HIV and ID Observations

May 21st, 2008

When Expert Clinicians Disagree

Periodically, in AIDS Clinical Care, we publish a case in the “Antiretroviral Rounds” section and ask two clinical experts in our field how they would manage such a patient. The most recent case elicited responses that were 180 degrees different. (This is exactly what we’re after, by the way — why present a case in which […]

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May 14th, 2008

Certification in HIV Medicine — Another Try

In March, the American Board of Internal Medicine (ABIM) issued a proposal for a “Maintenance of Certification” (MOC) pathway in HIV medicine for general internists. This is the second such special pathway ABIM is considering (the first was hospitalist medicine). Regardless of whether you agree with the proposal, it’s a good read, providing an excellent […]

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May 5th, 2008

Brush with Greatness: Paul Farmer

Perhaps you caught this week’s 60 Minutes, featuring the work done by Partners in Health, the group founded and run by Paul Farmer. (If he reads this, he’ll no doubt want to correct my description of him as playing these major roles, eager to give equal credit to his impressive colleague Jim Kim and his mentor […]

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April 30th, 2008

Young Doctors “Get a Life” — Whither ID/HIV?

A front-page article in yesterday’s Wall Street Journal says that younger physicians (definition:  younger than I am), “intent on balancing work and family,” are choosing specialties that allow them to control their hours.  The content of the article will be familiar, including: The rise of the hospitalist movement A decline in those entering primary care fields The […]

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April 23rd, 2008

Antiretrovirals in the Pipeline: And Then There Were … None?

The flurry of drug approvals that began in 2005 with tipranavir – followed rapidly by darunavir, maraviroc, raltegravir, and most recently etravirine – has been nothing short of astounding. Every experienced HIV clinician now has many patients who are on successful (read: suppressive) treatment for the first time ever. The Vancouver HIV program — wonderfully called […]

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April 17th, 2008

Required Reading: Bat-Related Human Rabies

A group of researchers in Canada have done infectious diseases experts a big favor — they’ve summarized a staggering amount of useful data on bat-related cases of human rabies in a paper just published in Clinical Infectious Diseases. (Note to non-ID specialists: infectious diseases doctors spend a lot of time answering questions about rabies in general […]

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April 10th, 2008

Needed: Something Better than “HAART”

I think we all have pet peeves, and so I’ll confess one of mine: I hate the term “HAART.” (I work with someone, by the way, who hates the term “viral load,” preferring “virus load.” Go figure.) Standing for “highly active antiretroviral therapy,” HAART first surfaced in the mid-1990s in order to distinguish potent anti-HIV treatment from the older, not-so-active form […]

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March 20th, 2008

How to Solve at Least One Part of the Healthcare Mess: ADAP for All

The presidential elections have once again made our Byzantine healthcare system a regular feature in the news. A recent film also made quite a splash, and though Michael Moore offered no plausible solutions (Cuba? c’mon!), he certainly made me wonder what I’d do if I had two severed fingers that needed to be reattached and only enough money […]

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March 19th, 2008

How long have I got, Doc?

Some aspects of seeing a patient newly-diagnosed with HIV haven’t changed much over the years — for example, the emotions in the room remain a mix of fear, shame (note to world: this is still a highly stigmatized disease), incredulity, and ultimately relief in finding a clinician who is comfortable with the condition. But a lot […]

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