HIV and ID Observations

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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March 26th, 2011

Zoster Vaccine for Age 50 and Up? A Resounding “Yea” Vote Here

I was getting off the elevator at the hospital the other day, and a cardiologist greeted me with the phrase every ID doctor in the world will instantly recognize: Can I ask you a quick question? It was actually a series of questions, and, as is often the case, it wasn’t so “quick”.  But I was happy […]

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February 17th, 2011

Zinc May Work for Colds — But Don’t Pretend It’s Not a Drug

Does zinc work for colds? Apparently it does, according to this Cochrane Review.  From the “Plain Language Summary”: This review identified 15 randomized controlled trials, enrolling 1360 participants of all age groups, comparing zinc with placebo (no zinc). We found that zinc (lozenges or syrup) is beneficial in reducing the duration and severity of the common cold […]

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February 14th, 2011

Pspring Training Pseudomonads

A few ID/HIV issues to ponder as we welcome back the most important sport in the universe: Interesting new Guidelines on UTIs from IDSA — especially their recommendations not to use fluoroquinolones for uncomplicated cystitis and to promote nitrofurantoin for 5 days to first-line for this indication. And welcome to fosfomycin — though this could eliminate one […]

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January 26th, 2011

Insurance Company Cheese Shop Redux

I had an interesting exchange with one of our nurses this week about a long-term patient of ours. The e-mails went something like this: Got a fax from —-‘s insurance that his Lipitor won’t be covered anymore.  They will cover simvastatin, lovastatin, and pravastatin.  Let me know what you want to do. Charlie He’s on darunavir, and […]

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January 6th, 2011

Thursday Thienamycins

Plenty going on in the ID, HIV, and (for the middle of winter) baseball worlds: Just out in CID, there’s a comprehensive review of Management of MRSA as part of the IDSA’s Practice Guidelines Series. Soft tissue infections, bacteremia, endocarditis, pneumonia, bone and joint infections, frequent relapses …  MRSA in all its painful glory. Some interesting […]

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