HIV Flashcards
When should PEP be administered?
within 72 hrs
what are the PEP drugs and how long are they prescribed for?
The two drugs used are Raltegravir and Truvada. These are prescribed for 28 days
hoe does PCP present?
The patient can present with:
Fever
Non productive cough (however can have superimposed bacterial infection)
Exertional breathlessness associated with onset of infection
Exertional breathlessness is a specific sign for PCP, and is used to stratify severity.
On examination, the chest is often clear, however sometimes there are end inspiratory crackles present.
how will the CXR look for PCP?
bilateral bihilar interstitial infiltrates. In 10% of cases there can be a completely normal Chest X-Ray.
what is the management for PCP?
The first choice agent in the treatment of PCP, regardless of severity, is Co-trimoxazole
Alternative therapy can be used if Co-trimoxazole does not eliminate infection. This includes
- > Clindamycin-primaquine
- > dapsone
- > IV pentamidine.
If the patient has p02 <9.3kPa and an arterial alveolar 02 gradient >4.7kPa, is it important to consider adjuvant corticosteroids. This has a proven reduction of mortality.
what type of infection is PCP?
PCP is infection with the fungus Pneumocystis Jiroveci.
what is the most common opportunistic eye infection in HIV?
- CMV retinitis
- presents with…reduced visual acuity. On fundoscopy,there may be a classic ‘pizza pie’ appearance.
how id CMV retinitis managed?
Treatment involves using intraocular injections of ganciclovir
and systemic oral valganciclovir.
how does primary HIV present?
Primary HIV infection is the period immediately after exposure to virus
Classically, patients present with fever and lymphadenopathy.
The second most common feature of infection is a maculopapular rash, found commonly on the upper chest
third most common feature are mucosal ulcers.
Onset of symptoms within 3 weeks of infection that last for longer than 2 weeks or that involve the CNS are associated with a rapid progression to AIDS.
