Paul E. Sax, MD is the Editor-in-Chief, Journal Watch HIV/AIDS Clinical Care, Clinical Director of the Division of Infectious Diseases at Brigham and Women's Hospital, and Professor of Medicine at Harvard Medical School.
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(2 votes, average: 5.00 out of 5)The FDA has approved an 800-mg tablet of darunavir for treatment naive patients. This single tablet will obviously replace the two darunavir 400-mg tablets in first-line therapy. (Yes, my math is that good.) Darunavir will still require 100-mg ritonavir boosting plus two NRTIs to make a complete regimen. Once upon a time I might have thought this [...]
(2 votes, average: 5.00 out of 5)He’d never acknowledge it, but in our field, it’s no secret this guy is something of a rock star. I can think of several key principles in HIV pathogenesis and treatment that he and his research group have discovered, or elucidated most clearly, or simply explained the best — largely through his unique ability to [...]
(2 votes, average: 4.50 out of 5)Two studies were just published on alternative strategies for initial HIV therapy. I’ve already reviewed the first one here. The second paper is a single-arm (n=112) study of darunavir/r (once daily) plus raltegravir, the latest riff on the “NRTI sparing” approach. As I mentioned when I first covered this study, the high rate of virologic failure [...]
(8 votes, average: 4.50 out of 5)Just back from IAS 2011 (which was followed, I’m thrilled to say, with a visit to perhaps the most beautiful region in the world). Here is a Really Rapid Review™ of the meeting, with apologies ahead of time for lack of organization and (even more likely) leaving out something important. FYI, the abstracts are online [...]
(7 votes, average: 4.71 out of 5)I had an interesting exchange with one of our nurses this week about a long-term patient of ours. The e-mails went something like this: Got a fax from —-’s insurance that his Lipitor won’t be covered anymore. They will cover simvastatin, lovastatin, and pravastatin. Let me know what you want to do. Charlie He’s on [...]
(3 votes, average: 4.67 out of 5)Some items to consider in HIV/ID world as you dig into your salmonella-free holiday bird: Drug label change for stavudine (d4T): The label no longer has recommendations for dose-reduction in case of peripheral neuropathy, and cites data more strongly linking d4T use to lipoatrophy. The strategy of decreasing the dose to reduce d4T toxicity hasn’t [...]
(No Ratings Yet)Fresh back from lovely Montreal, where the temperature (I’m glad to report) climbed into the balmy 40′s … Here’s a rapid-fire listing of the Greatest Hits. As I’m sure to be leaving something off this list, happy to accept other suggestions: Interleukin-2 does not work. The ESPRIT and SILCAAT studies are over. Yes, the CD4′s [...]
(No Ratings Yet)We recently published a case in AIDS Clinical Care entitled “Too Many Options”, describing a patient with longstanding HIV infection, virologic failure, and resistance to NRTIs, NNRTIs, and PIs. Fortunately, resistance and tropism testing gave him several options for a new drug regimen — including darunavir, etravirine, maraviroc, enfuvirtide, and — if one believes phenotypic [...]
(No Ratings Yet)As part of our regular series “Antiretroviral Rounds” in AIDS Clinical Care, today we post a case of a highly treatment-experienced patient with dreaded “triple class” resistance — that is, resistance to NRTIs, NNRTIs, and PIs. The good news now, of course, is that we have more than these three drug classes. The tough part [...]
(No Ratings Yet)I’ve written before how the number of treatment experienced patients who have no options for successful therapy has dwindled to a tiny — but unfortunate — few. Darunavir, maraviroc, raltegravir, and etravirine (in order of FDA approval) are that good. Two presentations at recent scientific meetings confirmed the staggering efficacy of these newer drugs. Notably, [...]
