HIV and ID Observations

March 5th, 2017

High-Dose Flu Vaccine, Robert De Niro Challenge, Antibiotics for Colds, and More: March Comes in Like a Lion ID Link-o-Rama

Here are a few ID/HIV items blowing around the neighborhood on this, a bitterly cold and windy first weekend of March (at least here in Boston): Compared with the standard dose vaccine, the high-dose flu vaccine reduced deaths among older adults. The benefit was seen in the 2012-13 flu season, but not 2013-14. The authors speculate that the circulating […]

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February 26th, 2017

Improving Outcomes with ID Consultation: Three More Papers For the Collection

Several years ago, one of my very brilliant colleagues posed an interesting question. Why do ID specialists even exist? “After all,” he said in an accent that happens to be a distinctive mix of several former British colonies. “There is nothing we do that other doctors couldn’t also do, provided they had the motivation.” He had a point — with no required […]

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February 19th, 2017

Really Rapid Review — CROI 2017, Seattle

The Conference on Retroviruses and Opportunistic Infections (CROI) returned to Seattle this past week for its 24th meeting. It’s the 4th time CROI has been held in Seattle, an excellent city for a meeting of this size, which includes “only” 4200 people. The convention center is pleasant and user-friendly — big but not cavernous, actually encourages […]

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February 13th, 2017

How to Make Preventing Heart Disease in HIV Fun and Exciting: The REPRIEVE Trial

The people researching cardiovascular disease in HIV have quite the challenge. Because when you think about it for a second, we HIV treaters are a pretty spoiled bunch when it comes to therapeutic success. We saw the transformation of a terrifying, incurable, and rapidly progressive disease (AIDS) into something that can be managed for decades — usually with just […]

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February 5th, 2017

Case Report of PrEP Failure: What Can We Learn From It?

The New England Journal of Medicine has published the first well-documented case of HIV pre-exposure prophylaxis (PrEP) failure despite good medication adherence. We heard lots of this information at CROI last year, and again I’m impressed at the extraordinary degree of virologic investigation done on a case from clinical practice. To refresh your memory, here are the critical details from the […]

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January 29th, 2017

In A Weekend of Paranoia and Anger and Fear, Some Release From the Other Side of the Globe

This was not a happy or comfortable weekend for ID doctors, given our predilection for inclusiveness, non-judgmental care, global health, and that “safety net” idea that seems to us such an intrinsic part of being a good doctor. Exclusion of foreigners? Why, we ask, would you do that? People from other countries are our friends, our colleagues, and our patients. […]

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January 22nd, 2017

Fun With Old Medical Images!

Welcome to Fun with Old Medical Images! Here’s how it works: You’ll see a series of images — old, strange, and perplexing — and each will have a caption that I have created for you at no extra cost. Accustomed to high-quality and clinically relevant information from your NEJM Journal Watch contributors, you will laugh happily at the contrast between […]

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January 16th, 2017

Two Case Reports Worth Reading, and Enlisting Pro-Vaccine Support

Case reports are pretty low down on the “levels of evidence” pyramid. This low status notwithstanding, when they are well done they can illustrate important clinical lessons, including these two: A Las Vegas woman died after infection with a pan-resistant strain of Klebsiella. While CDC receives many isolates of carbapenem-resistant enterobacteriaceae (CRE), 80% are susceptible to at least one aminoglycoside […]

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January 8th, 2017

Poll: Should Medicine and Family Practice Residency Programs Have a Dedicated HIV Track?

A few medicine and family practice residency programs around the country have a dedicated track that focuses on HIV care. Though the programs naturally differ somewhat in structure — here are two examples from University of Washington and Yale — they generally involve placing the resident into an HIV clinic for their longitudinal outpatient experience. We don’t have […]

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January 1st, 2017

Top Stories in HIV Medicine for 2016

A lot of these “Best of …” or “Top Stories in …” lists have already been published, as they seem to be appearing earlier and earlier each year. Pretty soon we’ll start reading them around the same time they sell Halloween Candy — and that’s just too early, sorry. Now this list, however, appears just as 2016 is in […]

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