HIV and ID Observations

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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May 12th, 2011

HPTN 052 Results — Another Win for Early HIV Therapy

The results of the HPTN Study 052 — which randomized 1,763 serodiscordant couples to early vs delayed ART to evaluate whether this reduced the risk of HIV transmission — have just been released: Findings from the study were reviewed by an independent Data and Safety Monitoring Board (DSMB) …The DSMB concluded that initiation of ART by HIV-infected […]

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April 28th, 2011

Hepatitis C Week is Upon Us

After many — and I mean many — years of telling patients that new hepatitis C drugs were “coming soon,” that time has finally come. An FDA Advisory Panel yesterday favorably reviewed the HCV protease inhibitor boceprevir; today telaprevir got the same unanimous report. The FDA will  certainly follow with approval for both drugs, and hence […]

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April 25th, 2011

FEM-PrEP: A Set Back in HIV Prevention Research

HIV prevention has been on such a roll recently that the recent negative news from the FEM-PrEP study came as something of a surprise.  Bottom line: Following a scheduled interim review of the FEM-PrEP study data, the Independent Data Monitoring Committee (IDMC) advised that the FEM-PrEP study will be highly unlikely to be able to demonstrate […]

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April 1st, 2011

Clindamycin or Cephalexin for (Mostly) MRSA?

Over on the Journal Watch Pediatrics site, there’s a summary of a study that compared clindamycin with cephalexin for purulent skin infections in kids age 6 months to 18 years.  The results? MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) were isolated from 70% and 19% of children, respectively … The primary outcome — clinical improvement at 48 […]

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March 30th, 2011

Journal Club: Even When You Think You Should Wait, It’s Probably Time to Start

Two papers just published in AIDS with relevance to the “when to start” antiretroviral therapy question. Both apply to certain patients in whom we might consider waiting to start treatment– but both these studies suggest we do otherwise. The first applies to the patients with slooooow CD4 decline. Perhaps so slow that both you and your patient […]

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