HIV and ID Observations

September 17th, 2011

Drinking Coffee Prevents MRSA

I follow the medical literature on coffee very closely. Why?  Because I’m completely addicted — and, judging from the lines at the Starbucks, Dunkin’ Donuts, etc at the airports before early morning flights, I am not alone. (It’s just one cup a day. Any more and say hello to palpitations, jitters, sweats, and long sleepless nights. Is […]

---

September 11th, 2011

Must-Read Paper: “Antiscience” and Lyme Disease

As I’ve written before, there are few clinical encounters more challenging for Infectious Diseases specialists than the patient who, despite negative standard  diagnostic testing, believes he/she has Lyme disease. Now, in Lancet Infectious Diseases, comes a paper entitled “Antiscience and ethical concerns associated with advocacy of Lyme disease.” It meticulously describes the distinctive world of alternative diagnosis, treatment, […]

---

September 4th, 2011

“Novel” Approaches to Initial HIV Therapy: Part II

Two studies were just published on alternative strategies for initial HIV therapy. I’ve already reviewed the first one here. The second paper is a single-arm (n=112) study of darunavir/r (once daily) plus raltegravir, the latest riff on the “NRTI sparing” approach. As I mentioned when I first covered this study, the high rate of virologic failure — […]

---

September 3rd, 2011

“Novel” Approaches to Initial HIV Therapy: Part I

It’s been several years since the “preferred” or “recommended” initial regimens for HIV treatment have been consolidated into one of the following four: TDF/FTC + efavirenz TDF/FTC + atazanavir/r TDF/FTC + darunavir/r TDF/FTC + raltegravir Any room for improvement in this “TDF/FTC + key third drug” approach? With the recent approval of TDF/FTC/rilpivirine, certainly this will […]

---

August 31st, 2011

It’s Time for Antibiotic Placebos

As I’m sure you all agree, it’s high time we had a good antibiotic placebo. Just think — we’d be able to prescribe a 100% effective treatment for viral respiratory tract infections, with the assurance of no risk of antibiotic resistance, C diff, allergic reactions, tendon ruptures, photosensitivity, drug-drug interactions, or any of the myriad other […]

---

August 19th, 2011

A Reason To Continue Restrictive HIV Testing Laws? Not Really …

The pending HIV legislation is much on my mind these days, for reasons I outlined here. Bottom line is that I don’t think it’s good for patient care, and we’re missing a real opportunity to make things better here in the Bay State. But yesterday I heard a perspective on the bill I hadn’t considered, and […]

---

August 11th, 2011

Next Single-Pill HIV Treatment Approved, and It’s Not Called “B-Tripla”

One famous HIV clinician/clinical researcher likens co-formulated TDF/FTC/EFV (Atripla) to a “Godzilla,”  so dominant has the treatment become as initial therapy for HIV. He bases his comments on this study done at his institution, showing that in 2007, fully 85% of patients starting treatment in their clinic began TDF/FTC/EFV. Does this big lizard of a regimen […]

---

August 3rd, 2011

Why the Proposed Massachusetts HIV Testing Bill is Bad for Patients

As I’ve written about here multiple times, I’m not a big fan of the HIV testing law in our state. First, there’s the requirement for written informed consent, something that every state (except a couple) has wisely abandoned. Second, it’s more than a testing law — it’s also an HIV privacy law, which is arguably unnecessary […]

---

July 12th, 2011

A Thank You to Nice Patients

Yesterday I saw one of my favorite long-term patients. She’s just wonderful, and it’s always a joy to see her. Here are some reasons: She’s uniformly nice — not just to me, but to all the nurses and social workers and other support staff in our clinic. She shows up on time for her appointments. Love […]

---

July 3rd, 2011

Proof That We Are Not French

In case you were worrying about fading American national identity as we celebrate July 4, did you see this detail on a recent E. coli O104:H4 outbreak from France? More recently, at least 15 people in Bordeaux, in southwestern France, appear to have been infected with the strain found in Germany. Most of them have been […]

---