HIV and ID Observations

April 22nd, 2010

Should Transmission of HIV be a Crime?

Not according to Journal Watch editor and New York Times writer Abigail Zuger, writing here in the Times.  She’s referring to the recent Darren Chiacchia case, where his former partner has filed a legal complaint that Chiacchia did not disclose having HIV — potentially a first-degree felony in Florida. Were it a matter of science alone, […]

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April 14th, 2010

Maraviroc Rarely Used for Treatment-Naive Patients

Over in Journal of Infectious Diseases, the MERIT study was recently published (with Chuck Hicks’ Journal Watch summary here), demonstrating that maraviroc is non-inferior to efavirenz — provided that the enhanced-sensitivity tropism test is used to select appropriate candidates. (The MERIT study began in 2004-5.  Don’t think I’ll ever forget that, since the investigator meeting overlapped […]

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April 4th, 2010

San Francisco Public Health: Treatment Recommended for All with HIV

Could there be anything more interesting than the start of the baseball season? Maybe, because this is quite something: In a major shift of HIV treatment policy, San Francisco public health doctors have begun to advise patients to start taking antiviral medicines as soon as they are found to be infected, rather than waiting — sometimes years — […]

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March 17th, 2010

This One Drives Me Crazy

In the debate over efforts to expand HIV testing by making it less “exceptional” and more like other important tests done in medical care — something I heartily endorse (no kidding) — comes one particular protest that makes absolutely no sense to me. It goes something like this: We cannot expand HIV testing before guaranteeing that all newly-diagnosed […]

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March 10th, 2010

The Extraordinary Power of Placebo

Just published in the journal Neurology — not typically on my radar screen — is this remarkable study comparing pregabalin to placebo for HIV-related distal sensory peripheral neuropathy. Here are the results: At endpoint, pregabalin and placebo showed substantial reductions in mean Numeric Pain Rating Scale (NPRS) score from baseline: -2.88 vs -2.63, p = 0.3941. (-snip-) […]

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March 3rd, 2010

Ritonavir Tablets: Any Experience Out There Yet?

Ritonavir tablets have been approved, and are apparently now in pharmacies.  The capsules will also remain available for the foreseeable future. However, I haven’t switched anyone over from the capsules yet, and neither has anyone else in our practice. Would be interested in hearing how it’s going so far — best news would be that the tablets […]

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February 28th, 2010

CROI 2010 Recap: No Obvious Blockbusters, But …

Ok, I’ll admit it — I didn’t see any studies presented at CROI this year that will immediately transform HIV care on a day-to-day basis.  Nothing that will alter practice right now. Nothing like last year’s NA-ACCORD, or 2008’s surprising DAD study, or 2007’s raltegravir studies, to name a few recent examples. (All subsequently published, of course — links are to […]

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February 14th, 2010

Retrovirus Conference (CROI) 2010 Preview

Just as pitchers and catchers report to Spring Training this week, many HIV specialists are gearing up for the 17th Conference on Retroviruses and Opportunistic Infections (CROI), which starts this Tuesday in San Francisco. (I don’t suppose many people see the link between those two events.  Oh well.) And since the “pocket program” to the Conference has […]

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January 27th, 2010

No Vicriviroc — Yet

Apparently, Merck — taking over for Schering-Plough — will not seek approval for vicriviroc in treatment-experienced patients: In two Phase III studies in this patient population, vicriviroc did not meet the primary efficacy endpoint. These studies enrolled a high percentage of patients who had three or more active drugs in their optimized background therapy regimen. The report […]

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January 1st, 2010

Top 10 Stories of the Year

No end-of-year wrap-up is complete without a “Top 10” list, and Journal Watch: AIDS Clinical Care is no exception. This year we did two lists, one chosen by the Editors, the other a numeric tally of what’s read on line by the Readers. The “When to start” issue was the top story from the Editors. The big […]

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