An ongoing dialogue on HIV/AIDS, infectious diseases,
December 30th, 2014
Common Curbsides: The Patient with “Recurrent Zoster”
Just in time for the New Year celebration, here’s a curbside consult I’ve received several times, probably because the answer isn’t in most textbooks. As usual, the actual question is slightly edited, as well as lightly (and affectionately) annotated: Hey Paul — Quick question [of course] — I have a patient with a history of irritable bowel, otherwise […]
December 20th, 2014
New HCV Option Effective, Safe, Well-Tolerated — And Use Will Likely Be Driven by Payors
As expected, the FDA approved the next treatment option for HCV on Friday — “Viekira Pak”, a (sometimes complete) regimen consisting of ritonavir-booted parataprevir and ombitasvir given as a two pills once a day, plus one pill of of dasabuvir given twice daily. It is indicated for treatment of HCV genotype 1. For those of you mechanistically inclined, […]
December 14th, 2014
2014 Top Stories in HIV Medicine
Boy do we love end-of-year “Best of …” and “Top Stories of …” lists! Love them! They never gets old! Until January, that is. My own particular favorites are the Best Movies of the Year lists, since for whatever reason it always seems like some masterpiece slips by. Missed it! So we leave it up to […]
November 23rd, 2014
Five ID/HIV Things to be Grateful for this Holiday Season, 2014 Edition
Amidst outbreak hysterias, anti-vaccine imbecility, electronic medical record whining, and slug-related eosinophilia, I bring you this year’s version of the good news — the 2014 edition of Five ID/HIV Things to be Grateful for this Holiday Season, just in time for your holiday turkeys. (Needless to say, the bird will be properly cooked to ensure it’s salmonella-free, with all […]
November 16th, 2014
Electronic Medical Records and the Demise of the Useful Medical Note
Electronic medical records (EMRs) are much on my mind, as last week at Medical Grand Rounds Robert (Bob) Wachter, chief of the medical service at UCSF, gave a brilliant talk on the unanticipated consequences of our move towards what he calls the “Digital Doctor.” Bob has thought a lot about this issue, so much so that he’s about […]
November 10th, 2014
Common Curbsides: The Tuberculin Skin Test and IGRA That Don’t Agree
Here’s one I’ve received twice in the past week, plus my answer. As always, names/some details changed to protect patient confidentiality, plus my annotations in brackets/italics. Hey Paul, Quick question [Need I even comment about the “quick question” phrase, and how this unintentionally devalues what ID docs do? OK, I’ve commented, and yes I’m hypersensitive] — one […]
October 30th, 2014
Why the IPERGAY (Yes, That’s Its Name) Study Could Substantially Increase Use of PrEP
Yesterday, the French IPERGAY study of intermittent pre-exposure prophylaxis (PrEP) was stopped early by the Data Safety Monitoring Board, and for the best reason — the evidence demonstrating that it prevented HIV was overwhelming. For those who read French, here’s the official announcement. (Scroll down for the English.) And for those who can’t believe the name, it […]
October 19th, 2014
Almost Filovirus-Free (That is, Ebola-Free) ID Link-o-Rama
If you’re an ID doctor right now, the filovirus of the moment Ebola is consuming a big chunk of all of your non-clinical time — and this is particularly true for those heavily involved in Infection Control, who are spending every waking hour responding to public hysteria, to various clinicians who seem to have all the answers, and to ever […]
October 15th, 2014
Second U.S. Healthcare Worker with Ebola Further Underscores Urgent Need for Enhanced Preparedness — and Perhaps Designated Care Centers
If you’re like most of us, when you heard that a healthcare worker in Dallas had been diagnosed with Ebola virus disease, you assumed that the exposure occurred during his first visit to the hospital. That is, before he was diagnosed with Ebola, and before infection precautions had been instituted. But no, it happened after […]
October 12th, 2014
Approval of Sofosbuvir/Ledipasvir Was Expected, but Still Is a Huge Advance
As expected, the FDA just approved the first single-pill treatment for hepatitis C genotype 1, a tablet containing 400 mg of sofosbuvir (SOF) and 90 mg of ledipasvir (LDV). For those not following this story closely, sofosbuvir is the pan-genotypic NRTI polymerase inhibitor approved last December to much rejoicing — and controversy about the price. Ledipasvir […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
Learn more about HIV and ID Observations.
FROM NEJM — Recent Infectious Disease Articles- Borrelia burgdorferi Infection and Erythema Migrans January 15, 2026Expansion of the range of the lone star tick, a vector for southern tick-associated rash illness, has led to overlap with the range of the Lyme disease vector Ixodes scapularis, which may cause diagnostic uncertainty.
- Case 2-2026: A 63-Year-Old Man with Pulmonary Nodules, Liver Mass, and Vision Loss January 15, 2026A 63-year-old man was admitted to the hospital because of fever, cough, and vision loss in the right eye. He had pulmonary nodules, a liver mass, and multiple brain lesions. A diagnosis was made.
- Primary Palmoplantar Pustulosis January 15, 2026A 60-year-old man with a 30-pack-year smoking history presented with a 2-year history of a painful rash on his palms and soles. Numerous pustules with erosions, crusting, and surrounding erythema were noted.
- The Things We Carry January 15, 2026The ID, the pen, the epinephrine, the scalpel are the nonnegotiables, the necessities for any hospital shift. But they are not the only things a physician carries, and certainly not the most burdensome.
- Serogroup Switching in Neisseria meningitidis with Dual Antibiotic Resistance January 8, 2026Serogroup switching away from serogroup Y has been identified in the major ciprofloxacin-resistant Neisseria meningitidis strain, which may impede identification of ciprofloxacin-resistant cases of N. meningitidis infection.
- Borrelia burgdorferi Infection and Erythema Migrans January 15, 2026