The big ID story the past couple of weeks is that the price of pyrimethamine -- a drug that's been available generically for decades -- went from $13.50 to $750 for one pill after the exclusive rights to the drug were purchased by Turing Pharmaceuticals.
Recently, an ENT colleague (fictionally named "Clint" below), sent me two emails triggered by drug-drug interaction warnings he received while seeing HIV patients.
Pre-exposure prophylaxis (PrEP) against HIV infection utilizing tenofovir/emtricitabine (Truvada) has been nothing short of revolutionary in changing the landscape of HIV prevention. What has been less discussed are the enormous secondary benefits that have followed the introduction of PrEP.
Recently we got great news from a real-world study of HIV pre-exposure prophylaxis (PrEP).
Researchers at San Francisco's Kaiser Permanente Medical Center reported on the real-world experience of 657 people who started PrEP between 2012 and 2015. Over 99% were men who have sex with men, 84% reported multiple sexual partners, and 30% had HIV-positive partners. Together they were observed for over 388 person-years of PrEP use.
We're in the midst of an HIV prevention revolution. Over the past few years, we have gained new tools and knowledge to prevent HIV, from pre-exposure prophylaxis (PrEP) to the knowledge that an undetectable viral load dramatically reduces the risk of transmission.
By now, the fact that HCV treatment carries a high price is a fact as well known to the medical and non-medical public as 1) a million dollars doesn't get you much in Manhattan or Bay-area real estate; 2) a Rolex is an expensive way to know what time it is; and 3) even though a Tesla doesn't need gas, buying one won't save you money.
An email query from a colleague:
Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV+. Any post-exposure prophylaxis recommended?
Title of this post notwithstanding, the weather in Boston this summer has been great -- mostly warm days, cool nights, low humidity -- hence the energetic jumping pooch in the picture (not mine, click on it for full effect). I just love the phrase, "dog days of summer," and wanted an excuse to use it.
Here's a scintillating series of events that happened recently on our inpatient consult service.
Thirty-three million people are infected with HIV worldwide, but less than 50% receive antiretroviral therapy. This was the stark reality addressed in June at the 10th International Conference on HIV Treatment and Prevention Adherence (Adherence 2015), which is jointly provided by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM). Every aspect of the ubiquitous treatment cascade was addressed in an effort to stop the "leaks" of people not engaging in treatment, falling out of care or not maintaining viral suppression. While access to prevention and treatment has significantly improved worldwide, certain issues such as stigma still impact prevention and treatment, and gender, age, race and sexual orientation continue to make certain populations vulnerable and in need of interventions tailored to their specific needs.
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