HIV and ID Observations

September 7th, 2015

Two Drugs with High Prices — One is (Surprise!) Good Value, The Other is Truly a Rip-off

By now, the fact that HCV treatment carries a high price is a fact as well known to the medical and non-medical public as 1) a million dollars doesn’t get you much in Manhattan or Bay-area real estate; 2) a Rolex is an expensive way to know what time it is; and 3) even though […]

---

August 30th, 2015

(Not) Doing the Retinal Exam, and the Importance of Acknowledging Limitations

This past week, the New England Journal of Medicine released one of its excellent instructional videos, detailing how to do direct ophthalmoscopy to examine the retina. That’s the use of one of those hand-held gizmos — an ophthalmoscope, see picture on the right — to look at the back of the eye. As usual, the video was […]

---

August 23rd, 2015

Post-Exposure Prophylaxis for HCV Can’t Be Cost-Effective — But We Might End Up Recommending It Anyway

An email query from a colleague: Hi Paul, Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV +. Any post-exposure prophylaxis recommended? Thanks, Dan The quick answer is no, it’s not recommended. From the guidelines: But it’s a natural question to ask for several reasons — […]

---

August 17th, 2015

Dog Days of Summer ID Link-o-Rama

A few ID/HIV items of note to consider as you gather up your sunscreen, flip flops, towels, and sand toys and head off to the beach: Interesting review of the impact of low socioeconomic status in the recent outbreak of Legionnaires’ Disease in the South Bronx. It’s just like (almost) every infection — the combined effects of crowding, poor sanitation, and […]

---

August 9th, 2015

The Pain — and Potential Power — of Electronic Health Records in One Little Anecdote

Here’s a scintillating series of events that happened recently on our inpatient consult service: Reason for consult: “Treatment of UTI in a 26-year-old pregnant woman with multiple allergies.” Culture result:  Group B strep, resistant to clindamycin and nitrofurantoin. She’s been on the latter. Patient’s allergies as listed on her chart:  Penicillins, cephalosporins, sulfonamides. Plan per OB service: […]

---

August 1st, 2015

Ten Reasons to Attend Our “Infectious Diseases in Primary Care” Course

With an up-front apology for the shameless plug — sorry! — here are 10 great reasons to attend our annual postgraduate course. It’s called Infectious Diseases in Primary Care, and takes place October 14-16 here at the Fairmont Copley Plaza Hotel in Boston. All the topics are clinically relevant to day-to-day practice. Look at these topics! There’s a strict […]

---

July 7th, 2015

For HIV in the USA, Not in Care Exceeds the Undiagnosed — Solutions Welcome

In last week’s post, I asked about two of the key components of the HIV care cascade — the “undiagnosed” vs the “diagnosed but not in care,” and which group was larger in the USA. Here are your answers as of now: The people who read this site are a pretty knowledgeable group when it comes to […]

---

June 11th, 2015

Summer Is Almost Here ID Link-o-Rama

I know, I know. You’re sick of hearing Bostonians complain about the winter we just had. But did you know that the weather here didn’t get reliably warm here until, well, this week? We all have PTSD. Don’t talk to us about anything even vaguely white, flakey, and cold. Yes, we’re afraid of refrigerated coconut. I’ll stop […]

---

June 4th, 2015

A Slightly Less Painful Way to Learn the Three-Letter Abbreviations for HIV Meds

One of the stupid things about being an HIV/ID specialist is the highly arcane code we use to abbreviate HIV treatments. Why was zidovudine originally AZT, and now ZDV? Why is lamivudine 3TC? And tenofovir TDF? Of course there are legitimate biochemical reasons why these are the right abbreviations, but they are lost to most of us who do […]

---

May 21st, 2015

Which Infectious Diseases Do We Fear Too Much? Which Not Enough?

My friend (and HIV/ID colleague) Mauro Schechter sent me a funny email the other day — from Brazil, where he lives and works: I just read your post and watched the news clip about Powassan. And you still wonder why we think you Americans are paranoid disease freaks? 65 cases in 12 years in a population of 350 […]

---