Diane V. Havlir

Intriguing Differences in Lipid Effects Between Efavirenz and Nevirapine

The unfavorable lipid changes associated with many antiretroviral agents have raised concerns about the potential long-term consequences of HIV

Refining the Choices for Initial HIV Therapy

The optimal sequencing of antiretroviral regimens continues to be a challenging aspect of HIV care. In a large, randomized study conducted in the U.S.

Antiretroviral Therapy in Infants: Earlier Is Better

The best time to start antiretroviral therapy is as controversial in HIV-infected children as it is in adults. In infants, CD4-cell counts and HIV RNA

A Paradox Confirmed: GB Virus C and HIV Disease Progression

Some researchers have found GB virus C (GBV-C) infection to be associated with longer survival in HIV-infected patients (see Journal Watch Infectious Diseases Sep 20 2001). However, studies examining this association have not been controlled for potentially important variables (e.g., duration of infection) and have produced conflicting data. Researchers in the U.S. and …

A Vitamin a Day to Keep HIV at Bay

Nutritional deficiencies in HIV-infected individuals have been associated with more rapid disease progression and higher mortality rates in observational studies. In 1995, long before antiretroviral therapy was an option in Africa, Fawzi and colleagues began a double-blind, randomized, placebo-controlled trial to evaluate the effect of vitamin supplementation on disease progression in …

Insights into Initial HIV Therapy

Numerous options are now available for the initial treatment of HIV-infected patients. Current guidelines recommend a protease inhibitor or a

Drug-Resistant HIV -- Persistent from the Start

During chronic HIV infection, drug-sensitive HIV often becomes the dominant circulating species after treatment discontinuation in patients harboring drug-resistant virus. The explanation for this phenomenon is that among the mixture of viruses, the drug-sensitive virus has a growth advantage over resistant virus in the absence of drug pressure. The natural history of transmitted drug-resistant virus has …

HIV Co-Infection -- The Evidence Accumulates

Although clade B is the dominant circulating HIV strain in the U.S., the global epidemic involves multiple clades and new combinations referred to as circulating recombinant forms (CRFs). The observation that CRFs are responsible for 20% to 30% of all HIV infections provides compelling indirect evidence of simultaneous and sequential acquisition (co- and superinfection, respectively) of genetically distinct HIV strains. Two …

HIV and Malaria: Double Trouble During Pregnancy

The devastating effects of the HIV epidemic in sub-Saharan Africa are magnified by comorbidities such as malaria. For pregnant women, the interaction

Oral Induction Therapy for CMV Retinitis, at Last

Cytomegalovirus (CMV) retinitis is one of the most devastating complications of AIDS. Treatment reduces disease progression and the risk for blindness.