HIV and ID Observations

July 19th, 2017

Mystifying Cochrane Library Review on HCV Therapy Elicits Strong Response from IDSA

Last month, the Cochrane Review published a controversial paper on HCV therapy that left many ID doctors and hepatologists perplexed. After reviewing 138 randomized clinical trials using directly acting, non-interferon based therapies, they came to the following conclusions: The use of sustained virologic response (“SVR”) — or “cure”, if you want to use plain English — […]

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July 9th, 2017

Should You Answer Medical Questions from Clinicians You Don’t Know About Patients You’ve Never Seen?

This email popped into my inbox the other day from a person I’ve never met: Hi Dr. Sax, I do mostly hospital-based ID in Pennsylvania, and was consulted on a newly diagnosed HIV patient with CD4 10, viral load 210,000, and lymphoma. I started him on Truvada and dolutegravir, which is going well so far. Because he […]

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July 2nd, 2017

Delafloxacin, a New Quinolone, Is Approved for Skin Infections — But That’s Not Where It’s Really Needed

The history of the fluoroquinolone antibiotics can be divided into four eras, alternating good news and bad: Ciprofloxacin is approved — it covers everything, and is miraculous. We’re talking some tough customers here. Pseudomonas aeruginosa! Staphylococcus aureus! Neisseria gonorrhoeae! Plus, pretty much every gram negative causing urinary tract infections. There was no intravenous formulation initially, but that hardly mattered since it […]

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June 18th, 2017

On Father’s Day, A Rumination on Families with Lots of Doctors

My father is a doctor. So was my father’s father. And my father’s uncle. And my father’s cousin. But that’s not all. My father’s brother was also a doctor — he loved being a doctor more than anyone on the planet, and attended neurology meetings long after he retired, right up until the time he […]

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June 10th, 2017

What’s Your Favorite Antibiotic? A Fantasy Draft

Over on the journal Open Forum Infectious Diseases (that’s “O-F-I-D”, not “Oh-FID”), the generous people from IDSA and Oxford University Press have allowed me to record a series of podcasts, interviewing various interesting people in the ID field. This time, however, I strayed from the usual format and asked my colleague Rebeca Plank to join me in […]

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June 4th, 2017

Can’t HIV Serodiscordant Couples Now Just Have Children the Regular Way?

MMWR just published a paper entitled, Strategies for Preventing HIV Infection Among HIV-Uninfected Women Attempting Conception with HIV-Infected Men — United States, and it’s both a welcome and a very strange document indeed. It’s welcome because it acknowledges that serodiscordant couples may wish to have children without the use of an HIV-negative sperm donor. Advances in HIV […]

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May 29th, 2017

Healthcare Providers Shouldn’t Come to Work While Sick, but They Do — Here’s Why

Let’s start with two questions: Have you ever seen a doctor, nurse, PA, pharmacist or other person directly involved in patient care wearing a surgical mask because they have a respiratory tract infection? Has this mask-wearing person ever been you? Bold prediction: Virtually every reader who works in a hospital or large office practice answered “Yes” to #1. […]

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May 21st, 2017

The Curious Case of M184V, Part 1

Thanks to our sophisticated research team here at NEJM Journal Watch, we have an excellent idea who reads this thing for its scintillating ID/HIV content. Most of you are clinicians — doctors, nurses, PAs, PharmDs. A smaller proportion are researchers, lab-oriented types who wandered over here unexpectedly after an errant search, expecting the latest in CRISPR-Cas9 gene editing […]

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May 14th, 2017

Poll: Which Feature of Electronic Health Records is Most Important to Patient Care?

The first electronic medical record I used regularly — called “BICS” — initially had one purpose. It was a tool to look up a patient’s lab results. Simple, reliable, and blazingly fast, it did one thing remarkably well. Later, one of our Emergency Department doctors, who happens to have impressive coding skills, worked with a team to add a […]

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May 7th, 2017

CRISPR and HIV “Cure,” Zinc for Colds, New AIDSInfo Site, CROI Dates, Vanco Pricing, and More: I Can’t Believe It’s May ID Link-o-Rama

A few Infectious Diseases/HIV items to consider as we wait (and keep waiting!) for the warm weather to arrive in chilly, and often wet, New England: CRISPR-Cas9 excises latent HIV from the cells of humanized mice. With the usual caveat about not overreacting (like this) to an animal model, this CRISPR strategy seems like a more viable HIV cure intervention than […]

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