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Top Infectious Disease News of the Week—August 19, 2018


#3: An Update to Antiretroviral Therapies for Pediatric Patients Living with HIV

The burden of pediatric HIV infection in the United States has decreased in the recent years. The number of patients 19 years and younger at their HIV diagnosis declined from 4250 in 2011 to 3813 in 2016. And among children who received the diagnosis when they were younger than 13 years, the number of perinatal infections fell to below 100 in the United States in 2016.1 This drop may be attributed to efforts focused on the prevention of HIV transmission from mother to child. Examples of such efforts include universal prenatal HIV screening, combination antiretroviral therapies (ARTs) to maximally suppress the maternal viral load, elective cesarean delivery, provision of neonatal antiretroviral (ARV) prophylaxis, and neonatal replacement feeding.

In the current era of ART, treatment options are more potent but have fewer toxicities and better adverse effect profiles. Lower pill burdens and dosing frequencies and more combination drug formulations, including single-tablet regimen (STR) options, provide multiple options to complement patients’ preferences and lifestyles. Specifically, for pediatric patients who have difficulty swallowing pills, the availability of chewable formulations, such as chewable raltegravir (Isentress), provides patients a better chance of improved adherence to achieve viral suppression and preservation of immune function.

Read more about ART for pediatric patients with HIV.

#2: Smallpox—A Nightmare We Cannot Shake

There are some things in public health that seem to leave a mark forever. The Black Death, smallpox contaminated blankets used as a weapon, Amerithrax, the Tuskegee syphilis study, etc. Public health is filled with wonderful and horrifying moments alike and the truth is that we do not get many moments to truly celebrate on a global level. Outbreaks may end, but the act of completely eradicating a disease? That’s something we’ve been striving toward for centuries, and with smallpox, we hit the goal in 1980. The eradication is considered one of the greatest public health accomplishments in history. A monumental global effort, it is something we remember as a proud moment in public health. Given the success of eradication, it begs the question: Why does the nightmare of smallpox still linger?

In July 2018, the antiviral TPOXX was approved as the first ever treatment for smallpox. It may seem odd that treatments for an eradicated disease are still being developed, but the truth is that there is still a chance smallpox could resurface. That may seem a bit “doomsday-ish” but here are a few reasons why we should take the threat of smallpox seriously.

Read more about smallpox.

Is there a cure? How long until we find it? And will it work for the majority of people living with HIV?