Dr. Francesca Conradie at the Hope Conference

Good morning! Yesterday was the Hope Conference coordinated by Dr. Raj Gandhi. The lecturer was Dr. Francesca Conradie from South Africa speaking about Bedaquiline (BDQ), a medication used for drug-resistant TB. Among the benefits are improved cure rates for XDR-TB and it also enables clinicians to eliminate toxic drugs from patients’ regimens. For example, ototoxicity (hearing loss) is becoming less common with the advent of BDQ. A few other points:

  • BDQ can’t be given with efavirenz (levels go down)
  • Many patients in South Africa are on amitriptyline for peripheral neuropathy or depression which causes an increased QT so BDQ can’t be coprescribed with this medication.
  • At the Union World Conference in Cape Town next week, there will be a symposium about resistance, monitoring for adverse events, and pharmacovigilance.
  • Drug resistant TB surveillance in South Africa is done using the EDR.web system.
  • Delaminid co-administration with BDQ is an area of controversy.
  • Xpert Ultra/Omni will probably be approved 2016 in Europe and 2017 by the WHO. The Xpert machines won’t need to be replaced, only the software will need to be updated.

Otherwise, a few other things to note:

  • Yesterday was a very busy day in clinic but I learned a lot. What a privilege to practice at MGH with a great team.
  • An interesting article about heroin in the New York Times.
  • An important story about the Syrian refugees and parallel’s to the 1930s.
  • Pretreatment HIV drug resistance in Africa is an important issue– but viral load testing is very rarely available.
  • At end of the day I was very happy to meet with Marc Siedner. Check out his innovative work. What a great friend and mentor.
  • Music for today is Monk’s Dream by the Thelonious Monk Quartet, thanks to Matt Reed, one of the nurses in the MGH ID clinic and a jazz drummer.

Thanks so much for visiting my website! Writing and reading blog posts does take time and we all know that time is in short supply. You and I will both get much more out of this blog if it leads to dialogue. If you found my post useful and wouldn’t mind leaving a brief comment or sharing on social media, I would be grateful. Or if you’re shy about Tweeting but are willing to email me a comment that I can post anonymously or send an anonymous Surveymonkey, that would be great. My posts are generally written quickly, so if you find any factual or grammatical errors, please do let me know. Best regards, Philip Lederer

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