An ongoing dialogue on HIV/AIDS, infectious diseases,
June 2nd, 2010
Screening for Anal Cancer and the World’s Worst Job
In Journal Watch AIDS Clinical Care, we published a simple case: Clinically stable HIV+ gay man, on HIV treatment; anal pap comes back with “atypical squamous cells of undetermined significance” (ASCUS). What to do with this result? Two experts weighed in, Howard Libman and Joel Gallant. In Howard’s thoughtful response, he acknowledges the limitations of the data […]
May 27th, 2010
HIV Treatment is Prevention!
The Lancet has just published a large prospective study demonstrating the protective effect of HIV treatment on the risk of viral transmission: 3381 couples were eligible for analysis … Only one of 103 genetically-linked HIV-1 transmissions was from an infected participant who had started ART, corresponding to transmission rates of 0·37 (95% CI 0·09—2·04) per 100 […]
May 23rd, 2010
Dengue in the News … Again
The recent dengue cases acquired in Florida prompted me to think of two things. First, is this really a surprise? Dengue has become increasingly common in the Caribbean, the mosquitoes that transmit the virus are widespread in the United States, and it’s not as if there’s some sort of microbiologically (if that’s a word) impermeable barrier between […]
May 4th, 2010
Zoster Vaccine Underutilized
From the Annals of Internal Medicine: Eighty-eight percent of providers recommend herpes zoster vaccine and 41% strongly recommend it, compared with more than 90% who strongly recommend influenza and pneumococcal vaccines. For physicians in both specialties [Internal Medicine and Family Practice], the most frequently reported barriers to vaccination were financial. From my admittedly biased perspective […]
May 2nd, 2010
Learning from Clinical Trials with Limited “Generalizability”
In the ongoing debate about when to start antiretroviral therapy in our sickest patients — those with acute opportunistic infections — comes this study from Zimbabwe of early vs. deferred ART in patients with cryptococcal meningitis: The median durations of survival were 28 days and 637 days in the early and delayed ART groups, respectively […]
April 24th, 2010
Choosing an Official State Microbe
Wisconsin has selected Lactococcus lactis as its official state microbe: The people of the state of Wisconsin, represented in senate and assembly, do enact as follows: SECTION 1. 1.10 (3) (t) of the statutes is created to read: 1.10 (3) (t) The bacterium Lactococcus lactis is the state microbe. SECTION 2. 1.10 (4) of the statutes is amended […]
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 […]
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 […]
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 […]
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 […]
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
Biography | Disclosures | Summaries
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NEJM Journal Watch — Recent Infectious Disease Articles- Cefixime: Might It Be an Option for Treating Early Syphilis?
- Should Emergency Departments Offer Routine Vaccines to Adults?
- Should Immunosuppression Be Interrupted During an Infection?
- Is Endotracheal Aspirate Adequate for Diagnosis of Pneumocystis Pneumonia?
- For Early Syphilis, Are Three Doses of Benzathine Penicillin Better Than One?