HIV and ID Observations

October 29th, 2015

The Most Important HIV Study at IDWeek 2015

After reporting my choice for the most important HIV study at ICAAC, I received this email from a colleague: If that’s the most important study, I really didn’t miss much … Now she has notoriously high standards — hard to impress her — but her opinion notwithstanding, I still think the STRIIVING study has some important messages we can apply […]

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October 24th, 2015

Pumpkin-Flavored ID Link-o-Rama

As the leaves change colors and fall from the trees, the days grow shorter and colder, and pumpkin-colored and flavored merchandise shows up everywhere, I ask you this important question: What precisely are the infectious risks of bobbing for apples? Off we go. Receiving antibiotics in childhood is associated with weight gain. The important finding in this study is that the […]

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October 17th, 2015

Dear Flu Vaccine: Please Improve!

Dear Flu Vaccine, As the supply of you and your brethren have arrived in our clinics, on our hospital floors, and in pharmacies, I thought it would be a good time to reach out and tell you how to get better. That’s right — here, free of charge, is  a to-do list for how you can improve. Understand, I’m one of your top […]

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October 7th, 2015

The Future of Diagnostic Microbiology, in 17 Minutes!

Over at Open Forum Infectious Diseases, I had the pleasure to interview Dr. Angela Caliendo about the latest advances in diagnostic microbiology. She touches on molecular testing in general, rapid pathogen identification (especially with MALDI-TOF, everyone’s favorite acronym), “syndromic” diagnostic testing for respiratory infections and diarrhea, use of Xpert for TB even here in the United States, […]

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September 24th, 2015

Decision to Lower Price of Pyrimethamine a Good One, Especially Given the Weak Defense of the Price Hike

The big ID story the past couple of weeks is that the price of pyrimethamine — a drug that’s been available generically for decades — went from $13.50 to $750 for one pill after the exclusive rights to the drug were purchased by Turing Pharmaceuticals. Now, after a barrage of criticism — all the way from this […]

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September 20th, 2015

EHR and Drug Prescribing Warnings: The Good, the Bad, the Ugly

Part 1. The Good. Recently, an ENT colleague (fictionally named “Clint” below), sent me two emails triggered by drug-drug interaction warnings he received while seeing HIV patients. Here’s #1: Hey Paul, I saw Mark C yesterday for hoarseness, and his exam was negative. Thought we’d try a PPI for reflux, but when I wrote the script, I […]

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September 13th, 2015

Station Eleven Is a Very Good Read — Even for ID Doctors

One of my colleagues, an MD/PhD, stopped me after our clinical conference a few weeks ago. He does basic science research, doesn’t see patients anymore — but he still comes to our clinical conference. Definitely scores points for that. And for being a very smart, interesting, and nice fellow. This was our conversation, reproduced verbatim: HIM:  Hey Pablo […]

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September 7th, 2015

Two Drugs with High Prices — One is (Surprise!) Good Value, The Other is Truly a Rip-off

By now, the fact that HCV treatment carries a high price is a fact as well known to the medical and non-medical public as 1) a million dollars doesn’t get you much in Manhattan or Bay-area real estate; 2) a Rolex is an expensive way to know what time it is; and 3) even though […]

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August 23rd, 2015

Post-Exposure Prophylaxis for HCV Can’t Be Cost-Effective — But We Might End Up Recommending It Anyway

An email query from a colleague: Hi Paul, Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV +. Any post-exposure prophylaxis recommended? Thanks, Dan The quick answer is no, it’s not recommended. From the guidelines: But it’s a natural question to ask for several reasons — […]

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August 17th, 2015

Dog Days of Summer ID Link-o-Rama

A few ID/HIV items of note to consider as you gather up your sunscreen, flip flops, towels, and sand toys and head off to the beach: Interesting review of the impact of low socioeconomic status in the recent outbreak of Legionnaires’ Disease in the South Bronx. It’s just like (almost) every infection — the combined effects of crowding, poor sanitation, and […]

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