HIV and ID Observations

July 4th, 2009

Progress on Consent for HIV Testing?

As I’ve noted here several times (some might say ad nauseum), I am convinced that Massachusetts’ arcane law requiring written informed consent prior to HIV testing is a barrier to more widespread screening — an opinion that is shared by virtually every clinician I’ve asked about this issue. Last week, there was an announcement about […]

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June 24th, 2009

An Irrational Fear of IRIS?

One of the most important recent studies in HIV has just been “published” in (on?) PLoS ONE.  It’s ACTG 5164, led by Andrew Zolopa, which compared “early” versus “deferred” antiretroviral therapy in 282 patients presenting with acute opportunistic infections. (Full disclosure: I am on the protocol study team — but am not an author on […]

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June 20th, 2009

More HIV in the Adult Film Industry (Maybe)

From the New York Times last week: Health officials in Los Angeles said Friday that 22 actors in adult sex movies had contracted HIV since 2004, when a previous outbreak led to efforts to protect pornography industry employees. (snip) Occupational health officials have long argued that failing to require that performers wear condoms during intercourse […]

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June 16th, 2009

Q: What is the Purpose of a Note in the Patient Chart?

A:  Depends who you’re asking. The best guidance I ever received on how to write a good note came from my residency program director, who told us that a note needn’t be encyclopedic to be excellent; in fact, he urged us to get away from the “second-year medical student” style, which typically includes absolutely everything. […]

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June 13th, 2009

Occupational Exposures and HIV Testing

A couple of years ago, an ID-colleague of mine told me about a tough case:  While working in the ICU, an anesthesiologist sustained a pretty severe needle stick.  Approached for HIV testing, the source of the exposure felt threatened by the providers in the ICU, and refused to sign the consent. The patient then deteriorated […]

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June 8th, 2009

H1N1: A Tale of Two Practices

As an adult ID/HIV doctor, I must say the clinical impact of H1N1 thus far has been underwhelming, notable more for the calls about prophylaxis or suspected cases than the real thing. (Last week, one patient with fever and “suspected swine” — hard for people to shake that name — turned out to have … […]

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June 1st, 2009

“Long-term Nonprogressors” and “HIV Controllers”: Rare Indeed

When giving an overview of HIV pathogenesis to a group of clinicians, Bruce Walker usually asks the assembled if they have any patients in their practice who have undetectable viral loads without antiretroviral therapy. Generally about three-quarters of the audience has at least one such patient.  They are then asked to refer them to his […]

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May 24th, 2009

Another State Gets Ready to Make HIV Testing Easier

Don’t look now, Massachusetts, but Connecticut could be next: AN ACT CONCERNING REVISIONS TO THE HIV TESTING CONSENT LAW. This bill revises the law on consent for HIV-related testing. Specifically, the bill: 1. eliminates the requirement for separate, written or oral consent for HIV testing and instead allows general consent for the performance of medical […]

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April 26th, 2009

Swine Flu Curbsides: Anthrax, SARS Redux?

In my email in-box yesterday AM from a primary care doc: A patient of mine, 40 year old woman totally healthy, is going to Cancun on Tuesday for a conference.  She’ll be there for 6 days. I know there are no cases of swine flu in Cancun yet, and the situation is evolving, but here’s […]

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April 20th, 2009

Another HIV Pharmaceutical Partnership

GlaxoSmithKline and Pfizer have created an alliance for HIV drug development. Since there is only one collaborative effort in the HIV treatment area — the colossally-successful “Atripla” between Gilead and BMS — I had thought this kind of arrangement was fairly rare in the drug biz, but according to this interesting take, apparently not. Perhaps […]

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