HIV and ID Observations

May 19th, 2019

CDC Does Us a Huge Favor by Advising Against Annual Screening of Healthcare Workers for Latent TB

There are definitely things we do in medicine just because that’s how we’ve always done them. Among these evidence-free actions, we can include yearly screening for latent TB infection (LTBI) in all healthcare workers If we carefully examine the rationale behind this practice — as this thorough review nicely does — one would be hard-pressed to find any […]

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March 18th, 2019

Just 1 Month of TB Preventive Therapy Works for People with HIV in TB-Endemic Regions — How About Other People in Other Places?

There’s a look our patients frequently give us when we tell them that preventive therapy for tuberculosis involves 9 months of treatment. If I were to put that look into words, they would be: Yikes, Doc, 9 months is waaay too long — you must be out of your mind. It’s the “9 months?!?!” face. We’ve […]

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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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October 23rd, 2011

TB, Timing of Antiretroviral Therapy, and Being a Lumper Rather Than a Splitter

Three key papers on timing of ART in patients with TB have just been published in the New England Journal of Medicine. Fortunately, Carlos Del Rio has done a bang-up job summarizing them in Journal Watch AIDS Clinical Care. And if you’re wondering how we got our title for Carlos’ piece, here’s an e-mail between our Executive Editor to me […]

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March 24th, 2010

Now for Some Good News: TB Cases Continue to Decline

From the latest MMWR: This figure speaks for itself, but two sentences from the Editorial Note deserve highlighting: The 11.4% decrease in reported TB rate in 2009 is the largest single-year decrease ever recorded. From 1953 to 1993, the single largest annual percentage decrease in TB case rate was 11.1% in 1956 Since I started my ID career […]

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November 25th, 2008

Coming Soon: A Great Advance in TB Diagnostics

An all-too-frequent problem in the ID clinical world is the case where tuberculosis is possibly the diagnosis, but confirming it is difficult, or impossible. Now, in a scientific breakthrough of such magnitude that it warranted front page coverage in our local newspaper, I am pleased to report that we may have a solution: giant rats. Yes, giant […]

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