flashcards_hiv
What is the initial referral for HIV management?
Refer to a specialist service with a high focus on holistic approach to care.
What factors influence the decision to start HIV treatment?
Clinical status, HIV viral load, and CD4 count.
Why should infants start ART shortly after diagnosis?
Infants are at higher risk of disease progression.
What is the first line therapy for HIV?
2 NRTI with an INSTI or NNRTI or PI.
What type of counselling is important for HIV patients?
Counselling to help commit to long term ART.
What prophylaxis is recommended for opportunistic infections in HIV patients?
Prophylaxis for opportunistic infections e.g. PCP with co-trimoxazole.
What should be done for other concomitant infections in HIV patients?
Treat other concomitant infections.
What additional management aspects are important for HIV patients?
Micronutrient supplementation, immunisation (follow normal vaccination schedule but do NOT give BCG), additional immunisation against influenzae, hepatitis A, B and VZV.
What immunisations should be considered for HIV patients?
Consider additional immunisation against influenzae, hepatitis A, B and VZV.
What is the MDT approach in HIV management?
Seen together in a family clinic with other members of the family who may be HIV-infected and an adult specialist can be involved.
What is the recommended follow-up for HIV patients?
Regular follow-up with particular attention to weight and developmental progress.
What is the PEP regimen for HIV exposure?
Tenofovir disoproxil + emtricitabine + raltegravir as 1st line (2NRTI and HIV integrase inhibitor), started within 72hrs of exposure and lasts 28 days.
What strategies are recommended for reducing vertical transmission of HIV?
Mothers with a high viral load are more likely to transmit HIV to their infant (C-section recommended), babies born to HIV-positive mothers receive zidovudine for 6 weeks, avoidance of breastfeeding.
What support should be provided to HIV patients?
Provide details for information/support groups (e.g. aidsmap).
What health promotion advice should be given to young HIV patients?
CVD prevention, cervical screening, immunisations, safe sex practices (undetectable = untransmissible), contraception (check interactions with ART), mental health screening.
