HIV and ID Observations

November 25th, 2011

Childhood Meningitis Terrifying, Fortunately Very Rare

Back in fellowship, we used to discuss the various reasons why we’d be called back into the hospital at night when we were on call. Mind you, this was a fairly rare event, since unlike gastroenterology fellows doing emergency endoscopy for bleeding and cardiology fellows coming in to do the urgent cath, what were we supposed […]

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November 20th, 2011

Who Should Care For The Aging HIV Patient? Everything Old is … Oh You Know

Over in Journal Watch AIDS Clinical Care, Carlos Del Rio reviews a couple of remarkable studies on HIV and aging. From one of them: Compared with the controls, the HIV-infected patients had a higher prevalence of renal failure, bone fracture, and diabetes in every age range evaluated, as well as a higher prevalence of cardiovascular disease and […]

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November 14th, 2011

Here Are Two Things You Don’t Hear Together Very Often: Walmart and HIV

As the parent of teenagers (and having been one myself many years ago), I’m acutely aware that everyone wants to think that he or she is special in some way. And while that is literally true (that is, no two people are exactly alike), as anyone will tell you who looks up a Sunday Times crossword puzzle […]

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November 5th, 2011

A Mysteriosis about Listeriosis

For obvious reasons, listeriosis has been much in the news recently.  The latest information from CDC on the Colorado cantaloupe outbreak cites 139 cases and 29 deaths. The recent outbreak aside, however, actual cases of listeriosis are pretty rare. We easily could go months in our hospital without seeing a single case, and we have the largest obstetrical […]

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October 26th, 2011

Xigris is Gone — Not That Many ID Docs Will Notice

From the FDA comes this news: FDA notified healthcare professionals and the public that on October 25, 2011, Eli Lilly and Company announced a worldwide voluntary market withdrawal of Xigris [drotrecogin alfa (activated)]. In a recently completed clinical trial (PROWESS-SHOCK trial), Xigris failed to show a survival benefit for patients with severe sepsis and septic shock. Some […]

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October 19th, 2011

Going, Going, Gone … HIV Treatment Failure Is Disappearing in People Who Take Their Meds

World Series time, hence the baseball reference in the title. (Doesn’t take much.) But over in Lancet Infectious Diseases — which has turned out to be a terrific journal, by the way — there’s a study reminding us that advances in HIV treatment in the late 2000s were truly spectacular. The goal of the paper was to track […]

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October 4th, 2011

Hormonal Contraception MAY Increase Risk of HIV

From the pages of Lancet Infectious Diseases, a study from Africa: We aimed to assess the association between hormonal contraceptive use and risk of HIV-1 acquisition by women and HIV-1 transmission from HIV-1-infected women to their male partners … Among 1314 couples in which the HIV-1-seronegative partner was female, rates of HIV-1 acquisition were 6·61 per […]

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October 4th, 2011

Spanish HIV Vaccine Story Gets Lots of Attention — Here’s Why

If you’re looking for a good way to pass the time while running errands, traveling, or walking to work, I highly recommend the Freakonomics podcasts, which have taught me all sorts of interesting things. Such as the fact that suicide is more common than murder in the USA, but gets way less attention. And how a […]

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October 3rd, 2011

CASCADE: When to Start, (Yet) Another Take

As we await the enrollment, analysis, and results of the START study — which is randomizing patients with CD4>500 to start HIV therapy  vs waiting until the CD4 falls to 350 — much of the research on “when to start” ART in patients with high CD4’s comes from observational studies. Several have already been published […]

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September 24th, 2011

Warning: Viral Replication is Hazardous to Your Health

When studies evaluate the prognostic importance of measuring HIV viral load, they generally do so by assessing a single measurement rather than values obtained longitudinally.  One obvious limitation of this approach is that baseline VL poorly predicts outcome after ART initiation — a finding in stark contrast to the original description of VL from the […]

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