Wk 32: HIV 3 Flashcards
1
Q
What are the 4 different moa of ARVs?
A
- CCR5 inhibitors
- Reverse transcriptase Nucleoside/NRTI/NNRTI
- Integrase inhibitors
- Protease inhibitors
2
Q
When would you start treatment?
A
- Primary infection
- Chronic infection
- AIDs/major infection
- Prevent onward transmission
3
Q
When would you start primary infection?
A
Only if ppt ready or:
- Neurological involvement
- AIDs defining illness
- CD4 count <350 cells/uL
- Diagnosis w/in 12 wks of previous -ve
4
Q
When would you start presentation with AIDs/major infection?
A
W/in 2 wks of antimicrobials:
- AIDS-defining infection
– Serious bacterial infection with CD4 count <200cells/μL
5
Q
What are factors to consider before starting treatment?
A
- CD4 + viral count
- Discordant couples where 1 patient has high VL
- Transmission risk
- Pregnancy
- Co-morbidities: Hep C/B, established CVD risk, IRIS
6
Q
What is IRIS?
A
Immune reconstitution inflammatory syndrome
- Initiating ART: inc inflammatory activity = autoimmune syndromes
- Symptoms: respiratory, lymphadenopathy, pleural/pericardial effusions
7
Q
When would you give ARV prophylaxis?
A
- Post exposure prophylaxis: w/in 72 hrs exposure, 28 day treatment
- Pre-exposure prophylaxis: daily/PRN by HIV -ve ppt
