HIV and ID Observations

April 23rd, 2013

Two Papers, Four Sofosbuvir Studies, and Soon the End of “Interferonologists”

Today, as the The International Liver Congress is about to start, two papers are published in the New England Journal of Medicine on sofosbuvir, the investigational anti-HCV nucleotide submitted to the FDA for approval earlier this month. Each paper actually includes within them two studies. (For some reason, all the studies sound like 1950s science fiction magazines.) […]

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April 20th, 2013

Postexposure Prophylaxis (PEP) After Blast Injuries

From a colleague came this query: We are being consulted by surgeons who are finding within blast victims tissues from other humans. We have been offering post-exposure prophylaxis. Have you folks developed any policies re PEP for explosion victims? Welcome your thoughts, P Needless to say, the bombing victims are currently facing far greater challenges than […]

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April 10th, 2013

Simeprevir and Sofosbuvir Submitted to FDA — Clock Ticking on Boceprevir, Telaprevir, Even Interferon

Two weeks, two companies, two press releases, two future HCV drugs that begin with “S”: March 28, 2013: Janssen Research & Development announced that it has submitted a New Drug Application to the FDA seeking approval for simeprevir (TMC435), an investigational NS3/4A protease inhibitor, administered as a 150 mg capsule once daily with pegylated interferon and ribavirin for the […]

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April 2nd, 2013

Banner Day for ID on Physician’s First Watch, and a Big Pitch to Sign Up Now

Every weekday morning, right around the time the rest of my family gets up, the smart people at Physician’s First Watch send me an email listing the top medical news stories of the day. Imagine my delight yesterday when the following were deemed worthy for specific mention: Coccidioidomycosis! Valley fever cases on the rise in the USA. You […]

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March 28th, 2013

Poll: How Often Do You Measure CD4 Cell Counts?

Over in Clinical Infectious Diseases, a recent study pretty much nails the fact that routine measurement of CD4 cell counts in clinically stable patients is an all but useless exercise.  As summarized by Abbie Zuger in Journal Watch, here’s the key finding: When patients with an unrelated cause for an alteration in CD4-cell count such as […]

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March 23rd, 2013

ID Doctors, Pets in the Medical History, and a Cute Puppy

One of the things Infectious Disease doctors get teased about by our non-ID colleagues is our inclusion of pets in medical histories. It’s part of the social history, where we list a grab bag of  potential “exposures” that increase the risk of infection — where someone is from, what they do, plus travel, dietary practices, sex, […]

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February 24th, 2013

Solve This Problem Please — Microbiology Results in Electronic Medical Records

Our hospital and affiliated practices have had electronic medical record (EMRs) of some sort for decades, so I’ve had my chance to try my hand at multiple “platforms,” both commercial and home-brew. (Weirdly — and I kid you not on this — a version of the first iteration from the 1980s is still around, running parallel […]

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February 17th, 2013

An Adherence Intervention That Works — But There’s a Catch

In a previous post, we reviewed the various flavors of medication non-adherence, and concluded with this tantalizing line: Next up:  An Adherence Intervention that Actually Works — But There’s a Catch Well here it is, just published online in JAMA Internal Medicine. Dr. Robert Gross (a long-time HIV adherence researcher from U Penn) and colleagues enrolled 180 patients […]

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February 13th, 2013

Medication Adherence: The Final Frontier

Treatment of HIV has become so amazingly effective that when it fails, it’s no overstatement to say that it’s usually because the patient is not taking the medications.  There are all kinds of provider-related reasons for this — inadequate patient education, prescribing and dispensing errors, failure to address language or education deficits — but here […]

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February 7th, 2013

Ciguatera Is Hot (But It Could Be Cold)

The news about the cases of ciguatera fish poisoning in New York (NY Times here, MMWR here) reminded me of several unusual things about this form of “harmful algal bloom,” as it is so artfully called by the experts. Specifically, here are six: Symptoms are bizarre.  It starts out like a standard case of gastroenteritis — nausea […]

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