HIV and ID Observations

June 13th, 2012

Questions About HIV Cure, and a Very Funny Quote

The single case of HIV cure following allogeneic bone marrow transplant is in the news again, this time because of data just presented at “The International Workshop on HIV and Hepatitis Virus Drug Resistance and Curative Strategies” (formerly known as the “HIV Resistance Workshop” — how’s that for rebranding?). I’m not at the meeting, which is too […]

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June 8th, 2012

SPARTAN: Two-Drug, NRTI-Sparing Strategies Continue to Disappoint

Just published is the cleverly named “SPARTAN” study — spartan because it leaves out both NRTIs and ritonavir — and the results are very interesting. Ninety-three treatment-naive HIV-positive study subjects were randomized 2:1 to receive either a two-drug regimen of raltegravir 400 mg BID + atazanavir 300 mg BID, or a standard regimen of TDF/FTC + boosted atazanavir. […]

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June 2nd, 2012

Cryptococcal Meningitis Study Stopped — Early HIV Therapy Clearly Harmful

From NIAID, an important clinical trial has been stopped early: The Phase IV study … was evaluating whether HIV-infected participants hospitalized with cryptococcal meningitis (CM) but not yet taking antiretroviral therapy (ART) would improve their chances of survival if they began ART while receiving CM treatment as inpatients compared with the standard practice of beginning ART […]

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May 25th, 2012

Generic Nevirapine Now Available — But the Big One is Next Year

As I’m sure you’ve heard from your patients — as I did — lamivudine (3TC) is now available generically. Now comes news of the release of several generic formulations of nevirapine (NVP), an effective but always somewhat overshadowed medication. Since its approval way back when in 1996, there has always been a solid reason to pick […]

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May 20th, 2012

News on HIV and HCV Testing, and in Praise of Accurate Screening Tests

Two recent news items reminded me how lucky we are to have some very accurate screening tests for certain infectious diseases. The news: An expert FDA panel backed approval of the first true home test for HIV, the OraQuick mouth swab test. Approval of OraQuick for home use may occur later this year. While home testing for […]

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May 10th, 2012

Advisory Meeting Today on Tenofovir/FTC for PrEP, and a Proposed “Niche” for its Use

From Bloomberg News: Gilead Sciences Inc.’s pill Truvada was safe and effective when used to protect uninfected people from getting HIV, U.S. regulators said in a report indicating the main concerns are when and how it should be used … The FDA asked its advisers to suggest who should get Truvada; what testing would be needed […]

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April 30th, 2012

Do We Really Need Primary Prophylaxis for OIs Anymore?

I’m currently on the inpatient consult service and just saw a guy who fits the typical profile of many hospitalized HIV patients in 2012: Low CD4 (in this case, 120) Irregular to non-existent outpatient care before admission (lots of no-shows, cancellations, etc) Has received several prescriptions for antiretroviral therapy but for a whole variety of reasons, hasn’t […]

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April 23rd, 2012

An Answer to a Commonly Asked Question: Is Treatment 100% Effective in Preventing HIV Transmission?

The excitement about “treatment as prevention”, and the results of Study 052, have led to many patients asking the question (if not in these words, than using others with a less medical slant), “So if I’m on treatment and doing well, just what is the risk of my transmitting HIV to others?” It’s not a question […]

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April 14th, 2012

2004 HIV Treatment Guidelines: Available Now!

Bargain hunters will be glad to hear that over on Amazon, they can get a copy of the 2004 Guidelines for the Use of Antiretroviral Agents in HIV-1 Infected Adults and Adolescents — all for the remarkably low price of $16.15. Notable content from that banner year included: for asymptomatic patients with CD4 > 350, the HIV […]

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April 10th, 2012

A Skeptical Look at “Test and Treat”

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 testing and […]

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