FDA approved Edurant (rilpivirine) 25 mg tablets, a new non-nucleoside reverse transcriptase inhibitor (NNRTI) for the treatment of HIV. Rilpivirine is an antiviral drug that helps to block reverse transcriptase, an enzyme necessary for HIV replication. The recommended dose of rilpivirine is one 25 mg tablet once daily taken orally with a meal.
Maybe I'm being presumptuous here, but one of these -- virologic suppression -- completely blows the rest of them away. Sure, the others are worthwhile, but data linking them to improved outcomes for people with HIV are either pretty weak (adherence counseling, flu vaccine) or nonexistent (toxoplasmosis serology).
The results of the HPTN Study 052 -- which randomized 1,763 serodiscordant couples to early vs delayed ART to evaluate whether this reduced the risk of HIV transmission -- have just been released:
"Deep salvage patients no longer exist. The ones in that situation are already dead or have responded to the latest HIV antiretrovirals."
There's a new antiretroviral option out there, a 400-mg extended-release tablet formulation of nevirapine that can be dosed once daily.
On the heels of last month's report of HIV transmission from an organ donor -- covered here in Journal Watch -- comes this remarkable article in The New York Times about lifting the ban on organ donation from donors known to be HIV positive.
As I look back over the recent past in HIV research, I am impressed at what advancements we have made, yet disturbed at what little we know and have done regarding HIV prevention and treatment in women.
Both apply to certain patients in whom we might consider waiting to start treatment -- but both these studies suggest we do otherwise.
We marked U.S. National Women and Girls HIV/AIDS Awareness Day on March 10. The theme this year was "Now it's time for you to decide: What can you do?" Although the day is meant to raise awareness among the general population, and although it passed weeks ago, in my opinion we need to have that awareness every day as health care providers. We regularly see people in our HIV agencies/organizations that, if health education had reached them the way it should, would have never walked through the door in the first place.
When I was going through clinical supervision before licensure, my mentor pointed out that one's particular therapeutic modality, be it cognitive, behavioral, psychodynamic, Gestalt or whatever, is often not as important for good clinical results as simply being present with the patient. Because at that time I was very focused on mastery of particular skills, I was somewhat incredulous. But I have since come to understand that beneath good technique there is indeed a realm of energetic exchange with a patient that is often non-verbal and that has great power for healing. I call it being present at both physical and emotional levels.
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