AIDS Clinical Care Index

 
 
  • Directly Administered ART Improves Short-Term Outcomes Adapting antiretroviral therapy (ART) for direct administration poses challenges. Might monitored dosing of ART be feasible and successful in improving treatment response in HIV-infected drug users?
  • Raltegravir in Treatment-Naive Patients: 48-Week Data Raltegravir rapidly decreases viral load in treatment-experienced, HIV-infected patients. Might raltegravir have similarly potent effects in treatment-naïve patients after 48 weeks of therapy?
  • Effectiveness of Pneumococcal Vaccine in HIV-Infected Patients The 23-valent pneumococcal vaccine is recommended for HIV-infected patients with CD4 counts of at least 200 cells/mm3. Is it effective for patients with CD4 counts that are less than 200 cells/mm3?
  • A Quick Blood Test for PCP? ß-glucan, a fungal cell-wall component, can be present in the sera of persons with overwhelming systemic fungal infection. Might ß-glucan be a good marker of Pneumocystis jiroveci pneumonia infection?
  • Limitations of Rapid Testing Rapid HIV tests have advantages that lead to their preferred use for HIV screening, especially in many resource-limited settings. But how accurate are the results from sequential rapid HIV testing?
  • Persistence of Neuropsychologic Impairment After Starting ART Neurocognitive impairment is a complication of advanced HIV infection that potent ART cannot always completely reverse. Persistence of neuropsychological deficits is associated with what factors?
  • Febrile Respiratory Symptoms in HIV: Think Flu HIV-infected outpatients presenting with fever and respiratory symptoms could have influenza. What is the actual incidence of the flu in such patients and what impact does flu vaccination have?
  • Viral Rebound Rates Decrease Over Time in Suppressed Patients Viral rebound risk exists for people who've fully suppressed HIV replication. What does UK cohort study data show for rebound rates for suppressed patients with and without treatment failure history?
  • Primary HIV Infection–Predicting the Set Point Early diagnosis of acute HIV infection, an uncommon event, has advantages that aren't always apparent to the patient or provider. What factors related to primary HIV infection predict viral set point?
  • ART-Free Weekends? Clinicians and patients remain highly interested in the concept of structured treatment interruption. One such approach involves patients cycling on and off ART for defined periods of time.
  • The Travels of a Multidrug-Resistant Strain of HIV Clinicians and patients remain highly interested in the concept of structured treatment interruption. One such approach involves patients cycling on and off ART for defined periods of time.
  • Antiretroviral Therapy and Cardiovascular Disease Dr. Paul Sax reviews the latest report from the DAD Study Group which suggests that long-term treatment with PI- but not NNRTI-based therapy slightly, but significantly, increased the risk for MI.
  • Does HIV Infection Predispose to the Metabolic Syndrome? Study of a large Midwestern cohort suggests that metabolic syndrome is no more common among the HIV-infected than among uninfected peers; lipid abnormalities were prominent in HIV-infected, however.
  • Who Will Benefit from CCR5 Inhibitors? Correlates of co-receptor tropism were investigated in a population of highly-treatment experienced patients.
  • Do HIV Testing Rates Improve When Written Consent Is No Longer Required? Elimination of risk-based testing is part of the CDC's new HIV testing recommendations.
  • Long-Term CD4 Response: Where You Start Predicts Where You End Up After 6 years of successful antiretroviral therapy for HIV, the only patients likely to achieve a low-to-normal CD4-cell count were those who had started treatment with CD4s >350.
  • NNRTIs Best PIs ... Again In a randomized trial of treatment-naive HIV patients, the most virologically active strategy was 2 NRTIs plus an NNRTI; a triple-class strategy yielded greater toxicity but not greater efficacy.
  • High Lung Cancer Rates in AIDS Not Entirely Due to Smoking Elevated lung cancer risk remains despite the advent of HAART. Young people are at a particularly elevated risk—more than 10-fold relative to HIV-negative people.
  • After Virologic Rebound, Should T-20 Be Continued? Continuing a failing antiretroviral regimen is usually not advised, but in some cases, even failing regimens continue to exert a modest anti-HIV effect. Is that true for T-20?
  • HCV Clinical Practice: Few Referred for Treatment, Even Fewer Respond In a large urban HIV clinic, fewer than 1% of coinfected individuals were successfully treated for HCV.
  • Successful Antiretroviral Therapy Eliminates Virus from the CSF New findings suggest that antiretroviral effects are magnified, not muffled, in the CNS.
  • Intermittent HIV Treatment Fails Dramatically The SMART study leaves little doubt that continuous antiretroviral therapy, for all its problems, is better for overall health than intermittent therapy.
  • High Mortality in a South African XDR TB Outbreak Researchers found alarmingly high prevalences of both multidrug-resistant and extensively drug-resistant TB among HIV-coinfected people in rural South Africa.
  • Is Nonoccupational PEP Effective? HIV seroconversion occurred in approximately 1% of adults who received PEP after nonoccupational exposure. Whether these seroconversions represent failures of PEP is unclear.
  • CD4-Cell Decline Not Predicted by Viral Load New findings suggest that baseline viral load, although very useful for assessing response to HIV therapy, should play a limited role in determining when to start treatment.
 
 
 
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