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 vein) […]

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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 increased […]

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January 17th, 2010

Hey, Didn’t You Used to be the Cause of CFS?

The report last year that xenotropic murine leukemia virus-related virus (XMRV) was found in a high proportion of patients with Chronic Fatigue Syndrome (CFS) caused quite a stir — which is totally understandable given how frustrated the people with CFS are with the lack of adequate explanations for their suffering. The investigators of the original report […]

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January 14th, 2010

Magic Wand Destroys H1N1 — and More!

From the folks at Hammacher Schlemmer comes this extraordinary device: Tests performed by an independent antimicrobial testing laboratory showed the wand destroyed 99.98% of the H1N1 virus after a five-second exposure when held 3/4″ above the contaminated surface. Also capable of killing MRSA, mold, and dust mites, the UV-C light penetrates viral and bacterial membranes and […]

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January 10th, 2010

Ceftobiprole’s Long Road to Approval Gets Longer

Cephalosporins with activity against MRSA are out there, but we don’t have them yet.  Just recently, the leader of the pack, ceftobiprole, hit another roadblock: The FDA has indicated in its Complete Response Letter to Johnson & Johnson PRD that it has completed the review of the application and has determined that it cannot approve the […]

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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. The big […]

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December 28th, 2009

Holiday Surprise: Generic Valacyclovir

Last week one of my patients went to refill a Valtrex prescription, and was offered generic valacyclovir for the first time.  It made him nervous, so he requested I write a “brand-name only” script. I confess the existence of a generic formulation of valacyclovir — which according to the PharmD here has been available for several […]

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December 20th, 2009

Infections from Transplant Donors: Rare but Inevitable

Two kidney transplant patients are critically ill due to Balamuthia mandrillaris encephalitis they acquired from the organ donor: The same infection probably killed the organ donor, but it was not diagnosed; his doctors thought he had an autoimmune disease. Two other patients also received heart and liver transplants from the donor, but neither has become ill. Infections […]

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December 13th, 2009

Infection and the ICU: Outcome Predictable, but Important

If you enrolled over 14,000 ICU patients into a study on a single day, and then did follow-up, what would you find regarding the relationship of infection to the outcomes of ICU stay and mortality? Just such a study was published in JAMA last week, and here are the not-so-stunning conclusions: Infections are common in patients in […]

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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 than […]

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