HIV and ID Observations

June 2nd, 2023

Continued Activity of NRTIs Despite Resistance Is a Real Thing

In our last post, we reviewed a case of a person with longstanding HIV with extensive multi-class resistance, but now a decade of viral suppression. They’re currently on an HIV treatment regimen of fully active raltegravir, partially active etravirine, and barely active (or not active at all!) darunavir. There are no NRTIs in the regimen, […]

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May 25th, 2023

The Legacy of a Disappointing HIV Clinical Trial — Does It Still Apply to HIV Today?

A long, long time ago, back in the early exciting days of raltegravir, the first HIV integrase inhibitor, we learned something important from a clinical trial with disappointing results. The trial bore the (barely) hidden name of the company that developed the drug — SWITCHMRK, get it? — and had a profound impact on how […]

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June 28th, 2020

Is COVID-19 Different in People with HIV?

From the start of the COVID-19 pandemic, one of most common questions I’ve received has been whether COVID-19 has different clinical manifestations in people with HIV. Would it be more lethal since people with HIV have impaired immune systems? Or milder since some of the damage in severe cases is immunologically mediated? Or would it be similar, […]

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December 23rd, 2019

FDA Defers Approval of First Long-Acting HIV Therapy, Surprising Everyone

We HIV/ID specialists are lucky. For over two decades, steady progress in HIV treatment brings regular excitement to our field. Some of these advances are incremental, but others represent major leaps forward. One such example of the latter is long-acting injectable therapy with cabotegravir (CAB) and rilpivirine (RPV) for maintaining viral suppression. This strategy — two […]

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November 18th, 2019

The Best Guide to HIV Drug Names — Yours for Free!

Earlier this month, I noted something that all of us ID/HIV specialists should readily concede — namely, that learning the names of the HIV drugs is fiendishly difficult. Afterwards, I heard from a few old-timers (that is, people like me). They acknowledged that we were lucky to experience the roll-out of these medications (and their convoluted […]

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January 27th, 2019

For Our Stable HIV Patients, Why Are We Still Sending All These Lab Tests So Often?

Interesting query from a colleague recently: I’m a community ID doc in the trenches (the measles trenches at present) with an HIV question. Why do we still check CBCs & chem panels every 3-6 months in our HIV patients? Particularly our well-controlled, virologically-suppressed patients? This strikes me as a tremendous waste. I haven’t been in practice that long, […]

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August 23rd, 2018

Eye Worm, MALDI-TOF, New Lyme Testing Approach, Dogs Fail as C. diff Testers, Uiyk (?), and More — A Summer Is Getting Shorter ID Link-o-Rama

A recent chilly spell here in Boston recalled a universal truth about aging — that summer seems to get shorter every year. As far as I can tell in my unscientific poll of everyone who will engage with me on this topic, there are no exceptions to this rule. Everyone thinks summer is shorter than when […]

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August 5th, 2018

Why Caring for People with HIV Is Still Great

Earlier this year, I wrote a piece about friends and colleagues of mine who have left HIV clinical practice. Something about it touched a nerve. It’s one of the most commented-on pieces in the history of this blog. Read this for a typical response. Admittedly, it was kind of a downer — but it might have been […]

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July 22nd, 2018

FDA Approves First PI-Based Single-Tablet Treatment for HIV — How Will It Be Used?

The latest HIV drug approval from the FDA came this past week with the release of a single-tablet treatment containing the following drugs: Darunavir (DRV) 800 mg Cobicistat (c) 150 mg Emtricitabine (FTC) 200 mg Tenofovir alafenamide (TAF) 10 mg Often abbreviated “DCF-TAF,” this is the first full treatment regimen in a single pill with a […]

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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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