{"id":1297,"date":"2010-12-22T09:49:37","date_gmt":"2010-12-22T14:49:37","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=1297"},"modified":"2015-06-04T15:24:13","modified_gmt":"2015-06-04T19:24:13","slug":"holiday-hafnias","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/holiday-hafnias\/2010\/12\/22\/","title":{"rendered":"Holiday Hafnias"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-1298\" title=\"holiday goose\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2010\/12\/holiday-goose1.jpg\" alt=\"holiday goose\" width=\"240\" height=\"286\" \/>Some items to consider in HIV\/ID world as you dig into your salmonella-free holiday bird:<\/p>\n<ul>\n<li><a href=\"http:\/\/www.fda.gov\/ForConsumers\/ByAudience\/ForPatientAdvocates\/HIVandAIDSActivities\/ucm236552.htm\" target=\"_blank\">Drug label change for stavudine (d4T)<\/a>: \u00a0The label no longer has recommendations for dose-reduction in case of peripheral neuropathy, and cites data more strongly linking d4T use to lipoatrophy. \u00a0The strategy of decreasing the dose to reduce d4T toxicity hasn&#8217;t made much sense for over a decade, since it&#8217;s long been known that most other NRTIs have less mitochondrial toxicity. \u00a0Which of course begs the question &#8212; why is anyone in the United States on d4T <em>at all?<\/em><\/li>\n<li>Speaking of HIV drug label changes, darunavir is now <a href=\"http:\/\/www.spinics.net\/lists\/fda\/msg03460.html\" target=\"_blank\">approved for once-daily dosing in treatment-experienced patients<\/a>, provided there is no darunavir resistance. \u00a0This makes sense: \u00a0once-daily dosing greatly exceeds the required levels for inhibition of susceptible viruses, and the strategy was shown to be OK in the <a href=\"http:\/\/www.retroconference.org\/2010\/Abstracts\/37635.htm\" target=\"_blank\">ODIN study<\/a>. I suspect most of us have been doing this for many months already (certainly I have).<\/li>\n<li>Another (mostly) <a href=\"http:\/\/www.annals.org\/content\/153\/12\/769.full.pdf+html\" target=\"_blank\">negative study of echinacea\u00a0for colds<\/a> over in the <em>Annals of Internal Medicine<\/em>. \u00a0We are so desperate for something that actually works for colds that we keep flogging this dead horse. \u00a0Or maybe it&#8217;s <a href=\"http:\/\/www.thelancet.com\/journals\/laninf\/article\/PIIS1473-3099(07)70160-3\/fulltext\" target=\"_blank\">&#8220;not dead yet&#8221;?<\/a> But whether this new study settles the issue once and for all, certainly any large effect of echinacea seems highly unlikely.\u00a0Which reminds me &#8212; remember when pleconaril\u00a0was seeking an indication for treatment of the common cold? \u00a0A well-respected ID doc I know thought that if it got approved (it didn&#8217;t), hardly anyone would want it since most colds are &#8220;mild and self-limited&#8221;. \u00a0But one peek at the &#8220;coughs and colds&#8221; aisle at your local pharmacy shows you just how wrong he was!<\/li>\n<li>Want the best site for the latest on the XMRV controversy? \u00a0My personal favorite source is the <em>Wall Street Journal<\/em> Health blog, and <a href=\"http:\/\/blogs.wsj.com\/health\/2010\/12\/20\/xmrv-raising-the-issue-of-contamination\/\" target=\"_blank\">here&#8217;s the most recent entry<\/a>.<\/li>\n<li>For those of you vacationing in Missouri, and somehow tempted to eat raw crayfish, check out these <a href=\"http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm5948a1.htm\" target=\"_blank\">case reports of paragonimiasis<\/a> in the <em>MMWR. <\/em>My favorite sentence in the report: \u00a0&#8220;Behavioral factors that led patients in this report to eat raw or undercooked crayfish included alcohol consumption, dares, and demonstration of survival skills.&#8221; \u00a0Any surprise that 8 of 9 of the cases were in males?<\/li>\n<\/ul>\n<p>Happy <a href=\"http:\/\/cmr.asm.org\/cgi\/content\/full\/19\/1\/12\" target=\"_blank\">Hafnias<\/a>!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Some items to consider in HIV\/ID world as you dig into your salmonella-free holiday bird: Drug label change for stavudine (d4T): \u00a0The label no longer has recommendations for dose-reduction in case of peripheral neuropathy, and cites data more strongly linking d4T use to lipoatrophy. \u00a0The strategy of decreasing the dose to reduce d4T toxicity hasn&#8217;t [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,5,8,10],"tags":[261,266,303,348,423,730,874,1000],"class_list":["post-1297","post","type-post","status-publish","format-standard","hentry","category-hiv","category-infectious-diseases","category-patient-care","category-research","tag-d4t","tag-darunavir","tag-echinacea","tag-fda","tag-hiv","tag-pleconaril","tag-stavudine","tag-xmrv"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1297","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=1297"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1297\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=1297"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=1297"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=1297"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}