An ongoing dialogue on HIV/AIDS, infectious diseases,
June 23rd, 2010
Combined HIV Antibody/Antigen Test Approved
From the FDA: The U.S. Food and Drug Administration today approved the first assay to detect both antigen and antibodies to Human Immunodeficiency Virus (HIV)… The highly sensitive assay is intended to be used as an aid in the diagnosis of HIV-1/HIV-2 infection, including acute or primary HIV-1 infection. Since it actually detects the HIV-1 […]
June 16th, 2010
Another HIV Drug Development Program Bows Out
Last month, Avexa announced that they will not be going forward with their development of the investigational NRTI apricitabine. Now Myriad says its program to develop bevirimat is closing as well. The problems with these drugs — twice daily dosing with apricitabine, formulation and mixed responses with bevirimat — are not the real story here, since arguably we […]
June 11th, 2010
Plays at the (Culture) Plate
Some quick ID/HIV/other thoughts while we marvel in all that is Strasburgian: Did you know that HIV medication adherence improves over time? So much for “pill fatigue.” By the way, this anecdotally fits with my experience as well. And right now, the biggest reason for patients’ stopping their HIV meds is financial, usually due to loss of or […]
June 2nd, 2010
Screening for Anal Cancer and the World’s Worst Job
In Journal Watch AIDS Clinical Care, we published a simple case: Clinically stable HIV+ gay man, on HIV treatment; anal pap comes back with “atypical squamous cells of undetermined significance” (ASCUS). What to do with this result? Two experts weighed in, Howard Libman and Joel Gallant. In Howard’s thoughtful response, he acknowledges the limitations of the data thus […]
May 27th, 2010
HIV Treatment is Prevention!
The Lancet has just published a large prospective study demonstrating the protective effect of HIV treatment on the risk of viral transmission: 3381 couples were eligible for analysis … Only one of 103 genetically-linked HIV-1 transmissions was from an infected participant who had started ART, corresponding to transmission rates of 0·37 (95% CI 0·09—2·04) per 100 person-years […]
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, […]
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, […]
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 […]
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 — […]
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? […]
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
Biography | Disclosures | Summaries
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