HIV/AIDS

Question 1

What antibiotic is used for the treatment of PCP?

Answer 1

Cotrimoxazole (trimethoprim/sulfamethoxazole)

aka Bactrim

Question 2

What is immune reconstitution inflammatory syndrome?

Answer 2

A inflammatory illness that occurs shortly after starting ART

Due to inflammation against a previously asymptomatic infection

Commonly due to mycobacterium infection (TB, mycobacterium avium complex [MAC])

Question 3

Which cancers occur at a higher prevalence in HIV patients?

Answer 3

Lymphoma

Kaposi’s sarcoma

Anal cancer

Question 4

What is the CD4 count cutoff for treatment?

What is the cutoff for development of HIV related infections?

Answer 4

<500 cells/mm3

<200 cells/mm3

Question 5

How is infection status monitored? What is the target while being treated?

Answer 5

Viral load in RNA copies/mL

<200 RNA copies/mL

Question 6

What atypical infections occur in HIV patients? (think opportunistics, and skin infections)

Answer 6

Opportunistic infections

• Cerebral toxoplasmosis
• MAC
• Cryptococcus neoformans
• PCP
• CMV retinitis

Skin

• Shingles in a young person
• Intra-oral warts
• Severe or widespread herpes simplex

TB

Question 7

When does the early nonspecific seroconversion illness of HIV occur? How long does it last for?

Answer 7

3-6 weeks after infection

3 weeks

Question 8

What questions should you ask someone with known HIV?

Answer 8

Regularly taking meds?

Seroconversation illness? IRIS?

Viral load control?

Have you donated blood/semen in the past year?

Question 9

What is the standard treatment regimen for HIV?

Answer 9

2 Nucleotide reverse transcriptase inhibitors

• Emtricitabine and tenofovir (combination called Truvada)

Plus either a

Non-nucleotide reverse transcriptase inhibitor

• Efavirenz

Or a Protease inhibitor

• Atazanavir plus ritonavir

Or a integrase inhibitor

• Raltegravir