0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA |

Highlights FREE

JAMA. 2014;312(4):313-315. doi:10.1001/jama.2013.279627.
Text Size: A A A
Published online

Jeanette M. Smith, MD

Treatment of hepatitis C virus (HCV) infection in patients coinfected with HIV is challenging. In a multicenter, open-label, and nonrandomized trial that enrolled 223 patients concurrently infected with HCV and HIV, Sulkowski and colleagues found that combination treatment with sofosbuvir and ribavirin was associated with high rates of sustained virologic response. In an Editorial, Saag discusses advances in treating patients with HCV and HIV coinfection.

Mugo and colleagues assessed pregnancy outcomes in 1785 HIV-serodiscordant heterosexual couples in which the female partner was HIV uninfected and was randomly assigned to receive antiretroviral preexposure prophylaxis or placebo during the periconceptual period. The authors report there were no differences in pregnancy incidence, birth outcomes, or infant growth among women who received HIV preexposure prophylaxis vs placebo at the time of conception.

In a cluster randomized trial that provided 16 660 adults in Malawi with access to HIV self-testing, MacPherson and colleagues found that compared with standard facility-based care, offering optional home initiation of HIV care to participants who reported a positive HIV self-test result prompted a significant increase in the proportion of adults who initiated antiretroviral therapy.

In a randomized placebo-controlled trial that enrolled 50 antiretroviral drug–treated HIV-infected patients with abdominal fat accumulation, Stanley and colleagues found that treatment with tesamorelin—a growth hormone–releasing hormone analog—resulted in significant reductions in measures of visceral adipose tissue and, additionally, modest reductions in liver fat.

CLINICAL REVIEW & EDUCATION

Marrazzo and colleagues—members of the International Antiviral Society-USA Panel—report results of a comprehensive and systematic literature review (1996-2014) and consensus development process undertaken to provide updated recommendations for the prevention and treatment of HIV infection in adults and adolescents. The authors emphasize integrated biomedical and behavioral approaches to prevention, provide recommendations for preexposure and postexposure HIV infection prophylaxis, and stress the importance of timely HIV infection diagnosis and treatment. In an Editorial, Mathers and Cooper discuss integration of HIV prevention in routine clinical practice.

This article by Günthard and colleagues—members of the International Antiviral Society-USA Panel—provides updated treatment recommendations for adults with HIV infection. The recommendations emphasize early initiation of treatment with proven regimens of combination therapy, provide guidance for laboratory monitoring, and consider treatment failure and drug regimen switches for adverse effects and patient burden.

A woman with a history of hepatitis C virus infection had a 2-year history of painful skin and oral lesions, which improved with prednisone but recurred when prednisone was discontinued. The patient had no history of herpes simplex virus (HSV) infection; however, HSV serologies were positive. What would you do next?

This Medical Letter article summarizes results of clinical studies of dolutegravir—an integrase strand transfer inhibitor—recently approved for the treatment of HIV infection.

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
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.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.