HIV and ID Observations

November 27th, 2013

Gynecologists May Treat Men After All

Good news here for gynecologists who screen men for anal cancer: A professional group that certifies obstetrician-gynecologists reversed an earlier directive and said on Tuesday that its members were permitted to treat male patients for sexually transmitted infections and to screen men for anal cancer… It’s always impressive when a group swiftly reverses what is widely perceived […]

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November 23rd, 2013

OB/GYN Board Says Their Docs May Only Treat Women

Here’s a surprising move:  The American Board of Obstetrics and Gynecology has decreed that gynecologists may only treat women. From the New York Times coverage: In September, the American Board of Obstetrics and Gynecology insisted that its members treat only women, with few exceptions, and identified the procedure [high-resolution anoscopy] in which Dr. Stier has expertise as […]

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November 13th, 2013

How Doctors, Nurses, and Other Medical Providers Spend Their Free Time

More absurd paperwork follies, this time from our friends at a mail-order pharmacy: Here, confronted with the challenge of refilling a patient’s HIV medications — which for the record he has been receiving unchanged for over 3 years — the pharmacy decides for the first time to reject the request and send the prescription back to […]

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November 6th, 2013

SINGLE Study Underscores Waning of the Efavirenz Era — But Probably Just in the USA

In today’s New England Journal of Medicine, the SINGLE study finally makes its appearance “in print.”  (The study results were first presented over a year ago.) The highlights: SINGLE was a double-blind, randomized clinical trial comparing abacavir/lamivudine plus dolutegravir to tenofovir/FTC/efavirenz in 833 treatment-naive study subjects. That’s right, three different drugs in each arm — you […]

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October 30th, 2013

HIV Treatment of Serodiscordant Couples: The Home Run, Slam Dunk, and Open Goal in Clinical Research

Just in time for Game 6 of the World Series, my colleague Rochelle Walensky has published a paper in theNew England Journal of Medicine (covered here in NEJM Journal Watch). evaluating the cost-effectiveness of treating HIV-infected individuals in serodiscordant couples. The results: In South Africa, early ART was cost-saving over a 5-year period. In both South Africa and India, early […]

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October 25th, 2013

GARDEL Two-Active-Drug Study Not a Game-Changer, but Might Be a Paradigm-Shifter

Don’t look now, but a two-drug lamivudine (3TC) + LPV/r strategy did just as well as a standard three-drug regimen of two NRTIs + LPV/r. Better, actually, since virologic outcomes were the same and the two-drug regimen had fewer side effects. Here are the key details about the GARDEL study, presented just this week by Pedro […]

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October 14th, 2013

MODERN Study Stopped: An NRTI-Sparing, Two-Drug Initial Regimen Disappoints Again

In case you didn’t know, “MODERN” is the clever name for the “Maraviroc Once-daily with Darunavir Enhanced by Ritonavir in a New regimen” trial, which compared TDF/FTC to maraviroc, both with boosted darunavir. And once again, the NRTI-sparing two-drug regimen comes up short, this time in a fully powered, double-blind noninferiority study. From a PDF provided by […]

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October 7th, 2013

CD4 Cell Count at Presentation: A Figure with a Depressingly Small Upward Slope

You know how to make an ID/HIV specialist angry? Frustrated? Sigh loudly? Tell a clinical anecdote that involves “late” presentation of HIV diagnosis, in particular someone who has been seeking medical care for various ailments for months or even years without getting tested. You know — it goes something like this: “He was seen 3 years ago for […]

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September 20th, 2013

CROI Abstract Submissions Now Open, and Old CROI Website Still “Lost” in Cyberspace

HIV researchers can now submit their abstracts to the 2014 Conference on Retroviruses and Opportunistic Infections — or “CROI”. (It rhymes with “soy”, as in “soy sauce”; or, if you prefer, “oy”, as in “oy vey”.) Further details here. General submission for abstracts closes on October 8. Meanwhile, people continue to wonder what happened to the now defunct CROI website, […]

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August 28th, 2013

Poll: At $14,105/year, Is Dolutegravir Fairly Priced?

The recently approved once-daily integrase inhibitor dolutegravir is now in pharmacies and, like every new HIV drug, the price — around $14k/year — has generated some controversy. For the record, here are the per-year wholesale acquisition costs of the three FDA-approved integrase inhibitors. Raltegravir:  $12,976 Elvitegravir:  $13,428 (once disentangled from the price of TDF/FTC) Dolutegravir:  $14,105 If […]

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