An ongoing dialogue on HIV/AIDS, infectious diseases,
August 28th, 2013
Poll: At $14,105/year, Is Dolutegravir Fairly Priced?
The recently approved once-daily integrase inhibitor dolutegravir is now in pharmacies and, like every new HIV drug, the price — around $14k/year — has generated some controversy. For the record, here are the per-year wholesale acquisition costs of the three FDA-approved integrase inhibitors. Raltegravir: $12,976 Elvitegravir: $13,428 (once disentangled from the price of TDF/FTC) Dolutegravir: […]
August 26th, 2013
When Eating Guinea Pig, Make Sure to Ask for it Well Done
I’ve written before about how ID doctors are no fun to have at cook outs, what with our obsession with well-done hamburgers. Now, there’s another menu item we can berate grill-meisters on, and that’s guinea pig meat: At least 81 people fell ill from suspected salmonella poisoning after eating guinea pig meat and other foods […]
August 25th, 2013
Death from “Brain-Eating Parasite”: A Reminder of How Little We Really Know
Sometimes it takes a lot to surprise an ID doctor — we who try to make it seem like we’ve seen it all — but certain infections are either so severe (e.g., necrotizing fasciitis from group A strep) or so rare (e.g., endocarditis from Erysipelothrix rhusiopathiae) that even we are startled. Doubly startling are those […]
August 20th, 2013
Underreporting of Lyme Disease No Surprise, but a Big Problem
In a welcome update, CDC just presented revised data on the number of Lyme Disease cases annually in the United States. Here are the key facts: Cases reported by clinicians: 30,000 Estimated number of cases using additional information from insurance claims, laboratories, and patient reports: 300,000 Go ahead, check my math — that’s a whopping […]
August 12th, 2013
Dolutegravir Approval Signals a Beginning and the End of Something Very Special
As anticipated, the FDA approved dolutegravir today for HIV treatment, the third integrase inhibitor now available. This was about as surprising as the arrival of Royal Baby Prince George. We knew dolutegravir was coming soon, just not exactly when or what it would be named. Here’s a short list of the data we have thus far on […]
August 7th, 2013
Occupational Post-Exposure Prophylaxis (PEP) Guidelines Updated — And They Are Clear and Sensible
Good news here — the United States Public Health Service has issued new national guidelines for management of occupational exposure to HIV. Authored by an expert panel, these updated occupational PEP guidelines replace the (woefully outdated, sorry, had to write that) previous version, which dates back to 2005. On a quick read-through, despite the density of […]
August 6th, 2013
Nelson Cruz and Yet Another ID-Baseball Link
Texas slugger Nelson Cruz is one of the Biogenesis gang just suspended from baseball for use of performance-enhancing drugs (PEDs). For those who care about these things, he’s also probably the most important player from the banned list, since he’s 1) very good and 2) on a team in contention for a playoff spot. For […]
August 1st, 2013
Poll: Will There Be A Shortage of HIV Providers?
Over on NEJM Journal Watch — love that new name — I reviewed a paper on the demographics of people living with AIDS in San Francisco. Bottom line — more than half are now older than 50. Implication — that’s so old! First, it really isn’t, unless you compare it to the dismal era 20+ […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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