HIV and ID Observations

January 3rd, 2012

Prevnar Now Approved for Adults — But Should We Start Using It?

From the FDA (and thanks to Physician’s First Watch for reporting the news): Prevnar 13, a pneumococcal 13-valent conjugate vaccine, was approved today by the U.S. Food and Drug Administration for people ages 50 years and older to prevent pneumonia and invasive disease caused by the bacterium, Streptococcus pneumoniae. As shown in multiple studies, Prevnar has dramatically […]

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October 26th, 2011

Xigris is Gone — Not That Many ID Docs Will Notice

From the FDA comes this news: FDA notified healthcare professionals and the public that on October 25, 2011, Eli Lilly and Company announced a worldwide voluntary market withdrawal of Xigris [drotrecogin alfa (activated)]. In a recently completed clinical trial (PROWESS-SHOCK trial), Xigris failed to show a survival benefit for patients with severe sepsis and septic shock. Some […]

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September 22nd, 2011

Common Sense on HIV Testing

There’s an editorial in today’s Boston Globe that concisely (188 words) describes the problems with both the current and proposed HIV testing laws in Massachusetts. I’ve not been shy about the fact that I agree with every word of this piece. And though I strongly recommend reading the whole editorial — it’s very well written — if you […]

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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, […]

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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 […]

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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 […]

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June 13th, 2011

More on Generic Antiretrovirals …

In the recent post on the approval of generic Combivir — and the lack of availability of generic Epivir (lamivudine, 3TC), which was both anticipated and likely to be more useful — I speculated there were several possible causes of this surprising turn of events. But ultimately I concluded, “In sum, the real reason there’s no generic […]

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June 4th, 2011

HIV Epidemiology and Something Even Many Smart Medical Students Don’t Know

Periodically I like to give an informal quiz to the medical students about HIV epidemiology. It’s a multiple choice question that goes something like this: Based on the recent epidemiology of HIV in the United States, in what group are new cases of HIV infection rising the fastest? Men who have sex with men (MSM) Injection drug […]

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May 26th, 2011

Surprise! It’s Generic Combivir!

After last week’s unveiling of the new NNRTI rilpivirine, now we have a different kind of drug approval from the FDA: FDA granted approval for a generic formulation fixed dose combination of lamivudine and zidovudine tablets, 150 mg/300 mg, two nucleoside analogue reverse transcriptase inhibitors, indicated in combination with other antiretroviral agents for the treatment of […]

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May 18th, 2011

HIV Exceptionalism and the Department of Unintended Consequences

Quick question:  If there were one piece of information — clinical or lab — that you would use to determine the quality of care in an HIV program, what would it be?  (Choose one.) Rates of influenza vaccine administration Receiving PCP prophylaxis with CD4 < 200 Adherence counseling before starting antiretroviral therapy Baseline toxoplasmosis serology Proportion of […]

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