An ongoing dialogue on HIV/AIDS, infectious diseases,
July 6th, 2010
Torrid Tuesday
Some ID/HIV-related items for a sweltering summer day:
- Are the AIDS Drug Assistance Programs (ADAPs) in trouble? Certainly in some states they are, and this interview gives additional perspective. But I wonder — how much of this is HIV-specific, and how much is just the ongoing lousy economy. In other words, are other government-funded programs comparably stressed?
- Headline: Men on ED Drugs Get More STDs. But read the fine print in the actual study — the risk was greater the year before they received the prescription as well. Some serious confounding going on here, I bet.
- XMRV and Chronic Fatigue Syndrome? CDC says no; NIH says … maybe. You decide.
- Great review of the (nearly empty) HIV drug development pipeline here — and I’m not saying that just because I make a small appearance towards the end!
- You mean taking the catheter out promptly doesn’t improve the prognosis of patients with candidemia? Granted, it’s only one study, but it’s fairly large (n=842), and raises the question — how many other “rules” of ID consultation are not data driven? I suspect a lot.
- Uh-oh … first coyotes, and now this? A rabid bat in my home town? Perhaps I’ll move to Canada.
Stay cool, it’s hot out there!
6 Responses to “Torrid Tuesday”
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
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See this interesting NYT article on the CBC/NIH dispute about XMRV and CFS, and note that some people are already trying ARV drugs!
http://www.nytimes.com/2010/07/14/health/14fatigue.html?_r=3&ref=health
Reminds me of the early days of AIDS when people tried that they could get, sharing info with friends. Sort of “underground trials”.
AR, thanks for the link. I had heard that some were trying antiretrovirals.
Needless to say, this is both understandable (people are desperate) and (in my opinion) not the way to go about proving anything. Plus it’s risky.
More here:
http://articles.chicagotribune.com/2010-06-07/health/ct-met-chronic-fatigue–20100607_1_chronic-fatigue-syndrome-xmrv-autism
Suzanne D. Vernon, PhD, Scientific Director for
The CFIDS Association of America critques the CDC study here: http://www.cfids.org/xmrv/070110study.asp
Her conclusions – the CDC’s cohort selection was haphazard at best and at worst deliberately excluded patients with the cardinal symptoms of CFS, the CDC used an array of collection tubes, some incapable of preserving viruses.
In summary:
“So the explanation for not finding XMRV in these samples is simple – this was a study designed to not detect XMRV using a hodge-podge sample set.”
Dr. Vernon conducted research on infectious diseases at the U.S. Centers for Disease Control and Prevention for 17 years before joining the CFIDS Association of America’s staff as scientific director in 2007.
New work on assays for XMRV:
http://www.retrovirology.com/content/7/1/68/abstract/
Is anyone in Boston area interested in studying prevalence, and exploring possible treatments?
Also, new study on retrovirus association with CFS finally out:
http://www.pnas.org/content/early/2010/08/16/1006901107.full.pdf+html
AR, saw the paper and the news coverage… will wait until I’ve fully read it and reviewed it with our virologists before commenting further. Paul