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HIV Diploma > PREP > Flashcards

PREP Flashcards

1
Q

WHO definition of PrEP

A

The use of ARVs by HIV -ve individuals who are at substantial risk of acquiring HIV BEFORE potential exposure to HIV to PREVENT HIV acquisition

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2
Q

List populations at greater risk of contracting HIV infection

A
  1. Adolescents
  2. Women (pregnant and breastfeeding)
  3. IVDU
  4. Workers (migrant and sex)
  5. People who request
  6. Sexual practices
    - MSM
    - multiple partners
    - previous STIs
    - serodiscordant couples
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3
Q

What else should you provide with PrEP?

A
  1. HTS
  2. ART initiation if +ve
  3. Voluntary partner HTS
  4. Condoms and lubricants
  5. Pregnancy screening
  6. Contraception
  7. TB screening
  8. STI screening
    1. Risk reduction counselling
  10. Mental health counselling
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4
Q

Name individual risk factors for PrEP screening

A
  1. Without a condom
  2. Multiple partners
  3. Partner HIV +ve
  4. Partner unknown status
  5. Under influence of alcohol/drugs
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5
Q

Name symptoms of acute HIV infections

A

Sore throat
Headache
Swollen lymph nodes
Body aches
Rash
Fatigue
Fever

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6
Q

Name criteria for eligibility of PrEP

A
  1. HIV -ve rapid
  2. Absence acute HIV infection symptoms
  3. Willing and able to take PrEP as prescribed
  4. No TDF/FTC contraindications
  5. > 35kg, >14yo OR Tanner 3 stage or greater
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7
Q

Name contraindications for PrEP

A

HIV infection
>16yo eGFR <50
10-16yo eGFR <80
Pregnant women with sCr >85

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8
Q

Name baseline investigations at PrEP initiation

A

HIV test
HBsAg
Syndromic STI screening
Pregnancy screening

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9
Q

Do you need to assess renal function at baseline in patients <30yo with no comorbidities taking PrEP?

A

No

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10
Q

At what age do you begin to assess renal function at baseline in patients with no comorbidities taking PrEP?

A

30yo

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11
Q

How often do you assess renal function in patients with comorbiditiestaking PrEP?

A

Baseline
Annually

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12
Q

How often do you assess renal function in pregnant patients taking PrEP?

A

Baseline
3 months
6 months

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13
Q

What are the prescription intervals for PrEP?

A

1 month supply - 1 month visit - 3 month supply - 3 month visit

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14
Q

How do you proceed if a patient’s baseline eGFR/sCR is abnormal?

A

Repeat
- if normal, continue
- if abnormal, discontinue

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15
Q

How do you proceed if a patient with abnormal renal function remains at risk for HIV and wants to be re-initiated on PrEP?

A

Repeat eGFR/sCr after 1-3 months
- if normal, restart PrEP
- if abnormal, refer for further investigations

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16
Q

When should you assess a pregnant female for other causes of elevated sCr?

A

Elevations >3x baseline
Elevation continues after discontinuation of PrEP
Elevation remains high 3 months after discontinuation of PrEP

17
Q

What are key counselling messages before PrEP initiation and during follow up visits?

A
  1. What it is
  2. Not for life
  3. Works if taken
  4. Side effects
  5. Drug interactions
  6. Starting and stopping PrEP
  7. Pregnancy and breastfeeding
  8. Safer conception
  9. Visit schedule
18
Q

Name common side effects of PrEP

A

Diarrhoea
Headache
Abdominal pain
Nausea

19
Q

Name rare side effects of PrEP

A

Renal toxicity
Decreased bone mineral density
Lactic acidosis
Steatohepatitis

20
Q

Are there any drug interactions with PrEP?

A

Alcohol, contraception and gender-affirming hormone therapy do not interact with PrEP

21
Q

Give a summary of risk-benefit counselling for pregnant and breastfeeding women eligible for PrEP

A
  1. Risk of HIV for mom and baby
  2. Risk of PrEP to baby
  3. Benefits of PrEP to mom and baby
22
Q

Name benefits of PrEP to mom and baby

A
  1. Protection from HIV
  2. Easy use
  3. Private
  4. Safe conception
  5. Serodiscordant couples
23
Q

What are the follow up procedures for patients on PrEP

A
  1. Confirm HIV status
  2. Address side effects
  3. Adherence counselling
  4. STI screening
  5. Risk reduction counselling
  6. Creatinine clearance if indicated
  7. Medication issuance
24
Q

Name reasons for stopping PrEP

A
  1. HIV +ve
  2. Persistently abnormal renal function
  3. Non-adherence
  4. Safety concerns
  5. No longer wants/needs PrEP
25
Q

Name 3 reasons for HIV seroconversion while on PrEP

A
  1. Inconsistence
  2. Stopped
  3. PrEP failure
26
Q

Name biomedical methods for HIV prevention

A

PrEP
PEP
ART for partners living with HIV
Healthy lifestyle
Medical male circumcision
Condoms (male and female)
STI management
Clean needle use

27
Q

Which formula is used to check eGFR for initiating PrEP?

A

Counahan Barrat formula

eGFR (mL/min/1.73m2) = height (cm) x 40 / creatinine (umol/L)

HIV Diploma (1 decks)

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