HIV and ID Observations

June 4th, 2015

A Slightly Less Painful Way to Learn the Three-Letter Abbreviations for HIV Meds

One of the stupid things about being an HIV/ID specialist is the highly arcane code we use to abbreviate HIV treatments. Why was zidovudine originally AZT, and now ZDV? Why is lamivudine 3TC? And tenofovir TDF? Of course there are legitimate biochemical reasons why these are the right abbreviations, but they are lost to most of us who do […]

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May 27th, 2015

START is STOPPED: Study Confirms HIV Treatment Is Beneficial for All, Even Those with High CD4 Cell Counts

The Strategic Timing of AntiRetroviral Treatment (START) study began in 2009, enrolling over 4000 asymptomatic people with HIV and CD4 cell counts > 500, and randomizing them to immediate ART or to wait until the count dropped to 350. Now, from the National Institute of Allergy and Infectious Diseases comes this important announcement: Though the study was expected […]

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May 21st, 2015

Which Infectious Diseases Do We Fear Too Much? Which Not Enough?

My friend (and HIV/ID colleague) Mauro Schechter sent me a funny email the other day — from Brazil, where he lives and works: I just read your post and watched the news clip about Powassan. And you still wonder why we think you Americans are paranoid disease freaks? 65 cases in 12 years in a population of 350 […]

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May 13th, 2015

WHO Guidelines on Naming Diseases Are Well-Meaning, Sensible — But Kind of Boring

From the World Health Organization (WHO), a recommendation on how to name a new disease: The best practices state that a disease name should consist of generic descriptive terms, based on the symptoms that the disease causes (e.g. respiratory disease, neurologic syndrome, watery diarrhoea) and more specific descriptive terms when robust information is available on how […]

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May 6th, 2015

An Apology to Subscribers, and Five Random ID/HIV Questions to Ponder

Some of you have been kind enough to enter your email address in the little box on the right side of this page, which gives you a “subscription” to this site. It looks like this: We thank you for signing up! Delivery is usually prompt and reliable (even during this past winter’s historic snowstorms), and the price […]

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May 4th, 2015

A Drug for Neck Fat, and Some Thoughts on Fat Accumulation Syndromes in HIV

It’s not often that a FDA drug approval for cosmetic dermatologists and plastic surgeons will get the attention of HIV/ID specialists, but this past week was an exception. From the FDA report: The U.S. Food and Drug Administration today approved Kybella (deoxycholic acid), a treatment for adults with moderate-to-severe fat below the chin, known as submental […]

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April 22nd, 2015

Seriously — How Much Would You Pay for a Curbside Consult?

Yes, seriously. Let me start with an email exchange I had with a PCP recently: Hi, Paul, quick question 😉 This lady, 49 YO woman from Haiti, asymptomatic, totally healthy. Got TSpot done for immigration purposes, it’s positive with negative chest Xray. Treated with INH 6 months in 2001. She travels to Haiti annually so could had been reexposed, though […]

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April 8th, 2015

New HIV Treatment Guidelines, and the End of an Era

The new Department of Health and Human Services (DHHS) HIV treatment guidelines are out, and thanks to skillful direction by Alice Pau, it’s as usual a must-read document — all 288 pages, of course! There are several major changes, so a good place to start is the all-important “What’s New in the Guidelines” summary page. Some of the […]

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April 3rd, 2015

Melting Snow ID Link-o-Rama

A few ID/HIV tidbits to contemplate as we go from slipping on ice and snow to dodging the mud: Beta-lactam therapy alone is non-inferior to regimens that also cover “atypicals” for hospitalized patients with pneumonia. These results challenge a dogma that has been present for a couple of decades — namely, that all patients admitted with community-acquired pneumonia should get either […]

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March 28th, 2015

Quick Question: Should HIV-Negative People in Serodiscordant Relationships All Get PrEP?

From a very thoughtful and experienced primary care provider came this query: Hey Paul, quick question — One of my patients, an HIV-negative gay man, is in a long-term relationship with one of your HIV-positive patients — my patient says his partner has been on successful HIV treatment for years. Obviously I can’t check his partner’s […]

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