HIV and ID Observations

February 13th, 2013

Medication Adherence: The Final Frontier

Treatment of HIV has become so amazingly effective that when it fails, it’s no overstatement to say that it’s usually because the patient is not taking the medications.  There are all kinds of provider-related reasons for this — inadequate patient education, prescribing and dispensing errors, failure to address language or education deficits — but here […]

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January 17th, 2013

Why the Results of the C Diff Study (You Know Which One) Were No Surprise

In cased you missed it, fecal transplant — use of poop from a healthy donor, which is then infused into the colon either from above (nasogastric tube) or below (colonoscope) — is unquestionably the most effective treatment for people who have multiple recurrences of C. difficile colitis (C diff). We know this because of a randomized […]

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January 1st, 2013

HIV Incidence: The Latest Numbers

The CDC has recently issued the latest report on HIV incidence (i.e., new infections) in the United States, and as always it’s fascinating to review the numbers. To start, the year-by-year estimated incidence: 2007:  53,200 2008:  47,500 2009:  45,000 2010:  47,500 (38,000 men, 9,500 women) Nope, not much change. Will data from HPTN 052 — published in the […]

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December 5th, 2012

Top HIV Stories of 2012

Somewhere in our genome, we are programmed to use the end of the year as a time to reflect on the previous 12 months — and to make lists! If you don’t believe me, there’s barely a publication or web site out there that hasn’t already succumbed, and we’re just in early December. And what we can […]

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November 7th, 2012

Vitamins and the Department of Bad Timing

Now that the election is over, we can get back to something that really matters — namely vitamins, and specifically whether they really help people. Last month there was a large, well-done study from Tanzania showing that mega-doses of vitamins not only didn’t help those HIV starting ART, but they actually were harmful — LFTs went […]

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October 28th, 2012

Dolutegravir and the 88% Rule

In the latest treatment-naive trials of elvitegravir and dolutegravir, there’s a striking consistency in the results of the “test” regimen. Here are the studies, with the percentage of responders by treatment arm: Study 102:  TDF/FTC/EFV (84%) vs. TDF/FTC/EVG/c (88%) — non-inferior Study 103:  TDF/FTC + ATV/r (87%) vs. TDF/FTC/EVG/c (90%) — non-inferior SPRING-2:  TDF/FTC or ABC/3TC […]

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October 22nd, 2012

Can a “Treat Everyone with HIV” Policy Actually Work? In San Francisco, Yes

As has often been the case in the history of the HIV epidemic, the HIV/AIDS Division at San Francisco General Hospital and the San Francisco Department of Health were ahead of the curve in 2010 when they issued a recommendation that all people with HIV should receive treatment, regardless of CD4 count. Of course, US guidelines […]

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October 17th, 2012

It’s Time to Tell Our Patients to Stop Their Vitamin Supplements

Over in JAMA, there’s a large study out today that (yet again) failed to demonstrate a benefit of vitamins. Over 3000 patients with HIV in Tanzania were randomized to receive either high-dose or standard-dose multivitamin supplementation, in addition to “HAART” (ugh). Though the study was planned for 24 months, it was stopped early by the Data Safety […]

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October 16th, 2012

Some Liver Meeting “Wow!” Studies Start to Emerge

The Liver Meeting, the annual meeting of the American Association for the Study of Liver Disease, does not take place until November 9-13, in Boston. But if you want a preview, a couple of notable studies have already been “announced” in the press. Specifically, there’s this: Abbott today announced initial results from “Aviator,” a phase 2b study of its interferon-free, […]

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September 1st, 2012

CROI 2013: March 3-7, Atlanta

The title says it all. Abstract deadline is October 9. Photo below is completely irrelevant.

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