HIV and ID Observations

July 6th, 2010

Torrid Tuesday

Some ID/HIV-related items for a sweltering summer day: Are the AIDS Drug Assistance Programs (ADAPs) in trouble?  Certainly in some states they are, and this interview gives additional perspective.  But I wonder — how much of this is HIV-specific, and how much is just the ongoing lousy economy.  In other words, are other government-funded programs comparably stressed?  Headline:  […]

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July 1st, 2010

RFA-AI-10-009, HIV Cure, and “Berlin Patient” Update

Interesting “RFA” (Request for Application, #RFA-AI-10-009) from Bethesda: The National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Mental Health (NIMH), National Institutes of Health (NIH), encourage grant applications from institutions/organizations to address the problem of HIV-1 persistence in HIV-1-infected persons treated with suppressive antiretroviral drug regimens… The goal of this initiative […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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May 23rd, 2010

Dengue in the News … Again

The recent dengue cases acquired in Florida prompted me to think of two things. First, is this really a surprise?  Dengue has become increasingly common in the Caribbean, the mosquitoes that transmit the virus are widespread in the United States, and it’s not as if there’s some sort of microbiologically (if that’s a word) impermeable barrier between the […]

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May 4th, 2010

Zoster Vaccine Underutilized

From the Annals of Internal Medicine: Eighty-eight percent of providers recommend herpes zoster vaccine and 41% strongly recommend it, compared with more than 90% who strongly recommend influenza and pneumococcal vaccines. For physicians in both specialties [Internal Medicine and Family Practice], the most frequently reported barriers to vaccination were financial. From my admittedly biased perspective as an […]

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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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