Shankar Subramanian

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Questions related from Shankar Subramanian

Can HIV test turn negative in a proven HIV patient who shows a progressive decline in CD4 counts?

A 30 year old lady tested positive for HIV in 2011 during routine antenatal check up of her first pregnancy. The patient confirmed the same from multiple other laboratories as is the norm (most...

28 September 2017 1,608 5 View

How common is ANCA positivity in SLE and ANA positivity in ANCA associated vasculitis?

We have a 21 year old girl who has been symptomatic for last 3 months with polyarthritis and multiple cutaneous ulcers over lower limbs with hemorrhagic blisters. She thereafter developed multiple...

04 December 2015 8,579 7 View

Do most clinical clinical trials in Rheumatoid arthritis comparing methotrexate Vs different biologic agents share a common faulty design?

For the last 2 decades we have seen a spate of clinical trials for different biologic agents starting from anti TNF agents (etanercept/Infliximab/adalimumab/golimumab), T cell costimulation...

22 November 2015 2,525 15 View

Immunovirological discordance in HIV patients on antiretroviral therapy, how would you approach such patients?

During the practice of HIV care, I have often come across this curious phenomenon of Immunovirological discordance. Here the patient comes with a falling CD4 count over time but the plasma viral...

12 September 2015 1,366 11 View

Are START trial findings applicable to India in initiating antiretroviral therapy?

The START (“Strategic Timing of AntiRetroviral Treatment”) study was a randomized, controlled clinical trial designed to more clearly define the optimal time for HIV- infected individuals to begin...

19 August 2015 3,067 5 View