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HIV Care Today

5 ID/HIV Things to Be Grateful for This Holiday Season, 2014 Edition
By Paul E. Sax, M.D.
November 24, 2014

Amidst outbreak hysterias, anti-vaccine imbecility, electronic medical record whining, and slug-related eosinophilia, I bring you this year's version of the good news -- the 2014 edition of Five ID/HIV Things to be Grateful for this Holiday Season, just in time for your holiday turkeys.

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Why the IPERGAY (Yes, That's Its Name) Study Could Substantially Increase Use of PrEP
By Paul E. Sax, M.D.
October 30, 2014

For those who read French, here's the official announcement. (Scroll down for the English.) And for those who can't believe the name, it stands for "Intervention Prophylactique pour Et avec les Gays". Of course.

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Approval of Sofosbuvir/Ledipasvir Was Expected, but Still Is a Huge Advance
By Paul E. Sax, M.D.
October 12, 2014

As expected, the FDA just approved the first single-pill treatment for hepatitis C genotype 1, a tablet containing 400 mg of sofosbuvir (SOF) and 90 mg of ledipasvir (LDV). For those not following this story closely, sofosbuvir is the pan-genotypic NRTI polymerase inhibitor approved last December to much rejoicing -- and controversy about the price. Ledipasvir is the first HCV NS5A inhibitor, and is only available as part of this combination.

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New FDA HIV Drug Approvals Unlikely to Have Much Impact, Unless ...
By Paul E. Sax, M.D.
September 28, 2014

If you're an ID doc based in the U.S., you probably received notice last week that two new HIV drugs were approved -- cobicistat and elvitegravir.

And if you're wondering what the big deal is, welcome to the club.

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Quick Question: How Do I Fill Out This Tricky Patient Job or School Form?
By Paul E. Sax, M.D.
September 25, 2014

Hi Paul,
One of my HIV pts, doing wonderfully well, is planning to enroll in a nursing program. She does not want to disclose her HIV status (fine with me), but the hospital requests a list of current meds which, of course, would blow her cover. My inclination is simply to leave the HIV meds off the list, but I asked our legal office who advises me not to do so -- they say just decline to fill out the form. However, I don't like that advice, since it essentially means my patient cannot enroll in the program. Of course I question whether the employer has the legal right to know all the meds, but I can't change that in the short term.

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Could an Integrase Inhibitor Have Prevented One More HIV Infection?
By Monica Gomes, M.D., M.Sc.
September 19, 2014

When it comes to preventing mother-to-child transmission (MTCT) of HIV anywhere in the world, the target must be zero. Of course, we know that a lot of variables may affect the chain of events that can lead to an HIV-infected child.

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Health Insurance Companies Are the Biggest Impediment to PEP and PrEP for HIV Prevention
By Howard Grossman, M.D.
September 12, 2014

Post-exposure prophylaxis (PEP) for HIV, which consists of immediate treatment for possible exposure to HIV to prevent infection, has been the standard of care for quite a few years.

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Is HIV Superinfection Unhealthy?
By Tim Lahey, M.D., M.M.Sc.
August 13, 2014

People who contract HIV once can contract it again, often through the same risk behaviors that led to the initial infection. A long-standing question has been whether getting infected with a second strain of HIV leads to more rapid HIV disease progression than infection with a single strain.

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Best Wishes, Joep
By Benjamin Young, M.D., Ph.D.
July 19, 2014

Best wishes,

So ended Joep's last email to me.

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Ms. Mississippi Not Cured of HIV. What Next?
By Benjamin Young, M.D., Ph.D.
July 16, 2014

Last year, like many others in the HIV community, I was thrilled to learn that a little girl born in Mississippi with HIV may have been cured of HIV infection by the early initiation of antiretroviral treatment. I thought that we were on the cusp of a monumental public policy and humanitarian advance -- not one that required experimental space-age treatments, but one achievable today with the very antiretroviral tools we already have. The enthusiasm that Ms. Mississippi's story generated demonstrates just how urgently we all desire a HIV cure, even if not for all adults, at least for the babies born to HIV-infected mothers. The community cared about her story, and the media cared about her story. Her story was on the front page of the New York Times and the Wall Street Journal alike.

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