Human immunodeficiency virus: Difference between revisions
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Revision as of 18:08, 11 August 2019
HIV/AIDS
Definition
- A chronic immunodeficiency resulting from infection with the human immunodeficiency virus (HIV)
- Acquired immune deficiency syndrome (AIDS) is a severe form of HIV characterized by low CD4 count resulting in characteristic infections
Pathophysiology
Presentation
Acute seroconversion
- Influenza-like illness
- Rash
- ...
Chronic HIV
- Fever
- Weight loss
- Dyspnea, cough, hemoptysis
- Dysphagia, diarrhea
- Anemia, neutropenia, thrombocytopenia
- Metabolic derangements
- [Opportunistic infections](Complications/Opportunistic infections/Opportunistic infections.md)
Investigations
- HIV serology
- If concern for acute seroconversion syndrome, may need to repeat serology
- HIV viral load and CD4 count
Management
Initial management
- See [HIV first clinic visit](Treatment/HIV first clinic visit.md) and [single-tablet regimens](Treatment/Single-tablet regimens.md)
Follow-up
- HIV viral load
- Every 4 to 6 weeks until undetectable
- Then every 3 months until undetectable for 1 year
- Then every 6 months
- CD4 count
- Every 3 to 4 months until viral load undetectable and CD4 count >350 for 1 year
- Then every 6 months until viral load undetectable for at least 2 years and CD4 count > 500
- Then stop monitoring routinely unless evidence of treatment failure
- Assess for failure if RNA level remains detectable at 24 weeks or if it increases to above 50 at any time
- Repeat RNA level within 4 weeks
