HIV and ID Observations

May 20th, 2012

News on HIV and HCV Testing, and in Praise of Accurate Screening Tests

Two recent news items reminded me how lucky we are to have some very accurate screening tests for certain infectious diseases. The news: An expert FDA panel backed approval of the first true home test for HIV, the OraQuick mouth swab test. Approval of OraQuick for home use may occur later this year. While home […]

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May 16th, 2012

Azithromycin Linked to Cardiovascular Death — Not A Placebo After All

I’ve commented before about azithromycin, that remarkable antibiotic that clinicians seem to prescribe for, gosh, you-name-it. But a paper just published in the New England Journal of Medicine links use of azithromycin to an increased risk of cardiovascular death, a reminder that “azithro” is in fact a drug — and that all drugs have side […]

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May 10th, 2012

Advisory Meeting Today on Tenofovir/FTC for PrEP, and a Proposed “Niche” for its Use

From Bloomberg News: Gilead Sciences Inc.’s pill Truvada was safe and effective when used to protect uninfected people from getting HIV, U.S. regulators said in a report indicating the main concerns are when and how it should be used … The FDA asked its advisers to suggest who should get Truvada; what testing would be […]

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April 30th, 2012

Do We Really Need Primary Prophylaxis for OIs Anymore?

I’m currently on the inpatient consult service and just saw a guy who fits the typical profile of many hospitalized HIV patients in 2012: Low CD4 (in this case, 120) Irregular to non-existent outpatient care before admission (lots of no-shows, cancellations, etc) Has received several prescriptions for antiretroviral therapy but for a whole variety of reasons, […]

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April 23rd, 2012

An Answer to a Commonly Asked Question: Is Treatment 100% Effective in Preventing HIV Transmission?

The excitement about “treatment as prevention”, and the results of Study 052, have led to many patients asking the question (if not in these words, than using others with a less medical slant), “So if I’m on treatment and doing well, just what is the risk of my transmitting HIV to others?” It’s not a […]

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April 18th, 2012

Been There, Done That

I’d estimate the verisimilitude of the following video at approximately 100%: (Thanks to Raphy Landovitz for the link!)

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April 14th, 2012

2004 HIV Treatment Guidelines: Available Now!

Bargain hunters will be glad to hear that over on Amazon, they can get a copy of the 2004 Guidelines for the Use of Antiretroviral Agents in HIV-1 Infected Adults and Adolescents — all for the remarkably low price of $16.15. Notable content from that banner year included: for asymptomatic patients with CD4 > 350, […]

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April 4th, 2012

Infectious Diseases Specialists Take the Best Medical Histories

In an era where control-c followed by control-v — that’s cut and paste, for those of you who don’t use keyboard shortcuts — is the prime method by which most clinicians write their medical notes, I’d like to come right out and brag that ID doctors take the best medical histories. You could argue (as […]

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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 […]

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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 […]

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