An ongoing dialogue on HIV/AIDS, infectious diseases,
October 21st, 2008
Back to School, Day 4: PEP and More PEP
After a lecture on HIV for Primary Care Providers in our course last week, the most controversial topic was, not surprisingly, the use of post-exposure prophylaxis (PEP) for both occupational and non-occupational exposures. And today, after an entire lecture on PEP to a group of HIV providers in our AIDS course, again the subject drew […]
October 18th, 2008
Back to School, Day 2
During the course, often the best questions and anecdotes come during the breaks. Here are a few: Tons of questions about our favorite nemesis, MRSA. What works for chronic carriers? How do you manage family members who you suspect would be culture-positive (and the source of recurrences), but are not your patient? What if the vet […]
October 15th, 2008
Back to School, Day 1
We offer two post-graduate courses each year, one entitled Infectious Diseases in Primary Care, and the other AIDS Medicine: An Intensive Case-Based Course. The Primary Care one started today, the AIDS course starts on Monday. (Both are equally fascinating. I am entirely unbiased.) What is so striking is that the participants — and content — barely overlap […]
October 8th, 2008
The French Win This One
The 2008 Nobel Prize in Medicine goes to Françoise Barré-Sinoussi and Luc Montagnier for discovery of HIV. They each get one-quarter of the prize money, with one-half going to Harald zur Hausen for showing the relationship between human papillomavirus and cervical cancer. For the record, if you search the Nobel press release for the word “Gallo”, […]
June 2nd, 2008
Zoster Vaccine Guidelines — Official Answers, but Still Some Questions
The CDC’s Advisory Committee on Immunization Practices has just released the “official” guidelines for use of the zoster vaccine. And none too soon — if I had a dollar (or these days, make that a euro) for every curbside consult I’ve received about the zoster vaccine … The vaccine’s indications are simple — age over 60, […]
May 21st, 2008
When Expert Clinicians Disagree
Periodically, in AIDS Clinical Care, we publish a case in the “Antiretroviral Rounds” section and ask two clinical experts in our field how they would manage such a patient. The most recent case elicited responses that were 180 degrees different. (This is exactly what we’re after, by the way — why present a case in which […]
May 14th, 2008
Certification in HIV Medicine — Another Try
In March, the American Board of Internal Medicine (ABIM) issued a proposal for a “Maintenance of Certification” (MOC) pathway in HIV medicine for general internists. This is the second such special pathway ABIM is considering (the first was hospitalist medicine). Regardless of whether you agree with the proposal, it’s a good read, providing an excellent […]
April 23rd, 2008
Antiretrovirals in the Pipeline: And Then There Were … None?
The flurry of drug approvals that began in 2005 with tipranavir – followed rapidly by darunavir, maraviroc, raltegravir, and most recently etravirine – has been nothing short of astounding. Every experienced HIV clinician now has many patients who are on successful (read: suppressive) treatment for the first time ever. The Vancouver HIV program — wonderfully called […]
April 10th, 2008
Needed: Something Better than “HAART”
I think we all have pet peeves, and so I’ll confess one of mine: I hate the term “HAART.” (I work with someone, by the way, who hates the term “viral load,” preferring “virus load.” Go figure.) Standing for “highly active antiretroviral therapy,” HAART first surfaced in the mid-1990s in order to distinguish potent anti-HIV treatment from the older, not-so-active form […]
March 31st, 2008
FDA Investigating Safety of Abacavir and Didanosine — Old News or New?
The FDA has issued one of its new “early communications” indicating that it has opened an investigation into the safety of abacavir and didanosine based on analyses showing higher rates of myocardial infarction with these drugs than with other NRTIs in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. The pace of our […]