Treatment of patients co-infected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) is challenging. In a randomized, open-label study that included 63 patients with HCV genotype 1 and HIV co-infection and who were either treatment-naive or did not respond prior treatment with pegylated interferon plus ribavirin, Sulkowski and colleagues found that 12 or 24 weeks’ treatment with an all-oral, interferon-free antiviral regimen consisting of ombitasvir/paritaprevir co-dosed with ritonavir, dasabuvir, and ribavirin resulted in high sustained virologic response rates. In an Editorial, Graham discusses treatment of patients co-infected with HCV and HIV.
Editorial and Related Article
Continuing Medical Education
In an open-label, pilot study that enrolled 50 patients with hepatitis C virus (HCV) genotype 1 infection (treatment-naive) and human immunodeficiency virus (HIV) co-infection, Osinusi and colleagues found that administration of an oral combination of ledipasvir and sofosbuvir for 12 weeks was associated with high rates of sustained virologic response after treatment completion.
Intracranial stenosis is a common cause of stroke. In a multicenter, randomized trial involving 112 patients with symptomatic intracranial stenosis, Zaidat and colleagues assessed the safety and efficacy of combination treatment with a balloon-expandable stent and medical therapy—clopidogrel and aspirin therapy and management of individual medical risk factors—compared with medical therapy alone. Trial enrollment was stopped after early assessment of short-term outcomes suggested futility. In an analysis of data from the 111 study participants treated, the authors found that patients receiving a balloon-expandable stent and medical therapy had an increased 12-month risk of stroke or transient ischemic attack (TIA) in the same territory and an increased 30-day risk of any stroke or TIA. In an Editorial, Chimowitz and Derdeyn discuss endovascular therapy for intracranial arterial stenosis.
A physician who experienced a needlestick while working in an Ebola treatment unit in Sierra Leone consented to postexposure vaccination with an experimental vesicular stomatitis virus-vectored Ebola vaccine (VSVΔG-ZEBOV), which was administered 43 hours after the needle–stick occurred. Lai and colleagues report details of the patient’s clinical course and immune response after vaccination. In an Editorial, Geisbert discusses progress in the development of an Ebola vaccine.
Author Video Interview
An article in JAMA Psychiatry reported there are nearly 90 000 emergency department visits each year in the United States for adverse drug events resulting from therapeutic use of psychiatric medications among adults. In this From The JAMA Network article, Olfson discusses the adverse drug events identified and medications implicated in the study and highlights the need to improve surveillance of adverse medication events in clinical practice.
This JAMA Clinical Evidence Synopsis article by Venekamp and colleagues summarizes a Cochrane review of data from 5 randomized trials (1193 patients) that compared systemic corticosteroids with either placebo or standard clinical care for acute sinusitis in adults. Limited data suggest oral corticosteroids combined with antibiotics (vs antibiotics alone) may be effective for short-term relief in patients with severe symptoms. The evidence does not support corticosteroid monotherapy for acute sinusitis.
This JAMA Diagnostic Test Interpretation article by Cohen and Ellison presents a patient with abdominal pain and hyponatremia. Twenty years ago the patient underwent radiation for an optic glioma; treatment sequelae included anterior hypopituitarism. Medication review revealed recent prescription of haloperidol. Peripheral edema was absent on physical examination. How would you interpret the laboratory values?
Highlights. JAMA. 2015;313(12):1185-1187. doi:10.1001/jama.2014.11651