An ongoing dialogue on HIV/AIDS, infectious diseases,
March 27th, 2012
Latest Guidelines Recommend HIV Treatment for All
From the key “What’s New in the Guidelines” section of today’s Department of Health and Human Services update: ART is recommended for all HIV-infected individuals. The strength of this recommendation varies on the basis of pretreatment CD4 cell count. This recommendation replaces a rather confusing categorization on when to start ART that, not surprisingly, was widely […]
March 1st, 2012
Post-Exposure Prophylaxis, the World’s Most Outdated HIV Guidelines, and What To Do About Them
Every time I cover HIV prevention in a lecture, it’s always kind of embarrassing to cite the “official” post-exposure prophylaxis (PEP) guidelines, which are here (non-occupational) and here (occupational). That’s right, they were last updated in 2005, the year of Hurricane Katrina. Yes — more than six years ago. The alternative choices seem particularly curious (read: […]
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 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 […]
October 26th, 2011
Xigris is Gone — Not That Many ID Docs Will Notice
From the FDA comes this news: FDA notified healthcare professionals and the public that on October 25, 2011, Eli Lilly and Company announced a worldwide voluntary market withdrawal of Xigris [drotrecogin alfa (activated)]. In a recently completed clinical trial (PROWESS-SHOCK trial), Xigris failed to show a survival benefit for patients with severe sepsis and septic […]
September 22nd, 2011
Common Sense on HIV Testing
There’s an editorial in today’s Boston Globe that concisely (188 words) describes the problems with both the current and proposed HIV testing laws in Massachusetts. I’ve not been shy about the fact that I agree with every word of this piece. And though I strongly recommend reading the whole editorial — it’s very well written — […]
September 11th, 2011
Must-Read Paper: “Antiscience” and Lyme Disease
As I’ve written before, there are few clinical encounters more challenging for Infectious Diseases specialists than the patient who, despite negative standard diagnostic testing, believes he/she has Lyme disease. Now, in Lancet Infectious Diseases, comes a paper entitled “Antiscience and ethical concerns associated with advocacy of Lyme disease.” It meticulously describes the distinctive world of alternative diagnosis, […]
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 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 […]
June 13th, 2011
More on Generic Antiretrovirals …
In the recent post on the approval of generic Combivir — and the lack of availability of generic Epivir (lamivudine, 3TC), which was both anticipated and likely to be more useful — I speculated there were several possible causes of this surprising turn of events. But ultimately I concluded, “In sum, the real reason there’s no […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
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