An ongoing dialogue on HIV/AIDS, infectious diseases,
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, […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
April 11th, 2011
Organ Transplants from HIV-Infected Donors
On the heels of last month’s report of HIV transmission from an organ donor — covered here in Journal Watch — comes this remarkable article in the New York Times about lifting the ban on organ donation from donors known to be HIV positive. Naturally, the first group of patients slated to receive these HIV positive […]
March 18th, 2011
Friday Fosfomycins
Today’s ID/HIV comments and links are named after every ID specialist’s favorite new toy for UTIs. This HIV transmission from a kidney donor is getting quite a bit of media play, as such complications always do. I was at a meeting this AM when one of my colleagues (an endocrinologist) commented how horrible she thought it […]
March 1st, 2011
Like It or Not, PrEP Enters the Clinic
Since the publication of iPrEx, the hypothetical decision about whether to prescribe pre-exposure prophylaxis (PrEP) has become a practical reality. As a result, we’ve posted a case on the Journal Watch/AIDS Clinical Care site, describing someone who requests intermittent pre-exposure prophylaxis to prevent HIV. It’s a high-risk, HIV-negative man who’s been treated several times with post-exposure prophylaxis. The case […]
Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
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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?