Managing the HIV-Infected Adult Patient in the Emergency Department

Show Notes

Announcement

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In This Episode

• Why HIV?
  • 2018 , 1,2 million people living with HIV, almost 40k new infections
  • People living with HIV visit the ED 3x per year on average
  • HIV-infected patients accounted for 6 in 1000 ED visits in 2017
• What does acute infection look like?
• What about chronic infection? The chronic phase can last 10 years or more and be asymptomatic.
• Are people with HIV more likely to develop: CAD, COPD, DVT, and why?
  • What if they are on medication for HIV?
• Screening in the ED -- everyone? Do they have to have symptoms or risks?
  • What does universal screening mean?
  • What does risk-based screening mean?
• What are the risk factors? What if you see someone on PrEP who is in the ED for an unrelated complaint?
• History
  • Ask about cd4, viral load, and last test
  • Ask about history of opportunistic infections
  • Ask about medication side effects
• Exam
• Labs: rapid testing, 4th gen, viral load and cd4, etc
• Imaging
• Treatment
  • Table 1
  • Highly effective and reduces transmission
• Medication side effects
• Hepatitis B virus deactivation
• System-Based Disease
  • Heart failure and CAD
  • PCP (role of LDH)
  • TB
  • COPD
  • Renal Disease - stones , radiolucent
  • Neurologic- CVA, cryptococcal meningitis, toxo, progressive multi focal leukoencephalopathy, HAND
  • GI - diarrhea causes, c diff, hep C
  • Heme- cytopenia
  • Endocrine - metabolic syndrome
  • Musculoskeletal
  • Psychiatric
  • Derm
• Special Circumstances
  • PEP
  • PrEP

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