HIV and ID Observations

November 30th, 2009

WHO HIV Treatment Guidelines Updated

This just in: WHO is now recommending that ART be initiated at a higher CD4 threshold of 350 cells/mm3 for all HIV-positive patients, including pregnant women, regardless of symptoms. Which makes eminent sense, of course.  Because if starting HIV therapy might prolong survival in developed countries, why shouldn’t it do the same in the developing world? In fact, […]

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November 20th, 2009

Ties Tied to Bugs

Are doctors’ neckties causing infections?  That’s the implication of this Wall Street Journal piece: The list of things to avoid during flu season includes crowded buses, hospitals and handshakes. Consider adding this: your doctor’s necktie. … A 2004 analysis of neckties worn by 42 doctors and medical staffers at the New York Hospital Medical Center of […]

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November 7th, 2009

A Career in Infectious Diseases and “The Next Big Thing”

I was working with a medical intern in clinic this past week who is potentially interested in ID. After seeing our 3rd consecutive stable HIV patient, he asked me what I thought the next big challenge would be in our field — especially since HIV treatment has been “solved.” “Solved” might be stating it a bit […]

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October 17th, 2009

Is Chronic Fatigue Syndrome Another Retroviral Disease?

Here’s a surprising report in Science: Studying peripheral blood mononuclear cells (PBMCs) from CFS patients, we identified DNA from a human gammaretrovirus, xenotropic murine leukemia virus-related virus (XMRV), in 68 of 101 patients (67%) compared to 8 of 218 (3.7%) healthy controls … These findings raise the possibility that XMRV may be a contributing factor […]

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September 30th, 2009

The Battle for Colonic Microflora

My two favorite newspapers (New York Times and Wall Street Journal — sorry, hometown paper) have just covered opposite ends of a topic on the edges of ID practice — namely, colonic micro-organisms. Too few? Too many? Wrong type? In the Times, a review of the probiotic debate: Probiotics are live micro-organisms that work by restoring the balance of intestinal […]

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September 24th, 2009

HIV Vaccine Study Shows Promise …

So says this press release by the US Military HIV Research Program: A Phase III clinical trial involving more than 16,000 adult volunteers in Thailand has demonstrated that an investigational HIV vaccine regimen was safe and modestly effective in preventing HIV infection. According to final results released by the trial sponsor, the U.S. Army Surgeon General, […]

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September 16th, 2009

News Flash: The Internet Cannot Replace an Actual Human

Interested in researching the cause of AIDS?  Well go ahead and give NetBase Solutions’ healthBase a try, but don’t expect much in the way of filtering: One of the most unfortunate examples is when you type in a search for “AIDS,” one of the listed causes of the disease is “Jew.” Really. The ridiculousness continues. […]

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September 4th, 2009

For Suspected H1N1, Get Out the N95 Masks?

So says the Institute of Medicine’s recommendations for protection of health care workers: Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators … Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with […]

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September 2nd, 2009

Etravirine Warning

From the FDA Advisory: There have been postmarketing reports of cases of Stevens-Johnson syndrome, toxic epidermal necrolysis and erythema multiforme, as well as hypersensitivity reactions characterized by rash, constitutional findings, and sometimes organ dysfunction, including hepatic failure. Intelence therapy should be immediately discontinued when signs and symptoms of severe skin or hypersensitivity reactions develop. These rare — […]

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August 26th, 2009

Late Summer Odds and Ends: Circumcision, H1N1 Vaccine, Lyme Movie, etc.

A few ID/HIV items to cover before summer “unofficially” ends (Sept 1?  Kids back at school?  Labor Day?): Will US Public Health officials recommend infant male circumcision to prevent HIV?  They might be considering such a move, but I suspect it will not be strongly promoted.  After all, none of the studies demonstrating its efficacy have […]

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