Is She or Isn't She?
ANTIRETROVIRAL ROUNDS
An HIV-infected pregnant woman says she's taking her antiretrovirals — but the blood test results say otherwise. How would you manage?
Initial Antiretroviral Therapy — Switching Still Common
SUMMARY AND COMMENT
February 8, 2010
Paul E. Sax, MD
In an observational cohort study, treatment changes within the first year of therapy were common but did not reduce rates of virologic suppression.
Reviewing:
Elzi L et al., Arch Intern Med 2010 Jan 11; 170:57
Transmitted HIV Drug Resistance — The Role of an Ultra-Sensitive Assay
SUMMARY AND COMMENT
February 8, 2010
Jonathan Z. Li, MD, and Paul E. Sax, MD
In this prospective study, 20% of treatment-naive patients had minority drug-resistance mutations detected on an ultra-sensitive assay, but the presence of such mutations did not lead to worse outcomes.
Reviewing:
Jakobsen MR et al., Clin Infect Dis 2010 Feb 15; 50:566
ddI and Portal Hypertension
AIDS WATCH
The FDA has concluded that ddI use is associated with the development of noncirrhotic portal hypertension. Forty-two cases have been reported, including several that led . . .
TB Recurrence: Reinfection or Relapse?
SUMMARY AND COMMENT
Recurrences after successful TB treatment are more common among HIV-positive than HIV-negative patients, and the reasons are different: About half the recurrences in HIV-positive patients represent reinfection rather than reactivation.
Reviewing:
Crampin AC et al., AIDS 2010 Jan 28; 24:417
More from the DAD Study on Antiretrovirals and MI Risk
SUMMARY AND COMMENT
February 1, 2010
Keith Henry, MD
An increased risk for myocardial infarction was found with recent exposure to abacavir and ddI and with cumulative exposure to abacavir, indinavir, and lopinavir/ritonavir.
Reviewing:
Worm SW et al., J Infect Dis 2010 Feb 1; 201:318
Aberg JA and Ribaudo H., J Infect Dis 2010 Feb 1; 201:315
Isoniazid Prophylaxis in HIV-Infected Patients
SUMMARY AND COMMENT
February 1, 2010
Shahin Lockman, MD, MSc
HIV-infected patients who received isoniazid preventive therapy as part of a clinical trial in Botswana had low rates of incident tuberculosis and severe adverse events; adherence was quite high.
Reviewing:
Mosimaneotsile B et al., J Acquir Immune Defic Syndr 2009 Nov 20
Prevalence and Incidence of HBV Infection in an HIV-Positive Cohort
SUMMARY AND COMMENT
Hepatitis B virus infection continues to be a major problem in a U.S. military cohort of HIV-infected individuals. More effective "prevention for positives" is needed.
Reviewing:
Chun HM et al., Clin Infect Dis 2010 Feb 1; 50:426
Predictors of Non-Hodgkin Lymphoma in HIV-Infected Patients
SUMMARY AND COMMENT
Low CD4-cell counts and high-level viremia were each associated with increased NHL risk in a cohort of HIV-infected individuals.
Reviewing:
Engels EA et al., J Acquir Immune Defic Syndr 2009 Dec 5
Pooled NAAT Following Various HIV Antibody Tests
SUMMARY AND COMMENT
January 25, 2010
Anna K. Person, MD, and Charles B. Hicks, MD
Pooled NAAT can improve detection of HIV infection, even when highly sensitive third-generation immunoassays are used for initial antibody testing.
Reviewing:
Patel P et al., Arch Intern Med 2010 Jan 11; 170:66