HIV and ID Observations

January 29th, 2016

Elbasvir/Grazoprevir Combination Pill for HCV a Welcome New Option — With a Few Buts

As expected, there’s a new option for HCV therapy, the combination pill elbasvir/grazoprevir (EBR/GZR, brand name Zepatier, more on this below), and it’s indicated for genotypes 1 and 4. For those mechanistically inclined, elbasvir is an NS5A inhibitor (like ledipasvir), and grazoprevir is a protease inhibitor (like simeprevir). This is the second one-pill, once a day […]

---

January 18th, 2016

IV and Injectable HIV Treatments Are Much Discussed — But Won’t Be Here Anytime Soon

Something interesting happens when you poll people who treat HIV — and people who have HIV — about whether they’d prefer a treatment option that consists of a periodic injection or infusion in place of the pill or pills that they take every day. Lots of them say yes. Even people who are taking just one […]

---

January 4th, 2016

A Riddle, the 2015 Clinical Trial of the Year, and a Guaranteed Laugh for All ID Doctors

Things quiet on this end recently from me due to various circumstances. but here are three ID-related (sort of) things worth sharing — enjoy if you haven’t seen them already. Let’s start with a riddle: What animal is responsible for the most human deaths a year? Readers of Bill Gates’ blog will think this is old […]

---

December 19th, 2015

Part 2, Now The Good News: Why ID Will Survive as a Specialty

Part 1 of this post, which highlighted the primary reason for declining applications to ID fellowship programs, could come across as something of a downer. “Moping about it won’t get us anywhere,” someone said to me, and it’s true nobody likes a whiner. But my point was to acknowledge the issue, and find a way forward. It […]

---

December 6th, 2015

Do Electronic Health Records Make You a Better (or Worse) Clinician?

Earlier this week, JAMA Internal Medicine published a study entitled, “Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction”. A more descriptive title would have been “More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction”, as here’s the take home point: High computer use by clinicians in safety-net clinics was associated with lower […]

---

November 29th, 2015

Flu Vaccine Keeps Taking Hits, Still the Best We’ve Got — Don’t Stop “Belivin'” [sic]

For reasons understood only by the geniuses in Mountain View, CA, for some reason my Google news feed picked up this bit of “scientific” reporting: Let me allow the author, an unfortunately named “Clapway” (gonorrhea researcher?), to speak for him/herself: However, is the flu vaccine really worth it? The author of this article never takes it […]

---

November 26th, 2015

Five (OK, Six) ID/HIV Things to be Grateful for this Holiday Season, 2015 Edition

Some quick ID/HIV gratitude items for 2015, done rapidly as we’re hosting a big meal later today. I wonder what that might be. New Ebola virus disease cases and deaths have dramatically declined. I write that sentence with some trepidation, as cases continue to occur sporadically, and this late relapse in a nurse was a chilling […]

---

November 22nd, 2015

Just Wondering: Quick ID Questions to Consider

Several quick ID queries, some of them answerable on the Google machine — but I’m not going there. Too busy laundering my white coat! What ever happened to amphotericin A? What’s the difference between a “serovar” and a “serotype”? Do dogs feel bad that Pasteurella multocida is more famous than Capnocytophaga canimorsus? Colistin resistance is bad — but how often does colistin actually […]

---

November 18th, 2015

Are There Remaining Challenges in HCV Therapy?

Prompted by (yet more) spectacular HCV study results, I posted the following questions on Twitter: Is velpatasvir/sofosbuvir the endgame for HCV? And what will HCV researchers do now? https://t.co/vL2A9FOttR @NEJM — Paul Sax (@PaulSaxMD) November 18, 2015 To which I got this reply from one of our very energetic second-year ID fellows: @PaulSaxMD @NEJM what […]

---

November 8th, 2015

New HIV Treatment “ECF-TAF” is Really All About the “TAF” Part

HIV providers and patients recently got this news from the FDA: The U.S. Food and Drug Administration today approved Genvoya (a fixed-dose combination tablet containing elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide) as a complete regimen for the treatment of HIV-1 infection in adults and pediatric patients 12 years of age and older. (Disclosure:  I have […]

---