Archive for May, 2010

May 27th, 2010

HIV Treatment is Prevention!

The Lancet has just published a large prospective study demonstrating the protective effect of HIV treatment on the risk of viral transmission: 3381 couples were eligible for analysis … Only one of 103 genetically-linked HIV-1 transmissions was from an infected participant who had started ART, corresponding to transmission rates of 0·37 (95% CI 0·09—2·04) per 100 person-years […]


May 23rd, 2010

Dengue in the News … Again

The recent dengue cases acquired in Florida prompted me to think of two things. First, is this really a surprise?  Dengue has become increasingly common in the Caribbean, the mosquitoes that transmit the virus are widespread in the United States, and it’s not as if there’s some sort of microbiologically (if that’s a word) impermeable barrier between the […]


May 18th, 2010

Electronic Medical Records and (LONG) ID Notes

When it comes to writing consult notes, it often seems as if we ID specialists have a blatant form of obsessive-compulsive disorder. Every detail is fair game — travel history, dietary habits, all sorts of seemingly trivial exposures, and of course microbiologic data stretching back to the Cretaceous period. I’ll never forget receiving sign-out from the graduating […]


May 14th, 2010

The Luxury of the START Study … and Running Out of ART in Uganda

Over on our Journal Watch AIDS Clinical Care site, we did a poll asking about the ongoing START study: In the START study, HIV-infected patients with CD4 counts greater than 500 cells per cubic mm are being randomized to start antiretroviral therapy right away or to wait until the CD4 count falls to 350 cells per […]


May 9th, 2010

Amusing Medical Cartoons … and Humor in Medicine

Someone pointed out this cartoon to me. What an eloquent depiction of the interior dialogue of a young doctor as she considers various non-medical careers. Brilliant! Which led me to thinking more broadly about humor in medicine, about which I quickly remembered that anyone writing about humor (as opposed to writing humorously) will be instantly unfunny. Sorry. So […]


May 4th, 2010

Zoster Vaccine Underutilized

From the Annals of Internal Medicine: Eighty-eight percent of providers recommend herpes zoster vaccine and 41% strongly recommend it, compared with more than 90% who strongly recommend influenza and pneumococcal vaccines. For physicians in both specialties [Internal Medicine and Family Practice], the most frequently reported barriers to vaccination were financial. From my admittedly biased perspective as an […]


May 2nd, 2010

Learning from Clinical Trials with Limited “Generalizability”

In the ongoing debate about when to start antiretroviral therapy in our sickest patients — those with acute opportunistic infections — comes this study from Zimbabwe of early vs. deferred ART in patients with cryptococcal meningitis: The median durations of survival were 28 days and 637 days in the early and delayed ART groups, respectively (P=.031, […]


HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

Biography | Disclosures | Summaries

Learn more about HIV and ID Observations.