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Every day physicians are confronted with situations that require evaluation concerning the indication for a post-exposition prophylaxis (PEP) for HIV or, less frequently, for hepatitis B (HBV). There is no specific prophylaxis for hepatitis C (HCV). In light of the experience gained in the domain of HIV in the last years, some international guidelines for PEP have been changed with regard to the choice of drugs and when to start PEP. This article attempts to resume the different factors contributing to the evaluation of PEP according to the local guidelines and to introduce the foreseen changes in the new Swiss-guidelines for PEP that will be released in autumn 2013.

Pyoderma gangrenosum is a rare ulcerative disease associated with inflammatory bowel disease, arthritis or haematological malignancies. The diagnosis of Pyoderma gangrenosum is often delayed while consideration is given to the more likely diagnoses of wound breakdown or bacterial infection. The outcome depends on early diagnosis and on excellent collaboration between the surgical team and the infectious disease specialist. We present two puzzling cases of Pyoderma gangrenosum and discuss the physiopathology, the diagnosis strategy and the management.

The amplification of nucleic acids is often used for the diagnosis and the follow-up of infectious diseases. The interpretation of PCR results varies according to the pathogens detected, the site of infection and the clinical presentation. PCR tests might be the reference method or only an help for the diagnosis. With the development of antiviral treatments quantitative PCR tests are now essential for the evaluation of treatment efficacy. A discussion with the laboratory is important for the correct interpretation of PCR results.

Zidovudine (ZDV) was the most widely used anti-HIV drug between 1987 and 1995, and, as already reported, transmission of ZDV-resistant viruses occurs. Several mutations of the reverse transcriptase gene have been identified; one of them affects the 215 codon and is associated with a high degree of resistance. We have determined, using selective PCR, the prevalence of transmission of 215 mutant isolates in 134 patients with primary HIV infection (PHI) and have identified 8 patients with 215 mutant virus between 1989 and 1995 in Switzerland. Mutant resistant viruses have been isolated from patients treated with most antiviral drugs. A systematic search for mutant viruses may provide useful information for the adaptation of treatment strategies.