HIV and ID Observations

October 19th, 2014

Almost Filovirus-Free (That is, Ebola-Free) ID Link-o-Rama

If you’re an ID doctor right now, the filovirus of the moment Ebola is consuming a big chunk of all of your non-clinical time — and this is particularly true for those heavily involved in Infection Control, who are spending every waking hour responding to public hysteria, to various clinicians who seem to have all the answers, and to ever […]

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October 15th, 2014

Second U.S. Healthcare Worker with Ebola Further Underscores Urgent Need for Enhanced Preparedness — and Perhaps Designated Care Centers

If you’re like most of us, when you heard that a healthcare worker in Dallas had been diagnosed with Ebola virus disease, you assumed that the exposure occurred during his first visit to the hospital. That is, before he was diagnosed with Ebola, and before infection precautions had been instituted. But no, it happened after he was […]

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October 12th, 2014

Approval of Sofosbuvir/Ledipasvir Was Expected, but Still Is a Huge Advance

As expected, the FDA just approved the first single-pill treatment for hepatitis C genotype 1, a tablet containing 400 mg of sofosbuvir (SOF) and 90 mg of ledipasvir (LDV). For those not following this story closely, sofosbuvir is the pan-genotypic NRTI polymerase inhibitor approved last December to much rejoicing — and controversy about the price. Ledipasvir […]

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September 7th, 2014

It’s OK to Limit Who Prescribes HCV Therapy, but Insurers Shouldn’t Be Deciding

Some insurers would like to limit the prescribing of HCV treatment to gastroenterologists, hepatologists, or infectious diseases specialists. Not surprisingly, this doesn’t sit well with either the HIV Medicine Association (HIVMA) or the American Academy of HIV Medicine (AAHIVM), both of which have long acknowledged that some of the most seasoned HIV providers are generalists: “There is no medical […]

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July 19th, 2014

Mood Solemn in Melbourne as AIDS 2014 Starts

There is unquestionably a shadow cast over this year’s international AIDS meeting here in Melbourne, and it’s not the result of the Australian winter. It’s the crash of Malaysia Airlines Flight 17, of course, which prematurely ended the lives of hundreds of people — including many people en route to this conference, most notably one of the field’s finest […]

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June 28th, 2014

CDC Nixes HIV Western Blot in Latest Testing Guidelines

Finally, it’s official — the Western blot is no longer recommended as a confirmatory test for HIV infection. From the latest Laboratory Testing for the Diagnosis of HIV Infection, updated June 27: The HIV-1 Western blot and HIV-1 immunofluorescence assay, previously recommended to make a laboratory diagnosis of HIV-1 infection, are no longer part of the recommended algorithm. […]

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June 15th, 2014

Poll: Should ID Doctors Still Do HIV Primary Care?

My friend and colleague Ken Freedberg is giving a talk soon at our regional IDSA meeting called, “Who Should Be Providing HIV Care?” He’s a very smart guy (except during the football playoffs, when he is possessed by evil forces), so maybe he’ll answer this question that has strangely bedeviled our field for decades. But I’m sure […]

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June 4th, 2014

Anti-Vaccine Movement Slammed By Daily Show; ID Doctors, Pediatricians Happy

The anti-vaccine crowd gets a pretty good drubbing here from Samantha Bee on The Daily Show. I’d feel a tiny bit bad for them — gosh their opinions are pathetic — but since I’m an ID specialist married to a pediatrician, I can only rejoice in the brilliance of this piece. And yes, stupidity crosses political party lines. Enjoy! The Daily Show […]

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May 15th, 2014

CDC Recommends Broader Use of Pre-Exposure Prophylaxis — Can We Make It Happen?

Making a much stronger and more comprehensive statement than their earlier “Guidance,” the CDC is now recommending tenofovir/FTC (Truvada) for all Americans at high risk for HIV. More specifically, they recommend it for a broad range of people who have certain risk factors (click to see full size image): One certainly gets why this was done — as summarized nicely in […]

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May 3rd, 2014

The Top Items from the Revised DHHS HIV Treatment Guidelines

A sparkling, shiny new revision of the DHHS HIV Treatment Guidelines was released this week (thanks Alice Pau!), and provides plenty to read and think about — 285 pages, if you’re counting. A few ways to navigate this gargantuan effort more efficiently — the What’s New section, the recommendations summarized here, and the tables here. But if you want the […]

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