HIV and ID Observations

June 15th, 2011

Hockey Helicobacters

Today’s ID/HIV items come to you courtesy of a winter game being played during a summer month: So it appears that community-based care of HCV augmented by telemedicine is just as good as traditional clinic visits to specialists. My first thought on reading this important paper is that there are undoubtedly lots of ways to incorporate […]

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June 13th, 2011

More on Generic Antiretrovirals …

In the recent post on the approval of generic Combivir — and the lack of availability of generic Epivir (lamivudine, 3TC), which was both anticipated and likely to be more useful — I speculated there were several possible causes of this surprising turn of events. But ultimately I concluded, “In sum, the real reason there’s no generic […]

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June 4th, 2011

HIV Epidemiology and Something Even Many Smart Medical Students Don’t Know

Periodically I like to give an informal quiz to the medical students about HIV epidemiology. It’s a multiple choice question that goes something like this: Based on the recent epidemiology of HIV in the United States, in what group are new cases of HIV infection rising the fastest? Men who have sex with men (MSM) Injection drug […]

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May 26th, 2011

Surprise! It’s Generic Combivir!

After last week’s unveiling of the new NNRTI rilpivirine, now we have a different kind of drug approval from the FDA: FDA granted approval for a generic formulation fixed dose combination of lamivudine and zidovudine tablets, 150 mg/300 mg, two nucleoside analogue reverse transcriptase inhibitors, indicated in combination with other antiretroviral agents for the treatment of […]

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May 23rd, 2011

Rilpivirine Approved — the “iPod” of NNRTIs?

From the FDA on Friday (it’s always on Friday, isn’t it): FDA approved Edurant (rilpivirine) 25 mg tablets, a new non-nucleoside reverse transcriptase inhibitor (NNRTI) for the treatment of HIV. Rilpivirine is an antiviral drug that helps to block reverse transcriptase, an enzyme necessary for HIV replication. The recommended dose of rilpivirine is one 25 mg […]

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May 18th, 2011

HIV Exceptionalism and the Department of Unintended Consequences

Quick question:  If there were one piece of information — clinical or lab — that you would use to determine the quality of care in an HIV program, what would it be?  (Choose one.) Rates of influenza vaccine administration Receiving PCP prophylaxis with CD4 < 200 Adherence counseling before starting antiretroviral therapy Baseline toxoplasmosis serology Proportion of […]

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May 12th, 2011

HPTN 052 Results — Another Win for Early HIV Therapy

The results of the HPTN Study 052 — which randomized 1,763 serodiscordant couples to early vs delayed ART to evaluate whether this reduced the risk of HIV transmission — have just been released: Findings from the study were reviewed by an independent Data and Safety Monitoring Board (DSMB) …The DSMB concluded that initiation of ART by HIV-infected […]

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May 4th, 2011

How Much Do ID/HIV Doctors Get Paid?

A long time ago, I was very close to becoming a Cardiologist. Really. Even though my fascination with ID and microbiology started in medical school — and believe me, not much fascinated me in medical school — the fact that all the top residents in my program were going into Cardiology made me feel that somehow […]

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April 25th, 2011

FEM-PrEP: A Set Back in HIV Prevention Research

HIV prevention has been on such a roll recently that the recent negative news from the FEM-PrEP study came as something of a surprise.  Bottom line: Following a scheduled interim review of the FEM-PrEP study data, the Independent Data Monitoring Committee (IDMC) advised that the FEM-PrEP study will be highly unlikely to be able to demonstrate […]

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April 18th, 2011

When to Start Antiretroviral Therapy, Take 3

A third observational study on “When to Start ART” has just appeared in the Annals of Internal Medicine,  “The HIV-CAUSAL Collaboration.” As with ART-CC and NA-ACCORD, it’s a large study, starting with over 20,000 people with HIV with baseline CD4s >500 receiving care in Europe and the United States.  Out of this group, 8392 experienced CD4 […]

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