HIV and ID Observations

February 25th, 2020

First Week on Service, with One-a-Day ID Learning Units

There is almost always something to be learned from every new patient. It might be buried somewhere in the history, or the physical, or the lab tests, or the micro, or the imaging — but the odds are excellent that, with enough rumination, you’ll find it. I can’t remember now who taught me this important fact, or […]

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February 17th, 2020

Short-Course Treatment of Latent TB, Combination Therapy for Staph Bacteremia, Adult Vaccine Guidelines, Novel Antifungals, and Others — A Non-COVID-19 ID Link-o-Rama

There’s so much out there right now on COVID-19 (the disease) and SARS-CoV-2 (the virus) that the other ID news gets crowded out. Which means it’s time for non-COVID-19 ID/HIV Link-o-Rama! I haven’t done one of these in a while, so there’s plenty of material in the vaults yearning to be free. The CDC now recommends short-course, […]

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January 6th, 2020

The Decade’s Top 10 Biggest Changes to ID Clinical Practice

Here’s a question for you ID and HIV and other clinicians out there as you start 2020 — what are the 10 biggest changes to ID/HIV clinical practice over the past 10 years? Not necessarily what are the biggest stories or biggest advances (though they certainly are eligible) — but more specifically, when you are seeing […]

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December 23rd, 2019

FDA Defers Approval of First Long-Acting HIV Therapy, Surprising Everyone

We HIV/ID specialists are lucky. For over two decades, steady progress in HIV treatment brings regular excitement to our field. Some of these advances are incremental, but others represent major leaps forward. One such example of the latter is long-acting injectable therapy with cabotegravir (CAB) and rilpivirine (RPV) for maintaining viral suppression. This strategy — two […]

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December 1st, 2019

On World AIDS Day 2019 — Wouldn’t It Be Nice…?

With apologies to a 1960s band with a flair for complex harmonies and evoking warm ocean breezes (as the first winter storm barrels in), here’s a miscellaneous list of wishes for World AIDS Day. Wouldn’t It Be Nice … If everyone with HIV could be on suppressive antiretroviral therapy? Here are the latest estimates, showing we’re […]

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November 25th, 2019

Vaccine Defenders, U=U Holds Up, Zika Is Gone, and Other ID Things to Be Grateful For, 2019 Edition

An excellent episode of the Freakonomics podcast introduced me to the headwinds vs tailwinds asymmetry, and how we humans perceive life. It goes like this: We go for a walk, a run, or a bike ride, and the wind faces us dead-on, making the exercise a struggle. (In windy Boston, the wind is always in my face. Always […]

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November 11th, 2019

When TV Gets ID Wrong — Or At Least Not Quite Right

A busy week for Infectious Diseases on television! First, Dr. Aditya Shah, an ID doctor at Mayo Clinic, treated us to several snippets of truly idiotic ID-related drama in a network television show. After seeing them, I commented: Hey, my services to this show to help you talk about infectious diseases without sounding dumb are available at a […]

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November 3rd, 2019

Learning the Names of HIV Drugs Is Horribly Difficult — Here’s Why

Happens every time. We start teaching about HIV, and at first, everything is going great. Epidemiology, pathogenesis, diagnosis, clinical presentation. The students are right there with us. However, then we start covering treatment — and things immediately get tricky. Because no matter how engaged and brilliant they are, and no matter how scintillating we are, when the long […]

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October 7th, 2019

Our HIV Testing Algorithm Has a Major Problem — Here’s How to Fix It

Mostly, HIV testing works great. It’s long been so accurate that we can strongly support HIV testing even in relatively low-risk people. The 2014 revised lab testing guidelines made it even better, recommending a combined antigen/antibody screening test (called the 4th generation test), and replacing the Western blot with the HIV-1/2 differentiation immunoassay as the preferred […]

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September 28th, 2019

What Is the Best Treatment for Advanced HIV Disease?

One of the things that keeps me on Twitter — besides cute dog videos — is the periodic realization that the platform can help patients. Which is, after all, why most of us do this doctor thing — to help people get better. Example: Several months ago we had a challenging patient. I asked twitter if anyone […]

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