An ongoing dialogue on HIV/AIDS, infectious diseases,
June 21st, 2022
Mayo Clinic Study on Paxlovid Outcomes is Reassuring — but Likely Underestimates Rebound Rate
Over at Clinical Infectious Diseases, researchers from the Mayo Clinic published a retrospective analysis of nirmatrelvir/r (Paxlovid) treatment, with a careful review of each patient’s chart. The goal was to determine the clinical outcomes after the 5-day treatment course, with a focus on the frequency of rebounds — a topic of great clinical interest but with little […]
June 6th, 2022
Still More Fun with Old Medical Images
Back in the Before Times, this site would occasionally dabble in lighter fare: Cartoon caption contests Commentaries on doctor attire Thoughts on the first-name “Morgan” Penguins chasing a butterfly (Well, actually, this is a new one!) https://twitter.com/buitengebieden/status/1533022340887486466?s=20&t=ShPbhfDhg-BwCP2bWisXfA And, the subject of today’s post — Fun with Old Medical Images. Here’s how it works: We display an old medical […]
May 23rd, 2022
In Praise of Dr. Glaucomflecken
Sometimes there is someone so good at something that there is universal agreement we are witnessing something special. Babe Ruth, Serena Williams, and Michael Jordan competing at their peaks. Charles Dickens or Jane Austen creating whole worlds out of invented characters and plots. Vladimir Horowitz performing Rachmaninoff at Carnegie Hall. Bernini creating sculptures from cold, hard […]
May 4th, 2022
More on Relapses after Paxlovid Treatment for COVID-19
Unless you’ve been hiding under a rock, you’ve heard that some people treated for COVID-19 with nirmatrelvir/ritonavir (Paxlovid) experience a relapse in illness shortly after stopping treatment. It’s both a recurrence of symptoms and a positive antigen test — sometimes after the test became negative. One case report published as a pre-print shows that a relapse can have […]
April 25th, 2022
Yes, Relapses After Paxlovid Happen — Now What?
Around two weeks ago, one of my long-term, very stable patients with HIV called me saying she’d just been diagnosed with COVID-19. Over 60 with hypertension, and overweight, she qualified for nirmatrelvir/r (Paxlovid) under the Emergency Use Authorization (EUA), and took it without problem. (Certain details changed for confidentiality.) In fact, she started to improve within 24 […]
April 12th, 2022
Should We Prescribe Nirmatrelvir/r (Paxlovid) to Low-Risk COVID-19 Patients?
The top recommended treatment for high-risk outpatients with COVID-19 in the NIH Guidelines is nirmatrelvir/r (Paxlovid). It’s quite clear why. In the EPIC-HR study, unvaccinated people at high risk for severe outcomes had an 89% reduction in the risk for hospitalization or death compared to placebo. If we just look at mortality — another important endpoint, […]
April 1st, 2022
As the World Around Us Moves On, We ID Docs Just … Can’t
Something quite remarkable happened as Omicron tore through the United States in December and January. Despite triggering a record number of cases — which should have made people more concerned about COVID-19 — Omicron paradoxically did the opposite. It made most of our country decide to move on, even parts famous (or infamous, depending on your […]
March 22nd, 2022
What Have We Learned from the Pandemic So Far?
Dear Readers, I need your help. Recently one of my colleagues reached out and asked if I could give a talk to his research group. “Just give one of your canned Covid talks,” he said. Ha. Needless to say — but I will say it anyway — he’s not an ID doctor. Otherwise he’d know that, as I’ve said […]
March 7th, 2022
How to Induce Rage in a Doctor
If you’re wondering how to make a doctor angry — really, really angry — read on. Because asking us to justify treatment decisions to insurance companies and their pharmacy benefit managers must rank right up there with the greatest tortures of practicing medicine in this country. Mind you, this isn’t just about my patient, or about […]
February 18th, 2022
A Return of Antiretroviral Rounds — What Regimen Would You Choose?
Years ago, back in the pre- and early internet days, one of the most popular features in the newsletter Journal Watch AIDS Clinical Care was something called Antiretroviral Rounds. We’d present a case, then have two expert discussants weigh in on what they would do. The link above is a case from ancient history — 1998! […]
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
Biography | Disclosures | Summaries
Learn more about HIV and ID Observations.
NEJM Journal Watch — Recent Infectious Disease Articles- Observations from ID and Beyond: Federal HIV Guidelines Face a Shutdown — A Critical Loss for Clinicians and Patients
- Ceftriaxone for Patients Hospitalized with Pneumonia: One Gram or Two?
- More PrEP, Less HIV: U.S. State Data
- Observations from ID and Beyond: Why the Sudden Firing of ACIP Members Should Put Every Clinician on High Alert
- Does HIV RNA Testing to Monitor PrEP Add Value?