HIV and ID Observations

April 24th, 2010

Choosing an Official State Microbe

Wisconsin has selected Lactococcus lactis as its official state microbe: The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:  SECTION 1. 1.10 (3) (t) of the statutes is created to read: 1.10 (3) (t) The bacterium Lactococcus lactis is the state microbe. SECTION 2. 1.10 (4) of the statutes is amended to […]

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April 22nd, 2010

Should Transmission of HIV be a Crime?

Not according to Journal Watch editor and New York Times writer Abigail Zuger, writing here in the Times.  She’s referring to the recent Darren Chiacchia case, where his former partner has filed a legal complaint that Chiacchia did not disclose having HIV — potentially a first-degree felony in Florida. Were it a matter of science alone, […]

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April 4th, 2010

San Francisco Public Health: Treatment Recommended for All with HIV

Could there be anything more interesting than the start of the baseball season? Maybe, because this is quite something: In a major shift of HIV treatment policy, San Francisco public health doctors have begun to advise patients to start taking antiviral medicines as soon as they are found to be infected, rather than waiting — sometimes years — […]

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March 31st, 2010

C diff Guidelines: Metronidazole Still Preferred?

IDSA and The Society for Healthcare Epidemiology of America (SHEA) have published Clinical Practice Guidelines for Clostridium difficile infection. Not surprisingly, it’s a comprehensive, extensively-referenced document that will be an invaluable resource, especially since the previous version is approximately 15 years old. But with the caveat that I’m not an expert in this area, these particular treatment recommendations […]

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March 24th, 2010

Now for Some Good News: TB Cases Continue to Decline

From the latest MMWR: This figure speaks for itself, but two sentences from the Editorial Note deserve highlighting: The 11.4% decrease in reported TB rate in 2009 is the largest single-year decrease ever recorded. From 1953 to 1993, the single largest annual percentage decrease in TB case rate was 11.1% in 1956 Since I started my ID career […]

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February 2nd, 2010

Bats in the Bedroom: Canadians Make a Policy Change

ID doctors know all too well the panicky call — usually from a terrified friend, family member, or colleague, or possibly the emergency room or primary care doc — about finding a bat in the house. Usually in the bedroom. (In one memorable case, it was the house cat’s leaping in the air to try and catch […]

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January 14th, 2010

Magic Wand Destroys H1N1 — and More!

From the folks at Hammacher Schlemmer comes this extraordinary device: Tests performed by an independent antimicrobial testing laboratory showed the wand destroyed 99.98% of the H1N1 virus after a five-second exposure when held 3/4″ above the contaminated surface. Also capable of killing MRSA, mold, and dust mites, the UV-C light penetrates viral and bacterial membranes and […]

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December 28th, 2009

Holiday Surprise: Generic Valacyclovir

Last week one of my patients went to refill a Valtrex prescription, and was offered generic valacyclovir for the first time.  It made him nervous, so he requested I write a “brand-name only” script. I confess the existence of a generic formulation of valacyclovir — which according to the PharmD here has been available for several […]

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December 2nd, 2009

So Much in Less than a Week!

First the updated WHO Guidelines.  Then the following: Updated DHHS Guidelines.  Agree?  Disagree?  Sensible or crazy?  Practical or ivory-tower academic? South Africa does the right thing.  Yes, it’s about time, but good news nonetheless. 2012 International AIDS Meeting in Washington, D.C. First time in USA in a long, long time — 1990, to be exact — […]

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November 30th, 2009

WHO HIV Treatment Guidelines Updated

This just in: WHO is now recommending that ART be initiated at a higher CD4 threshold of 350 cells/mm3 for all HIV-positive patients, including pregnant women, regardless of symptoms. Which makes eminent sense, of course.  Because if starting HIV therapy might prolong survival in developed countries, why shouldn’t it do the same in the developing world? In fact, […]

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