{"title":"Changing trends in bacterial infections: Staphylococcus aureus, bacterial pneumonia, Clostridium difficile.","authors":"John G Bartlett","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Changing bacterial diseases in the general population of which HIV practitioners should be aware include: new staphylococcal syndromes caused by community-acquired methicillin-resistant Staphylococcus aureus USA300 strains (eg, necrotizing skin infections, pneumonia, fasciitis); continued high rates of community-acquired pneumonia in the potent antiretroviral therapy era; increase rates and severity of Clostridium difficile-associated disease due to the fluoroquinolone-resistant NAP1 strain, and the new scare from extensively drug-resistant tuberculosis, primarily as a potential threat to health care in Africa. This article summarizes a presentation on important bacterial infections made by John G. Bartlett, MD, at the International AIDS Society-USA course in New York in March 2007.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 3","pages":"94-8"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26803817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recent efforts in biomedical prevention of HIV.","authors":"Raphael J Landovitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite major advances in HIV treatment and progress in distribution of antiretroviral therapy in the developing world, staggering rates of new HIV infections persist. Innovative approaches to prevention of transmission are needed. Recent data have confirmed previous observational studies that demonstrated a substantial reduction in acquisition risk with male circumcision and microbicide technology experienced a setback with the early termination of a large-scale vaginal microbicide trial of cellulose sulfate. Limited data from one trial of pre-exposure prophylaxis was not able to validate nor refute efficacy. This article summarizes a presentation on biomedical prevention of HIV infection made by Raphael J. Landovitz, MD, at an International AIDS Society-USA Continuing Medical Education course in Los Angeles in March 2007.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 3","pages":"99-103"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26803819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joyce Jones, Barbara Taylor, Timothy J Wilkin, Scott M Hammer
{"title":"Advances in antiretroviral therapy.","authors":"Joyce Jones, Barbara Taylor, Timothy J Wilkin, Scott M Hammer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The 14th Conference on Retroviruses and Opportunistic Infections provided a forum for presentation of state-of-the-art research on antiretroviral therapy. This year's conference marked the first public presentation of phase III trials of the lead compounds in 2 new drug classes: maraviroc (a CCR5 inhibitor) and raltegravir (an HIV-1 integrase inhibitor). These agents are likely to be approved by the US Food and Drug Administration this year and should provide major new options for treatment-experienced patients with multidrug resistant virus. Other dominant themes of the conference were the impressive number of presentations describing outcomes of antiretroviral therapy programs in resource-limited settings and new information on mechanisms of drug resistance. Among the latter, the importance of drug resistance mutations occurring in the RNase H and connection domains of the HIV-1 reverse transcriptase was of special note. In addition, substantial new information was presented on other new antiretroviral agents, studies in treatment-naive patients, antiretroviral therapy strategies, prevention of mother-to-child transmission, predictors of clinical response to therapy, and antiretroviral pharmacokinetics. Research in antiretroviral therapy remains dynamic and advances in the field continue to improve our ability to maintain long-term control of HIV-1 replication in infected persons.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 2","pages":"48-82"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26709744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Complications of HIV disease and therapy.","authors":"Judith S Currier, Diane V Havlir","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Complications and consequences of untreated and treated HIV infection in domestic and international settings continue to be a major focus of HIV clinical research efforts. In this review major findings in these areas are highlighted, with a focus on studies that have application to clinical practice. As the field of clinical research in HIV continues to mature, we are repeatedly surprised by the findings from well-designed studies.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 2","pages":"40-7"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26709746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Scott Letendre, Beau Ances, Sarah Gibson, Ronald J Ellis
{"title":"Neurologic complications of HIV disease and their treatment.","authors":"Scott Letendre, Beau Ances, Sarah Gibson, Ronald J Ellis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Important new information regarding neurologic complications of HIV disease was presented at the 2007 Conference on Retroviruses and Opportunistic Infections. In addition to presentations on pathogenesis and treatment of neurologic complications, the conference included findings that have implications for the management of HIV disease outside the nervous system. Key findings included that the distribution of antiretrovirals into the central nervous system may influence the effectiveness of treatment outside this protected compartment; that postponing initiation of therapy until blood CD4+ counts fall to 300 cells/mm3 may increase the risk for HIV-associated neurocognitive impairment but interruption of antiretroviral therapy in individuals with high CD4+ counts may have neuropsychologic benefits; that substantial changes, including macrophage activation and neuronal injury can occur shortly after HIV transmission; that HIV can influence neural progenitor cells to decrease neuronal differentiation; that newer neuroimaging technologies, such as diffusion tensor imaging and blood oxygen level-dependent functional magnetic resonance imaging can identify important effects of HIV on the brain such as alterations in cerebral oxygen consumption; that serotonin reuptake inhibitors and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors may reduce HIV RNA levels in cerebral spinal fluid; and that erythropoietin and the non-immunosuppressive immunophilin ligand, GPI-1046, may improve HIV-associated injury of peripheral nerves. The conference also included an important focus on JC virus encephalitis (also known as progressive multifocal leukoencephalopathy).</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 2","pages":"32-9"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26709743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HIV epidemiology and prevention interventions.","authors":"Susan Buchbinder","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Several presentations at the 2007 Conference on Retroviruses and Opportunistic Infections focused on the underlying factors driving the HIV epidemic in selected regions of the world and on selected populations. The conference also provided updated data on 1 of 2 successful adult male circumcision efficacy trials to prevent HIV acquisition, and a review of 1 of 2 unsuccessful efficacy trials of the microbicide cellulose sulfate. Presentations also focused on strategies to prevent HIV acquisition through pre-exposure prophylaxis, treatment of sexually transmitted diseases, and prevention of mother-to-child transmission through breastfeeding.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 2","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26709742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Basic science highlights.","authors":"Mario Stevenson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The 14th Conference on Retroviruses and Opportunistic Infections generated a lot of excitement with the announcement of clinical studies employing the use of 2 new classes of antiretroviral drugs that target the viral integrase enzyme and the viral coreceptor CCR5. In addition, a number of presentations on cellular restriction factors provided surprises regarding the mechanism by which cellular restrictions antagonize viral infection. There was also much interest in studies presenting novel cellular cofactors of HIV-1 infection. The conference illustrated how basic science research is paying off. Essential steps in the viral life cycle, uncovered through basic research, are now being targeted by new classes of antiviral agents. In addition, basic science is unveiling potential new targets of antiretroviral therapy.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 2","pages":"21-5"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26709741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Review on structured treatment interruptions (STIs).","authors":"Bernard Hirschel","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 1","pages":"17; author reply 17"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26697836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HIV infection in women: perinatal issues and cervical cancer surveillance.","authors":"Carmen D Zorrilla","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Issues of HIV infection in women include perinatal care to prevent mother-child transmission and screening for cervical dysplasia. Antiretroviral therapy has been very successful in reducing perinatal transmission rates. Ongoing issues in this setting include absense of relevant pharmacokinetics data for new drugs and formulations, implementation of new resistance testing guidelines, and recent apparently conflicting findings on the potential role of protease inhibitor treatment in preterm delivery. Recent findings also include a similar low transmission rate with vaginal delivery and emergency cesarean delivery versus elective cesarean delivery in women on antiretroviral therapy with HIV viral load of less than 1000 copies/mL, and a low rate of postpartum morbidity in women undergoing elective cesarean delivery. Recent changes in recommendations for cervical cancer screening in the general population should not be applied to HIV-infected women. However, the recent finding that HIV-infected women with CD4+ cell counts greater than 500/ul do not have a greater rate of squamous intraepithelial lesions than women without HIV infection suggests that the former can be followed less frequently if they have normal Pap tests. This article summarizes a presentation on HIV infection in women made by Carmen D. Zorrilla, MD, at the 9th Annual Ryan White CARE Act Clinical Update in Washington, DC, in August 2006. The original presentation is available as a Webcast at www.iasusa.org.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26242249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HIV testing: rationale for changing recommendations.","authors":"Robert S Janssen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>HIV testing is an important and effective strategy for preventing HIV infection. Infected individuals who know their HIV serostatus are less likely to engage in high-risk sexual behavior, and it is estimated that knowledge of HIV serostatus in unaware persons could reduce new infections by more than 30%. The availability of rapid testing for HIV expands testing opportunities. Expanded routine, voluntary, and opt-out screening in health care settings is needed to reduce the number of persons who are unaware of their HIV-infected status, get newly diagnosed patients into care, and reduce transmission of HIV infection. This article summarizes a presentation on revisions to Centers for Disease Control and Prevention HIV screening recommendations made by Robert S. Janssen, MD, at the 9th Annual Ryan White CARE Act Clinical Update in Washington, DC, in August 2006. The original presentation is available as a Webcast at www.iasusa.org.</p>","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"15 1","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26242250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}