HIV and ID Observations

November 23rd, 2014

Five ID/HIV Things to be Grateful for this Holiday Season, 2014 Edition

Amidst outbreak hysterias, anti-vaccine imbecility, electronic medical record whining, and slug-related eosinophilia, I bring you this year’s version of the good news — the 2014 edition of Five ID/HIV Things to be Grateful for this Holiday Season, just in time for your holiday turkeys. (Needless to say, the bird will be properly cooked to ensure it’s salmonella-free, with all cooking […]

---

October 30th, 2014

Why the IPERGAY (Yes, That’s Its Name) Study Could Substantially Increase Use of PrEP

Yesterday, the French IPERGAY study of intermittent pre-exposure prophylaxis (PrEP) was stopped early by the Data Safety Monitoring Board, and for the best reason — the evidence demonstrating that it prevented HIV was overwhelming. For those who read French, here’s the official announcement. (Scroll down for the English.) And for those who can’t believe the name, it stands […]

---

October 25th, 2014

What Makes An Ideal Applicant for a Fellowship in Infectious Diseases?

We’re at the tail end of the ID fellowship interview process, and am pleased to report we’ve seen some outstanding applicants. They know that our field is the most interesting in medicine, and they view our recent “Epidemic of Epidemics” — to coin a phrase from John Bartlett to describe all this activity (Ebola, MERS, Enterovirus D68, […]

---

October 19th, 2014

Almost Filovirus-Free (That is, Ebola-Free) ID Link-o-Rama

If you’re an ID doctor right now, the filovirus of the moment Ebola is consuming a big chunk of all of your non-clinical time — and this is particularly true for those heavily involved in Infection Control, who are spending every waking hour responding to public hysteria, to various clinicians who seem to have all the answers, and to ever […]

---

October 12th, 2014

Approval of Sofosbuvir/Ledipasvir Was Expected, but Still Is a Huge Advance

As expected, the FDA just approved the first single-pill treatment for hepatitis C genotype 1, a tablet containing 400 mg of sofosbuvir (SOF) and 90 mg of ledipasvir (LDV). For those not following this story closely, sofosbuvir is the pan-genotypic NRTI polymerase inhibitor approved last December to much rejoicing — and controversy about the price. Ledipasvir […]

---

October 6th, 2014

Back to School: Questions from “ID in Primary Care” Course

Just wrapped our our annual postgraduate course, “Infectious Diseases in Primary Care,” where each year we get together with primary care providers (doctors, nurses, PAs) and review what we hope are the most clinically relevant topics in ID. And each year we get a great bunch of questions, some of which I’ve listed below (along with […]

---

September 28th, 2014

New FDA HIV Drug Approvals Unlikely to Have Much Impact, Unless …

If you’re an ID doc based in the USA, you probably received notice last week that two new HIV drugs were approved — cobicistat and elvitegravir. And if you’re wondering what the big deal is, welcome to the club. In fact, the Canadians beat us to the punch with more significant approval, the co-formulated darunavir/cobicistat, branded […]

---

September 24th, 2014

Quick Question: How Do I Fill Out This Tricky Patient Job or School Form?

From a long-term and highly respected colleague comes this challenging query: Hi Paul, One of my HIV pts, doing wonderfully well, is planning to enroll in a nursing program. She does not want to disclose her HIV status (fine with me), but the hospital requests a list of current meds which, of course, would blow her […]

---

September 7th, 2014

It’s OK to Limit Who Prescribes HCV Therapy, but Insurers Shouldn’t Be Deciding

Some insurers would like to limit the prescribing of HCV treatment to gastroenterologists, hepatologists, or infectious diseases specialists. Not surprisingly, this doesn’t sit well with either the HIV Medicine Association (HIVMA) or the American Academy of HIV Medicine (AAHIVM), both of which have long acknowledged that some of the most seasoned HIV providers are generalists: “There is no medical […]

---

August 24th, 2014

Combination ABC/3TC/DTG Approved — Fourth One Pill a Day HIV Treatment

As expected, there’s a new single pill regimen for HIV, this one containing abacavir (ABC)/lamivudine (3TC)/dolutegravir (DTG), and it’s called Triumeq. (Where oh where do companies get these names?) A few thoughts/comments: The most important study for this combination was the SINGLE study, which showed that ABC/3TC + DTG (given as two pills) was superior to TDF/FTC/EFV (given as one), the difference […]

---