HIV and ID Observations

April 6th, 2009

Delayed Opening Day Videos, and More

Some random HIV/ID issues while awaiting a delayed opening day here in cold, rainy Boston: If you enjoy video highlights, check out these of HIV making its way from T cell to T cell.  If you’re short on time, #’s 9-12 are particularly amazing.  Still, I don’t imagine that this video will make it to Youtube anytime […]

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March 31st, 2009

Infectious Disease in the ICU: Help Please? Part II

In Part I of this topic, I commented on the ironic sameness of ICU Infectious Diseases — that incredibly sick, complex patients entered the ICU with vastly different problems, then over time, seemed to converge, presenting similar kinds of clinical issues and management challenges for the ID doc. Or, as a visiting medical student said to […]

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March 25th, 2009

March (Guideline) Madness …

A couple of interesting ID guidelines out this week.  For those of you too busy with basketball, here are the relevant links: Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities. Identified in 24 states and now found “routinely” in New York and New Jersey, these carbapenem-resistant Enterobacteriaceae (“CPE” is much […]

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March 20th, 2009

Hair Today, Gone Tomorrow …

Since providers — especially doctors — are notoriously poor at predicting medication adherence, here’s some good news: In a paper from the Women’s Interagency Health Study, protease inhibitor levels in hair samples were the strongest independent predictor of virologic success — better than self-reported adherence, age, race, baseline viral load and CD4 cell count, and […]

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March 14th, 2009

Maybe It’s Not the Cheeseburgers

… At least that’s the implied message in this nice paper from the latest Annals of Internal Medicine, which evaluated responses to lipid-lowering therapy among patients with and without HIV. The study included patients from the Kaiser Permanente of Northern California integrated health system, with 829 individuals with HIV and 6941 without. The quick summary is that […]

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March 10th, 2009

Unwelcome Visitor: Cost of HIV Meds

Those of us who practice HIV medicine in Taxachusetts (warning, click link at your peril) live a pretty charmed life, at least so far as getting HIV medications paid for.  Due to an incredibly generous AIDS Drug Assistance Program (ADAP), rare is the patient who faces financial barriers getting his or her drugs. (By the way, […]

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March 4th, 2009

TaqMan HIV RNA Assay: Be Careful What You Wish For

At our hospital lab, we recently switched from the bDNA viral load assay to the new Roche TaqMan real-time PCR test.  The virologist in charge of our lab and the tech both agreed the assay was more accurate, more sensitive, and easier to do — so much so that we could increase the frequency of […]

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February 26th, 2009

Meningococcal Resistance to Ciprofloxacin

Ciprofloxacin-resistant Neisseria meningitidis has now been documented in the United States. Here’s a nice summary in Journal Watch, with two different perspectives. I suppose we shouldn’t be surprised, but it did take a while.  (At least compared to that other famous neisseria-bug, Neisseria gonorrhoeae.) Oh well. Why is this important?  As every practicing ID doc/primary care provider/public health […]

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February 13th, 2009

CROI 2009: Greatest Hits

Fresh back from lovely Montreal, where the temperature (I’m glad to report) climbed into the balmy 40’s … Here’s a rapid-fire listing of the Greatest Hits.  As I’m sure to be leaving something off this list, happy to accept other suggestions: Interleukin-2 does not work.  The ESPRIT and SILCAAT studies are over. Yes, the CD4’s increase, but […]

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February 4th, 2009

Brush with Greatness: Bruce Walker

Bruce Walker has just received a $100 million grant from Terry and Susan Ragon to start a vaccine research institute, with a focus on finding an HIV vaccine. The news of this gift (which as you can imagine has been floating around these parts for some time) is all the more remarkable since it comes […]

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