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

    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 April 29, 2022

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