HIV and ID Observations

August 14th, 2009

Who Gets Toxoplasmosis in the United States?

This might seem bizarre, but one of the reasons I chose to go into Infectious Diseases as a field was the names of the diseases (and often the micro-organisms that caused them) sounded so darn cool. For example, if you were a science fiction writer you could hardly come up with a better-sounding name for […]

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August 5th, 2009

Just Out: Primary Care HIV Guidelines

Over on the CID web site, they have the revised version of the “IDSA Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus”. It’s a great document, filled with useful references and a particularly strong table where to find other consensus guidelines (diabetes, hyperlipidemia, mental health, others). My vote for what […]

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July 25th, 2009

IAS Cape Town 2009: Some Greatest Hits

Below is a highly-subjective list of some of the highlights from the Cape Town IAS meeting. I’m sure I missed something — it’s impossible to see everything at these large conferences.  Corrections/additions welcome! My miss-rate might be particularly high since the international AIDS meetings are appropriately focused on HIV treatment in resource-limited settings (especially Africa) […]

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July 20th, 2009

Cape Town IAS Meeting — A Quick Look Back at Durban 2000

The international AIDS meeting finds its way today to South Africa, the country with arguably the greatest needs for HIV prevention and treatment. This is not the first time the meeting was in this country, of course — in 2000, the World AIDS Conference took place in Durban, a truly landmark event in the history […]

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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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