HIV and ID Observations

December 28th, 2009

Holiday Surprise: Generic Valacyclovir

Last week one of my patients went to refill a Valtrex prescription, and was offered generic valacyclovir for the first time.  It made him nervous, so he requested I write a “brand-name only” script. I confess the existence of a generic formulation of valacyclovir — which according to the PharmD here has been available for […]

---

December 2nd, 2009

So Much in Less than a Week!

First the updated WHO Guidelines.  Then the following: Updated DHHS Guidelines.  Agree?  Disagree?  Sensible or crazy?  Practical or ivory-tower academic? South Africa does the right thing.  Yes, it’s about time, but good news nonetheless. 2012 International AIDS Meeting in Washington, D.C. First time in USA in a long, long time — 1990, to be exact […]

---

November 30th, 2009

WHO HIV Treatment Guidelines Updated

This just in: WHO is now recommending that ART be initiated at a higher CD4 threshold of 350 cells/mm3 for all HIV-positive patients, including pregnant women, regardless of symptoms. Which makes eminent sense, of course.  Because if starting HIV therapy might prolong survival in developed countries, why shouldn’t it do the same in the developing […]

---

November 20th, 2009

Ties Tied to Bugs

Are doctors’ neckties causing infections?  That’s the implication of this Wall Street Journal piece: The list of things to avoid during flu season includes crowded buses, hospitals and handshakes. Consider adding this: your doctor’s necktie. … A 2004 analysis of neckties worn by 42 doctors and medical staffers at the New York Hospital Medical Center […]

---

October 31st, 2009

Would Changing Restrictive HIV Testing Laws Improve Survival?

Emphatically yes — to the tune of >600,000* years of life gained nationwide.  So says a nifty paper being presented at the annual IDSA meeting today by Mike April, under the direction of Rochelle Walensky. (*Original abstract said 549,437, cited in the link; number at the actual presentation, though, was 609,656.) Bottom line is that […]

---

October 20th, 2009

Well That Was Fast! HIV Vaccine Trial Published

Remember the HIV vaccine trial press release?  The one announcing the first-ever positive result? Then the backlash, with people questioning how the analyses were done, and reported? Now, less than a month later, we have the scientific presentation and the paper appear on the same day. Read all about it here and here. If you […]

---

October 5th, 2009

No Baseball Tonight

“Are you writing another funny blog post because there’s no baseball?” asks my son J. As “funny” is very much in the eye of the beholder, that remains to be seen.  But here are a few things on my mind the last few days: No data supporting N95 over surgical masks for flu.  One huge […]

---

September 24th, 2009

HIV Vaccine Study Shows Promise …

So says this press release by the US Military HIV Research Program: A Phase III clinical trial involving more than 16,000 adult volunteers in Thailand has demonstrated that an investigational HIV vaccine regimen was safe and modestly effective in preventing HIV infection. According to final results released by the trial sponsor, the U.S. Army Surgeon […]

---

September 4th, 2009

For Suspected H1N1, Get Out the N95 Masks?

So says the Institute of Medicine’s recommendations for protection of health care workers: Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators … Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance […]

---

August 20th, 2009

The V.A. Opts Out

Read all about it here: As of August 17, 2009, written (signature) consent is no longer required for HIV testing in the VHA. Instead, patients will provide verbal informed consent prior to HIV testing. Furthermore, scripted pre-test and post-test counseling are no longer mandated. Since the VA is the largest HIV provider in the nation […]

---