HIV and ID Observations

September 24th, 2015

Decision to Lower Price of Pyrimethamine a Good One, Especially Given the Weak Defense of the Price Hike

The big ID story the past couple of weeks is that the price of pyrimethamine — a drug that’s been available generically for decades — went from $13.50 to $750 for one pill after the exclusive rights to the drug were purchased by Turing Pharmaceuticals. Now, after a barrage of criticism — all the way from this […]

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September 20th, 2015

EHR and Drug Prescribing Warnings: The Good, the Bad, the Ugly

Part 1. The Good. Recently, an ENT colleague (fictionally named “Clint” below), sent me two emails triggered by drug-drug interaction warnings he received while seeing HIV patients. Here’s #1: Hey Paul, I saw Mark C yesterday for hoarseness, and his exam was negative. Thought we’d try a PPI for reflux, but when I wrote the script, I […]

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September 7th, 2015

Two Drugs with High Prices — One is (Surprise!) Good Value, The Other is Truly a Rip-off

By now, the fact that HCV treatment carries a high price is a fact as well known to the medical and non-medical public as 1) a million dollars doesn’t get you much in Manhattan or Bay-area real estate; 2) a Rolex is an expensive way to know what time it is; and 3) even though […]

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August 17th, 2015

Dog Days of Summer ID Link-o-Rama

A few ID/HIV items of note to consider as you gather up your sunscreen, flip flops, towels, and sand toys and head off to the beach: Interesting review of the impact of low socioeconomic status in the recent outbreak of Legionnaires’ Disease in the South Bronx. It’s just like (almost) every infection — the combined effects of crowding, poor sanitation, and […]

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August 1st, 2015

Ten Reasons to Attend Our “Infectious Diseases in Primary Care” Course

With an up-front apology for the shameless plug — sorry! — here are 10 great reasons to attend our annual postgraduate course. It’s called Infectious Diseases in Primary Care, and takes place October 14-16 here at the Fairmont Copley Plaza Hotel in Boston. All the topics are clinically relevant to day-to-day practice. Look at these topics! There’s a strict […]

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July 26th, 2015

Really Rapid Review — IAS 2015, Vancouver

Vancouver will always have a special place in HIV treatment history. It was here, in 1996, that many of us first saw the potential of combination antiretroviral therapy to control this disease. Specifically, Study 035 of AZT, 3TC, and indinavir (presented by Trip Gulick) demonstrated the astounding finding that triple therapy induced sustained virologic suppression and dramatic immunologic improvement. Could it be that not everyone […]

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July 7th, 2015

For HIV in the USA, Not in Care Exceeds the Undiagnosed — Solutions Welcome

In last week’s post, I asked about two of the key components of the HIV care cascade — the “undiagnosed” vs the “diagnosed but not in care,” and which group was larger in the USA. Here are your answers as of now: The people who read this site are a pretty knowledgeable group when it comes to […]

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June 11th, 2015

Summer Is Almost Here ID Link-o-Rama

I know, I know. You’re sick of hearing Bostonians complain about the winter we just had. But did you know that the weather here didn’t get reliably warm here until, well, this week? We all have PTSD. Don’t talk to us about anything even vaguely white, flakey, and cold. Yes, we’re afraid of refrigerated coconut. I’ll stop […]

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June 4th, 2015

A Slightly Less Painful Way to Learn the Three-Letter Abbreviations for HIV Meds

One of the stupid things about being an HIV/ID specialist is the highly arcane code we use to abbreviate HIV treatments. Why was zidovudine originally AZT, and now ZDV? Why is lamivudine 3TC? And tenofovir TDF? Of course there are legitimate biochemical reasons why these are the right abbreviations, but they are lost to most of us who do […]

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May 27th, 2015

START is STOPPED: Study Confirms HIV Treatment Is Beneficial for All, Even Those with High CD4 Cell Counts

The Strategic Timing of AntiRetroviral Treatment (START) study began in 2009, enrolling over 4000 asymptomatic people with HIV and CD4 cell counts > 500, and randomizing them to immediate ART or to wait until the count dropped to 350. Now, from the National Institute of Allergy and Infectious Diseases comes this important announcement: Though the study was expected […]

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