Infectious Disease

ALEXANDRIA, Va. -- All health-care workers should be required to get a flu shot every year, unless they formally refuse in writing, the Infectious Diseases Society of America said today.

MAINZ, Germany -- A novel antifungal agent has emerged from two randomized trials as effective and safe in preventing invasive fungal disease after chemotherapy or treatment for graft-versus-host disease.

ROCHESTER, N.Y. -- When a rapid test catches the flu, it reduces inappropriate use of antibiotics in adults, according to researchers here.

BUENOS AIRES -- Patients with relapsing-remitting multiple sclerosis who also had parasitic worm infections had significantly better clinical courses than non-infected MS patients, investigators here found on a small study.

PITTSBURGH -- Small children with persistent middle-ear effusion who did not get immediate insertion of tympanostomy tubes developed as well as peers given rapid treatment when they grew to ages nine to 11 years, investigators here reported.

WINNIPEG, Manitoba -- The 1918-19 Spanish flu may have killed 50 million persons by unleashing an uncontrolled immune response that fatally damaged lung tissue, according to researchers here.

ATLANTA -- For the second year in a row, the absolute number of cancer deaths edged downward in the United States, the American Cancer Society said today.

NEW YORK -- Men from large families, particularly those who are the youngest siblings, are at increased risk for Helicobacter pylori-related stomach cancer, researchers said.

BOSTON -- Universal one-time melanoma screening of adults ages 50 or older by dermatologists would cost about ,000 per quality-adjusted life year gained, which compares favorably with the cost of breast or colon cancer screening.

LONDON -- As a quick screening tool, the ratio of a patient's white blood cell types differentiated acute purulent tonsillitis from infectious mononucleosis, researchers here reported.

BOSTON -- A history of gonorrhea may translate into a twofold increased risk of bladder cancer for men, researchers here reported.

BOSTON -- For women in developing countries who are HIV-positive, a dose of Viramune (nevirapine) during labor to prevent mother-to-child viral transmission does not preclude the safe renewed use of Viramune-based antiretroviral therapy after a six-month delay.

SEATTLE -- Persons newly released from prison, within their first two weeks of freedom, have a nearly 13-fold higher risk of death than those in the general population.

VILLEJUIF, France -- Risk factors for new-onset diabetes following liver transplantation include hepatitis C status, weight, and impaired fasting glucose status, French investigators reported.

BOSTON -- Clinical and research developments in neurology in 2006 seemed to be as much about prevention as treatment.

ATLANTA -- A more comprehensive vaccination schedule for children and adolescents has been issued by the CDC for 2007.

ATLANTA -- Those cute little hamsters can carry nasty salmonella pathogens. A rodent is a rodent.

BOSTON -- The so-called Bacterial Meningitis Score remains a useful tool, even as the condition has become less common in the U.S., a collaborative research committee says.

The introduction of effective antiretroviral therapy has resulted in dramatic clinical benefits for those persons who have access to it. Adherence to such therapy has emerged as both the major determinant and the Achilles' heel of this success. Many patients have levels of adherence too low for durable virologic control.

The elimination of perinatal HIV transmission in the United States is within reach. When antiretroviral therapy is effective in controlling maternal viremia during pregnancy, the risk of perinatal transmission is less than 1%.

HIV can be transmitted from an infected mother to her child during pregnancy or labor and postnatally through breast milk. Nearly 25 years after the first documented case of HIV infection, the decrease in perinatal HIV infections in the United States represents a major success in public health.

Liver disease, particularly hepatitis C, has emerged as a major cause of morbidity and mortality for people with HIV/AIDS in the era of potent antiretroviral therapy. Mortality is increased in patients with HIV–hepatitis C virus (HCV) coinfection compared with that in patients with HIV alone.1,2

The title of this column is the slogan from World AIDS Day 2006, and as we look to 2007 and a new Congress, a more appropriate slogan could not have been chosen. However, rather than keeping the promise, we are only slightly farther ahead than we were 1, 5, 10, or even 20 years ago and at some risk of going backward, as evinced by the sobering information made available through the World Health Organization (WHO) and the CDC.

Salivary gland enlargement, most commonly involving one or both parotid glands, is sometimes seen in association with HIV infection. Enlargement of the parotid gland may be due to diffuse infiltrative lymphocytosis syndrome; lymphoepithelial cysts; or malignant tumors, such as squamous cell carcinoma, Kaposi sarcoma, and Hodgkin and non-Hodgkin lymphomas.1,2 Non–HIV-related causes of parotid enlargement include acute and chronic viral infection, granulomatous disease, malnutrition, alcoholism, and diabetes mellitus.3,4 Here we report the case of a 41-year-old HIV-infected man with fat maldistribution syndrome associated with type 2 diabetes and hyperlipidemia. Sialadenosis developed presumably as a result of HIV infection and hypertriglyceridemia.

Shortly after the introduction of combination antiretroviral therapy, it was noted that a significant fraction of patients, from 8% to 17%, had poor CD4+ T-cell recovery despite suppression of HIV RNA to undetectable levels for at least 6 to 12 months.1