HIV and ID Observations

January 29th, 2016

Elbasvir/Grazoprevir Combination Pill for HCV a Welcome New Option — With a Few Buts

As expected, there’s a new option for HCV therapy, the combination pill elbasvir/grazoprevir (EBR/GZR, brand name Zepatier, more on this below), and it’s indicated for genotypes 1 and 4. For those mechanistically inclined, elbasvir is an NS5A inhibitor (like ledipasvir), and grazoprevir is a protease inhibitor (like simeprevir). This is the second one-pill, once a day option […]

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January 27th, 2016

Here’s an Idea: Justify Your Specialty’s (Low) Relative Salary Using Moral Superiority

In an otherwise excellent piece on recruitment to the ID field from the pages of Infectious Diseases News, comes this: But while inadequate compensation [for ID doctors] may hamper recruitment, it also could prove beneficial to some degree … Reduced salaries filter out the less-passionate applicants in favor of those who are more dedicated to their patients and to […]

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January 4th, 2016

A Riddle, the 2015 Clinical Trial of the Year, and a Guaranteed Laugh for All ID Doctors

Things quiet on this end recently from me due to various circumstances. but here are three ID-related (sort of) things worth sharing — enjoy if you haven’t seen them already. Let’s start with a riddle: What animal is responsible for the most human deaths a year? Readers of Bill Gates’ blog will think this is old news, but […]

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December 26th, 2015

A Few Things We Were Talking About On Rounds …

Remember when people passed out papers of interesting clinical studies and relevant reviews? And how some doctors even had a special stamp they put in the upper right hand corner? OK, full confession — I did that. A lot. See evidence to the right. Haven’t used the thing in well over a decade, surprised I still have […]

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December 19th, 2015

Part 2, Now The Good News: Why ID Will Survive as a Specialty

Part 1 of this post, which highlighted the primary reason for declining applications to ID fellowship programs, could come across as something of a downer. “Moping about it won’t get us anywhere,” someone said to me, and it’s true nobody likes a whiner. But my point was to acknowledge the issue, and find a way forward. It wasn’t […]

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November 29th, 2015

Flu Vaccine Keeps Taking Hits, Still the Best We’ve Got — Don’t Stop “Belivin'” [sic]

For reasons understood only by the geniuses in Mountain View, CA, for some reason my Google news feed picked up this bit of “scientific” reporting: Let me allow the author, an unfortunately named “Clapway” (gonorrhea researcher?), to speak for him/herself: However, is the flu vaccine really worth it? The author of this article never takes it and […]

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November 26th, 2015

Five (OK, Six) ID/HIV Things to be Grateful for this Holiday Season, 2015 Edition

Some quick ID/HIV gratitude items for 2015, done rapidly as we’re hosting a big meal later today. I wonder what that might be. New Ebola virus disease cases and deaths have dramatically declined. I write that sentence with some trepidation, as cases continue to occur sporadically, and this late relapse in a nurse was a chilling reminder of […]

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November 22nd, 2015

Just Wondering: Quick ID Questions to Consider

Several quick ID queries, some of them answerable on the Google machine — but I’m not going there. Too busy laundering my white coat! What ever happened to amphotericin A? What’s the difference between a “serovar” and a “serotype”? Do dogs feel bad that Pasteurella multocida is more famous than Capnocytophaga canimorsus? Colistin resistance is bad — but how often does colistin actually work […]

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November 18th, 2015

Are There Remaining Challenges in HCV Therapy?

Prompted by (yet more) spectacular HCV study results, I posted the following questions on Twitter: Is velpatasvir/sofosbuvir the endgame for HCV? And what will HCV researchers do now? https://t.co/vL2A9FOttR @NEJM — Paul Sax (@PaulSaxMD) November 18, 2015 To which I got this reply from one of our very energetic second-year ID fellows: @PaulSaxMD @NEJM what about coinfected patients, […]

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November 1st, 2015

Should Doctors Still Be Allowed to Wear White Coats? You Decide

If you’re not immersed in the ID or the Infection Control world, you might not be aware that there’s currently quite the controversy about whether doctors should wear white coats. I almost wrote “raging controversy” — but the adjective “raging” doesn’t really fit the sort of people who specialize in Infection Control, who are some of the most measured, […]

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