HIV and ID Observations

June 30th, 2023

The Yin and the Yang of Cabotegravir-Rilpivirine: Part One, the Good News

Long-acting cabotegravir-rilpivirine (CAB-RPV) is the biggest advance in HIV therapeutics in years. It’s also creating quite the challenge for ID and HIV clinicians, which makes its availability a fascinating example of the importance of education, patient communication, and shared decision-making. This post will be the good news about this groundbreaking treatment; in the next post, I’ll […]

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June 15th, 2023

Clinical Teaching at the 99.9th Percentile: Dr. Martin (Marty) Samuels

One of the true joys of practicing at academic medical centers is working alongside great clinical teachers. No one exemplified this talented group better than Dr. Martin (Marty) Samuels, former chief of neurology at Brigham and Women’s Hospital (where I work), and professor of neurology at Harvard Medical School. He was quite simply the best clinical […]

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June 8th, 2023

Fifteen Years Later, Why I’m Still Writing This

Seems like just yesterday that my wonderful editors at NEJM Journal Watch helped me write a piece marking this site’s 10-year anniversary. But no — that was 5 years ago. Yikes. Let’s see, what happened since the spring of 2018 that is relevant to this place: 216 posts. According to our crack research team, that’s one every 8.449074 […]

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June 2nd, 2023

Continued Activity of NRTIs Despite Resistance Is a Real Thing

In our last post, we reviewed a case of a person with longstanding HIV with extensive multi-class resistance, but now a decade of viral suppression. They’re currently on an HIV treatment regimen of fully active raltegravir, partially active etravirine, and barely active (or not active at all!) darunavir. There are no NRTIs in the regimen, […]

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May 25th, 2023

The Legacy of a Disappointing HIV Clinical Trial — Does It Still Apply to HIV Today?

A long, long time ago, back in the early exciting days of raltegravir, the first HIV integrase inhibitor, we learned something important from a clinical trial with disappointing results. The trial bore the (barely) hidden name of the company that developed the drug — SWITCHMRK, get it? — and had a profound impact on how […]

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May 15th, 2023

Types of HIV Papers — A Quick Guide

I spend a lot of my time reading HIV clinical research papers. A lot.  So here, for your viewing pleasure, is a poster I updated and modified from a brilliant xkcd web comic (using this tool), describing some common HIV clinical research themes. Suitable for framing, it should prove helpful as you embark on your next […]

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May 8th, 2023

As the Public Health Emergency Comes to an End, How Are We Feeling About This?

As you no doubt heard, on Friday, May 5, 2023, the WHO declared the end of the global health emergency from COVID-19. Here in the U.S., the federal public health emergency will expire on May 11. That’s Thursday, just a few days from now. These events reflect two realities that, while seemingly contradictory, make these decisions reasonable […]

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April 28th, 2023

What is the Future of HIV Primary Care?

Here’s a figure I’ve made for an upcoming talk, which is entitled “The Future of HIV Care.” It summarizes several eras in HIV treatment, finishing up with the current unprecedented successful phase where most people with HIV take 1–2 pills a day, have virologic suppression and no clinically apparent immunodeficiency. HIV is often the least […]

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April 21st, 2023

A Change-of-Season ID/HIV Link-o-Rama

The warm weather takes its sweet time to arrive here in Boston, teasing us with an occasional comfortable day, but reverting frequently to chilly temperatures and high winds until mid-to-late May at the earliest. The afternoon sunlight might say, “Spring is here!”, but the nightly temps in the upper 30s/low 40s definitely say otherwise. Brrr. Anyway, […]

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March 27th, 2023

Three Effective Treatments for COVID-19 Not in Treatment Guidelines — at Least Not Yet

A few weeks ago, in a patented (and copyrighted and trademarked) Really Rapid Review™, I summarized some of the Greatest Hits from CROI 2023. The conference included new data on not just HIV, but also a grab bag of opportunistic infections, STIs, viral hepatitis — and, as has been the case since 2020, COVID-19. You know, […]

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