HIV and ID Observations

December 23rd, 2008

Flu Resistance to Oseltamivir: The Bugs Win Again

I must admit, the recent report that 49 of the 50 H1N1 flu viruses tested by the CDC are resistant to oseltamivir caught me by surprise.  For the non-math majors among the readership, that’s a 98% resistance rate.  Yikes. Actually, the rate of resistance is so high that at first I didn’t believe it when my wife […]

---

December 19th, 2008

Infectious Disease in the ICU: Help Please? Part I

I am currently attending on the inpatient service, which means I spend a good chunk of my day seeing new ID consults and rounding on follow-ups.  As I’m sure is true in most hospitals, many of these consults are from the intensive care units (ICUs).  After 18 years in this ID business, I confess I still find myself quite challenged […]

---

December 10th, 2008

Unintended Consequences of ART “Rollout”

According to this BBC article, teenagers in South Africa are grinding up antiretrovirals and then smoking them for their “hallucinogenic and relaxing effect”.  (Apologies for the pun on the title.) It’s impossible to tell with a report like this how widespread the practice is, but it’s potentially worrisome.  And no mention in the article which antivirals are being used, […]

---

December 4th, 2008

More Support for HIV Screening

On Monday December 1 — World AIDS Day, if you’re keeping track — the American College of Physicians released a position paper supporting routine HIV screening for adolescents and adults in the United States.  (If you don’t want to read the whole thing, we’ll have a perfectly-executed summary by the inimitable Abbie Zuger on our AIDS Clinical […]

---

November 30th, 2008

How to End the HIV Epidemic

Answer:  Put everyone on treatment. Conspicuously absent for decades, the prevention part of the “when to start antiviral therapy?” question has now moved front and center in two recent papers:  In this week’s Lancet, a group from the WHO estimated what would happen if there were annual universal HIV testing, and then immediate treatment for all […]

---

November 25th, 2008

Coming Soon: A Great Advance in TB Diagnostics

An all-too-frequent problem in the ID clinical world is the case where tuberculosis is possibly the diagnosis, but confirming it is difficult, or impossible. Now, in a scientific breakthrough of such magnitude that it warranted front page coverage in our local newspaper, I am pleased to report that we may have a solution: giant rats. Yes, giant […]

---

November 17th, 2008

Promising C diff Rx, and Google as Surveillance Tool

A few items from recent ID/HIV news: Bad enough when it happens once, relapsing C diff is one of the modern plagues for which our bag of tricks sometimes comes up woefully short.  (Anything that tests stool transplants as a therapy is pretty desperate.)  Here was some bright news on the treatment front, however:  an experimental […]

---

November 10th, 2008

Yes, Just a Case Report, but Incredibly Cool

At this year’s Retrovirus Conference (was it really this year’s conference, seems like much longer ago than that), there was a poster presentation summarizing a very unusual case.  A man with HIV, stable on antiretroviral therapy, developed acute leukemia.  He underwent an allogeneic bone marrow transplant — here’s the kicker — from a donor who […]

---

November 2nd, 2008

The Big HIV News from ICAAC/IDSA

Tons of interesting stuff at this year’s combined ICAAC/IDSA meeting, most of it in non-HIV related Infectious Diseases.  In aggregate, literally hundreds of posters, presentations, and symposia on MRSA, C diff, osteomyelitis, complicated UTIs, hospital-acquired pneumonia, antibiotic resistance … It’s a great meeting to catch up on general ID, and the literature review sessions alone […]

---

October 27th, 2008

Antibiotics as Placebos?

This article in the BMJ is geting lots of news:  Out of 679 practicing physicians in the United States, about half admitted to prescribing placebos on a regular basis.  A “small but notable proportion (13%) of physicians reported using antibiotics.” My first instinct was surprise that the rate was this low, but then I remembered that public […]

---