HIV and ID Observations

September 10th, 2008

Yes, TNF blockers increase infection risk. Now what?

So the FDA has issued (another) warning about TNF (tumor necrosis factor) blockers and increased infection risk, this time focusing on fungal infections, in particular histoplasmosis.  TNF blockers are used for treatment of rheumatoid arthritis, Crohn’s Disease, ankylosing spondylitis, psoriasis, and a wide range of other autoimmune diseases, both in approved and in off-label use. ID/HIV […]

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September 5th, 2008

West Nile Virus and Friday Night Lights

The town of Braintree, just south of Boston, has cancelled Friday night high school football games until the first frost of the year due to concerns about West Nile.  Apparently the campus has a lake and wetlands,  good breeding grounds for mosquitoes.  “This is all in the name of safety,” says the school headmaster. (If someone […]

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August 22nd, 2008

We have met the enemy … and it is MRSA

In Jerry Groopman’s recent New Yorker piece on antibiotic-resistant bacteria, he quotes Dr. Louis Rice from the Cleveland VA, who uses the term “ESKAPE” bacteria:  an acronym for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa, and Enterobacter. Nothing against the mostly gram-negative nasties in this list (and the focus of the New Yorker […]

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August 8th, 2008

More from Mexico City

A bit more travelogue from the XVII International AIDS Conference: It’s impossible to see everything you want at such a large, sprawling conference, sometimes because of conflicting meetings, sometimes because the room is full, sometimes because of a feeling analagous to being in a giant museum for too many hours — fatigue just takes over.  But […]

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August 4th, 2008

Mexico City: Drive on the right … most of the time

Some early and completely non-scientific observations from the XVII AIDS Conference, taking place now in Mexico City: Everyone said getting to and from the Banamex Convention Center would be difficult, and of course they were right.  Mexico City is the largest city in the Western Hemisphere, has a road/traffic system that makes driving in Boston seem […]

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July 29th, 2008

Antiretroviral Rounds: Immediate ART After an OI — Are We There Yet?

A few things have been guaranteed to get widely divergent views among HIV specialists — and one of them was when to start antiretroviral therapy in someone presenting with an acute OI.  However, in the latest Antiretroviral Rounds, our two experts (Raphy Landovitz and Phil Grant/Andrew Zolopa) kind of agreed.  They’d start immediately.   At least that’s […]

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July 25th, 2008

Word salad: Jalapenos, abacavir, doripenem, and PAVE

Some miscellaneous recent items from the ID/HIV world jumbling around this Friday: Tomatoes are off the hook — it’s the jalapenos that likely caused the recent salmonella outbreak.  Since this is the only time of year that tomatoes are even edible in this part of the world, I for one am quite relieved.  I am sure […]

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July 19th, 2008

“Floxins” and the black-box warning: Anyone notice? Anyone care?

Fluoroquinolones — the “floxins”, every medical house officer’s favorite antibiotic class — will carry a black-box warning about the risk of tendinitis and tendon rupture. We’ve known about this side effect for years, why now the change? In FDA speak: FDA’s recent evaluation of the medical literature and the post-marketing adverse event reports submitted to […]

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July 11th, 2008

M184V: So many options, but does that include TDF/FTC/EFV?

Co-formulated TDF/FTC/EFV (Atripla) is a nifty bit of pharmacologic packaging (ever so much more so since it involves collaboration between two different pharmaceutical companies, ahem) — and our patients have noticed.  All of us who practice HIV medicine have been asked for the “one pill” treatment; often these requests make sense, sometimes they don’t. It’s easy to […]

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July 6th, 2008

HIV Testing: The Bronx is Up …

So the New York City Public Health Department would like to have every adult living in the Bronx tested for HIV.  The  Times coverage of the effort cites the best reason for reason for such a move — the high death rates from the disease, and the cause: Public health officials attribute this [the deaths] to […]

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