ART Initiation in Resource-Poor Settings
Infectious Diseases Summary and Comment
A computer model suggests that starting ART at CD4 counts <350 cells/mm3 , rather than <250 cells/mm3 , would improve morbidity and mortality and be cost-effective.
By Stephen G. Baum, MD
August 5, 2009
Covering:
Walensky RP et al., Ann Intern Med 2009 Aug 4; 151:157
Women and HIV: More Work to Be Done
Infectious Diseases Summary and Comment
The age-matched death rate remains much higher among HIV-infected women than among HIV-uninfected women, despite a decrease in AIDS-related deaths.
By Rajesh T. Gandhi, MD
August 5, 2009
Covering:
French AL et al., J Acquir Immune Defic Syndr 2009 Aug 1; 51:399
Loss to Follow-Up Worsens Outcomes for HIV Patients, Even If They Return to Care
HIV/AIDS Clinical Care Summary and Comment
Free
Mortality risk was five times higher among HIV patients in northern France who returned to care after being lost to follow-up than among those who were never lost.
By Rochelle P. Walensky, MD, MPH
August 3, 2009
Covering:
Ndiaye B et al., AIDS 2009 Jun 15
Does Circumcision of HIV-Infected Men Prevent HIV Acquisition in Their Female Partners?
Women's Health Summary and Comment
Free
Risk for HIV transmission was highest among couples who resumed sexual activity before wound healing was complete.
By Anna Wald, MD, MPH
July 30, 2009
Covering:
Wawer MJ et al., Lancet 2009 Jul 18; 374:229
Baeten JM et al., Lancet 2009 Jul 18; 374:182
Does Hormonal Contraception Accelerate HIV Progression?
Women's Health Summary and Comment
Use of either DMPA or OCPs was associated with hastened unfavorable disease outcomes.
By Anna Wald, MD, MPH
July 30, 2009
Covering:
Stringer EM et al., AIDS 2009 Jul 17; 23:1377
Death from Non–AIDS-Related Causes: Another Risk of Immunodeficiency
Non–AIDS-related deaths accounted for more than half of all deaths in this cohort; the risk was reduced with a higher CD4-cell count.
By Paul E. Sax, MD
July 27, 2009
Covering:
Marin B et al., AIDS 2009 Jun 30
Which HIV Test Is Best in High-Incidence Groups?
In a study of specimens from Seattle-area MSM, a rapid antibody test detected HIV infection less well than did either enzyme immunoassay antibody testing or nucleic-acid amplification testing.
By Carlos del Rio, MD
July 27, 2009
Covering:
Stekler JD et al., Clin Infect Dis 2009 Aug 1; 49:444
Sex-Drug Use Increases HIV Risk for MSM
In a cohort of HIV-uninfected MSM, the use of poppers, stimulants, or erectile dysfunction drugs significantly increased the risk for acquiring HIV.
By Keith Henry, MD
July 27, 2009
Covering:
Ostrow DG et al., J Acquir Immune Defic Syndr 2009 Jul; 51:349
Does Abacavir/3TC Still Have a Role in First-Line Therapy for HIV?
HIV/AIDS Clinical Care Summary and Comment
Free
In the HEAT randomized trial, abacavir/3TC was noninferior to tenofovir/FTC when each was used in combination with lopinavir/r in treatment-naive patients, regardless of pretreatment viral load.
Stepwise Efavirenz Decreases Neurotoxicity
Infectious Diseases Summary and Comment
Free
Neuropsychiatric side effects during the initial weeks of efavirenz therapy can be reduced by building up to the full dose gradually.
By Stephen G. Baum, MD
July 15, 2009
Covering:
Gutiérrez-Valencia A et al., Ann Intern Med 2009 Jul 7
Another Benefit to Starting ART Early: Lower Risk for Resistance
HIV/AIDS Clinical Care Summary and Comment
Free
Among patients who experienced virologic rebound in this observational cohort study, risk for resistance was decreased in those who initiated ART at CD4 counts >350 cells/mm3 .
By Paul E. Sax, MD
July 13, 2009
Covering:
Uy J et al., J Acquir Immune Defic Syndr 2009 Aug; 51:450
Failure on First-Line Lopinavir/r Monotherapy: High Rates of PI Resistance
Results from the MONARK trial do not support lopinavir/r monotherapy as first-line treatment for HIV infection, because it was both less effective and more likely to cause major PI resistance than triple therapy with lopinavir/r, AZT, and 3TC.
By Keith Henry, MD
July 13, 2009
Covering:
Delaugerre C et al., Antimicrob Agents Chemother 2009 Jul; 53:2934
Assisted Reproduction for Couples with HIV-Positive Male Partners
Women's Health Summary and Comment
IVF with intracytoplasmic sperm injection using washed sperm is safe and effective.
Hepatitis B and HIV — A Tale of Two Viruses
In HIV-infected women with isolated antibody to hepatitis B core antigen, use of ART was associated with acquisition of antibody to hepatitis B surface antigen.
Cutaneous Non–AIDS-Defining Cancers in HIV-Infected Individuals
Infectious Diseases Summary and Comment
Such cancers are not associated with immune status or receipt of ART.
By Larry M. Baddour, MD
July 1, 2009
Covering:
Crum-Cianflone N et al., Arch Intern Med 2009 Jun 22; 169:1130
Clinical Effectiveness of HBV Vaccination in HIV-Positive Patients
In an observational cohort study that showed a high incidence of hepatitis B virus infection after HIV diagnosis, HBV vaccination was effective only in a subgroup with HBV surface antibody titers
Rifampin-Resistant TB During Boosted PI Therapy in HIV Patients
In New York City, three HIV patients with tuberculosis developed rifampin resistance after being switched to boosted PI therapy and alternate-day rifabutin.
By Carlos del Rio, MD
June 29, 2009
Covering:
Jenny-Avital ER and Joseph K., Clin Infect Dis 2009 May 15; 48:1471
PEPFAR in Sub-Saharan Africa: Effects on HIV-Related Outcomes
An analysis of PEPFAR’s effectiveness in 12 African countries reveals a significant decrease in the number of HIV-related deaths, but not in HIV prevalence.
Recycling Enfuvirtide: Possible Clinical Benefit
Salvage therapy that included enfuvirtide appeared to show a survival benefit in a small, uncontrolled, retrospective study of HIV-positive patients who had already experienced virologic failure on an enfuvirtide-containing regimen.
By Keith Henry, MD
June 29, 2009
Covering:
Cossarini F et al., J Acquir Immune Defic Syndr 2009 Jun 1; 51:179
ART and Neurocognitive Function
Infectious Diseases Summary and Comment
HIV-infected patients with neurocognitive impairment can show progressive improvement in function for at least 48 weeks after starting ART.
HPV Vaccine for Women in Mid-Adulthood
General Medicine Summary and Comment
Infection and disease were prevented in women between the ages of 24 and 45.
By Bruce Soloway, MD
June 23, 2009
Covering:
Muñoz N et al., Lancet 2009 Jun 6; 373:1949
Harper DM., Lancet 2009 Jun 6; 373:1921
MRSA Colonization and Infection in HIV-Infected Patients
The increased rate of MRSA colonization in HIV-infected patients probably explains their elevated rate of MRSA skin and soft-tissue infections.
High Rate of New HIV Infection in Late Pregnancy
Among pregnant women in South Africa, repeat testing conducted between 36 and 40 weeks of gestation revealed new HIV infection in 3%.
By Keith Henry, MD
June 8, 2009
Covering:
Moodley D et al., AIDS 2009 May 18
CNS Penetration of ART and Cognitive Performance: An Unexpected Finding
Increased CNS penetration effectiveness of the ART regimen was associated with poorer neurocognitive outcomes, despite increased rates of CSF viral suppression.
By Jennifer Johnson, MD, and Paul E. Sax, MD
June 8, 2009
Covering:
Marra CM et al., AIDS 2009 May 6
Long-Term Nonprogressors and HIV Controllers: Definitions and Prevalence
Very few HIV-positive patients met strict criteria for immunologic stability, virologic control, or both, in a large, prospective cohort study in France.
By Paul E. Sax, MD
June 8, 2009
Covering:
Grabar S et al., AIDS 2009 Jun 1; 23:1163
