|
Topics, Trends & Updates
April 2026
| | | Updated: Immunizations for Adults With HIV | | |
The Immunizations for Adults With HIV guideline was developed to assist clinical practitioners who provide primary care to adults with HIV.
Updates by author Dr. Shauna H. Gunaratne and the MCCC include:
-
Meningococcal Serotype B (MenB) section: New text and references to note that existing data do not support use of MenB vaccine to prevent gonorrhea.
-
Pneumococcal section: Capavaxive (PCV21; 21-valent pneumococcal conjugate vaccine) added to available vaccines.
- Links added to NYSDOH AI vaccine recommendations for hepatitis A virus, hepatitis B virus, human papillomavirus, and mpox (CDC vaccine schedules removed for these topics).
| | | Updated: Prevention and Management of Hepatitis B Virus Infection in Adults With HIV | | |
The Prevention and Management of Hepatitis B Virus Infection in Adults With HIV guideline was developed to guide clinicians who provide medical care for adults (aged ≥18 years) with HIV.
Updates by author Dr. Alok Gupta and the MCCC include:
-
HBV Screening and Diagnosis section: Anti-HBs testing added to the recommendation: “If acute HBV infection is confirmed and the patient is asymptomatic, the clinician should repeat ALT testing within 2 to 4 weeks to assess for symptoms of liver disease progression (B3) and repeat HBsAg, HBeAg, anti-HBe, anti-HBs and HBV DNA testing 6 months later to determine whether infection has cleared. (A3)”
-
HBV Vaccination section:
- Recommended anti-HBS testing interval changed to “1 to 6 months” throughout
- Rating for the preferred HBV vaccine, 2-dose Heplisav-B, changed to “(A1)”
- Updated recommendation: “In a patient with negative HBsAg, negative anti-HBs, and positive anti-HBc test results (isolated anti-HBc positive), the clinician should offer a single dose of Heplisav-B followed by anti-HBs titer testing 1 to 6 months after vaccination OR vaccination with 2 doses of Heplisav-B followed by anti-HBs titer testing 1 to 6 months after the last dose. (A2) For patients who received only 1 dose of Heplisav-B, if the anti-HBs titer is <100 mIU/mL, complete the HBV vaccine series and repeat anti-HBs testing 1 to 6 months after the last vaccine. (A2)”
- Updated recommendation for individuals with nonresponse to HBV vaccine: “If the Heplisav-B vaccine series was administered as the initial HBV vaccination, revaccinate with 1 dose of Heplisav-B and repeat the anti-HBs titer test in 1 to 6 months. (A1)”
- Updated recommendation for individuals with nonresponse to HBV vaccine: “If the Heplisav-B vaccine series was not administered as the initial HBV vaccination, revaccinate with a 2-dose series of Heplisav-B and repeat anti-HBs titer testing 1 to 6 months after the last dose. If the patient is still not immune, give an additional dose of Heplisav-B and repeat the anti-HBs titer test in 1 to 6 months. (A1)”
- Text and Table 3 revised to state that the HBV vaccine Twinrix is not recommended for individuals with HIV
- Discussion added regarding waning immunity after HBV vaccination, including the option to test anti-HBs titers annually in patients with ongoing HBV risk and give a booster dose of Heplisav-B
| | | Updated: Management of Periodontal Disease | | |
The Management of Periodontal Disease guideline was developed to guide clinicians who provide dental care for adults with HIV.
Updates by author Dr. Stephen N. Abel and the MCCC include:
-
Introduction section: New text and reference added on how a shift in the oral microbiome of patients on ART may affect systemic and periodontal inflammation; new text added emphasizing the importance of routine dental care and monitoring in people with HIV, particularly older individuals.
| | | |
New Guidance:
Partner Treatment to Prevent Recurrent Bacterial Vaginosis
| | |
Updated:
Use of Injectable CAB/RPV LA as Replacement ART
| | |
Updated:
Second-Line ART After Treatment Failure or for Regimen Simplification
| | Viremic—Cases in HIV Podcast | |
Join Hosts Eileen Scully and Christopher Hoffmann as they present cases, explore quandaries in adult HIV care, and discuss key evidence and guidelines that inform clinical decision-making.
New Episodes
| | Case 18. What’s New from CROI 2026 with Dr. Paul Sax: Dr. Paul Sax, author of an annual “Really Rapid Review of the Conference on Retroviruses and Opportunistic Infections (CROI),” joins host Eileen Scully to review CROI 2026 abstracts of particular interest to clinicians taking care of patients with HIV. Listen Now | | Case 19. Similar, but Not the Same: HIV-2 Diagnosis and Treatment: Eileen presents the case of a 32-year-old woman newly diagnosed with HIV-2 and invites guest Dr. Sanjiv Shah to discuss HIV-2 epidemiology, diagnosis, treatment, and monitoring. Listen as they explore the difficulties in diagnosing HIV-2, the complexity of treatment, including in pregnant women, and resources available to clinicians. Listen Now | | Case 20. New Options for Treating Pharyngeal Gonorrhea: How to treat pharyngeal gonorrhea in a 32-year-old gay man with HIV who has a documented cephalosporin allergy? Chris presents this case to guest Dr. Marguerite (Margie) Urban, director of the NYSDOH CEI Sexual Health Center of Excellence and longtime member of the Adult HIV Guidelines Committee of the Clinical Guidelines Program. They explore options for treatment and consider the role of gepotidacin and zoliflodacin, 2 new first-in-class drugs approved by the FDA in December 2025 for treatment of uncomplicated gonorrhea. Listen April 14 | | Case 21. If You’ve Seen One, You Haven’t Seen Them All: Elite Controllers: Eileen welcomes Dr. Joel Blankson to review the case of a 28-year-old man who is an elite controller. They discuss elite control characteristics, monitoring, and treatment, while also touching upon patient education and shared ART decision-making. Listen April 28 | | We’re open to suggestions! To submit a clinical topic for a Viremic case discussion, email us at viremicpodcast@jh.edu. | | | Conversations With CEI Podcast | | |
Misconceptions About Contraception: Host Dr. Erica Bostick from the University of Rochester Medical Center Division of Adolescent Medicine chats with Dr. Stacy Sun, a double board-certified physician in obstetrics and gynecology and complex family planning at the University of Rochester, about misconceptions they hear from patients about contraception. Should patients get their hormone levels checked before starting a birth control method? What is emergency contraception, and how does it work? Is it safe to use contraception to suppress the menstrual cycle? What do recent studies show about the Depo-Provera shot and the risk of meningioma? Listen to this episode to hear all about these common questions and more, and to get real examples of counseling tips from Dr. Bostick and Dr. Sun! Listen Now
| | Upcoming Training, Education, and Events | | |
Are You a Subscriber?
If this newsletter was forwarded to you, please subscribe now to make sure you receive the Clinical Guidelines Program Topics, Trends, and Updates newsletter every month and stay current with new and updated guidelines. We send 1 email per month and do not share our mailing list.
| |  | |
Comments? Questions? Suggestions?
Email us: aiguidelines@jhmi.edu.
We'll get back to you as quickly as possible.
Note that we cannot answer questions about the care or treatment of specific patients and cannot provide clinical advice.
| | | | | |
