HIV and ID Observations

January 29th, 2016

Elbasvir/Grazoprevir Combination Pill for HCV a Welcome New Option — With a Few Buts

As expected, there’s a new option for HCV therapy, the combination pill elbasvir/grazoprevir (EBR/GZR, brand name Zepatier, more on this below), and it’s indicated for genotypes 1 and 4. For those mechanistically inclined, elbasvir is an NS5A inhibitor (like ledipasvir), and grazoprevir is a protease inhibitor (like simeprevir). This is the second one-pill, once a day option […]

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January 27th, 2016

Here’s an Idea: Justify Your Specialty’s (Low) Relative Salary Using Moral Superiority

In an otherwise excellent piece on recruitment to the ID field from the pages of Infectious Diseases News, comes this: But while inadequate compensation [for ID doctors] may hamper recruitment, it also could prove beneficial to some degree … Reduced salaries filter out the less-passionate applicants in favor of those who are more dedicated to their patients and to […]

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January 18th, 2016

IV and Injectable HIV Treatments Are Much Discussed — But Won’t Be Here Anytime Soon

Something interesting happens when you poll people who treat HIV — and people who have HIV — about whether they’d prefer a treatment option that consists of a periodic injection or infusion in place of the pill or pills that they take every day. Lots of them say yes. Even people who are taking just one pill […]

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January 10th, 2016

Medical Marijuana and Painful Neuropathy — An Opportunity to Make Us Believers

Medical marijuana is now officially available in New York, the city with by far the largest number of people living with HIV/AIDS in the country. Reporting on the first dispensary in Manhattan, the aptly named Julie Weed (yes! her real name!) writes: One of the most promising areas for research is the substitution of medical marijuana for […]

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January 4th, 2016

A Riddle, the 2015 Clinical Trial of the Year, and a Guaranteed Laugh for All ID Doctors

Things quiet on this end recently from me due to various circumstances. but here are three ID-related (sort of) things worth sharing — enjoy if you haven’t seen them already. Let’s start with a riddle: What animal is responsible for the most human deaths a year? Readers of Bill Gates’ blog will think this is old news, but […]

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December 26th, 2015

A Few Things We Were Talking About On Rounds …

Remember when people passed out papers of interesting clinical studies and relevant reviews? And how some doctors even had a special stamp they put in the upper right hand corner? OK, full confession — I did that. A lot. See evidence to the right. Haven’t used the thing in well over a decade, surprised I still have […]

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December 19th, 2015

Part 2, Now The Good News: Why ID Will Survive as a Specialty

Part 1 of this post, which highlighted the primary reason for declining applications to ID fellowship programs, could come across as something of a downer. “Moping about it won’t get us anywhere,” someone said to me, and it’s true nobody likes a whiner. But my point was to acknowledge the issue, and find a way forward. It wasn’t […]

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December 17th, 2015

A Certain Billionaire’s Arrest Prompts Universal Responses — and a Brilliantly Funny One, Too

Several words swiftly come to mind when hearing the news that Turing’s Martin Shkreli was arrested for security fraud. Karma. Just desserts. Kismet. Schadenfreude. Inevitable. But leave it to Andy Borowitz to get it just right: Ha, that’s perfect. Diana Olson from IDSA emailed me “Someone should make a movie …”, which is of course exactly right. What a script: […]

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December 12th, 2015

The 2015 ID Fellowship Match “Historic Bad”: Part 1, Debating the Cause

This year’s ID fellowship match has just taken place, and the results were, ahem, not pretty. Part 1 will cover why we’re in this situation; in Part 2, I’ll offer some reasons for optimism, and even some solutions. According to data provided by NRMP, 117 of the 335 ID fellowship positions were unfilled. Dan Diekema from U of Iowa, […]

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December 6th, 2015

Do Electronic Health Records Make You a Better (or Worse) Clinician?

Earlier this week, JAMA Internal Medicine published a study entitled, “Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction”. A more descriptive title would have been “More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction”, as here’s the take home point: High computer use by clinicians in safety-net clinics was associated with lower patient satisfaction […]

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