HIV and ID Observations

September 7th, 2014

It’s OK to Limit Who Prescribes HCV Therapy, but Insurers Shouldn’t Be Deciding

Some insurers would like to limit the prescribing of HCV treatment to gastroenterologists, hepatologists, or infectious diseases specialists. Not surprisingly, this doesn’t sit well with either the HIV Medicine Association (HIVMA) or the American Academy of HIV Medicine (AAHIVM), both of which have long acknowledged that some of the most seasoned HIV providers are generalists: “There is no medical […]

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August 24th, 2014

Combination ABC/3TC/DTG Approved — Fourth One Pill a Day HIV Treatment

As expected, there’s a new single pill regimen for HIV, this one containing abacavir (ABC)/lamivudine (3TC)/dolutegravir (DTG), and it’s called Triumeq. (Where oh where do companies get these names?) A few thoughts/comments: The most important study for this combination was the SINGLE study, which showed that ABC/3TC + DTG (given as two pills) was superior to TDF/FTC/EFV (given as one), the difference […]

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July 27th, 2014

Really Rapid Review — AIDS 2014, Melbourne

For the second time — the first time was in Sydney, 2007 — the annual “summer” international AIDS conference took place in Australia, this time in Melbourne way down in the southern part of the country. I’ll note again how the crash of Malaysia Airlines flight MH-17 cast a sad note over the opening sessions, and […]

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July 19th, 2014

Mood Solemn in Melbourne as AIDS 2014 Starts

There is unquestionably a shadow cast over this year’s international AIDS meeting here in Melbourne, and it’s not the result of the Australian winter. It’s the crash of Malaysia Airlines Flight 17, of course, which prematurely ended the lives of hundreds of people — including many people en route to this conference, most notably one of the field’s finest […]

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July 14th, 2014

Despite Baby’s Relapse, HIV Cure Research Marches On

The big news in the HIV world over the past week was of course the virologic rebound of the Mississippi Baby, who up to this point was considered possibly the second person cured of HIV. (Timothy Brown — stem-cell transplant recipient from CCR5 negative donor — remains the first and only HIV cure. Every report on this topic […]

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June 28th, 2014

CDC Nixes HIV Western Blot in Latest Testing Guidelines

Finally, it’s official — the Western blot is no longer recommended as a confirmatory test for HIV infection. From the latest Laboratory Testing for the Diagnosis of HIV Infection, updated June 27: The HIV-1 Western blot and HIV-1 immunofluorescence assay, previously recommended to make a laboratory diagnosis of HIV-1 infection, are no longer part of the recommended algorithm. […]

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June 15th, 2014

Poll: Should ID Doctors Still Do HIV Primary Care?

My friend and colleague Ken Freedberg is giving a talk soon at our regional IDSA meeting called, “Who Should Be Providing HIV Care?” He’s a very smart guy (except during the football playoffs, when he is possessed by evil forces), so maybe he’ll answer this question that has strangely bedeviled our field for decades. But I’m sure […]

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May 28th, 2014

Some ID Stuff We’re Talking About on Rounds

Just finished two weeks on the inpatient general medical service — hence the radio silence — giving me a chance to work with residents, interns, and medical students. Here’s a smattering of the ID topics we discussed, along with a comment or two: “Common” causes of gram negative soft tissue infection (at least for board exam purposes), and […]

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May 15th, 2014

CDC Recommends Broader Use of Pre-Exposure Prophylaxis — Can We Make It Happen?

Making a much stronger and more comprehensive statement than their earlier “Guidance,” the CDC is now recommending tenofovir/FTC (Truvada) for all Americans at high risk for HIV. More specifically, they recommend it for a broad range of people who have certain risk factors (click to see full size image): One certainly gets why this was done — as summarized nicely in […]

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May 3rd, 2014

The Top Items from the Revised DHHS HIV Treatment Guidelines

A sparkling, shiny new revision of the DHHS HIV Treatment Guidelines was released this week (thanks Alice Pau!), and provides plenty to read and think about — 285 pages, if you’re counting. A few ways to navigate this gargantuan effort more efficiently — the What’s New section, the recommendations summarized here, and the tables here. But if you want the […]

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