HIV and ID Observations

An ongoing dialogue on HIV/AIDS, infectious diseases,
all matters medical, and some not so medical.

October 23rd, 2011

TB, Timing of Antiretroviral Therapy, and Being a Lumper Rather Than a Splitter

Three key papers on timing of ART in patients with TB have just been published in the New England Journal of Medicine.

Fortunately, Carlos Del Rio has done a bang-up job summarizing them in Journal Watch AIDS Clinical Care.

And if you’re wondering how we got our title for Carlos’ piece, here’s an e-mail between our Executive Editor to me a few weeks ago:

Hi Paul-
Later this month, NEJM will be publishing three articles on the timing of ART initiation relative to TB treatment. I assume we should cover these?
Cath

To which I responded:

Yep.  And they all can be summarized as follows: “TB + low CD4 = start ART sooner rather than later”.

Yes, there are lots more data from these studies than this simple equation, but my response was a reminder that, despite being a thrice-certified ID specialist, I tend to be more of a lumper rather than a splitter — which makes me feel somewhat deficient in our field.

Oh well.

Of course even the less detail-obsessed ID docs like me probably score pretty high on the OCD-meter, so I can take some comfort in that.

Categories: HIV, Infectious Diseases, Patient Care, Research
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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Associate Editor

NEJM Clinician

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