An ongoing dialogue on HIV/AIDS, infectious diseases,
February 3rd, 2012
More on Low (but Detectable) Viral Loads — Is Knowing This Useful?
I have a very smart, very experienced colleague — clue, his initials are CC, and he doesn’t pitch for the Yankees — who continues to use bDNA testing for HIV viral load monitoring. You know, the assay with a lower limit of detection of 75 copies. He knows that bDNA is less sensitive than PCR. […]
January 29th, 2012
Pre-Super Sunday Scombroids
Some quick ID/HIV links while we await big guys playing the big game with a big (or at least bigger) ball. Did you see how this doctor cheated Medicaid out of more than $700,000 by prescribing HIV meds to people who didn’t have HIV? Not surprisingly, he’s going to jail. Proof that if there’s money behind […]
January 22nd, 2012
Generic Lamivudine Has Arrived
An e-mail from a patient last week: Just got refills. Epivir is now generic??? Refill is simply labeled Lamivudine Tablets by Aurobindo Pharma USA, Inc …but made in India. Should I be concerned about that??? John I told John (not his real name) not to be concerned — he is merely substituting the generic for […]
January 21st, 2012
More Medical Testing! No, Less! You Decide
Fascinating Yin-Yang this week on the issue of medical testing. Want more? Want less? First, this remarkable piece on retail medical labs, including a description of a company called ANY LAB TEST NOW: Labs where folks can just walk in and order tests on themselves are popping up in retail centers across the country… At Any […]
January 18th, 2012
ID Case Conference Discussant Types
We specialists in Infectious Diseases love case conferences — especially those where the case is presented as an “unknown”, and we try to figure out the diagnosis from the history. I suppose this isn’t very surprising, since ID cases in general are already among the most interesting in all of medicine. Those that are case-conference-worthy […]
January 8th, 2012
Journal Club: In Early HIV Infection, Little Reason to Delay Therapy
Every experienced HIV clinician will recognize the following new-patient scenario: At least one, but often several negative HIV antibody tests in the past, generally due to being in a “high risk” group. Recent non-specific viral-type illness that, in hindsight, was undoubtedly acute HIV infection, undiagnosed. Now completely recovered, but found to be newly HIV antibody […]
January 4th, 2012
How Does Herpes Treatment Trigger a Positive Test for Performance-Enhancing Drugs?
Here’s my guess on how many of this blog’s readers know the following “facts”: Acyclovir and related drugs are used to treat herpes: nearly 100% Ryan Braun, superstar left fielder for the Milwaukee Brewers, is facing a 50 game suspension for testing positive for elevated levels of a “banned substance”, most likely testosterone: 10% Braun […]
January 3rd, 2012
Prevnar Now Approved for Adults — But Should We Start Using It?
From the FDA (and thanks to Physician’s First Watch for reporting the news): Prevnar 13, a pneumococcal 13-valent conjugate vaccine, was approved today by the U.S. Food and Drug Administration for people ages 50 years and older to prevent pneumonia and invasive disease caused by the bacterium, Streptococcus pneumoniae. As shown in multiple studies, Prevnar […]
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 […]
December 11th, 2011
An Unlikely Interviewee Discusses “Six-Class” HIV Drug Resistance
He’d never acknowledge it, but in our field, it’s no secret this guy is something of a rock star. I can think of several key principles in HIV pathogenesis and treatment that he and his research group have discovered, or elucidated most clearly, or simply explained the best — largely through his unique ability to […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
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FROM NEJM — Recent Infectious Disease Articles- Challenging Claims of an Autism Epidemic — Misconceptions and a Path Forward January 17, 2026Autism research programs should focus on both causes and effective services and supports. Alarmist claims, chasing of debunked theories of causation, and further stigmatizing autism are counterproductive.
- Pneumocystis jirovecii Pneumonia January 17, 2026A 60-year-old man with recently diagnosed HIV infection presented with a 10-day history of fever, dry cough, and shortness of breath. A CT scan of the chest showed diffuse nodules and ground-glass opacities.
- 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.
- 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.
- 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.
- Challenging Claims of an Autism Epidemic — Misconceptions and a Path Forward January 17, 2026