HIV and ID Observations

February 23rd, 2012

Hepatitis C and the “Retooling” of HIV/ID Specialists

The news that hepatitis C (HCV) has passed HIV as a cause of death in the United States got quite a bit of attention when it was first presented last year at ICAAC — and no doubt the published paper, in this week’s Annals of Internal Medicine, will also cause a stir. In fact, I boldly predict […]

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February 10th, 2012

Boceprevir – PI Interaction: A “Dear Doctor” Letter We Didn’t Want To Get

By now I’m sure that most of you ID folks out there have received the following letter from Merck, the makers of boceprevir: URGENT — IMPORTANT DRUG WARNING: VICTRELIS (BOCEPREVIR) The purpose of this communication is to inform you of recent pharmacokinetic study results evaluating drug interactions between VICTRELIS, an oral chronic hepatitis C virus (HCV) NS3/4A […]

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February 3rd, 2012

More on Low (but Detectable) Viral Loads — Is Knowing This Useful?

I have a very smart, very experienced colleague — clue, his initials are CC, and he doesn’t pitch for the Yankees — who continues to use bDNA testing for HIV viral load monitoring. You know, the assay with a lower limit of detection of 75 copies. He knows that bDNA is less sensitive than PCR. He knows […]

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January 29th, 2012

Pre-Super Sunday Scombroids

Some quick ID/HIV links while we await big guys playing the big game with a big (or at least bigger) ball. Did you see how this doctor cheated Medicaid out of more than $700,000 by prescribing HIV meds to people who didn’t have HIV? Not surprisingly, he’s going to jail. Proof that if there’s money behind a […]

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January 22nd, 2012

Generic Lamivudine Has Arrived

An e-mail from a patient last week: Just got refills. Epivir is now generic???  Refill is simply labeled Lamivudine Tablets by Aurobindo Pharma USA, Inc …but made in India.  Should I be concerned about that??? John I told John (not his real name) not to be concerned — he is merely substituting the generic for the […]

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January 8th, 2012

Journal Club: In Early HIV Infection, Little Reason to Delay Therapy

Every experienced HIV clinician will recognize the following new-patient scenario: At least one, but often several negative HIV antibody tests in the past, generally due to being in a “high risk” group. Recent non-specific viral-type illness that, in hindsight, was undoubtedly acute HIV infection, undiagnosed. Now completely recovered, but found to be newly HIV antibody positive. […]

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December 28th, 2011

Why We Still Need HIV/ID Specialists

Over on Journal Watch AIDS Clinical Care, we periodically publish a tricky case — always drawn from clinical practice — then ask some experts how they would manage it, and why. The most recent case pretty much has it all: Multiple prior regimens Multi-class drug resistance Metabolic complications Bad allergy history, one event nearly requiring hospitalization Disfiguring […]

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December 24th, 2011

Making a List and Checking it Twice, Then Making Sure 052 is On It

How big a news story was HPTN 052, which demonstrated that HIV treatment reduced transmission by at least 96%? (I like to emphasize that “at least” bit, since it’s likely that none of the study subjects with undetectable HIV RNA levels transmitted to their partners — the one case that did transmit did so before virologic suppression.) […]

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December 14th, 2011

No HIV in Pepsi? Now THAT’S a Relief

How reassuring to be treated with the following news: An SMS has been circulating that Pepsi products are contaminated with HIV but Permanis Sandilands Sdn Bhd has clarified that this is a hoax. Its marketing vice-president Hemalatha Ragavan said there was no truth to it. She urged people not to believe such claims. I have a couple of […]

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December 11th, 2011

An Unlikely Interviewee Discusses “Six-Class” HIV Drug Resistance

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 link […]

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