Update in HIV Medicine for the Generalist
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
This update reviews the literature in the prevention and management of HIV infection as pertinent to the general internist. Our objectives were (1) to review the most recent data regarding HIV prevention, counseling, testing, and treatment, with a special focus on cost-effectiveness; (2) to discuss new findings regarding survival and general management of HIV, including a brief review of updated treatment guidelines and new antiretroviral medications; and (3) to discuss the intersection of HIV with other chronic diseases commonly encountered by generalist physicians. We included papers with both domestic and international relevance.
We performed a literature search of peer-reviewed studies published since July 2006. Initially, we performed a PUBMED search using the Medical Subject Heading (MeSH) term “HIV,” limiting our search to English articles dealing with human subjects published in core clinical journals on or after July 1, 2006. We narrowed our results to studies focus ...
- Siegfried N, Muller M, Deeks J, et al. HIV and male circumcision–a systematic review with assessment of the quality of studies. Lancet Infect Dis. 2005;5(3):165–73. Mar.
- Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med. 2005;211:e298. Nov. CrossRef
- Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. Lancet. 2007;369:643–56. CrossRef
- Wawer M, Kigozi G, Serwadda D, et al. Trial of male circumcision in HIV+ men, Rakai, Uganda: Effects in HIV+ men and in women partners. Presented at the 15th Conference on Retroviruses and Opportunistic Infections, Boston, MA, USA. February 3–6, 2008. Abstract 33LB.
- Joint United Nations Programme on HIV/AIDS, World Health Organization. New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications. 2007. Available at: http://data.unaids.org/pub/Report/2007/mc_recommendations_en.pdf. Accessed September 29, 2008.
- Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR. Centers for Disease Control. 2006;55RR-141–17.
- Paltiel AD, Weinstein MC, Kimmel AD, et al. Expanded screening for HIV in the United States-an analysis of cost-effectiveness. N Engl J Med. 2005;352:586–95. CrossRef
- Sanders GD, Bayoumi AM, Sundaram V, et al. Cost-effectiveness of screening for HIV in the era of highly active antiretroviral therapy. N Engl J Med. 2005;352:570–85. CrossRef
- Panel on Antiretroviral Guidelines for Adult and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. 2006 October 10, 2006. Available at: http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL000629.pdf. Accessed September 29, 2008.
- Panel on Antiretroviral Guidelines for Adult and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. 2007 December 1, 2007. Available at: http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL000721.pdf. Accessed September 29, 2008.
- Gallant JE, DeJesus E, Arribas JR, et al. Tenofovir DF, emtricitabine, and efavirenz vs. zidovudine, lamivudine, and efavirenz for HIV. N Engl J Med. 2006;354:251–60. Jan 19. CrossRef
- Haubrich R, Cahn P, Grinsztejn B, et al. DUET-1: Week-48 results of a phase III randomized double-blind trial to evaluate the efficacy and safety of TMC125 vs placebo in 612 treatment-experienced HIV-1-infected patients. Presented at the 15th Conference on Retroviruses and Opportunistic Infections, Boston, MA, USA. February 3–6, 2008. Abstract 790.
- Johnson M, Campbell T, Clotet B, et al. DUET-2: Week-48 results of a phase III randomized double-blind trial to evaluate the efficacy and safety of TMC125 vs placebo in 591 treatment-experienced HIV-1-infected patients. Presented at the 15th Conference on Retroviruses and Opportunistic Infections, Boston, MA, USA. February 3–6, 2008. Abstract 791.
- Hicks CB, Cahn P, Cooper DA, et al. Durable efficacy of tipranavir-ritonavir in combination with an optimised background regimen of antiretroviral drugs for treatment-experienced HIV-1-infected patients at 48 weeks in the randomized evaluation of strategic intervention in multi-drug resistant patients with tipranavir (RESIST) studies: An analysis of combined data from two randomised open-label trials. Lancet. 2006;368:466–75. CrossRef
- Ortiz R, Dejesus E, Khanlou H, et al. Efficacy and safety of once-daily darunavir/ritonavir versus lopinavir/ritonavir in treatment-naive HIV-1-infected patients at week 48. AIDS. 2008;22:1389–97. CrossRef
- Clotet B, Bellos N, Molina JM, et al. Efficacy and safety of darunavir-ritonavir at week 48 in treatment-experienced patients with HIV-1 infection in POWER 1 and 2: A pooled subgroup analysis of data from two randomised trials. Lancet. 2007;369:1169–78. CrossRef
- Madruga JV, Berger D, McMurchie M, et al. Efficacy and safety of darunavir-ritonavir compared with that of lopinavir-ritonavir at 48 weeks in treatment-experienced, HIV-infected patients in TITAN: A randomised controlled phase III trial. Lancet. 2007;370:49–58. CrossRef
- Hardy D, Reynes J, Kornourina I, et al. Efficacy and safety of maraviroc plus optimized background therapy in treatment-experienced patients infected with CCR5-tropic HIV-1: 48-week combined analysis of the MOTIVATE studies. Presented at the 15th Conference on Retroviruses and Opportunistic Infections, Boston, MA, USA. February 3–6, 2008. Abstract 792.
- Saag M, Ive P, Heera J, et al. A multicenter, randomized, double-blind, comparative trial of a novel CCR5 antagonist, maraviroc versus efavirenz, both in combination with Combivir (zidovudine/lamivudine), for the treatment of antiretroviral naive subjects infected with R5 HIV-1: Week 48 results of the MERIT study. Presented at the 4th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention, Sydney, Australia. July 22–25, 2007. Abstract WESS104.
- Markowitz M, Nguyen BY, Gotuzzo E, et al. Rapid and durable antiretroviral effect of the HIV-1 integrase inhibitor raltegravir as part of combination therapy in treatment-naive patients with HIV-1 infection: Results of a 48-week controlled study. J Acquir Immune Defic Syndr. 2007;46:125–33. CrossRef
- Steigbigel RT, Cooper DA, Kumar PN, et al. Raltegravir with optimized background therapy for resistant HIV-1 infection. N Engl J Med. 2008;359:339–54. CrossRef
- Hetherington S, McGuirk S, Powell G, et al. Hypersensitivity reactions during therapy with the nucleoside reverse transcriptase inhibitor abacavir. Clin Ther. 2001;10:1603–14. CrossRef
- Hetherington S, Hughes AR, Mosteller M, et al. Genetic variations in HLA-B region and hypersensitivity reactions to abacavir. Lancet. 2002;359:1121–2. CrossRef
- Mallal S, Nolan D, Witt C, et al. Association between presence of HLA-B*5701, HLA-DR7, and HLA-DQ3 and hypersensitivity to HIV-1 reverse-transcriptase inhibitor abacavir. Lancet. 2002;359:727–32. CrossRef
- Saag M, Balu R, Phillips E, et al. High sensitivity of human leukocyte antigen-b*5701 as a marker for immunologically confirmed abacavir hypersensitivity in white and black patients. Clin Infect Dis. 2008;46:1111–8. CrossRef
- Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Available at: http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf. Accessed September 29, 2008.
- Lundgren JD. Combination antiretroviral therapy and the risk of myocardial infarction: The data collection on adverse events of anti-HIV drugs (DAD) study group. N Engl J Med. 2003;349:1993–2003. CrossRef
- Anderson KM, Wilson PWF, Odell PM, Kannel WB. An updated coronary risk profile. A statement for health professionals. Circulation. 1991;83:356–62.
- Panel on Antiretroviral Guidelines for Adults and Adolescents. DHHS adults and adolescents antiretroviral treatment guidelines Panel’s communication regarding abacavir. Available at: http://aidsinfo.nih.gov/contentfiles/ABCComm.pdf. Accessed September 29, 2008.
- Update in HIV Medicine for the Generalist
Journal of General Internal Medicine
Volume 24, Issue 2 , pp 276-282
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- 2. Department of Medicine, VA New England Healthcare and Boston University School of Medicine, Boston, MA, USA
- 3. Department of Medicine, University of Wisconsin School of Medicine, Madison, WI, USA
- 4. Department of Medicine, Yale University School of Medicine, New Haven, CT, USA