HIV and ID Observations

November 2nd, 2012

Antiretroviral Rounds: Resistance on Two Fronts

Got this challenging curbside consult from a colleague, and it has a interesting wrinkle: I have a longstanding patient with HIV who had many failed regimens in the 1990’s with resultant following mutations on a genotype done in 2003: NRTI (M184V, Q151M mutations);  PI (A71, I54V, K20M, L10I, L90M, V82A mutations); no NNRTI resistance. She has been undetectable since then on TDF/FTC/EFV; […]

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January 26th, 2011

Insurance Company Cheese Shop Redux

I had an interesting exchange with one of our nurses this week about a long-term patient of ours. The e-mails went something like this: Got a fax from —-‘s insurance that his Lipitor won’t be covered anymore.  They will cover simvastatin, lovastatin, and pravastatin.  Let me know what you want to do. Charlie He’s on darunavir, and […]

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February 1st, 2009

Whither PEPFAR?

Mark Dybul will no longer be running the President’s Emergency Plan for AIDS Relief, or PEPFAR, the multi-billion dollar international program for HIV treatment program started by Bush in 2003. Some are happy.  Others are not. (Note the exquisite use of euphemism — he was “required to submit his resignation“, not “fired.”) Experts on global HIV treatment […]

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October 1st, 2008

Deadlines of Note

Just a reminder of some interesting deadlines/events out there, in case you were too wrapped up sharpening pencils for tomorrow’s Vice Presidential debate: As of today, Medicare will no longer reimburse hospitals for medical errors — which includes some hospital-acquired infections.  According to this article, several other payors (including private insurers) are using this as a precedent […]

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