| Friday, May 1, 2009 |
Updated Pediatric Guidelines
Mobeen Rathore, MD
This session will outline the goals of ARV treatment in HIV-infected children and adolescents. Topics include immunologic HIV RNA and laboratory monitoring, when to initiate ARV therapy by age group, choices of combination therapy for ARV-naïve children and adolescents, and laboratory monitoring of children on ARV therapy. Experts will discuss choice of next ARV regimen for treatment failure with evidence of drug resistance, the use of ARV agents not approved for use in children for salvage therapy, and the management of medication toxicity and/or intolerance.
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Transition of Pediatric Patients to Adult Care
Larry Friedman, MD and Diane Straub, MD, MPH and Ana Garcia, MSW, LCSW
As HIV-infected children and youth live longer and healthier lives, their need to transition into adult care becomes more imperative. Transitioning from a child-friendly clinic to an adult setting can be daunting for clients. In order to facilitate a smooth and successful transfer to adult services, specific procedures should be in place ahead of time. Integral factors in determining readiness for transition will be highlighted during this workshop. Panelists will review the challenges faced and lessons learned from their experiences.
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Perinatal Update
Patricia Emmanuel, MD
Participants will review appropriate HIV testing during pregnancy, and antiretroviral interventions to reduce perinatal HIV transmission. Participants will study appropriate monitoring of the woman and fetus during pregnancy and review of major toxicities. The session will consider breastfeeding and HIV-transmission, the diagnosis of HIV-infection in infants including timing and choice of diagnostic test, and the significance of antiretroviral drug resistance testing in pregnancy.
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| Saturday, May 2, 2009 |
Immunopathogenesis of HIV Disease: What We Know, What Has Changed, What We Speculate
Carina Rodriguez, MD, FAAP
This session will cover the current concepts of HIV transmission and recent advances in the understanding of HIV pathogenesis and immune activation. Participants will examine viral and host factors that determine disease progression, impact of HIV in the gut, mechanisms contributing to immune control in elite controllers and exposed uninfected individuals and the unique characteristics of pediatric HIV-infection. Participants will learn and understand the spectrum of SIV and HIV disease.
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Update on HIV and Vaccines
Carina Rodriguez, MD
This session will cover the current immunization schedule for HIV-infected and exposed infants and the causes of defective immune responses in HIV-infected children and adolescents. Updates on the use of HPV, rotavirus, pneumococcal, influenza, and meningococcal vaccines in HIV-infected children and adolescents will be discussed throughout.
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Opportunistic Infections in HIV Positive Children
Robert Lawrence, MD
This session will cover the updates in the Opportunistic Infections guidelines in pediatrics and adolescents including criteria for initiation, discontinuation, and re-initiation of OI prophylaxis. Participants will review changes in epidemiology and incidents of OI post-HAART and will also discuss the most common OIs with a focus on serious bacterial infections, tuberculous and non-tuberculous mycobacterial infections, fungal infections, viral, and parasitic infections. Participants will review timing of initiation of therapy for OI and ARVs, and examine risk factors for immune reconstitution syndrome (IRIS).
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Adherence
Aditya Gaur, MD
This session will identify successes and challenges in HIV treatment adherence in various settings and populations. Participants will learn behavioral and clinical interventions, and adherence assessment tools that can be integrated into patient care to improve ARV adherence. The speaker will discuss how adherence impacts HIV transmission, HIV prevention and public health, viral suppression, and resistance. Participants will review different technologies to improve adherence (text messaging, drug packaging, electronic monitoring, software, and web) and the benefits of a multidisciplinary approach to adherence.
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Access to Alternative Populations in HIV Care
Larry Friedman, MD
A brief discussion of gaining entry into agencies and services that work with youth clients will hopefully promote dialogue about working with high-risk young people. Juvenile justice programs, substance abuse residential facilities, alternative educational entities, foster care settings, social groups, and other venues will be mentioned by an experienced health educator who has been working with adolescents for nearly two decades.
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How to Talk about Sex
Larry Friedman, MD
Two patient advocates/peer educators from the University of Miami’s clinical and research services within the Department of Pediatrics’ Division of Adolescent Medicine will demonstrate their style of conversation with teenage and young adult clients. They will make suggestions for confidential non-judgmental questioning, use of understandable wording, need for sensitivity to cultural variations, and ability to obtain comprehensive sexual history. Time for examples will be provided.
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