Blog: ID Clinic Director Claire Farel, MD, MPH, Answers Most Common Patient Questions

Claire Farel, MD, MPH, medical director of the UNC Infectious Diseases Clinic.

Claire Farel, MD, MPH, medical director of the UNC Infectious Diseases Clinic.

Claire Farel, MD, MPH, is an assistant professor of medicine in the UNC School of Medicine and medical director of the UNC Infectious Diseases Clinic. In answering the most common questions she is asked as a clinician, Dr. Farel illustrates the vast prevention and treatment services available at the clinic, and how they can be accessed.

I love it when patients ask questions. Being able to partner with patients in their care keeps all of us in the UNC Infectious Diseases (ID) Clinic going. Asking questions shows that patients and their families are engaged in what all of us find most important: a healthier life, an understanding of illness and treatment, reliable information to pass along to others, support during stressful times, options for prevention of infection, maybe even a lasting contribution to science.

There are some questions I get more than others. The following are some of the perennial favorites:

“My significant other has HIV. What can I do to keep from getting it?”
We love to get the word out about HIV prevention resources. If your loved one is on HIV medications already and doing well with an “undetectable” amount of virus on blood tests, their risk of passing HIV on to anyone else is greatly reduced by somewhere between 92-100 percent. We call this “treatment as prevention,” but there are other ways to use HIV medications to keep from getting the virus. You can take a pill every day to prevent HIV before an exposure, known as pre-exposure prophylaxis, or PrEP. Using PrEP consistently creates a “shield” in your body against possible infection, dropping the risk of acquiring HIV by at least 90 percent. In an emergency situation (for example, if a condom breaks during sex or in cases of sexual assault), you can take a combination of medications called post-exposure prophylaxis (PEP) to prevent infection after an exposure. There’s a fixed window of time for PEP medications to have a benefit, however – so it’s important to start those emergency medications within three days of the exposure. Our emergency department has expertise in providing this care and our clinic team can assist in accessing preventative medicine if needed.

We are happy to see folks who are interested in HIV prevention in our clinic and can offer lots of resources to make taking preventative medicine manageable and affordable – as well as advice on protecting yourself in other ways.

“How can I arrange to be seen in your clinic?”
We have special programs for HIV-positive patients that allow self-referral – just give us a call (information is included below) to arrange an appointment. We require that most other patients get a referral from a medical provider (such as a primary care provider or another specialist). Having your medical records and the initial workup for your problem allows us to provide a focused, expert consultation. We advise that anyone at risk gets testing for HIV and hepatitis C as recommended by the CDC (Centers for Disease Control and Prevention), either through regular healthcare provider, free testing events, or local health departments. We take referrals from all of these sources and provide hepatitis C treatment through our clinic if you have a new or longstanding diagnosis.

Our contact information is below, or many practices can send referrals electronically.

UNC Infectious Diseases Clinic
101 Manning Drive, 1st floor Memorial Hospital
Chapel Hill, NC 27599
Phone: 984-974-7198
Fax: 984-974-4587
www.med.unc.edu/infdis/clinical-care/infectious-diseases-clinic

Our mission is to provide excellent clinical care and education for all of our patients, whatever their concern, and to offer them every advance and advantage in our field to keep them healthy. Keep asking questions!

For more information and commonly asked questions, please visit the Institute for Global Health and Infectious Diseases Blog!

UNC HIV Cure Seminar: Understanding mechanisms of HIV persistence using virus sequence analysis in HIV controllers

A talk by Eli Boritz, M.D., Ph.D.
NIAID Clinical Fellow
National Institute Allergy and Infectious Diseases (NIAID) National Institutes of Health
Bethesda, MD

Targeted HIV cure strategies require definition of the mechanisms that maintain the virus. We tracked HIV replication and the persistence of infected CD4 T cells in individuals with natural virologic control by sequencing viruses, T cell receptor genes, HIV integration sites and cellular transcriptomes. Our results revealed three mechanisms of HIV persistence operating within distinct anatomic and functional compartments. In lymph node, we detected viruses with genetic and transcriptional attributes of active replication in both T follicular helper (TFH) cells and non-TFH memory cells. In blood, we detected inducible proviruses of archival origin among highly differentiated, clonally expanded cells. Linking the lymph node and blood was a small population of circulating cells harboring inducible proviruses of recent origin. Thus, HIV replication in lymphoid tissue, clonal expansion of infected cells, and recirculation of recently infected cells act together to maintain the virus in HIV controllers despite effective antiviral immunity.

Refreshments will be served.

Dr. Margolis Featured in New Yorker Article on HIV Cure

Dr David MargolisThe New Yorker recently featured the research of UNC School of Medicine researcher David Margolis, MD, in this article about the search for a cure to HIV infection.

Margolis, a professor of medicine, epidemiology, and microbiology and immunology, serves as director of the School of Medicine’s Program in Translational Clinical Research.

Dr. Margolis currently leads the largest collaboration of HIV researchers, working to force HIV out of “latency” so they can attempt to kill virus particles that typically lay dormant, hidden from therapies. Margolis was among the first researchers to explore methods to force HIV particles out of latency, which is considered a major obstacle to finding curative therapies.

Read the full story here.