HIV and ID Observations

November 22nd, 2012

The U.S. Preventive Services Task Force Recommends HIV Screening — And Why is This News?

A flurry of coverage recently appeared about the U.S. Preventive Services Task Force’s recommendation for one-time HIV screening for all Americans, ages 15-64. Some might wonder why this is news — um, hasn’t this been recommended now for years? — and I think I’ve figured it out. Let me start by relaying that every ID/HIV specialists can tell […]

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November 18th, 2012

The 800-mg Darunavir Tablet Arrives, and Scoring the Top Protease Inhibitors

The FDA has approved an 800-mg tablet of darunavir for treatment naive patients. This single tablet will obviously replace the two darunavir 400-mg tablets in first-line therapy. (Yes, my math is that good.) Darunavir will still require 100-mg ritonavir boosting plus two NRTIs to make a complete regimen. Once upon a time I might have thought this was […]

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November 2nd, 2012

Antiretroviral Rounds: Resistance on Two Fronts

Got this challenging curbside consult from a colleague, and it has a interesting wrinkle: I have a longstanding patient with HIV who had many failed regimens in the 1990’s with resultant following mutations on a genotype done in 2003: NRTI (M184V, Q151M mutations);  PI (A71, I54V, K20M, L10I, L90M, V82A mutations); no NNRTI resistance. She has been undetectable since then on TDF/FTC/EFV; […]

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September 19th, 2012

It’s Time to Dump the HIV Western Blot

Hard to believe, but we have to get rid of the HIV Western blot — at least as our HIV confirmatory test. Here’s why (case adapted from several seen the past few years; I’m sure most of you have seen similar): 30-year-old man, high risk for HIV. He’s worried he might have become infected due to recent […]

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September 8th, 2012

People Fear EEE and West Nile, but not Influenza — Can Someone Explain Why?

OK, here’s a quick quiz — match the viral infection with the average annual US deaths: 1.  Eastern Equine Encephalitis A.  36,000, mostly in the elderly 2.  Influenza B.  < 10, mostly in the elderly I know, it was an easy one — 1 goes with B, and 2 with A. Here’s a good reference for more on […]

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August 28th, 2012

“Quad” Approved by FDA

We now have a third single-pill treatment available for HIV treatment, co-formulated tenofovir/emtricitabine/elvitegravir/cobicistat. From the FDA announcement: The U.S. Food and Drug Administration today approved Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate), a new once-a-day combination pill to treat HIV-1 infection in adults who have never been treated for HIV infection. Stribild contains two previously approved HIV […]

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August 13th, 2012

A Poll: Clintons vs Bush

Got this email recently from a former colleague who now does mostly international work: Hey Paul — nice recap of the IAC conference. But I was wondering if you’d forgotten about someone very important when you wrote, “I can’t think of any major politicians who have done more for HIV than the Clintons.” Um, how about […]

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August 9th, 2012

New PrEP “Guidance” Released by CDC

The CDC issued its second “Interim Guidance” on the use of tenofovir/FTC as pre-exposure prophylaxis for prevention of HIV, this time for prevention of HIV in heterosexually active adults. The rationale? Since January 2011, data from studies of PrEP among heterosexual men and women have become available, and on July 16, 2012, the Food and Drug […]

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July 26th, 2012

Pigs are Flying: Written Consent No Longer Needed for an HIV Test in Massachusetts

Let the record show that as of July 26, 2012, a person in Massachusetts can legally get an HIV test without signing a written consent. Hooray. There, that wasn’t so hard, was it?

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July 5th, 2012

Home HIV Test Big News — But Why? And What Impact Will It Have?

The recent FDA approval of a home HIV antibody test (OraQuick In-Home HIV Test) was covered just about everywhere. It’s an oral swab test, takes 20-40 minutes, and will be available over-the-counter. How big a news story was it? Several hundred sources featured it on the day of the announcement, and the total count is now well over a thousand […]

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