HIV: treatment & care Flashcards
what investigations must be done to establish infection stage?
CD4 count HIV viral load HIV genotypic resistance assay FBC Biochem: U+E, LFT, Lipid profile, urinalysis
Hep B/C serology
Syphilis serology
STI screen
What are the targets for anti retro viral medications? (7)
revers transcriptase Integrase Protease Fusion of virus to CD4 receptor CCR5 receptor Maturation
highly active ant-retroviral therapy
- definition?
- Function? (4)
-combination of 3 drugs from at least 2 drug classes to which the virus is susceptible
-reduce viral load to undetectable level
restore immunocompetence
Reduce morbidity and mortality
Minimise toxicity
How does resistance occur?
Pill needs to be taken at the same time everyday for the rest of life
Due to pharmacokinetics and differing half lives of combined medications,
If pill is not taken for 2 days then patient is effectively on mono therapy and HIV resistance can develop
HAART toxicity describe the side effects of HAART in terms of: -GI -Skin -CNS SE -Renal toxicity -Bone -CVS -Haematology -what class of drugs commonly interacts with HAART?
- transaminitis, fulminant hepatitis
- rash, stevens-johnsons
- mood, Psychosis
- proximal renal tubulopathies
- Osteomalacia
- increased MI risk
- anaemia
- protease inhibitors
How should transmission of HIV be prevented?
Condom use HIV treatment STI screening & treatment Seri-Adaptive sexual behaviour Disclosure Post-exposure prophylaxis Pre-exposure prophylaxis
Reproduction & HIV
-HIV+ male and HIV- female
-HIV+ female, HIV- male
how should transmission from mother to child be prevented?
-Timed unprotected sex with HAART
treatment as prevention
-Self insemination
Timed unprotected sex with HAART
treatment as prevention
-HAART during preg vaginal delivery if undetectable viral load C-section if detectable viral load 4/52 PEP for neonate formula feeding only
