NNRTIs Best PIs . . . Again
HIV/AIDS Clinical Care Summary and Comment
Free
In a large randomized trial of treatment-naive patients, the most virologically active strategy was two NRTIs plus an NNRTI; a triple-class strategy yielded greater toxicity but not greater efficacy.
By Paul E. Sax, MD
January 8, 2007
Covering:
MacArthur RD et al., Lancet 2006 Dec 16; 368:2125-35
Abgrall S., Lancet 2006 Dec 16; 368:2107-9
More Support for Rapid HIV Testing
After rapid HIV testing was introduced in New York, more clients were tested — and more received their results — than when only standard HIV testing was available.
By Carlos del Rio, MD
January 8, 2007
Covering:
San Antonio-Gaddy M et al., J Acquir Immune Defic Syndr 2006 Dec 1; 43:446-50
Which Antiretroviral Regimen to Start FIRST?
Infectious Diseases Summary and Comment
Free
For initial therapy in HIV-infected patients, a two-class regimen is better than a three-class regimen.
By Rajesh T. Gandhi, MD
January 3, 2007
Covering:
MacArthur RD et al., Lancet 2006 Dec 16; 368:2125-35
Malaria and HIV: A Double Whammy
Infectious Diseases Summary and Comment
HIV infection significantly increases susceptibility to malaria and vice versa, and in coinfected persons, recurrent viral-load increases during malaria episodes may promote spread of HIV.
By Bradley E. Britigan, MD
January 3, 2007
Covering:
Abu-Raddad LJ et al., Science 2006 Dec 8; 314:1603-6
Circumcision Greatly Reduces Risk for HIV Infection
Adult male circumcision halved the risk for HIV transmission in an interim analysis of two randomized, controlled studies.
Treating Lipodystrophy in HIV-Infected Patients
Infectious Diseases Summary and Comment
In HIV-infected patients with lipodystrophy, metformin and rosiglitazone improved insulin sensitivity but had limited effects on abnormal fat redistribution.
By Rajesh T. Gandhi, MD
December 20, 2006
Covering:
Mulligan K et al., AIDS 2007 Jan 2; 21:47-57
Missed Opportunities for Earlier HIV Diagnosis
About 40% of new HIV cases in South Carolina were among late testers, many of whom had had multiple medical encounters prior to their HIV diagnosis.
By Rochelle P. Walensky, MD, MPH
December 18, 2006
Covering:
Centers for Disease Control and Prevention., MMWR Morb Mortal Wkly Rep 2006 Dec 1; 55:1269-72
Cost-Effectiveness of Expanded HIV Testing
Infectious Diseases Summary and Comment
In the U.S., testing all adolescents and adults for HIV would be cost-effective, given the current prevalence of the infection in the general population.
By Stephen G. Baum, MD
December 13, 2006
Covering:
Paltiel AD et al., Ann Intern Med 2006 Dec 5; 145:797-806
Branson BM., Ann Intern Med 2006 Dec 5; 145:857-9
Making HIV Testing Cost-Effective
HIV/AIDS Clinical Care Summary and Comment
Free
A new analysis illustrates the complexities of constructing rational policies for routine HIV testing.
By Abigail Zuger, MD
December 11, 2006
Covering:
Paltiel AD et al., Ann Intern Med 2006 Dec 5; 145:797-806
Late AIDS Diagnosis Is All Too Common
Nearly 40% of people diagnosed with AIDS in San Francisco had their first HIV-positive test within the preceding year.
By Keith Henry, MD
December 11, 2006
Covering:
Schwarcz S et al., J Acquir Immune Defic Syndr 2006 Dec 1; 43:491-4
New Vaccines and Updates
Rotavirus vaccine, human papillomavirus vaccine, and varicella vaccine
By Peggy Sue Weintrub, MD
December 6, 2006
Covering:
Parashar UD et al., MMWR Recomm Rep 2006 Aug 11; 55:1-13
Does Circumcision Prevent Sexually Transmitted Infections?
The authors found that it could reduce risk for STIs in men.
By Howard Bauchner, MD
December 6, 2006
Covering:
Fergusson DM et al., Pediatrics 2006 Nov; 118:1971-7
HPV Vaccine for Preadolescents and Adolescent Boys and Girls
Infectious Diseases Summary and Comment
These data, which show that the quadrivalent HPV vaccine is immunogenic for preadolescent boys and girls, support current recommendations.
By Robert S. Baltimore, MD
December 6, 2006
Covering:
Block SL et al., Pediatrics 2006 Nov; 118:2135-45
Intermittent HIV Treatment Fails Dramatically
HIV/AIDS Clinical Care Summary and Comment
Free
The SMART study leaves little doubt that continuous antiretroviral therapy, for all its problems, is better for overall health than intermittent therapy.
By Abigail Zuger, MD
November 29, 2006
Covering:
The Strategies for Management of Antiretroviral Therapy (SMART) Study Group., N Engl J Med 2006 Nov 30; 355:2283-96
Currier JS and Baden LR., N Engl J Med 2006 Nov 30; 355:2359-61
Episodic HIV Treatment: Not a SMART Idea
Infectious Diseases Summary and Comment
Free
An episodic CD4-count–guided treatment strategy was associated with higher morbidity and mortality than was continuous antiretroviral therapy in HIV-infected patients.
By Rajesh T. Gandhi, MD
November 29, 2006
Covering:
The Strategies for Management of Antiretroviral Therapy (SMART) Study Group., N Engl J Med 2006 Nov 30; 355:2283-96
Currier JS and Baden LR., N Engl J Med 2006 Nov 30; 355:2359-61
An Updated Overview of Triple-Drug HIV Therapy
HIV/AIDS Clinical Care Summary and Comment
Free
A review of 53 triple-drug studies supports the use of NNRTI- and boosted PI-based regimens for treatment-naive individuals.
By Rebeca M. Plank, MD
November 27, 2006
Covering:
Bartlett JA et al., AIDS 2006 Oct 24; 20:2051-64
How Should We Allocate ADAP Funds?
Researchers compared a first-come, first-served approach with an approach based on patient CD4-cell count.
By Carlos del Rio, MD
November 27, 2006
Covering:
Linas BP et al., Clin Infect Dis 2006 Nov 15; 43:1357-64
Saag MS., Clin Infect Dis 2006 Nov 15; 43:1365-7
The Cost of HIV Care in the U.S.
HIV/AIDS Clinical Care Summary and Comment
Free
According to a simulation model, adults who initiate potent combination antiretroviral therapy when their CD4 counts are <350 cells/mm3 can expect to live another 24.2 years, at a projected discounted lifetime cost of $385,200.
By Carlos del Rio, MD
November 20, 2006
Covering:
Schackman BR et al., Med Care 2006 Nov; 44:990-7
An HIV Envelope Variant Is Associated with Dementia
Infectious Diseases Summary and Comment
A specific HIV envelope variant is associated with dementia, which might explain why only some HIV-infected patients develop this feared complication.
By Rajesh T. Gandhi, MD
November 15, 2006
Covering:
Dunfee RL et al., Proc Natl Acad Sci U S A 2006 Oct 10; 103:15160-5
High Mortality in a South African XDR TB Outbreak
HIV/AIDS Clinical Care Summary and Comment
Free
Researchers found alarmingly high prevalences of both multidrug-resistant and extensively drug-resistant TB among HIV-coinfected people in rural South Africa.
By Salim S. Abdool Karim, MD, PhD
November 13, 2006
Covering:
Gandhi NR et al., Lancet 2006 Nov 4; 368:1575-80
HIV Transmission by Men Who Have Sex with Men and with Women
Retrospective epidemiologic data from North Carolina support the hypothesis that MSM/W serve as a bridge for infection between MSM and women.
By G. Sonia Nagy, MD
November 13, 2006
Covering:
Hightow LB et al., Sex Transm Dis 2006 Oct; 33:585-93
HIV-Infected Pregnant Women: Outcomes at 3 Years
Maternal 3-year clinical outcomes were good with each of three HIV-management strategies.
By Judith Feinberg, MD
November 13, 2006
Covering:
Martin F et al., J Acquir Immune Defic Syndr 2006 Oct 1; 43:186-92
Rescreening People with STDs
General Medicine Summary and Comment
Given the rates of reinfection, repeat screening seems to be warranted.
By Richard Saitz, MD, MPH, FACP, FASAM
November 9, 2006
Covering:
Peterman TA et al., Ann Intern Med 2006 Oct 17; 145:564-72
Extensively Drug-Resistant TB: Bad News
Infectious Diseases Summary and Comment
Free
XDR-TB progresses rapidly, spreads nosocomially, causes high mortality, and is more prevalent than previously recognized.
By Mary E. Wilson, MD
November 8, 2006
Covering:
Gandhi NR et al., Lancet 2006 Nov 4; 368:1575-80
Van Rie A and Enarson D., Lancet 2006 Nov 4; 368:1554-6
TMP-SMX Prophylaxis During Pregnancy: Good for Baby, Too?
Infectious Diseases Summary and Comment
TMP-SMX prophylaxis for HIV-infected pregnant women could reduce preterm births and neonatal mortality.
By Daniel J. Diekema, MD, MS
November 8, 2006
Covering:
Walter J et al., J Infect Dis 2006 Dec 1; 194:1510-8
