geoffrey modest medical blogs

  The CDC reported a spike in hepatitis A infections in men who have sex with men (MSM), see https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7024a2-H.pdf  )    Details:   --from 1994-2011, there was a 95% decrease in hepatitis A infections from 12 cases/100K population to 0.4 cases/100K  --from 2012-2015, the number of cases plateaued  --from 2016-2018, the incidence increased 294% vs 2013-2015      --most cases occurred in high-risk people (MSM, homeless, injection and noninjection drug users)     --from Jan 2017-Nov 2018, the CDC reported 260 cases of confirmed hep A (symptoms of viral hepatitis and positive IgM against hepatitis A virus, HAV) in MSM in 8 states (had been 16 cases from all 50 cases during 2013-2015), in California, Colorado, Georgia, Maryland, New York, North Carolina, Pennsylvania and Virginia. These states reported 1,229 additional cases without indication of MSM status    ...

  A recent study found that cabotegravir (CAB) was better than TDF-FTC (tenofovir disoproxil fumarate/emtricitabine, or truvada, which is available as a generic) for preexposure prophylaxis (PrEP) against HIV (see  hiv pre-exp proph cabotegravir nejm2021  in dropbox, or DOI: 10.1056/NEJMoa2101016)    Details:  -- randomized, double-blind, noninferiority trial compared long-acting injectable CAB 600 mg given intramuscularly every eight weeks with daily oral TDF/FTC for the prevention of HIV infection in at-risk MSM and transgender women who have sex with men  -- multicenter trial in the United States (37%), Latin America (Argentina 7%/Brazil 17%/Peru 18%), Asia (Thailand 12%/Vietnam 4%), and Africa (3 %)  -- 4566 participants were randomized, including 570 (13%) transgender women  -- median age 26; in the US component, 845 (50%) were Black (ie, it was a racially diverse population)  -- all had negative HIV viral load within 14 days b...