Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue will be available on the Internet at www.annals.org on June 20, 2000.
New anti-inflammatory drugs, COX-2 inhibitors, have been thought to cause fewer side effects than the older COX-1 inhibitors, but a randomized, controlled trial found that rofecoxib, a COX-2 inhibitor, decreased kidney function at about the same rate as indomethacin, an older anti-inflammatory (Article, p.1). The decrease appeared to be reversible when the drug was stopped. Researchers concluded that physicians should undertake the same kidney surveillance precautions with the new drugs as the old.
A young girl who received a transfusion containing HIV-positive blood began treatment with three powerful antiretroviral drugs about two days after her transfusion (Brief Communication, p. 31). The girl did not develop HIV infection during the nine months she took the drugs nor for six months after stopping treatment. The authors conclude that people recently exposed to HIV-contaminated blood should be given immediate therapy with anti-HIV drugs.
Twenty-one of 33 HIV-infected people receiving a three-drug regimen of indinavir, zidovudine and lamivudine continued to have a low viral load throughout a three-year study period (Brief Communication, p. 35). This represents the longest prospectively followed group of HIV-infected patients receiving a potent antiretroviral regimen. However, 12 people withdrew from the study, for reasons that included failure of the regimen to control the infection. Thirty-six percent of all patients developed kidney stones.