HIV and ID Observations

August 13th, 2017

Dog-Related Infectious Diseases as an Excuse to Show Pictures of Dogs

For proof that we’re not like other human members of the planet, when ID doctors think of dogs, it sometimes brings to mind one or more of following associations: Gastroenteritis due to Campylobacter jejuni. No, there’s nothing cuter in the world than a puppy — but remember that these little critters are particularly predisposed to symptomatic (and asymptomatic) campylobacter infection, […]

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August 6th, 2017

Have We Reached the End of HCV Drug Development?

Two new HCV regimens gained FDA approval recently, bringing us closer to the end of this extraordinary phase of drug development. Think about it — has there ever been a more spectacularly rapid improvement in treatment of anything? If so, please let me know what that is. Remember, as recently as early 2013, highly toxic interferon-based therapy (with ribavirin and telaprevir […]

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July 30th, 2017

Really Rapid Review — Paris IAS 2017

Last week, the International AIDS Society meeting returned to Paris for the first time since 2003. Yes, you and I are that old. Jeeze. Here’s a Really Rapid Review® of some of the conference highlights, roughly ordered by “cure”, prevention, treatment, and complications. As always, feel free to use the comments section for notable studies I might have missed […]

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July 19th, 2017

Mystifying Cochrane Library Review on HCV Therapy Elicits Strong Response from IDSA

Last month, the Cochrane Review published a controversial paper on HCV therapy that left many ID doctors and hepatologists perplexed. After reviewing 138 randomized clinical trials using directly acting, non-interferon based therapies, they came to the following conclusions: The use of sustained virologic response (“SVR”) — or “cure”, if you want to use plain English — as a […]

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July 9th, 2017

Should You Answer Medical Questions from Clinicians You Don’t Know About Patients You’ve Never Seen?

This email popped into my inbox the other day from a person I’ve never met: Hi Dr. Sax, I do mostly hospital-based ID in Pennsylvania, and was consulted on a newly diagnosed HIV patient with CD4 10, viral load 210,000, and lymphoma. I started him on Truvada and dolutegravir, which is going well so far. Because he complained […]

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July 2nd, 2017

Delafloxacin, a New Quinolone, Is Approved for Skin Infections — But That’s Not Where It’s Really Needed

The history of the fluoroquinolone antibiotics can be divided into four eras, alternating good news and bad: Ciprofloxacin is approved — it covers everything, and is miraculous. We’re talking some tough customers here. Pseudomonas aeruginosa! Staphylococcus aureus! Neisseria gonorrhoeae! Plus, pretty much every gram negative causing urinary tract infections. There was no intravenous formulation initially, but that hardly mattered since it had […]

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June 18th, 2017

On Father’s Day, A Rumination on Families with Lots of Doctors

My father is a doctor. So was my father’s father. And my father’s uncle. And my father’s cousin. But that’s not all. My father’s brother was also a doctor — he loved being a doctor more than anyone on the planet, and attended neurology meetings long after he retired, right up until the time he died last year. […]

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June 10th, 2017

What’s Your Favorite Antibiotic? A Fantasy Draft

Over on the journal Open Forum Infectious Diseases (that’s “O-F-I-D”, not “Oh-FID”), the generous people from IDSA and Oxford University Press have allowed me to record a series of podcasts, interviewing various interesting people in the ID field. This time, however, I strayed from the usual format and asked my colleague Rebeca Plank to join me in a […]

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June 4th, 2017

Can’t HIV Serodiscordant Couples Now Just Have Children the Regular Way?

MMWR just published a paper entitled, Strategies for Preventing HIV Infection Among HIV-Uninfected Women Attempting Conception with HIV-Infected Men — United States, and it’s both a welcome and a very strange document indeed. It’s welcome because it acknowledges that serodiscordant couples may wish to have children without the use of an HIV-negative sperm donor. Advances in HIV prevention […]

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May 29th, 2017

Healthcare Providers Shouldn’t Come to Work While Sick, but They Do — Here’s Why

Let’s start with two questions: Have you ever seen a doctor, nurse, PA, pharmacist or other person directly involved in patient care wearing a surgical mask because they have a respiratory tract infection? Has this mask-wearing person ever been you? Bold prediction: Virtually every reader who works in a hospital or large office practice answered “Yes” to #1. Some […]

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