HIV and ID Observations

July 25th, 2008

Word salad: Jalapenos, abacavir, doripenem, and PAVE

Some miscellaneous recent items from the ID/HIV world jumbling around this Friday: Tomatoes are off the hook — it’s the jalapenos that likely caused the recent salmonella outbreak.  Since this is the only time of year that tomatoes are even edible in this part of the world, I for one am quite relieved.  I am sure many […]

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July 19th, 2008

“Floxins” and the black-box warning: Anyone notice? Anyone care?

Fluoroquinolones — the “floxins”, every medical house officer’s favorite antibiotic class — will carry a black-box warning about the risk of tendinitis and tendon rupture. We’ve known about this side effect for years, why now the change? In FDA speak: FDA’s recent evaluation of the medical literature and the post-marketing adverse event reports submitted to the […]

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July 11th, 2008

M184V: So many options, but does that include TDF/FTC/EFV?

Co-formulated TDF/FTC/EFV (Atripla) is a nifty bit of pharmacologic packaging (ever so much more so since it involves collaboration between two different pharmaceutical companies, ahem) — and our patients have noticed.  All of us who practice HIV medicine have been asked for the “one pill” treatment; often these requests make sense, sometimes they don’t. It’s easy to say […]

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July 6th, 2008

HIV Testing: The Bronx is Up …

So the New York City Public Health Department would like to have every adult living in the Bronx tested for HIV.  The  Times coverage of the effort cites the best reason for reason for such a move — the high death rates from the disease, and the cause: Public health officials attribute this [the deaths] to people […]

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June 29th, 2008

And Now… The “Answer”

Last month, I wrote a post inviting responses to our Antiretroviral Rounds case in AIDS Clinical Care, and inviting you to respond. It was a case of someone with (mostly) undetectable HIV RNA levels, but lots of resistance detected when he had to stop meds due to pancreatitis. I also promised to tell you how the […]

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June 15th, 2008

Curbside Consults: What are They Worth?

Below is a friendly email exchange I had last week with with one of our hospital’s primary care providers: Dear Paul, do you know anything about whether pts should be given prophylactic antibiotics prior to dental procedures etc. if they have an indwelling IV catheter?  I have a pt. who has a BardPort porta cath in […]

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June 2nd, 2008

Zoster Vaccine Guidelines — Official Answers, but Still Some Questions

The CDC’s Advisory Committee on Immunization Practices has just released the “official” guidelines for use of the zoster vaccine. And none too soon — if I had a dollar (or these days, make that a euro) for every curbside consult I’ve received about the zoster vaccine … The vaccine’s indications are simple — age over 60, […]

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May 21st, 2008

When Expert Clinicians Disagree

Periodically, in AIDS Clinical Care, we publish a case in the “Antiretroviral Rounds” section and ask two clinical experts in our field how they would manage such a patient. The most recent case elicited responses that were 180 degrees different. (This is exactly what we’re after, by the way — why present a case in which […]

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May 5th, 2008

Brush with Greatness: Paul Farmer

Perhaps you caught this week’s 60 Minutes, featuring the work done by Partners in Health, the group founded and run by Paul Farmer. (If he reads this, he’ll no doubt want to correct my description of him as playing these major roles, eager to give equal credit to his impressive colleague Jim Kim and his mentor […]

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April 23rd, 2008

Antiretrovirals in the Pipeline: And Then There Were … None?

The flurry of drug approvals that began in 2005 with tipranavir – followed rapidly by darunavir, maraviroc, raltegravir, and most recently etravirine – has been nothing short of astounding. Every experienced HIV clinician now has many patients who are on successful (read: suppressive) treatment for the first time ever. The Vancouver HIV program — wonderfully called […]

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