Two HIV experts discuss their ongoing research involving HIV in aging adults and provide insights on how some major health concerns can be addressed to improve the overall care and outcomes of older adults with HIV.
A serological pattern called isolated anti-HBc, characterized by the presence of hepatitis B core antibody (anti-HBc) and the absence of hepatitis B surface antigen and hepatitis B surface antibody, is explored further in the Q&A.
Last month the South Africa National Tuberculosis Program decided to make oral bedaqualine available for all rifampin-resistant TB (RR-TB) in place of — the often more toxic — injectable drugs.
Clostridium difficile is the most common cause of healthcare-associated infections, with as many as 500,000 cases occurring annually in the United States. Efforts to prevent transmission within hospitals typically focus on patients with symptomatic Clostridium difficile infection.
Health professionals from many disciplines need to be able to recognize the clinical presentations, essential diagnostic tests, and treatment approach of Lyme neuroborreliosis.
Some advocates say that women with undetectable viral loads should be able to breastfeed after thorough consultation with their clinicians.
Although the CDC recommends routine HIV screening for all people age 13-64 years, numerous barriers to HIV testing in healthcare settings have been identified, including lack of access and fear of stigma and discrimination.
A higher prevalence of traditional cardiovascular risk factors may be partially responsible for the increased incidence of cardiovascular disease in people living with HIV.
Point-Counterpoint: Should We Implement Needle Exchange Programs for the Prevention of Hepatitis C Virus?
Of the approximately 12.7 to 16 million people who inject drugs (PWID) worldwide, an estimated 10 million individuals have hepatitis C virus (HCV), making it the most prevalent infectious disease in this population.
The connection between vitamin D deficiency and the incidence and severity of HIV is examined in a featured article.
Unrestricted use of DAAs may be an invaluable component of preventing HCV transmission by reducing the infectious pool of individuals.
It has been proposed that inflammation stemming from persistent pathogens may influence the development of mood disorders.
Alberto V. Carli, MD, and Ashley E. Levack, MD, MAS, discuss preventive and treatment options for periprosthetic joint infections.
Infectious Disease Advisor speaks with Elizabeth D. Lowenthal, MD, about the challenges associated with revealing HIV seropositive status to children.
Proadrenomedullin and procalcitonin have demonstrated superiority to C-reactive protein for predicting mortality and guiding antimicrobial therapy in critically ill patients with fever.
To shed further light on the study's implications, MPR interviewed lead author Anupam B. Jena, MD, PhD, Ruth L. Newhouse Associate Professor, Harvard Medical School, Boston, MA.
Before the advent of potent antiviral agents, liver transplantation was the only treatment option for patients with hepatitis and a poor prognosis; antiretrovirals can now provide a potentially curative approach.
How many second chances should a drug user get? As many as it takes for us — physicians, society, government, and the healthcare system — to get it right.
Mental health professionals supporting patients living with HIV need to make space for their patients to process the emotional effect of their diagnosis, but not to make assumptions about what it means to them.
With the advent of platform manufacturing technology, vaccines can be developed quickly to stop the spread of outbreaks.
Research shows that palliative care can help with symptom management, care coordination, therapeutic decision making, and the psychosocial aspects of living with hepatocellular carcinoma.
Although internet-based surveillance methods have recently been established to enhance vector-borne disease surveillance, assessment of their utility is required to determine how best to position this technology to improve infectious disease outcomes.
The Lancet Respiratory Medicine staged a debate between proponents and opponents of pan-TB regimens to tackle the current suboptimal worldwide management of TB resistance.
While immunocompromised patients are the most susceptible to CNS fungal infections, they can also occur in immunocompetent patients undergoing invasive procedures such as neurosurgery and in patients exposed to contaminated devices or drugs.
Important strategies to consider for people involved in the criminal justice systems include linkage to antiretroviral therapy for those who are HIV positive and linkage to PrEP postrelease and/or beginning PrEP before people are released so they build up adherence.
Identifying a patient's preferences and goals leads to a care plan that can reflect those goals, and this may improve patient satisfaction.
In patients with psoriasis who were previously exposed to HBV or who have chronic HBV, immunosuppressive therapies can cause viral reactivation, although the risk is minimal for patients with resolved or occult infection.
In this review, David C. Helfgott, MD, editorial advisory board member for Infectious Disease Advisor, focuses on infectious complications from the use of monoclonal antibodies for malignancy.
Mental health problems are 1 of the most important reasons for failing to engage in long-term control of HIV.
Early antibiotic administration in treating infection has evident biological plausibility, however, time-sensitivity to outcomes appears to be most relevant in septic shock.
Clinicians need to monitor reactivation of the hepatitis B virus in patients with rheumatic diseases by testing for elevation of liver enzymes and HBV DNA levels.
Training on adherence to guidelines, the development of guidelines specific to the pediatric population, and the employment of tools and techniques to decrease contamination of blood cultures could decrease the overuse of blood cultures.
The risk for HBV transfusion-transmitted infection has been significantly reduced in the last few decades by the careful selection of donors and testing of blood donations, using sensitive serological and molecular screening techniques.
Generic antiretroviral agents have had a dramatic effect on outcomes in developing nations, and their availability in developed countries is rapidly expanding as more brand-name drugs are coming off patent. But unique challenges surrounding their use remain.
Although substantial emphasis is placed on vaccinations in considering how to limit the spread of influenza, simple hygienic methods have been found to be the most effective and should be more widely supported.
To meet the goals of the World Health Organization for reducing new infections and decreasing deaths associated with hepatitis B and C virus by 2030, people on the margins of society will need to be tested and treated, including refugees and migrants from endemic regions, as well as people who inject drugs.
The potential role of vaccinations in combatting antimicrobial resistance (AMR) is currently undervalued. The distribution and development of new vaccines should be priorities in efforts to address the AMR crisis.
GBS infections in infants, cellulitis and necrotizing fasciitis, although uncommon in infants, requires swift treatment with antibiotics and occasionally surgical debridement.
The rapidly developing landscape of antiretroviral therapy adherence monitoring has great potential for clinical application, but cost-effectiveness and feasibility studies are needed to define the appropriate roles for these new technologies.
First trimester treatment for malaria could change with the results of 1 of the most robust meta-analyses to date that compared artemisinin-based therapy vs quinine.
The new WHO guidelines restricts antibiotic use in animals for purposes of growth promotion as well as avoidance of use for disease prevention.
Community-acquired pneumonia and other acute infections can cause or exacerbate cardiovascular complications.
Expert perspective on management and treatment of acute urinary tract infections in postmenopausal women.
Prompt diagnosis of tick-borne diseases is essential but testing methods have been imprecise. Learn about some recent testing advances for Lyme disease and other tick-borne illnesses.
As more deaths among individuals living with HIV are not directly associated with communicable diseases, the influence of sex hormones and inflammation on morbidity is coming under scrutiny.
After hospital discharge for sepsis, the healthcare team should focus on identifying new functional, mental, and cognitive impairments and referring patients to appropriate treatment; reviewing and adjusting long-term medications; and evaluating for treatable conditions that commonly result in hospitalizations.
In the past 2 decades, prophylactic antiviral therapies have drastically reduced the rates of HBV recurrence, allograft loss, and mortality in patients undergoing liver transplantation.
Review of subclinical and clinical cardiovascular diseases in patients with chronic hepatitis C infection.
Despite worse outcomes in older adults, treatment efficacy and safety of direct-acting antivirals appear to be similar between older adults and younger patients, based on limited available data. Age should not be considered a barrier to treatment in older HCV-infected adults.
Learn about drugs in the pipeline for treatment-resistant gonorrhea.
The goal of ART in neonates has expanded from reducing morbidity and mortality to the possibility of facilitating remission, but further research is needed to advance this goal, and additional treatment options are also needed for this population.
Experts from the World Health Organization and the London School of Hygiene and Tropical Medicine in the United Kingdom discuss the imperative to stop viral hepatitis, current diagnostic challenges, and the future of testing.
Dr McKinnell provides a summary of drugs in development for infections caused by Gram-negative bacteria, including carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Enterobacteriaceae.
Expert from the National Center for Immunization and Respiratory Diseases, a division of the CDC, discusses prevention strategies for group B streptococcus in infants, including the development of a maternal vaccine.
The availability of low-cost generic DAAs in lower income countries are a major step forward in combating HCV in these countries, but substantial work is still needed to put the WHO's goal of HCV elimination by 2030 within reach.
Transcutaneous vagus nerve stimulation could provide a safe alternative treatment in HIV-depression by targeting both depression and other comorbidities that can burden people living with HIV.
A dedicated research effort led by NIH's National Institute of Allergy and Infectious Diseases is aimed at developing a universal influenza vaccine that would confer better and longer-lasting protection against influenza virus strains.
Experts discusses the potential pitfalls of machine learning algorithms in medicine.
Evaluating conscious vs unconscious decision making in medicine.
Evaluating the effects of computerized decision support systems in medicine.
Evidence of the streetlight effect can be found across several fields, from physics and astronomy, to economics, in which cases investigators draw suspect conclusions from analysis of irrelevant data. Medicine, unsurprisingly, has not been immune, particularly in cancer research.
Differences in life expectancy have widened between wealthy and low-income Americans: the poorest 1% of citizens have a life expectancy 10.1 years and 14.6 years shorter for women and men, respectively, compared with the richest 1%.
Experts discuss the various imaging modalities for children who require diagnostic workup beyond urine culture, as well as the consequences of overusing antibiotics and antibiotic route of administration.
Chest X-rays do not differentiate between viral and bacterial pathogens, and they do not subsequently alter the course of treatment.
Experts discuss the management of drug-drug interactions in patients receiving treatment for HIV and HCV coinfection.
Although a positive impact on behavior change has been reported following the implementation of curriculum-based programs, there is a lack of clear evidence that school-based educational interventions directly prevent HIV/STIs.
Vaccination may confer modest reductions in acute otitis media (AOM) and AOM-targeted antibiotic use but use of influenza vaccine as a strategy to reduce AOM is likely unjustified.
Women with HIV have an increased risk for persistent HPV infection, which frequently progresses to cervical cancer, and they should be warned of their increased risk for HPV and cervical cancer and, when appropriate, advised to undergo HPV vaccination.
Without proactive measures and response, the changing climate is projected to continue to adversely affect the global incidence and distribution of infectious diseases and cause 250,000 additional deaths per year between 2030 and 2050.
MicroRNAs are currently under investigation for various clinical applications in infectious disease because of their role in host response to infection and effects on innate and adaptive immune pathways.
Dr Gianella Weibel talks with Dr Li and Dr Dubé, investigators of a new study from the AIDS Clinical Trials Group, which uses an intensively monitored antiretroviral pause to identify changes in HIV reservoirs after anti-HIV medications are stopped.
Study was the first to examine the geographical variation of seminal HPV prevalence, showing a relatively high prevalence in fertility clinic attendees when compared to the general population.
Educational campaigns regarding the value of vaccines should go beyond facts and statistics to integrating social psychological considerations with health communication principles.
The FDA has granted Fast Track designation to Visterra's lead product, VIS410.
The opioid epidemic has fueled the transmission of HCV, particularly among younger persons, who are often unaware of their risks and prevented from receiving timely treatment due to a variety of care barriers, even in settings ideally suited to identifying and treating HCV.
A representative from the California Department of Public Health discusses latent TB infection testing and treatment recommendations and reasons why US physicians have been slow to test for and treat for the condition.
The 2017 revisions to the Common Rule deal largely with improving the transparency and clarity of intended uses under the current standard of informed consent, while introducing a new concept of "broad consent."
Racial disparities in HCV treatment outcomes can be partially explained by the differences in underlying immune/genetic characteristics of patients.
Experts discuss antibiotic classes in development, which agents holds the most promise, and how to prevent further resistance.
Use of incentives makes the most sense with disadvantaged populations including homeless, drug users, and people in developing countries.
There is no cure or even effective antiviral therapy for yellow fever. Vaccination remains the sole route for preventing mortality from the disease, and WHO projections have already pointed to a significant global shortage.
Diagnosing Lyme disease can be difficult because symptoms vary from one person to another and can resemble symptoms of other infectious diseases spread by ticks.
Mortality rates associated with infective endocarditis range from 16% to 25%, with the highest rates observed among patients with nosocomial healthcare-associated infective endocarditis.
First-hand accounts of the care that was delivered during the 2013-16 West African outbreak of Ebola virus disease provided impetus for these guidelines.
Diagnosis of tuberculous meningitis is challenging, although new, next-generation rapid POC testing holds promise for greatly improved sensitivity. Shorter and more effective treatments are needed.
The Infectious Diseases Society of America updated its guidelines for the management of acute or persistent infectious diarrhea.
The high cost of DAA-based regimens remains an ethical issue and an obstacle to treatment accessibility. Shorter treatment regimens may offer substantial cost savings, improved treatment adherence, and a reduced rate of side effects.
Once-daily regimens have been shown to improve adherence to treatment with no adverse effect on outcomes in patients with HIV.
Data have shown patients with genotype 3 HCV have faster progression of fibrosis and higher rates of cirrhosis, severe steatosis, and hepatocellular carcinoma.
Investigators review results from the first study to assess the efficacy of a Vi-conjugate vaccine using a controlled human infection model of typhoid fever.
In recent years, a link between childhood Helicobacter pylori and gastric cancer in adulthood has elevated the need to detect and treat H pylori in asymptomatic children.
Vaginal microbiota dominated by L iners has been shown to exhibit rapid change in composition in and out of community states similar to bacterial vaginosis.
Optimizing outcomes with an antibiotic stewardship programs requires a team approach that involves point-of-care providers.
Physicians can help avoid contributing to antibiotic resistance by recognizing and using appropriate alternative treatments, and having a strategy so that patients are not on antibiotics for a long period of time.
The incidence of neurocognitive impairment is high in HIV-infected population, despite the introduction of combination antiretroviral therapy (CART).
A substantial portion of cases of antibiotic overprescription are linked to overdiagnosis of conditions such as sinusitis and otitis media without meeting diagnostic criteria and with high variability in diagnosis by race and by clinician.
Despite continual efforts aimed at finding new treatment options, HCC still has a very low 5-year survival rate, less than 20%, as many patients are diagnosed at an advanced stage of the disease.
Incidence of adverse events with delafloxacin (Baxdela™, Melinta Therapeutics) was comparable to the combination regimen of vancomycin plus aztreonam across 2 phase 3 registrational ABSSSI studies.
An international panel of experts applied the GRADE system and choose 7 PICO questions to generate recommendations for HAP/VAP.
Learn more about when stopping antiretroviral therapy (ART) may be necessary, why patients discontinue ART, predicting viral suppression, and predicting and encouraging adherence.
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Infectious Disease Advisor Articles
- Improving the Care of Aging Adults Living With HIV
- Resistance to Antibiotic Treatments for H pylori Infection
- Automated EHR Algorithm More Effective Than Nurse-Driven Protocol for HCV, HIV Screening
- Addressing Motivations That May Drive PrEP Appeal in MSM
- Sensitivity and Specificity of 7 Treponemal Tests for Syphilis Diagnosis
- Identifying the Source of C difficile in Hospitalized Patients
- Sensitivity and Specificity of 7 Treponemal Tests for Syphilis Diagnosis
- Automated EHR Algorithm More Effective Than Nurse-Driven Protocol for HCV, HIV Screening
- A Pan-Tuberculosis Regimen: The Debate Continues
- Tobramycin Efficacy Decreased by Human Airway Mucus
- Effects of Enhanced Prior Authorizations on Chronic Hepatitis C Treatment Adherence
- Regular Feedback May Optimize Blood Culture Sample Volumes in the PICU
- Mavyret Labeling Updated With Dosing for Liver, Kidney Transplant Patients
- CDC: More Than 400 Sickened by McDonald's Salads
- FDA Warns Against Long-Term Azithromycin Use for Some