HIV and ID Observations

June 27th, 2013

Testing Out the New Website with an ID Link-o-Rama

Hey, new website is live! Interested to hear what you think about our new-ish look. In celebration, here are some quick ID/HIV tidbits that have recently crossed my path, or have been sitting in my inbox for a while, dying to get out: Doxycycline shortage. Hardly anything more frightening to a New England ID doc than a shortage […]

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June 20th, 2013

Let’s Move the HIV Testing Algorithm Into the 21st Century

As I’ve written before, the most widely used testing algorithm for HIV — enzyme immunoassay followed, if positive, by Western blot confirmation — is long overdue for an update. A brief review why this is the case, and also why sticking with it is so problematic: Immunoassays have become progressively more sensitive, especially when paired with p24 […]

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June 17th, 2013

Gallant is Answering Your HIV Questions and Zuger Writes About the Tough Practice of “Doing Nothing”

Two highly recommended products from a couple of my friends in the HIV/ID world: First, the inimitable Joel Gallant — long time of Johns Hopkins, soon to be of Santa Fe — has resuscitated his terrific Patient Q & A Forum here. He used to answer patients’ questions regularly on www.hopkins-aids.edu, but that whole site appears […]

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June 13th, 2013

PrEP Works in Injection Drug Users, CDC Offers “Guidance”

From The Lancet comes this important study of tenofovir pre-exposure prophylaxis for injection drug users (IDUs): In this randomised, double-blind, placebo-controlled trial, we enrolled volunteers from 17 drug-treatment clinics in Bangkok, Thailand … We randomly assigned [2413] participants to either tenofovir or placebo … 50 became infected during follow-up: 17 in the tenofovir group and 33 […]

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June 11th, 2013

Both Simeprevir and Sofosbuvir Likely Approved by 2014 — Clinical/Ethical/Pharmacoeconomic Dilemmas Loom

As expected, simeprevir, and now also sofosbuvir, are being given “priority review” by the FDA. With the 6-month rule under the Prescription Drug User Fee Act — usually just said as “pah-DOOF-ah” — that means there’s a good chance we’ll have both of these anti-HCV drugs some time in late 2013. Which also means HCV treaters will soon […]

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May 8th, 2013

HIV Opportunistic Infection Guidelines Updated

Some very hard-working folks at the NIH, CDC, and IDSA have updated the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, which are available for review here. As with the previous versions (the prior iteration is from 2009), the OI Guidelines are comprehensive, exhaustively referenced (184 references for TB alone!), […]

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May 2nd, 2013

How to Interpret Medical Breakthroughs in the Mainstream Media

There it is, right in your daily paper, on your tablet or computer screen, or wherever you get your news today — a headline about a great medical breakthrough everyone’s been waiting for: Scientists on brink of HIV cure Researchers believe that there will be a breakthrough in finding a cure for HIV “within months” Yes, […]

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April 23rd, 2013

Two Papers, Four Sofosbuvir Studies, and Soon the End of “Interferonologists”

Today, as the The International Liver Congress is about to start, two papers are published in the New England Journal of Medicine on sofosbuvir, the investigational anti-HCV nucleotide submitted to the FDA for approval earlier this month. Each paper actually includes within them two studies. (For some reason, all the studies sound like 1950s science fiction magazines.) […]

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April 20th, 2013

Postexposure Prophylaxis (PEP) After Blast Injuries

From a colleague came this query: We are being consulted by surgeons who are finding within blast victims tissues from other humans. We have been offering post-exposure prophylaxis. Have you folks developed any policies re PEP for explosion victims? Welcome your thoughts, P Needless to say, the bombing victims are currently facing far greater challenges than […]

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April 5th, 2013

Another “Important Advance” in HIV Vaccine Research?

On reading this other real news about a single patient and how it may shape the future of HIV vaccine research, I decided to write the following fake news, drawing liberally on many similar stories over the years: Scientists today reported a discovery that could finally pave the way for an effective AIDS vaccine. In the study, published […]

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