HIV and ID Observations

July 10th, 2012

Are ID Doctors the Worst Dressed Specialists?

Unusual exchange the other day with one of my (non-ID) colleagues. All dialogue reported verbatim: Non-ID guy: Hi Paul. Me:  Hi Jon. [I’m expecting the next line to be: “Quick question: I’ve got a patient with a positive PPD and a history of BCG, etc.” Instead, it’s this bizarre comment:] Non-ID guy:  You know, I would say that […]

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July 5th, 2012

Home HIV Test Big News — But Why? And What Impact Will It Have?

The recent FDA approval of a home HIV antibody test (OraQuick In-Home HIV Test) was covered just about everywhere. It’s an oral swab test, takes 20-40 minutes, and will be available over-the-counter. How big a news story was it? Several hundred sources featured it on the day of the announcement, and the total count is now well over a thousand […]

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July 1st, 2012

“HAART Era” Now Longer Than “Pre-HAART Era” — Can We Officially Retire “HAART”?

As I’ve shared before, I’m no fan of the term “HAART” and do everything I can to stop people from using it. (I’m a fun guy to have at parties.) I’m returning to this pet peeve of mine because I realized recently that we’ve passed a milestone of sorts: Period of no effective HIV treatment, 15 years (1981-1996) […]

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June 24th, 2012

ID Learning Unit — Choosing a Quinolone

We love quinolones on medical services, and it’s easy to understand why. Advantages: Ideal spectrum for several common infections, including community-acquired pneumonia, UTIs, and more complex infections when combined with other drugs Great oral absorption Few drug-drug interactions Once- or twice-daily dosing Generally well tolerated Reasonable cost But how do you choose between them? Below, in […]

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June 20th, 2012

Abacavir Becomes the Latest Generic Antiretroviral Agent

Hot on the heels of generic nevirapine comes generic abacavir: On June 18, 2012, FDA granted approval for a generic formulation of abacavir tablets, 300 mg, manufactured by Mylan Pharmaceuticals, indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection. FDA has determined that the generic formulation is bioequivalent and, therefore, therapeutically equivalent to the […]

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June 18th, 2012

ID Learning Unit — Serologic Tests for Syphilis

Diagnosing syphilis is tricky for lots of reasons, including: The protean disease manifestations, many of which were best described in older medical literature — and hence not known to people who don’t read words on paper (vs a screen) very often. You can’t visualize the bug (Treponema pallidum), unless you happen to have a darkfield microscope […]

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June 17th, 2012

For Inpatients, HIV Medication Errors Common — Then Promptly Corrected

Several papers have shown that antiretrovirals may be incorrectly prescribed for hospitalized patients with HIV. How do they do at Johns Hopkins — the site of one of the best comprehensive HIV programs in the country (and perennial US News and World Report #1 Hospital in the Universe)? As described in a new CID paper, investigators reviewed ART […]

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June 15th, 2012

ID Learning Unit — The D Test

I suppose it’s not surprising that we’d follow-up the Etest with the D test, though perhaps if I were being alphabetical, the order would have been reversed. The D test is important, because it screens for a form of clindamycin resistance in MRSA that might otherwise not be detected — the “inducible” kind, which can be […]

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June 12th, 2012

ID Learning Unit — The Etest

Every year I attend on the general medical service, so it gives me a chance to work directly with the medical residents — and to brush up on my non-ID-related Internal Medicine. In exchange for what they teach me, each day on rounds I try to tell them about at least one ID-related thing that they […]

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June 8th, 2012

SPARTAN: Two-Drug, NRTI-Sparing Strategies Continue to Disappoint

Just published is the cleverly named “SPARTAN” study — spartan because it leaves out both NRTIs and ritonavir — and the results are very interesting. Ninety-three treatment-naive HIV-positive study subjects were randomized 2:1 to receive either a two-drug regimen of raltegravir 400 mg BID + atazanavir 300 mg BID, or a standard regimen of TDF/FTC + boosted atazanavir. […]

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