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HIV Care Today


Janssen to Stop Offering "Virtual Phenotype" Testing, and Musings on Progress
By Paul E. Sax, M.D.
November 16, 2013

Must say it's in some ways sad to see it go -- in my opinion the nifty work they did correlating genotype results with their database of phenotypes gave the clearest representation of what a genotype actually means. If you didn't want to order both genotype and phenotype simultaneously -- which was expensive and took weeks to come back from the lab -- vircoTYPE was was the most efficient way to get information on complex resistance patterns. Sure, one could quibble about methodology and validation of the test, but it was remarkable indeed to send a genotype and get back results estimating fold-change, upper and lower cut-offs, full and partial activity -- and virus clade, just for kicks.

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SINGLE Study Underscores Waning of the Efavirenz Era -- But Probably Just in the USA
By Paul E. Sax, M.D.
November 6, 2013

In today's New England Journal of Medicine, the SINGLE study finally makes its appearance "in print." (The study results were first presented over a year ago.) The highlights:

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Research on Two Supplements Addresses HIV-Driven Inflammation in the Gut
By Jeannie Wraight
October 31, 2013

Gastrointestinal (GI) health is proving to be a vital, though often ignored, component of HIV infection. Recent research presented at the 7th International AIDS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013), which took place this past July in Kuala Lumpur, Malaysia, showed that microbial translocation and the damage done to gut-associated lymphoid tissue (GALT) during primary HIV infection has a dramatic effect on the pathogenesis of HIV, including the disruption of microflora, resulting in ongoing and damaging inflammation. While more research on the effects of HIV on the GI system is sorely needed, the consequences of sequestration on the National Institutes of Health (NIH) budget, along with the growing competition to prioritize directions in therapeutic investigation, ranging from viral host restrictive factors to preventive vaccines, make putting anything else on the table an enormous challenge.

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GARDEL Two-Active-Drug Study Not a Game-Changer, but Might Be a Paradigm-Shifter
By Paul E. Sax, M.D.
October 25, 2013

Here are the key details about the GARDEL study, presented just this week by Pedro Cahn at the European AIDS Clinical Society meeting, or EACS:

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A Perfect Storm: Prescription Opioids, Heroin, Needles and HIV
By David Fawcett, Ph.D., L.C.S.W.
October 18, 2013

It was a common scene several years ago throughout Fort Lauderdale. Clinic parking lots were filled with cars bearing license plates from Georgia, Tennessee, Pennsylvania and Kentucky. When one vehicle pulled out it was immediately replaced by another, and another after that. These were not snow birds seeking sun and warm temperatures, but rather people trafficking opiates. They shopped at dozens of pain management clinics dotting Broward County, buying hundreds of OxyContin (oxycodone) to take home and sell. At one point, Broward County had more so-called "pill mills" than McDonald's, and a few local physicians prescribed more of the narcotic than the rest of the country combined.

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MODERN Study Stopped: An NRTI-Sparing, Two-Drug Initial Regimen Disappoints Again
By Paul E. Sax, M.D.
October 14, 2013

In case you didn't know, "MODERN" is the clever name for the "Maraviroc Once-daily with Darunavir Enhanced by Ritonavir in a New regimen" trial, which compared TDF/FTC to maraviroc, both with boosted darunavir.

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CD4 Cell Count at Presentation: A Figure With a Depressingly Small Upward Slope
By Paul E. Sax, M.D.
October 7, 2013

You know how to make an ID/HIV specialist angry? Frustrated? Sigh loudly?

Tell a clinical anecdote that involves "late" presentation of HIV diagnosis, in particular someone who has been seeking medical care for various ailments for months or even years without getting tested.

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CROI Abstract Submissions Now Open, and Old CROI Website Still "Lost" in Cyberspace
By Paul E. Sax, M.D.
September 20, 2013

HIV researchers can now submit their abstracts to the 2014 Conference on Retroviruses and Opportunistic Infections -- or "CROI."

(It rhymes with "soy," as in "soy sauce"; or, if you prefer, "oy," as in "oy vey.")

Further details here. General submission for abstracts closes on October 8.

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Poll: At $14,105/Year, Is Dolutegravir Fairly Priced?
By Paul E. Sax, M.D.
August 28, 2013

The recently approved once-daily integrase inhibitor dolutegravir is now in pharmacies and, like every new HIV drug, the price -- around $14k/year -- has generated some controversy.

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Dolutegravir Approval Signals a Beginning and the End of Something Very Special
By Paul E. Sax, M.D.
August 12, 2013

As anticipated, the FDA approved dolutegravir today for HIV treatment, the third integrase inhibitor now available.

This was about as surprising as the arrival of Royal Baby Prince George. We knew dolutegravir was coming soon, just not exactly when or what it would be named.

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This article was provided by TheBodyPRO.com.
 

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