HIV and ID Observations

November 30th, 2009

WHO HIV Treatment Guidelines Updated

This just in: WHO is now recommending that ART be initiated at a higher CD4 threshold of 350 cells/mm3 for all HIV-positive patients, including pregnant women, regardless of symptoms. Which makes eminent sense, of course.  Because if starting HIV therapy might prolong survival in developed countries, why shouldn’t it do the same in the developing world? In fact, […]

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March 25th, 2009

March (Guideline) Madness …

A couple of interesting ID guidelines out this week.  For those of you too busy with basketball, here are the relevant links: Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities. Identified in 24 states and now found “routinely” in New York and New Jersey, these carbapenem-resistant Enterobacteriaceae (“CPE” is much […]

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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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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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April 23rd, 2008

Antiretrovirals in the Pipeline: And Then There Were … None?

The flurry of drug approvals that began in 2005 with tipranavir – followed rapidly by darunavir, maraviroc, raltegravir, and most recently etravirine – has been nothing short of astounding. Every experienced HIV clinician now has many patients who are on successful (read: suppressive) treatment for the first time ever. The Vancouver HIV program — wonderfully called […]

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