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July 25, 2012, Vol 308, No. 4 >
This Week in JAMA | July 25, 2012| July 25, 2012

This Week in JAMA FREE

JAMA. 2012;308(4):315. doi:10.1001/jama.2012.3664.
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HIV/AIDS

A JAMA THEME ISSUE

Edited by Jeanette M. Smith, MD

HIV INFECTION, IMMUNE ACTIVATION, AND INFLAMMATION

Two articles in this issue report findings relating to immune activation and inflammation in individuals with HIV infection. In a randomized trial involving 83 patients with asymptomatic HIV infection, Paton and colleagues investigated the effect of oral hydroxychloroquine on immune activation, inflammation, and disease progression. The authors report that compared with placebo, hydroxychloroquine did not decrease immune activation and was associated with a greater decline in CD4 cell count and increased HIV viral load. Subramanian and colleagues assessed aortic wall inflammation in 81 individuals with HIV infection and 54 uninfected control participants who had similar cardiac risk factors. They found that HIV-infected individuals had increased arterial inflammation compared with controls. In an editorial, Stein and Hsue discuss inflammation, immune activation, and cardiac risk in individuals with HIV infection.

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CERVICAL CANCER RISK AND HIV INFECTION

Keller and colleagues assessed the risk of cervical precancer or cancer in a prospective cohort of 420 HIV-infected women and 279 HIV-uninfected women who at baseline had normal cervical cytology and were oncogenic human papillomavirus negative. The authors found that cervical precancer and cancer risks were similar among HIV-infected and uninfected women through 5 years of follow-up.
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HIV/HCV COINFECTION AND LIVER-RELATED EVENTS

Limketkai and colleagues examined the effect of hepatic fibrosis stage on the incidence of a composite outcome of end-stage liver disease, hepatocellular carcinoma, or death in a prospective cohort of 638 patients who were coinfected with HIV and hepatitis C virus (HCV). The authors report that hepatic fibrosis stage at baseline was independently associated with the composite outcome during a median follow-up of 5.8 years.
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TREATMENT OF ADULT HIV INFECTION

Thompson and colleagues report the 2012 recommendations of the International Antiviral Society–USA Panel for treatment of adult HIV infection, which reflect a systematic review of recent data (July 2010 to May 2012) and panel consensus. Among the new recommendations is that all patients should be offered antiretroviral therapy regardless of CD4 cell count.
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CLINICIAN'S CORNER JAMA CLINICAL CHALLENGE

A healthy heterosexual man presents with a crusted plaque on his nipple, which formed after a bite during sexual intercourse and has persisted for 1 month, and a generalized macular rash. What would you do next?

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MEDICAL NEWS & PERSPECTIVES

Researchers hope to find ways to eradicate latent reservoirs of HIV.
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VIEWPOINTS

Toward an AIDS-free generation
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AIDS: 1990 and 2012
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HIV prevention in the United States
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Aging and HIV-related cognitive loss
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A PIECE OF MY MIND

“There is nothing more you can do for me here. I just want to go home.” From “Forever Young.”
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EDITORIAL

HIV/AIDS: increasing evidence, advancing ahead
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EDITOR'S AUDIO SUMMARY

Dr Smith summarizes and comments on this week's issue. Go to http://jama.jamanetwork.com/multimedia.aspx#Weekly.

READERS RESPOND

How would you manage a patient with probable nonalcoholic fatty liver disease? Read the case at www.jama.com and submit your response by August 5.

AUTHOR IN THE ROOM TELECONFERENCE

Join Melanie A. Thompson, MD, and Paul A. Volberding, MD, Wednesday, August 15, from 2 to 3 PM eastern time to discuss updated recommendations for treatment of HIV infection. To register, go to http://www.ihi.org/AuthorintheRoom.

JAMA PATIENT PAGE

For your patients: Information about HIV infection.
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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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