HIV and ID Observations

June 16th, 2010

Another HIV Drug Development Program Bows Out

Last month, Avexa announced that they will not be going forward with their development of the investigational NRTI apricitabine. Now Myriad says its program to develop bevirimat is closing as well. The problems with these drugs — twice daily dosing with apricitabine, formulation and mixed responses with bevirimat — are not the real story here, since arguably we […]

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May 18th, 2010

Electronic Medical Records and (LONG) ID Notes

When it comes to writing consult notes, it often seems as if we ID specialists have a blatant form of obsessive-compulsive disorder. Every detail is fair game — travel history, dietary habits, all sorts of seemingly trivial exposures, and of course microbiologic data stretching back to the Cretaceous period. I’ll never forget receiving sign-out from the graduating […]

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May 14th, 2010

The Luxury of the START Study … and Running Out of ART in Uganda

Over on our Journal Watch AIDS Clinical Care site, we did a poll asking about the ongoing START study: In the START study, HIV-infected patients with CD4 counts greater than 500 cells per cubic mm are being randomized to start antiretroviral therapy right away or to wait until the CD4 count falls to 350 cells per […]

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May 9th, 2010

Amusing Medical Cartoons … and Humor in Medicine

Someone pointed out this cartoon to me. What an eloquent depiction of the interior dialogue of a young doctor as she considers various non-medical careers. Brilliant! Which led me to thinking more broadly about humor in medicine, about which I quickly remembered that anyone writing about humor (as opposed to writing humorously) will be instantly unfunny. Sorry. So […]

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April 24th, 2010

Choosing an Official State Microbe

Wisconsin has selected Lactococcus lactis as its official state microbe: The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:  SECTION 1. 1.10 (3) (t) of the statutes is created to read: 1.10 (3) (t) The bacterium Lactococcus lactis is the state microbe. SECTION 2. 1.10 (4) of the statutes is amended to […]

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April 22nd, 2010

Should Transmission of HIV be a Crime?

Not according to Journal Watch editor and New York Times writer Abigail Zuger, writing here in the Times.  She’s referring to the recent Darren Chiacchia case, where his former partner has filed a legal complaint that Chiacchia did not disclose having HIV — potentially a first-degree felony in Florida. Were it a matter of science alone, […]

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April 10th, 2010

Why Are Doctors Still Carrying Beepers?

I was going through security at the airport the other day, and tossed my beeper into one of those gray bins — along with the device that should make the beeper superfluous, a cell phone. “I didn’t know anyone used beepers anymore,” said the 30-something guy behind me. What could I say?  That doctors also use typewriters, […]

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March 31st, 2010

C diff Guidelines: Metronidazole Still Preferred?

IDSA and The Society for Healthcare Epidemiology of America (SHEA) have published Clinical Practice Guidelines for Clostridium difficile infection. Not surprisingly, it’s a comprehensive, extensively-referenced document that will be an invaluable resource, especially since the previous version is approximately 15 years old. But with the caveat that I’m not an expert in this area, these particular treatment recommendations […]

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March 28th, 2010

Kidneys: Fortunately, We Have Two

Here’s a case over in our Journal Watch: AIDS Clinical Care site:  a man with suspected PCP develops rapidly progressive renal failure after being starting on both empiric PCP treatment with TMP-SMX and ART with TDF/FTC plus darunavir/ritonavir. The specific questions at the end of the case were: What do you think is causing the renal failure? […]

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March 17th, 2010

This One Drives Me Crazy

In the debate over efforts to expand HIV testing by making it less “exceptional” and more like other important tests done in medical care — something I heartily endorse (no kidding) — comes one particular protest that makes absolutely no sense to me. It goes something like this: We cannot expand HIV testing before guaranteeing that all newly-diagnosed […]

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