An ongoing dialogue on HIV/AIDS, infectious diseases,
June 11th, 2010
Plays at the (Culture) Plate
Some quick ID/HIV/other thoughts while we marvel in all that is Strasburgian: Did you know that HIV medication adherence improves over time? So much for “pill fatigue.” By the way, this anecdotally fits with my experience as well. And right now, the biggest reason for patients’ stopping their HIV meds is financial, usually due to loss of or […]
June 2nd, 2010
Screening for Anal Cancer and the World’s Worst Job
In Journal Watch AIDS Clinical Care, we published a simple case: Clinically stable HIV+ gay man, on HIV treatment; anal pap comes back with “atypical squamous cells of undetermined significance” (ASCUS). What to do with this result? Two experts weighed in, Howard Libman and Joel Gallant. In Howard’s thoughtful response, he acknowledges the limitations of the data […]
May 27th, 2010
HIV Treatment is Prevention!
The Lancet has just published a large prospective study demonstrating the protective effect of HIV treatment on the risk of viral transmission: 3381 couples were eligible for analysis … Only one of 103 genetically-linked HIV-1 transmissions was from an infected participant who had started ART, corresponding to transmission rates of 0·37 (95% CI 0·09—2·04) per 100 […]
May 23rd, 2010
Dengue in the News … Again
The recent dengue cases acquired in Florida prompted me to think of two things. First, is this really a surprise? Dengue has become increasingly common in the Caribbean, the mosquitoes that transmit the virus are widespread in the United States, and it’s not as if there’s some sort of microbiologically (if that’s a word) impermeable barrier between […]
May 4th, 2010
Zoster Vaccine Underutilized
From the Annals of Internal Medicine: Eighty-eight percent of providers recommend herpes zoster vaccine and 41% strongly recommend it, compared with more than 90% who strongly recommend influenza and pneumococcal vaccines. For physicians in both specialties [Internal Medicine and Family Practice], the most frequently reported barriers to vaccination were financial. From my admittedly biased perspective […]
May 2nd, 2010
Learning from Clinical Trials with Limited “Generalizability”
In the ongoing debate about when to start antiretroviral therapy in our sickest patients — those with acute opportunistic infections — comes this study from Zimbabwe of early vs. deferred ART in patients with cryptococcal meningitis: The median durations of survival were 28 days and 637 days in the early and delayed ART groups, respectively […]
April 14th, 2010
Maraviroc Rarely Used for Treatment-Naive Patients
Over in Journal of Infectious Diseases, the MERIT study was recently published (with Chuck Hicks’ Journal Watch summary here), demonstrating that maraviroc is non-inferior to efavirenz — provided that the enhanced-sensitivity tropism test is used to select appropriate candidates. (The MERIT study began in 2004-5. Don’t think I’ll ever forget that, since the investigator meeting […]
April 10th, 2010
Why Are Doctors Still Carrying Beepers?
I was going through security at the airport the other day, and tossed my beeper into one of those gray bins — along with the device that should make the beeper superfluous, a cell phone. “I didn’t know anyone used beepers anymore,” said the 30-something guy behind me. What could I say? That doctors also […]
April 4th, 2010
San Francisco Public Health: Treatment Recommended for All with HIV
Could there be anything more interesting than the start of the baseball season? Maybe, because this is quite something: In a major shift of HIV treatment policy, San Francisco public health doctors have begun to advise patients to start taking antiviral medicines as soon as they are found to be infected, rather than waiting — sometimes […]
March 31st, 2010
C diff Guidelines: Metronidazole Still Preferred?
IDSA and The Society for Healthcare Epidemiology of America (SHEA) have published Clinical Practice Guidelines for Clostridium difficile infection. Not surprisingly, it’s a comprehensive, extensively-referenced document that will be an invaluable resource, especially since the previous version is approximately 15 years old. But with the caveat that I’m not an expert in this area, these particular […]
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