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VOLUME 1, NUMBER 7
HIV-Associated Neurocognitive Disorder (HAND)
In this Issue...
HIV-associated neurocognitive disorder (HAND) arises from multifactorial pathologies, including sustained central nervous system (CNS) inflammation, CNS amyloid deposition, and persistent vascular disease. Despite the widespread use of combination antiretroviral therapy (cART) throughout much of the developed world, the prevalence rate for HAND remains high, even among the many who have achieved immune competence and virologic suppression. After more than a decade of research on HAND, no effective pharmacologic treatment has become available other than cART itself, although even this therapy is often inadequate to reverse or even slow disease progression. HAND is associated with broad and severe functional limitations in affected patients, including poor medication management and increased mortality. Thus, a research effort focused not only on therapies, but also on discovering diagnostically accurate bedside screening tests and biomarkers, is paramount.
In this issue, we review reports describing HAND from a variety of perspectives, including prevalence and risk factors, potential predictive biomarkers for cognitive impairment, and the effects of antiviral CNS penetration on development of the disorder.
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LEARNING
OBJECTIVES
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After participating in this activity, the participant will demonstrate the ability to:
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Explain the meaning of HIV-associated neurocognitive disorder (HAND) and discuss the prevalence of this condition in the current era |
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Describe the functional limitations experienced by those affected with HAND |
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Evaluate potential strategies for patients with HAND in an outpatient clinical setting |
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The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity. |
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IMPORTANT CME INFORMATION |
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Accreditation
Statements
The Johns Hopkins University School of Medicine is accredited by
the Accreditation Council for Continuing Medical Education to
provide continuing medical education for physicians.
Credit Designations
eNewsletter: The Johns Hopkins University School of
Medicine designates this enduring material for a maximum of 1.0
AMA PRA Category 1 Credit(s)�. Physicians should
claim only the credit commensurate with the extent of their
participation in the activity.
Podcast: The Johns Hopkins University School of Medicine
designates this enduring material for a maximum of 0.5 AMA PRA
Category 1 Credit(s)�. Physicians should claim only the
credit commensurate with the extent of their participation in the
activity.
Successful Completion
To successfully complete this activity, participants must read the
content, then link to The Johns Hopkins University School of
Medicine's website to complete the post-test and evaluation. Once
you receive a passing grade, you can access and print your
certificate of credit.
NOTE: If you already have registered for other Hopkins CME courses
on the OCME website, simply enter the requested information when
prompted.
There are no fees or prerequisites for this activity.
This activity is supported by educational grants from Abbott
Laboratories, Boehringer Ingelheim Pharmaceuticals, Inc., and
Bristol-Myers Squibb.
Launch Date
June 20, 2012; activities expire 1 year from the date of
publication.
planner Disclosure
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Continuing Medical Education (ACCME), The Johns Hopkins University
School of Medicine Office of Continuing Medical (OCME) requires
signed disclosure of the existence of any financial relationships
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of a CME activity sponsored by OCME. Members of the Planning
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disclose only those relationships that are relevant to their
specific presentations. The following relationships have been
reported for this activity:
Richard Moore, MD, MHS has disclosed he has
received grants/research support from Pfizer and GlaxoSmithKline.
He has also served as a consultant for Bristol Myers-Squibb.
No other planners have indicated that they have any financial
interests or relationships with a commercial entity.
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The Office of Continuing Medical Education (CME) at The Johns
Hopkins University School of Medicine is committed to protecting
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Your information will never be given to anyone outside of the Johns
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Disclaimer
Statement
The opinions and recommendations expressed by faculty and other
experts whose input is included in this program are their own. This
enduring material is produced for educational purposes only. Use of
The Johns Hopkins University School of Medicine name implies review
of educational format design and approach. Please review the
complete prescribing information for specific drugs or combinations
of drugs, including indications, contraindications, warnings, and
adverse effects before administering pharmacologic therapy to
patients.
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Statement of Responsibility
The Johns Hopkins University School of Medicine takes
responsibility for the content, quality, and scientific integrity
of this CME activity.
STATEMENT OF NEED:
Three central ideas emerged from our needs assessment. In order to provide optimal treatment to patients with HIV.
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Clinicians caring for patients with HIV need current information about: appropriate treatment and maintenance of care�guidance for treating comorbidities�and information about emerging findings for treating HIV-associated neurocognitive disorders (HAND) |
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The need for more information on HIV topics including updated guidelines for HIV, treating older patients with HIV, managing patients with comorbidities and coinfections, treatment and sequencing strategies for maximizing future therapeutic options, and new and emerging agents for HIV |
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Treating comorbidities in patients with HIV, especially among people older than age 50 |
Intended Audience
This activity has been developed for infectious disease
specialists, primary care physicians, nurse practitioners, and
other health care practitioners whose work/practice includes
treating HIV patients.
Confidentiality Disclaimer for Attendees
I certify that I am attending a Johns Hopkins University School of
Medicine CME activity for accredited training and/or educational
purposes.
I understand that while I am attending in this capacity, I may be
exposed to "protected health information," as that term
is defined and used in Hopkins policies and in the federal HIPAA
privacy regulations (the Privacy Regulations). Protected health
information is information about a person's health or
treatment that identifies the person.
I pledge and agree to use and disclose any of this protected health
information only for the training and/or educational purposes of my
visit and to keep the information confidential.
I understand that I may direct to the Johns Hopkins Privacy Officer
any questions I have about my obligations under this
Confidentiality Pledge or under any of the Hopkins policies and
procedures and applicable laws and regulations related to
confidentiality. The contact information is Johns Hopkins Privacy
Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.
"The Office of Continuing Medical Education at The Johns
Hopkins University School of Medicine, as provider of this
activity, has relayed information with the CME
attendees/participants and certifies that the visitor is attending
for training, education and/or observation purposes
only."
For CME Questions, please contact the CME Office at (410) 955-2959
or e-mail cmenet@jhmi.edu.
For CME Certificates, please call (410) 502-9634.
Johns Hopkins University School of Medicine
Office of Continuing Medical Education
Turner 20/720 Rutland Avenue
Baltimore, Maryland 21205-2195
Reviewed and Approved by
General Counsel, Johns Hopkins Medicine (4/1/03)
Updated 4/09
Hardware & Software Requirements
Pentium 800 processor or greater, Windows 98/NT/2000/XP/7 or Mac OS
9/X, Microsoft Internet Explorer 5.5 or later, 56K or better modem,
Windows Media Player 9.0 or later, 128 MB of RAM, sound card and
speakers, Adobe Acrobat Reader, storage, Internet connectivity, and
minimum connection speed. Monitor settings: High color at 800 x 600
pixels.
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Guest
Authors of the Month
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Commentary & Reviews: |
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Justin McArthur, MBBS, MPH, FAAN
Professor of Neurology, Medicine, Epidemiology and Pathology
Director, Department of Neurology
Neurologist in Chief
The Johns Hopkins University School of Medicine
Baltimore, Maryland |
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Bryan Smith, MD
Fellow, Division of Neuroimmunology and Neurological Infections
The Johns Hopkins University School of Medicine
Baltimore, Maryland |
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Guest Faculty Disclosures
The authors have no financial interests or relationships with a commercial entity whose products or services are relevant to the content of their presentation.
Unlabeled/Unapproved Uses
The authors have indicated that there will be no references to unlabeled or unapproved uses of drugs or products.
Program Directors'
Disclosures |
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TO ACCESS THE
POST�TEST
Step 1.
Review the CME Information and study the educational content.
Step 2.
Click the post�test link at the end of the newsletter.
Step 3.
Follow the instructions to access a post�test.
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