{"id":5640,"date":"2014-12-06T08:06:32","date_gmt":"2014-12-06T13:06:32","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=5640"},"modified":"2015-06-04T14:31:55","modified_gmt":"2015-06-04T18:31:55","slug":"holiday-season-2014-idhiv-link-o-rama","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/holiday-season-2014-idhiv-link-o-rama\/2014\/12\/06\/","title":{"rendered":"Holiday Season 2014 ID\/HIV Link-O-Rama"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2014\/12\/village-snow1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-5665\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2014\/12\/village-snow-294x3001.jpg\" alt=\"village snow\" width=\"294\" height=\"300\" \/><\/a>A little spin around the internet brings us these ID\/HIV tidbits, all of them designed to go well with holiday music, egg nog, and potato pancakes, plus a can&#8217;t-miss video clip:<\/p>\n<ul>\n<li><strong><a href=\"http:\/\/emergency.cdc.gov\/han\/han00374.asp\" target=\"_blank\">Flu vaccine match with circulating virus doesn&#8217;t look so great.<\/a><\/strong> This <em>could<\/em> mean it&#8217;s going to be a tough flu season, but estimates of flu season severity are notoriously terrible. And here&#8217;s a un-bold prediction &#8212; this news will make the flu vaccine skeptics (patients and health care providers alike) feel more entrenched about not getting or giving the vaccine than ever. Until there&#8217;s a shortage of shots in the midst of a bad flu season, that is.<\/li>\n<li><strong><a href=\"http:\/\/www.newyorker.com\/magazine\/2014\/12\/01\/excrement-experiment\" target=\"_blank\">&#8220;The Excrement Experiment&#8221;<\/a> <\/strong>is the title of a highly entertaining article on fecal microbial transplantation (FMT) in the <em>New Yorker.<\/em> Probably should be required reading for all ID doctors and gastroenterologists, if for nothing else than for the nicknames of the &#8220;professional&#8221; stool donors.<\/li>\n<li><a href=\"http:\/\/www.nytimes.com\/2014\/11\/17\/upshot\/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html?module=Search&amp;mabReward=relbias%3Ar%2C%7B%221%22%3A%22RI%3A6%22%7D&amp;abt=0002&amp;abg=1\" target=\"_blank\"><strong>Should we reconsider our enthusiasm for PrEP to prevent HIV?<\/strong><\/a> Have been holding this one for a while (sorry, it was published a few weeks ago), but it&#8217;s one of the best summaries to date describing the conflict between policy makers (such as CDC), who favor PrEP for high-risk HIV negative gay men, and the AIDS Healthcare Foundation, led by Michael Weinstein, who most certainly does not. Comments section demonstrates the strong feelings people have on this issue.<\/li>\n<li><strong><a href=\"http:\/\/www.cell.com\/cell\/abstract\/S0092-8674(14)01236-7\" target=\"_blank\">Even our microbiome gets jet lag<\/a> <\/strong>says this <em>Cell<\/em> paper, providing yet another reason why crossing time zones makes us feel so horrible. And not only that, these sleep-deprived bacteria may promote diabetes and obesity. In other words: &#8220;These findings provide evidence of coordinated metaorganism diurnal rhythmicity and offer a microbiome-dependent mechanism for common metabolic disturbances in humans with aberrant circadian rhythms, such as those documented in shift-workers and frequent flyers.&#8221; <strong><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2014\/12\/fx1.jpg\" target=\"_blank\">Exactly!<\/a><\/strong><\/li>\n<li><a href=\"http:\/\/cid.oxfordjournals.org\/content\/early\/2014\/12\/02\/cid.ciu898.abstract\" target=\"_blank\"><strong>More fat gain with atazanavir than darunavir-based initial regimens.<\/strong><\/a> In this small randomized clinical trial comparing ATV\/r with DRV\/r (both with TDF\/FTC), subcutaneous and total fat increased more in the ATV\/r arm, along with triglycerides and markers of insulin resistance. This is <em>exactly the opposite<\/em> of what I would have expected, which is why doing randomized trials is so important!<\/li>\n<li><a href=\"http:\/\/www.nytimes.com\/2014\/11\/27\/world\/asia\/gunmen-in-pakistan-kill-4-members-of-anti-polio-campaign.html?_r=0\" target=\"_blank\"><strong>Polio crisis worsens in Pakistan.<\/strong><\/a> Bad news out of what&#8217;s called the &#8220;world&#8217;s incubator&#8221; for this scary disease. (Just ask anyone from the pre-immunization era how scary.) Pakistan has reported 260 cases this year, four times the 2013 number. Blame refugee displacement, political chaos, and a Taliban-held belief that immunization efforts are a CIA-driven, covert Western plot. The glimmer of hope here is that the government of Pakistan is deeply committed to broadening immunization rates, and there is apparently good external aid.<\/li>\n<li><strong><a href=\"http:\/\/op-talk.blogs.nytimes.com\/2014\/11\/26\/what-if-were-wrong-about-depression\/?module=Search&amp;mabReward=relbias%3As%2C%7B%221%22%3A%22RI%3A6%22%7D&amp;_r=0\" target=\"_blank\">Is depression really an infectious disease?<\/a> <\/strong>Could be, says this provocative (but highly speculative) piece in the <em>New York Times. <\/em>It&#8217;s entitled &#8220;What if We&#8217;re Wrong About Depression?&#8221;, and let me answer that question right now &#8212; YES WE ARE WRONG, just as we are wrong (or more kindly, &#8220;still learning&#8221;) about treatment of virtually all major psychiatric diseases. We clearly haven&#8217;t figured them out yet. But before we start seeking referrals from our psychiatry colleagues to treat cases of depression with antibiotics, here&#8217;s the cited lead investigator&#8217;s much more nuanced take: \u201cThere\u2019s never been enough compelling data to isolate one or even several infectious agents that are reliably associated with the development of depression.\u201d Sounds right to me.<\/li>\n<li><strong><a href=\"http:\/\/genomebiology.com\/2014\/15\/11\/510\/abstract\" target=\"_blank\">Tapeworm parasite slowly eats a man&#8217;s brain.<\/a><\/strong> No, not a 1950s horror movie, just the cause of this poor patient&#8217;s four years (!) of &#8220;experiencing headaches and strange smells.&#8221; Serial MRIs demonstrated something slowly crawling through his brain, or more accurately, &#8220;migration of the lesions from the right hemisphere through the thalamus&#8221; to the left. Ultimately, the diagnosis of sparganosis from <em>Spirometra erinaceieuropaei<\/em> (you knew it all the time) was made by sequencing tissue from a second brain biopsy sample. And check out the coverage of the case report in <strong><a href=\"http:\/\/www.theguardian.com\/science\/2014\/nov\/21\/tapeworm-parasite-mans-brain-four-years-china\" target=\"_blank\"><em>The Guardian<\/em><\/a><\/strong> &#8212; the &#8220;Related Content&#8221; and comments from readers at the bottom of the page are intentionally and unintentionally quite amusing (that is, if you&#8217;re an ID doctor).<\/li>\n<\/ul>\n<p>Hey, what a treat &#8212; a Colbert interview with the one-and-only Dr. Paul Edward Farmer:<\/p>\n<div style=\"background-color: #000000;width: 520px\">\n<div style=\"padding: 4px\">\n<iframe loading=\"lazy\" src=\"http:\/\/media.mtvnservices.com\/embed\/mgid:arc:video:colbertnation.com:06a62bb3-35ba-4e74-b1cf-670495d5e810\" width=\"512\" height=\"288\" frameborder=\"0\"><\/iframe><\/p>\n<p style=\"text-align: left;background-color: #ffffff;padding: 4px;margin-top: 4px;margin-bottom: 0px;font-family: Arial, Helvetica, sans-serif;font-size: 12px\"><b><a href=\"http:\/\/thecolbertreport.cc.com\/\">The Colbert Report<\/a><\/b><br \/>\nGet More: <a href=\"http:\/\/thecolbertreport.cc.com\/full-episodes\/\">Daily Show Full Episodes<\/a>,<a href=\"http:\/\/www.comedycentral.com\/indecision\">Indecision Political Humor<\/a>,<a href=\"http:\/\/www.facebook.com\/thecolbertreport\">The Colbert Report on Facebook<\/a><\/p>\n<\/div>\n<\/div>\n<p style=\"text-align: left\"><em>(Seasonally appropriate hat tips to Drs. Carlos Del Rio and Ralph Blair for helpful suggestions. And you can receive a 100% sterile, autoclaved notification of new posts by entering your email address in the subscription box on the right. Our holiday gift to you, free of charge.)<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A little spin around the internet brings us these ID\/HIV tidbits, all of them designed to go well with holiday music, egg nog, and potato pancakes, plus a can&#8217;t-miss video clip: Flu vaccine match with circulating virus doesn&#8217;t look so great. This could mean it&#8217;s going to be a tough flu season, but estimates of [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,5],"tags":[87,266,362,423,565,748],"class_list":["post-5640","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-infectious-diseases","tag-atazanavir","tag-darunavir","tag-flu-shot","tag-hiv","tag-link-o-rama","tag-prep"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/5640","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=5640"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/5640\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=5640"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=5640"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=5640"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}