HIV and ID Observations

November 25th, 2019

Vaccine Defenders, U=U Holds Up, Zika Is Gone, and Other ID Things to Be Grateful For, 2019 Edition

An excellent episode of the Freakonomics podcast introduced me to the headwinds vs tailwinds asymmetry, and how we humans perceive life. It goes like this: We go for a walk, a run, or a bike ride, and the wind faces us dead-on, making the exercise a struggle. (In windy Boston, the wind is always in my face. Always […]

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November 18th, 2019

The Best Guide to HIV Drug Names — Yours for Free!

Earlier this month, I noted something that all of us ID/HIV specialists should readily concede — namely, that learning the names of the HIV drugs is fiendishly difficult. Afterwards, I heard from a few old-timers (that is, people like me). They acknowledged that we were lucky to experience the roll-out of these medications (and their convoluted […]

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November 11th, 2019

When TV Gets ID Wrong — Or At Least Not Quite Right

A busy week for Infectious Diseases on television! First, Dr. Aditya Shah, an ID doctor at Mayo Clinic, treated us to several snippets of truly idiotic ID-related drama in a network television show. After seeing them, I commented: Hey, my services to this show to help you talk about infectious diseases without sounding dumb are available at a […]

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November 3rd, 2019

Learning the Names of HIV Drugs Is Horribly Difficult — Here’s Why

Happens every time. We start teaching about HIV, and at first, everything is going great. Epidemiology, pathogenesis, diagnosis, clinical presentation. The students are right there with us. However, then we start covering treatment — and things immediately get tricky. Because no matter how engaged and brilliant they are, and no matter how scintillating we are, when the long […]

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October 27th, 2019

The Enduring Appeal of Live, Face-to-Face, Real-Time Continuing Medical Education

Around 15 years ago, after high-speed internet became a de facto part of work life and was rapidly becoming more widely available at home, I attended a meeting with other medical educators to decide what to do about our various post-graduate courses. The wisdom in the room was that most continuing medical education (CME) would soon […]

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October 21st, 2019

Amoxicillin for Chronic Low Back Pain? Are You Kidding Me? In Defense of a Controversial Clinical Trial

The BMJ just published a randomized trial comparing amoxicillin to placebo for people with chronic low back pain. I kid you not. The appearance of this trial elicited all kinds of snark from the medical community. Here, check this out, along with the responses: Important RCT for anyone who’s been treating low back pain with <checks notes> amoxicillin […]

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October 14th, 2019

Common Questions About the Shingles Vaccine — Answered Here!

Here’s an interesting email from my friend and ID-colleague Dr. Carlos Del Rio (shared with his permission): Went Tuesday to see my PCP for a routine visit and had my second dose of Shingrix that day. I had gotten my first dose about 3 months ago and had severe chills and even a fever of 38.5 […]

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October 7th, 2019

Our HIV Testing Algorithm Has a Major Problem — Here’s How to Fix It

Mostly, HIV testing works great. It’s long been so accurate that we can strongly support HIV testing even in relatively low-risk people. The 2014 revised lab testing guidelines made it even better, recommending a combined antigen/antibody screening test (called the 4th generation test), and replacing the Western blot with the HIV-1/2 differentiation immunoassay as the preferred […]

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September 28th, 2019

What Is the Best Treatment for Advanced HIV Disease?

One of the things that keeps me on Twitter — besides cute dog videos — is the periodic realization that the platform can help patients. Which is, after all, why most of us do this doctor thing — to help people get better. Example: Several months ago we had a challenging patient. I asked twitter if anyone […]

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September 15th, 2019

A Former Medical School Dean Invents a False Dichotomy in Curriculum Content, and Advises Physicians to Stay in Their Lane

Over on the editorial pages of the Wall Street Journal, a piece appeared last week with the following provocative title and subtitle: Take Two Aspirin and Call Me by My Pronouns At ‘woke’ medical schools, curricula are increasingly focused on social justice rather than treating illness. Dr. Stanley Goldfarb, former associate dean of curriculum at the […]

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