July 2008 Briefing - Infectious Disease

Here are what the editors at HealthDay consider to be the most important developments in Infectious Disease for July 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Deportation Linked to More HIV Infection in Male Mexicans

THURSDAY, July 31 (HealthDay News) -- The likelihood of HIV infection among injection drug users in Tijuana, Mexico depends on gender and how long they have lived in Tijuana, with a higher prevalence among males deported from the United States, according to the results of a study published online July 29 in PLoS ONE.

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United States' AIDS Relief Plan at Crossroads

THURSDAY, July 31 (HealthDay News) -- The President's Emergency Plan for AIDS Relief (PEPFAR) has achieved dramatic results so far, thanks to a strong results-oriented focus and sense of urgency, but as Congress reauthorizes funding for the program, it must consider where it goes from here, according to an article published online July 30 in the New England Journal of Medicine.

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Microbicidal HIV Prevention Trial Halted Early

WEDNESDAY, July 30 (HealthDay News) -- Cellulose sulfate gel -- investigated as a vaginal microbicide against HIV -- didn't reduce HIV infections and may have even increased the risk in a sample of women, according to research published in the July 31 New England Journal of Medicine.

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Salmonella Slows Tumor Growth in Some Cancers

WEDNESDAY, July 30 (HealthDay News) -- Salmonella typhimurium inhibits the growth of breast and colon tumors and decreases pulmonary metastasis in breast cancer models without inducing severe toxicity, according to a study published online July 29 in the Journal of the National Cancer Institute .

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Hepatitis C Doesn't Impair CD4 Recovery in HIV Context

TUESDAY, July 29 (HealthDay News) -- Coinfection with hepatitis C virus does not reduce CD4 recovery in subjects with HIV who are receiving highly active antiretroviral therapy, according to research published in the July AIDS Research and Human Retroviruses.

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Use of Antibiotic Prophylaxis for Endocarditis Discouraged

TUESDAY, July 29 (HealthDay News) -- Antibiotic prophylaxis should no longer routinely be given to prevent infective endocarditis in patients undergoing dental and other medical procedures, according to updated guidelines published online July 28 in the Journal of the American College of Cardiology. The guidelines were jointly developed by the American College of Cardiology and the American Heart Association.

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Nevirapine Dosing Studied in Breast-Feeding Moms with HIV

FRIDAY, July 25 (HealthDay News) -- In HIV-infected mothers, risk of HIV transmission to their uninfected breast-feeding infants may be reduced by a prolonged postpartum course of nevirapine, according to an article published in the July 26 issue of The Lancet.

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HIV Transmission Possible Despite Effective Treatment

FRIDAY, July 25 (HealthDay News) -- While individual risk of HIV transmission per sexual encounter is fairly small when one partner is effectively treated and the other is seronegative, the rate of transmission over large numbers of sexual encounters may be substantial, according to research published in the July 26 issue of The Lancet.

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West Nile Virus Cases Reported in 14 States

FRIDAY, July 25 (HealthDay News) -- There were 43 cases of West Nile virus reported from 14 states this year up to July 22, according to a report published in the July 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Timing Is Crucial in Measles Vaccination

FRIDAY, July 25 (HealthDay News) -- The age at which the protective effect of maternal measles antibodies wears off varies widely from region to region and should be taken into account when formulating optimum immunization strategies, according to an editorial published online July 24 in BMJ.

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HIV Survival Increases with Antiretroviral Therapy

FRIDAY, July 25 (HealthDay News) -- Significant declines in mortality and an increase in life expectancy have been seen among HIV-positive patients using combination antiretroviral therapy, according to study findings published in the July 26 issue of The Lancet.

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On-Site Vaccination Utilized to Control Pertussis Outbreak

FRIDAY, July 25 (HealthDay News) -- A school-based vaccination clinic was set up to control an outbreak of pertussis in a Cook County, Ill., high school after multiple recommendations to get vaccinated went unheeded, according to a report published in the July 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Tuberculosis Screenings Urged for Psoriasis Patients

THURSDAY, July 24 (HealthDay News) -- Before psoriasis patients are treated with systemic and biologic agents, they should be screened and treated for latent tuberculosis infections, according to a National Psoriasis Foundation consensus statement published in the August issue of the Journal of the American Academy of Dermatology.

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Raltegravir Beneficial in Drug-Resistant HIV

WEDNESDAY, July 23 (HealthDay News) -- In patients with drug-resistant HIV, treatment with raltegravir -- an integrase inhibitor -- in combination with optimized background therapy leads to significantly improved viral suppression, according to two studies published in the July 24 issue of the New England Journal of Medicine.

Abstract - Steigbigel
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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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Genetic Variation May Raise HIV Risk in African Americans

WEDNESDAY, July 23 (HealthDay News) -- A genetic variation that provides protection from Plasmodium vivax malaria appears to increase susceptibility to HIV infection, according to research published in the July 17 issue of Cell Host & Microbe.

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Shifts in Focus Could Reduce Tuberculosis

TUESDAY, July 22 (HealthDay News) -- Focusing on some foreign-born individuals with latent tuberculosis infection may represent one of the more effective options for improving TB control in this group in the United States, and a framework of strategic activities in HIV care programs could address pressing global concerns related to TB, according to two studies in the July 23/30 issue of the Journal of the American Medical Association.

Abstract - Cain
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Abstract - Havlir
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Homosexuals in Pakistan at High Risk of HIV Infection

TUESDAY, July 22 (HealthDay News) -- Although homosexuality is prohibited in the Islamic Republic of Pakistan, it is widely practiced and men who have sex with men are at high risk of HIV infection. Policy changes are needed in Pakistan to reach this vulnerable population, according to an article published in the August issue of The Lancet Infectious Diseases.

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Using Older Liver Donors May Help Reduce Waiting Lists

TUESDAY, July 22 (HealthDay News) -- Using livers donated by marginal donors may reduce the waiting time for liver transplant patients without having a negative impact on outcomes, even for patients with hepatitis C virus, according to research published in the July issue of the Archives of Surgery.

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Routine Human Papillomavirus Vaccination Cost-Effective

FRIDAY, July 18 (HealthDay News) -- Routine vaccination of 12-year-old girls against human papillomavirus, combined with an initial catch-up campaign to cover girls up to the age of 18, would likely be cost-effective, according to research published online July 17 in BMJ.

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Anti-HIV Microbicides Could Have Surprising Outcomes

FRIDAY, July 18 (HealthDay News) -- Vaginal microbicides containing antiretrovirals to prevent HIV infection in women could lead to many cases of drug resistance, according to research published in the July 15 issue of the Proceedings of the National Academy of Sciences.

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Bacterial Infection Linked to Reduced Childhood Asthma

THURSDAY, July 17 (HealthDay News) -- Childhood infection with Helicobacter pylori reduces the likelihood of developing asthma and related illnesses, according to an article published online July 3 in the Journal of Infectious Diseases. A related review in the May issue of Gut discusses the current evidence and possible mechanisms linking H. pylori infection, asthma and allergy.

Abstract - Journal of Infectious Diseases
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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

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Importance of Adolescent Vaccines Highlighted

THURSDAY, July 17 (HealthDay News) -- The United States must focus on effective delivery if adolescents are going to benefit from the development of recent vaccines, according to two articles published in the August issue of the American Journal of Preventive Medicine.

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AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Cancers Increasing in HIV-Infected Patients

THURSDAY, July 10 (HealthDay News) -- Although treatment advances have reduced HIV-related deaths in HIV-infected patients, they are at increasing risk of dying from cancer, and little is known about optimal treatments or the effects of combining antiretroviral and anticancer drugs, according to a review published online June 30 in the Journal of Clinical Oncology.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

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Tuberculosis Risk for Children Adopted Internationally

WEDNESDAY, July 9 (HealthDay News) -- It is common for internationally adopted children to have latent tuberculosis infection and to have an initial false negative result from a tuberculin skin test, according to a report published in the July issue of Pediatrics.

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FDA Requests New Warning on Fluoroquinolone Labels

TUESDAY, July 8 (HealthDay News) -- Manufacturers of fluoroquinolone antimicrobial drugs must add a boxed warning to the product labeling that explains the increased risk of tendinitis and tendon rupture in those taking the drugs, according to an alert issued by the U.S. Food and Drug Administration Tuesday. The alert also notifies manufacturers that they should provide a medication guide to warn patients about the risk.

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Test Provides Good Specificity for Latent Tuberculosis

MONDAY, July 7 (HealthDay News) -- Interferon-γ-release assays (IGRAs) and tuberculin skin tests both offer high specificity for tuberculosis in populations unvaccinated with bacille Calmette-Guerin, but the IGRAs also offer high specificity in those who are vaccinated, according to research published in the Aug. 5 issue of the Annals of Internal Medicine.

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Researchers Document Process of Herpes Latency

THURSDAY, July 3 (HealthDay News) -- The hypothesis that herpes viruses utilize microRNAs (miRNAs) to initiate and maintain latency was supported by a finding that herpes viruses are capable of downregulating key viral immediate early proteins, according to an article published online July 2 in Nature.

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Combo Therapy Improves Survival in Hepatitis B

THURSDAY, July 3 (HealthDay News) -- Combining hepatitis B immunoglobulin (HBIG) and lamivudine significantly improves prevention of hepatitis B virus (HBV) recurrence, HBV-related death and all-cause mortality in the post-liver transplantation setting, according to an article published in the June issue of Clinical Gastroenterology and Hepatology.

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Increase Seen in HIV Diagnoses Among Young Men

THURSDAY, July 3 (HealthDay News) -- Data from 33 states on new HIV diagnoses shows that from 2001 to 2006 there was a 12 percent rise in diagnoses among men who have sex with men (MSM) in the 13 to 24 age group, according to a report published in the June 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Drug Demonstrates Efficacy in Chronic Hepatitis B Patients

WEDNESDAY, July 2 (HealthDay News) -- Entecavir improved multiple efficacy endpoints compared to continued lamivudine in patients with chronic hepatitis B with resistance to lamivudine, according to an article published in the July issue of Hepatology.

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Access to Treatment Pushes HIV Mortality Rates Down

TUESDAY, July 1 (HealthDay News) -- Because of the introduction of highly active antiretroviral therapy, mortality rates for HIV patients have declined and are now much closer to mortality rates in the general population, according to a report published in the July 2 issue of the Journal of the American Medical Association.

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Multiple Vaccines for Iraq-Bound U.K. Forces Not Harmful

TUESDAY, July 1 (HealthDay News) -- British armed forces personnel did not suffer any adverse health effects from the multiple vaccinations they were given prior to deployment, according to research published online June 30 in BMJ.

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Tuberculosis Outbreaks Predicted from First Cases

TUESDAY, July 1 (HealthDay News) -- Large tuberculosis outbreaks occurring within two years of the initial case can be predicted based on the characteristics of the first two cases, researchers report in the July 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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New Recommendations for Quality Performance Measures

TUESDAY, July 1 (HealthDay News) -- Health care quality performance measures should be developed with the participation of end users and should take a cautious and flexible approach, according to an article published in the July 1 issue of the Annals of Internal Medicine.

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Screening Pregnant Women for Bacteriuria Reaffirmed

TUESDAY, July 1 (HealthDay News) -- The U.S. Preventive Services Task Force has reaffirmed its 2004 recommendation to screen all pregnant women at 12 to 16 weeks' gestation for asymptomatic bacteriuria but not to screen non-pregnant women or men, according to an article published in the July 1 issue of the Annals of Internal Medicine.

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