The Prospect of PrEP
The use of antiretrovirals for pre-exposure prophylaxis is being widely investigated. What if its found to be safe and effective?
Sexual Risk Behavior During HIV Prevention Trials
Results from the oral-tenofovir HIV prevention trial in Ghana show that being in an HIV prevention study does not necessarily lead to risk disinhibition.
Another Microbicide Fails to Prevent HIV Transmission
Infectious Diseases
Summary and Comment
Carraguard, a vaginal microbicide made from a seaweed derivative, is not effective in preventing HIV acquisition.
By Rajesh T. Gandhi, MD
December 18, 2008
Covering:
Skoler-Karpoff S et al., Lancet 2008 Dec 6; 372:1977
Cates W and Feldblum P., Lancet 2008 Dec 6; 372:1932
Is Elimination of a Generalized HIV Epidemic Possible?
HIV/AIDS Clinical Care
Summary and Comment
Free
A mathematical model using data from South Africa suggests that the HIV epidemic in this region could be eliminated with rapid scale-up of universal voluntary HIV testing and immediate ART.
Another Call for Routine HIV Screening
HIV/AIDS Clinical Care
Clinical Practice Guideline Watch
Free
The American College of Physicians adds its support to a policy of HIV testing for all adolescents and adults, regardless of perceived risk.
By Abigail Zuger, MD
December 8, 2008
Covering:
Qaseem A et al., Ann Intern Med 2009 Jan 20
A Pivotal Step for HIV Vaccines
Investigators continue to explore why the HIV vaccine used in the Step Study failed to protect high-risk individuals from HIV acquisition — and seemed to increase risk in some.
By Frances Priddy, MD, MPH
December 8, 2008
Covering:
Buchbinder SP et al., Lancet 2008 Dec 5; 372:1881
McElrath MJ et al., Lancet 2008 Dec 5; 372:1894
Reduced Mortality Among HIV-Infected Infants
Infectious Diseases
Summary and Comment
Free
ART initiated soon after birth reduced HIV disease progression by 75% and early mortality by 76%.
By Larry M. Baddour, MD
November 19, 2008
Covering:
Violari A et al., N Engl J Med 2008 Nov 20; 359:2233
Spontaneous HCV Clearance in HIV-Infected Patients
Infectious Diseases
Summary and Comment
The likelihood of such clearance was associated with geographic origin, HBV status, and risk behavior.
By Rajesh T. Gandhi, MD
November 19, 2008
Covering:
Soriano V et al., J Infect Dis 2008 Nov 1; 198:1337
Bruno R and Sacchi P., J Infect Dis 2008 Nov 1; 198:1262
A Single Case of Cure?
On November 7, 2008, the Wall Street Journal described an AIDS patient in Germany who was “functionally cured” after receiving a bone marrow transplant from . . .
Syphilis in San Francisco
Syphilis rates are rising again in San Francisco after declining for the past 3 years. During the first 8 months of 2008, 409 syphilis cases . . .
November 17, 2008
Covering:
Bajko MS., Bay Area Reporter 2008 Oct 2
Origin of Rebounding HIV During ART Interruption
Infectious Diseases
Summary and Comment
Free
Detailed analysis of HIV strains obtained during treatment interruptions indicates viral reactivation of latently infected cells.
Cervical Cancer Screening Test Tailored for Use in Developing Countries
Women's Health
Summary and Comment
A quick, technologically simple HPV-DNA test for use in resource-poor settings performed well in rural China.
By Anna Wald, MD, MPH
October 30, 2008
Covering:
Qiao Y-L et al., Lancet Oncol 2008 Oct; 9:929
Circumcision Status and HIV Risk Among MSM
A meta-analysis of observational studies does not provide evidence that male circumcision protects MSM against HIV or other sexually transmitted infections.
By Rebeca M. Plank, MD
October 20, 2008
Covering:
Millett GA et al., JAMA 2008 Oct 8; 300:1674
Vermund SH and Qian HZ., JAMA 2008 Oct 8; 300:1698
USPSTF Recommends STI Counseling for Sexually Active Adolescents and At-Risk Adults
General Medicine
Clinical Practice Guideline Watch
However, evidence was insufficient to advocate counseling for other adolescents or adults.
By Richard Saitz, MD, MPH, FACP, FASAM
October 16, 2008
Covering:
Lin JS et al., Ann Intern Med 2008 Oct 7; 149:497
U.S. Preventive Services Task Force., Ann Intern Med 2008 Oct 7; 149:491
Doxycycline or Tetracycline for Primary Syphilis
Infectious Diseases
Summary and Comment
In a retrospective study, serologic success rates were 97% with benzathine penicillin and 100% with doxycycline or tetracycline.
By Neil M. Ampel, MD
October 15, 2008
Covering:
Wong T et al., Am J Med 2008 Oct; 121:903
When Did HIV Emerge?
Infectious Diseases
Summary and Comment
Analysis of a newly discovered HIV sequence from 1960 suggests that the virus entered the human population around the beginning of the twentieth century.
Not All Med Students See Safe-Sex Counseling as Relevant to Practice
General Medicine
Summary and Comment
Student attitudes on the importance of counseling patients about safe sex changed from their freshman to their senior year and varied significantly by anticipated medical specialty.
By Robert W. Rebar, MD
October 2, 2008
Covering:
Frank E et al., Obstet Gynecol 2008 Aug; 112:311
Maraviroc: Phase III Studies Published
Infectious Diseases
Summary and Comment
Free
Maraviroc, a CCR5 antagonist, is effective against R5-tropic HIV.
By Rajesh T. Gandhi, MD
October 1, 2008
Covering:
Gulick RM et al., N Engl J Med 2008 Oct 2; 359:1429
Fätkenheuer G et al., N Engl J Med 2008 Oct 2; 359:1442
Dolin R., N Engl J Med 2008 Oct 2; 359:1509
What Happens When PEP or PrEP Fails?
A case report provides at least some reassurance that failure of antiretroviral prophylaxis does not necessarily result in drug resistance.
By Raphael J. Landovitz, MD
September 29, 2008
Covering:
Prada N et al., J Acquir Immune Defic Syndr 2008 Sep 2
Patients on Suppressive ART Can Transmit HIV Infection
HIV/AIDS Clinical Care
Summary and Comment
Free
The documented transmission of HIV from a nonviremic patient to his partner makes a strong case for patients on successful ART to continue safer-sex practices.
Intermittent ART and Risk for HIV Transmission
A SMART substudy demonstrates a greater likelihood of HIV transmission in patients who do not take antiretrovirals continuously.
By Abigail Zuger, MD
September 22, 2008
Covering:
Burman W et al., J Acquir Immune Defic Syndr 2008 Oct 1
Using Serum RPR to Monitor Neurosyphilis Treatment
Infectious Diseases
Summary and Comment
Free
Normalization of serum RPR correlated with normalization of CSF WBC count and CSF VDRL titer in >90% of patients.
By Neil M. Ampel, MD
September 17, 2008
Covering:
Marra CM et al., Clin Infect Dis 2008 Oct 1; 47:893
Acute HCV Infection in HIV-Positive Men
Infectious Diseases
Summary and Comment
More than 80% of HIV-infected men with newly acquired HCV had moderately advanced fibrosis.
Abacavir Use and CVD Risk
Infectious Diseases
Summary and Comment
Abacavir use has now been linked to increased risk for cardiovascular disease by a second large study.
By Rajesh T. Gandhi, MD
September 17, 2008
Covering:
The SMART/INSIGHT and the D:A:D Study Groups., AIDS 2008 Sep 12; 22:F17
Has Your Lab Changed Its Syphilis Testing Protocol?
General Medicine
Summary and Comment
If so, you might be facing an unfamiliar decision tree.
By Abigail Zuger, MD
September 16, 2008
Covering:
CDC., MMWR Morb Mortal Wkly Rep 2008 Aug 15; 57:872