HIV and ID Observations

July 15th, 2018

On-Service Digest, July 2018 — with Special Section Just for Staph aureus

I’m currently on-service for the inpatient ID consult team, and this is July. At a teaching hospital.  Here’s where some would play scary music. After all, the interns and fellows have just started! YIKES! But no scary music for me — I love working with the July newbies. Because whatever they lack in experience or efficiency, they more than make up […]

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October 1st, 2017

With Several Wrong Predictions Behind Me, Here’s One I Got Right

As I’ve mentioned before, I’ve been wrong on several predictions that ultimately came to pass. Whoppingly wrong. A partial list: Cameras in cellphones are a short-lived gimmick. My kids still tease me about that one. Buying clothing — and especially shoes — on the internet will never catch on. C’mon, you can’t try things on! How do you know […]

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July 19th, 2017

Mystifying Cochrane Library Review on HCV Therapy Elicits Strong Response from IDSA

Last month, the Cochrane Review published a controversial paper on HCV therapy that left many ID doctors and hepatologists perplexed. After reviewing 138 randomized clinical trials using directly acting, non-interferon based therapies, they came to the following conclusions: The use of sustained virologic response (“SVR”) — or “cure”, if you want to use plain English — as a […]

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March 25th, 2017

HIV and Hepatitis C Are No Longer the Most Serious Infectious Threats to People Who Inject Drugs

I had dinner with my daughter Mimi the other evening, and was ruminating about how things have changed since I started work as an Infectious Diseases doctor around 25 years ago. Here’s an excerpt of our chat: Me:  There are way more cases of endocarditis in young people than there used to be, a complication of injecting drugs. People in their 20s and […]

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November 20th, 2016

Seven ID/HIV Things to Be Grateful For This Holiday Season, 2016 Edition

I know, I know — you read that title and thought, “Grateful now? He must be out of his mind.” But with the (unsurprising) concession that I too felt that watching the election returns was akin to witnessing a slowly developing and incomprehensible train wreck, I remind you that the expression of gratitude is well known to make you happier. […]

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July 3rd, 2016

Velpatasvir/Sofosbuvir Makes HCV Treatment Simpler, Especially For Genotypes 2 and 3

One of the ways ID and hepatology hepatitis C experts like to show off is by discoursing on the nuances of cleverly named clinical trials, and how these impact treatment guidelines. It usually goes something like this: “In the EP-CILEON [I made that up] study of [insert HCV regimen here], treatment-experienced patients with genotype [insert non-genotype 1 patients here, […]

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November 26th, 2015

Five (OK, Six) ID/HIV Things to be Grateful for this Holiday Season, 2015 Edition

Some quick ID/HIV gratitude items for 2015, done rapidly as we’re hosting a big meal later today. I wonder what that might be. New Ebola virus disease cases and deaths have dramatically declined. I write that sentence with some trepidation, as cases continue to occur sporadically, and this late relapse in a nurse was a chilling reminder of […]

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November 18th, 2015

Are There Remaining Challenges in HCV Therapy?

Prompted by (yet more) spectacular HCV study results, I posted the following questions on Twitter: Is velpatasvir/sofosbuvir the endgame for HCV? And what will HCV researchers do now? https://t.co/vL2A9FOttR @NEJM — Paul Sax (@PaulSaxMD) November 18, 2015 To which I got this reply from one of our very energetic second-year ID fellows: @PaulSaxMD @NEJM what about coinfected patients, […]

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October 24th, 2015

Pumpkin-Flavored ID Link-o-Rama

As the leaves change colors and fall from the trees, the days grow shorter and colder, and pumpkin-colored and flavored merchandise shows up everywhere, I ask you this important question: What precisely are the infectious risks of bobbing for apples? Off we go. Receiving antibiotics in childhood is associated with weight gain. The important finding in this study is that the […]

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September 7th, 2015

Two Drugs with High Prices — One is (Surprise!) Good Value, The Other is Truly a Rip-off

By now, the fact that HCV treatment carries a high price is a fact as well known to the medical and non-medical public as 1) a million dollars doesn’t get you much in Manhattan or Bay-area real estate; 2) a Rolex is an expensive way to know what time it is; and 3) even though […]

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