HIV and ID Observations

May 25th, 2020

A Major Advance in Non-COVID-19 ID Research You Might Have Missed

One thing about the COVID-19 pandemic — other important non-COVID ID news gets crowded out. As a prime example, take HPTN 083, a major clinical trial in HIV prevention. The results are a big deal, and should have garnered more attention when they were released last week. This randomized, double-blind pre-exposure prophylaxis (PrEP) study compared long-acting injectable […]

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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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August 7th, 2013

Occupational Post-Exposure Prophylaxis (PEP) Guidelines Updated — And They Are Clear and Sensible

Good news here — the United States Public Health Service has issued new national guidelines for management of occupational exposure to HIV. Authored by an expert panel, these updated occupational PEP guidelines replace the (woefully outdated, sorry, had to write that) previous version, which dates back to 2005. On a quick read-through, despite the density of print, the […]

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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 1st, 2012

Post-Exposure Prophylaxis, the World’s Most Outdated HIV Guidelines, and What To Do About Them

Every time I cover HIV prevention in a lecture, it’s always kind of embarrassing to cite the “official” post-exposure prophylaxis (PEP) guidelines, which are here (non-occupational) and here (occupational). That’s right, they were last updated in 2005, the year of Hurricane Katrina. Yes — more than six years ago. The alternative choices seem particularly curious (read: don’t do […]

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September 3rd, 2011

“Novel” Approaches to Initial HIV Therapy: Part I

It’s been several years since the “preferred” or “recommended” initial regimens for HIV treatment have been consolidated into one of the following four: TDF/FTC + efavirenz TDF/FTC + atazanavir/r TDF/FTC + darunavir/r TDF/FTC + raltegravir Any room for improvement in this “TDF/FTC + key third drug” approach? With the recent approval of TDF/FTC/rilpivirine, certainly this will […]

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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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