovir (see sections&nbsp;4.4 and&nbsp;5.1). Delstrigo is also indicated for the treatment of adolescents aged 12 years and older weighing at least 35 kg who are infected with HIV-1 without past or present evidence of resistance to the NNRTI class, lamivudine, or tenofovir and who have experienced toxicities which preclude the use of other regimens that do not contain tenofovir disoproxil (see sections 4.4 and 5.1). <strong>4.2 Posology and method of administration <\/strong>Therapy should be initiated by a physician experienced in the management of HIV infection. <strong><u>Posology<\/u><\/strong> The recommended dose of Delstrigo is one 100\/300\/245&nbsp;mg tablet taken orally once daily with or without food. <em><u>Dose adjustment<\/u>&nbsp; <\/em>If Delstrigo is co-administered with rifabutin, the doravirine dose should be increased to 100&nbsp;mg twice daily. This is achieved by adding one 100&nbsp;mg tablet of doravirine (as a single agent), to be taken approximately 12&nbsp;hours apart from the dose of Delstrigo (see section&nbsp;4.5). Co-administration of doravirine with other moderate CYP3A inducers has not been evaluated, but decreased doravirine concentrations are expected. If co-administration with other moderate CYP3A inducers (e.g., dabrafenib, lesinurad, bosentan, thioridazine, nafcillin, modafinil, telotristat ethyl) cannot be avoided, one 100&nbsp;mg tablet of doravirine should be taken daily, approximately 12&nbsp;hours after the dose of Delstrigo (see section&nbsp;4.5). <em><u>Missed dose<\/u><\/em> If the patient misses a dose of Delstrigo within 12&nbsp;hours of the time it is usually taken, the patient should take Delstrigo as soon as possible and resume the normal dosing schedule. If a patient misses a dose of Delstrigo by more than 12&nbsp;hours, the patient should not take the missed dose and instead take the next dose at the regularly scheduled time. The patient should not take 2&nbsp;doses at one time. <strong><em>Special populations Elderly <\/em><\/strong>There are limited data available on the use of doravirine, lamivudine, and tenofovir disoproxil in patients aged 65&nbsp;years and over. There is no evidence that elderly patients require a different dose than younger adult patients (see section&nbsp;5.2). Special care is advised in this age group due to age associated changes such as decreases in renal function (see section&nbsp;4.4). <strong><em>Renal impairment <\/em><\/strong>No dose adjustment of Delstrigo is required in patients with estimated creatinine clearance (CrCl) &ge;&nbsp;50&nbsp;mL\/min. Delstrigo should not be initiated in patients with estimated CrCl &lt;&nbsp;50&nbsp;mL\/min (see sections&nbsp;4.4 and&nbsp;5.2). Delstrigo should be discontinued if estimated CrCl declines below 50&nbsp;mL\/min (see section&nbsp;4.4). Patients with moderate or severe renal impairment require a dose interval adjustment of lamivudine and tenofovir disoproxil that cannot be achieved with the combination tablet (see sections&nbsp;4.4 and&nbsp;5.2). <strong><em>Hepatic impairment <\/em><\/strong>No dose adjustment of doravirine\/lamivudine\/tenofovir disoproxil is required in patients with mild (Child-Pugh Class A) or moderate (Child-Pugh Class B) hepatic impairment. Doravirine has not been studied in patients with severe hepatic impairment (Child-Pugh Class C). It is not known whether the exposure to doravirine will increase in patients with severe hepatic impairment. Therefore, caution is advised when doravirine\/lamivudine\/tenofovir disoproxil is administered to patients with severe hepatic impairment (see section&nbsp;5.2). <strong><em>Paediatric population <\/em><\/strong>Safety and efficacy of Delstrigo in children aged less than 12 years or weighing less than 35 kg have not been established. No data are available. <strong><u>Method of administration<\/u> <\/strong>Delstrigo must be taken orally, once daily with or without food and swallowed whole (see section&nbsp;5.2). <strong>4.3 Contraindications <\/strong>Hypersensitivity to the active substances or to any of the excipients listed in section&nbsp;6.1. Co-administration with medicinal products that are strong cytochrome P450&nbsp;CYP3A enzyme inducers is contraindicated as significant decreases in doravirine plasma concentrations are expected to occur, which may decrease the effectiveness of Delstrigo (see sections&nbsp;4.4 and&nbsp;4.5). These medicinal products include, but are not limited to the following: carbamazepine, oxcarbazepine, phenobarbital, phenytoin; rifampicin, rifapentine; St. John&rsquo;s wort (<em>Hypericum perforatum<\/em>); mitotane; enzalutamide; lumacaftor. <strong>4.8 Undesirable effects <\/strong><strong><em>Summary of the safety profile <\/em><\/strong>In phase 3 clinical trials with doravirine plus 2 nucleoside reverse transcriptase inhibitors (NRTIs), the most frequently reported adverse reactions considered possibly or probably related to doravirine were nausea (4&nbsp;%) and headache (3&nbsp;%). <strong><em>Tabulated summary of adverse reactions<\/em><\/strong> The adverse reactions with doravirine plus 2 NRTIs from Phase 3 clinical trials (DRIVE-FORWARD, DRIVE-SHIFT and DRIVE-AHEAD) and postmarketing experience are listed below by body system organ class and frequency. Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness. Frequencies are defined as very common (&ge;&nbsp;1\/10), common (&ge;&nbsp;1\/100 to &lt;&nbsp;1\/10), uncommon (&ge;&nbsp;1\/1 000 to &lt;&nbsp;1\/100), rare (&ge;&nbsp;1\/10 000 to &lt;&nbsp;1\/1,000), very rare (&lt;&nbsp;1\/10 000), or not known (cannot be estimated from the available data). <em>Table 2: Tabulated summary of adverse reactions associated with doravirine\/lamivudine\/tenofovir disoproxil <\/em>Frequency\/ Adverse reactions: <u>Infections and infestations:<\/u> Rare: rash pustular. <u>Blood and lymphatic systems disorders:<\/u> Uncommon: neutropenia*, anaemia*, thrombocytopenia*; Very rare: pure red cell aplasia*. <u>Metabolism and nutrition disorders:<\/u> Uncommon: hypophosphataemia, hypokalaemia*; Rare: hypomagnesaemia, lactic acidosis*. <u>Psychiatric disorders:<\/u> Common: abnormal dreams, insomnia<sup>1<\/sup>; Uncommon: nightmare, depression<sup>2<\/sup>, anxiety<sup>3<\/sup>, irritability, confusional state, suicidal ideation; Rare: aggression, hallucination, adjustment disorder, mood altered, somnambulism. <u>Nervous system disorders:<\/u> Common: headache, dizziness, somnolence; Uncommon: disturbance in attention, memory impairment, paraesthesia, hypertonia, poor quality sleep; Very rare: peripheral neuropathy (or paraesthesia)*.&nbsp; <u>Vascular disorders:<\/u> Uncommon: hypertension. <u>Respiratory, thoracic and mediastinal disorders:<\/u> Common: cough*, nasal symptoms*; Rare: dyspnoea, tonsillar hypertrophy. <u>Gastrointestinal disorders:<\/u> Common: nausea, diarrhoea, abdominal pain<sup>4<\/sup>, vomiting, flatulence; Uncommon: constipation, abdominal discomfort<sup>5<\/sup>, abdominal distension, dyspepsia, faeces soft<sup>6<\/sup>, gastrointestinal motility disorder<sup>7<\/sup>, pancreatitis*; Rare: rectal tenesmus. <u>Hepatobiliary disorders:<\/u> Rare: hepatic steatosis*, hepatitis<sup>&dagger;<\/sup>. <u>Skin and subcutaneous tissue disorders:<\/u> Common: alopecia*, rash<sup>8<\/sup>; Uncommon: pruritus; Rare: dermatitis allergic, rosacea, angioedema*; Not known: toxic epidermal necrolysis. <u>Musculoskeletal and connective tissue disorders:<\/u> Common: muscle disorders*, bone mineral density decreased*; Uncommon: myalgia, arthralgia, rhabdomyolysis*<sup>&Dagger;<\/sup>, muscular weakness*<sup>&Dagger;<\/sup>; Rare: musculoskeletal pain, osteomalacia (manifested as bone pain and infrequently contributing to fractures)*, myopathy*. <u>Renal and urinary disorders:<\/u> Uncommon : increased creatinine*, proximal renal tubulopathy (including Fanconi syndrome)*; Rare: acute kidney injury, renal disorder, calculus urinary, nephrolithiasis, acute renal failure*, renal failure*, acute tubular necrosis*, nephritis (including acute interstitial)*, nephrogenic diabetes insipidus*. <u>General disorders and administration site conditions:<\/u> Common: fatigue, fever*; Uncommon: asthenia, malaise; Rare: chest pain, chills, pain, thirst. <u>Investigations:<\/u> Common: alanine aminotransferase increased<sup>9<\/sup>; Uncommon: aspartate aminotransferase increased, lipase increased, amylase increased, haemoglobin decreased; Rare: blood creatine phosphokinase increased. *This adverse reaction was not identified as an adverse reaction associated with doravirine from the Phase&nbsp;3 clinical studies (DRIVE-FORWARD, DRIVE-AHEAD, DRIVE-SHIFT), but is included in this table as an adverse reaction based on the Summary of Product Characteristics of 3TC and\/or TDF. The highest frequency category reported in the 3TC or TDF Summary of Product Characteristics (SmPC) of 3TC and\/or TDF. The highest frequency category reported in the 3TC or TDF SmPC is used. <sup>&dagger;<\/sup>This adverse reaction was not identified as an adverse reaction associated with doravirine from the Phase&nbsp;3 clinical studies (DRIVE-FORWARD, DRIVE-AHEAD, DRIVE-SHIFT), but was seen during post-marketing use of doravirine-containing regimens and is an adverse reaction listed in the SmPC of 3TC and TDF. The highest frequency category reported in the 3TC and TDF SmPCs is used. <sup>&Dagger;<\/sup>This adverse reaction may occur as a consequence of proximal renal tubulopathy. It is not considered to be causally associated with tenofovir disoproxil in the absence of this condition. <sup>1<\/sup>insomnia includes: insomnia, initial insomnia and sleep disorder. <sup>2<\/sup>depression includes: depression, depressed mood, major depression, and persistent depressive disorder. <sup>3<\/sup>anxiety includes: anxiety and generalised anxiety disorder. <sup>4<\/sup>abdominal pain includes: abdominal pain, and abdominal pain upper. <sup>5<\/sup>abdominal discomfort includes: abdominal discomfort, and epigastric discomfort. <sup>6<\/sup>faeces soft includes: faeces soft and abnormal faeces. <sup>7<\/sup>gastrointestinal motility disorder includes: gastrointestinal motility disorder, and frequent bowel movements. <sup>8<\/sup>rash includes: rash, rash macular, rash erythematous, rash generalised, rash maculo-papular, rash papular, and urticarial. <sup>9<\/sup>alanine aminotransferase increased includes: alanine aminotransferase increased and hepatocellular injury. <strong>Description of selected adverse reactions<\/strong> <strong><em>Immune reactivation syndrome<\/em><\/strong> In HIV\u2011infected patients with severe immune deficiency at the time of initiation of combination antiretroviral therapy (CART), an inflammatory reaction to asymptomatic or residual opportunistic infections may arise. Autoimmune disorders (such as Graves&rsquo; disease and autoimmune hepatitis) have also been reported; however, the reported time to onset is more variable and these events can occur many months after initiation of treatment (see section&nbsp;4.4). <strong><em>Lactic acidosis<\/em><\/strong> Cases of lactic acidosis have been reported with tenofovir disoproxil alone or in combination with other antiretrovirals. Patients with predisposing factors such as patients with decompensated liver disease, or patients receiving concomitant medicinal products known to induce lactic acidosis are at increased risk of experiencing severe lactic acidosis during tenofovir disoproxil treatment, including fatal outcomes. <strong><em>Severe cutaneous adverse reactions (SCARs)<\/em><\/strong> Severe cutaneous adverse reactions (SCARs), such as toxic epidermal necrolysis (TEN), have been reported in association with doravirine-containing treatment regimens (see section 4.4). <strong><em>Paediatric population <\/em><\/strong>The safety of doravirine\/lamivudine\/tenofovir disoproxil was evaluated in 45 HIV-1 infected virologically suppressed or treatment-na&iuml;ve paediatric patients 12 to less than 18 years of age through Week 48 in an open-label trial (IMPAACT 2014 (Protocol 027)). The safety profile in paediatric subjects was similar to that in adults. <strong><em>Reporting of suspected adverse reactions<\/em><\/strong> Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit\/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system: <strong>In Belgium<\/strong> : Agence F&eacute;d&eacute;rale des M&eacute;dicaments et des Produits de Sant&eacute;, www.afmps.be &#8211; Division Vigilance : Site internet: www.notifieruneffetindesirable.be, e-mail: adr@fagg-afmps.be, <strong>au Luxembourg<\/strong> : Centre R&eacute;gional de Pharmacovigilance de Nancy ou Division de la pharmacie et des m&eacute;dicaments de la Direction de la sant&eacute;. Site internet: www.guichet.lu\/pharmacovigilance. <strong>7. <\/strong><strong>MARKETING AUTHORISATION HOLDER <\/strong>Merck Sharp &amp; Dohme B.V., Waarderweg 39, 2031 BN Haarlem, The Netherlands.&nbsp; <strong>8. MARKETING AUTHORISATION NUMBER(S) <\/strong>EU\/1\/18\/1333\/001, EU\/1\/18\/1333\/002. <strong>9. DATE OF FIRST AUTHORISATION\/RENEWAL OF THE AUTHORISATION <\/strong>Date of first authorisation: 22 November 2018; Date of latest renewal: 23 June 2023. <strong>10. DATE OF REVISION OF THE TEXT <\/strong>10\/2025. Detailed information on this medicinal product is available on the website of the European Medicines Agency https:\/\/www.ema.europa.eu. <strong>DELIVERY<\/strong>: on medical prescription.<\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-mconnect-theme-tab-item tabs__tab-item sub__entry__content \" id=\"tab-6a317a1a32587\" data-tab-label=\"&lt;strong&gt;PIFELTRO\u00ae SmPC - 10\/2025&lt;\/strong&gt;\" data-tracking-id=\"tabs__tab-item\">\n\t\n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--7b727739083a35c3ca1b7980cfeeb1f9\"><strong>1. NAME OF <\/strong><strong>THE MEDICINAL PRODUCT <\/strong>Pifeltro 100&nbsp;mg film-coated tablets. <strong>2. QUALITATIVE AND QUANTITATIVE COMPOSITION <\/strong>Each film-coated tablet contains 100&nbsp;mg of doravirine. Excipient with known effect: Each film-coated tablet contains 222&nbsp;mg lactose (as monohydrate). For the full list of excipients, see section&nbsp;6.1. <strong>3. PHARMACEUTICAL FORM <\/strong>Film-coated tablet (tablet). White, oval-shaped, tablet of dimensions 19.00&nbsp;mm x 9.50&nbsp;mm, debossed with the corporate logo and 700 on one side and plain on the other side. <strong>4. CLINICAL PARTICULARS 4.1 Therapeutic indications <\/strong>Pifeltro is indicated, in combination with other antiretroviral medicinal products, for the treatment of adults, and adolescents aged 12 years and older weighing at least 35 kg infected with human immunodeficiency virus type 1 (HIV\u20111) without past or present evidence of resistance to the non-nucleoside reverse transcriptase inhibitors (NNRTI) class (see sections&nbsp;4.4 and&nbsp;5.1). <strong>4.2 Posology and method of administration <\/strong>Therapy should be initiated by a physician experienced in the management of HIV infection. <strong><u>Posology<\/u><\/strong> The recommended dose is one 100&nbsp;mg tablet taken orally once daily with or without food. <em><u>Dose adjustment<\/u> <\/em>If Pifeltro is co-administered with rifabutin, one 100&nbsp;mg tablet of Pifeltro should be taken twice daily (approximately 12&nbsp;hours apart) (see section&nbsp;4.5). Co-administration of doravirine with other moderate CYP3A inducers has not been evaluated, but decreased doravirine concentrations are expected. If co-administration with other moderate CYP3A inducers (e.g., dabrafenib, lesinurad, bosentan, thioridazine, nafcillin, modafinil, telotristat ethyl) cannot be avoided, one 100&nbsp;mg tablet of Pifeltro should be taken twice daily (approximately 12&nbsp;hours apart). <em><u>Missed dose<\/u> <\/em>If the patient misses a dose of Pifeltro within 12&nbsp;hours of the time it is usually taken, the patient should take as soon as possible and resume the normal dosing schedule. If a patient misses a dose by more than 12&nbsp;hours, the patient should not take the missed dose and instead take the next dose at the regularly scheduled time. The patient should not take 2&nbsp;doses at one time. <strong><em>Special populations Elderly <\/em><\/strong>No dose adjustment of doravirine is required in elderly patients (see section&nbsp;5.2). <strong><em>Renal impairment <\/em><\/strong>No dose adjustment of doravirine is required in patients with mild, moderate, or severe renal impairment. Doravirine has not been studied in patients with end-stage renal disease and has not been studied in dialysis patients (see section&nbsp;5.2). <strong><em>Hepatic impairment <\/em><\/strong>No dose adjustment of doravirine is required in patients with mild (Child-Pugh Class A) or moderate (Child-Pugh Class B) hepatic impairment. Doravirine has not been studied in patients with severe hepatic impairment (Child-Pugh Class C). It is not known whether the exposure to doravirine will increase in patients with severe hepatic impairment. Therefore, caution is advised when doravirine is administered to patients with severe hepatic impairment (see section&nbsp;5.2). <strong><em>Paediatric population <\/em><\/strong>Safety and efficacy of Pifeltro in children aged less than 12 years or weighing less than 35 kg have not been established. No data are available. <strong><u>Method of administration<\/u> <\/strong>Pifeltro must be taken orally, once daily with or without food and swallowed whole (see section&nbsp;5.2). <strong>4.3 Contraindications <\/strong>Hypersensitivity to the active substance or to any of the excipients listed in section&nbsp;6.1. Co-administration with medicinal products that are strong cytochrome P450 CYP3A enzyme inducers is contraindicated as significant decreases in doravirine plasma concentrations are expected to occur, which may decrease the effectiveness of Pifeltro (see sections 4.4 and 4.5). These medicinal products include, but are not limited, to the following: carbamazepine, oxcarbazepine, phenobarbital, phenytoin; rifampicin, rifapentine; St. John&rsquo;s wort (<em>Hypericum perforatum<\/em>); mitotane; enzalutamide; lumacaftor. <strong>4.8 Undesirable effects <em>Summary of the safety <\/em><\/strong>In phase 3 clinical trials with doravirine plus 2 nucleoside reverse transcriptase inhibitors (NRTIs), the most frequently reported adverse reactions were nausea (4&nbsp;%) and headache (3&nbsp;%). <strong><em>Tabulated summary of adverse reactions <\/em><\/strong>The adverse reactions with doravirine plus 2 NRTIs from Phase 3 clinical trials (DRIVE FORWARD, DRIVE SHIFT and DRIVE AHEAD) and postmarketing experience are listed below by body system organ class and frequency. Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness. Frequencies are defined as very common (&ge;&nbsp;1\/10), common (&ge;&nbsp;1\/100 to &lt;&nbsp;1\/10), uncommon (&ge;&nbsp;1\/1&nbsp;000 to &lt;&nbsp;1\/100), rare (&ge;&nbsp;1\/10&nbsp;000 to &lt;&nbsp;1\/1&nbsp;000), or not known (cannot be estimated from the available data). <em>Table 2: Tabulated summary of adverse reactions associated with doravirine used in combination with other antiretrovirals <\/em>Frequency\/ Adverse reactions: <u>Infections and infestations: <\/u>Rare: rash pustular. <u>Metabolism and nutrition disorders:<\/u> Uncommon: hypophosphataemia; Rare: hypomagnesaemia. <u>Psychiatric disorders:<\/u> Common: abnormal dreams, insomnia<sup>1<\/sup><strong>; <\/strong>Uncommon: nightmare, depression<sup>2<\/sup>, anxiety<sup>3<\/sup>, irritability, confusional state, suicidal ideation; Rare: aggression, hallucination, adjustment disorder, mood altered, somnambulism. <u>Nervous system disorders:<\/u> Common: headache, dizziness, somnolence; Uncommon: disturbance in attention, memory impairment, paraesthesia, hypertonia, poor quality sleep. <u>Vascular disorders:<\/u> Uncommon: hypertension. <u>Respiratory, thoracic and mediastinal disorders:<\/u>&nbsp; Rare: dyspnoea, tonsillar hypertrophy. <u>Gastrointestinal disorders:<\/u> Common: nausea, diarrhoea, flatulence, abdominal pain<sup>4<\/sup>, vomiting; Uncommon: constipation, abdominal discomfort<sup>5<\/sup>, abdominal distension, dyspepsia, faeces soft<sup>6<\/sup>, gastrointestinal motility disorder<sup>7<\/sup><strong>; <\/strong>Rare: rectal tenesmus. <u>Hepatobiliary disorders:<\/u> Not known: hepatitis. <u>Skin and subcutaneous tissue disorders:<\/u> Common: rash<sup>8<\/sup>; Uncommon: pruritus; Rare: dermatitis allergic, rosacea; Not known: toxic epidermal necrolysis. <u>Musculoskeletal and connective tissue disorders:<\/u> Uncommon: myalgia, arthralgia; Rare: musculoskeletal pain. <u>Renal and urinary disorders:<\/u> Rare: acute kidney injury, renal disorder, calculus urinary, nephrolithiasis. <u>General disorders and administration site conditions:<\/u> Common: fatigue; Uncommon: asthenia, malaise; Rare: chest pain, chills, pain, thirst. <u>Investigations:<\/u> Common: alanine aminotransferase increased<sup>9<\/sup><strong>; <\/strong>Uncommon: lipase increased, aspartate aminotransferase increased, amylase increased, haemoglobin decreased; Rare: blood creatine phosphokinase increased.<sup> 1<\/sup>insomnia includes: insomnia, initial insomnia and sleep disorder. <sup>2<\/sup>depression includes: depression, depressed mood, major depression, and persistent depressive disorder. <sup>3<\/sup>anxiety includes: anxiety and generalised anxiety disorder. <sup>4<\/sup>abdominal pain includes: abdominal pain, and abdominal pain upper. <sup>5<\/sup>abdominal discomfort includes: abdominal discomfort, and epigastric discomfort. <sup>6<\/sup>faeces soft includes: faeces soft and abnormal faeces. <sup>7<\/sup>gastrointestinal motility disorder includes: gastrointestinal motility disorder, and frequent bowel movements. <sup>8<\/sup>rash includes: rash, rash macular, rash erythematous, rash generalised, rash maculo-papular, rash papular, and urticarial. <sup>9<\/sup>alanine aminotransferase increased includes: alanine aminotransferase increased and hepatocellular injury. <strong>Description of selected adverse reactions<\/strong> <strong><em>Immune reactivation syndrome<\/em><\/strong> In HIV\u2011infected patients with severe immune deficiency at the time of initiation of combination antiretroviral therapy (CART), an inflammatory reaction to asymptomatic or residual opportunistic infections may arise. Autoimmune disorders (such as Graves&rsquo; disease and autoimmune hepatitis) have also been reported; however, the reported time to onset is more variable and these events can occur many months after initiation of treatment (see section&nbsp;4.4). <strong><em>Severe cutaneous adverse reactions (SCARs)<\/em><\/strong> Severe cutaneous adverse reactions (SCARs), such as toxic epidermal necrolysis (TEN), have been reported in association with doravirine-containing treatment regimens (see section&nbsp;4.4). <strong><em>Paediatric population<\/em><\/strong> The safety of doravirine as a component of doravirine\/lamivudine\/tenofovir disoproxil was evaluated in 45 HIV-1 infected virologically suppressed or treatment-na&iuml;ve paediatric patients 12 to less than 18 years of age through Week 48 in an open-label trial (IMPAACT 2014 (Protocol 027)). The safety profile in paediatric subjects was similar to that in adults. <strong><em>Reporting of suspected adverse reactions <\/em><\/strong>Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit\/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system: <strong>in Belgium<\/strong>: Agence F&eacute;d&eacute;rale des M&eacute;dicaments et des Produits de Sant&eacute;, www.afmps.be &#8211; Division Vigilance&nbsp;: Site internet: www.notifieruneffetindesirable.be, e-mail: adr@fagg-afmps.be, <strong>in Luxembourg :<\/strong> Centre R&eacute;gional de Pharmacovigilance de Nancy ou Division de la pharmacie et des m&eacute;dicaments de la Direction de la sant&eacute;. Site&nbsp;internet: www.guichet.lu\/pharmacovigilance <strong>7. MARKETING AUTHORISATION HOLDER <\/strong>Merck Sharp &amp; Dohme B.V., Waarderweg 39, 2031 BN Haarlem, The Netherlands. <strong>8. MARKETING AUTHORISATION NUMBER(S) <\/strong>EU\/1\/18\/1332\/001; EU\/1\/18\/1332\/002. <strong>9. DATE OF FIRST AUTHORISATION\/RENEWAL OF THE AUTHORISATION <\/strong>Date of first authorisation: 22 November 2018; Date of latest renewal: 07 July 2023 <strong>10. DATE OF REVISION OF THE TEXT <\/strong>10\/2025. Detailed information on this medicinal product is available on the website of the European Medicines Agency https:\/\/www.ema.europa.eu. <strong>DELIVERY<\/strong>: only on prescription.<\/p>\n\n<\/div>\n\n\t<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Dive into the different themes addressed by Dr Boffito Aging HIV population and the impact of their comorbidities Clinical pathway 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