An ongoing dialogue on HIV/AIDS, infectious diseases,
September 3rd, 2011
“Novel” Approaches to Initial HIV Therapy: Part I
It’s been several years since the “preferred” or “recommended” initial regimens for HIV treatment have been consolidated into one of the following four: TDF/FTC + efavirenz TDF/FTC + atazanavir/r TDF/FTC + darunavir/r TDF/FTC + raltegravir Any room for improvement in this “TDF/FTC + key third drug” approach? With the recent approval of TDF/FTC/rilpivirine, certainly this […]
August 31st, 2011
It’s Time for Antibiotic Placebos
As I’m sure you all agree, it’s high time we had a good antibiotic placebo. Just think — we’d be able to prescribe a 100% effective treatment for viral respiratory tract infections, with the assurance of no risk of antibiotic resistance, C diff, allergic reactions, tendon ruptures, photosensitivity, drug-drug interactions, or any of the myriad […]
August 19th, 2011
A Reason To Continue Restrictive HIV Testing Laws? Not Really …
The pending HIV legislation is much on my mind these days, for reasons I outlined here. Bottom line is that I don’t think it’s good for patient care, and we’re missing a real opportunity to make things better here in the Bay State. But yesterday I heard a perspective on the bill I hadn’t considered, […]
August 11th, 2011
Next Single-Pill HIV Treatment Approved, and It’s Not Called “B-Tripla”
One famous HIV clinician/clinical researcher likens co-formulated TDF/FTC/EFV (Atripla) to a “Godzilla,” so dominant has the treatment become as initial therapy for HIV. He bases his comments on this study done at his institution, showing that in 2007, fully 85% of patients starting treatment in their clinic began TDF/FTC/EFV. Does this big lizard of a […]
August 3rd, 2011
Why the Proposed Massachusetts HIV Testing Bill is Bad for Patients
As I’ve written about here multiple times, I’m not a big fan of the HIV testing law in our state. First, there’s the requirement for written informed consent, something that every state (except a couple) has wisely abandoned. Second, it’s more than a testing law — it’s also an HIV privacy law, which is arguably […]
July 12th, 2011
A Thank You to Nice Patients
Yesterday I saw one of my favorite long-term patients. She’s just wonderful, and it’s always a joy to see her. Here are some reasons: She’s uniformly nice — not just to me, but to all the nurses and social workers and other support staff in our clinic. She shows up on time for her appointments. […]
July 3rd, 2011
Proof That We Are Not French
In case you were worrying about fading American national identity as we celebrate July 4, did you see this detail on a recent E. coli O104:H4 outbreak from France? More recently, at least 15 people in Bordeaux, in southwestern France, appear to have been infected with the strain found in Germany. Most of them have […]
June 24th, 2011
Reflections on Levofloxacin as it Goes Generic
With the news that a generic form of levofloxacin has just been approved by the FDA, some thoughts about this remarkable antibiotic: When it was first approved in 1996, levofloxacin was the first oral antibiotic that really covered all common causes of community acquired pneumonia. Strep pneumo, H flu, mycoplasma, legionella, chlamydia — check, check, […]
June 19th, 2011
Abacavir Agonistes
The studies on abacavir and its potential association with increased cardiovascular risk have been inconsistent ever since the news first broke at CROI 2008. But recently the data have been swirling around so fast and furious that it seems appropriate to take out this famous Greek epithet. A summary of some recent notable studies: An […]
June 15th, 2011
Hockey Helicobacters
Today’s ID/HIV items come to you courtesy of a winter game being played during a summer month: So it appears that community-based care of HCV augmented by telemedicine is just as good as traditional clinic visits to specialists. My first thought on reading this important paper is that there are undoubtedly lots of ways 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