Episode 59 – HIV – An Interview With Dr. Daniel Egan

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Episode 59 – HIV – An Interview With Dr. Daniel Egan

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HIV- An Interview With Dr. Daniel Egan

See the EB Medicine Article @ https://www.ebmedicine.net/topics/infectious-disease/HIV

1. Why HIV?
   • 2018 , 1,2 million people living with HIV, almost 40k new infections
   • People living with HIV visit the ED 3 x per year on average
   • HIV infected patients accounted for 6 in 1000 ED visits in 2017
   • New Transmission of HIV, Figure 1
2. What does acute infection look like ?
3. What about chronic infection ?The chronic phase can last 10 years or more and be asymptomatic.
4. Are people with HIV more likely to develop: CAD, COPD, DVT and why?
   • What if they are on medication for HIV?
5. Screening in the ED, everyone? Do they have to have symptoms or risks?
   • What does universal screening mean?
   • What does risk based screening mean?
6. What are the risk factors? What if I see someone on PrEP who is in the ED for an unrelated complaint?
7. History
   • Ask about cd4 and viral load and last test
   • Ask about he of opportunistic infections
   • Ask about medication side effects
   • What else?
8. Exam
9. Labs – rapid testing, 4th gen, viral load and cd4, etc
10. Imaging
11. Treatment
    • Table 1
    • Highly effective and reduces transmission
12. Medication side effects (we don’t have to dwell on each Med and side effect and just reference the charts)
13. hep B virus deactivation
14. 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 table 3
    • Derm
15. Special Circumstances
    • PEP
    • PrEP

Last Updated on January 25, 2023

Sam Ashoo, MD

Sam Ashoo, MD, FACEP,  is board certified in emergency medicine and clinical informatics. He serves as EB Medicine’s editor-in-chief of interactive clinical pathways and FOAMEd blog, and host of EB Medicine’s EMplify podcast. Follow him below for more…