NEJM â Collection Updates for HIV/AIDS

ORIGINAL ARTICLE: Acyclovir and Transmission of HIV-1 from Persons Infected with HIV-1 and HSV-2

Thu, 04Â FebÂ 2010 00:00:00 -05:00

Background: Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated...

EDITORIAL: HIV Vaccine Trial Results â An Opening for Further Research

Raphael Dolin, M.D. — Thu, 03Â DecÂ 2009 00:00:00 -05:00

HIV-AIDS has emerged as an enormous, worldwide public health problem over the past 25 years. An estimated 33 million persons are infected with human immunodeficiency virus type 1 (HIV-1), and...

ORIGINAL ARTICLE: AbacavirâLamivudine versus TenofovirâEmtricitabine for Initial HIV-1 Therapy

Thu, 03Â DecÂ 2009 00:00:00 -05:00

Background: The use of fixed-dose combination nucleoside reverse-transcriptase inhibitors (NRTIs) with a nonnucleoside reverse-transcriptase inhibitor or a ritonavir-boosted protease inhibitor is recommended as initial therapy in patients with human immunodeficiency...

ORIGINAL ARTICLE: Vaccination with ALVAC and AIDSVAX to Prevent HIV-1 Infection in Thailand

Thu, 03Â DecÂ 2009 00:00:00 -05:00

Background: The development of a safe and effective vaccine against the human immunodeficiency virus type 1 (HIV-1) is critical to pandemic control.

Methods: In a community-based, randomized, multicenter, double-blind, placebo-controlled efficacy...

CLINICAL PRACTICE: Postexposure Prophylaxis for HIV Infection

Raphael J. Landovitz, M.D., and Judith S. Currier, M.D. — Thu, 29Â OctÂ 2009 00:00:00 -05:00

A 24-year-old man presents to an outpatient clinic, reporting that 36 hours previously he had receptive anal intercourse without the use of a condom with an anonymous male partner who...

ORIGINAL ARTICLE: Interleukin-2 Therapy in Patients with HIV Infection

The INSIGHTâESPRIT Study Group and SILCAAT Scientific Committee — Thu, 15Â OctÂ 2009 00:00:00 -05:00

Background: Used in combination with antiretroviral therapy, subcutaneous recombinant interleukin-2 raises CD4+ cell counts more than does antiretroviral therapy alone. The clinical implication of these increases is not known.

Methods: We...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2009 â An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive

Thu, 17Â SepÂ 2009 00:00:00 -05:00

Dr. Jenica N. Upshaw (Medicine): An 81-year-old man was admitted to the hospital because of cough, weight loss, odynophagia, and failure to thrive.

The patient had been in his usual state...

CORRESPONDENCE: Persistent Carriage of Hepatitis E Virus in Patients with HIV Infection

Thu, 03Â SepÂ 2009 00:00:00 -05:00

To the Editor: Hepatitis E virus is an emerging infection in developed countries, with many clinical manifestations.1 We describe a 48-year-old bisexual white male who was infected with human immunodeficiency...

CORRESPONDENCE: 5-Year Survival of Patients with AIDS Receiving Antiretroviral Therapy in Haiti

Thu, 20Â AugÂ 2009 00:00:00 -05:00

To the Editor: We report 5-year outcomes of 910 adults with human immunodeficiency virus (HIV) infection who consecutively initiated antiretroviral therapy according to guidelines of the World Health Organization (WHO)...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2009 â A 24-Year-Old Woman with AIDS and Tuberculosis with Progressive Cough, Dyspnea, and Wasting

Douglas Wilson, M.B., Ch.B., RocÃo M. Hurtado, M.D., and Subba Digumarthy, M.D. — Thu, 04Â JunÂ 2009 00:00:00 -05:00

Dr. Anne Griffin (Medicine and Pediatrics): A 24-year-old woman with the acquired immunodeficiency syndrome (AIDS) and pulmonary tuberculosis was admitted to a hospital in South Africa that is affiliated with...

EDITORIAL: When to Start Antiretroviral Therapy â Ready When You Are?

Paul E. Sax, M.D., and Lindsey R. Baden, M.D. — Thu, 30Â AprÂ 2009 00:00:00 -05:00

The optimal time to start antiretroviral therapy in asymptomatic patients has been one of the central controversies in the care of patients with the human immunodeficiency virus (HIV) since the...

ORIGINAL ARTICLE: Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival

Thu, 30Â AprÂ 2009 00:00:00 -05:00

Background: The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain.

Methods: We conducted two parallel analyses involving a total of...

PERSPECTIVE: Rationing Antiretroviral Therapy in Africa â Treating Too Few, Too Late

Thu, 30Â AprÂ 2009 00:00:00 -05:00

The past 6 years have seen striking advances in access to antiretroviral therapy in Africa. From 2002 onward, the international drive to scale up antiretroviral treatment gained considerable momentum, most...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 11-2009 â A 47-Year-Old Man with Fever, Headache, Rash, and Vomiting

Sigall K. Bell, M.D., and Eric S. Rosenberg, M.D. — Thu, 09Â AprÂ 2009 00:00:00 -05:00

Dr. Mary Berlik Rice (Medicine): A 47-year-old man was admitted to the hospital because of fever, headache, rash, and vomiting. The patient had been well until 8 days earlier, when...

BOOK REVIEW:

Thu, 26Â MarÂ 2009 00:00:00 -05:00

The Wisdom of Whores is an engaging account of the author's journey through a wide range of positions on the epidemic of human immunodeficiency virus (HIV) infection and AIDS â...

EDITORIAL: Not an HIV Cure, but Encouraging New Directions

Jay A. Levy, M.D. — Thu, 12Â FebÂ 2009 00:00:00 -05:00

The history of infectious diseases frequently includes people who were resistant to a pathogen. Such a phenomenon helped the Spanish, who had resistance to smallpox, in their conquest of South...

ORIGINAL ARTICLE: Long-Term Control of HIV by Delta32/Delta32 Stem-Cell Transplantation

Thu, 12Â FebÂ 2009 00:00:00 -05:00

Infection with the human immunodeficiency virus type 1 (HIV-1) requires the presence of a CD4 receptor and a chemokine receptor, principally chemokine receptor 5 (CCR5). Homozygosity for a 32-bp deletion...

PERSPECTIVE: Circumcision â A Surgical Strategy for HIV Prevention in Africa

Thu, 04Â DecÂ 2008 00:00:00 -05:00

In a radical departure from earlier strategies, public health officials are now arguing that circumcision of men should be a key weapon in the fight against infection with the human...

ORIGINAL ARTICLE: Early Antiretroviral Therapy and Mortality among HIV-Infected Infants

Thu, 20Â NovÂ 2008 00:00:00 -05:00

Background: In countries with a high seroprevalence of human immunodeficiency virus type 1 (HIV-1), HIV infection contributes significantly to infant mortality. We investigated antiretroviral-treatment strategies in the Children with HIV...

EDITORIAL: A New Class of Anti-HIV Therapy and New Challenges

Raphael Dolin, M.D. — Thu, 02Â OctÂ 2008 00:00:00 -05:00

The development of new drugs against human immunodeficiency virus type 1 (HIV-1) has resulted in combination therapy that can inhibit various steps of viral replication. Maraviroc is an example of...

ORIGINAL ARTICLE: Subgroup Analyses of Maraviroc in Previously Treated R5 HIV-1 Infection

Thu, 02Â OctÂ 2008 00:00:00 -05:00

Background: We conducted subanalyses of the combined results of the Maraviroc versus Optimized Therapy in Viremic Antiretroviral Treatment-Experienced Patients (MOTIVATE) 1 and MOTIVATE 2 studies to better characterize the efficacy...

ORIGINAL ARTICLE: Maraviroc for Previously Treated Patients with R5 HIV-1 Infection

Thu, 02Â OctÂ 2008 00:00:00 -05:00

Background: CC chemokine receptor 5 antagonists are a new class of antiretroviral agents.

Methods: We conducted two double-blind, placebo-controlled, phase 3 studies â Maraviroc versus Optimized Therapy in Viremic Antiretroviral Treatment-Experienced...

BOOK REVIEW:

Thu, 28Â AugÂ 2008 00:00:00 -05:00

This book is an autopsy of errors. Drawing on his 20 years as chief of epidemiology in the division for the prevention of the human immunodeficiency virus (HIV) and the...

PERSPECTIVE: An HIV Vaccine â Challenges and Prospects

Thu, 28Â AugÂ 2008 00:00:00 -05:00

Now well into the third decade of the pandemic of human immunodeficiency virus (HIV) and AIDS, we have seen dramatic successes in the treatment of HIV-infected persons in the United...

PERSPECTIVE: The AIDS Epidemic â A Progress Report from Mexico City

Thu, 28Â AugÂ 2008 00:00:00 -05:00

A quarter-century after the discovery of the human immunodeficiency virus (HIV), the world is finally gaining ground against AIDS. Yet the millions of new infections and deaths each year are...

PERSPECTIVE: The President's Emergency Plan for AIDS Relief â Is the Emergency Over?

Thu, 07Â AugÂ 2008 00:00:00 -05:00

In his 2003 State of the Union Address, President George W. Bush asked Congress to commit $15 billion over the next 5 years for the President's Emergency Plan for AIDS...

ORIGINAL ARTICLE: Lack of Effectiveness of Cellulose Sulfate Gel for the Prevention of Vaginal HIV Transmission

Thu, 31Â JulÂ 2008 00:00:00 -05:00

Background: Women make up more than 50% of adults living with human immunodeficiency virus (HIV) infection or the acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa. Thus, female-initiated HIV prevention methods...

EDITORIAL: HIV Integrase Inhibitors â Out of the Pipeline and into the Clinic

Diane V. Havlir, M.D. — Thu, 24Â JulÂ 2008 00:00:00 -05:00

Human immunodeficiency virus (HIV) infection has been transformed over the past two decades from a fatal to a chronic disease, because of combination antiretroviral therapy â a medical triumph.1 However,...

ORIGINAL ARTICLE: Subgroup and Resistance Analyses of Raltegravir for Resistant HIV-1 Infection

Thu, 24Â JulÂ 2008 00:00:00 -05:00

Background: We evaluated the efficacy of raltegravir and the development of viral resistance in two identical trials involving patients who were infected with human immunodeficiency virus type 1 (HIV-1) with...

ORIGINAL ARTICLE: Raltegravir with Optimized Background Therapy for Resistant HIV-1 Infection

Thu, 24Â JulÂ 2008 00:00:00 -05:00

Background: Raltegravir (MK-0518) is an inhibitor of human immunodeficiency virus type 1 (HIV-1) integrase active against HIV-1 susceptible or resistant to older antiretroviral drugs.

Methods: We conducted two identical trials in...

EDITORIAL: Breast-Feeding, Antiretroviral Prophylaxis, and HIV

Glenda E. Gray, M.B., B.Ch., and Haroon Saloojee, M.B., B.Ch. — Thu, 10Â JulÂ 2008 00:00:00 -05:00

More than 200,000 of the 500,000 new human immunodeficiency virus (HIV) infections that occur each year in children are the result of transmission of the virus through the mother's breast...

ORIGINAL ARTICLE: Effects of Early, Abrupt Weaning on HIV-free Survival of Children in Zambia

Thu, 10Â JulÂ 2008 00:00:00 -05:00

Background: In low-resource settings, many programs recommend that women who are infected with the human immunodeficiency virus (HIV) stop breast-feeding early. We conducted a randomized trial to evaluate whether abrupt...

ORIGINAL ARTICLE: Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission

Thu, 10Â JulÂ 2008 00:00:00 -05:00

Background: Effective strategies are urgently needed to reduce mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) through breast-feeding in resource-limited settings.

Methods: Women with HIV-1 infection who were breast-feeding infants...

SOUNDING BOARD: Informing Candidates for Solid-Organ Transplantation about Donor Risk Factors

Thu, 26Â JunÂ 2008 00:00:00 -05:00

For the first time in 15 years, there has been documented transmission of the human immunodeficiency virus (HIV) through solid-organ transplantation.1 Although transmission of infectious agents through transplantation is rare,2...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 19-2008 â A 63-Year-Old HIV-Positive Man with Cutaneous Merkel-Cell Carcinoma

Thu, 19Â JunÂ 2008 00:00:00 -05:00

Dr. Gregory K. Robbins (Infectious Diseases): A 63-year-old man was referred to the clinic for head and neck cancer, a multidisciplinary unit of this hospital, for management of cutaneous Merkel-cell...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: How HIV Guts the Immune System

R. Paul Johnson, M.D. — Thu, 22Â MayÂ 2008 00:00:00 -05:00

Although in the absence of treatment, the acquired immunodeficiency syndrome (AIDS) generally develops 8 to 10 years after infection with human immunodeficiency virus (HIV) type 1 (HIV-1), the onslaught on...

EDITORIAL: Initial Treatment for HIV Infection â An Embarrassment of Riches

Bernard Hirschel, M.D., and Alexandra Calmy, M.D. — Thu, 15Â MayÂ 2008 00:00:00 -05:00

Drugs that are used to treat patients with human immunodeficiency virus (HIV) infection are classified according to their target. The first ones to be developed were nucleoside reverse-transcriptase inhibitors (NRTIs),...

ORIGINAL ARTICLE: Class-Sparing Regimens for Initial Treatment of HIV-1 Infection

Thu, 15Â MayÂ 2008 00:00:00 -05:00

Background: The use of either efavirenz or lopinavirâritonavir plus two nucleoside reverse-transcriptase inhibitors (NRTIs) is recommended for initial therapy for patients with human immunodeficiency virus type 1 (HIV-1) infection, but...

REVIEW ARTICLE: The Challenge of HIV-1 Subtype Diversity

Thu, 10Â AprÂ 2008 00:00:00 -05:00

Nearly 27 years after the first reported cases of the acquired immunodeficiency syndrome (AIDS) and 25 years after the discovery of the etiologic agent, effective control of the AIDS pandemic...

ORIGINAL ARTICLE: Effect of Herpes Simplex Suppression on Incidence of HIV among Women in Tanzania

Thu, 10Â AprÂ 2008 00:00:00 -05:00

Background: Infection with herpes simplex virus type 2 (HSV-2) is associated with an increased risk of acquiring infection with the human immunodeficiency virus (HIV). This study tested the hypothesis that...

PERSPECTIVE: Challenges to HIV Prevention â Seeking Effective Measures in the Absence of a Vaccine

Thu, 10Â AprÂ 2008 00:00:00 -05:00

In this issue of the Journal, Watson-Jones et al. (pages 1560â1571) report anxiously awaited findings about a strategy for preventing infection with the human immunodeficiency virus (HIV) by pharmacologically suppressing...

IMAGES IN CLINICAL MEDICINE: Crystalluria from Acyclovir Use

William J. Mason, M.D. and Hilary H. Nickols, M.D., Ph.D. — Thu, 27Â MarÂ 2008 00:00:00 -05:00

A 60-year-old man infected with the human immunodeficiency virus (HIV) (CD4 count of 450 per cubic millimeter and HIV viral load of <50 copies per milliliter) who had HIV-associated dementia...

PERSPECTIVE: Tuberculosis in Africa â Combating an HIV-Driven Crisis

Thu, 13Â MarÂ 2008 00:00:00 -05:00

Africa is facing the worst tuberculosis epidemic since the advent of the antibiotic era. Driven by a generalized human immunodeficiency virus (HIV) epidemic and compounded by weak health care systems,...

ORIGINAL ARTICLE: HLA-B*5701 Screening for Hypersensitivity to Abacavir

Thu, 07Â FebÂ 2008 00:00:00 -05:00

Background: Hypersensitivity reaction to abacavir is strongly associated with the presence of the HLA-B*5701 allele. This study was designed to establish the effectiveness of prospective HLA-B*5701 screening to prevent the...

PERSPECTIVE: HIV in India â A Downsized Epidemic

Thu, 10Â JanÂ 2008 00:00:00 -05:00

In 2006, the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimated that 5.7 million people in India were infected with the human immunodeficiency virus...

PERSPECTIVE: One Step Forward, Two Steps Back â Will There Ever Be an AIDS Vaccine?

Thu, 27Â DecÂ 2007 00:00:00 -05:00

In April 1984, when the human immunodeficiency virus (HIV) and AIDS were just beginning to be understood, a senior official in the Department of Health and Human Services stated at...

SOUNDING BOARD: Rapid Expansion of the Health Workforce in Response to the HIV Epidemic

Thu, 13Â DecÂ 2007 00:00:00 -05:00

The World Health Organization (WHO) estimates that there is now a global deficit of more than 4 million trained health workers. The shortages in health workers are critical in 57...

EDITORIAL: Corticosteroids for Acute Bacterial Meningitis

Brian M. Greenwood, M.D. — Thu, 13Â DecÂ 2007 00:00:00 -05:00

Death and long-term disabilities are common outcomes of acute bacterial meningitis, especially in developing countries, even when highly effective antibiotic therapy is given. Therefore, improvement in the outcomes of acute...

ORIGINAL ARTICLE: Corticosteroids for Bacterial Meningitis in Adults in Sub-Saharan Africa

Thu, 13Â DecÂ 2007 00:00:00 -05:00

Background: In sub-Saharan Africa, bacterial meningitis is common and is associated with a high mortality. Adjuvant therapy with corticosteroids reduces mortality among adults in the developed world, but it has...

EDITORIAL: Manipulation of the Growth Hormone Axis in Patients with HIV Infection

Marc R. Blackman, M.D. — Thu, 06Â DecÂ 2007 00:00:00 -05:00

Patients with human immunodeficiency virus (HIV) infection often have a reduced mass of skeletal muscle and bone and a maldistribution of body fat. Loss of muscle mass, strength, and function...

ORIGINAL ARTICLE: Metabolic Effects of a Growth HormoneâReleasing Factor in Patients with HIV

Thu, 06Â DecÂ 2007 00:00:00 -05:00

Background: Visceral adipose tissue accumulates during antiretroviral therapy in many patients who are infected with the human immunodeficiency virus (HIV); this process is associated with an increased cardiovascular risk. We...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 33-2007 â A 49-Year-Old HIV-Positive Man with Anemia

Eyal C. Attar, M.D., Suzanne L. Aquino, M.D., and Robert P. Hasserjian, M.D. — Thu, 25Â OctÂ 2007 00:00:00 -05:00

A 49-year-old man infected with the human immunodeficiency virus (HIV) was seen in the hematology clinic at this hospital for evaluation of anemia.

Five weeks earlier (1 week before a routine...

EDITORIAL: Entecavir Surprise

Martin S. Hirsch, M.D. — Thu, 21Â JunÂ 2007 00:00:00 -05:00

The truly remarkable advances in the treatment of human immunodeficiency virus type 1 (HIV-1) infection have turned a once nearly uniform death sentence into a treatable condition. The survival benefits...

ORIGINAL ARTICLE: The HBV Drug Entecavir â Effects on HIV-1 Replication and Resistance

Thu, 21Â JunÂ 2007 00:00:00 -05:00

Entecavir, a drug approved by the Food and Drug Administration for the treatment of chronic hepatitis B virus (HBV) infection, is not believed to inhibit replication of human immunodeficiency virus...

REVIEW ARTICLE: An HIV Vaccine â Evolving Concepts

Margaret I. Johnston, Ph.D., and Anthony S. Fauci, M.D. — Thu, 17Â MayÂ 2007 00:00:00 -05:00

Classic preventive vaccines are designed to mimic the effects of natural exposure to microbes. They provide a high level of long-lasting protection against infection in the vast majority of recipients...

PERSPECTIVE: China and HIV â A Window of Opportunity

Thu, 03Â MayÂ 2007 00:00:00 -05:00

Last December in Wuhan, China, two middle-aged rural women who had become infected with HIV in the 1990s struggled to describe to foreign visitors how China's new HIV-treatment program had...

EDITORIAL: Cardiovascular Risks of Antiretroviral Therapy

James H. Stein, M.D. — Thu, 26Â AprÂ 2007 00:00:00 -05:00

Treatment with potent antiretroviral therapy has transformed human immunodeficiency virus (HIV) infection from a rapidly fatal disease into a chronic illness that some patients can live with for more than...

ORIGINAL ARTICLE: Class of Antiretroviral Drugs and the Risk of Myocardial Infarction

The DAD Study Group — Thu, 26Â AprÂ 2007 00:00:00 -05:00

Background: We have previously demonstrated an association between combination antiretroviral therapy and the risk of myocardial infarction. It is not clear whether this association differs according to the class of...

REVIEW ARTICLE: Viral Hepatitis in HIV Infection

Margaret James Koziel, M.D., and Marion G. Peters, M.D. — Thu, 05Â AprÂ 2007 00:00:00 -05:00

Hepatitis c virus (hcv) and hepatitis b virus (hbv) infections are common among patients with human immunodeficiency virus (HIV) infection because of shared routes of viral transmission. Liver disease due...

PERSPECTIVE: Tuberculosis and HIV in India

Thu, 22Â MarÂ 2007 00:00:00 -05:00

Tuberculosis is the most common HIV-related opportunistic infection in India, and caring for patients with both diseases is a major public health challenge. India has about 1.8 million new cases...

PERSPECTIVE: HIV in India â The Challenges Ahead

Thu, 22Â MarÂ 2007 00:00:00 -05:00

On April 1, 2007, India will launch a new phase of its National AIDS Control Program (NACP). Its goals include reducing the number of new human immunodeficiency virus (HIV) infections...

PERSPECTIVE: HIV in India â A Complex Epidemic

Thu, 15Â MarÂ 2007 00:00:00 -05:00

Since the human immunodeficiency virus (HIV) was found in Chennai in 1986, India has had an AIDS epidemic.1 In many respects, however, its extent and complexities have only recently begun...

EDITORIAL: Synergistic Copathogens â HIV-1 and HSV-2

Lawrence Corey, M.D. — Thu, 22Â FebÂ 2007 00:00:00 -05:00

The variability in both the clinical progression and transmission of human immunodeficiency virus (HIV) infection has prompted a search for cofactors influencing replication of the virus. Although it is clear...

ORIGINAL ARTICLE: Reduction of HIV-1 RNA Levels with Therapy to Suppress Herpes Simplex Virus

Thu, 22Â FebÂ 2007 00:00:00 -05:00

Background: Epidemiologic data suggest that infection with herpes simplex virus type 2 (HSV-2) is associated with increased genital shedding of human immunodeficiency virus type 1 (HIV-1) RNA and HIV-1 transmissibility.

Methods:...

PERSPECTIVE: Thailand and the Compulsory Licensing of Efavirenz

Thu, 08Â FebÂ 2007 00:00:00 -05:00

Of the many medicines for human immunodeficiency virus (HIV) infection, efavirenz, a nonnucleoside reverse-transcriptase inhibitor that became available in the late 1990s, is one of the most important. For the...

ORIGINAL ARTICLE: Response to Antiretroviral Therapy after a Single, Peripartum Dose of Nevirapine

Thu, 11Â JanÂ 2007 00:00:00 -05:00

Background: A single dose of nevirapine during labor reduces perinatal transmission of human immunodeficiency virus type 1 (HIV-1) but often leads to viral nevirapine resistance mutations in mothers and infants.

Methods:...

PERSPECTIVE: Sex, Drugs, Prisons, and HIV

Thu, 11Â JanÂ 2007 00:00:00 -05:00

One recent morning at a medium-security compound at Rhode Island's state prison, Mr. M, a middle-aged black inmate, described some of the high-risk behavior he has witnessed while serving time....

IMAGES IN CLINICAL MEDICINE: Disseminated Paracoccidioidomycosis and Coinfection with HIV

Gleusa Castro, M.D. and Roberto Martinez, M.D. — Thu, 21Â DecÂ 2006 00:00:00 -05:00

A 32-year-old man infected with the human immunodeficiency virus (HIV) who had a CD4 count of 9 cells per cubic millimeter had a 9-month history of weight loss, with progressive...

PERSPECTIVE: HIV Injustice in Libya â Scapegoating Foreign Medical Professionals

Thu, 14Â DecÂ 2006 00:00:00 -05:00

On December 19, 2006, a Libyan court is scheduled to announce its verdict in the trial of five Bulgarian nurses and one Palestinian doctor who have languished in prison for...

EDITORIAL: Getting Smarter â The Toxicity of Undertreated HIV Infection

Judith S. Currier, M.D., and Lindsey R. Baden, M.D. — Thu, 30Â NovÂ 2006 00:00:00 -05:00

Soon after the benefits of potent combination antiretroviral therapy were recognized in the late 1990s,1 clinicians understood that patients would need to be highly adherent to antiretroviral therapy and treated...

ORIGINAL ARTICLE: CD4+ CountâGuided Interruption of Antiretroviral Treatment

The Strategies for Management of Antiretroviral Therapy (SMART) Study Group — Thu, 30Â NovÂ 2006 00:00:00 -05:00

Background: Despite declines in morbidity and mortality with the use of combination antiretroviral therapy, its effectiveness is limited by adverse events, problems with adherence, and resistance of the human immunodeficiency...

PERSPECTIVE: HIVâAIDS in Tanzania â Realities on the Ground

Thu, 30Â NovÂ 2006 00:00:00 -05:00

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PERSPECTIVE: Pioneers in AIDS Care â Reflections on the Epidemic's Early Years

Thu, 30Â NovÂ 2006 00:00:00 -05:00

In 1995, Constance Wofsy, who had been a leader in San Francisco's response to AIDS in the 1980s, recalled the way she and other physicians had been drawn to the...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Key Role for a Viral Lytic Gene in Kaposi's Sarcoma

Robert Yarchoan, M.D. — Thu, 28Â SepÂ 2006 00:00:00 -05:00

Several types of cancer, including the majority of those typically associated with AIDS, are caused by gammaherpesviruses. Herpesviruses undergo both latent and lytic infection; most research on herpesvirus-induced tumors has...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2006 â A 41-Year-Old Man with Dyspnea, Fever, and Lymphadenopathy

David T. Scadden, M.D., Victorine V. Muse, M.D., and Robert P. Hasserjian, M.D. — Thu, 28Â SepÂ 2006 00:00:00 -05:00

A 41-year-old man was admitted to the hospital because of shortness of breath and fever. He had been well until 7 months earlier, when a rash and wheezing developed after...

SPECIAL ARTICLE: Cost-Effectiveness of HIV Treatment in Resource-Poor Settings â The Case of CÃ´te d'Ivoire

Thu, 14Â SepÂ 2006 00:00:00 -05:00

Background: As antiretroviral therapy is increasingly used in settings with limited resources, key questions about the timing of treatment and use of diagnostic tests to guide clinical decisions must be...

PERSPECTIVE: Global Health â The GatesâBuffett Effect

Thu, 14Â SepÂ 2006 00:00:00 -05:00

Standing before a giant AIDS ribbon, Bill and Melinda Gates greeted some 26,000 researchers and public health workers on the opening night of last month's conference hosted by the International...

PERSPECTIVE: Message from Toronto â Deliver AIDS Treatment and Prevention

Thu, 14Â SepÂ 2006 00:00:00 -05:00

The clear message from the XVI International AIDS Conference in Toronto in August was that the growth of the pandemic continues to outpace the broad and expanding efforts to control...

PERSPECTIVE: Changing the Paradigm for HIV Testing â The End of Exceptionalism

Thu, 17Â AugÂ 2006 00:00:00 -05:00

The Centers for Disease Control and Prevention (CDC) is poised to issue new recommendations for testing for HIV in adults, adolescents, and pregnant women. Frustrated that more than 25 percent...

PERSPECTIVE: AIDS in 2006 â Moving toward One World, One Hope?

Thu, 17Â AugÂ 2006 00:00:00 -05:00

For the past two decades, AIDS experts â clinicians, epidemiologists, policymakers, activists, and scientists â have gathered every two years to confer about what is now the world's leading infectious...

REVIEW ARTICLE: Intensive Care of Patients with HIV Infection

Thu, 13Â JulÂ 2006 00:00:00 -05:00

Antiretroviral therapy has increased the life expectancy of patients who are infected with the human immunodeficiency virus (HIV) and has reduced the incidence of illnesses associated with the acquired immunodeficiency...

PERSPECTIVE: Condoms and Sexually-Transmitted Infections

Thu, 22Â JunÂ 2006 00:00:00 -05:00

Polarization of opinion about condoms may finally be starting to abate, as scientific evidence mounts that their use can reduce the risk of most sexually transmitted infections, including human immunodeficiency...

PERSPECTIVE: The HIVâAIDS Pandemic at 25 â The Global Response

Thu, 08Â JunÂ 2006 00:00:00 -05:00

On June 5, 1981, when the Centers for Disease Control reported five cases of Pneumocystis carinii pneumonia in young homosexual men in Los Angeles,1 few suspected it heralded a pandemic...

PERSPECTIVE: One Disease, Two Epidemics â AIDS at 25

Thu, 08Â JunÂ 2006 00:00:00 -05:00

Twenty-five years have passed since the first cases of AIDS were recognized. During the first two decades, the epidemiology and clinical presentation of the disease were established, and potent antiviral...

CLINICAL PROBLEM-SOLVING: Thinking outside the Box

Ramin Farzaneh-Far, M.D., Talya Schwarzberg, M.D., and Stuart B. Mushlin, M.D. — Thu, 01Â JunÂ 2006 00:00:00 -05:00

A 35-year-old man with advanced acquired immunodefiency syndrome (AIDS) presented to the emergency department after a witnessed syncopal event. He had noted light-headedness after walking from the bathroom to his...

PERSPECTIVE: Fighting HIV â Lessons from Brazil

Thu, 11Â MayÂ 2006 00:00:00 -05:00

In Brazil this past February, during the week before Carnaval, the pre-Lenten bacchanal of parades and street parties, citizens who ventured out to catch a bus, buy a beer, or...

IMAGES IN CLINICAL MEDICINE: Scrofula

Sakib K. Khalid, M.D. and Omar Jassim, M.D. — Thu, 04Â MayÂ 2006 00:00:00 -05:00

A 39-year-old Zambian man who was visiting the United States presented with a three-week history of a draining neck mass and a three-month history of swelling on the left side...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 6-2006 â A 71-Year-Old Woman with Urinary Incontinence and a Mass in the Bladder

Thu, 23Â FebÂ 2006 00:00:00 -05:00

Dr. Donald S. Kaufman: A 71-year-old woman was referred to this hospital for a second opinion on the management of a malignant tumor of the urinary bladder. Urinary incontinence had...

PERSPECTIVE: Unfinished Business â Expanding HIV Testing in Developing Countries

Thu, 02Â FebÂ 2006 00:00:00 -05:00

When the Group of Eight (G8) major industrial countries (France, the United States, Britain, Germany, Japan, Italy, Canada, and Russia) made a commitment in July 2005 to work toward universal...

PERSPECTIVE: Home Testing for HIV

Thu, 02Â FebÂ 2006 00:00:00 -05:00

The Food and Drug Administration (FDA) has been struggling for nearly two decades over the possible approval of a do-it-yourself home test for human immunodeficiency virus (HIV). Now, after years...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 2-2006 â A 31-Year-Old, HIV-Positive Man with Rectal Pain

Benjamin T. Davis, M.D., Michael Thiim, M.D., and Lawrence R. Zukerberg, M.D. — Thu, 19Â JanÂ 2006 00:00:00 -05:00

A 31-year-old man with the acquired immunodeficiency syndrome (AIDS) was evaluated at the infectious disease clinic of this hospital because of rectal pain and a mucopurulent rectal discharge.

Four days before...

ORIGINAL ARTICLE: Tenofovir DF, Emtricitabine, and Efavirenz vs. Zidovudine, Lamivudine, and Efavirenz for HIV

Thu, 19Â JanÂ 2006 00:00:00 -05:00

Background: Durable suppression of replication of the human immunodeficiency virus (HIV) depends on the use of potent, well-tolerated antiretroviral regimens to which patients can easily adhere.

Methods: We conducted an open-label,...

SOUNDING BOARD: Applying Public Health Principles to the HIV Epidemic

Thu, 01Â DecÂ 2005 00:00:00 -05:00

Although human immunodeficiency virus (HIV) infection has killed more than half a million people in the United States, a comprehensive public health approach that has stopped other epidemics has not...

EDITORIAL: Scaling Up Treatment â Why We Can't Wait

Jim Yong Kim, M.D., Ph.D., and Charlie Gilks, D.Phil., F.R.C.P. — Thu, 01Â DecÂ 2005 00:00:00 -05:00

Many arguments have been raised over the years to justify not moving rapidly forward with antiretroviral treatment programs for people living with the human immunodeficiency virus (HIV) and AIDS in...

ORIGINAL ARTICLE: Antiretroviral Therapy in a Thousand Patients with AIDS in Haiti

Thu, 01Â DecÂ 2005 00:00:00 -05:00

Background: The one-year survival rate of adults and children with the acquired immunodeficiency syndrome (AIDS), without antiretroviral therapy, has been about 30 percent in Haiti. Antiretroviral therapy has recently become...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2005 â A 34-Year-Old HIV-Positive Woman Who Desired to Become Pregnant

Laura E. Riley, M.D., and Sigal Yawetz, M.D. — Thu, 20Â OctÂ 2005 00:00:00 -05:00

A 34-year-old woman who was infected with the human immunodeficiency virus (HIV) was evaluated in the infectious-disease and obstetrics outpatient divisions because of a desire to become pregnant.

HIV infection had...

CLINICAL PRACTICE: Management of Newly Diagnosed HIV Infection

Scott M. Hammer, M.D. — Thu, 20Â OctÂ 2005 00:00:00 -05:00

As part of a routine examination for insurance coverage, a 25-year-old previously healthy woman is found to have a positive test for human immunodeficiency virus type 1 (HIV-1) antibody. Heterosexual...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Targeting Specific Cell Types with Silencing RNA

Bryan R. Williams, Ph.D. — Thu, 29Â SepÂ 2005 00:00:00 -05:00

RNA interference, which is mediated by small, double-stranded fragments of RNA called short interfering RNA (siRNA), is now a popular method to silence the expression of specific genes. It exploits...

PERSPECTIVE: Occupational Hazards

Ted Louie, M.D. — Thu, 25Â AugÂ 2005 00:00:00 -05:00

It was a gray Sunday in late February 1993, no longer cold enough for skiing or ice-skating but still chilly and windy enough to be oppressive. As a senior medical...

PERSPECTIVE: The Search for Effective HIV Vaccines

Howard Markel, M.D., Ph.D. — Thu, 25Â AugÂ 2005 00:00:00 -05:00

In February 2003, after more than a decade of work, a team of scientists representing the biotechnology company VaxGen announced the results of the first phase 3 trial to test...

PERSPECTIVE: Curing Stigma â The Limits of Antiretroviral Access

Oni Blackstock, M.D. — Thu, 25Â AugÂ 2005 00:00:00 -05:00

Once physically incapacitated by their disease, many people with human immunodeficiency virus (HIV) infection or AIDS have found new life, thanks to the increasing availability of antiretroviral drugs. But for...

PERSPECTIVE: Patents versus Patients? Antiretroviral Therapy in India

Diane V. Havlir, M.D., and Scott M. Hammer, M.D. — Thu, 25Â AugÂ 2005 00:00:00 -05:00

Legislation passed by the government of India rarely draws international attention, let alone global outrage. But in December 2004, to comply with the requirement of the World Trade Organization (which...

ORIGINAL ARTICLE: Detection of Acute Infections during HIV Testing in North Carolina

Thu, 05Â MayÂ 2005 00:00:00 -05:00

Background: North Carolina has added nucleic acid amplification testing for the human immunodeficiency virus (HIV) to standard HIV antibody tests to detect persons with acute HIV infection who are viremic...

PERSPECTIVE: Generic HIV Drugs â Enlightened Policy for Global Health

Mark A. Wainberg, Ph.D. — Thu, 24Â FebÂ 2005 00:00:00 -05:00

The 2000 International AIDS Conference in Durban, South Africa, focused the world's attention on disparities between rich and poor countries with respect to access to antiretroviral drugs. At that time,...

IMAGES IN CLINICAL MEDICINE: Tinea Circinata

Kimberly A. Rovansek, M.D. and Anthony Papadopolous, M.D. — Thu, 17Â FebÂ 2005 00:00:00 -05:00

A 46-year-old woman with a history of infection with the human immunodeficiency virus (HIV) presented to the emergency department for evaluation of a painful rash. The CD4 cell count was...

IMAGES IN CLINICAL MEDICINE: Condylomata Lata of Secondary Syphilis

Josip Begovac, M.D., Ph.D. and Davorka Lukas, M.D., Ph.D. — Thu, 17Â FebÂ 2005 00:00:00 -05:00

A 34-year old bisexual man with newly diagnosed human immunodeficiency virus type 1 (HIV-1) infection presented with a one-month history of anal and oral lesions. He recalled having had a...

PERSPECTIVE: Women, Inequality, and the Burden of HIV

Bisola O. Ojikutu, M.D., M.P.H., and Valerie E. Stone, M.D., M.P.H. — Thu, 17Â FebÂ 2005 00:00:00 -05:00

Driving through KwaZulu-Natal, South Africa, one is struck by the lush farmland and beautiful coast. Beyond this panorama, however, lie rural communities such as Umbumbulu, with its unemployment rate of...

EDITORIAL: Routine Screening for HIV Infection â Timely and Cost-Effective

Samuel A. Bozzette, M.D., Ph.D. — Thu, 10Â FebÂ 2005 00:00:00 -05:00

In the United States, HIV infection is generally discovered at an advanced stage, usually in the course of medical care and often during care for complications of AIDS. Earlier diagnosis...

SPECIAL ARTICLE: Expanded Screening for HIV in the United States â An Analysis of Cost-Effectiveness

Thu, 10Â FebÂ 2005 00:00:00 -05:00

Background: Although the Centers for Disease Control and Prevention (CDC) recommend routine HIV counseling, testing, and referral (HIVCTR) in settings with at least a 1 percent prevalence of HIV, roughly...

SPECIAL ARTICLE: Cost-Effectiveness of Screening for HIV in the Era of Highly Active Antiretroviral Therapy

Thu, 10Â FebÂ 2005 00:00:00 -05:00

Background: The costs, benefits, and cost-effectiveness of screening for human immunodeficiency virus (HIV) in health care settings during the era of highly active antiretroviral therapy (HAART) have not been determined.

Methods:...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Topical Microbicides Become Topical

John P. Moore, Ph.D. — Thu, 20Â JanÂ 2005 00:00:00 -05:00

Developing a preventive human immunodeficiency virus type 1 (HIV-1) vaccine that decisively reduces the rate of spread of the AIDS pandemic will take many years, at best. In the meantime,...

IMAGES IN CLINICAL MEDICINE: Lipodystrophy Induced by Antiretroviral Therapy

Stephen M. Warren, M.D. and James W. May, Jr., M.D. — Thu, 06Â JanÂ 2005 00:00:00 -05:00

A 51-year-old man who was positive for the human immunodeficiency virus (HIV) and had been treated with a conventional protease-inhibitorâbased antiretroviral regimen for four years had wasting of the fat...

REVIEW ARTICLE: Cardiovascular Risk and Body-Fat Abnormalities in HIV-Infected Adults

Steven Grinspoon, M.D., and Andrew Carr, M.D. — Thu, 06Â JanÂ 2005 00:00:00 -05:00

Metabolic complications, including dyslipidemia, insulin resistance, and altered fat distribution (loss of subcutaneous fat and a relative increase in central fat), are common in adults infected with the human immunodeficiency...

ORIGINAL ARTICLE: Detection of HIV-1 and HCV Infections among Antibody-Negative Blood Donors by Nucleic AcidâAmplification Testing

Thu, 19Â AugÂ 2004 00:00:00 -05:00

Background: Testing of blood donors for human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) RNA by means of nucleic acid amplification was introduced in the United States...

ORIGINAL ARTICLE: Probability of Viremia with HBV, HCV, HIV, and HTLV among Tissue Donors in the United States

Thu, 19Â AugÂ 2004 00:00:00 -05:00

Background: Tissue-banking organizations in the United States have introduced various review and testing procedures to reduce the risk of the transmission of viral infections from tissue grafts. We estimated the...

PERSPECTIVE: Viral Entry Denied

Robert W. Doms, M.D., Ph.D. — Thu, 19Â AugÂ 2004 00:00:00 -05:00

Until recently, antiviral drugs were both uncommon and not terribly potent. This has changed: during the past decade, more than 30 antiviral drugs have been licensed, and many of them...

PERSPECTIVE: Antiretroviral Medications â From Thailand to Africa

Robert Steinbrook, M.D. — Thu, 19Â AugÂ 2004 00:00:00 -05:00

The international AIDS conference highlighted the substantial progress that Thailand has made in reducing the frequency of mother-to-child transmission of HIV and providing antiretroviral treatment. Now, Krisana Kraisintu, the Thai...

PERSPECTIVE: After Bangkok â Expanding the Global Response to AIDS

Robert Steinbrook, M.D. — Thu, 19Â AugÂ 2004 00:00:00 -05:00

The progress that has been made in the global response to AIDS is real â but inadequate. An estimated 1 million people throughout the world are now using antiretroviral medications...

ORIGINAL ARTICLE: Peginterferon Alfa-2a plus Ribavirin versus Interferon Alfa-2a plus Ribavirin for Chronic Hepatitis C in HIV-Coinfected Persons

Thu, 29Â JulÂ 2004 00:00:00 -05:00

Background: Chronic hepatitis C virus (HCV) infection is a cause of major complications in persons who are also infected with the human immunodeficiency virus (HIV). However, the treatment of HCV...

ORIGINAL ARTICLE: Peginterferon Alfa-2a plus Ribavirin for Chronic Hepatitis C Virus Infection in HIV-Infected Patients

Thu, 29Â JulÂ 2004 00:00:00 -05:00

Background: Hepatitis C virus (HCV) infection is highly prevalent and is associated with substantial morbidity and mortality among persons infected with the human immunodeficiency virus (HIV). We compared the efficacy...

PERSPECTIVE: Treating Hepatitis C in âDifficult-to-Treatâ Patients

Jean-Michel Pawlotsky, M.D., Ph.D. — Thu, 29Â JulÂ 2004 00:00:00 -05:00

The current standard treatment for chronic hepatitis C is the combination of pegylated interferon alfa and ribavirin, a synthetic guanosine analogue. In the pegylated form of interferon, the interferon alfa...

EDITORIAL: Antiretroviral Agents â How Best to Protect Infants from HIV and Save Their Mothers from AIDS

Hoosen Coovadia, M.D. — Thu, 15Â JulÂ 2004 00:00:00 -05:00

Preventing transmission of human immunodeficiency virus type 1 (HIV-1) and caring for those already infected are essential services in any comprehensive program, and enhancing the mutually beneficial effect of each...

ORIGINAL ARTICLE: Intrapartum Exposure to Nevirapine and Subsequent Maternal Responses to Nevirapine-Based Antiretroviral Therapy

Thu, 15Â JulÂ 2004 00:00:00 -05:00

Background: A single intrapartum dose of nevirapine for the prevention of mother-to-child transmission of human immunodeficiency virus (HIV) leads to the selection of resistance mutations. Whether there are clinically significant...

ORIGINAL ARTICLE: Single-Dose Perinatal Nevirapine plus Standard Zidovudine to Prevent Mother-to-Child Transmission of HIV-1 in Thailand

Thu, 15Â JulÂ 2004 00:00:00 -05:00

Background: Although zidovudine prophylaxis decreases the rate of transmission of the human immunodeficiency virus (HIV) type 1 substantially, a large number of infants still become infected. We hypothesized that the...

PERSPECTIVE: HIV and AIDS in the Former Soviet Bloc

Mark G. Field, Ph.D. — Thu, 08Â JulÂ 2004 00:00:00 -05:00

As compared with most nations affected by the human immunodeficiency virus (HIV) and AIDS, the countries of the former Soviet Bloc encountered the disease rather late. The first public announcement...

PERSPECTIVE: The AIDS Epidemic in 2004

Robert Steinbrook, M.D. — Thu, 08Â JulÂ 2004 00:00:00 -05:00

As the AIDS pandemic enters its 24th year, the number of people living with human immunodeficiency virus (HIV) infection continues to increase steadily (see Figure).1 Two thirds of infected persons...

HEALTH POLICY REPORT: Health Care Reform and the Crisis of HIV and AIDS in South Africa

Solomon R. Benatar, M.B., Ch.B. — Thu, 01Â JulÂ 2004 00:00:00 -05:00

South Africa's transition to a democracy â characterized by a liberal constitution, a bill of rights, and attempts to pursue reconciliation rather than revenge â has been widely admired as...

EDITORIAL: Multivitamins, Nutrition, and Antiretroviral Therapy for HIV Disease in Africa

Barbara Marston, M.D., and Kevin M. De Cock, M.D. — Thu, 01Â JulÂ 2004 00:00:00 -05:00

Readers could be forgiven for being confused by the literature on micronutrients and the pathogenesis of human immunodeficiency virus (HIV) disease. Micronutrients play important roles in maintaining immune function and...

ORIGINAL ARTICLE: A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality

Thu, 01Â JulÂ 2004 00:00:00 -05:00

Background: Results from observational studies suggest that micronutrient status is a determinant of the progression of human immunodeficiency virus (HIV) disease.

Methods: We enrolled 1078 pregnant women infected with HIV in...

PERSPECTIVE: Journal Clubs â Science as Conversation

Joe Wright, B.A. — Thu, 01Â JulÂ 2004 00:00:00 -05:00

I had forgotten about it amidst the other tasks of medical-student life: exams, patient write-ups, the shirt I needed to iron. But an e-mail from my fellow student John reminded...

REVIEW ARTICLE: Pneumocystis Pneumonia

Charles F. Thomas, Jr., M.D., and Andrew H. Limper, M.D. — Thu, 10Â JunÂ 2004 00:00:00 -05:00

Pneumocystis pneumonia remains the most prevalent opportunistic infection in patients infected with the human immunodeficiency virus (HIV).12 First identified as a protozoan nearly 100 years ago and reclassified as a...

ORIGINAL ARTICLE: A Trial of Three Antiretroviral Regimens in HIV-1âInfected Children

Thu, 10Â JunÂ 2004 00:00:00 -05:00

Background: Depletion of CD4 T-cell counts or progression of human immunodeficiency virus (HIV) disease occurs rapidly in children, but few data address the efficacy of aggressive therapy for HIV-infected children.

Methods:...

REVIEW ARTICLE: Where Does HIV Live?

Thu, 29Â AprÂ 2004 00:00:00 -05:00

The worldwide dissemination of human immunodeficiency virus (HIV) over the past four decades is one of the most catastrophic examples of the emergence, transmission, and propagation of a microbial genome.1...

ORIGINAL ARTICLE: Triple-Nucleoside Regimens versus Efavirenz-Containing Regimens for the Initial Treatment of HIV-1 Infection

Thu, 29Â AprÂ 2004 00:00:00 -05:00

Background: Regimens containing three nucleoside reverse-transcriptase inhibitors offer an alternative to regimens containing nonnucleoside reverse-transcriptase inhibitors or protease inhibitors for the initial treatment of human immunodeficiency virus type 1 (HIV-1)...

REVIEW ARTICLE: Acquired and Inherited Lipodystrophies

Abhimanyu Garg, M.D. — Thu, 18Â MarÂ 2004 00:00:00 -05:00

Lipodystrophies are clinically heterogeneous acquired or inherited disorders characterized by the selective loss of adipose tissue. Affected patients are predisposed to insulin resistance and its attendant complications, including diabetes mellitus,...

IMAGES IN CLINICAL MEDICINE: Nodular Colitis

Faheem Younus, M.D. and Roy T. Steigbigel, M.D. — Thu, 04Â MarÂ 2004 00:00:00 -05:00

A 29-year-old man infected with the human immunodeficiency virus (HIV) presented with right-sided abdominal pain and diarrhea. His CD4 cell count was 24 per cubic millimeter, and his HIV viral...

ORIGINAL ARTICLE: Persistent GB Virus C Infection and Survival in HIV-Infected Men

Thu, 04Â MarÂ 2004 00:00:00 -05:00

Background: GB virus C (GBV-C), which is not known to be pathogenic in humans, replicates in lymphocytes, inhibits the replication of human immunodeficiency virus (HIV) in vitro, and has been...

PERSPECTIVE: Questions for an Epidemic

Rafael Campo, M.D. — Thu, 04Â MarÂ 2004 00:00:00 -05:00

It is a perverse reaction, but one that I notice myself having more and more frequently these days. After all, it should not still be happening, not here in America,...

PERSPECTIVE: HIV and GB Virus C â Can Two Viruses Be Better Than One?

Roger J. Pomerantz, M.D., and Giuseppe Nunnari, M.D. — Thu, 04Â MarÂ 2004 00:00:00 -05:00

GB virus C (GBV-C), an RNA virus in the Flaviviridae family, is a close relative of the hepatitis C virus. Although it has been shown that many people worldwide are...

REVIEW ARTICLE: HIV Drug Resistance

FranÃ§ois Clavel, M.D., and Allan J. Hance, M.D. — Thu, 04Â MarÂ 2004 00:00:00 -05:00

The use of combinations of antiretroviral drugs has proven remarkably effective in controlling the progression of human immunodeficiency virus (HIV) disease and prolonging survival,1 but these benefits can be compromised...

EDITORIAL: HIV Therapy â What Do We Know, and When Do We Know It?

Paul R. Skolnik, M.D. — Thu, 11Â DecÂ 2003 00:00:00 -05:00

It has often been stated that the central questions in therapy for human immunodeficiency virus (HIV) infection are the same now as they were when the epidemic started. When do...

IMAGES IN CLINICAL MEDICINE: Cecal Kaposi's Sarcoma

Tamer Atassi, M.D. and Elizabeth Montgomery, M.D. — Thu, 11Â DecÂ 2003 00:00:00 -05:00

A 35-year-old man with human immunodeficiency virus infection was admitted because of weight loss, fatigue, anorexia, and chronic, watery, nonbloody diarrhea. The workup for diarrhea revealed steatorrhea (110 g of...

ORIGINAL ARTICLE: Comparison of Four-Drug Regimens and Pairs of Sequential Three-Drug Regimens as Initial Therapy for HIV-1 Infection

Thu, 11Â DecÂ 2003 00:00:00 -05:00

Background: It is unclear whether therapy for human immunodeficiency virus type 1 (HIV-1) should be initiated with a four-drug or two sequential three-drug regimens.

Methods: In this multicenter trial we compared...

ORIGINAL ARTICLE: Comparison of Sequential Three-Drug Regimens as Initial Therapy for HIV-1 Infection

Thu, 11Â DecÂ 2003 00:00:00 -05:00

Background: The optimal sequencing of antiretroviral regimens for the treatment of infection with human immunodeficiency virus type 1 (HIV-1) is unknown. We compared several different antiretroviral treatment strategies.

Methods: 03121130.xml This...

PERSPECTIVE: The Discovery of HIV as the Cause of AIDS

Robert C. Gallo, M.D., and Luc Montagnier, M.D. — Thu, 11Â DecÂ 2003 00:00:00 -05:00

Progress in scientific research rarely follows a straight path. Generally, it entails many unexpected meanderings, with a mix of good and bad ideas, good and bad luck. The discovery of...

EDITORIAL: HIV Infection and Cardiovascular Disease â Is There Really a Link?

Peter Sklar, M.D., M.P.H., and Henry Masur, M.D. — Thu, 20Â NovÂ 2003 00:00:00 -05:00

Soon after the introduction of protease inhibitors and nonnucleoside reverse-transcriptase inhibitors for the management of human immunodeficiency virus (HIV) infection, clinicians observed unexpected cardiovascular events among patients receiving these new,...

ORIGINAL ARTICLE: Combination Antiretroviral Therapy and the Risk of Myocardial Infarction

The Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study Group — Thu, 20Â NovÂ 2003 00:00:00 -05:00

Background: It remains controversial whether exposure to combination antiretroviral treatment increases the risk of myocardial infarction.

Methods: In this prospective observational study, we enrolled 23,468 patients from 11 previously established cohorts...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 31-2003 â A 44-Year-Old Man with HIV Infection and a Right Atrial Mass

Thu, 02Â OctÂ 2003 00:00:00 -05:00

A 44-year-old man was seen in the clinic because of a right atrial mass.

Six years earlier, the patient had been found to have Pneumocystis carinii pneumonia and human immunodeficiency virus...

ORIGINAL ARTICLE: A Trial of a 9-Valent Pneumococcal Conjugate Vaccine in Children with and Those without HIV Infection

Thu, 02Â OctÂ 2003 00:00:00 -05:00

Background: Acute respiratory tract infections caused by Streptococcus pneumoniae are a leading cause of morbidity and mortality in young children. We evaluated the efficacy of a 9-valent pneumococcal conjugate vaccine...

ORIGINAL ARTICLE: Substitution of Nevirapine, Efavirenz, or Abacavir for Protease Inhibitors in Patients with Human Immunodeficiency Virus Infection

Thu, 11Â SepÂ 2003 00:00:00 -05:00

Background: We assessed the strategy of substituting nevirapine, efavirenz, or abacavir for a protease inhibitor in patients infected with human immunodeficiency virus type 1 (HIV-1) in whom virologic suppression had...

ORIGINAL ARTICLE: Structured Treatment Interruption in Patients with Multidrug-Resistant Human Immunodeficiency Virus

Thu, 28Â AugÂ 2003 00:00:00 -05:00

Background: We compared two strategies for treating patients infected with multidrug-resistant human immunodeficiency virus (HIV).

Methods: Patients with multidrug-resistant HIV and HIV RNA levels of more than 5000 copies per milliliter...

PERSPECTIVE: Beware of Drug Holidays before HIV Salvage Therapy

Bernard Hirschel, M.D. — Thu, 28Â AugÂ 2003 00:00:00 -05:00

Not unlike its human host, the human immunodeficiency virus (HIV) is often unfaithful while reproducing. Copies made are not completely true to the original; a mistake occurs about once every...

ORIGINAL ARTICLE: Successful Cardiac Transplantation in an HIV-1âInfected Patient with Advanced Disease

Thu, 05Â JunÂ 2003 00:00:00 -05:00

Advances in the management of human immunodeficiency virus (HIV) infection â specifically, the introduction of highly active antiretroviral therapy â have dramatically delayed the progression of disease, enhanced immunologic function,...

PERSPECTIVE: Responding to Organ Failure in HIV-Infected Patients

Michelle E. Roland, M.D., and Diane V. Havlir, M.D. — Thu, 05Â JunÂ 2003 00:00:00 -05:00

Until recently, patients infected with the human immunodeficiency virus (HIV) who had organ failure were not routinely evaluated for transplantation. The poor prognosis for persons with the acquired immunodeficiency syndrome...

EDITORIAL: Fusion Inhibition â A Major but Costly Step Forward in the Treatment of HIV-1

Karen T. Tashima, M.D., and Charles C.J. Carpenter, M.D. — Thu, 29Â MayÂ 2003 00:00:00 -05:00

Two studies reported in this issue of the Journal12 provide heartening news of the success of a new antiretroviral drug in decreasing plasma human immunodeficiency virus (HIV) RNA levels in...

REVIEW ARTICLE: Novel Therapies Based on Mechanisms of HIV-1 Cell Entry

J. Michael Kilby, M.D., and Joseph J. Eron, M.D. — Thu, 29Â MayÂ 2003 00:00:00 -05:00

Infection with human immunodeficiency virus type 1 (HIV-1), the retrovirus that causes the acquired immunodeficiency syndrome (AIDS), is one of the leading causes of death worldwide. 03052933.xml All currently available...

ORIGINAL ARTICLE: Efficacy of Enfuvirtide in Patients Infected with Drug-Resistant HIV-1 in Europe and Australia

Thu, 29Â MayÂ 2003 00:00:00 -05:00

Background: The T-20 vs. Optimized Regimen Only Study 2 (TORO 2) compared the efficacy and safety of 24 weeks of treatment with the fusion inhibitor enfuvirtide in combination with an...

ORIGINAL ARTICLE: Enfuvirtide, an HIV-1 Fusion Inhibitor, for Drug-Resistant HIV Infection in North and South America

Thu, 29Â MayÂ 2003 00:00:00 -05:00

Background: The T-20 vs. Optimized Regimen Only Study 1 (TORO 1) was a randomized, open-label, phase 3 study of enfuvirtide (T-20), a human immunodeficiency virus type 1 (HIV-1) fusion inhibitor.

Methods:...

PERSPECTIVE: HIV Infection â A New Drug and New Costs

Robert Steinbrook, M.D. — Thu, 29Â MayÂ 2003 00:00:00 -05:00

Although combination antiretroviral therapy has dramatically improved the lives of patients with human immunodeficiency virus (HIV) infection, viral strains that are resistant to multiple medications are a serious problem. Enfuvirtide,...

SOUNDING BOARD: Antiretroviral Therapy Where Resources Are Limited

Thu, 01Â MayÂ 2003 00:00:00 -05:00

In the State of the Union address of January 2003, President George W. Bush announced an unprecedented five-year, $15 billion Emergency Plan for AIDS Relief1 to provide highly active antiretroviral...

SOUNDING BOARD: Curbing the Global AIDS Epidemic

Helene D. Gayle, M.D., M.P.H. — Thu, 01Â MayÂ 2003 00:00:00 -05:00

President George W. Bush's recent pledge of $15 billion to fight human immunodeficiency virus (HIV) infection and AIDS is another welcome sign of the increased priority placed on the global...

SOUNDING BOARD: Turning the Tide on the AIDS Pandemic

President William J. Clinton — Thu, 01Â MayÂ 2003 00:00:00 -05:00

Human immunodeficiency virus (HIV) infection and AIDS affect 42 million people worldwide. If the current projections are correct, 100 million more people will contract the disease by the end of...

CLINICAL PRACTICE: Occupational Exposure to HIV in Health Care Settings

Julie Louise Gerberding, M.D., M.P.H. — Thu, 27Â FebÂ 2003 00:00:00 -05:00

While obtaining a peripheral venous blood sample from a patient with the acquired immunodeficiency syndrome (AIDS), a 35-year-old phlebotomist is injured by a bloody 18-gauge needle attached to a syringe....

LEGAL ISSUES IN MEDICINE: The Right to Health and the Nevirapine Case in South Africa

George J. Annas, J.D., M.P.H. — Thu, 20Â FebÂ 2003 00:00:00 -05:00

Thanks to activists in South Africa, the right to health as a human right has returned to the international stage, just as it was being displaced by economists who see...

ORIGINAL ARTICLE: Cardiovascular and Cerebrovascular Events in Patients Treated for Human Immunodeficiency Virus Infection

Thu, 20Â FebÂ 2003 00:00:00 -05:00

Background: Metabolic abnormalities associated with human immunodeficiency virus (HIV) infection, including dysglycemia and hyperlipidemia, are increasingly prevalent, and there is concern about the possibility of an association with accelerated cardiovascular...

PERSPECTIVE: Cardiovascular Risk Factors and Antiretroviral Therapy

Daniel R. Kuritzkes, M.D., and Judith Currier, M.D. — Thu, 20Â FebÂ 2003 00:00:00 -05:00

The advent of potent combination antiretroviral therapy has led to a profound decrease in the rate of illness related to the acquired immunodeficiency syndrome (AIDS) and has significantly improved survival...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: In Search of a Better HIV Vaccine â The Heat Is On

Elizabeth G. Phimister, Ph.D. — Thu, 13Â FebÂ 2003 00:00:00 -05:00

Human immunodeficiency virus type 1 (HIV-1) is notorious for its ability to evade the immune system. A recent study by Kwong and colleagues1 has uncovered a new molecular mechanism of...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: RNA Interference â A New Weapon against HIV and Beyond

Thu, 24Â OctÂ 2002 00:00:00 -05:00

The finding that infections with drug-resistant human immunodeficiency virus (HIV) are increasing in North America1 underscores the need to develop inhibitors of HIV molecules other than reverse transcriptase and protease....

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Defying Death â HIV Mutation to Evade Cytotoxic T Lymphocytes

Thu, 10Â OctÂ 2002 00:00:00 -05:00

Cytotoxic T lymphocytes control viral infections by lysing infected cells and secreting soluble factors (cytokines) that enhance antiviral immunity and suppress infection. The importance of antiviral killer cells in controlling...

EDITORIAL: HIV-1 Superinfection â A Word of Caution

Thu, 05Â SepÂ 2002 00:00:00 -05:00

Acute human immunodeficiency virus type 1 (HIV-1) infection is typically associated with an influenza-like syndrome, with levels of virus in the bloodstream during the initial symptomatic period typically in excess...

ORIGINAL ARTICLE: A Patient with HIV-1 Superinfection

Thu, 05Â SepÂ 2002 00:00:00 -05:00

The detection of an increasing number of circulating recombinant strains of human immunodeficiency virus type 1 (HIV-1) indicates that genetic recombination can occur in cells infected with two strains of...

PERSPECTIVE: Beyond Barcelona â The Global Response to HIV

Thu, 22Â AugÂ 2002 00:00:00 -05:00

There is a striking contrast between the countries where people are dying from AIDS and the countries where they are receiving effective therapy. In Western nations, there were 25,000 deaths...

EDITORIAL: HIV Drug Resistance â A Chink in the Armor

Thu, 08Â AugÂ 2002 00:00:00 -05:00

In the resource-rich countries, a remarkable success story has emerged during the past decade in the treatment of human immunodeficiency virus (HIV) infections. There has been strikingly reduced morbidity and...

ORIGINAL ARTICLE: Antiretroviral-Drug Resistance among Patients Recently Infected with HIV

Thu, 08Â AugÂ 2002 00:00:00 -05:00

Background: Among persons in North America who are newly infected with the human immunodeficiency virus (HIV), the prevalence of transmitted resistance to antiretroviral drugs has been estimated at 1 to...

SOUNDING BOARD: Solid-Organ Transplantation in HIV-Infected Patients

Thu, 25Â JulÂ 2002 00:00:00 -05:00

Before the introduction of highly active antiretroviral therapy in the mid-1990s, transplantation centers were understandably reluctant to provide scarce solid organs for patients infected with the human immunodeficiency virus (HIV)....

IMAGES IN CLINICAL MEDICINE: Disseminated Histoplasmosis in a Patient with Human Immunodeficiency Virus Infection

J. Manuel Dominguez, M.D. and Karim Serri, M.D. — Thu, 27Â JunÂ 2002 00:00:00 -05:00

Figure 1. A 37-year-old man who had emigrated to Montreal in 1990 was hospitalized because of a three-week history of high fever and weight loss. He had been given a...

ORIGINAL ARTICLE: LopinavirâRitonavir versus Nelfinavir for the Initial Treatment of HIV Infection

Thu, 27Â JunÂ 2002 00:00:00 -05:00

Background: Lopinavir is a newly developed inhibitor of human immunodeficiency virus (HIV) protease that, when formulated with ritonavir, yields mean trough plasma lopinavir concentrations that are at least 75 times...

PERSPECTIVE: Increasing Choices for HIV Therapy

Thu, 27Â JunÂ 2002 00:00:00 -05:00

The field of antiretroviral therapy has witnessed remarkable progress during the past 15 years. There are now 16 approved therapeutic agents for infection with the human immunodeficiency virus (HIV), a...

ORIGINAL ARTICLE: Fumagillin Treatment of Intestinal Microsporidiosis

Thu, 20Â JunÂ 2002 00:00:00 -05:00

Background: Intestinal microsporidiosis due to Enterocytozoon bieneusi is a cause of chronic diarrhea, malabsorption, and wasting in immunocompromised patients. Currently, there is no effective treatment.

Methods: We conducted a randomized, double-blind,...

REVIEW ARTICLE: Management of Human Immunodeficiency Virus Infection in Pregnancy

D. Heather Watts, M.D. — Thu, 13Â JunÂ 2002 00:00:00 -05:00

An estimated 16.4 million women worldwide are living with human immunodeficiency virus (HIV) infection; 600,000 children are infected annually, most of them by mother-to-child transmission.1 Interventions designed to reduce perinatal...

ORIGINAL ARTICLE: Antiretroviral Therapy during Pregnancy and the Risk of an Adverse Outcome

Thu, 13Â JunÂ 2002 00:00:00 -05:00

Background: Some studies suggest that combination antiretroviral therapy in pregnant women with human immunodeficiency virus type 1 (HIV-1) infection increases the risk of premature birth and other adverse outcomes of...

PERSPECTIVE: Preventing HIV Infection in Children

Thu, 13Â JunÂ 2002 00:00:00 -05:00

For a child, the risk of becoming infected with the human immunodeficiency virus (HIV) is a stark example of the difference between being born in a rich country and being...

EDITORIAL: Racial Disparities in Clinical Trials

Thu, 02Â MayÂ 2002 00:00:00 -05:00

The rational use of a new drug or treatment should be based on the results of controlled clinical trials that are well designed, avoid bias, and include subjects representing the...

SPECIAL ARTICLE: Participation in Research and Access to Experimental Treatments by HIV-Infected Patients

Thu, 02Â MayÂ 2002 00:00:00 -05:00

Background: Although there is concern that minority groups and women are underrepresented in research involving patients with human immunodeficiency virus (HIV) infection, the available data are inconclusive.

Methods: We used nationally...

ORIGINAL ARTICLE: Development of Kaposi's Sarcoma in a Surgical Wound

Jennifer Webster-Cyriaque, D.D.S., Ph.D. — Thu, 18Â AprÂ 2002 00:00:00 -05:00

Kaposi's sarcoma is the most common neoplasm in patients with the acquired immunodeficiency syndrome (AIDS) and is diagnostic of the progression of human immunodeficiency virus (HIV) infection to AIDS.1 The...

ORIGINAL ARTICLE: A Controlled Trial of Valganciclovir as Induction Therapy for Cytomegalovirus Retinitis

Thu, 11Â AprÂ 2002 00:00:00 -05:00

Background: Valganciclovir is an orally administered prodrug that is rapidly hydrolyzed to ganciclovir. We compared the effects of oral valganciclovir with those of intravenous ganciclovir as induction therapy for newly...

ORIGINAL ARTICLE: Changes in Mitochondrial DNA as a Marker of Nucleoside Toxicity in HIV-Infected Patients

Thu, 14Â MarÂ 2002 00:00:00 -05:00

Background: Nucleoside analogues can induce toxic effects on mitochondria by inhibiting the human DNA polymerase Î³. The toxic effects can range from increased serum lactate levels to potentially fatal lactic...

CLINICAL PROBLEM-SOLVING: Where Are You From?

Thu, 07Â MarÂ 2002 00:00:00 -05:00

A 54-year-old man of Guyanese origin with human immunodeficiency virus (HIV) infection was hospitalized in Toronto with a one-week history of low-grade fever (temperature, <38Â°C). He had had a temperature...

EDITORIAL: The Changing Face of Pediatric HIV-1 Infection

Thu, 22Â NovÂ 2001 00:00:00 -05:00

It has been nearly 20 years since the first cases of AIDS were reported in children in the United States, and the face of pediatric human immunodeficiency virus type 1...

ORIGINAL ARTICLE: Effect of Combination Therapy Including Protease Inhibitors on Mortality among Children and Adolescents Infected with HIV-1

Thu, 22Â NovÂ 2001 00:00:00 -05:00

Background: Combination therapy including protease inhibitors has been shown to be effective in treating adults infected with human immunodeficiency virus type 1 (HIV-1), but there are only limited data regarding...

IMAGES IN CLINICAL MEDICINE: Disseminated Intravascular Coagulopathy

Sheldon Bastacky, M.D. and Robert E. Lee, M.D. — Thu, 08Â NovÂ 2001 00:00:00 -05:00

Figure 1. A 34-year-old man with the acquired immunodeficiency syndrome, hemoglobin SC chronic hemolytic anemia, and recurrent episodes of pneumonia due to gram-negative bacteria, cryptococcus, and most recently, aspergillus was...

EDITORIAL: GB Virus C and Mortality from HIV Infection

Thu, 06Â SepÂ 2001 00:00:00 -05:00

Infection with the human immunodeficiency virus (HIV) is associated with conditions ranging from stability of the immune system and asymptomatic infection to severe compromise of the immune system and the...

ORIGINAL ARTICLE: Infection with GB Virus C and Reduced Mortality among HIV-Infected Patients

Thu, 06Â SepÂ 2001 00:00:00 -05:00

Background: The flavivirus GB virus C (GBV-C, also designated hepatitis G virus) was identified in a search for hepatitis viruses, but no disease is currently known to be associated with...

ORIGINAL ARTICLE: Effect of Coinfection with GB Virus C on Survival among Patients with HIV Infection

Thu, 06Â SepÂ 2001 00:00:00 -05:00

Background: Previous studies have suggested that people with human immunodeficiency virus (HIV) infection who are coinfected with GB virus C (GBV-C, or hepatitis G virus) have delayed progression of HIV...

EDITORIAL: Antiretroviral Therapy for Previously Treated Patients

Thu, 09Â AugÂ 2001 00:00:00 -05:00

Combination therapy with three antiretroviral drugs improves the outcome of patients infected with human immunodeficiency virus type 1 (HIV-1) and has led to sustained decreases in AIDS-related morbidity and mortality...

ORIGINAL ARTICLE: Nelfinavir, Efavirenz, or Both after the Failure of Nucleoside Treatment of HIV Infection

Thu, 09Â AugÂ 2001 00:00:00 -05:00

Background: The optimal antiretroviral treatment for patients who have human immunodeficiency virus (HIV) viremia despite treatment with nucleoside reverse-transcriptase inhibitors (nucleoside analogues) remains uncertain. We studied treatment with regimens that...

ORIGINAL ARTICLE: Nephropathy and Establishment of a Renal Reservoir of HIV Type 1 during Primary Infection

Thu, 28Â JunÂ 2001 00:00:00 -05:00

Human immunodeficiency virus type 1 (HIV-1)âassociated nephropathy is the chief cause of chronic renal disease in patients with HIV-1 infection and is now the third leading cause of end-stage renal...

SOUNDING BOARD: AIDS â Past and Future

Thu, 07Â JunÂ 2001 00:00:00 -05:00

The AIDS epidemic in the United States officially began with the publication in the June 5, 1981, issue of Morbidity and Mortality Weekly Report (MMWR), the bulletin of the Centers...

EDITORIAL: AIDS â Will the Next 20 Years Be Different?

Thu, 07Â JunÂ 2001 00:00:00 -05:00

In the fall of 1981, a patient was referred to one of us at a teaching hospital in Boston for the evaluation of hypoxemia and a mildly abnormal chest radiograph....

SPECIAL ARTICLE: AIDS â The First 20 Years

Kent A. Sepkowitz, M.D. — Thu, 07Â JunÂ 2001 00:00:00 -05:00

The disease now known as the acquired immunodeficiency syndrome, or AIDS, was first reported 20 years ago this week in the Morbidity and Mortality Weekly Report under the quiet title...

IMAGES IN CLINICAL MEDICINE: Disseminated Infection in a Patient with AIDS

Kenrad E. Nelson, M.D. and Thira Sirisanthana, M.D. — Thu, 07Â JunÂ 2001 00:00:00 -05:00

Figure 1. A 29-year-old man from northern Thailand had a three-week history of recurrent fever (a temperature of up to 40Â°C), generalized weakness, poor appetite, and weight loss. One week...

ORIGINAL ARTICLE: Effect of a Single Amino Acid Change in MHC Class I Molecules on the Rate of Progression to AIDS

Thu, 31Â MayÂ 2001 00:00:00 -05:00

Background: From studies of genetic polymorphisms and the rate of progression from human immunodeficiency virus type 1 (HIV-1) infection to the acquired immunodeficiency syndrome (AIDS), it appears that the strongest...

REVIEW ARTICLE: Interactions among Drugs for HIV and Opportunistic Infections

Stephen C. Piscitelli, Pharm.D., and Keith D. Gallicano, Ph.D. — Thu, 29Â MarÂ 2001 00:00:00 -05:00

Drug interactions are an important factor in the treatment of patients with human immunodeficiency virus (HIV) infection. The complexity of current drug regimens for such patients requires that clinicians recognize...

EDITORIAL: Breaching the Barrier of ABO Incompatibility in Heart Transplantation for Infants

Thu, 15Â MarÂ 2001 00:00:00 -05:00

Cardiac transplantation has now been performed for 15 years as therapy for neonates and infants with lethal myopathic or structural heart disease. Such transplantation has been stimulated by both the...

SPECIAL ARTICLE: The Cost Effectiveness of Combination Antiretroviral Therapy for HIV Disease

Thu, 15Â MarÂ 2001 00:00:00 -05:00

Background: Combination antiretroviral therapy with a combination of three or more drugs has become the standard of care for patients with human immunodeficiency virus (HIV) infection in the United States....

SPECIAL ARTICLE: Expenditures for the Care of HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy

Thu, 15Â MarÂ 2001 00:00:00 -05:00

Background: The introduction of expensive but very effective antiviral medications has led to questions about the effects on the total use of resources for the care of patients with human...

ORIGINAL ARTICLE: Initial Plasma HIV-1 RNA Levels and Progression to AIDS in Women and Men

Thu, 08Â MarÂ 2001 00:00:00 -05:00

Background: It is unclear whether there are differences between men and women with human immunodeficiency virus type 1 (HIV-1) infection in the plasma level of viral RNA (the viral load)....

EDITORIAL: Should Patients with Drug-Resistant HIV-1 Continue to Receive Antiretroviral Therapy?

Thu, 15Â FebÂ 2001 00:00:00 -05:00

The ultimate goal of antiretroviral therapy for patients with human immunodeficiency virus type 1 (HIV-1) infection is to cure the infection. Failing that, the objective is to stop the progression...

ORIGINAL ARTICLE: Virologic and Immunologic Consequences of Discontinuing Combination Antiretroviral-Drug Therapy in HIV-Infected Patients with Detectable Viremia

Thu, 15Â FebÂ 2001 00:00:00 -05:00

Background: In many patients with human immunodeficiency virus (HIV) infection, therapy with potent antiretroviral drugs does not result in complete suppression of HIV replication. The effect of cessation of therapy...

EDITORIAL: Discontinuing Prophylaxis

Thu, 18Â JanÂ 2001 00:00:00 -05:00

Until the widespread adoption of specific prophylaxis in the late 1980s, Pneumocystis carinii pneumonia was among the most common life-threatening opportunistic infections associated with infection with the human immunodeficiency virus...

ORIGINAL ARTICLE: Discontinuation of Secondary Prophylaxis against Pneumonia in Patients with HIV Infection Who Have a Response to Antiretroviral Therapy

Thu, 18Â JanÂ 2001 00:00:00 -05:00

Background: Patients with human immunodeficiency virus (HIV) infection and a history of Pneumocystis carinii pneumonia are at high risk for relapse if they are not given secondary prophylaxis. Whether secondary...

ORIGINAL ARTICLE: A Randomized Trial of the Discontinuation of Primary and Secondary Prophylaxis against Pneumonia after Highly Active Antiretroviral Therapy in Patients with HIV Infection

Thu, 18Â JanÂ 2001 00:00:00 -05:00

Background: Prophylaxis against Pneumocystis carinii pneumonia is indicated in patients with human immunodeficiency virus (HIV) infection who have less than 200 CD4 cells per cubic millimeter and in those with...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Antibodies and Resistance to Natural HIV Infection

Thu, 26Â OctÂ 2000 00:00:00 -05:00

The unprecedented spread of the human immunodeficiency virus (HIV) throughout the world has made the development of an effective AIDS vaccine one of the most urgent challenges facing biomedical science....

ORIGINAL ARTICLE: A Trial of Shortened Zidovudine Regimens to Prevent Mother-to-Child Transmission of Human Immunodeficiency Virus Type 1

Thu, 05Â OctÂ 2000 00:00:00 -05:00

Background: The optimal duration of zidovudine administration to prevent perinatal transmission of human immunodeficiency virus type 1 (HIV-1) should be determined to facilitate its use in areas where resources are...

EDITORIAL: Preventing Vertical Transmission of HIV Infection

Thu, 05Â OctÂ 2000 00:00:00 -05:00

The complex clinical trial described by Lallemant and colleagues in this issue of the Journal 1 was designed to determine the optimal duration of treatment with zidovudine to prevent the...

EDITORIAL: Perinatal Exposure to Zidovudine â Benefits and Risks

Thu, 14Â SepÂ 2000 00:00:00 -05:00

Mother-to-child transmission of the human immunodeficiency virus (HIV) causes a chronic and ultimately fatal pediatric infection that is now essentially preventable with antiretroviral prophylaxis. In more developed countries, prophylaxis has...

ORIGINAL ARTICLE: Absence of Cardiac Toxicity of Zidovudine in Infants

Thu, 14Â SepÂ 2000 00:00:00 -05:00

Background: Some evidence suggests that perinatal exposure to zidovudine may cause cardiac abnormalities in infants. We prospectively studied left ventricular structure and function in infants born to mothers infected with...

SOUNDING BOARD: Ethical Considerations in the Treatment of Infertility in Women with Human Immunodeficiency Virus Infection

Thu, 08Â JunÂ 2000 00:00:00 -05:00

An estimated 120,000 to 160,000 women in the United States are currently living with human immunodeficiency virus (HIV) infection.1 The majority of these women are of reproductive age, and many...

REVIEW ARTICLE: Prophylaxis against Opportunistic Infections in Patients with Human Immunodeficiency Virus Infection

Joseph A. Kovacs, M.D., and Henry Masur, M.D. — Thu, 11Â MayÂ 2000 00:00:00 -05:00

Soon after the acquired immunodeficiency syndrome (AIDS) was first described in 1981,1234 it became clear that opportunistic infections occurred with remarkable frequency and caused substantial morbidity and mortality among patients...

ORIGINAL ARTICLE: Discontinuation of Prophylaxis against Complex Disease in HIV-Infected Patients Who Have a Response to Antiretroviral Therapy

Thu, 13Â AprÂ 2000 00:00:00 -05:00

Background: Several agents are effective in preventing Mycobacterium avium complex disease in patients with advanced human immunodeficiency virus (HIV) infection. However, there is uncertainty about whether prophylaxis should be continued...

REVIEW ARTICLE: Kaposi's Sarcoma

Karen Antman, M.D., and Yuan Chang, M.D. — Thu, 06Â AprÂ 2000 00:00:00 -05:00

In 1872, Moritz Kaposi, a Hungarian dermatologist, described five men with aggressive âidiopathic multiple pigmented sarcomas of the skin.â1 One patient died of gastrointestinal bleeding 15 months after the initial...

EDITORIAL: Preventing Sexual Transmission of HIV â New Ideas from Sub-Saharan Africa

Thu, 30Â MarÂ 2000 00:00:00 -05:00

When human immunodeficiency virus type 1 (HIV-1) was identified as the cause of AIDS more than 15 years ago, it seemed possible that an end to the epidemic would follow....

EDITORIAL: Investigators' Responsibilities for Human Subjects in Developing Countries

Thu, 30Â MarÂ 2000 00:00:00 -05:00

Most people agree that investigators assume some responsibility for their human subjects, but how much? And does it matter where the research is carried out? These issues are raised by...

ORIGINAL ARTICLE: HTLV-IIâAssociated Cutaneous T-Cell Lymphoma in a Patient with HIV-1 Infection

Thu, 30Â MarÂ 2000 00:00:00 -05:00

Patients infected with human immunodeficiency virus type 1 (HIV-1) are susceptible to neoplasms, including Kaposi's sarcoma, non-Hodgkin's lymphoma, and anal and cervical carcinoma.12345 Some of these neoplasms have been associated...

ORIGINAL ARTICLE: Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1

Thu, 30Â MarÂ 2000 00:00:00 -05:00

Background: and Methods: We examined the influence of viral load in relation to other risk factors for the heterosexual transmission of human immunodeficiency virus type 1 (HIV-1). In a community-based...

EDITORIAL: Choosing the Best Initial Therapy for HIV-1 Infection

Thu, 16Â DecÂ 1999 00:00:00 -05:00

Fifteen drugs are currently available for the treatment of patients with human immunodeficiency virus type 1 (HIV-1) infection, all of which target the virally encoded transcriptase or protease enzymes. Under...

ORIGINAL ARTICLE: Combination Therapy with Efavirenz, Nelfinavir, and Nucleoside Reverse-Transcriptase Inhibitors in Children Infected with Human Immunodeficiency Virus Type 1

Thu, 16Â DecÂ 1999 00:00:00 -05:00

Background: Consistent long-term viral suppression has been difficult to achieve in children with human immunodeficiency virus type 1 (HIV-1) infection. We tested the safety and antiviral efficacy of a novel...

ORIGINAL ARTICLE: Efavirenz plus Zidovudine and Lamivudine, Efavirenz plus Indinavir, and Indinavir plus Zidovudine and Lamivudine in the Treatment of HIV-1 Infection in Adults

Thu, 16Â DecÂ 1999 00:00:00 -05:00

Background: Efavirenz is a nonnucleoside reverse-transcriptase inhibitor of human immunodeficiency virus type 1 (HIV-1). We compared two regimens containing efavirenz, one with a protease inhibitor and the other with two...

SPECIAL ARTICLE: The AIDS Epidemic â Considerations for the 21st Century

Anthony S. Fauci, M.D. — Thu, 30Â SepÂ 1999 00:00:00 -05:00

Humankind has been besieged through-out its evolution by microorganisms that pose a continual challenge to the survival of the species.1 Although such ancient killers as tuberculosis and malaria persistently take...

EDITORIAL: Reducing the Risk of MaternalâInfant Transmission of HIV by Attacking the Virus

Thu, 05Â AugÂ 1999 00:00:00 -05:00

The findings of AIDS Clinical Trials Group (ACTG) Protocol 0761 opened the door to a major effort to reduce perinatal infection with the human immunodeficiency virus (HIV). We have witnessed...

ORIGINAL ARTICLE: Maternal Levels of Plasma Human Immunodeficiency Virus Type 1 RNA and the Risk of Perinatal Transmission

Thu, 05Â AugÂ 1999 00:00:00 -05:00

Background: The importance of plasma levels of human immunodeficiency virus type 1 (HIV-1) RNA in pregnant women in relation to the other factors known to influence the risk of transmission...

ORIGINAL ARTICLE: Risk Factors for Perinatal Transmission of Human Immunodeficiency Virus Type 1 in Women Treated with Zidovudine

Thu, 05Â AugÂ 1999 00:00:00 -05:00

Background: Maternal, obstetrical, and infant-related factors associated with the risk of perinatal transmission of human immunodeficiency virus type 1 (HIV-1) were identified before the widespread use of zidovudine therapy in...

IMAGES IN CLINICAL MEDICINE: Cystic Lymphoma of the Brain

Irwin A. Keller, M.D. and Robert N. Greco, M.D. — Thu, 15Â JulÂ 1999 00:00:00 -05:00

Figure 1. A 47-year-old afebrile man infected with the human immunodeficiency virus presented with headache, weakness of the left arm, a CD4 count of 2 per cubic millimeter, and white-cell...

ORIGINAL ARTICLE: Cytomegalovirus Infection and HIV-1 Disease Progression in Infants Born to HIV-1âInfected Women

Thu, 08Â JulÂ 1999 00:00:00 -05:00

Background: and Methods: Cytomegalovirus (CMV) has been implicated as a cofactor in the progression of human immunodeficiency virus type 1 (HIV-1) disease. We assessed 440 infants (75 of whom were...

EDITORIAL: Naturally Attenuated HIV â Lessons for AIDS Vaccines and Treatment

Thu, 03Â JunÂ 1999 00:00:00 -05:00

The pathogenic effects of infection by the human immunodeficiency virus (HIV) are controlled by genes encoded by the virus and the host. One of the HIV genes, called nef, is...

REVIEW ARTICLE: Treatments for Wasting in Patients with the Acquired Immunodeficiency Syndrome

Colleen Corcoran, N.P., and Steven Grinspoon, M.D. — Thu, 03Â JunÂ 1999 00:00:00 -05:00

Wasting was an early identifying characteristic of human immunodeficiency virus (HIV) infection, originally termed âslim diseaseâ in Africa.1 As defined by the Centers for Disease Control and Prevention (CDC), wasting...

ORIGINAL ARTICLE: Immunologic and Virologic Status after 14 to 18 Years of Infection with an Attenuated Strain of HIV-1 â A Report from the Sydney Blood Bank Cohort

Thu, 03Â JunÂ 1999 00:00:00 -05:00

Background: and Methods: The Sydney Blood Bank Cohort consists of a blood donor and eight transfusion recipients who were infected before 1985 with a strain of human immunodeficiency virus type...

EDITORIAL: Residual HIV-1 Disease in the Era of Highly Active Antiretroviral Therapy

Thu, 27Â MayÂ 1999 00:00:00 -05:00

Over the past 18 years the human immunodeficiency virus type 1 (HIV-1) epidemic has evolved, with the disease shifting from a syndrome whose cause was undefined to one in which...

ORIGINAL ARTICLE: Persistence of HIV-1 Transcription in Peripheral-Blood Mononuclear Cells in Patients Receiving Potent Antiretroviral Therapy

Thu, 27Â MayÂ 1999 00:00:00 -05:00

Background: and Methods: Although potent antiretroviral therapy can control infection with human immunodeficiency virus type 1 (HIV-1), a long-lived reservoir of infectious virus persists in CD4+ T cells. We investigated...

ORIGINAL ARTICLE: Quantifying Residual HIV-1 Replication in Patients Receiving Combination Antiretroviral Therapy

Thu, 27Â MayÂ 1999 00:00:00 -05:00

Background: In patients infected with human immunodeficiency virus type 1 (HIV-1), combination antiretroviral therapy can result in sustained suppression of plasma levels of the virus. However, replication-competent virus can still...

EDITORIAL: Does Prophylaxis Still Need to Be Lifelong?

Thu, 29Â AprÂ 1999 00:00:00 -05:00

Before the advent of antiretroviral therapy and prophylaxis against Pneumocystis carinii pneumonia, this type of pneumonia ultimately developed in 60 to 80 percent of adult patients with human immunodeficiency virus...

IMAGES IN CLINICAL MEDICINE: Indinavir Crystalluria

Jack W. Tsao, M.D., D.Phil. and Scott C. Kogan, M.D. — Thu, 29Â AprÂ 1999 00:00:00 -05:00

Figure 1. A 33-year-old man with hemophilia and the acquired immunodeficiency syndrome had a six-hour history of severe right-sided flank pain and right-lower-quadrant pain accompanied by nausea, vomiting, and anorexia....

ORIGINAL ARTICLE: Discontinuation of Primary Prophylaxis against Pneumonia in HIV-1âInfected Adults Treated with Combination Antiretroviral Therapy

Thu, 29Â AprÂ 1999 00:00:00 -05:00

Background: It is unclear whether primary prophylaxis against Pneumocystis carinii pneumonia can be discontinued in patients infected with the human immunodeficiency virus (HIV) who are successfully treated with combination antiretroviral...

IMAGES IN CLINICAL MEDICINE: Severe Herpes Simplex Infection

Jessica Justman, M.D. and Marina Zabezhanskaya, M.D. — Thu, 22Â AprÂ 1999 00:00:00 -05:00

Figure 1. A 30-year-old man with the acquired immunodeficiency syndrome (CD4 cell count, 14 per cubic millimeter) presented with a six-month history of enlarging facial lesions. The lesions had not...

ORIGINAL ARTICLE: The Mode of Delivery and the Risk of Vertical Transmission of Human Immunodeficiency Virus Type 1 â A Meta-Analysis of 15 Prospective Cohort Studies

The International Perinatal HIV Group — Thu, 01Â AprÂ 1999 00:00:00 -05:00

Background: To evaluate the relation between elective cesarean section and vertical transmission of human immunodeficiency virus type 1 (HIV-1), we performed a meta-analysis using data on individual patients from 15...

EDITORIAL: Elective Cesarean Delivery to Reduce the Transmission of HIV

Thu, 01Â AprÂ 1999 00:00:00 -05:00

Each year in the United States 6000 to 7000 women with human immunodeficiency virus (HIV) infection give birth. Worldwide, about 2.3 million HIV-infected women give birth each year. The transmission...

REVIEW ARTICLE: Tuberculosis in Patients with Human Immunodeficiency Virus Infection

Diane V. Havlir, M.D., and Peter F. Barnes, M.D. — Thu, 04Â FebÂ 1999 00:00:00 -05:00

Tuberculosis remains an important problem in patients with human immunodeficiency virus (HIV) infection in the United States, with an estimated 6000 to 9000 new cases annually.1 The case rates are...

EDITORIAL: Caring for People with Human Immunodeficiency Virus Infection

Thu, 24Â DecÂ 1998 00:00:00 -05:00

The good news continues in the battle against AIDS. In the United States, the age-adjusted death rate among people with human immunodeficiency virus (HIV) in 1997 was less than 40...

SPECIAL ARTICLE: The Care of HIV-Infected Adults in the United States

Thu, 24Â DecÂ 1998 00:00:00 -05:00

Background: and Methods: In order to elucidate the medical care of patients with human immunodeficiency virus (HIV) infection in the United States, we randomly sampled HIV-infected adults receiving medical care...

ORIGINAL ARTICLE: Atovaquone Compared with Dapsone for the Prevention of Pneumonia in Patients with HIV Infection Who Cannot Tolerate Trimethoprim, Sulfonamides, or Both

Thu, 24Â DecÂ 1998 00:00:00 -05:00

Background: Although trimethoprimâsulfamethoxazole is the drug of choice for the prevention of Pneumocystis carinii pneumonia, many patients cannot tolerate it and must switch to an alternative agent.

Methods: We conducted a...

EDITORIAL: Potential for the Transmission of HIV-1 despite Highly Active Antiretroviral Therapy

Thu, 17Â DecÂ 1998 00:00:00 -05:00

The use of highly active antiretroviral therapy to control infection with human immunodeficiency virus type 1 (HIV-1) is in many ways a success story. Under optimal circumstances, combinations of drugs...

ORIGINAL ARTICLE: Human Immunodeficiency Virus Type 1 in the Semen of Men Receiving Highly Active Antiretroviral Therapy

Thu, 17Â DecÂ 1998 00:00:00 -05:00

Background: Highly active antiretroviral therapy can effectively decrease the levels of human immunodeficiency virus type 1 (HIV-1) virions in peripheral plasma and seminal fluid of infected men. Whether the genital...

ORIGINAL ARTICLE: A Controlled Trial of Itraconazole to Prevent Relapse of Infection in Patients Infected with the Human Immunodeficiency Virus

Thu, 10Â DecÂ 1998 00:00:00 -05:00

Background: In Southeast Asia, disseminated infection with Penicillium marneffei is common among patients with human immunodeficiency virus (HIV) infection. Even after successful primary treatment, the relapse rate for this potentially...

EDITORIAL: Short (And Shorter) Courses of Zidovudine

Thu, 12Â NovÂ 1998 00:00:00 -05:00

In this issue of the Journal, Wade and colleagues1 present data on the outcomes of short, prophylactic courses of zidovudine administered to infants born to women infected with the human...

ORIGINAL ARTICLE: Abbreviated Regimens of Zidovudine Prophylaxis and Perinatal Transmission of the Human Immunodeficiency Virus

Thu, 12Â NovÂ 1998 00:00:00 -05:00

Background: The Pediatric AIDS Clinical Trials Group Protocol 076 reported a reduction in the rate of perinatal transmission of the human immunodeficiency virus (HIV) from 25.5 percent to 8.3 percent...

EDITORIAL: Therapeutic Strategies for HIV Infection â Time to Think Hard

Thu, 29Â OctÂ 1998 00:00:00 -05:00

The concept of induction therapy followed by maintenance therapy has its origins in the treatment of a number of infectious and neoplastic diseases. Highly potent but toxic and inconvenient treatment...

IMAGES IN CLINICAL MEDICINE: Buffalo Hump in a Patient with the Acquired Immunodeficiency Syndrome

David M. Aboulafia, M.D. and Denise Bundow, A.R.N.P. — Thu, 29Â OctÂ 1998 00:00:00 -05:00

Figure 1. A 52-year-old man infected with the human immunodeficiency virus (HIV) was treated with zidovudine and lamivudine when his CD4+ lymphocyte count dropped to 105 cells per cubic millimeter...

IMAGES IN CLINICAL MEDICINE: Lipodystrophy Associated with an HIV-Protease Inhibitor

Andrew Carr, M.D. and David A. Cooper, D.Sc., M.D. — Thu, 29Â OctÂ 1998 00:00:00 -05:00

Figure 1. A 53-year-old man had human immunodeficiency virus (HIV)ârelated lymphoma, which had been in remission since 1987; a CD4+ lymphocyte count of 510 cells per cubic millimeter; and an...

ORIGINAL ARTICLE: A Randomized Trial of Three Maintenance Regimens Given after Three Months of Induction Therapy with Zidovudine, Lamivudine, and Indinavir in Previously Untreated HIV-1âInfected Patients

Thu, 29Â OctÂ 1998 00:00:00 -05:00

Background: The long-term effectiveness of potent three-drug antiretroviral regimens for the treatment of human immunodeficiency virus type 1 (HIV-1) infection is limited by problems related to compliance and tolerability. We...

ORIGINAL ARTICLE: Maintenance Antiretroviral Therapies in HIV-Infected Subjects with Undetectable Plasma HIV RNA after Triple-Drug Therapy

Thu, 29Â OctÂ 1998 00:00:00 -05:00

Background: Combination antiretroviral therapy with indinavir, zidovudine, and lamivudine can suppress the level of human immunodeficiency virus (HIV) RNA in plasma below the threshold of detection for two years or...

LEGAL ISSUES IN MEDICINE: Protecting Patients from Discrimination â The Americans with Disabilities Act and HIV Infection

George J. Annas, J.D., M.P.H. — Thu, 22Â OctÂ 1998 00:00:00 -05:00

The Americans with Disabilities Act (ADA) was passed in 1990 to expand the reach of the Rehabilitation Act of 1973 and make discrimination on the basis of disability unlawful.1 The...

EDITORIAL: Dilated Cardiomyopathy in HIV-Infected Patients

Thu, 15Â OctÂ 1998 00:00:00 -05:00

In this issue of the Journal, Barbaro and colleagues present the results of a large, prospective study of dilated cardiomyopathy in adults with human immunodeficiency virus (HIV) infection.1 This study...

ORIGINAL ARTICLE: Incidence of Dilated Cardiomyopathy and Detection of HIV in Myocardial Cells of HIV-Positive Patients

Thu, 15Â OctÂ 1998 00:00:00 -05:00

Background: Human immunodeficiency virus (HIV) infection is increasingly recognized as an important cause of dilated cardiomyopathy. However, the pathogenesis of the heart-muscle disease in the acquired immunodeficiency syndrome is unclear.

Methods:...

IMAGES IN CLINICAL MEDICINE: Human Immunodeficiency Virus Nephropathy and Intraglomerular Cryptococcus Neoformans

Andrea Veatch, M.D. and Steven H. Dikman, M.D. — Thu, 24Â SepÂ 1998 00:00:00 -05:00

Figure 1. A 24-year-old man with the acquired immunodeficiency syndrome presented in May 1997 with proteinuria and renal insufficiency. The most recent assessment of viral burden revealed a human immunodeficiency...

ORIGINAL ARTICLE: A Controlled Trial of Nonoxynol 9 Film to Reduce Male-to-Female Transmission of Sexually Transmitted Diseases

Thu, 20Â AugÂ 1998 00:00:00 -05:00

Background: Nonoxynol 9 is a proved spermicide, but whether it is also a microbicide is uncertain. A truly effective vaginal microbicide would reduce the susceptibility of women to sexually transmitted...

EDITORIAL: Transmission of Multidrug-Resistant Human Immunodeficiency Virus â The Wake-Up Call

Thu, 30Â JulÂ 1998 00:00:00 -05:00

The addition of human immunodeficiency virus type 1 (HIV-1)âprotease inhibitors to the armamentarium of antiretroviral drugs has dramatically improved the prognosis for HIV-infected persons.123 Although these agents do not eradicate...

ORIGINAL ARTICLE: Sexual Transmission of an HIV-1 Variant Resistant to Multiple Reverse-Transcriptase and Protease Inhibitors

Thu, 30Â JulÂ 1998 00:00:00 -05:00

Combination treatments with agents that inhibit protease and reverse transcriptase of human immunodeficiency virus type 1 (HIV-1) decrease mortality and slow disease progression.1 The development of resistance to these drugs,...

REVIEW ARTICLE: Ocular Manifestations of HIV Infection

Thu, 23Â JulÂ 1998 00:00:00 -05:00

The human immunodeficiency virus (HIV) has infected nearly 900,000 persons in North America and more than 30 million worldwide.12 Since the initial description of eye abnormalities in HIV-positive patients more...

REVIEW ARTICLE: Acute Human Immunodeficiency Virus Type 1 Infection

James O. Kahn, M.D., and Bruce D. Walker, M.D. — Thu, 02Â JulÂ 1998 00:00:00 -05:00

Acute human immunodeficiency virus type 1 (HIV-1) infection is a transient symptomatic illness associated with high-titer HIV-1 replication and a robust and expansive immunologic response to the invading pathogen. From...

IMAGES IN CLINICAL MEDICINE: Budding of Human Immunodeficiency Virus

Philippe Roingeard, Ph.D. and Denys Brand, Ph.D. — Thu, 02Â JulÂ 1998 00:00:00 -05:00

Figure 1. During budding, the nascent capsid of the human immunodeficiency virus (HIV) associates with the plasma membrane of the host cell and induces the extrusion of the lipid bilayer....

EDITORIAL: The Global Threat of Drug-Resistant Tuberculosis

Thu, 04Â JunÂ 1998 00:00:00 -05:00

In this issue of the Journal, Pablos-MÃ©ndez et al., on behalf of the World Health OrganizationâInternational Union against Tuberculosis and Lung Diseases Working Group on Anti-Tuberculosis Drug Resistance Surveillance, report...

ORIGINAL ARTICLE: Transient Angiolymphoid Hyperplasia and Kaposi's Sarcoma after Primary Infection with Human Herpesvirus 8 in a Patient with Human Immunodeficiency Virus Infection

Thu, 28Â MayÂ 1998 00:00:00 -05:00

DNA sequences of human herpesvirus 8 (HHV-8) have been detected in all forms of Kaposi's sarcoma.123 HHV-8 has also been detected in primary effusion lymphomas,4 Castleman's disease,5 and multiple myeloma6...

EDITORIAL: Progressive Multifocal Leukoencephalopathy â Progress Made and Lessons Relearned

Thu, 07Â MayÂ 1998 00:00:00 -05:00

Progressive multifocal leukoencephalopathy is an opportunistic demyelinating infection caused by a ubiquitous, usually nonpathogenic papovavirus known as JC virus. The symptoms and characteristic radiologic findings of progressive multifocal leukoencephalopathy are...

ORIGINAL ARTICLE: Failure of Cytarabine in Progressive Multifocal Leukoencephalopathy Associated with Human Immunodeficiency Virus Infection

Thu, 07Â MayÂ 1998 00:00:00 -05:00

Background: Progressive multifocal leukoencephalopathy affects about 4 percent of patients with the acquired immunodeficiency syndrome (AIDS), and survival after the diagnosis of leukoencephalopathy averages only about three months. There have...

REVIEW ARTICLE: HIV-Protease Inhibitors

Charles Flexner, M.D. — Thu, 30Â AprÂ 1998 00:00:00 -05:00

Inhibitors of human immunodeficiency virus (HIV)âencoded protease, combined with nucleoside analogues with antiretroviral activity, cause profound and sustained suppression of viral replication, reduce morbidity, and prolong life in patients with...

EDITORIAL: Progress and Problems in the Fight against AIDS

Thu, 26Â MarÂ 1998 00:00:00 -05:00

In this issue of the Journal, Palella et al. provide evidence of a massive decrease in morbidity and mortality related to human immunodeficiency virus (HIV) infection.1 Among 1255 study participants...

IMAGES IN CLINICAL MEDICINE: Molluscum Contagiosum in a Patient with the Acquired Immunodeficiency Syndrome

Stephanie L. Cotell, M.D. and Natalie S. Roholt, M.D. — Thu, 26Â MarÂ 1998 00:00:00 -05:00

Figure 1. Numerous flesh-colored umbilicated papules appeared on the face of a 33-year-old man with a three-year history of the acquired immunodeficiency syndrome (AIDS) and a CD4 cell count of...

ORIGINAL ARTICLE: Declining Morbidity and Mortality among Patients with Advanced Human Immunodeficiency Virus Infection

Thu, 26Â MarÂ 1998 00:00:00 -05:00

Background: and Methods: National surveillance data show recent, marked reductions in morbidity and mortality associated with the acquired immunodeficiency syndrome (AIDS). To evaluate these declines, we analyzed data on 1255...

EDITORIAL: Postexposure Treatment of HIV â Taking Some Risks for Safety's Sake

Thu, 20Â NovÂ 1997 00:00:00 -05:00

In April 1988 a health care worker here at the National Institutes of Health's Warren G. Magnuson Clinical Center became infected with the human immunodeficiency virus (HIV) after an occupational...

ORIGINAL ARTICLE: A CaseâControl Study of HIV Seroconversion in Health Care Workers after Percutaneous Exposure

Thu, 20Â NovÂ 1997 00:00:00 -05:00

Background: The average risk of human immunodeficiency virus (HIV) infection after percutaneous exposure to HIV-infected blood is 0.3 percent, but the factors that influence this risk are not well understood.

Methods:...

ORIGINAL ARTICLE: Human Papillomavirus Infection in Women Infected with the Human Immunodeficiency Virus

Thu, 06Â NovÂ 1997 00:00:00 -05:00

Background: Among women infected with the human immunodeficiency virus (HIV), there is a high prevalence of human papillomavirus (HPV) infections. However, little is known about the natural history of HPV...

EDITORIAL: HIV versus Cytotoxic T Lymphocytes â The War Being Lost

Thu, 30Â OctÂ 1997 00:00:00 -05:00

Viruses have caused human diseases throughout history.1 They have developed remarkable and unique properties to help them survive. In response to the threat from viruses, the immune system has evolved...

ORIGINAL ARTICLE: Cytotoxic-T-Cell Responses, Viral Load, and Disease Progression in Early Human Immunodeficiency Virus Type 1 Infection

Thu, 30Â OctÂ 1997 00:00:00 -05:00

Background: Early in human immunodeficiency virus type 1 (HIV-1) infection there is a decline in viral replication that has been attributed to host immunity, but the components of this response,...

SOUNDING BOARD: National HIV Case Reporting for the United States â A Defining Moment in the History of the Epidemic

Thu, 16Â OctÂ 1997 00:00:00 -05:00

Reporting of patients with AIDS by name (AIDS surveillance) has until now formed the cornerstone of the nation's efforts to monitor and characterize the epidemic of human immunodeficiency virus (HIV)...

SOUNDING BOARD: Unethical Trials of Interventions to Reduce Perinatal Transmission of the Human Immunodeficiency Virus in Developing Countries

Thu, 18Â SepÂ 1997 00:00:00 -05:00

It has been almost three years since the Journal1 published the results of AIDS Clinical Trials Group (ACTG) Study 076, the first randomized, controlled trial in which an intervention was...

EDITORIAL: The Double Burden of HIV Infection and Tuberculosis in Sub-Saharan Africa

Thu, 18Â SepÂ 1997 00:00:00 -05:00

The World Health Organization (WHO) estimated that by June 1996 14 million people were living with human immunodeficiency virus (HIV) infection in sub-Saharan Africa. Although it contains only 10 percent...

ORIGINAL ARTICLE: A Trial of Three Regimens to Prevent Tuberculosis in Ugandan Adults Infected with the Human Immunodeficiency Virus

Thu, 18Â SepÂ 1997 00:00:00 -05:00

Background: Infection with the human immunodeficiency virus (HIV) greatly increases the risk of reactivation tuberculosis. We evaluated the safety and efficacy of three preventive-therapy regimens in a setting where exposure...

EDITORIAL: Battling HIV on Many Fronts

Thu, 11Â SepÂ 1997 00:00:00 -05:00

After years of bad news, there is optimism in the battle against AIDS. In the United States, the number of deaths declined 19 percent in the first nine months of...

IMAGES IN CLINICAL MEDICINE: HIV-Associated Nephropathy

S.Y. Tan, M.D. and P.J. O'Donnell, F.R.C.Path. — Thu, 11Â SepÂ 1997 00:00:00 -05:00

Figure 1. A previously healthy bisexual man presented with the nephrotic syndrome and acute renal failure. The serum creatinine concentration was 7.8 mg per deciliter (693 Î¼mol per liter), the...

ORIGINAL ARTICLE: Treatment with Indinavir, Zidovudine, and Lamivudine in Adults with Human Immunodeficiency Virus Infection and Prior Antiretroviral Therapy

Thu, 11Â SepÂ 1997 00:00:00 -05:00

Background: The new protease inhibitors are potent inhibitors of the human immunodeficiency virus (HIV), and in combination with other antiretroviral drugs they may be able to cause profound and sustained...

ORIGINAL ARTICLE: A Controlled Trial of Two Nucleoside Analogues plus Indinavir in Persons with Human Immunodeficiency Virus Infection and CD4 Cell Counts of 200 per Cubic Millimeter or Less

Thu, 11Â SepÂ 1997 00:00:00 -05:00

Background: The efficacy and safety of adding a protease inhibitor to two nucleoside analogues to treat human immunodeficiency virus type 1 (HIV-1) infection are not clear. We compared treatment with...

ORIGINAL ARTICLE: A Controlled Trial of Isoniazid in Persons with Anergy and Human Immunodeficiency Virus Infection Who Are at High Risk for Tuberculosis

Thu, 31Â JulÂ 1997 00:00:00 -05:00

Background: Patients with human immunodeficiency virus (HIV) infection and latent tuberculosis are at substantial risk for the development of active tuberculosis. As a public health measure, prophylactic treatment with isoniazid...

ORIGINAL ARTICLE: A Randomized Trial of Enhanced Therapy for Early Syphilis in Patients with and without Human Immunodeficiency Virus Infection

Thu, 31Â JulÂ 1997 00:00:00 -05:00

Background: Reports of neurosyphilis and invasion of cerebrospinal fluid by Treponema pallidum in patients with human immunodeficiency virus (HIV) infection have led to doubts about the adequacy of the recommended...

ORIGINAL ARTICLE: Treatment of Cytomegalovirus Retinitis with a Sustained-Release Ganciclovir Implant

Thu, 10Â JulÂ 1997 00:00:00 -05:00

Background: Sustained-release, intraocular implants that deliver ganciclovir are an alternative method for the treatment of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome (AIDS).

Methods: We conducted a randomized study...

REVIEW ARTICLE: Treatment of Cytomegalovirus Retinitis in Patients with the Acquired Immunodeficiency Syndrome

Mark A. Jacobson, M.D. — Thu, 10Â JulÂ 1997 00:00:00 -05:00

Until recently, long-term regimens consisting of daily intravenous infusions of ganciclovir or foscarnet were the only available treatments for patients with cytomegalovirus (CMV) retinitis, a sight-threatening complication that affects approximately...

ORIGINAL ARTICLE: Treatment of Cryptococcal Meningitis Associated with the Acquired Immunodeficiency Syndrome

Thu, 03Â JulÂ 1997 00:00:00 -05:00

Background: Treatment with low-dose amphotericin B (0.4 mg per kilogram of body weight per day) or oral azole therapy in patients with the acquired immunodeficiency syndrome (AIDS) and cryptococcal meningitis...

ORIGINAL ARTICLE: Zidovudine, Didanosine, or Both as the Initial Treatment for Symptomatic HIV-Infected Children

Thu, 12Â JunÂ 1997 00:00:00 -05:00

Background: Zidovudine has been the drug of choice for the initial treatment of symptomatic children infected with the human immunodeficiency virus (HIV). This trial was designed to assess the efficacy...

ORIGINAL ARTICLE: Thalidomide for the Treatment of Oral Aphthous Ulcers in Patients with Human Immunodeficiency Virus Infection

Thu, 22Â MayÂ 1997 00:00:00 -05:00

Background: In patients with advanced human immunodeficiency virus (HIV) infection, aphthous ulceration of the mouth and oropharynx can become extensive and debilitating. Preliminary reports suggest that thalidomide may promote the...

ORIGINAL ARTICLE: Combination Treatment with Zidovudine, Didanosine, and Nevirapine in Infants with Human Immunodeficiency Virus Type 1 Infection

Thu, 08Â MayÂ 1997 00:00:00 -05:00

Background: In infants and children with maternally acquired human immunodeficiency virus type 1 (HIV-1) infection, treatment with a single antiretroviral agent has limited efficacy. We evaluated the safety and efficacy...

ORIGINAL ARTICLE: Viral Load and Disease Progression in Infants Infected with Human Immunodeficiency Virus Type 1

Thu, 08Â MayÂ 1997 00:00:00 -05:00

Background: There are only limited data on human immunodeficiency virus type 1 (HIV-1) RNA in perinatally infected infants. Understanding the dynamics of HIV-1 infection and its relation to disease progression...

SOUNDING BOARD: Postexposure Treatment of People Exposed to the Human Immunodeficiency Virus through Sexual Contact or Injection-Drug Use

Thu, 10Â AprÂ 1997 00:00:00 -05:00

Among health care workers who have occupational exposures to the human immunodeficiency virus (HIV), a recent caseâcontrol study indicates that treatment with zidovudine after exposure decreases the odds of HIV...

REVIEW ARTICLE: Sexual Transmission of HIV

Thu, 10Â AprÂ 1997 00:00:00 -05:00

Transmission through sexual contact accounts for 75 to 85 percent of the nearly 28 million infections with the human immunodeficiency virus (HIV) that have occurred so far.1 The probability of...

IMAGES IN CLINICAL MEDICINE: Cutaneous Cryptococcosis

Donald J. Baker, M.D. and Annette C. Reboli, M.D. — Thu, 03Â AprÂ 1997 00:00:00 -05:00

Figure 1. A 32-year-old man infected with the human immunodeficiency virus presented with multiple papules of various sizes, many of which were umbilicated. The lesions were located mainly on his...

ORIGINAL ARTICLE: Monoclonal Origin of Multicentric Kaposi's Sarcoma Lesions

Thu, 03Â AprÂ 1997 00:00:00 -05:00

Background: Kaposi's sarcoma has features of both hyperplastic proliferation and neoplastic growth. Multiple lesions, in which spindle cells are prominent, often arise synchronously over widely dispersed areas. We tested the...

ORIGINAL ARTICLE: Simultaneous Transmission of Human Immunodeficiency Virus and Hepatitis C Virus from a Needle-Stick Injury

Thu, 27Â MarÂ 1997 00:00:00 -05:00

Human immunodeficiency virus type 1 (HIV) and hepatitis C virus (HCV) are blood-borne viruses that pose occupational hazards to health care workers exposed to the blood of infected patients. As...

ORIGINAL ARTICLE: Cerebral Microsporidiosis Due to in a Patient with Human Immunodeficiency Virus Infection

Thu, 13Â FebÂ 1997 00:00:00 -05:00

Microsporidia are obligate, intracellular, spore-forming protozoa that are parasitic in every major animal group.1 Cerebral microsporidial infection was first described in 1922 in rabbits with granulomatous encephalitis,2 and the organism...

SPECIAL ARTICLE: Physician-Assisted Suicide and Patients with Human Immunodeficiency Virus Disease

Thu, 06Â FebÂ 1997 00:00:00 -05:00

Background: Data are limited on the attitudes and practices of physicians regarding assisting the suicide of patients with human immunodeficiency virus (HIV) disease.

Methods: Between November 1994 and January 1995, we...

EDITORIAL: Beginning to Make Progress against HIV

Thu, 28Â NovÂ 1996 00:00:00 -05:00

For nearly three years we have known that zidovudine is efficacious in preventing transmission of the human immunodeficiency virus (HIV) from mother to infant.1 A randomized, placebo-controlled trial, AIDS Clinical...

ORIGINAL ARTICLE: Maternal Viral Load, Zidovudine Treatment, and the Risk of Transmission of Human Immunodeficiency Virus Type 1 from Mother to Infant

Thu, 28Â NovÂ 1996 00:00:00 -05:00

Background: and Methods: A placebo-controlled trial has shown that treatment with zidovudine reduces the rate at which human immunodeficiency virus type 1 (HIV-1) is transmitted from mother to infant. We...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Infection by Human Immunodeficiency Virus â CD4 is Not Enough

Thu, 14Â NovÂ 1996 00:00:00 -05:00

The interaction between the human immunodeficiency virus (HIV) and its cellular target once seemed fairly simple: the virus attached to the CD4 molecule on the cell surface, entered the cell,...

ORIGINAL ARTICLE: Early Progression of Disease in HIV-Infected Infants with Thymus Dysfunction

Thu, 07Â NovÂ 1996 00:00:00 -05:00

Background: Infants with congenital thymic deficiency (the DiGeorge syndrome) have immunodeficiency and a characteristic pattern of low CD4+ and CD8+ T-lymphocyte counts and low CD5+ B-lymphocyte counts. Because the thymus...

ORIGINAL ARTICLE: Controlled Trial of Interleukin-2 Infusions in Patients Infected with the Human Immunodeficiency Virus

Thu, 31Â OctÂ 1996 00:00:00 -05:00

Background: Interleukin-2 is a cytokine that regulates the proliferation and differentiation of lymphocytes. In preliminary studies, intermittent infusions of interleukin-2 led to increases in CD4 counts in patients with human...

ORIGINAL ARTICLE: Controlled Trial of Interleukin-2 Infusions in Patients Infected with the Human Immunodeficiency Virus

Thu, 31Â OctÂ 1996 00:00:00 -05:00

SOUNDING BOARD: ICD-9 Code for Palliative or Terminal Care

Thu, 17Â OctÂ 1996 00:00:00 -05:00

The Health Care Financing Administration (HCFA) has announced the approval of a new diagnosis code for palliative care, which was included in the International Classification of Diseases, 9th Revision, Clinical...

EDITORIAL: Therapy for Human Immunodeficiency Virus Infection â What Have We Learned?

Thu, 10Â OctÂ 1996 00:00:00 -05:00

In this issue of the Journal three important articles appear, with major implications for the clinical management of infection with the human immunodeficiency virus (HIV).123 Hammer et al.1 and Katzenstein...

ORIGINAL ARTICLE: Zidovudine Alone or in Combination with Didanosine or Zalcitabine in HIV-Infected Patients with the Acquired Immunodeficiency Syndrome or Fewer Than 200 CD4 Cells per Cubic Millimeter

Thu, 10Â OctÂ 1996 00:00:00 -05:00

Background: We compared two combinations of nucleosides with zidovudine alone in patients with advanced human immunodeficiency virus (HIV) infection.

Methods: A total of 1102 patients with the acquired immunodeficiency syndrome or...

ORIGINAL ARTICLE: The Relation of Virologic and Immunologic Markers to Clinical Outcomes after Nucleoside Therapy in HIV-Infected Adults with 200 to 500 CD4 Cells per Cubic Millimeter

Thu, 10Â OctÂ 1996 00:00:00 -05:00

Background: We studied measures of human immunodeficiency virus (HIV) replication, the viral phenotype, and immune function (CD4 cell counts) and the relation of changes in these indicators to clinical outcomes...

ORIGINAL ARTICLE: A Trial Comparing Nucleoside Monotherapy with Combination Therapy in HIV-Infected Adults with CD4 Cell Counts from 200 to 500 per Cubic Millimeter

Thu, 10Â OctÂ 1996 00:00:00 -05:00

Background: This double-blind study evaluated treatment with either a single nucleoside or two nucleosides in adults infected with human immunodeficiency virus type 1 (HIV-1) whose CD4 cell counts were from...

EDITORIAL: Advances in the Prevention and Treatment of Disease

Thu, 08Â AugÂ 1996 00:00:00 -05:00

Mycobacterium avium complex disease is the third most common opportunistic disease affecting patients with AIDS. In a nationwide survey, it occurred in 22 percent of such patients1; only Pneumocystis carinii...

ORIGINAL ARTICLE: Prophylaxis against Disseminated Complex with Weekly Azithromycin, Daily Rifabutin, or Both

Thu, 08Â AugÂ 1996 00:00:00 -05:00

Background: Azithromycin is active in treating Mycobacterium avium complex disease, but it has not been evaluated as primary prophylaxis in patients with human immunodeficiency virus (HIV) infection. Because the drug...

ORIGINAL ARTICLE: A Randomized Trial of Clarithromycin as Prophylaxis against Disseminated Complex Infection in Patients with Advanced Acquired Immunodeficiency Syndrome

Thu, 08Â AugÂ 1996 00:00:00 -05:00

Background: Disseminated infection with Mycobacterium avium complex is the most common opportunistic infection in patients with advanced stages of the acquired immunodeficiency syndrome (AIDS). We studied the efficacy and safety...

ORIGINAL ARTICLE: A Comparison of Two Regimens for the Treatment of Complex Bacteremia in AIDS: Rifabutin, Ethambutol, and Clarithromycin versus Rifampin, Ethambutol, Clofazimine, and Ciprofloxacin

Thu, 08Â AugÂ 1996 00:00:00 -05:00

Background: Bacteremia with the Mycobacterium avium complex is common in patients with the acquired immunodeficiency syndrome (AIDS), but the most effective treatment for this infection remains unclear.

Methods: We randomly assigned...

EDITORIAL: The March of AIDS through Asia

Thu, 01Â AugÂ 1996 00:00:00 -05:00

In this issue of the Journal, Nelson and colleagues1 describe a modest victory in what had been a losing battle in northern Thailand to control the most rapid epidemic of...

EDITORIAL: The March of AIDS through Asia

Thu, 01Â AugÂ 1996 00:00:00 -05:00

In this issue of the Journal, Nelson and colleagues1 describe a modest victory in what had been a losing battle in northern Thailand to control the most rapid epidemic of...

ORIGINAL ARTICLE: Changes in Sexual Behavior and a Decline in HIV Infection among Young Men in Thailand

Thu, 01Â AugÂ 1996 00:00:00 -05:00

Background: In Thailand the epidemic of human immunodeficiency virus (HIV) infection is of recent origin. Because of the high seroprevalence of HIV among sex workers, the Ministry of Public Health...

ORIGINAL ARTICLE: Changes in Sexual Behavior and a Decline in HIV Infection among Young Men in Thailand

Thu, 01Â AugÂ 1996 00:00:00 -05:00

EDITORIAL: Reducing Mother-to-Infant Transmission of HIV â The Door Remains Open

Thu, 20Â JunÂ 1996 00:00:00 -05:00

As of the end of 1995, over 90 percent of the reported cases of AIDS in children were acquired through mother-to-infant transmission of the human immunodeficiency virus (HIV).1 Nearly all...

ORIGINAL ARTICLE: Obstetrical Factors and the Transmission of Human Immunodeficiency Virus Type 1 from Mother to Child

Thu, 20Â JunÂ 1996 00:00:00 -05:00

Background: A substantial proportion of perinatally acquired infections with the human immunodeficiency virus type 1 (HIV-1) occur at or near delivery, which suggests that obstetrical factors may have an important...

ORIGINAL ARTICLE: Rifampin-Resistant Tuberculosis in a Patient Receiving Rifabutin Prophylaxis

Thu, 13Â JunÂ 1996 00:00:00 -05:00

Drug-resistant tuberculosis has become a major public health problem in the United States.12 In 1979 less than 1 percent of tuberculosis isolates from untreated patients in New York City were...

SOUNDING BOARD: AIDS Prevention â Sexual Ethics and Responsibility

Thu, 06Â JunÂ 1996 00:00:00 -05:00

Do people infected with the human immunodeficiency virus (HIV) have special responsibilities to their sexual partners? If so, what do these responsibilities involve? Merely raising these questions directly has tended,...

ORIGINAL ARTICLE: Oral Ganciclovir for the Prevention of Cytomegalovirus Disease in Persons with AIDS

Thu, 06Â JunÂ 1996 00:00:00 -05:00

Background: In the advanced stages of the acquired immunodeficiency syndrome (AIDS), cytomegalovirus (CMV) disease, particularly vision-damaging retinitis due to CMV, is common. We evaluated prophylactic treatment with orally administered ganciclovir...

EDITORIAL: Denying HIV Safe Haven

Thu, 09Â MayÂ 1996 00:00:00 -05:00

The ability of the human immunodeficiency virus (HIV) to replicate successfully in vitro appears inextricably linked to the state of activation of its cellular host. Indeed, an activated cellular environment...

ORIGINAL ARTICLE: Effect of Immunization with a Common Recall Antigen on Viral Expression in Patients Infected with Human Immunodeficiency Virus Type 1

Thu, 09Â MayÂ 1996 00:00:00 -05:00

Background: Activation of the immune system is a normal response to antigenic stimulation, and such activation enhances the replication of human immunodeficiency virus type 1 (HIV-1). We studied the effect...

ORIGINAL ARTICLE: Treatment of Human Immunodeficiency Virus Infection with Saquinavir, Zidovudine, and Zalcitabine

Thu, 18Â AprÂ 1996 00:00:00 -05:00

Background: In patients with human immunodeficiency virus (HIV) infection, combined treatment with several agents may increase the effectiveness of antiviral therapy. We studied the safety and efficacy of saquinavir, an...

EDITORIAL: Social Vulnerability and Death by Infection

Thu, 28Â MarÂ 1996 00:00:00 -05:00

Nearly a half-century after RenÃ© and Jean Dubos wrote these words,1 tuberculosis continues to cause more deaths worldwide than any other single microbe, though the human immunodeficiency virus (HIV) may...

ORIGINAL ARTICLE: Tuberculosis, AIDS, and Death among Substance Abusers on Welfare in New York City

Thu, 28Â MarÂ 1996 00:00:00 -05:00

Background: In New York City, the incidence of tuberculosis has more than doubled during the past decade. We examined the incidence of tuberculosis and the acquired immunodeficiency syndrome (AIDS) and...

EDITORIAL: Improving the Outcomes of Care for Patients with Human Immunodeficiency Virus Infection

Thu, 14Â MarÂ 1996 00:00:00 -05:00

A wide spectrum of specialists and generalists are now delivering care of increasing complexity for patients infected with the human immunodeficiency virus (HIV). Few of these physicians have had any...

SPECIAL ARTICLE: Physicians' Experience with the Acquired Immunodeficiency Syndrome as a Factor in Patients' Survival

Thu, 14Â MarÂ 1996 00:00:00 -05:00

Background: Previous studies have found that patients with the acquired immunodeficiency syndrome (AIDS) who are admitted to hospitals that admit many such patients have lower mortality rates than patients in...

ORIGINAL ARTICLE: Changes in Plasma HIV-1 RNA and CD4+ Lymphocyte Counts and the Risk of Progression to AIDS

Thu, 15Â FebÂ 1996 00:00:00 -05:00

Background: Clinical trials of antiretroviral drugs can take years to complete because the outcomes measured are progression to the acquired immunodeficiency syndrome (AIDS) or death. Trials could be accelerated by...

ORIGINAL ARTICLE: Biliary Cryptosporidiosis in HIV-Infected People after the Waterborne Outbreak of Cryptosporidiosis in Milwaukee

Thu, 04Â JanÂ 1996 00:00:00 -05:00

Background: In March 1993, the municipal water supply in Milwaukee became contaminated with cryptosporidium and a widespread outbreak of cryptosporidiosis occurred.

Methods: We retrospectively studied the relations among the clinical presentation,...

NEJM â Collection Updates for HIV/AIDS

ORIGINAL ARTICLE: Acyclovir and Transmission of HIV-1 from Persons Infected with HIV-1 and HSV-2

EDITORIAL: HIV Vaccine Trial Results â An Opening for Further Research

ORIGINAL ARTICLE: AbacavirâLamivudine versus TenofovirâEmtricitabine for Initial HIV-1 Therapy

ORIGINAL ARTICLE: Vaccination with ALVAC and AIDSVAX to Prevent HIV-1 Infection in Thailand

CLINICAL PRACTICE: Postexposure Prophylaxis for HIV Infection

ORIGINAL ARTICLE: Interleukin-2 Therapy in Patients with HIV Infection

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2009 â An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive

CORRESPONDENCE: Persistent Carriage of Hepatitis E Virus in Patients with HIV Infection

CORRESPONDENCE: 5-Year Survival of Patients with AIDS Receiving Antiretroviral Therapy in Haiti

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2009 â A 24-Year-Old Woman with AIDS and Tuberculosis with Progressive Cough, Dyspnea, and Wasting

EDITORIAL: When to Start Antiretroviral Therapy â Ready When You Are?

ORIGINAL ARTICLE: Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival

PERSPECTIVE: Rationing Antiretroviral Therapy in Africa â Treating Too Few, Too Late

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 11-2009 â A 47-Year-Old Man with Fever, Headache, Rash, and Vomiting

BOOK REVIEW:

EDITORIAL: Not an HIV Cure, but Encouraging New Directions

ORIGINAL ARTICLE: Long-Term Control of HIV by Delta32/Delta32 Stem-Cell Transplantation

PERSPECTIVE: Circumcision â A Surgical Strategy for HIV Prevention in Africa

ORIGINAL ARTICLE: Early Antiretroviral Therapy and Mortality among HIV-Infected Infants

EDITORIAL: A New Class of Anti-HIV Therapy and New Challenges

ORIGINAL ARTICLE: Subgroup Analyses of Maraviroc in Previously Treated R5 HIV-1 Infection

ORIGINAL ARTICLE: Maraviroc for Previously Treated Patients with R5 HIV-1 Infection

BOOK REVIEW:

PERSPECTIVE: An HIV Vaccine â Challenges and Prospects

PERSPECTIVE: The AIDS Epidemic â A Progress Report from Mexico City

PERSPECTIVE: The President's Emergency Plan for AIDS Relief â Is the Emergency Over?

ORIGINAL ARTICLE: Lack of Effectiveness of Cellulose Sulfate Gel for the Prevention of Vaginal HIV Transmission

EDITORIAL: HIV Integrase Inhibitors â Out of the Pipeline and into the Clinic

ORIGINAL ARTICLE: Subgroup and Resistance Analyses of Raltegravir for Resistant HIV-1 Infection

ORIGINAL ARTICLE: Raltegravir with Optimized Background Therapy for Resistant HIV-1 Infection

EDITORIAL: Breast-Feeding, Antiretroviral Prophylaxis, and HIV

ORIGINAL ARTICLE: Effects of Early, Abrupt Weaning on HIV-free Survival of Children in Zambia

ORIGINAL ARTICLE: Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission

SOUNDING BOARD: Informing Candidates for Solid-Organ Transplantation about Donor Risk Factors

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 19-2008 â A 63-Year-Old HIV-Positive Man with Cutaneous Merkel-Cell Carcinoma

CLINICAL IMPLICATIONS OF BASIC RESEARCH: How HIV Guts the Immune System

EDITORIAL: Initial Treatment for HIV Infection â An Embarrassment of Riches

ORIGINAL ARTICLE: Class-Sparing Regimens for Initial Treatment of HIV-1 Infection

REVIEW ARTICLE: The Challenge of HIV-1 Subtype Diversity

ORIGINAL ARTICLE: Effect of Herpes Simplex Suppression on Incidence of HIV among Women in Tanzania

PERSPECTIVE: Challenges to HIV Prevention â Seeking Effective Measures in the Absence of a Vaccine

IMAGES IN CLINICAL MEDICINE: Crystalluria from Acyclovir Use

PERSPECTIVE: Tuberculosis in Africa â Combating an HIV-Driven Crisis

ORIGINAL ARTICLE: HLA-B*5701 Screening for Hypersensitivity to Abacavir

PERSPECTIVE: HIV in India â A Downsized Epidemic

PERSPECTIVE: One Step Forward, Two Steps Back â Will There Ever Be an AIDS Vaccine?

SOUNDING BOARD: Rapid Expansion of the Health Workforce in Response to the HIV Epidemic

EDITORIAL: Corticosteroids for Acute Bacterial Meningitis

ORIGINAL ARTICLE: Corticosteroids for Bacterial Meningitis in Adults in Sub-Saharan Africa

EDITORIAL: Manipulation of the Growth Hormone Axis in Patients with HIV Infection

ORIGINAL ARTICLE: Metabolic Effects of a Growth HormoneâReleasing Factor in Patients with HIV

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 33-2007 â A 49-Year-Old HIV-Positive Man with Anemia

EDITORIAL: Entecavir Surprise

ORIGINAL ARTICLE: The HBV Drug Entecavir â Effects on HIV-1 Replication and Resistance

REVIEW ARTICLE: An HIV Vaccine â Evolving Concepts

PERSPECTIVE: China and HIV â A Window of Opportunity

EDITORIAL: Cardiovascular Risks of Antiretroviral Therapy

ORIGINAL ARTICLE: Class of Antiretroviral Drugs and the Risk of Myocardial Infarction

REVIEW ARTICLE: Viral Hepatitis in HIV Infection

PERSPECTIVE: Tuberculosis and HIV in India

PERSPECTIVE: HIV in India â The Challenges Ahead

PERSPECTIVE: HIV in India â A Complex Epidemic

EDITORIAL: Synergistic Copathogens â HIV-1 and HSV-2

ORIGINAL ARTICLE: Reduction of HIV-1 RNA Levels with Therapy to Suppress Herpes Simplex Virus

PERSPECTIVE: Thailand and the Compulsory Licensing of Efavirenz

ORIGINAL ARTICLE: Response to Antiretroviral Therapy after a Single, Peripartum Dose of Nevirapine

PERSPECTIVE: Sex, Drugs, Prisons, and HIV

IMAGES IN CLINICAL MEDICINE: Disseminated Paracoccidioidomycosis and Coinfection with HIV

PERSPECTIVE: HIV Injustice in Libya â Scapegoating Foreign Medical Professionals

EDITORIAL: Getting Smarter â The Toxicity of Undertreated HIV Infection

ORIGINAL ARTICLE: CD4+ CountâGuided Interruption of Antiretroviral Treatment

PERSPECTIVE: HIVâAIDS in Tanzania â Realities on the Ground

PERSPECTIVE: Pioneers in AIDS Care â Reflections on the Epidemic's Early Years

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Key Role for a Viral Lytic Gene in Kaposi's Sarcoma

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2006 â A 41-Year-Old Man with Dyspnea, Fever, and Lymphadenopathy

SPECIAL ARTICLE: Cost-Effectiveness of HIV Treatment in Resource-Poor Settings â The Case of CÃ´te d'Ivoire

PERSPECTIVE: Global Health â The GatesâBuffett Effect

PERSPECTIVE: Message from Toronto â Deliver AIDS Treatment and Prevention

PERSPECTIVE: Changing the Paradigm for HIV Testing â The End of Exceptionalism

NEJM â Collection Updates for HIV/AIDS

EDITORIAL: HIV Vaccine Trial Results â An Opening for Further Research

ORIGINAL ARTICLE: AbacavirâLamivudine versus TenofovirâEmtricitabine for Initial HIV-1 Therapy

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2009 â An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2009 â A 24-Year-Old Woman with AIDS and Tuberculosis with Progressive Cough, Dyspnea, and Wasting

EDITORIAL: When to Start Antiretroviral Therapy â Ready When You Are?

PERSPECTIVE: Rationing Antiretroviral Therapy in Africa â Treating Too Few, Too Late

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 11-2009 â A 47-Year-Old Man with Fever, Headache, Rash, and Vomiting

PERSPECTIVE: Circumcision â A Surgical Strategy for HIV Prevention in Africa

PERSPECTIVE: An HIV Vaccine â Challenges and Prospects

PERSPECTIVE: The AIDS Epidemic â A Progress Report from Mexico City

PERSPECTIVE: The President's Emergency Plan for AIDS Relief â Is the Emergency Over?

EDITORIAL: HIV Integrase Inhibitors â Out of the Pipeline and into the Clinic

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 19-2008 â A 63-Year-Old HIV-Positive Man with Cutaneous Merkel-Cell Carcinoma

EDITORIAL: Initial Treatment for HIV Infection â An Embarrassment of Riches

PERSPECTIVE: Challenges to HIV Prevention â Seeking Effective Measures in the Absence of a Vaccine

PERSPECTIVE: Tuberculosis in Africa â Combating an HIV-Driven Crisis

PERSPECTIVE: HIV in India â A Downsized Epidemic

PERSPECTIVE: One Step Forward, Two Steps Back â Will There Ever Be an AIDS Vaccine?

ORIGINAL ARTICLE: Metabolic Effects of a Growth HormoneâReleasing Factor in Patients with HIV

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 33-2007 â A 49-Year-Old HIV-Positive Man with Anemia

ORIGINAL ARTICLE: The HBV Drug Entecavir â Effects on HIV-1 Replication and Resistance

REVIEW ARTICLE: An HIV Vaccine â Evolving Concepts

PERSPECTIVE: China and HIV â A Window of Opportunity

PERSPECTIVE: HIV in India â The Challenges Ahead

PERSPECTIVE: HIV in India â A Complex Epidemic

EDITORIAL: Synergistic Copathogens â HIV-1 and HSV-2

PERSPECTIVE: HIV Injustice in Libya â Scapegoating Foreign Medical Professionals

EDITORIAL: Getting Smarter â The Toxicity of Undertreated HIV Infection

ORIGINAL ARTICLE: CD4+ CountâGuided Interruption of Antiretroviral Treatment

PERSPECTIVE: HIVâAIDS in Tanzania â Realities on the Ground

PERSPECTIVE: Pioneers in AIDS Care â Reflections on the Epidemic's Early Years

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2006 â A 41-Year-Old Man with Dyspnea, Fever, and Lymphadenopathy

SPECIAL ARTICLE: Cost-Effectiveness of HIV Treatment in Resource-Poor Settings â The Case of CÃ´te d'Ivoire

PERSPECTIVE: Global Health â The GatesâBuffett Effect

PERSPECTIVE: Message from Toronto â Deliver AIDS Treatment and Prevention

PERSPECTIVE: Changing the Paradigm for HIV Testing â The End of Exceptionalism

PERSPECTIVE: AIDS in 2006 â Moving toward One World, One Hope?

PERSPECTIVE: The HIVâAIDS Pandemic at 25 â The Global Response

PERSPECTIVE: One Disease, Two Epidemics â AIDS at 25

PERSPECTIVE: Fighting HIV â Lessons from Brazil

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 6-2006 â A 71-Year-Old Woman with Urinary Incontinence and a Mass in the Bladder

PERSPECTIVE: Unfinished Business â Expanding HIV Testing in Developing Countries

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 2-2006 â A 31-Year-Old, HIV-Positive Man with Rectal Pain

EDITORIAL: Scaling Up Treatment â Why We Can't Wait

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2005 â A 34-Year-Old HIV-Positive Woman Who Desired to Become Pregnant

PERSPECTIVE: Curing Stigma â The Limits of Antiretroviral Access

PERSPECTIVE: Generic HIV Drugs â Enlightened Policy for Global Health

EDITORIAL: Routine Screening for HIV Infection â Timely and Cost-Effective

SPECIAL ARTICLE: Expanded Screening for HIV in the United States â An Analysis of Cost-Effectiveness

ORIGINAL ARTICLE: Detection of HIV-1 and HCV Infections among Antibody-Negative Blood Donors by Nucleic AcidâAmplification Testing

PERSPECTIVE: Antiretroviral Medications â From Thailand to Africa

PERSPECTIVE: After Bangkok â Expanding the Global Response to AIDS

PERSPECTIVE: Treating Hepatitis C in âDifficult-to-Treatâ Patients

EDITORIAL: Antiretroviral Agents â How Best to Protect Infants from HIV and Save Their Mothers from AIDS

PERSPECTIVE: Journal Clubs â Science as Conversation

ORIGINAL ARTICLE: A Trial of Three Antiretroviral Regimens in HIV-1âInfected Children

PERSPECTIVE: HIV and GB Virus C â Can Two Viruses Be Better Than One?

EDITORIAL: HIV Therapy â What Do We Know, and When Do We Know It?

EDITORIAL: HIV Infection and Cardiovascular Disease â Is There Really a Link?

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 31-2003 â A 44-Year-Old Man with HIV Infection and a Right Atrial Mass