An ongoing dialogue on HIV/AIDS, infectious diseases,
January 11th, 2013
How to Make the Flu Vaccine More Popular, Warts and All
In a week that saw both our hospital’s influenza-induced bed crunch make the New York Times, and my son, mother-in-law, and me succumb to this seasonal plague despite our receiving flu shots, I have been highly attuned to all things influenza. But the focus here will be on that perennial whipping boy of preventive Infectious Diseases, […]
January 1st, 2013
HIV Incidence: The Latest Numbers
The CDC has recently issued the latest report on HIV incidence (i.e., new infections) in the United States, and as always it’s fascinating to review the numbers. To start, the year-by-year estimated incidence: 2007: 53,200 2008: 47,500 2009: 45,000 2010: 47,500 (38,000 men, 9,500 women) Nope, not much change. Will data from HPTN 052 — published […]
December 5th, 2012
Top HIV Stories of 2012
Somewhere in our genome, we are programmed to use the end of the year as a time to reflect on the previous 12 months — and to make lists! If you don’t believe me, there’s barely a publication or web site out there that hasn’t already succumbed, and we’re just in early December. And what […]
November 28th, 2012
A Complicated Curbside Consult I Won’t be Doing — But One Day Might Have To
From a local primary care provider comes this email: Any chance you can look at my notes and scanned outside records from 6/22/2010 till today (including Nov 6 notation that details extensive past evaluation, including two previous ID consults) and labs? Briefly: 72 yr old woman with 6 episodes over the last 4 years of […]
November 22nd, 2012
The U.S. Preventive Services Task Force Recommends HIV Screening — And Why is This News?
A flurry of coverage recently appeared about the U.S. Preventive Services Task Force’s recommendation for one-time HIV screening for all Americans, ages 15-64. Some might wonder why this is news — um, hasn’t this been recommended now for years? — and I think I’ve figured it out. Let me start by relaying that every ID/HIV specialists […]
November 18th, 2012
The 800-mg Darunavir Tablet Arrives, and Scoring the Top Protease Inhibitors
The FDA has approved an 800-mg tablet of darunavir for treatment naive patients. This single tablet will obviously replace the two darunavir 400-mg tablets in first-line therapy. (Yes, my math is that good.) Darunavir will still require 100-mg ritonavir boosting plus two NRTIs to make a complete regimen. Once upon a time I might have thought this […]
November 2nd, 2012
Antiretroviral Rounds: Resistance on Two Fronts
Got this challenging curbside consult from a colleague, and it has a interesting wrinkle: I have a longstanding patient with HIV who had many failed regimens in the 1990’s with resultant following mutations on a genotype done in 2003: NRTI (M184V, Q151M mutations); PI (A71, I54V, K20M, L10I, L90M, V82A mutations); no NNRTI resistance. She has been undetectable since […]
September 19th, 2012
It’s Time to Dump the HIV Western Blot
Hard to believe, but we have to get rid of the HIV Western blot — at least as our HIV confirmatory test. Here’s why (case adapted from several seen the past few years; I’m sure most of you have seen similar): 30-year-old man, high risk for HIV. He’s worried he might have become infected due […]
September 8th, 2012
People Fear EEE and West Nile, but not Influenza — Can Someone Explain Why?
OK, here’s a quick quiz — match the viral infection with the average annual US deaths: 1. Eastern Equine Encephalitis A. 36,000, mostly in the elderly 2. Influenza B. < 10, mostly in the elderly I know, it was an easy one — 1 goes with B, and 2 with A. Here’s a good reference for more […]
August 28th, 2012
“Quad” Approved by FDA
We now have a third single-pill treatment available for HIV treatment, co-formulated tenofovir/emtricitabine/elvitegravir/cobicistat. From the FDA announcement: The U.S. Food and Drug Administration today approved Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate), a new once-a-day combination pill to treat HIV-1 infection in adults who have never been treated for HIV infection. Stribild contains two previously approved […]

