HIV and ID Observations

July 26th, 2023

REPRIEVE Trial Highlights Shift in HIV Care from ID to General Medicine

The biggest news this week at the 12th IAS Conference on HIV Science here in Brisbane, Australia, was the results of REPRIEVE, a large randomized clinical trial conducted in people with HIV. It’s not a study of novel antiretroviral regimens, or of treatment or prevention of opportunistic infections, or of an HIV eradication strategy using […]

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July 5th, 2023

The Yin and the Yang of Cabotegravir-Rilpivirine: Part Two, the Limitations

In the last post, I cited examples of patients who are doing much better now because they are on long-acting cabotegravir-rilpivirine (CAB-RPV). One of these patients said he preferred it because it’s “simpler,” by which he meant he no longer had to go to the pharmacy to refill his medications each month. I’ll grant for him […]

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June 30th, 2023

The Yin and the Yang of Cabotegravir-Rilpivirine: Part One, the Good News

Long-acting cabotegravir-rilpivirine (CAB-RPV) is the biggest advance in HIV therapeutics in years. It’s also creating quite the challenge for ID and HIV clinicians, which makes its availability a fascinating example of the importance of education, patient communication, and shared decision-making. This post will be the good news about this groundbreaking treatment; in the next post, I’ll […]

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June 2nd, 2023

Continued Activity of NRTIs Despite Resistance Is a Real Thing

In our last post, we reviewed a case of a person with longstanding HIV with extensive multi-class resistance, but now a decade of viral suppression. They’re currently on an HIV treatment regimen of fully active raltegravir, partially active etravirine, and barely active (or not active at all!) darunavir. There are no NRTIs in the regimen, […]

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May 15th, 2023

Types of HIV Papers — A Quick Guide

I spend a lot of my time reading HIV clinical research papers. A lot.  So here, for your viewing pleasure, is a poster I updated and modified from a brilliant xkcd web comic (using this tool), describing some common HIV clinical research themes. Suitable for framing, it should prove helpful as you embark on your next […]

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April 28th, 2023

What is the Future of HIV Primary Care?

Here’s a figure I’ve made for an upcoming talk, which is entitled “The Future of HIV Care.” It summarizes several eras in HIV treatment, finishing up with the current unprecedented successful phase where most people with HIV take 1–2 pills a day, have virologic suppression and no clinically apparent immunodeficiency. HIV is often the least […]

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April 21st, 2023

A Change-of-Season ID/HIV Link-o-Rama

The warm weather takes its sweet time to arrive here in Boston, teasing us with an occasional comfortable day, but reverting frequently to chilly temperatures and high winds until mid-to-late May at the earliest. The afternoon sunlight might say, “Spring is here!”, but the nightly temps in the upper 30s/low 40s definitely say otherwise. Brrr. Anyway, […]

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February 28th, 2023

Really Rapid Review — CROI 2023, Seattle

In a recent chat I had on a local TV network on this year’s respiratory virus season, the host mentioned that “this year felt very post-pandemic”, prompting me reflexively to knock wood — and I’m not a superstitious person. But even we ID doctors must acknowledge the dramatic improvement in COVID severity this winter compared to […]

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December 19th, 2022

Chaos in the Diagnosis of Pneumocystis Pneumonia

Confession — no one knows the best way to diagnose Pneumocystis jirovecii pneumonia, commonly abbreviated as PJP, or for some stubborn old timers, PCP. Don’t believe me? Take a look at this poll — not just the results, but the extraordinary diversity of responses — then head on back here for a historical perspective sure to […]

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November 21st, 2022

Five ID Things to Be Grateful For, 2022 Edition

In what’s something of a holiday tradition on this site, I hereby present 5 ID things we can be grateful for as we prepare for the best holiday of the year. Why the best? Family and friends. A nice big meal, with something for everyone. (My family of four has two vegetarians — they have plenty […]

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