HIV and ID Observations

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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September 8th, 2019

The Curious Case of M184V, Part 2 — and More!

The inspiration for today’s post comes from two recent emails from ID/HIV colleagues — thank you. Here’s the first, from Dr. Mehri McKellar from Duke: Hi Paul, When are you going to do part 2 of The Curious Case of M184V, Part 1? I am waiting patiently. 🙂 Mehri Mehri, wait no more, because here it is! […]

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September 2nd, 2019

New Antibiotics for CRE, Draft Lyme Guidelines, Cost of Measles Outbreaks, and More — a Labor Day ID Link-o-Rama

Labor Day! Could summer really be over? Nah, we still have a few weeks — and as I’ve noted several times, this time of year (September-October) gives us far and away Boston’s best weather season. On with the links. Data from electronic medical records can accurately identify the best candidates for PrEP. The challenge in primary care is […]

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August 18th, 2019

Choosing the Top Research Papers in HIV Medicine — and Recalling the Joy of Working with a Great ID Fellow

Way back in 2008 — the year I started writing here — I drafted an exceedingly long post listing the top published papers in HIV medicine. Oh how I tortured myself over that thing. How to define “Top”? Most cited? Most clinically important? Most rigorously scientific? Best written? After a while, I just abandoned the monstrosity. It still […]

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July 28th, 2019

Really Rapid Review — IAS 2019 Mexico City

As I noted last week — and you did read last week’s post, didn’t you? — the International AIDS conference first took place in Mexico City in 2008. Last week we returned to this sprawling, vibrant city for the 2019 meeting. It was an excellent, well-run conference — with one small complaint. But more on that later… […]

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