An ongoing dialogue on HIV/AIDS, infectious diseases,
December 28th, 2011
Why We Still Need HIV/ID Specialists
Over on Journal Watch AIDS Clinical Care, we periodically publish a tricky case — always drawn from clinical practice — then ask some experts how they would manage it, and why.
The most recent case pretty much has it all:
- Multiple prior regimens
- Multi-class drug resistance
- Metabolic complications
- Bad allergy history, one event nearly requiring hospitalization
- Disfiguring lipoatrophy
- History of treatment discontinuation
In fact, the case is so complicated that our Executive Editor said it made her “head hurt.” She’s just lucky the guy doesn’t have hepatitis C.
Fortunately, Graeme Moyle and Karam Mounzer kindly agreed to take it on. Given the complexity of the case, not surprisingly they came up with two different treatment approaches.
And patients like this are a reminder why, even in this era of single-pill-daily-for-HIV-treatment and 80-90% of patients in care virologically suppressed, we HIV/ID specialists still have a job.
Categories: Antiretroviral Rounds, HIV, Patient Care
You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.
Comments are closed.

Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
Learn more about HIV and ID Observations.
Search this Blog
Follow HIV and ID Observations Posts via Email
Archives
Most Popular Posts
- When AI Gets the Medical Advice Wrong — and Right
- ID Things to Be Grateful for — 2025 Edition
- What Use Is the Physical Examination in Current Medical Practice?
- Dengue, Malaria, HIV Cure, and Others — First Cold Snap of the Winter ID Link-o-Rama
- SNAP Trial Helps Resolve Long-Running Controversies Over Management of Staph Bacteremia
-
From the Blog — Most Recent Articles
- What Use Is the Physical Examination in Current Medical Practice? December 17, 2025
- Dengue, Malaria, HIV Cure, and Others — First Cold Snap of the Winter ID Link-o-Rama December 10, 2025
- ID Things to Be Grateful for — 2025 Edition November 24, 2025
- When AI Gets the Medical Advice Wrong — and Right November 18, 2025
- Hot Takes from IDWeek: CDC, COVID, and Two Doses of Dalbavancin November 13, 2025
FROM NEJM — Recent Infectious Disease Articles- Interactive Perspective: Measles December 18, 2025This Double Take video reviews evidence-based recommendations on measles prevention and management and explores commonly asked questions about the measles virus and infection.
- Noninferiority of One HPV Vaccine Dose to Two Doses December 18, 2025In this trial, one dose of an HPV vaccine was noninferior to two doses in preventing HPV type 16 or 18 infection.
- From Crisis to Action — Policy Pathways to Reverse the Rise in Congenital Syphilis December 18, 2025In recent years, cases of congenital syphilis have surged. This trend reflects both prenatal care gaps and systemic issues, including failures in testing, treatment, and public health infrastructure.
- Contact Precautions for MRSA and Vancomycin-Resistant Enterococcus December 18, 2025This feature about the use of contact precautions in the hospital for patients with MRSA or VRE offers a case vignette accompanied by two essays, one supporting continuing the use of contact precautions and the other recommending discontinuing them.
- Evidence to Action — Single-Dose HPV Vaccination and Cervical HPV Infection December 18, 2025Kreimer and colleagues now report in the Journal1 the results of the ESCUDDO trial, which showed that the efficacy of a single dose of either a bivalent human papillomavirus (HPV) vaccine or a nonavalent formulation was similar to that of the standard two-dose schedule. This randomized trial...
- Interactive Perspective: Measles December 18, 2025
-
Tag Cloud
- Abacavir AIDS antibiotics antiretroviral therapy ART atazanavir baseball Brush with Greatness CDC C diff COVID-19 CROI darunavir dolutegravir elvitegravir etravirine FDA HCV hepatitis C HIV HIV cure HIV testing ID fellowship ID Learning Unit Infectious Diseases influenza Link-o-Rama lyme disease medical education MRSA PEP PrEP prevention primary care raltegravir Really Rapid Review resistance Retrovirus Conference rilpivirine sofosbuvir TDF/FTC tenofovir Thanksgiving vaccines zoster
