HIV and ID Observations

May 24th, 2009

Another State Gets Ready to Make HIV Testing Easier

Don’t look now, Massachusetts, but Connecticut could be next: AN ACT CONCERNING REVISIONS TO THE HIV TESTING CONSENT LAW. This bill revises the law on consent for HIV-related testing. Specifically, the bill: 1. eliminates the requirement for separate, written or oral consent for HIV testing and instead allows general consent for the performance of medical procedures […]

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May 19th, 2009

Time for a Switch? Room for Debate

With first-line therapy for HIV being so astonishingly successful, much of what we do in practice is tweak regimens that are by virologic and immunologic standards, working just fine:  Viral load undetectable, CD4 stable. But not so fast — while one of my colleagues said that if he didn’t change his patients’ regimens, then he’d have […]

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May 3rd, 2009

H1N1! Didn’t You Used to Be Swine Flu?

At the end of last week, “swine flu” became “H1N1”.  The CDC web site explains why: This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has […]

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April 24th, 2009

Colonoscopy in HIV Patients, Part II: Problem (Mostly) Solved

Both here and on the AIDS Clinical Care site, we posted a case of a 50-year-old HIV+ man in need of a screening colonoscopy.  What sedation could he receive while on tenofovir/FTC and ritonavir-boosted atazanavir?  Specifically, would midazolam and fentanyl (“contraindicated” in the ritonavir package insert) be ok? (Same issue for efavirenz, by the way.) We solicited […]

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April 20th, 2009

Another HIV Pharmaceutical Partnership

GlaxoSmithKline and Pfizer have created an alliance for HIV drug development. Since there is only one collaborative effort in the HIV treatment area — the colossally-successful “Atripla” between Gilead and BMS — I had thought this kind of arrangement was fairly rare in the drug biz, but according to this interesting take, apparently not. Perhaps not surprisingly, […]

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April 6th, 2009

Delayed Opening Day Videos, and More

Some random HIV/ID issues while awaiting a delayed opening day here in cold, rainy Boston: If you enjoy video highlights, check out these of HIV making its way from T cell to T cell.  If you’re short on time, #’s 9-12 are particularly amazing.  Still, I don’t imagine that this video will make it to Youtube anytime […]

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March 25th, 2009

March (Guideline) Madness …

A couple of interesting ID guidelines out this week.  For those of you too busy with basketball, here are the relevant links: Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities. Identified in 24 states and now found “routinely” in New York and New Jersey, these carbapenem-resistant Enterobacteriaceae (“CPE” is much […]

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March 20th, 2009

Hair Today, Gone Tomorrow …

Since providers — especially doctors — are notoriously poor at predicting medication adherence, here’s some good news: In a paper from the Women’s Interagency Health Study, protease inhibitor levels in hair samples were the strongest independent predictor of virologic success — better than self-reported adherence, age, race, baseline viral load and CD4 cell count, and […]

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March 14th, 2009

Maybe It’s Not the Cheeseburgers

… At least that’s the implied message in this nice paper from the latest Annals of Internal Medicine, which evaluated responses to lipid-lowering therapy among patients with and without HIV. The study included patients from the Kaiser Permanente of Northern California integrated health system, with 829 individuals with HIV and 6941 without. The quick summary is that […]

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March 10th, 2009

Unwelcome Visitor: Cost of HIV Meds

Those of us who practice HIV medicine in Taxachusetts (warning, click link at your peril) live a pretty charmed life, at least so far as getting HIV medications paid for.  Due to an incredibly generous AIDS Drug Assistance Program (ADAP), rare is the patient who faces financial barriers getting his or her drugs. (By the way, […]

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