HIV and ID Observations

January 13th, 2009

Can We Have “Too Many Options?”

As part of our regular series “Antiretroviral Rounds” in AIDS Clinical Care, today we post a case of a highly treatment-experienced patient with dreaded “triple class” resistance — that is, resistance to NRTIs, NNRTIs, and PIs. The good news now, of course, is that we have more than these three drug classes. The tough part is choosing […]

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January 4th, 2009

Top Stories in HIV Medicine

Happy New Year! In the spirit of list-making that seems to permeate the world right about this time, we’ve just published our own list over at AIDS Clinical Care.  Check it out — our editorial board this year did a superb job of summarizing the field. I have a strong feeling that next year’s version will have […]

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December 29th, 2008

Required Reading: Introducing the “iPatient”

Many HIV/ID specialists first heard of Abraham Verghese from his book My Own Country: A Doctor’s Story, which was published in 1994.  He told us what it was like to be a newly-minted ID doctor, thrust into treating the first cases of HIV/AIDS in a remote town in Tennessee during the mid-1980s. Compelling stuff — I […]

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December 23rd, 2008

Flu Resistance to Oseltamivir: The Bugs Win Again

I must admit, the recent report that 49 of the 50 H1N1 flu viruses tested by the CDC are resistant to oseltamivir caught me by surprise.  For the non-math majors among the readership, that’s a 98% resistance rate.  Yikes. Actually, the rate of resistance is so high that at first I didn’t believe it when my wife […]

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December 10th, 2008

Unintended Consequences of ART “Rollout”

According to this BBC article, teenagers in South Africa are grinding up antiretrovirals and then smoking them for their “hallucinogenic and relaxing effect”.  (Apologies for the pun on the title.) It’s impossible to tell with a report like this how widespread the practice is, but it’s potentially worrisome.  And no mention in the article which antivirals are being used, […]

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December 4th, 2008

More Support for HIV Screening

On Monday December 1 — World AIDS Day, if you’re keeping track — the American College of Physicians released a position paper supporting routine HIV screening for adolescents and adults in the United States.  (If you don’t want to read the whole thing, we’ll have a perfectly-executed summary by the inimitable Abbie Zuger on our AIDS Clinical […]

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November 30th, 2008

How to End the HIV Epidemic

Answer:  Put everyone on treatment. Conspicuously absent for decades, the prevention part of the “when to start antiviral therapy?” question has now moved front and center in two recent papers:  In this week’s Lancet, a group from the WHO estimated what would happen if there were annual universal HIV testing, and then immediate treatment for all […]

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November 22nd, 2008

“Salvage” Rx for HIV: Macro Good News, Micro Bad News

I’ve written before how the number of treatment experienced patients who have no options for successful therapy has dwindled to a tiny — but unfortunate — few.  Darunavir, maraviroc, raltegravir, and etravirine (in order of FDA approval) are that good. Two presentations at recent scientific meetings confirmed the staggering efficacy of these newer drugs. Notably, both […]

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November 17th, 2008

Promising C diff Rx, and Google as Surveillance Tool

A few items from recent ID/HIV news: Bad enough when it happens once, relapsing C diff is one of the modern plagues for which our bag of tricks sometimes comes up woefully short.  (Anything that tests stool transplants as a therapy is pretty desperate.)  Here was some bright news on the treatment front, however:  an experimental […]

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November 10th, 2008

Yes, Just a Case Report, but Incredibly Cool

At this year’s Retrovirus Conference (was it really this year’s conference, seems like much longer ago than that), there was a poster presentation summarizing a very unusual case.  A man with HIV, stable on antiretroviral therapy, developed acute leukemia.  He underwent an allogeneic bone marrow transplant — here’s the kicker — from a donor who […]

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