HIV and ID Observations

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 […]

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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 […]

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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. […]

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January 1st, 2010

Top 10 Stories of the Year

No end-of-year wrap-up is complete without a “Top 10” list, and Journal Watch: AIDS Clinical Care is no exception. This year we did two lists, one chosen by the Editors, the other a numeric tally of what’s read on line by the Readers. The “When to start” issue was the top story from the Editors. […]

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December 8th, 2009

Vancouver, Phishing Phlu Scam, Telavancin, and Cartoon

A few things to ponder as the flu activity (mercifully) declines, at least for now: Interested in evidence that HIV treatment has become staggeringly effective?  Fully 87% of patients receiving treatment in the large British Columbia cohort have an HIV RNA < 50; not only that, the incidence of HIV drug resistance has declined more […]

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December 2nd, 2009

So Much in Less than a Week!

First the updated WHO Guidelines.  Then the following: Updated DHHS Guidelines.  Agree?  Disagree?  Sensible or crazy?  Practical or ivory-tower academic? South Africa does the right thing.  Yes, it’s about time, but good news nonetheless. 2012 International AIDS Meeting in Washington, D.C. First time in USA in a long, long time — 1990, to be exact […]

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November 30th, 2009

WHO HIV Treatment Guidelines Updated

This just in: WHO is now recommending that ART be initiated at a higher CD4 threshold of 350 cells/mm3 for all HIV-positive patients, including pregnant women, regardless of symptoms. Which makes eminent sense, of course.  Because if starting HIV therapy might prolong survival in developed countries, why shouldn’t it do the same in the developing […]

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November 28th, 2009

ICAAC-IDSA — Alone Again (Naturally)

Just received my latest copy of Infectious Disease News, that large glossy review magazine* that arrives approximately monthly in my mailbox. As usual, I turned right to Dr. Theodore C. Eickhoff’s always-thoughtful editorial, this month entitled “Reflections on the 47th IDSA Meeting.”  He writes: It was a much more “user-friendly” number of attendees, in contrast […]

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November 7th, 2009

A Career in Infectious Diseases and “The Next Big Thing”

I was working with a medical intern in clinic this past week who is potentially interested in ID. After seeing our 3rd consecutive stable HIV patient, he asked me what I thought the next big challenge would be in our field — especially since HIV treatment has been “solved.” “Solved” might be stating it a […]

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October 31st, 2009

Would Changing Restrictive HIV Testing Laws Improve Survival?

Emphatically yes — to the tune of >600,000* years of life gained nationwide.  So says a nifty paper being presented at the annual IDSA meeting today by Mike April, under the direction of Rochelle Walensky. (*Original abstract said 549,437, cited in the link; number at the actual presentation, though, was 609,656.) Bottom line is that […]

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