HIV and ID Observations

May 2nd, 2010

Learning from Clinical Trials with Limited “Generalizability”

In the ongoing debate about when to start antiretroviral therapy in our sickest patients — those with acute opportunistic infections — comes this study from Zimbabwe of early vs. deferred ART in patients with cryptococcal meningitis: The median durations of survival were 28 days and 637 days in the early and delayed ART groups, respectively (P=.031, […]

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April 22nd, 2010

Should Transmission of HIV be a Crime?

Not according to Journal Watch editor and New York Times writer Abigail Zuger, writing here in the Times.  She’s referring to the recent Darren Chiacchia case, where his former partner has filed a legal complaint that Chiacchia did not disclose having HIV — potentially a first-degree felony in Florida. Were it a matter of science alone, […]

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April 14th, 2010

Maraviroc Rarely Used for Treatment-Naive Patients

Over in Journal of Infectious Diseases, the MERIT study was recently published (with Chuck Hicks’ Journal Watch summary here), demonstrating that maraviroc is non-inferior to efavirenz — provided that the enhanced-sensitivity tropism test is used to select appropriate candidates. (The MERIT study began in 2004-5.  Don’t think I’ll ever forget that, since the investigator meeting overlapped […]

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April 4th, 2010

San Francisco Public Health: Treatment Recommended for All with HIV

Could there be anything more interesting than the start of the baseball season? Maybe, because this is quite something: In a major shift of HIV treatment policy, San Francisco public health doctors have begun to advise patients to start taking antiviral medicines as soon as they are found to be infected, rather than waiting — sometimes years — […]

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March 28th, 2010

Kidneys: Fortunately, We Have Two

Here’s a case over in our Journal Watch: AIDS Clinical Care site:  a man with suspected PCP develops rapidly progressive renal failure after being starting on both empiric PCP treatment with TMP-SMX and ART with TDF/FTC plus darunavir/ritonavir. The specific questions at the end of the case were: What do you think is causing the renal failure? […]

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March 10th, 2010

The Extraordinary Power of Placebo

Just published in the journal Neurology — not typically on my radar screen — is this remarkable study comparing pregabalin to placebo for HIV-related distal sensory peripheral neuropathy. Here are the results: At endpoint, pregabalin and placebo showed substantial reductions in mean Numeric Pain Rating Scale (NPRS) score from baseline: -2.88 vs -2.63, p = 0.3941. (-snip-) […]

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March 3rd, 2010

Ritonavir Tablets: Any Experience Out There Yet?

Ritonavir tablets have been approved, and are apparently now in pharmacies.  The capsules will also remain available for the foreseeable future. However, I haven’t switched anyone over from the capsules yet, and neither has anyone else in our practice. Would be interested in hearing how it’s going so far — best news would be that the tablets […]

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February 28th, 2010

CROI 2010 Recap: No Obvious Blockbusters, But …

Ok, I’ll admit it — I didn’t see any studies presented at CROI this year that will immediately transform HIV care on a day-to-day basis.  Nothing that will alter practice right now. Nothing like last year’s NA-ACCORD, or 2008’s surprising DAD study, or 2007’s raltegravir studies, to name a few recent examples. (All subsequently published, of course — links are to […]

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February 19th, 2010

CROI 2011 Dates: February 27-March 3, Boston

CROI just about wrapping up — excellent, as usual.  Hope to provide some “greatest hits” shortly. But since John Mellors announced the dates of next year’s conference — and because the CROI web site can be “leisurely” in posting this information — I offer the following evidence as a public service to researchers, teachers, clinicians, and […]

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February 14th, 2010

Retrovirus Conference (CROI) 2010 Preview

Just as pitchers and catchers report to Spring Training this week, many HIV specialists are gearing up for the 17th Conference on Retroviruses and Opportunistic Infections (CROI), which starts this Tuesday in San Francisco. (I don’t suppose many people see the link between those two events.  Oh well.) And since the “pocket program” to the Conference has […]

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