HIV and ID Observations

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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September 8th, 2019

The Curious Case of M184V, Part 2 — and More!

The inspiration for today’s post comes from two recent emails from ID/HIV colleagues — thank you. Here’s the first, from Dr. Mehri McKellar from Duke: Hi Paul, When are you going to do part 2 of The Curious Case of M184V, Part 1? I am waiting patiently. 🙂 Mehri Mehri, wait no more, because here it is! […]

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September 2nd, 2019

New Antibiotics for CRE, Draft Lyme Guidelines, Cost of Measles Outbreaks, and More — a Labor Day ID Link-o-Rama

Labor Day! Could summer really be over? Nah, we still have a few weeks — and as I’ve noted several times, this time of year (September-October) gives us far and away Boston’s best weather season. On with the links. Data from electronic medical records can accurately identify the best candidates for PrEP. The challenge in primary care is […]

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August 25th, 2019

Save the Dates! International Scientific Conferences You Can’t Miss

On this beautiful summer Sunday, I’m sorting through a series of invitations to international scientific meetings. So many options. See, they really want me. And how do I know that my participation will be so important? Just look how personalized the greetings are — clearly intended for me and me alone. I’ve included actual screen shots of the […]

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August 18th, 2019

Choosing the Top Research Papers in HIV Medicine — and Recalling the Joy of Working with a Great ID Fellow

Way back in 2008 — the year I started writing here — I drafted an exceedingly long post listing the top published papers in HIV medicine. Oh how I tortured myself over that thing. How to define “Top”? Most cited? Most clinically important? Most rigorously scientific? Best written? After a while, I just abandoned the monstrosity. It still […]

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August 11th, 2019

The United States Needs Stricter Gun Control Now — and Yes, This Is an ID Issue

In general, I’ve tried to keep this site a pretty happy place. It’s not been difficult. The ID and HIV community includes many smart, like-minded individuals involved in all sorts of interesting and challenging work, both domestically and abroad. As one of our ID fellows recalled, after he did a rotation in our ID clinic during […]

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