HIV and ID Observations

April 10th, 2012

A Skeptical Look at “Test and Treat”

Over in Journal Watch AIDS Clinical Care, Abbie Zuger has written a fascinating perspective on the recent enthusiasm for universal HIV treatment. Her take? Let’s just say she doesn’t share the enthusiasm of public health officials and members of guidelines committees. Well, that’s a huge understatement. Specifically: This strategy, which calls for universal voluntary HIV testing and […]

---

April 4th, 2012

Infectious Diseases Specialists Take the Best Medical Histories

In an era where control-c followed by control-v — that’s cut and paste, for those of you who don’t use keyboard shortcuts — is the prime method by which most clinicians write their medical notes, I’d like to come right out and brag that ID doctors take the best medical histories. You could argue (as I […]

---

March 15th, 2012

CROI 2012 Really Rapid Review — with CROI 2013 Dates!

Some highly subjective highlights — a Really Rapid Review™– from this year’s Number One Greatest Super Scientific HIV Conference, the 19th Conference on Retroviruses and Opportunistic Infections (CROI), which ended last week in Seattle: Need more evidence that maintaining a CD4 cell count > 500 is beneficial? This compelling analysis from the SMART and ESPRIT  studies found that […]

---

March 4th, 2012

Be Careful What You “Catch”

On the eve of the 19th Retroconference, or “CROI” — and I’m headed to Seattle right this moment — two baseball players have intersected with the world of Infectious Diseases. Ike Davis of the Mets has Coccidioidomycosis (Valley Fever). And Ryan Howard of the Phillies has an infection after achilles tendon surgery. Bottom line, it’s quite obvious that Bud […]

---

March 1st, 2012

Post-Exposure Prophylaxis, the World’s Most Outdated HIV Guidelines, and What To Do About Them

Every time I cover HIV prevention in a lecture, it’s always kind of embarrassing to cite the “official” post-exposure prophylaxis (PEP) guidelines, which are here (non-occupational) and here (occupational). That’s right, they were last updated in 2005, the year of Hurricane Katrina. Yes — more than six years ago. The alternative choices seem particularly curious (read: don’t do […]

---

February 26th, 2012

A Truly Bizarre “Systematic” Review

You know that tenofovir, emtricitabine, and efavirenz HIV regimen? The one that’s universally listed as one of the “Preferred,” or “Recommended” or “First-line” options in all HIV treatment guidelines in the universe? And the regimen that is easily the most widely used in the USA today? Well, here’s a surprising review from Cochrane Summaries, entitled “Effectiveness and […]

---

February 23rd, 2012

Hepatitis C and the “Retooling” of HIV/ID Specialists

The news that hepatitis C (HCV) has passed HIV as a cause of death in the United States got quite a bit of attention when it was first presented last year at ICAAC — and no doubt the published paper, in this week’s Annals of Internal Medicine, will also cause a stir. In fact, I boldly predict […]

---

February 14th, 2012

Is It Time To Stop Treating Acute Sinusitis?

From the pages of JAMA comes this startling clinical trial: A randomized, placebo-controlled trial of adults with uncomplicated, acute rhinosinusitis [who] were recruited from 10 community practices in Missouri between November 1, 2006, and May 1, 2009 … [Subjects received a] ten-day course of either amoxicillin (1500 mg/d) or placebo administered in 3 doses per day … There was no […]

---

February 12th, 2012

Impossible Curbside at Medical Grand Rounds

Scene:  Medical Grand Rounds, 5 minutes before the start. Lecture is on coronary artery disease, which may have a link to Infectious Disease even if it isn’t actually caused by Chlamydia pneumoniae or CMV after all. A well-regarded, experienced primary care physician (PCP) approaches. PCP: Hi Paul, I have quick question*. [*Curbsiders often use this exact phrase — and rarely does […]

---

January 29th, 2012

Pre-Super Sunday Scombroids

Some quick ID/HIV links while we await big guys playing the big game with a big (or at least bigger) ball. Did you see how this doctor cheated Medicaid out of more than $700,000 by prescribing HIV meds to people who didn’t have HIV? Not surprisingly, he’s going to jail. Proof that if there’s money behind a […]

---