HIV

Question 1

The rate of HIV diagnosis is highest in what part of the US?

Answer 1

Southeast

Question 2

what is the lifetime risk of HIV diagnosis in MSM?

Answer 2

1 in 6

Question 3

what is the lifetime risk of HIV diagnosis for women who are IVDU and men who are IVDU?

Answer 3

Women 1 in 23

Men 1 in 36

Question 4

what is the lifetime risk of HIV diagnosis in heterosexual women and men?

Answer 4

women 1 in 241

men 1 in 473

Question 5

Among MSM, what is the lifetime risk of HIV diagnosis by race?

Answer 5

AA: 1 in 2

Hispanic: 1 in 4

White: 1 in 11

Question 6

What does the primary HIV infection look like and when does it start?

Answer 6

fever

malaise

nausea, vomiting and diarrhea

maculopapular rash

neurologic symptoms

Question 7

what are the characteristics of the rash in primary HIV infection?

Answer 7

maculopapular

trunk

blanching

Question 8

How do you stage HIV?

Answer 8

CD4 count, HIV RNA (viral load)

resistance testing

Question 9

how often do you monitor HIV patients?

Answer 9

every 3-6 months

check CD4, viral load (HIV RNA)

medication AEs check:

fasting lipids, fasting glucose or Hg A1C, kidneys, liver, CBC

Question 10

What vaccines should HIV+ people get at any CD4 count?

Answer 10

Flu

TDap

Hep A and B

antiviral - valacyclovir for Herpes + patients

Question 11

If an HIV + patient has a CD4 count <200, what prophylaxis should you institute?

Answer 11

PCP - TMP/SMX

dapsone (2nd line)

Question 12

If an HIV + patient has a CD4 less than 50, what should you start prophylaxis for?

Answer 12

MAC - Azithromycin or Clarithromycin 1x week/1mg

Question 13

what increases drug resistance in HIV?

Answer 13

semi-compliant patients who take meds sometimes - they are selecting the resistant virus

Question 14

What is the goal of HiV treatment?

Answer 14

undetectable viral load

(patients may still have “blips” during intercurrent infections)