Human immunodeficiency virus: Difference between revisions

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m (Aidan moved page RNA Human immunodeficiency virus HIV AIDS to Human immunodeficiency virus (HIV) without leaving a redirect)
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= HIV/AIDS =
= Definition =

== Definition ==


* A chronic immunodeficiency resulting from infection with the human immunodeficiency virus (HIV)
* 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
* Acquired immune deficiency syndrome (AIDS) is a severe form of HIV characterized by low CD4 count resulting in characteristic infections


== Pathophysiology ==
= Pathophysiology =


== Presentation ==
= Presentation =


=== Acute seroconversion ===
== Acute seroconversion ==


* Influenza-like illness
* Influenza-like illness
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* ...
* ...


=== Chronic HIV ===
== Chronic HIV ==


* Fever
* Fever
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* [Opportunistic infections](Complications/Opportunistic infections/Opportunistic infections.md)
* [Opportunistic infections](Complications/Opportunistic infections/Opportunistic infections.md)


== Investigations ==
= Investigations =


* HIV serology
* HIV serology
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* HIV viral load and CD4 count
* HIV viral load and CD4 count


== Management ==
= Management =


=== Initial management ===
== Initial management ==


* See [HIV first clinic visit](Treatment/HIV first clinic visit.md) and [single-tablet regimens](Treatment/Single-tablet regimens.md)
* See [HIV first clinic visit](Treatment/HIV first clinic visit.md) and [single-tablet regimens](Treatment/Single-tablet regimens.md)


=== Follow-up ===
== Follow-up ==


* HIV viral load
* HIV viral load

Revision as of 18:08, 11 August 2019

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