HIV and ID Observations

June 24th, 2008

HIV Occupational Post-exposure Prophylaxis: Do the Right Thing

From one of our local HIV providers: There were two occasions recently when our local infectious disease doctor was consulted by the emergency room to decide what type of post exposure prophylaxis regimen to recommend for individuals who had sustained an occupational exposure (needlesticks) to two of our HIV positive patients.  It had been known […]

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June 9th, 2008

When (and Where) in the World is the 2009 Retrovirus Conference?

The Conference on Retroviruses and Opportunistic Infections — “CROI” — is the premiere scientific and clinical conference in the HIV world.  Every February, thousands of serious scientists and clinicians huddle in some frozen northern city, spending three and a half days intensely reviewing the latest and greatest in the field. So it’s time for an annual […]

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June 2nd, 2008

Zoster Vaccine Guidelines — Official Answers, but Still Some Questions

The CDC’s Advisory Committee on Immunization Practices has just released the “official” guidelines for use of the zoster vaccine. And none too soon — if I had a dollar (or these days, make that a euro) for every curbside consult I’ve received about the zoster vaccine … The vaccine’s indications are simple — age over 60, […]

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May 21st, 2008

When Expert Clinicians Disagree

Periodically, in AIDS Clinical Care, we publish a case in the “Antiretroviral Rounds” section and ask two clinical experts in our field how they would manage such a patient. The most recent case elicited responses that were 180 degrees different. (This is exactly what we’re after, by the way — why present a case in which […]

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May 14th, 2008

Certification in HIV Medicine — Another Try

In March, the American Board of Internal Medicine (ABIM) issued a proposal for a “Maintenance of Certification” (MOC) pathway in HIV medicine for general internists. This is the second such special pathway ABIM is considering (the first was hospitalist medicine). Regardless of whether you agree with the proposal, it’s a good read, providing an excellent […]

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May 5th, 2008

Brush with Greatness: Paul Farmer

Perhaps you caught this week’s 60 Minutes, featuring the work done by Partners in Health, the group founded and run by Paul Farmer. (If he reads this, he’ll no doubt want to correct my description of him as playing these major roles, eager to give equal credit to his impressive colleague Jim Kim and his mentor […]

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April 30th, 2008

Young Doctors “Get a Life” — Whither ID/HIV?

A front-page article in yesterday’s Wall Street Journal says that younger physicians (definition:  younger than I am), “intent on balancing work and family,” are choosing specialties that allow them to control their hours.  The content of the article will be familiar, including: The rise of the hospitalist movement A decline in those entering primary care fields The […]

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April 23rd, 2008

Antiretrovirals in the Pipeline: And Then There Were … None?

The flurry of drug approvals that began in 2005 with tipranavir – followed rapidly by darunavir, maraviroc, raltegravir, and most recently etravirine – has been nothing short of astounding. Every experienced HIV clinician now has many patients who are on successful (read: suppressive) treatment for the first time ever. The Vancouver HIV program — wonderfully called […]

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April 10th, 2008

Needed: Something Better than “HAART”

I think we all have pet peeves, and so I’ll confess one of mine: I hate the term “HAART.” (I work with someone, by the way, who hates the term “viral load,” preferring “virus load.” Go figure.) Standing for “highly active antiretroviral therapy,” HAART first surfaced in the mid-1990s in order to distinguish potent anti-HIV treatment from the older, not-so-active form […]

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March 31st, 2008

FDA Investigating Safety of Abacavir and Didanosine — Old News or New?

The FDA has issued one of its new “early communications” indicating that it has opened an investigation into the safety of abacavir and didanosine based on analyses showing higher rates of myocardial infarction with these drugs than with other NRTIs in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. The pace of our […]

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