HIV and ID Observations

January 31st, 2013

When Your Language Gives Away That You Don’t Have a Clue

I was doing a clerkship in Medicine way back in my third year of medical school, and had this memorable exchange with one of the hospital’s Distinguished Professors during a case presentation on morning rounds: Me (nervous):  This is a 72-year-old man admitted with chest pain. He has a past medical history notable for a heart […]

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January 30th, 2013

“So You Think You’re an HIV Expert?”

I’ve been working with the folks over at Clinical Care Options (in particular, Elaine Seeskin) on a program entitled, “So You Think You’re an HIV Expert”, and it was just released here. It’s a series of quick interactive case presentations, and thanks to some nifty programming and great questions submitted by my colleagues Drs. Daar, […]

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January 21st, 2013

Must-Read Piece: “Fever of Too Many Origins”

Every so often a commentary gets something just right, and fortunately we have an example in this week’s New England Journal of Medicine. Entitled “Fever of Unknown Origin or Fever of Too Many Origins?”, it’s the best depiction I’ve read about doing ID consults in the intensive care unit (ICU). The author, Harold Horowitz (who has practiced […]

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January 17th, 2013

Why the Results of the C Diff Study (You Know Which One) Were No Surprise

In cased you missed it, fecal transplant — use of poop from a healthy donor, which is then infused into the colon either from above (nasogastric tube) or below (colonoscope) — is unquestionably the most effective treatment for people who have multiple recurrences of C. difficile colitis (C diff). We know this because of a randomized […]

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January 16th, 2013

More Evidence That Early HIV Treatment — REALLY Early — Is Beneficial

Management of recently acquired HIV infection — especially acute HIV, pre-seroconversion — has long been controversial, with the risks and benefits of treatment versus observation debated now for nearly two decades. (Yes, it’s been that long since the publication of this controlled trial of zidovudine monotherapy. Amazing.) On the risk side of the equation is the toxicity […]

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January 11th, 2013

How to Make the Flu Vaccine More Popular, Warts and All

In a week that saw both our hospital’s influenza-induced bed crunch make the New York Times, and my son, mother-in-law, and me succumb to this seasonal plague despite our receiving flu shots, I have been highly attuned to all things influenza. But the focus here will be on that perennial whipping boy of preventive Infectious Diseases, the […]

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January 9th, 2013

HIV Exceptionalism is Alive and Well — and That’s Too Bad

Email exchange with a colleague who works at one of our community health clinics: Guy:  Hi Paul, your patient 17432862 [that’s a made-up medical record number] came to our walk-in clinic with a rash on her hand. OK that I gave her a week of topical steroids? I know how inhaled steroids interact with some meds […]

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January 3rd, 2013

What’s a Fulyzaq? I Thought You’d Never Ask

As Physician’s First Watch noted, we sure know what the folks at the FDA were doing this holiday season — and most emphatically they weren’t visiting Aunt Selma in Boca Raton. Nope, they were stuck in White Oak, Maryland, reviewing various new drug applications, with three of the four related to Infectious Disease. The FDA’s late […]

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January 1st, 2013

HIV Incidence: The Latest Numbers

The CDC has recently issued the latest report on HIV incidence (i.e., new infections) in the United States, and as always it’s fascinating to review the numbers. To start, the year-by-year estimated incidence: 2007:  53,200 2008:  47,500 2009:  45,000 2010:  47,500 (38,000 men, 9,500 women) Nope, not much change. Will data from HPTN 052 — published in the […]

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