December 1, 2007

In the IDSA Journals

Suppressing Herpes Virus May Reduce Infectiousness of HIV

A recent study of men co-infected with herpes simplex virus type 2 (HSV-2) and HIV demonstrated that drugs used to suppress HSV-2 may also indirectly decrease the levels of HIV-1 in the blood and rectal secretions, making patients less likely to transmit the virus. (Zuckerman et al. J Infect Dis. 2007;196:1500-1508.)

Seminal Plasma Inhibits Vaginal Microbicides

This study found that two microbicides in Phase II/III clinical trials were much less effective against herpes simplex virus type 2 (HSV-2) when the virus was introduced in seminal plasma compared to saline solution. Most previous studies have introduced the virus in saline solution or tissue culture media. The results suggest the microbicides will need to be modified to retain effectiveness under certain in vivo conditions. (Patel et al., J Infect Dis. 2007;196:1394-1402.)

U.S. Measles Immunity High, but Not Uniform

measlesOverall measles antibody seropositivity between 1999 and 2004 was high enough to promote herd immunity in nearly all U.S. population subgroups between ages 6 to 49 years. The exception is the 1967 to 1976 birth cohort, probably related to lower vaccination rates among children before the widespread implementation of school immunization requirements, and a decrease in vaccine availability when federal funding for vaccine purchase was suspended, from 1969 to 1971.  The 1967 to 1976 cohort may be at increased risk if measles is re-introduced into the United States. (McQuillan et al. J Infect Dis. 2007;196:1459-1464.) 

Hospital Staph Infections Increasing in Frequency and Cost

Trends in the Staphylococcus aureus infection rate, associated economic burden, and associated mortality in U.S. hospitals from 1998 through 2003 were assessed from the Nationwide Inpatient Sample database. During this period, the prevalence of S. aureus infection at U.S. hospitals increased between1998 and 2003 at an annual rate of 7 to11 percent, with the rate depending on how the hospital stay was classified. The economic burden of S. aureus infection to hospitals also increased over this period, with annual increases ranging from 9 to 18 percent. The risk of in-hospital mortality associated with S. aureus infection remained stable or decreased over this period. (Noskin et al. Clin Infect Dis. 2007;45:1132-1140.)    

Patients’ Knowledge and Attitudes about Antiviral Drugs Fall Short   

Patients’ attitudes, beliefs, and knowledge regarding antiviral medication and vaccination for influenza were ascertained through a survey performed at an internal medicine clinic. Overall antiviral knowledge was poor. Compared with other patients, patients with conditions associated with a high risk for complications from influenza were no more likely to have had influenza vaccination, were not more knowledgeable about antiviral medication, and were no more likely to contact their physician within 48 hours after symptom onset. Only 37 percent of patients were willing to pay more than $20 for antiviral medication. (Gaglia et al., Clin Infect Dis. 2007;45:1182-1188.)

CD4+ Cell Count at First HIV Care Visit Declines

cd4To determine whether patients with H-IV infection were presenting themselves for care at an earlier disease stage than in past years, the authors examined the immune status and time between HIV infection diagnosis and presentation for care among patients from the Johns Hopkins HIV Clinic for the period 1990–2006. Disappointingly, heterosexual men, women, and injection drug users had an increase in the severity of immunocompromise at presentation over the course of the study, and women and individuals with heterosexual transmission showed no improvement with respect to the time between HIV infection diagnosis and presentation for care. (Keruly and Moore, Clin Infect Dis. 2007;45:1369-1374.) 

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