Viremic – Cases in HIV

About Viremic – Cases in HIV

Hosted by Eileen Scully, MD, PhD, and Christopher Hoffmann, MD, MSC, MPH, both HIV specialists at Johns Hopkins, Viremic explores quandaries in adult HIV care. Each case discussion includes medical history and diagnoses, challenges in care and treatment, and key evidence and guidelines that informed clinical decision making. Cases are presented as a composite from the hosts’ clinical practice, with all identifying details removed to protect the privacy of patients. Case discussions are for informational purposes only and not offered as medical or clinical practice advice for patients or clinicians. Any mention of specific medications or commercially available products is a description of use only, not an endorsement. Viremic is produced by the Clinical Guidelines Program, a collaborative effort of the New York State Department of Health AIDS Institute and the Johns Hopkins University Division of Infectious Diseases. Do you have comments or suggestions for future case topics? Email us at viremicpodcast@jh.edu. Please note that we cannot reply to questions about specific cases or medical conditions.

Publisher

Dr. Eileen Scully & Dr. Christopher Hoffmann

Category

health & fitness · science

Language

en

Explicit

No

First episode

8 Jul 2025

Latest episode

13 Oct 2026

Latest episodes

33 episodes in the feed.

1. 

   13 Oct 2026

   Case 31. bNAbs – Will They Be Broadly Used?

   A patient asks, “Can I get the every-six-month treatment?” Listen as Eileen Scully and Chris Hoffmann of Johns Hopkins review recent study results on HIV treatment with lenacapavir and two broadly neutralizing antibodies (bNAbs), the status of bNAbs for HIV treatment, cure, and prevention, and what to discuss with patients considering a bNAb clinical trial. References: Balazs, A., Chen, J., Hong, C, et al. Antibody-based protection against HIV infection by vectored immunoprophylaxis. Nature 2012:481, 81–84. PMID: 22139420 (https://pubmed.ncbi.nlm.nih.gov/22139420) Corey L, Gilbert PB, Juraska M, et al. Two randomized trials of neutralizing antibodies to prevent HIV-1 acquisition. N Engl J Med. 2021 Mar 18;384(11):1003-1014. doi: 10.1056/NEJMoa2031738. PMID: 33730454 (https://pubmed.ncbi.nlm.nih.gov/33730454) Lee M, Cherrill L, Zacharopoulou P, et al. Time to HIV rebound after infusion of long-acting broadly neutralising antibodies 3BNC117-LS and 10-1074-LS and analytical treatment interruption (the RIO trial): a double-blind, randomised, placebo-controlled trial. Lancet HIV 2026; 13: e527-e537. PMID: 42202839 (https://pubmed.ncbi.nlm.nih.gov/42202839) McMahon J, Eron J, Gaur A, et al. Efficacy and safety of twice-yearly lenacapavir, teropavimab and zinlirvimab as an HIV-1 Treatment for up to 104 Weeks. JIAS. Volume 29, Issue S4 Supplement: Abstracts from AIDS 2026, the 26th International AIDS Conference, 26–31 July 2026 Rio de Janeiro, Brazil and virtual July 2026. OAB1403 (https://onlinelibrary.wiley.com/doi/10.1002/jia2.70125#:~:text=implementation%20outcome%20monitoring.-,OAB1403,-Efficacy%20and%20Safety) Ndung'u T, Dong KL, Colby DJ, et al. Recommendations from the 2nd Consensus Workshop on Analytical Treatment Interruption in HIV Research trials. Lancet HIV 2026 Apr;13(4):e271-e281. PMID: 41747748 (https://pubmed.ncbi.nlm.nih.gov/41747748)

2. 

   29 Sept 2026

   Case 30. Problem Solving with New ARVs

   A 43-year-old man with HIV is virally suppressed on Odefsey. He started Biktarvy 5 years ago but was switched because of headaches. He recently developed worsening kidney function. Listen as Chris Hoffmann of Johns Hopkins and guest Tony Urbina (https://profiles.mountsinai.org/antonio-urbina), from the Icahn School of Medicine at Mount Sinai, discuss switching this patient to a newly or soon-to-be approved antiretroviral medication. References: Colson AE, Kumar PN, Ruane PJ, et al. Switch to once-weekly, single-tablet islatravir-lenacapavir from daily standard of care for HIV-1 (ISLEND-2): a multicentre, randomised, open-label, active-controlled, phase 3 non-inferiority trial. Lancet 2026; Aug 29;408(10557):821-832. PMID: 42586113 (https://pubmed.ncbi.nlm.nih.gov/42586113). Meissner EG, Ramgopal M, Ruane PJ, et al. Safety and efficacy of switching to bictegravir-lenacapavir versus continuing bictegravir-emtricitabine-tenofovir alafenamide in virologically suppressed people with HIV-1 (ARTISTRY-2): a double-blind, multicentre, randomised, controlled, phase 3, non-inferiority trial. Lancet HIV 2026; Aug;13(8):e538-e547. PMID: 42105781. (https://pubmed.ncbi.nlm.nih.gov/42105781) Orkin C, Mngqibisa R, Velez JD, et al. Switch to fixed-dose doravirine (100 mg) and islatravir (0·25 mg) once daily in virologically suppressed adults with HIV-1 on oral antiretroviral therapy: 48-week results of a phase 3, multicentre, randomised, open-label, non-inferiority trial. Lancet 2026; Feb 7;407(10528):599-610. PMID: 41654374. (https://pubmed.ncbi.nlm.nih.gov/41654374) Orkin C, Ruane PJ, Hedgcock M, et al. Switch to single-tablet bictegravir-lenacapavir from a complex HIV regimen (ARTISTRY-1): a randomised, open-label, phase 3 clinical trial. Lancet 2026; Mar 28;407(10535):1249-1258. PMID: 41763229 (https://pubmed.ncbi.nlm.nih.gov/41763229). Rockstroh JK, Ramgopal MN, Curran Fàbregas A, et al. Phase 3 Trial of Weekly Oral Islatravir-Lenacapavir for HIV-1 Treatment. N Engl J Med 2026; Jul 29. PMID: 42525925. (https://pubmed.ncbi.nlm.nih.gov/42525925) Rockstroh JK, Kassim S, Paredes R, et al. Fixed-dose daily doravirine (100 mg) with islatravir (0·25 mg) versus bictegravir, emtricitabine, and tenofovir alafenamide for initial HIV-1 therapy: 48-week results of a phase 3, randomised, controlled, double-blind, non-inferiority trial. Lancet HIV 2026; Jul;13(7):e440-e451. PMID: 41763226. (https://pubmed.ncbi.nlm.nih.gov/41763226) Related Resource: Viremic–Cases in HIV: Case 27. What’s New from AIDS 2026 in Brazil with Dr. Joel Gallant (https://viremic.org/episodes/case-27-what-s-new-from-aids-2026-in-brazil-with-dr-joel-gallant)

3. 

   15 Sept 2026

   Case 29. U=U: Living a New Normal

   A 48-year-old man with HIV that is well-controlled on dolutegravir/lamivudine has met someone and they are starting to date. His partner is HIV-seronegative, and they have not yet been sexually active. Listen as Eileen Scully and Chris Hoffmann of Johns Hopkins discuss the importance of normalizing sexuality in patients with HIV and strategies for counseling patients that “undetectable=untransmittable (U=U).” References: Bavinton BR, Pinto AN, Phanuphak N, et al. Opposites Attract Study Group. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV 2018 Aug;5(8):e438-e447. [PMID: 30025681 (https://pubmed.ncbi.nlm.nih.gov/30025681)] Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med 2016;375(9):830-39. [PMID: 27424812 (https://www.ncbi.nlm.nih.gov/pubmed/27424812)] Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med 2000 Mar 30;342(13):921-9. [PMID: 10738050 (https://pubmed.ncbi.nlm.nih.gov/10738050)] Rodger AJ, Cambiano V, Bruun T, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019;393(10189):2428-38. [PMID: 31056293 (https://www.ncbi.nlm.nih.gov/pubmed/31056293)] Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016;316(2):171-81. [PMID: 27404185 (https://www.ncbi.nlm.nih.gov/pubmed/27404185)] Vernazza P, Hirschelb B, Bernasconic E, Fleppd M. HIV positive individuals not suffering from any other STD and adhering to an effective antiretroviral treatment do not transmit HIV sexually. (Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitment antirétroviral efficace ne transmettent pas le VIH par voie sexuelle). Bulletin des médecins suisses 2008; 89 (5). [Link to the English translation and original French publication] (https://i-base.info/qa/wp-content/uploads/2008/02/Swiss-Commission-statement_May-2008_translation-EN.pdf) Related Guidelines and Resources: NYSDOH AI Clinical Guidelines Program: U=U Guidance for Implementation in Clinical Settings (https://www.hivguidelines.org/guideline/u-equals-u/?mycollection=hiv-treatment)

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3 ratings

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