HIV and ID Observations

May 15th, 2014

CDC Recommends Broader Use of Pre-Exposure Prophylaxis — Can We Make It Happen?

Making a much stronger and more comprehensive statement than their earlier “Guidance,” the CDC is now recommending tenofovir/FTC (Truvada) for all Americans at high risk for HIV. More specifically, they recommend it for a broad range of people who have certain risk factors (click to see full size image): One certainly gets why this was done — as summarized nicely in […]

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June 13th, 2013

PrEP Works in Injection Drug Users, CDC Offers “Guidance”

From The Lancet comes this important study of tenofovir pre-exposure prophylaxis for injection drug users (IDUs): In this randomised, double-blind, placebo-controlled trial, we enrolled volunteers from 17 drug-treatment clinics in Bangkok, Thailand … We randomly assigned [2413] participants to either tenofovir or placebo … 50 became infected during follow-up: 17 in the tenofovir group and 33 […]

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August 9th, 2012

New PrEP “Guidance” Released by CDC

The CDC issued its second “Interim Guidance” on the use of tenofovir/FTC as pre-exposure prophylaxis for prevention of HIV, this time for prevention of HIV in heterosexually active adults. The rationale? Since January 2011, data from studies of PrEP among heterosexual men and women have become available, and on July 16, 2012, the Food and Drug […]

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July 16th, 2012

Sizzling Summer Serratias

Several ID/HIV items to contemplate as the heat really kicks in here in the torrid USA: TDF/FTC approved for pre-exposure prophylaxis. The challenging issues of defining the best candidates for this strategy — and finding the providers to prescribe it — still remain, but FDA approval should at least help justify insurance coverage if clinicians choose […]

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May 10th, 2012

Advisory Meeting Today on Tenofovir/FTC for PrEP, and a Proposed “Niche” for its Use

From Bloomberg News: Gilead Sciences Inc.’s pill Truvada was safe and effective when used to protect uninfected people from getting HIV, U.S. regulators said in a report indicating the main concerns are when and how it should be used … The FDA asked its advisers to suggest who should get Truvada; what testing would be needed […]

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March 15th, 2012

CROI 2012 Really Rapid Review — with CROI 2013 Dates!

Some highly subjective highlights — a Really Rapid Review™– from this year’s Number One Greatest Super Scientific HIV Conference, the 19th Conference on Retroviruses and Opportunistic Infections (CROI), which ended last week in Seattle: Need more evidence that maintaining a CD4 cell count > 500 is beneficial? This compelling analysis from the SMART and ESPRIT  studies found that […]

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July 13th, 2011

More Favorable Results on PrEP, But …

As part of the usual flurry of studies released just before major scientific meetings, results of two pre-exposure prophylaxis (PrEP) trials in heterosexual men and women have just been made public: In the CDC TDF2 study, 1200 HIV-uninfected men and women in Botswana were randomized to take oral tenofovir/FTC or placebo daily. Tenofovir/FTC was found to reduce the […]

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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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March 1st, 2011

Like It or Not, PrEP Enters the Clinic

Since the publication of iPrEx, the hypothetical decision about whether to prescribe pre-exposure prophylaxis (PrEP) has become a practical reality. As a result, we’ve posted a case on the Journal Watch/AIDS Clinical Care site, describing someone who requests intermittent pre-exposure prophylaxis to prevent HIV. It’s a high-risk, HIV-negative man who’s been treated several times with post-exposure prophylaxis. The case […]

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January 28th, 2011

Wow, That Was Fast: PrEP Guidelines Appear

With the ink barely dry on iPrEx — still tricky to type — along come “interim” guidelines from the CDC on pre-exposure prophylaxis (PrEP). Based on the results [iPrEx], CDC and other U.S. Public Health Service (PHS) agencies have begun to develop PHS guidelines on the use of PrEP for MSM at high risk for HIV […]

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