HIV and ID Observations

April 8th, 2014

Would “HIV Controllers” Benefit from Antiretroviral Therapy?

Let me start with a disclosure — I’m the co-PI (along with Jon Li and Florencia Pereyra) on a study addressing the very question in the title. The reason for this post is that the topic has been the beneficiary of some terrific coverage in Nature Medicine, both of this research question specifically and the whole topic of […]

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March 12th, 2014

Really Rapid Review — CROI 2014, Boston

Despite the winter that would never end, intrepid HIV/ID researchers and clinicians arrived in Boston for this year’s Conference on Retroviruses and Opportunistic Infections –or more accurately, Conference on Retroviruses and Flaviviridae (little ID joke there) — which just finished last week. Not that it was easy — a winter storm roared eastward as the […]

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March 10th, 2014

CROI Is Over — and a Baby Once Again Takes Center Stage

One of our fellows asked me this AM when I was posting a RRR (Really Rapid Review™) of CROI 2014, and my response was to clear my throat, make some vague excuses, and curse the respiratory viruses that seem as perpetual as the cold weather this year. It’s in the works, promise — but in the […]

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January 2nd, 2014

A New Year’s Snowstorm ID Link-o-Rama

Some ID/HIV items jangling around in the inbox, just dying to get out, before they are covered in snow: Interesting, balanced piece in the New York Times about the slow uptake for PrEP, in particular among gay men. This caught my eye: “Certainly, fewer people have tried PrEP than many experts had anticipated.” I wonder who […]

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December 24th, 2013

Brush with Greatness: John G. Bartlett

At the IDSA meeting in 2012, John Bartlett gave a lecture called, “Infectious Diseases Update for the HIV Provider” — what a great title — which was, as usual, information-packed, practical, well-referenced, and just plain fun. It also occurred to me at the time that there is probably no other person on the planet who […]

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November 6th, 2013

SINGLE Study Underscores Waning of the Efavirenz Era — But Probably Just in the USA

In today’s New England Journal of Medicine, the SINGLE study finally makes its appearance “in print.”  (The study results were first presented over a year ago.) The highlights: SINGLE was a double-blind, randomized clinical trial comparing abacavir/lamivudine plus dolutegravir to tenofovir/FTC/efavirenz in 833 treatment-naive study subjects. That’s right, three different drugs in each arm — you […]

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October 30th, 2013

HIV Treatment of Serodiscordant Couples: The Home Run, Slam Dunk, and Open Goal in Clinical Research

Just in time for Game 6 of the World Series, my colleague Rochelle Walensky has published a paper in theNew England Journal of Medicine (covered here in NEJM Journal Watch). evaluating the cost-effectiveness of treating HIV-infected individuals in serodiscordant couples. The results: In South Africa, early ART was cost-saving over a 5-year period. In both South Africa and India, early […]

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October 25th, 2013

GARDEL Two-Active-Drug Study Not a Game-Changer, but Might Be a Paradigm-Shifter

Don’t look now, but a two-drug lamivudine (3TC) + LPV/r strategy did just as well as a standard three-drug regimen of two NRTIs + LPV/r. Better, actually, since virologic outcomes were the same and the two-drug regimen had fewer side effects. Here are the key details about the GARDEL study, presented just this week by Pedro […]

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October 14th, 2013

MODERN Study Stopped: An NRTI-Sparing, Two-Drug Initial Regimen Disappoints Again

In case you didn’t know, “MODERN” is the clever name for the “Maraviroc Once-daily with Darunavir Enhanced by Ritonavir in a New regimen” trial, which compared TDF/FTC to maraviroc, both with boosted darunavir. And once again, the NRTI-sparing two-drug regimen comes up short, this time in a fully powered, double-blind noninferiority study. From a PDF provided by […]

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October 7th, 2013

CD4 Cell Count at Presentation: A Figure with a Depressingly Small Upward Slope

You know how to make an ID/HIV specialist angry? Frustrated? Sigh loudly? Tell a clinical anecdote that involves “late” presentation of HIV diagnosis, in particular someone who has been seeking medical care for various ailments for months or even years without getting tested. You know — it goes something like this: “He was seen 3 years ago for […]

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