HIV and ID Observations

February 13th, 2016

“Choosing Wisely” in HIV Medicine — Sensible (But Safe) Suggestions

The American Board of Internal Medicine has a noble program called Choosing Wisely®, which is both trademarked (look, I even included the “®”), and pretty darn sensible — it has the goal of “advancing a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures.” If you clicked on the above link, you’ll be […]

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February 7th, 2016

Twelve Zika Questions, One ID Doctor’s Answers (Sort Of)

Got a Zika question? Welcome to the club — once again, as with any “new” or “emerging” infection, this is uncharted territory, and there are plenty of answers to these questions that could be summarized with 3 words: We Don’t Know. But never mind that — ever-intrepid ID doctors are most assuredly called upon as experts, even […]

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January 29th, 2016

Elbasvir/Grazoprevir Combination Pill for HCV a Welcome New Option — With a Few Buts

As expected, there’s a new option for HCV therapy, the combination pill elbasvir/grazoprevir (EBR/GZR, brand name Zepatier, more on this below), and it’s indicated for genotypes 1 and 4. For those mechanistically inclined, elbasvir is an NS5A inhibitor (like ledipasvir), and grazoprevir is a protease inhibitor (like simeprevir). This is the second one-pill, once a day option […]

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January 18th, 2016

IV and Injectable HIV Treatments Are Much Discussed — But Won’t Be Here Anytime Soon

Something interesting happens when you poll people who treat HIV — and people who have HIV — about whether they’d prefer a treatment option that consists of a periodic injection or infusion in place of the pill or pills that they take every day. Lots of them say yes. Even people who are taking just one pill […]

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January 4th, 2016

A Riddle, the 2015 Clinical Trial of the Year, and a Guaranteed Laugh for All ID Doctors

Things quiet on this end recently from me due to various circumstances. but here are three ID-related (sort of) things worth sharing — enjoy if you haven’t seen them already. Let’s start with a riddle: What animal is responsible for the most human deaths a year? Readers of Bill Gates’ blog will think this is old news, but […]

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December 19th, 2015

Part 2, Now The Good News: Why ID Will Survive as a Specialty

Part 1 of this post, which highlighted the primary reason for declining applications to ID fellowship programs, could come across as something of a downer. “Moping about it won’t get us anywhere,” someone said to me, and it’s true nobody likes a whiner. But my point was to acknowledge the issue, and find a way forward. It wasn’t […]

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December 6th, 2015

Do Electronic Health Records Make You a Better (or Worse) Clinician?

Earlier this week, JAMA Internal Medicine published a study entitled, “Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction”. A more descriptive title would have been “More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction”, as here’s the take home point: High computer use by clinicians in safety-net clinics was associated with lower patient satisfaction […]

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November 29th, 2015

Flu Vaccine Keeps Taking Hits, Still the Best We’ve Got — Don’t Stop “Belivin'” [sic]

For reasons understood only by the geniuses in Mountain View, CA, for some reason my Google news feed picked up this bit of “scientific” reporting: Let me allow the author, an unfortunately named “Clapway” (gonorrhea researcher?), to speak for him/herself: However, is the flu vaccine really worth it? The author of this article never takes it and […]

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November 26th, 2015

Five (OK, Six) ID/HIV Things to be Grateful for this Holiday Season, 2015 Edition

Some quick ID/HIV gratitude items for 2015, done rapidly as we’re hosting a big meal later today. I wonder what that might be. New Ebola virus disease cases and deaths have dramatically declined. I write that sentence with some trepidation, as cases continue to occur sporadically, and this late relapse in a nurse was a chilling reminder of […]

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November 22nd, 2015

Just Wondering: Quick ID Questions to Consider

Several quick ID queries, some of them answerable on the Google machine — but I’m not going there. Too busy laundering my white coat! What ever happened to amphotericin A? What’s the difference between a “serovar” and a “serotype”? Do dogs feel bad that Pasteurella multocida is more famous than Capnocytophaga canimorsus? Colistin resistance is bad — but how often does colistin actually work […]

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