HIV and ID Observations

December 4th, 2008

More Support for HIV Screening

On Monday December 1 — World AIDS Day, if you’re keeping track — the American College of Physicians released a position paper supporting routine HIV screening for adolescents and adults in the United States.  (If you don’t want to read the whole thing, we’ll have a perfectly-executed summary by the inimitable Abbie Zuger on our AIDS Clinical […]

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November 30th, 2008

How to End the HIV Epidemic

Answer:  Put everyone on treatment. Conspicuously absent for decades, the prevention part of the “when to start antiviral therapy?” question has now moved front and center in two recent papers:  In this week’s Lancet, a group from the WHO estimated what would happen if there were annual universal HIV testing, and then immediate treatment for all […]

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November 25th, 2008

Coming Soon: A Great Advance in TB Diagnostics

An all-too-frequent problem in the ID clinical world is the case where tuberculosis is possibly the diagnosis, but confirming it is difficult, or impossible. Now, in a scientific breakthrough of such magnitude that it warranted front page coverage in our local newspaper, I am pleased to report that we may have a solution: giant rats. Yes, giant […]

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November 22nd, 2008

“Salvage” Rx for HIV: Macro Good News, Micro Bad News

I’ve written before how the number of treatment experienced patients who have no options for successful therapy has dwindled to a tiny — but unfortunate — few.  Darunavir, maraviroc, raltegravir, and etravirine (in order of FDA approval) are that good. Two presentations at recent scientific meetings confirmed the staggering efficacy of these newer drugs. Notably, both […]

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November 17th, 2008

Promising C diff Rx, and Google as Surveillance Tool

A few items from recent ID/HIV news: Bad enough when it happens once, relapsing C diff is one of the modern plagues for which our bag of tricks sometimes comes up woefully short.  (Anything that tests stool transplants as a therapy is pretty desperate.)  Here was some bright news on the treatment front, however:  an experimental […]

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November 10th, 2008

Yes, Just a Case Report, but Incredibly Cool

At this year’s Retrovirus Conference (was it really this year’s conference, seems like much longer ago than that), there was a poster presentation summarizing a very unusual case.  A man with HIV, stable on antiretroviral therapy, developed acute leukemia.  He underwent an allogeneic bone marrow transplant — here’s the kicker — from a donor who […]

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November 2nd, 2008

The Big HIV News from ICAAC/IDSA

Tons of interesting stuff at this year’s combined ICAAC/IDSA meeting, most of it in non-HIV related Infectious Diseases.  In aggregate, literally hundreds of posters, presentations, and symposia on MRSA, C diff, osteomyelitis, complicated UTIs, hospital-acquired pneumonia, antibiotic resistance … It’s a great meeting to catch up on general ID, and the literature review sessions alone […]

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October 27th, 2008

Antibiotics as Placebos?

This article in the BMJ is geting lots of news:  Out of 679 practicing physicians in the United States, about half admitted to prescribing placebos on a regular basis.  A “small but notable proportion (13%) of physicians reported using antibiotics.” My first instinct was surprise that the rate was this low, but then I remembered that public […]

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October 21st, 2008

Back to School, Day 4: PEP and More PEP

After a lecture on HIV for Primary Care Providers in our course last week, the most controversial topic was, not surprisingly, the use of post-exposure prophylaxis (PEP) for both occupational and non-occupational exposures.  And today, after an entire lecture on PEP to a group of HIV providers in our AIDS course, again the subject drew […]

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October 18th, 2008

Back to School, Day 2

During the course, often the best questions and anecdotes come during the breaks.  Here are a few: Tons of questions about our favorite nemesis, MRSA.  What works for chronic carriers?  How do you manage family members who you suspect would be culture-positive (and the source of recurrences), but are not your patient?  What if the vet […]

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