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This Week in JAMA
April 13, 2011

This Week in JAMA

JAMA. 2011;305(14):1385. doi:10.1001/jama.2011.437

Edited by Gianna Zuccotti, MD, MPH, and Phil B. Fontanarosa, MD, MBA

In a randomized trial of patients with newly diagnosed tuberculosis (TB), Lienhardt and colleagues found that administration of rifampicin, isoniazid, pyrazinamide, and ethambutol in a daily fixed-dose regimen during the 8-week intensive treatment phase may be noninferior to treatment with the same drugs administered separately.

Neuzil and colleagues assessed the immunogenicity of alternative dosing schedules of the quadrivalent human papillomavirus (HPV) vaccine in a randomized trial of adolescent girls in Vietnam and found that compared with standard dosing at 0, 2, and 6 months, alternate dosing schedules (0, 3, and 9 months and 0, 6, and 12 months) were not associated with inferior antibody concentrations.

Persons infected with the human immunodeficiency virus (HIV) may have a compromised immunological response to vaccination. In a randomized trial of adults with HIV-1 infection who were hepatitis B virus (HBV) seronegative, Launay and colleagues found that compared with the standard HBV dose of 3 intramuscular injections of vaccine, either 4 intramuscular injections of double-dose vaccine or 4 intradermal injections of low-dose vaccine were associated with improved serological response.

Tronstein and colleagues assessed the virologic and clinical course of herpes simplex virus type 2 (HSV-2) genital shedding in a prospective cohort of persons with symptomatic and asymptomatic HSV-2 infection. They report that the risk of genital shedding was twice as high and the risk of lesions—associated with a higher quantity of shed virus—almost 3 times higher among symptomatic than asymptomatic individuals.

In an analysis of population-based and linked data from human immunodeficiency virus (HIV)/AIDS and cancer registries for the years 1980 to 2007, Shiels and colleagues examined the association between the HIV epidemic and AIDS-defining malignancies among persons with AIDS. The authors found that the proportion of Kaposi sarcoma and certain non-Hodgkin lymphomas peaked in the mid-1990s and then declined, while the proportion of cervical cancers increased over time.

In a 3-year prospective cohort study of 272 patients with rheumatoid arthritis receiving treatment with the human monoclonal antibody adalimumab, Bartelds and colleagues found that 28% of patients developed antibodies to adalimumab. Antidrug antibodies were associated with lower serum adalimumab concentrations and a lower likelihood of minimal disease activity or clinical remission.

Ms C, who has been dependent on total parenteral nutrition since 1987, has severe sepsis secondary to a central line infection. Angus discusses the treatment of sepsis, including the role of immunomodulatory therapy.

“They prepare Matthew for his last trip, down the hall, down in the elevator, into the operating room, into his final death.” From “The Walk.”

Innovative approaches to treating and preventing HIV infection, highlights of a national vaccine plan, and the hygiene hypothesis and risk of allergic diseases are featured.

From the Archives Journals

A March Archives of Surgery article reported that implementation of a bundle of evidence-based practices did not reduce abdominal surgery site infections. Kim discusses the need to carefully evaluate promising interventions in varied clinical settings.

Health care–associated infections in children

Comparative effectiveness research in infection prevention

Epigenetics: linking infectious diseases and cancer

Progress in infectious disease and immunology

For your patients: Information about hepatitis B.