An ongoing dialogue on HIV/AIDS, infectious diseases,
December 28th, 2011
Why We Still Need HIV/ID Specialists
Over on Journal Watch AIDS Clinical Care, we periodically publish a tricky case — always drawn from clinical practice — then ask some experts how they would manage it, and why.
The most recent case pretty much has it all:
- Multiple prior regimens
- Multi-class drug resistance
- Metabolic complications
- Bad allergy history, one event nearly requiring hospitalization
- Disfiguring lipoatrophy
- History of treatment discontinuation
In fact, the case is so complicated that our Executive Editor said it made her “head hurt.” She’s just lucky the guy doesn’t have hepatitis C.
Fortunately, Graeme Moyle and Karam Mounzer kindly agreed to take it on. Given the complexity of the case, not surprisingly they came up with two different treatment approaches.
And patients like this are a reminder why, even in this era of single-pill-daily-for-HIV-treatment and 80-90% of patients in care virologically suppressed, we HIV/ID specialists still have a job.
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
Learn more about HIV and ID Observations.
FROM NEJM — Recent Infectious Disease Articles- The Best of Both Worlds — Using Clinical Trial and Observational Data to Evaluate Vaccine Protection July 18, 2026Well-designed observational studies are critical to advancing understanding of the effects of vaccines. But they are often dismissed as lacking the methodologic rigor necessary to inform policymaking.
- Neurocysticercosis July 18, 2026A 52-year-old woman presented with a 4-month history of headache and visual hallucinations. MRI of the brain showed cystic lesions containing bright nodules.
- National Elimination of Hepatitis C — The Case for Starting in Prisons and Jails July 18, 2026The United States could take meaningful steps toward eliminating hepatitis C by broadly testing and treating people who are involved in the criminal legal system.
- Case 20-2026: A 38-Year-Old Man with Abdominal Pain July 16, 2026A 38-year-old man was evaluated at the hospital because of postprandial abdominal pain. Six weeks earlier, a diarrheal illness had developed while he was working in Madagascar. A diagnosis was made.
- Bundibugyo Virus Disease in 2026 — Clinical and Public Health Responses July 16, 2026This review summarizes the current state of the 2026 filovirus disease outbreak in the Democratic Republic of Congo, as well as the principles and approaches that are informing the response.
- The Best of Both Worlds — Using Clinical Trial and Observational Data to Evaluate Vaccine Protection July 18, 2026