HIV and ID Observations

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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July 7th, 2013

Almost Annual Whine About No CROI Dates, and a New Temporary (I Hope) CROI Website

Believe or not, sometimes we know a year in advance the dates of the Conference on Retroviruses and Opportunistic Infections (CROI). For example, we learned at the beginning of CROI 2010 that in 2011, it would take place February 27-March 3 — in Boston no less. Yay! (The meeting was a bit shorter, but it did in fact […]

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July 3rd, 2013

First Year ID Fellows — What Do They Learn, and What Do They Hate?

In the weird calendar of academic medical centers, July 1 is the “official” first day of school. In our ID program, however, we shifted it to July 5 a few years ago to avoid the interruption of the July 4 holiday at the beginning of the year. On July 3 — today — our incoming first-year […]

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June 27th, 2013

Testing Out the New Website with an ID Link-o-Rama

Hey, new website is live! Interested to hear what you think about our new-ish look. In celebration, here are some quick ID/HIV tidbits that have recently crossed my path, or have been sitting in my inbox for a while, dying to get out: Doxycycline shortage. Hardly anything more frightening to a New England ID doc than a shortage […]

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June 20th, 2013

Let’s Move the HIV Testing Algorithm Into the 21st Century

As I’ve written before, the most widely used testing algorithm for HIV — enzyme immunoassay followed, if positive, by Western blot confirmation — is long overdue for an update. A brief review why this is the case, and also why sticking with it is so problematic: Immunoassays have become progressively more sensitive, especially when paired with p24 […]

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June 19th, 2013

FDA, IND, FMT: Nine Letters, Some Common Sense, and a Real Video Link

Good news here — the FDA has reconsidered their requirement for an IND for fecal microbiota transplantation (FMT) for C diff: Some health care providers have stated that applying IND requirements will make FMT unavailable and have suggested that an alternative regulatory approach is needed to ensure the widespread availability of FMT for individuals with C. […]

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June 17th, 2013

Gallant is Answering Your HIV Questions and Zuger Writes About the Tough Practice of “Doing Nothing”

Two highly recommended products from a couple of my friends in the HIV/ID world: First, the inimitable Joel Gallant — long time of Johns Hopkins, soon to be of Santa Fe — has resuscitated his terrific Patient Q & A Forum here. He used to answer patients’ questions regularly on www.hopkins-aids.edu, but that whole site appears […]

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June 11th, 2013

Both Simeprevir and Sofosbuvir Likely Approved by 2014 — Clinical/Ethical/Pharmacoeconomic Dilemmas Loom

As expected, simeprevir, and now also sofosbuvir, are being given “priority review” by the FDA. With the 6-month rule under the Prescription Drug User Fee Act — usually just said as “pah-DOOF-ah” — that means there’s a good chance we’ll have both of these anti-HCV drugs some time in late 2013. Which also means HCV treaters will soon […]

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June 6th, 2013

ID Learning Unit — Aminoglycosides

You young whippersnappers out there may not believe it, but we once used aminoglycosides all the time — literally every day on inpatient medical and surgical services, especially in the ICUs. They were an inevitable part of “triples” (e.g., amp/gent/clinda), a broad-spectrum combination given to almost every critically ill patient way back when — think right around […]

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May 31st, 2013

Fecal Microbiota Transplantation — Try This At Home?

As noted before, the FDA says that an investigational new drug (IND) application is required for therapeutic use of fecal microbiota transplantation. The practical effect of this decision, at least at our institution, is to stop providing this service — it’s on hold pending those “internal discussions” planned by the FDA on the regulatory issues surrounding the procedure. Which […]

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