HIV and ID Observations

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 […]

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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 […]

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May 4th, 2015

A Drug for Neck Fat, and Some Thoughts on Fat Accumulation Syndromes in HIV

It’s not often that a FDA drug approval for cosmetic dermatologists and plastic surgeons will get the attention of HIV/ID specialists, but this past week was an exception. From the FDA report: The U.S. Food and Drug Administration today approved Kybella (deoxycholic acid), a treatment for adults with moderate-to-severe fat below the chin, known as […]

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April 22nd, 2015

Seriously — How Much Would You Pay for a Curbside Consult?

Yes, seriously. Let me start with an email exchange I had with a PCP recently: Hi, Paul, quick question 😉 This lady, 49 YO woman from Haiti, asymptomatic, totally healthy. Got TSpot done for immigration purposes, it’s positive with negative chest Xray. Treated with INH 6 months in 2001. She travels to Haiti annually so could had been […]

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April 8th, 2015

New HIV Treatment Guidelines, and the End of an Era

The new Department of Health and Human Services (DHHS) HIV treatment guidelines are out, and thanks to skillful direction by Alice Pau, it’s as usual a must-read document — all 288 pages, of course! There are several major changes, so a good place to start is the all-important “What’s New in the Guidelines” summary page. Some of […]

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April 3rd, 2015

Melting Snow ID Link-o-Rama

A few ID/HIV tidbits to contemplate as we go from slipping on ice and snow to dodging the mud: Beta-lactam therapy alone is non-inferior to regimens that also cover “atypicals” for hospitalized patients with pneumonia. These results challenge a dogma that has been present for a couple of decades — namely, that all patients admitted with community-acquired pneumonia should get […]

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March 28th, 2015

Quick Question: Should HIV-Negative People in Serodiscordant Relationships All Get PrEP?

From a very thoughtful and experienced primary care provider came this query: Hey Paul, quick question — One of my patients, an HIV-negative gay man, is in a long-term relationship with one of your HIV-positive patients — my patient says his partner has been on successful HIV treatment for years. Obviously I can’t check his […]

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March 21st, 2015

ID Learning Unit: Coagulase-Negative Staph, and the “Anti-Zebra” Residents’ Report

At the risk of betraying a deep streak of nerdiness, I confess to being a huge fan of Residents’ Report. This infatuation goes back to my medical student days, when the occasional chance to watch the Chief Medical Resident — who seemed the smartest doctor on the planet — lead a discussion of an interesting case inspired […]

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March 8th, 2015

Measles Vaccine Videos and the Challenge of Changing Someone’s Mind

I suspect most of you have already been treated to this highly amusing video about the measles outbreak from Jimmy Kimmel — a comedy segment featuring real-life doctors, imagine that. Not your typical late-night comedy show performers, but they forcefully (and obscenely) get their message across. If you have just returned from a tropical island where the internet connection was iffy, […]

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February 21st, 2015

Fusobacterium, Pharyngitis, and the Limits of Limiting Antibiotics

A paper on pharyngitis in young adults, just published in the Annals of Internal Medicine, is creating a controversy in the intersecting worlds of primary care and Infectious Diseases. The first author is Robert Centor, of the famous Centor criteria that assess the likelihood of group A strep. He’s been writing about our need to expand […]

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