Top Infectious Disease Publications Highlight HIV

Each year, the American Society of Health-System Pharmacists (ASHP) provides a tremendous service to pharmacists by publishing a list of significant articles on infectious diseases (ID) pharmacotherapy from the previous year.

The 2014 list of the top ID publications appears in the August 2015 issue of the American Journal of Health-Systems Pharmacists, and its attention to human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) is noteworthy.

All articles were nominated and selected by panels of pharmacists and ID experts. For the 2014 list, members of the Houston Infectious Diseases Network nominated 9 articles specifically on HIV/AIDS that were published in prominent peer-reviewed journals and considered as having a major impact.

One article titled “Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis,” was voted the most critical piece of HIV/AIDS research in 2014. Cryptococcal meningitis accounts for approximately 25% of AIDS-related deaths in Africa, or more than 1 million deaths annually.

Antiretroviral therapy (ART) is essential to AIDS survival, but patients diagnosed with cryptococcal meningitis are at risk of immune reconstitution inflammatory syndrome (IRIS) if treated too soon. This randomized study showed improved rates of survival among 117 patients with cryptococcal meningitis who received deferred ART (at the 5-week point) compared with early ART (within 1 to 2 weeks).

It’s important to note that this study was stopped early at 26 weeks. Patients in the group receiving early ART were significantly more likely to die than those in the deferred ART group—a trend that was noted as early as study days 8 and 30.

All nominated articles cover a range of topics important to pharmacists who treat HIV/AIDS patients, including prevention, drug resistance, life expectancy, response to ART, gene editing, antiretrovirals for HIV-associated neurocognitive disorder, and of course, treatment adherence.