{"id":603,"date":"2009-11-07T15:11:45","date_gmt":"2009-11-07T20:11:45","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=603"},"modified":"2015-06-04T15:29:54","modified_gmt":"2015-06-04T19:29:54","slug":"a-career-in-infectious-diseases-and-the-next-big-thing","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/a-career-in-infectious-diseases-and-the-next-big-thing\/2009\/11\/07\/","title":{"rendered":"A Career in Infectious Diseases and &#8220;The Next Big Thing&#8221;"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-thumbnail wp-image-604\" title=\"the_visionary\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2009\/11\/the_visionary-150x1501.gif\" alt=\"the_visionary\" width=\"150\" height=\"150\" \/>I was working with a medical intern in clinic this past week who is potentially interested in ID. After seeing our 3rd consecutive stable HIV patient, he asked me what I thought the next big challenge would be in our field &#8212; especially since HIV treatment has been &#8220;solved.&#8221;<\/p>\n<p>&#8220;Solved&#8221; might be stating it a bit strongly &#8212; after all, we still have no cure, the drugs aren&#8217;t perfect, not everyone can get them, there&#8217;s no vaccine,\u00a0 etc &#8212; but he had a point.\u00a0 Many of the research questions on HIV treatment are now about moving things forward incrementally, and it&#8217;s hard to imagine an advance anytime soon along the lines of combination therapy in the mid 1990s, or even the second wave of newer treatments that become available in 2006-8.<\/p>\n<p>So what&#8217;s the answer to his question?\u00a0 I compiled a brief list, shown below in no particular order:<\/p>\n<ul>\n<li>Highly drug-resistant bacteria &#8212; MRSA, carbapenemase-producing gram negatives, etc.<\/li>\n<li>Influenza, obviously, plus other SARS-like respiratory viruses<\/li>\n<li>Hepatitis C, though we&#8217;ll have to take this back from the hepatologists &#8212; I doubt they&#8217;ll mind &#8212; with nearly a hundred novel treatments in development<\/li>\n<li>Infections associated with therapeutic immunosuppression &#8212; TNF blockers, other biologics<\/li>\n<li>Food safety<\/li>\n<li>Device-related infections<\/li>\n<li>Novel diagnostics &#8212; PCR, other amplification techniques, direct antigen detection methods, etc<\/li>\n<li>Finding the next infectious cause of some idiopathic or autoimmune disease &#8212; some helicobacter-like discovery regarding Crohn&#8217;s, or multiple sclerosis, or sarcoid<\/li>\n<\/ul>\n<p><em>(Not <\/em>on my list are issues specifically related to ID in resource-limited settings, because that&#8217;s not what I do.)<\/p>\n<p>I&#8217;m sure I&#8217;m missing something, but it&#8217;s a start.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>I was working with a medical intern in clinic this past week who is potentially interested in ID. After seeing our 3rd consecutive stable HIV patient, he asked me what I thought the next big challenge would be in our field &#8212; especially since HIV treatment has been &#8220;solved.&#8221; &#8220;Solved&#8221; might be stating it a [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,5,8],"tags":[191,199,498,700],"class_list":["post-603","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-infectious-diseases","category-patient-care","tag-clinical-care","tag-clinicians","tag-infectious-diseases","tag-patient-care"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/603","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=603"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/603\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=603"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=603"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=603"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}