HIV and ID Observations

August 3rd, 2011

Why the Proposed Massachusetts HIV Testing Bill is Bad for Patients

As I’ve written about here multiple times, I’m not a big fan of the HIV testing law in our state. First, there’s the requirement for written informed consent, something that every state (except a couple) has wisely abandoned. Second, it’s more than a testing law — it’s also an HIV privacy law, which is arguably unnecessary […]

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July 28th, 2011

Really Rapid Review — IAS 2011 Rome

Just back from IAS 2011 (which was followed, I’m thrilled to say, with a visit to perhaps the most beautiful region in the world). Here is a Really Rapid Review™ of the meeting, with apologies ahead of time for lack of organization and (even more likely) leaving out something important.  FYI, the abstracts are online […]

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July 13th, 2011

More Favorable Results on PrEP, But …

As part of the usual flurry of studies released just before major scientific meetings, results of two pre-exposure prophylaxis (PrEP) trials in heterosexual men and women have just been made public: In the CDC TDF2 study, 1200 HIV-uninfected men and women in Botswana were randomized to take oral tenofovir/FTC or placebo daily. Tenofovir/FTC was found to reduce the […]

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July 12th, 2011

A Thank You to Nice Patients

Yesterday I saw one of my favorite long-term patients. She’s just wonderful, and it’s always a joy to see her. Here are some reasons: She’s uniformly nice — not just to me, but to all the nurses and social workers and other support staff in our clinic. She shows up on time for her appointments. Love […]

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June 24th, 2011

Reflections on Levofloxacin as it Goes Generic

With the news that a generic form of levofloxacin has just been approved by the FDA, some thoughts about this remarkable antibiotic: When it was first approved in 1996, levofloxacin was the first oral antibiotic that really covered all common causes of community acquired pneumonia. Strep pneumo, H flu, mycoplasma, legionella, chlamydia — check, check, check, […]

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June 19th, 2011

Abacavir Agonistes

The studies on abacavir and its potential association with increased cardiovascular risk have been inconsistent ever since the news first broke at CROI 2008. But recently the data have been swirling around so fast and furious that it seems appropriate to take out this famous Greek epithet. A summary of some recent notable studies: An FDA meta-analysis […]

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June 15th, 2011

Hockey Helicobacters

Today’s ID/HIV items come to you courtesy of a winter game being played during a summer month: So it appears that community-based care of HCV augmented by telemedicine is just as good as traditional clinic visits to specialists. My first thought on reading this important paper is that there are undoubtedly lots of ways to incorporate […]

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June 9th, 2011

E. Coli, ID Doctors, and Fear of Infections

This was going to be about the shiga-toxin-producing E. coli (STEC) outbreak in Germany, and I promise to get there eventually. But to start:  One very useful concept from psychiatry is “reaction formation.” For those of you who have forgotten your college Psych 101, here’s the definition: A psychological defense mechanism in which one form of behavior substitutes for […]

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May 18th, 2011

HIV Exceptionalism and the Department of Unintended Consequences

Quick question:  If there were one piece of information — clinical or lab — that you would use to determine the quality of care in an HIV program, what would it be?  (Choose one.) Rates of influenza vaccine administration Receiving PCP prophylaxis with CD4 < 200 Adherence counseling before starting antiretroviral therapy Baseline toxoplasmosis serology Proportion of […]

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May 17th, 2011

Physician Bloggers Categorized

About a year ago I linked this cartoon from “Dr. Fizzy”, and I’ve been a regular visitor to her site ever since. Anyway, more kudos to her for this dead-on categorization of MD bloggers. (I guess the British “spot-on” is a better choice for us docs.) Not exactly sure where I fit in this list — yikes — […]

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