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Episode 59 – HIV – An Interview With Dr. Daniel Egan
EMplify – July 2021
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HIV- An Interview With Dr. Daniel Egan
See the EB Medicine Article @ https://www.ebmedicine.net/topics/infectious-disease/HIV
- 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
- 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 I see someone on PrEP who is in the ED for an unrelated complaint?
- Ask about cd4 and viral load and last test
- Ask about he of opportunistic infections
- Ask about medication side effects
- What else?
- Labs – rapid testing, 4th gen, viral load and cd4, etc
- Table 1
- Highly effective and reduces transmission
- Medication side effects (we don’t have to dwell on each Med and side effect and just reference the charts)
- hep B virus deactivation
- System Based Disease
- Heart Failure and CAD
- PCP (role of LDH)
- 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
- Psychiatric table 3
- Special Circumstances
Last Updated on January 25, 2023