HIV and ID Observations

April 22nd, 2010

Should Transmission of HIV be a Crime?

Not according to Journal Watch editor and New York Times writer Abigail Zuger, writing here in the Times.  She’s referring to the recent Darren Chiacchia case, where his former partner has filed a legal complaint that Chiacchia did not disclose having HIV — potentially a first-degree felony in Florida. Were it a matter of science alone, […]

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April 4th, 2010

San Francisco Public Health: Treatment Recommended for All with HIV

Could there be anything more interesting than the start of the baseball season? Maybe, because this is quite something: In a major shift of HIV treatment policy, San Francisco public health doctors have begun to advise patients to start taking antiviral medicines as soon as they are found to be infected, rather than waiting — sometimes years — […]

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March 31st, 2010

C diff Guidelines: Metronidazole Still Preferred?

IDSA and The Society for Healthcare Epidemiology of America (SHEA) have published Clinical Practice Guidelines for Clostridium difficile infection. Not surprisingly, it’s a comprehensive, extensively-referenced document that will be an invaluable resource, especially since the previous version is approximately 15 years old. But with the caveat that I’m not an expert in this area, these particular treatment recommendations […]

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March 24th, 2010

Now for Some Good News: TB Cases Continue to Decline

From the latest MMWR: This figure speaks for itself, but two sentences from the Editorial Note deserve highlighting: The 11.4% decrease in reported TB rate in 2009 is the largest single-year decrease ever recorded. From 1953 to 1993, the single largest annual percentage decrease in TB case rate was 11.1% in 1956 Since I started my ID career […]

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March 14th, 2010

MRSA Bacteremia Question Redux — and the “Answer”

As noted here, I recently had to answer a question on management of MRSA bacteremia as part of an every-10-year cycle of test-taking. (For more on that joyous process, read this interesting debate here in the New England Journal of Medicine.) The question seemed to have no obvious right answer, so I did what one is explicitly allowed to […]

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February 28th, 2010

CROI 2010 Recap: No Obvious Blockbusters, But …

Ok, I’ll admit it — I didn’t see any studies presented at CROI this year that will immediately transform HIV care on a day-to-day basis.  Nothing that will alter practice right now. Nothing like last year’s NA-ACCORD, or 2008’s surprising DAD study, or 2007’s raltegravir studies, to name a few recent examples. (All subsequently published, of course — links are to […]

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February 14th, 2010

Retrovirus Conference (CROI) 2010 Preview

Just as pitchers and catchers report to Spring Training this week, many HIV specialists are gearing up for the 17th Conference on Retroviruses and Opportunistic Infections (CROI), which starts this Tuesday in San Francisco. (I don’t suppose many people see the link between those two events.  Oh well.) And since the “pocket program” to the Conference has […]

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February 2nd, 2010

Bats in the Bedroom: Canadians Make a Policy Change

ID doctors know all too well the panicky call — usually from a terrified friend, family member, or colleague, or possibly the emergency room or primary care doc — about finding a bat in the house. Usually in the bedroom. (In one memorable case, it was the house cat’s leaping in the air to try and catch […]

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January 29th, 2010

More on TaqMan Viral Load Testing

Since I first discussed the disruptive effect of introducing Mr. TaqMan to our clinic, many others have weighed in. One of my favorite reports is a nice paper from the Alabama group, presented first at IDSA, and soon to be published.  It shows not only a higher rate of low-level detectable results, but also the increased […]

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January 17th, 2010

Hey, Didn’t You Used to be the Cause of CFS?

The report last year that xenotropic murine leukemia virus-related virus (XMRV) was found in a high proportion of patients with Chronic Fatigue Syndrome (CFS) caused quite a stir — which is totally understandable given how frustrated the people with CFS are with the lack of adequate explanations for their suffering. The investigators of the original report […]

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