HIV and ID Observations

January 29th, 2012

Pre-Super Sunday Scombroids

Some quick ID/HIV links while we await big guys playing the big game with a big (or at least bigger) ball. Did you see how this doctor cheated Medicaid out of more than $700,000 by prescribing HIV meds to people who didn’t have HIV? Not surprisingly, he’s going to jail. Proof that if there’s money behind a […]

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January 22nd, 2012

Generic Lamivudine Has Arrived

An e-mail from a patient last week: Just got refills. Epivir is now generic???  Refill is simply labeled Lamivudine Tablets by Aurobindo Pharma USA, Inc …but made in India.  Should I be concerned about that??? John I told John (not his real name) not to be concerned — he is merely substituting the generic for the […]

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January 21st, 2012

More Medical Testing! No, Less! You Decide

Fascinating Yin-Yang this week on the issue of medical testing. Want more? Want less? First, this remarkable piece on retail medical labs, including a description of a company called ANY LAB TEST NOW: Labs where folks can just walk in and order tests on themselves are popping up in retail centers across the country… At Any Lab Test […]

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January 18th, 2012

ID Case Conference Discussant Types

We specialists in Infectious Diseases love case conferences — especially those where the case is presented as an “unknown”, and we try to figure out the diagnosis from the history. I suppose this isn’t very surprising, since ID cases in general are already among the most interesting in all of medicine. Those that are case-conference-worthy are […]

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January 10th, 2012

First Rabies Case in State in Over 75 Years Raises Questions (Again) About Preventive Strategies

The recent case of bat-related rabies in a Barnstable man has prompted my colleague Larry Madoff, director of the Division of Epidemiology and Immunization at the Mass Department of Public Health, to write this fine commentary in the Atlantic. I particularly like these passages: Rabies is perhaps the archetypal zoonotic disease, one spread between animals and humans. […]

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January 8th, 2012

Journal Club: In Early HIV Infection, Little Reason to Delay Therapy

Every experienced HIV clinician will recognize the following new-patient scenario: At least one, but often several negative HIV antibody tests in the past, generally due to being in a “high risk” group. Recent non-specific viral-type illness that, in hindsight, was undoubtedly acute HIV infection, undiagnosed. Now completely recovered, but found to be newly HIV antibody positive. […]

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January 4th, 2012

How Does Herpes Treatment Trigger a Positive Test for Performance-Enhancing Drugs?

Here’s my guess on how many of this blog’s readers know the following “facts”: Acyclovir and related drugs are used to treat herpes: nearly 100% Ryan Braun, superstar left fielder for the Milwaukee Brewers, is facing a 50 game suspension for testing positive for elevated levels of a “banned substance”, most likely testosterone: 10% Braun has […]

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January 3rd, 2012

Prevnar Now Approved for Adults — But Should We Start Using It?

From the FDA (and thanks to Physician’s First Watch for reporting the news): Prevnar 13, a pneumococcal 13-valent conjugate vaccine, was approved today by the U.S. Food and Drug Administration for people ages 50 years and older to prevent pneumonia and invasive disease caused by the bacterium, Streptococcus pneumoniae. As shown in multiple studies, Prevnar has dramatically […]

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