HIV and ID Observations

March 30th, 2012

Our Obsession with Dental Antibiotic Prophylaxis and an E-mail from Mom

I have a regular, highly efficient email correspondence with my mother — who never really liked talking on the phone to begin with (neither do I), so email is perfect for us. The topics we cover are mostly family stuff, and food — she’s a food writer, after all, so it might be a recipe worth […]

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March 22nd, 2012

More Confusion on Anal Cancer Screening

Screening for anal cancer in men who have sex with men (MSM) — with pap smears, high resolution anoscopy, with whatever test — is quite the quagmire. As I’ve mentioned before, the proponents of screening cite the success of cervical cancer screening and the startling high rates of anal cancer among HIV+ MSM as reason enough […]

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March 15th, 2012

CROI 2012 Really Rapid Review — with CROI 2013 Dates!

Some highly subjective highlights — a Really Rapid Review™– from this year’s Number One Greatest Super Scientific HIV Conference, the 19th Conference on Retroviruses and Opportunistic Infections (CROI), which ended last week in Seattle: Need more evidence that maintaining a CD4 cell count > 500 is beneficial? This compelling analysis from the SMART and ESPRIT  studies found that […]

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February 26th, 2012

A Truly Bizarre “Systematic” Review

You know that tenofovir, emtricitabine, and efavirenz HIV regimen? The one that’s universally listed as one of the “Preferred,” or “Recommended” or “First-line” options in all HIV treatment guidelines in the universe? And the regimen that is easily the most widely used in the USA today? Well, here’s a surprising review from Cochrane Summaries, entitled “Effectiveness and […]

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February 23rd, 2012

Hepatitis C and the “Retooling” of HIV/ID Specialists

The news that hepatitis C (HCV) has passed HIV as a cause of death in the United States got quite a bit of attention when it was first presented last year at ICAAC — and no doubt the published paper, in this week’s Annals of Internal Medicine, will also cause a stir. In fact, I boldly predict […]

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February 14th, 2012

Is It Time To Stop Treating Acute Sinusitis?

From the pages of JAMA comes this startling clinical trial: A randomized, placebo-controlled trial of adults with uncomplicated, acute rhinosinusitis [who] were recruited from 10 community practices in Missouri between November 1, 2006, and May 1, 2009 … [Subjects received a] ten-day course of either amoxicillin (1500 mg/d) or placebo administered in 3 doses per day … There was no […]

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February 12th, 2012

Impossible Curbside at Medical Grand Rounds

Scene:  Medical Grand Rounds, 5 minutes before the start. Lecture is on coronary artery disease, which may have a link to Infectious Disease even if it isn’t actually caused by Chlamydia pneumoniae or CMV after all. A well-regarded, experienced primary care physician (PCP) approaches. PCP: Hi Paul, I have quick question*. [*Curbsiders often use this exact phrase — and rarely does […]

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February 10th, 2012

Boceprevir – PI Interaction: A “Dear Doctor” Letter We Didn’t Want To Get

By now I’m sure that most of you ID folks out there have received the following letter from Merck, the makers of boceprevir: URGENT — IMPORTANT DRUG WARNING: VICTRELIS (BOCEPREVIR) The purpose of this communication is to inform you of recent pharmacokinetic study results evaluating drug interactions between VICTRELIS, an oral chronic hepatitis C virus (HCV) NS3/4A […]

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January 29th, 2012

Pre-Super Sunday Scombroids

Some quick ID/HIV links while we await big guys playing the big game with a big (or at least bigger) ball. Did you see how this doctor cheated Medicaid out of more than $700,000 by prescribing HIV meds to people who didn’t have HIV? Not surprisingly, he’s going to jail. Proof that if there’s money behind a […]

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January 21st, 2012

More Medical Testing! No, Less! You Decide

Fascinating Yin-Yang this week on the issue of medical testing. Want more? Want less? First, this remarkable piece on retail medical labs, including a description of a company called ANY LAB TEST NOW: Labs where folks can just walk in and order tests on themselves are popping up in retail centers across the country… At Any Lab Test […]

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