HIV and ID Observations

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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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July 28th, 2019

Really Rapid Review — IAS 2019 Mexico City

As I noted last week — and you did read last week’s post, didn’t you? — the International AIDS conference first took place in Mexico City in 2008. Last week we returned to this sprawling, vibrant city for the 2019 meeting. It was an excellent, well-run conference — with one small complaint. But more on […]

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July 21st, 2019

AIDS Conference Returns to Mexico City, Where We Saw an Underrated, Great Advance in HIV Therapy

If you’ve been an ID or HIV specialist for only a decade or so, the following statement might seem unfathomable to you: Until 2008, there were lots of people with HIV whose medication adherence was perfect — but they still had virologic failure. How could that be? The simple answer is that their virus had […]

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