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HIV Care Today


Antiretroviral Rounds: Resistance on Two Fronts
By Paul E. Sax, M.D.
November 2, 2012

Got this challenging curbside consult from a colleague, and it has an interesting wrinkle.

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Dolutegravir and the 88 Percent Rule
By Paul E. Sax, M.D.
October 28, 2012

In the latest treatment-naive trials of elvitegravir and dolutegravir, there's a striking consistency in the results of the "test" regimen. Here are the studies, with the percentage of responders by treatment arm ...

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Can a "Treat Everyone With HIV" Policy Actually Work? In San Francisco, Yes
By Paul E. Sax, M.D.
October 22, 2012

As has often been the case in the history of the HIV epidemic, the HIV/AIDS Division at San Francisco General Hospital and the San Francisco Department of Health were ahead of the curve in 2010 when they issued a recommendation that all people with HIV should receive treatment, regardless of CD4 count. Of course, U.S. guidelines (first DHHS, now IAS-USA) followed suit -- but how did the San Francisco experience play out?

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It's Time to Tell Our Patients to Stop Their Vitamin Supplements
By Paul E. Sax, M.D.
October 17, 2012

Over in JAMA, there's a large study out today that (yet again) failed to demonstrate a benefit of vitamins.

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It's Time to Dump the HIV Western Blot
By Paul E. Sax, M.D.
September 19, 2012

Hard to believe, but we have to get rid of the HIV Western blot -- at least as our HIV confirmatory test.

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Thoughts on "Quad" Approval by FDA
By Paul E. Sax, M.D.
August 28, 2012

We now have a third single-pill treatment available for HIV treatment, co-formulated tenofovir/emtricitabine/elvitegravir/cobicistat. From the FDA announcement:

The U.S. Food and Drug Administration today approved Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate), a new once-a-day combination pill to treat HIV-1 infection in adults who have never been treated for HIV infection. Stribild contains two previously approved HIV drugs plus two new drugs, elvitegravir and cobicistat ... Together, these drugs provide a complete treatment regimen for HIV infection.

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Living With HIV: Are We "Damaged Goods"?
By David Fawcett, Ph.D., L.C.S.W.
August 15, 2012

Todd sat slumped on the sofa in my office. He avoided eye contact and described a particularly painful experience with stigma. He had recently come around the corner at his part-time job and heard several co-workers speaking about him and his HIV positive status. More specifically, they were discussing how he might have acquired the virus by speculating about the nature and frequency of his sexual activities. It was meant as a cheap laugh among themselves, but for Todd it meant much more. Although he made no effort to hide his HIV status and was "out" at the office about being gay, hearing his co-workers making disparaging remarks about his sex life and his health status in such explicit terms felt like a strong punch in his gut. He had a brief flash of anger, telling them to shut up, and then stormed out, pulling inward and automatically falling into the old habit of numbing himself by detaching from the emotional pain.

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New PrEP "Guidance" Released by CDC
By Paul E. Sax, M.D.
August 9, 2012

The CDC issued its second "Interim Guidance" on the use of tenofovir/FTC as pre-exposure prophylaxis for prevention of HIV, this time for prevention of HIV in heterosexually active adults. The rationale?

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Really Rapid Review: 2012 International AIDS Conference, Washington, D.C.
By Paul E. Sax, M.D.
August 1, 2012

Last week's International AIDS Conference in Washington got plenty of media attention, mostly because it was the first time in umpteen years that it was held in the United States, the delay between meetings due to our absurd (and now repealed) immigration laws regarding HIV.

As is typical of these meetings, which alternate with the smaller International AIDS Society Conference from year-to-year, there was plenty going on from a political and activist perspective. Still, there was some notable clinical research.

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AIDS Quilt, the Early 1990s and Sadness
By Paul E. Sax, M.D.
July 25, 2012

The early 1990s has potentially many associations -- the break-up of the Soviet Union, the first Gulf War, the World Trade Center and Oklahoma City bombings, The Lion King, Forest Gump, The Fresh Prince of Bel-Air, "Smells Like Teen Spirit," and the cancellation of the baseball season, to name a few.

But we HIV/ID specialists will always remember that period for something else -- namely, that deaths from AIDS in the United States peaked then, making it an especially challenging time to practice.

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This article was provided by TheBodyPRO.com.
 

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