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HIV Care Today


More Confusion on Anal Cancer Screening
By Paul Sax, M.D.
March 22, 2012

Screening for anal cancer in men who have sex with men (MSM) -- with pap smears, high resolution anoscopy, with whatever test -- is quite the quagmire.

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CROI 2012 Really Rapid Review -- With CROI 2013 Dates!
By Paul Sax, M.D.
March 15, 2012

Some highly subjective highlights -- a Really Rapid Review™ -- from this year's Number One Greatest Super Scientific HIV Conference, the 19th Conference on Retroviruses and Opportunistic Infections (CROI), which ended last week in Seattle:

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A Truly Bizarre "Systematic" Review
By Paul Sax, M.D.
February 26, 2012

You know that tenofovir, emtricitabine, and efavirenz HIV regimen? The one that's universally listed as one of the "Preferred," or "Recommended" or "First-line" options in all HIV treatment guidelines in the universe? And the regimen that is easily the most widely used in the USA today? Well, here's a surprising review from Cochrane Summaries, entitled "Effectiveness and safety of first-line tenofovir + emtricitabine + efavirenz for patients with HIV" ...

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Hepatitis C and the "Retooling" of HIV/ID Specialists
By Paul Sax, M.D.
February 23, 2012

The news that hepatitis C (HCV) has passed HIV as a cause of death in the United States got quite a bit of attention when it was first presented last year at ICAAC -- and no doubt the published paper, in this week's Annals of Internal Medicine, will also cause a stir. In fact, I boldly predict that going forward, (approximately) 94.2% of HCV-related research grants, journal articles, and lay press articles will cite this paper, making it (for now) the "Palella NEJM 1998" of HCV.

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Nurse, What Did the Doctor Say?
By Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S.
February 22, 2012

As providers, we spend time in hospitals, clinics and offices attempting to educate our patients on prevention and treatment of disease. But how many times have we heard that, after the patient walked out of exam room, he or she stated to the nurse, "I don't understand what the doctor just said to me about my health. Can you tell me?" The patient probably heard what Charlie Brown hears when his teacher is speaking to him. "You should do this and you shouldn't do that, mwa mwa, blah, blah, wah, wah. Have a nice day." Total gibberish!

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Boceprevir/PI Interaction: A "Dear Doctor" Letter We Didn't Want to Get
By Paul Sax, M.D.
February 10, 2012

By now I'm sure that most of you ID folks out there have received the following letter from Merck, the makers of boceprevir:

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More on Low (but Detectable) Viral Loads -- Is Knowing This Useful?
By Paul Sax, M.D.
February 3, 2012

I have a very smart, very experienced colleague -- clue, his initials are CC, and he doesn't pitch for the Yankees -- who continues to use bDNA testing for HIV viral load monitoring. You know, the assay with a lower limit of detection of 75 copies. He knows that bDNA is less sensitive than PCR. He knows that it's more expensive than PCR.

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Avoiding the Slippery Slope to Burnout
By David Fawcett, Ph.D., L.C.S.W.
January 30, 2012

The text alert came in the middle of a session. It was from a colleague and read simply "call asap." I dialed his number between patients, and when he answered, I was surprised at his quiet tone and his admission that he was really shaken. We often utilized each other for consultation and support, but on this day he sounded defeated. He told me that a patient had just died.

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Generic Lamivudine Has Arrived
By Paul Sax, M.D.
January 22, 2012

An e-mail from a patient last week: "Just got refills. Epivir is now generic??? Refill is simply labeled Lamivudine Tablets by Aurobindo Pharma USA, Inc ... but made in India. Should I be concerned about that???"

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Journal Club: In Early HIV Infection, Little Reason to Delay Therapy
By Paul E. Sax, M.D.
January 8, 2012

Over in Journal of Infectious Diseases, the so-called Setpoint study -- a randomized strategy trial -- investigated whether a 36-week period of treatment would delay the need to go on continuous HIV therapy, compared with observation. After 130 of a planned 150 patients were enrolled, a Data Safety Monitoring Board elected to stop the study due to this key finding: "... the higher rate of progression to needing treatment in the Deferred Treatment group (50%) versus the Immediate Treatment (10%) group."

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This article was provided by TheBodyPRO.com.
 

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