A Case of Non-Cirrhotic Portal Hypertension Associated With Chronic Didanosine Therapy.

A 66-year-old man with HIV and recurrent thromboembolism presented with new-onset ascites with an extensive diagnostic work-up that was unremarkable. He was diagnosed with non-cirrhotic portal hypertension after a liver biopsy revealed mild fibrosis and hepatic venography revealed an elevated hepatic venous pressure gradient. The etiology of portal hypertension was attributed to didanosine therapy, a rare but noted side effect.

Efavirenz outperforms boosted atazanavir among treatment-naive HIV-1-infected persons in routine clinical care.

Background: Effectiveness of antiretroviral therapy (ART) in a routine clinical care may result different from the clinical trials. We assessed the virologic outcomes in treatment-naive persons who received either efavirenz (EFV) or atazanavir/ritonavir (ATV/r) with a backbone of tenofovir/emtricitabine (TDF/FTC) as their combination ART (cART).

Methods: This was a retrospective cohort study conducted at the Washington University HIV Outpatient Clinic from January 2004 to June 2009.

Paragonimus kellicotti flukes in Missouri, USA.

Paragonimiasis is an infection caused by lung flukes of the genus Paragonimus. In Asia, P. westermani infections are relatively common because of dietary practices.

Mental health disorders and the risk of AIDS-defining illness and death in HIV-infected veterans.

Objective: Mental health comorbidities are common in HIV-infected veterans and can impact clinical outcomes for HIV. We examined the impact of mental health diagnoses on progression to AIDS-defining illness (ADI) and death in a large cohort of HIV-infected veterans who accessed care between 2001 and 2006.

Design: Retrospective cohort study using the national Veterans Health Administration (VHA) HIV Clinical Case Registry.

Transmitted drug-resistant HIV type 1 remains prevalent and impacts virologic outcomes despite genotype-guided antiretroviral therapy.

Trends in transmitted drug resistance-associated mutations (TDRM) in HIV-1infection vary depending on geographic and cohort characteristics. The impact of TDRM among patients receiving fully active combination antiretroviral therapy (cART) is poorly characterized. This was a retrospective study of 801 HIV-1-infected treatment-naive patients from 2001 to 2009 who had pre-cART genotype resistance test results available.

Risk factors associated with Hepatitis C among female substance users enrolled in community-based HIV prevention studies.

Background: Hepatitis C virus (HCV) infection is one of the most frequent chronic blood-borne infections in the United States. The epidemiology of HCV transmission is not completely understood, particularly in women and minorities.

Findings: We examined the HCV associated risk factors in substance abusing females involved in National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Institute on Drug Abuse (NIDA) funded HIV prevention studies of street recruited women.

Factors associated with receipt of adequate antidepressant pharmacotherapy by VA patients with recurrent depression.

Objective: Adequate treatment of depression improves the prognosis of depressed individuals. This study identified sociodemographic, medical, psychiatric, and health care utilization factors associated with receipt of adequate antidepressant pharmacotherapy by Veterans Health Administration (VHA) patients with recurrent depression.

Methods: National VHA electronic medical records were used to construct a cohort of depressed patients who were experiencing a recurrent episode of depression between 1999 and 2006.

Rate of kidney function decline associates with mortality.

The effect of rate of decline of kidney function on risk for death is not well understood. Using the Department of Veterans Affairs national databases, we retrospectively studied a cohort of 4171 patients who had rheumatoid arthritis and early stage 3 chronic kidney disease (CKD; estimated GFR 45 to 60 ml/min) and followed them longitudinally to characterize predictors of disease progression and the effect of rate of kidney function decline on mortality. After a median of 2.

STD/HIV risk among adults in the primary care setting: are we adequately addressing our patients' needs?

Background: Risk behavior surveys often target sexually transmitted disease (STD) clinic populations, but few studies address risk behaviors in primary care settings.

Methods: This cross-sectional study performed at a university adult primary care clinic evaluated risk behaviors using an anonymous, self-administered survey. The following data were collected: demographics, sexual history, condom use, and confidence discussing STDs.

The interplay of sociodemographic factors on virologic suppression among a U.S. outpatient HIV clinic population.

Understanding challenges to virologic suppression is essential to optimizing health outcomes among individuals with HIV. This cross-sectional behavioral assessment was conducted among 514 individuals presenting at an urban U.S.

A review of nucleoside reverse transcriptase inhibitor use to prevent perinatal transmission of HIV.

Worldwide, women comprise > 50% of all people living with HIV and the vast majority of these women are of childbearing age. In fact, a significant proportion of these women are identified as HIV-infected during pregnancy. Preventing perinatal transmission has been one of the greatest prevention successes of the HIV epidemic with < 2% of live births resulting in an HIV-infected infant.

Adverse effects of tenofovir use in HIV-infected pregnant women and their infants.

Background: Data regarding use of tenofovir disoproxil fumarate in HIV-infected pregnant women are limited.

Objective: To identify adverse effects of tenofovir use during pregnancy in HIV-infected women and their infants.

Methods: In a retrospective case series, the charts of 127 pregnant HIV-infected women who received highly active antiretroviral therapy (HAART) between 2001 and 2005 were reviewed.

Effect of postpartum HIV treatment discontinuation on long-term maternal outcome.

Background: Long-term maternal outcomes after postpartum antiretroviral therapy (ART) discontinuation are unknown.

Methods: Retrospective review of pregnancies in HIV-infected women on treatment between 1997 and 2005. Women were grouped by postpartum ART use and followed until new opportunistic infection (OI), death or last clinic visit.

Incidence of sexually transmitted infections among HIV-infected women using depot medroxyprogesterone acetate contraception.

Background: Previous studies suggest that depot medroxyprogesterone acetate (DMPA) is associated with an increased risk of sexually transmitted infection (STI) acquisition. The primary aim of this study was to characterize the potential association between DMPA use and risk of STI acquisition among HIV-infected women.

Study Design: This is a retrospective cohort study among HIV-infected women followed at a university clinic from 1997 to 2005.