HIV and ID Observations

August 3rd, 2010

HIV Testing: NY Makes Progress; Massachusetts … Not So Much

From the office of New York Governor David Paterson: The Governor signed into law S.8227/A.11487, which will allow patients to agree to HIV testing as part of a general signed consent to medical care that remains in effect until it is revoked or expires. The bill will also, among other things:  allow oral consent to an HIV […]

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July 30th, 2010

Perinatal Transmission of HIV “Solved” — Now How Do We Pay For It?

Conspicuously absent from this year’s International AIDS Conference were major studies on prevention of maternal-to-child transmission. It could be that I just missed them, so I emailed a colleague who specializes in the area, and she concurred: Nope, did not see or hear major PMTCT updates at IAS. The thing is, this problem has been all but solved, […]

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July 12th, 2010

Neutralizing AB and How to Interpret HIV Vaccine News

Lots of attention in the news media on the recent papers in Science that elucidate the structure and function of broadly neutralizing antibody to HIV.  (Proof:  a patient asked me about it today.) For example, here’s the take by the Wall Street Journal: HIV research is undergoing a renaissance that could lead to new ways to develop […]

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July 1st, 2010

RFA-AI-10-009, HIV Cure, and “Berlin Patient” Update

Interesting “RFA” (Request for Application, #RFA-AI-10-009) from Bethesda: The National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Mental Health (NIMH), National Institutes of Health (NIH), encourage grant applications from institutions/organizations to address the problem of HIV-1 persistence in HIV-1-infected persons treated with suppressive antiretroviral drug regimens… The goal of this initiative […]

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June 23rd, 2010

Combined HIV Antibody/Antigen Test Approved

From the FDA: The U.S. Food and Drug Administration today approved the first assay to detect both antigen and antibodies to Human Immunodeficiency Virus (HIV)… The highly sensitive assay is intended to be used as an aid in the diagnosis of HIV-1/HIV-2 infection, including acute or primary HIV-1 infection. Since it actually detects the HIV-1 […]

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June 16th, 2010

Another HIV Drug Development Program Bows Out

Last month, Avexa announced that they will not be going forward with their development of the investigational NRTI apricitabine. Now Myriad says its program to develop bevirimat is closing as well. The problems with these drugs — twice daily dosing with apricitabine, formulation and mixed responses with bevirimat — are not the real story here, since arguably we […]

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June 11th, 2010

Plays at the (Culture) Plate

Some quick ID/HIV/other thoughts while we marvel in all that is Strasburgian: Did you know that HIV medication adherence improves over time? So much for “pill fatigue.” By the way, this anecdotally fits with my experience as well. And right now, the biggest reason for patients’ stopping their HIV meds is financial, usually due to loss of or […]

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May 27th, 2010

HIV Treatment is Prevention!

The Lancet has just published a large prospective study demonstrating the protective effect of HIV treatment on the risk of viral transmission: 3381 couples were eligible for analysis … Only one of 103 genetically-linked HIV-1 transmissions was from an infected participant who had started ART, corresponding to transmission rates of 0·37 (95% CI 0·09—2·04) per 100 person-years […]

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May 14th, 2010

The Luxury of the START Study … and Running Out of ART in Uganda

Over on our Journal Watch AIDS Clinical Care site, we did a poll asking about the ongoing START study: In the START study, HIV-infected patients with CD4 counts greater than 500 cells per cubic mm are being randomized to start antiretroviral therapy right away or to wait until the CD4 count falls to 350 cells per […]

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May 2nd, 2010

Learning from Clinical Trials with Limited “Generalizability”

In the ongoing debate about when to start antiretroviral therapy in our sickest patients — those with acute opportunistic infections — comes this study from Zimbabwe of early vs. deferred ART in patients with cryptococcal meningitis: The median durations of survival were 28 days and 637 days in the early and delayed ART groups, respectively (P=.031, […]

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