An ongoing dialogue on HIV/AIDS, infectious diseases,
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 […]
March 3rd, 2013
It’s Not Safe Sex If You’ve Just Had the Smallpox Vaccine
One of my more memorable teachers used to love warning us about the hazards of sex. No, this wasn’t in my 8th grade health class — this was during my first year of Infectious Diseases fellowship, and the teacher was one of our highly experienced attending physicians, now retired. To him, sex carried limitless infectious risks. He […]
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 […]
January 11th, 2013
How to Make the Flu Vaccine More Popular, Warts and All
In a week that saw both our hospital’s influenza-induced bed crunch make the New York Times, and my son, mother-in-law, and me succumb to this seasonal plague despite our receiving flu shots, I have been highly attuned to all things influenza. But the focus here will be on that perennial whipping boy of preventive Infectious Diseases, the […]
January 1st, 2013
HIV Incidence: The Latest Numbers
The CDC has recently issued the latest report on HIV incidence (i.e., new infections) in the United States, and as always it’s fascinating to review the numbers. To start, the year-by-year estimated incidence: 2007: 53,200 2008: 47,500 2009: 45,000 2010: 47,500 (38,000 men, 9,500 women) Nope, not much change. Will data from HPTN 052 — published in the […]
December 5th, 2012
Top HIV Stories of 2012
Somewhere in our genome, we are programmed to use the end of the year as a time to reflect on the previous 12 months — and to make lists! If you don’t believe me, there’s barely a publication or web site out there that hasn’t already succumbed, and we’re just in early December. And what we can […]
November 28th, 2012
A Complicated Curbside Consult I Won’t be Doing — But One Day Might Have To
From a local primary care provider comes this email: Any chance you can look at my notes and scanned outside records from 6/22/2010 till today (including Nov 6 notation that details extensive past evaluation, including two previous ID consults) and labs? Briefly: 72 yr old woman with 6 episodes over the last 4 years of prolonged […]
November 22nd, 2012
The U.S. Preventive Services Task Force Recommends HIV Screening — And Why is This News?
A flurry of coverage recently appeared about the U.S. Preventive Services Task Force’s recommendation for one-time HIV screening for all Americans, ages 15-64. Some might wonder why this is news — um, hasn’t this been recommended now for years? — and I think I’ve figured it out. Let me start by relaying that every ID/HIV specialists can tell […]
November 18th, 2012
The 800-mg Darunavir Tablet Arrives, and Scoring the Top Protease Inhibitors
The FDA has approved an 800-mg tablet of darunavir for treatment naive patients. This single tablet will obviously replace the two darunavir 400-mg tablets in first-line therapy. (Yes, my math is that good.) Darunavir will still require 100-mg ritonavir boosting plus two NRTIs to make a complete regimen. Once upon a time I might have thought this was […]
November 2nd, 2012
Antiretroviral Rounds: Resistance on Two Fronts
Got this challenging curbside consult from a colleague, and it has a interesting wrinkle: I have a longstanding patient with HIV who had many failed regimens in the 1990’s with resultant following mutations on a genotype done in 2003: NRTI (M184V, Q151M mutations); PI (A71, I54V, K20M, L10I, L90M, V82A mutations); no NNRTI resistance. She has been undetectable since then on TDF/FTC/EFV; […]
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
Biography | Disclosures | Summaries
Learn more about HIV and ID Observations.
NEJM Journal Watch — Recent Infectious Disease Articles- Observations from ID and Beyond: Federal HIV Guidelines Face a Shutdown — A Critical Loss for Clinicians and Patients
- Ceftriaxone for Patients Hospitalized with Pneumonia: One Gram or Two?
- More PrEP, Less HIV: U.S. State Data
- Observations from ID and Beyond: Why the Sudden Firing of ACIP Members Should Put Every Clinician on High Alert
- Does HIV RNA Testing to Monitor PrEP Add Value?