HIV and ID Observations

January 20th, 2020

Telemedicine, eConsults, and Other Remote ID Clinical Services Make So Much Sense — Why Isn’t Everyone Doing it?

The ID group at Mayo Clinic just published a small but important study on the use of remote ID telemedicine consults for hospitals that have no ID services on-site. The consults were “asynchronous”, meaning that the ID consultants at the main hospital finished them within 24 hours — they didn’t have to respond immediately. Importantly, all […]

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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 15th, 2019

Should Oseltamivir Become an Over-the-Counter Drug?

News broke last week that oseltamivir — most commonly known by its clever (expired) brand name, Tamiflu — may be heading to pharmacies soon as an over-the-counter (OTC) drug, available without a prescription. After hearing this, I immediately thought of several reasons both supporting and opposing this change — an ideal question for a poll! Oseltamivir (brand […]

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December 8th, 2019

A Midyear Letter to First-year ID Fellows — With Sympathy, Gratitude, and Hope!

Dear First-Year ID Fellows: Right around now, some of you might be feeling a bit prickly. The workday is long, the supply of daylight dwindles daily, and the cold winds blow in from the north. While friends outside of medicine gear up for holiday time off, your plans might include some hospital coverage. Some of you […]

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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 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 27th, 2019

The Enduring Appeal of Live, Face-to-Face, Real-Time Continuing Medical Education

Around 15 years ago, after high-speed internet became a de facto part of work life and was rapidly becoming more widely available at home, I attended a meeting with other medical educators to decide what to do about our various post-graduate courses. The wisdom in the room was that most continuing medical education (CME) would soon […]

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October 14th, 2019

Common Questions About the Shingles Vaccine — Answered Here!

Here’s an interesting email from my friend and ID-colleague Dr. Carlos Del Rio (shared with his permission): Went Tuesday to see my PCP for a routine visit and had my second dose of Shingrix that day. I had gotten my first dose about 3 months ago and had severe chills and even a fever of 38.5 […]

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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 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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