HIV and ID Observations

September 7th, 2013

FAX machines, and the Special Power of the MD Degree

Everyone hates mindless paperwork. But certain types are particularly annoying, seemingly designed to send you screaming into the night, dragging a broken fax machine behind you as your brain explodes. Too strong? Take a look at this fax cover sheet I recently received about a patient who had been receiving IV antibiotics at home: To get at the […]

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August 28th, 2013

Poll: At $14,105/year, Is Dolutegravir Fairly Priced?

The recently approved once-daily integrase inhibitor dolutegravir is now in pharmacies and, like every new HIV drug, the price — around $14k/year — has generated some controversy. For the record, here are the per-year wholesale acquisition costs of the three FDA-approved integrase inhibitors. Raltegravir:  $12,976 Elvitegravir:  $13,428 (once disentangled from the price of TDF/FTC) Dolutegravir:  $14,105 If […]

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August 26th, 2013

When Eating Guinea Pig, Make Sure to Ask for it Well Done

I’ve written before about how ID doctors are no fun to have at cook outs, what with our obsession with well-done hamburgers. Now, there’s another menu item we can berate grill-meisters on, and that’s guinea pig meat: At least 81 people fell ill from suspected salmonella poisoning after eating guinea pig meat and other foods from a […]

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August 25th, 2013

Death from “Brain-Eating Parasite”: A Reminder of How Little We Really Know

  Sometimes it takes a lot to surprise an ID doctor — we who try to make it seem like we’ve seen it all — but certain infections are either so severe (e.g., necrotizing fasciitis from group A strep) or so rare (e.g., endocarditis from Erysipelothrix rhusiopathiae) that even we are startled. Doubly startling are those infections […]

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August 20th, 2013

Underreporting of Lyme Disease No Surprise, but a Big Problem

In a welcome update, CDC just presented revised data on the number of Lyme Disease cases annually in the United States. Here are the key facts: Cases reported by clinicians: 30,000 Estimated number of cases using additional information from insurance claims, laboratories, and patient reports: 300,000 Go ahead, check my math — that’s a whopping 10:1 […]

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August 12th, 2013

Dolutegravir Approval Signals a Beginning and the End of Something Very Special

As anticipated, the FDA approved dolutegravir today for HIV treatment, the third integrase inhibitor now available. This was about as surprising as the arrival of Royal Baby Prince George. We knew dolutegravir was coming soon, just not exactly when or what it would be named. Here’s a short list of the data we have thus far on this drug […]

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August 6th, 2013

Nelson Cruz and Yet Another ID-Baseball Link

Texas slugger Nelson Cruz is one of the Biogenesis gang just suspended from baseball for use of performance-enhancing drugs (PEDs). For those who care about these things, he’s also probably the most important player from the banned list, since he’s 1) very good and 2) on a team in contention for a playoff spot. For those who […]

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August 1st, 2013

Poll: Will There Be A Shortage of HIV Providers?

Over on NEJM Journal Watch — love that new name — I reviewed a paper on the demographics of people living with AIDS in San Francisco. Bottom line — more than half are now older than 50. Implication — that’s so old! First, it really isn’t, unless you compare it to the dismal era 20+ years ago, when […]

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July 29th, 2013

CROI 2014: March 3-6, Boston, Massachusetts, USA, North America, Earth

Ok, that’s one mystery solved. (We’ll do our best to have the ice and snow cleared away by then, but no promises — New England weather is the very definition of unpredictable.) And now that we know the CROI 2014 dates, here’s some good news:  I hear they’re working on getting the 2015 dates squared away as well. If […]

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July 20th, 2013

There’s No US News & World Report Infectious Diseases Ranking — Is That A Good Thing?

As the internet burns through traditional print media, decimating anything paper in its path, several odd things have happened beyond simply putting those newspapers, magazines, and journals out of business. For example, Gourmet was subsumed into Bon Appetit — who could have predicted that? PLoS One and its ilk were born. And what about the hard-copy […]

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