HIV and ID Observations

February 14th, 2012

Is It Time To Stop Treating Acute Sinusitis?

From the pages of JAMA comes this startling clinical trial: A randomized, placebo-controlled trial of adults with uncomplicated, acute rhinosinusitis [who] were recruited from 10 community practices in Missouri between November 1, 2006, and May 1, 2009 … [Subjects received a] ten-day course of either amoxicillin (1500 mg/d) or placebo administered in 3 doses per day … There was no […]

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February 10th, 2012

Boceprevir – PI Interaction: A “Dear Doctor” Letter We Didn’t Want To Get

By now I’m sure that most of you ID folks out there have received the following letter from Merck, the makers of boceprevir: URGENT — IMPORTANT DRUG WARNING: VICTRELIS (BOCEPREVIR) The purpose of this communication is to inform you of recent pharmacokinetic study results evaluating drug interactions between VICTRELIS, an oral chronic hepatitis C virus (HCV) NS3/4A […]

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February 7th, 2012

Chronic Fatigue: Is There Hope After XMRV?

I’ve been following the chronic fatigue/XMRV story from the start, which was compelling for several reasons, including: A potential cause was identified of a very debilitating, mysterious illness. Lots of very smart ID people (including some of my colleagues) studied it. Media coverage, notably from the Wall Street Journal and the New York Times, was particularly […]

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February 3rd, 2012

More on Low (but Detectable) Viral Loads — Is Knowing This Useful?

I have a very smart, very experienced colleague — clue, his initials are CC, and he doesn’t pitch for the Yankees — who continues to use bDNA testing for HIV viral load monitoring. You know, the assay with a lower limit of detection of 75 copies. He knows that bDNA is less sensitive than PCR. He knows […]

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January 8th, 2012

Journal Club: In Early HIV Infection, Little Reason to Delay Therapy

Every experienced HIV clinician will recognize the following new-patient scenario: At least one, but often several negative HIV antibody tests in the past, generally due to being in a “high risk” group. Recent non-specific viral-type illness that, in hindsight, was undoubtedly acute HIV infection, undiagnosed. Now completely recovered, but found to be newly HIV antibody positive. […]

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December 24th, 2011

Making a List and Checking it Twice, Then Making Sure 052 is On It

How big a news story was HPTN 052, which demonstrated that HIV treatment reduced transmission by at least 96%? (I like to emphasize that “at least” bit, since it’s likely that none of the study subjects with undetectable HIV RNA levels transmitted to their partners — the one case that did transmit did so before virologic suppression.) […]

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December 18th, 2011

Let’s Just Say I’m Glad the Grades Don’t Count

A friend alerted me to this test of scientific literacy. Give it a try — no google cheating — and let me know how you do. And even though I got the first 5 questions right, my final score (to be disclosed in the comments, eventually) left little doubt that I was an English major in college. Yeah, that’s […]

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December 11th, 2011

An Unlikely Interviewee Discusses “Six-Class” HIV Drug Resistance

He’d never acknowledge it, but in our field, it’s no secret this guy is something of a rock star. I can think of several key principles in HIV pathogenesis and treatment that he and his research group have discovered, or elucidated most clearly, or simply explained the best — largely through his unique ability to link […]

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December 8th, 2011

Big TB Prevention Study Important, Highly Relevant — Even Here

As I’ve noted before, tuberculosis is disappearing from the United States — which means that the bulk of cutting-edge research in TB (both clinical and basic science) has little relevance to US-based practitioners. But over in NEJM, a much-anticipated TB study is published today that is highly relevant: We conducted an open-label, randomized noninferiority trial comparing 3 […]

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December 1st, 2011

World AIDS Day Wanderings

Some quick HIV and ID Observations (better blog title anyone?) for this 2011 World AIDS Day: Through meticulous, painstaking research that took me all of 10 seconds, I’ve learned that the first World AIDS Day was in 1988. What ever did we do before the internet? Looks like New York City’s health department  is following San […]

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