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Posts Tagged ‘aids clinical care’

A Skeptical Look at “Test and Treat”

Paul Sax • April 10th, 2012

Categories: HIV, Infectious Diseases, Patient Care, Policy

(3 votes, average: 5.00 out of 5)

Over in Journal Watch AIDS Clinical Care, Abbie Zuger has written a fascinating perspective on the recent enthusiasm for universal HIV treatment. Her take? Let’s just say she doesn’t share the enthusiasm of public health officials and members of guidelines committees. Well, that’s a huge understatement. Specifically: This strategy, which calls for universal voluntary HIV [...]

HIV Year in Review Posted on Journal Watch

Paul Sax • January 4th, 2011

Categories: HIV, Infectious Diseases, Research

(2 votes, average: 5.00 out of 5)

Want to catch up quickly in HIV clinical care? Forgive the bias, but the best strategy may well be to read our “Year in Review 2010” summary over on Journal Watch: AIDS Clinical Care. Always interesting to speculate what we’ll be choosing next year — I wouldn’t be surprised if progress in eradication (i.e., cure!) [...]

So Much in Less than a Week!

Paul Sax • December 2nd, 2009

Categories: Health Care, HIV, Infectious Diseases, Policy

(6 votes, average: 3.83 out of 5)

First the updated WHO Guidelines.  Then the following: Updated DHHS Guidelines.  Agree?  Disagree?  Sensible or crazy?  Practical or ivory-tower academic? South Africa does the right thing.  Yes, it’s about time, but good news nonetheless. 2012 International AIDS Meeting in Washington, D.C. First time in USA in a long, long time — 1990, to be exact [...]

Time for a Switch? What Actually Happened

Paul Sax • July 10th, 2009

Categories: Antiretroviral Rounds, HIV, Infectious Diseases

(No Ratings Yet)

A couple of months ago, I presented these three clinically stable, virologically suppressed patients — and asked if they should switch treatment: 50 year old man on ABC/3TC, EFV since 2000.  No renal disease.  Hyperlipidemia, on atorvastatin 80 mg a day.  Father died of an MI age 48. 63 year old man, on EFV + [...]

An Irrational Fear of IRIS?

Paul Sax • June 24th, 2009

Categories: Health Care, HIV, Patient Care, Policy

(No Ratings Yet)

One of the most important recent studies in HIV has just been “published” in (on?) PLoS ONE.  It’s ACTG 5164, led by Andrew Zolopa, which compared “early” versus “deferred” antiretroviral therapy in 282 patients presenting with acute opportunistic infections. (Full disclosure: I am on the protocol study team — but am not an author on [...]

Occupational Exposures and HIV Testing

Paul Sax • June 13th, 2009

Categories: Antiretroviral Rounds, Health Care, HIV, Infectious Diseases, Patient Care, Policy

(No Ratings Yet)

A couple of years ago, an ID-colleague of mine told me about a tough case:  While working in the ICU, an anesthesiologist sustained a pretty severe needle stick.  Approached for HIV testing, the source of the exposure felt threatened by the providers in the ICU, and refused to sign the consent. The patient then deteriorated [...]

Colonoscopy in HIV Patients, Part II: Problem (Mostly) Solved

Paul Sax • April 24th, 2009

Categories: Antiretroviral Rounds, HIV, Infectious Diseases, Patient Care

(No Ratings Yet)

Both here and on the AIDS Clinical Care site, we posted a case of a 50-year-old HIV+ man in need of a screening colonoscopy.  What sedation could he receive while on tenofovir/FTC and ritonavir-boosted atazanavir?  Specifically, would midazolam and fentanyl (“contraindicated” in the ritonavir package insert) be ok? (Same issue for efavirenz, by the way.) [...]