An ongoing dialogue on HIV/AIDS, infectious diseases,
2 Responses to “WHO HIV Treatment Guidelines Updated”
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
Learn more about HIV and ID Observations.
FROM NEJM — Recent Infectious Disease Articles- Postpartum Persistence of Ebola Virus in Breast Milk March 12, 2026To control EBOV outbreaks, defining potential sanctuary sites where the virus may persist and lead to transmission is important. In this report, persistence of EBOV RNA in breast milk was identified and characterized.
- Soft Tick Relapsing Fever March 12, 2026A 74-year-old man was admitted to the hospital with a 3-week history of intermittent fevers, muscle aches, and vomiting. Thin blood smears showed spirochetes.
- Case 8-2026: A 57-Year-Old Woman with Chest Pain, Dyspnea, and Syncope March 12, 2026A 57-year-old woman was evaluated because of 2 days of chest pain and dyspnea. Ultrasonography showed a pericardial effusion with diastolic inversion of the right ventricle. A diagnosis was made.
- Massive Intravascular Hemolysis from Clostridium perfringens Bacteremia March 12, 2026A 73-year-old woman presented in shock with a 1-day history of malaise, dyspnea, and confusion. Serum samples could not be processed owing to gross hemolysis. Dehemoglobinized red cells and bacilli were seen on a peripheral-blood smear.
- The Eyes Have It March 5, 2026A 47-year-old man was brought to the ED by EMS after being found dyspneic in his car. He reported having been drinking for 6 hours before presentation. He noted a sensation of tongue swelling and difficulty breathing.
- Postpartum Persistence of Ebola Virus in Breast Milk March 12, 2026
Should the guidelines have suggested initiation at < 500 as is expected in the next iteration of US centered guidelines? Although ARVs are limited in many parts of the world should an individual patient be witheld therapy when there is an accumulation of data suggesting 500 (or higher) may be the tipping point? A conundrum in areas where supplies of ARVs are limited perhaps.
CM,
I guess one way of looking at “start at CD4 350” is “start at CD4 > 350.” I realize it’s not exactly the same thing, but since you can’t predict when or if the CD4 will drop, as a pt approaches this threshold (i.e., between 350 and 500), it’s time to get ready to start.
As you know, DHHS guidelines just out as well.
Paul