New JAMA issue focuses on infectious diseases and immunology

Several media outlets report on findings published in this week's issue of JAMA, which focuses on infectious diseases and immunology.

MedPage Today describes one study that examined the efficacy of a four-drug fixed-dose combination (FDC) treatment for tuberculosis. Though such combinations offer regimens that are "easier to administer, require fewer pills, and have been seen as a way to prevent drug resistance arising from incorrect use of medications," some have questioned "their efficacy in comparison with the same drugs given separately," which has "slowed their acceptance," the news service writes.

The researchers studied 1,585 adults with newly diagnosed smear-positive pulmonary TB from Africa, Asia and Latin America, comparing those that received FDC treatment to those who received the four identical drugs separately. The study concluded that the "fixed-dose combination of four tuberculosis drugs yielded outcomes comparable to the four drugs given separately," according to the news service (Smith, 4/12).

"It is essential that FDCs are made available worldwide," study author Christian Liendhart, a senior scientific adviser at the WHO said during a press conference announcing the findings on Tuesday, according to Inter Press Service. "While new regimens of drugs are being developed for the treatment of tuberculosis, it is essential that strategies are developed for their introduction in national TB control programmes," Liendhart said. However, some scientists say introducing FDCs perpetuates conventional treatments that are failing and instead say resources should be put into developing new antimicrobial agents and prevention efforts, IPS reports (D'Almeida, 4/13).  

Meanwhile, HealthDay News/U.S. News & World Report describes how a separate JAMA study found "[g]iving doses of human papillomavirus (HPV) vaccine over a longer-than-normal period of time may prove an effective way to make the vaccine available to more females in poorer nations." The majority of HPV-related cancer deaths occur among women in developing countries.

For the study, "researchers looked at four different dosing schedules used to give HPV vaccine to 903 adolescents girls at 21 schools in Vietnam. The doses were given according to a standard schedule of 0, 2 and 6 months or one of three alternative schedules (0, 3 and 9 months; 0, 6 and 12 months; or 0, 12 and 24 months)," according to the news service. "The girls in the alternative dosing schedule groups developed antibody concentration levels similar to the girls in the standard dosing group, and no serious adverse events were reported" (4/12).

The study results "suppor[t] more widespread introduction of the vaccine," the study authors write. "The option of delivering HPV vaccine on flexible schedules will allow countries to minimize costs and maximize feasibility according to local vaccination practices," they conclude (Neuzil et al., 4/13).