HIV and ID Observations

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? […]

---

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-) […]

---

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 […]

---

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 […]

---

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 […]

---

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 […]

---

February 11th, 2010

Ritonavir Tablet Approved

It’s not on Abbott’s web site yet (update:  now it’s here), but the FDA has approved a new formulation of ritonavir — a heat-stable 100 mg tablet.  From an e-mail release by the FDA: On February 10, 2010, FDA approved Norvir (ritonavir) 100 mg Tablets. These tablets do not require refrigeration.  Unlike the capsule formulation [pictured], […]

---

February 4th, 2010

Non-Cirrhotic Portal Hypertension: A Rare but Serious Side Effect of ddI

The FDA has issued a warning about an association between use of ddI (didanosine) and the development of non-cirrhotic portal hypertension: Non-cirrhotic portal hypertension (portal hypertension that is not caused by cirrhosis of the liver) is rare in the United States. It occurs when blood flow in the major vein in the liver (the portal vein) […]

---

January 29th, 2010

More on TaqMan Viral Load Testing

Since I first discussed the disruptive effect of introducing Mr. TaqMan to our clinic, many others have weighed in. One of my favorite reports is a nice paper from the Alabama group, presented first at IDSA, and soon to be published.  It shows not only a higher rate of low-level detectable results, but also the increased […]

---

January 27th, 2010

No Vicriviroc — Yet

Apparently, Merck — taking over for Schering-Plough — will not seek approval for vicriviroc in treatment-experienced patients: In two Phase III studies in this patient population, vicriviroc did not meet the primary efficacy endpoint. These studies enrolled a high percentage of patients who had three or more active drugs in their optimized background therapy regimen. The report […]

---