HIV and ID Observations

November 30th, 2008

How to End the HIV Epidemic

Answer:  Put everyone on treatment. Conspicuously absent for decades, the prevention part of the “when to start antiviral therapy?” question has now moved front and center in two recent papers:  In this week’s Lancet, a group from the WHO estimated what would happen if there were annual universal HIV testing, and then immediate treatment for all […]

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November 22nd, 2008

“Salvage” Rx for HIV: Macro Good News, Micro Bad News

I’ve written before how the number of treatment experienced patients who have no options for successful therapy has dwindled to a tiny — but unfortunate — few.  Darunavir, maraviroc, raltegravir, and etravirine (in order of FDA approval) are that good. Two presentations at recent scientific meetings confirmed the staggering efficacy of these newer drugs. Notably, both […]

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November 17th, 2008

Promising C diff Rx, and Google as Surveillance Tool

A few items from recent ID/HIV news: Bad enough when it happens once, relapsing C diff is one of the modern plagues for which our bag of tricks sometimes comes up woefully short.  (Anything that tests stool transplants as a therapy is pretty desperate.)  Here was some bright news on the treatment front, however:  an experimental […]

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November 10th, 2008

Yes, Just a Case Report, but Incredibly Cool

At this year’s Retrovirus Conference (was it really this year’s conference, seems like much longer ago than that), there was a poster presentation summarizing a very unusual case.  A man with HIV, stable on antiretroviral therapy, developed acute leukemia.  He underwent an allogeneic bone marrow transplant — here’s the kicker — from a donor who […]

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November 2nd, 2008

The Big HIV News from ICAAC/IDSA

Tons of interesting stuff at this year’s combined ICAAC/IDSA meeting, most of it in non-HIV related Infectious Diseases.  In aggregate, literally hundreds of posters, presentations, and symposia on MRSA, C diff, osteomyelitis, complicated UTIs, hospital-acquired pneumonia, antibiotic resistance … It’s a great meeting to catch up on general ID, and the literature review sessions alone […]

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October 21st, 2008

Back to School, Day 4: PEP and More PEP

After a lecture on HIV for Primary Care Providers in our course last week, the most controversial topic was, not surprisingly, the use of post-exposure prophylaxis (PEP) for both occupational and non-occupational exposures.  And today, after an entire lecture on PEP to a group of HIV providers in our AIDS course, again the subject drew […]

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October 18th, 2008

Back to School, Day 2

During the course, often the best questions and anecdotes come during the breaks.  Here are a few: Tons of questions about our favorite nemesis, MRSA.  What works for chronic carriers?  How do you manage family members who you suspect would be culture-positive (and the source of recurrences), but are not your patient?  What if the vet […]

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October 8th, 2008

The French Win This One

The 2008 Nobel Prize in Medicine goes to Françoise Barré-Sinoussi and Luc Montagnier for discovery of HIV.  They each get one-quarter of the prize money, with one-half going to Harald zur Hausen for showing the relationship between human papillomavirus and cervical cancer. For the record, if you search the Nobel press release for the word “Gallo”, […]

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October 1st, 2008

Deadlines of Note

Just a reminder of some interesting deadlines/events out there, in case you were too wrapped up sharpening pencils for tomorrow’s Vice Presidential debate: As of today, Medicare will no longer reimburse hospitals for medical errors — which includes some hospital-acquired infections.  According to this article, several other payors (including private insurers) are using this as a precedent […]

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August 22nd, 2008

We have met the enemy … and it is MRSA

In Jerry Groopman’s recent New Yorker piece on antibiotic-resistant bacteria, he quotes Dr. Louis Rice from the Cleveland VA, who uses the term “ESKAPE” bacteria:  an acronym for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa, and Enterobacter. Nothing against the mostly gram-negative nasties in this list (and the focus of the New Yorker article), […]

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