Hello Viremic listeners. We are taking a break for the month of July. Please check out our past episodes and catch up on any cases you may have missed.

We love hearing from our listeners, so please send us comments or potential case topics to viremicpodcast@jh.edu. Don’t forget to give us a like and follow us wherever you access podcasts. We’ll be back on Tuesday, August 4 with a new case to discuss.

Thank you.

A new-to-you patient—51-yr-old man with HIV since the early 2000s—has spotty vaccine records. How to educate, make recommendations, and avoid too many vaccinations at once? Listen as Chris and Eileen from Johns Hopkins make the case argue for their favorite vaccines among the many recommended for adults with HIV and describe their approaches to patient education, prioritizing based on specific patient needs, and strategizing vaccination schedules.

Reference:

• Marks KM, Kang M, Umbleja T, et al. HepB-CpG vs HepB-Alum Vaccine in People With HIV and Prior Vaccine Nonresponse: The BEe-HIVe Randomized Clinical Trial. JAMA. 2025 Jan 28;333(4):295-306. PMID: 39616603.

Related Guidelines and Resources from the NYSDOH AI Clinical Guidelines Program:

• Immunizations for Adults With HIV; see especially:
  • Hepatitis B Virus (HBV)
  • Human Papillomavirus (HPV)
  • Measles, Mumps, Rubella (MMR)
  • Pneumococcal
  • Zoster
• Prevention and Management of Hepatitis B Virus Infection in Adults With HIV
• Prevention and Management of Human Papillomavirus Infection in Adults With HIV
• Viremic Case 15. A Pain in the Butt: Anal Cancer Screening and Prevention

A 42-yr-old man with AIDS presents feeling unwell, with white spots in his mouth, and scattered violaceous macules on his upper extremities; he has never taken ART. Listen as hosts Eileen Scully and Chris Hoffmann from Hopkins describe their initial work-up for a patient with a CD4 count of 10; discuss symptoms, diagnosis, and treatment of Kaposi sarcoma and other HHV8-related diseases; and remember the historical stigma of KS and the lingering effects of that stigma as they confirm the need to remain KS-aware even in 2026 in the U.S.

References Cited:

• Bettuzzi T, Lebbe C, Grolleau C. Modern Approach to Manage Patients With Kaposi Sarcoma. J Med Virol. 2025 Mar;97(3):e70294. PMID: 40119751.
• Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. National Institutes of Health, HIV Medicine Association, and Infectious Diseases Society of America. Human Herpesvirus-8 Disease. Updated April 23, 2025. Available online here. Accessed 5/21/2026.

Related Guidelines
NYSDOH AI Clinical Guidelines Program:

• Primary Care for Adults With HIV; see especially Flowchart 3: Initial Visit: New Patient, HIV Confirmed, NOT Taking ART
• Management of IRIS
• Rapid ART Initiation

Clinical Info HIV.gov:

• HIV Clinical Guidelines: Adult and Adolescent Opportunistic Infections – Human Herpesvirus-8 Disease

Resource:

• DermNet – Kaposi sarcoma images